Repair of skin defects at fingers by digital dorsal flaps based on vascular network / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the therapeutic effect of digital dorsal flap based on vascular network for skin defects at fingers.</p><p><b>METHODS</b>From August 2005 to August 2010, 49 cases with 61 skin defects at fingers were treated with the digital dorsal flaps, including 19 at the index fingers, 19 at the middle fingers, 16 at the ring fingers and 3 at the little fingers. The defects were 42 at the distal end, 12 at the middle segment and 7 at the proximal segment. The flaps size ranged from 27 mm x 20 mm to 10 mm x 8 mm.</p><p><b>RESULTS</b>61 flaps in 49 cases survived completely. 52 fingers were followed up for 6-22 months. The aesthetic and functional results were both satisfactory. The flaps sensation was graded as S3, with a discrimination distance of 6-9 mm (median, 7.6 mm). No complication happened in donor sites.</p><p><b>CONCLUSIONS</b>The digital dorsal flap based on vascular network has reliable blood supply with less morbidity to the main artery. It is safe and easily performed with good effect for skin defect at finger.</p>

Clinical application of reverse radial hypothenar flap for finger soft tissue defect / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the therapeutic effect of reverse radial hypothenar flap for finger soft tissue defect.</p><p><b>METHODS</b>From Mar. 2006 to Mar. 2010, 13 cases (14 fingers) with finger soft tissue defects were treated with reverse radial hypothenar flaps pedicled with ulnar palmar digital artery of little finger. The defects were 1.9 cm x 1.5 cm -4.0 cm x 2.0 cm in size. The flap size ranged from 1.5 cm x 2.0 cm to 4.0 cm x 2.0 cm.</p><p><b>RESULTS</b>All the flaps survived completely with primary healing both in donor and recipient area. 12 cases (13 fingers) were followed up for 1-3 years. The flaps color was similar to the unaffected fingers. Cicatricial contracture happened in one case due to contracture of palmar fascia. The two-point discrimination distance on flap was 3.2-5.3mm. The active and passive movement of finger joints was evaluated as excellent in 12 fingers, good in one finger. There was no complaint about the feeling at the donor site. Two months after operation, all patients could go back to work.</p><p><b>CONCLUSIONS</b>The reverse radial hypothenar flap is very suitable for finger soft tissue defect with less morbidity to donor site.</p>

Replantation of amputated ear with microtechnique / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To report replantation of amputated ear with microtechnique in 5 cases.</p><p><b>METHODS</b>From 2002 to 2005, 5 totally amputated ears were replanted and 4 obediently, 1 retrogressively. In every case, 1-2 arteries and 1-3 veins were anastomosed. Seven vessels were detective and 1-6 cm vessels were transplanted from forearm or dorsal side of hand. Amputated ears obtained blood supply again in about 6-10 hours after injury and exploration was enforced for venous crisis in 2 cases, and bloodletting in 1 case.</p><p><b>RESULTS</b>All 5 cases survived. Auricles possess perfect shape, no pigmentation, slight atrophy and perfect sensation.</p><p><b>CONCLUSIONS</b>Amputated ear should be replanted as long as no obvious contusion occurred, and the keys to prevent vascular crisis are cutting off unhealthy vessels, grafting superficial veins for bridging, and the high quality of vascular anastomosis.</p>

Lateral tarsal artery flap with dorsal lateral cutaneous nerve to close forefoot cutaneous defect / 中华显微外科杂志

Objective To investigate the clinical method of closing defect and regain the sensory on forefoot injury.Methods Lateral tarsal artery,flap was designed as a reverse flow flap to close forefoot de- fect in dorsal lateral foot while perforating branche of lateral tarsal artery as turning point.Lateral cutaneous nerve was inosculated to lateral plantar fascia.Donor site was covered by skin-grafting.Results seventeen cases survived satisfactorily with good shape and regaining sensory.Conclusion Lateral tarsal artery flap can be used in coveraged of forefoot defect.Lateral tarsal artery flap was thin flap with good shape and to regain the sensory of forefoot.