Application of free posterior tibial artery perforator flap for skin defect on the dorsum of hand or foot / 中华整形外科杂志

<p><b>OBJECTIVE</b>To summarize the technique and therapeutic effect of free posterior tibial artery perforator (PTP) flap for skin defect on the dorsum of hand or foot.</p><p><b>METHODS</b>The lower leg was divided into 6 sections equally from the level of tibial tuberosity to the connection of medial and lateral malleolus. The free PTP flap was designed along the inner edge of tibia within the proximal section 2 and 3. The flap was harvested with 2-3 bundles of the saphenous nerve included. The size of skin defects on the dorsum of hand or foot ranged from 3.0 cm x 7.5 cm to 6.0 cm x 12.0 cm.</p><p><b>RESULTS</b>From Jan. 2009 to Dec. 2010, 11 cases were treated with free PTP flaps. All the flaps survived completely. The follow-up period ranged from 3 to 10 months. The flaps had good color and texture. Two point discrimination recovered to 7-10 mm, leaving linear scar at the donor site. The appearance and function of the hand or foot was satisfactory.</p><p><b>CONCLUSIONS</b>The free PTP flap is thin with good sensation, leaving less morbidity at donor site. The posterior tibial artery can be reserved. It is an ideal method for skin defect on the dorsum of hand or foot.</p>

Mallet finger deformities treated by buried purse-string suture / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the efficacy of buried purse-string suture in the treatment of mallet finger deformities.</p><p><b>METHODS</b>From February 2009 to February 2010, 12 patients with closed non-fracture mallet fingers were treated by buried purse-string suture. The rupture tendons were sutured by purse-string suture with an atraumatic needle, and the knots were buried under subcutaneous tissue. External fixator was used at the extension position of the finger every night within three weeks after operation.</p><p><b>RESULTS</b>All patients were followed up for 6-12 months, mean 7 months. According to the Patel's evaluation criteria, 2 cases (17%) obtained excellent results, 7 good (58%), 2 fair (17%) and 1 poor (8%). The overall rate of the cases with excellent and good outcomes was 75%.</p><p><b>CONCLUSION</b>Buried purse-string suture is an easy and effective way to treat mallet finger deformities, with no serious postoperative complications or no need for reoperation.</p>

Influence of neutrophils from severe burn patients on morphology and function of vascular endothelial cells and the protective effect of intervention with Shenmai concoction / 中华烧伤杂志

<p><b>OBJECTIVE</b>To study the influence of neutrophils from severe burn patient on the morphology and function of vascular endothelial cells (VEC), and the protective effect of Shenmai concoction on VEC.</p><p><b>METHODS</b>Neutrophils were isolated from the venous blood of healthy volunteers and burn patients [at 6, 24, 48 post burn hour (PBH)], and they were cocultured with VECs (ECV304) in vitro. The viability of VECs was assessed by MTT. The contents of endothelin (ET) land nitric oxide (NO) in supernatant were determined by radioimmunoassay, the ratio between ET-1 and NO (ET-1/NO) was also calculated. Blood samples from burn patients were collected at 24 PBH to repeat experiment as above, but 100 L microL isotonic saline or 100 microL Shenmai concoction in concentrations of 0.5, 2.0, 8.0 g/L was added to the cultures respectively. The effect of Shenmai concoction on above indices and morphology of ECV3O4 were also observed.</p><p><b>RESULTS</b>Compared with neutrophils from healthy volunteers, the activity of VECs cocultured with neutrophils from burn patients at 6 PBH was obviously decreased, the content of ET-1 obviously increased, especially with neutrophils obtained at 24 PBH (P < 0.01). The content of NO in supernatant of VEC co-cultured with neutrophils from burn patients at 6 PBH was increased obviously (48.9 +/- 2.6 micromol/L, P < 0.01). There were no obvious difference in the content of NO under the stimulation of neutrophils between that of healthy volunteers and burn patients blood obtained at 24, 48 PBH (P > 0.05). With different concentrations of Shenmai, the activity of VECs and the content of NO were obviously increased , while the content of ET-1 was significantly decreased. The morphology of VECs after treatment of neutrophils of 24 PBH and 2.0 g/L Shenmai was similar to normal VECs.</p><p><b>CONCLUSION</b>The morphology, activity of VEC, and ET/NO can be affected by neutrophils after severe burn, especially that of 24 PBH in vitro. Shenmai concoction can ameliorate above indices, thus might possibly exert protective effects on VECs after severe burn.</p>