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Objective To investigate the clinical effect of infective foot ulcer and soft tissue defects of small area with free peroneal artery perforator flap.Methods From February,2016 to Apirl,2017,9 cases of infective foot ulcer and soft tissue defect of small area were repaired with peroneal artery perforator flap.Cause of infection:injury in 6 cases,diabetes in 2 cases,spinal cord injury subsequent pressure sore in 1 case.Infective ulcer part:4 cases on plantar metatarsophalangeal joint,2 cases on dorsal metatarsophalangeal joint,2 cases on interior of the first metatarsophalangeal joint and 1 case on the heel.Defect area:3.0 cm×2.0 cm-5.0 cm×3.0 cm;flap area:4.0 cm×3.5 cm-7.0 cm×4.5 cm.The donor sites were sutured directly.All the flaps contained lateral sural cutaneous nerve.In order to rebuild the sensation of flaps,nerves between surgical area and receiving area were received end-to-side anastomosis.Outpatient follow-up was used in all patients.Results All the flaps survived,and all the wounds were primary healed,without recurrence of infection.All patients were followed-up from 6 to 24 months with an average of 16 months.The appearance of flaps was good with slight bloated.The texture and color of the flaps were close to the recipient site.Flap feel was good except the cases of diabetes and spinal cord injury pressure sore.The AOFAS score at last follow-up time was 80.05±7.80,which was excellent in 5 cases,good in 2 cases,and fair in 2 cases.Conclusion The free peronerl artery perforator flap has many advantages,such as vascular anatomy constant,blood supply is reliable,thickness moderate,easy to get,strong resistance to infection,small district damage,etc.It is a useful clinical method to repair foot infection ulcer and soft issue defects of small area.
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Objective To explore the clinical application and effect of fibular head compound soft tissue flap transplantation on precision repairing of compound tissue defect at limb joints assisted by 3-Dimensional contrast printing technology.Methods From March,2014 to September,2017,9 patients with bone and soft tissue defect at limb joints were selected.In which,2 were distal radius bone defect with joint capsule and ligament defect,2 were lower segment tibia bone and soft tissue defect,2 were femur under section of the bone and soft tissue defect,2 were medial malleolus bone and ligament defect,and 1 was external ankle ligament and bone defect.Using 3-Dimensional printing to conduct bilateral mirror-image contrast prior to the operation,morphology of bone defect at limb joints was acquired.Based on the texture printed out,corresponding fibular head compound blocks with blood vessels were removed from the donor site and transplanted to the recipient site before anastomosing the blood vessels and restoring the blood flow.The regular post-operative followed-up was performed.Results The 9 transplanted tissue blocks survived.The donor sites and the recipient sites were healed.The followed-up for restoration of limb function was from 9 to 35 (average,17.5) months.The ankle function was assessed according Kofoed scale,resulted in 2 excellent and 1 good;The wrist function was assessed according Mayo scale,resulted in 1 excellent and 1 good.The medial malleolus bone defect and criteria bone defect were healed at 6 months.The patients were satisfied with the efficacy.Conclusion The application of 3-Dimensional contrast printing of fibular head compound tissue flap transplantation in repairing compound tissue defects at limb joints can reduce damage to the donor site,realizing precise repairing on limb tissue defect,and make good function restoration.
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BACKGROUND:Diacerein is a new kind of interleukin-1 block agent.Researches regarding intervention effect of interleukin correlation factor on increase of bone absorption in postmenopausal osteoporosis are few.OBJECTIVE:To investigate the intervention effect of diacerein on bone mass loss in ovariectomized(OVX) rats.DESIGN,TIME AND SETTING:The complete randomized controlled experiment was performed in the Laboratory of Experimental Animal Center of Chongqing Medical University from August to November 2008.MATERIALS:Forty female,3-month-old,Sprague Dawley rats were randomly divided into sham operation,OVX,diacerein 10mg,100 mg/(kg?d) groups,with 10 animals in each group.Anbiding capsule(contains 48.1 mg diacerein in each 50 mg capsule) was produced by Kunming Jida Pharmaceutical Co.,Ltd,with batch number of 20070532.METHODS:All rats received ovariectomy exception the sham operation group.Rats of sham operation group were only received a little fatty tissue removal around the ovary,and sutured the skin.Diacerein was intragastric administrated at the second day after the ovariectomy in the diacerein 10mg,100 mg/(kg?d) groups,equivalent volume of normal saline was administrated in the sham operation,OVX groups.Then all rats were killed under anesthesia to collect the blood and skeleton samples after 10 weeks continue medication.MAIN OUTCOME MEASURES:Bone mineral density of the right femur and the third lumbar vertebra were determined by Dual-Energy X-ray bone densitometry.The levels of interleukin-1?,interleukin-6 in bone tissue and the level of serum osteocalcin were determined by radio-immunity assay.RESULTS:All rats were involved in the final analysis.The levels of bone mineral density in two diacerein groups were higher than that in the OVX group(P 0.05).CONCLUSION:The bone loss is obviously 10 weeks later after ovariectomy.Diacerein has intervention effect on bone loss induced by increase of bone absorption in OVX rats,which have no significant effects on bone formation mediated by osteoblast.