ABSTRACT
Objective: To evaluate the treatment results of Ilizarov microcirculation reconstruction technique for chronic wounds in the post-traumatic ischemia limbs. Methods: Between January 2016 and July 2019, 7 cases of chronic wounds in the post-traumatic ischemia limbs were treated. There were 5 males and 2 females, with an average age of 42.4 years (range, 29-66 years). The duration of the wound ranged from 1 month to 2 years (mean, 7.7 months). The wounds located in the leg (3 cases) or in the foot and ankle (4 cases). The wound sizes ranged from 4.0 cm×2.2 cm to 12.0 cm×7.1 cm. There were 1 case of tibial varus, 3 cases of equinovarus, 1 case of scleroderma, and 2 cases of Volkmann's ischemic contracture. After debridement, external fixators were used for tibial transverse transport, or correction of tibial varus and correction of equinovarus. Results: All patients were followed up 8-20 months, with an average of 13 months. The infection of wound surface was all controlled in 7 cases and the granulation tissue grew well; the wound surface healed directly in 5 cases and healed after skin grafting in 2 cases, and the wound healing time was 1-3 months (mean, 1.7 months). During the follow-up, there was no recurrence of the wound. Six cases of limb deformity were corrected. Conclusion: For the chronic wounds in the post-traumatic ischemia limbs, Ilizarov microcirculation reconstruction technique can effectively improve local circulation and facilitate the fresh granule growth and wound healing.
ABSTRACT
Objective: To summarize the research progress of tibial transverse transport in the treatment of diabetic foot. Methods: The domestic and foreign literature on the tibial transverse transport for diabetic foot in recent years was summarized, and the advantages and disadvantages of the technique were analyzed. Results: The tibial transverse transport was an innovation based on Ilizarov technique. At present, the treatment of diabetic foot by the tibial transverse transport is in the initial stage and has achieved good results, but there are also problems such as ulcer recurrence and re-fracture. And its biological mechanism to promote tissue regeneration, clinical technical points (such as the selection of incision and bone window size), the technical parameters of postoperative removal program, and the postoperative effectiveness are still in dispute and exploration. More clinical studies and practices are needed in the future to develop a standard protocol for this technique. Conclusion: Tibial transverse transport is a hot spot for microcirculation reconstruction of lower extremity. Significant progress has been made in the treatment of diabetic foot, which provides a new direction for limb salvage treatment. However, the technique is not mature, there are still many disputes and difficulties to be further studied clearly.
ABSTRACT
Objective To investigate the microcirculative route of the arterialized venous flap.Methods Selecting 15 Chinese white rabbits designed the model of arterialized venous flap by anastomosis with from the central artery to central vein.The reversed blood flow perfusion was directly observed by the "ear windows" under the microscope and,simultaneous recording the changes in the microcirculation of the flap.Results All of the flaps were alived.The structure of the capillary net in the flap was a stereo-net .In the early arterialized stage,the upstream blood flows quickly in the venule;there was no blood flowing in the capillary net with the opening of the capillary net,the reconstructed procedure of the non-physilogical microcirculation was accomplished:the arterial blood mainly flow through small vein and venule,finally arrived the capillary net.Conclusions Keep up the drainage vein free,the arterialized venousflap could be alived by reconstructed effective microcirculation through the venous system.