Chinese Medicine in Intervention in Signaling Pathways Related to Flap Revascularization： A Review / 中国实验方剂学杂志

Flap surgery is an important method to repair large open wounds in trauma and plastic surgery. However， flap necrosis is a common issue. Good blood circulation that provides nutrition is a necessary condition for the survival of the flap. Promoting revascularization， establishing blood circulation， and restoring blood perfusion as soon as possible after flap transplantation is crucial for flap survival. However， revascularization/blood reperfusion can cause flap ischemia-reperfusion injury （FIRI） after flap repair. If FIRI is not treated correctly and timely， it can cause flap necrosis and graft failure eventually. Previous studies have shown that the signaling pathways related to cell proliferation and apoptosis， such as the Notch signaling pathway， mitogen-activated protein kinase （MAPK） signaling pathway， and phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt） signaling pathway， and inflammation-related pathways， such as nuclear factor E2-related factor 2 （Nrf2） signaling pathway， and nuclear factor-κB （NF-κB） signaling pathway can promote angiogenesis， improve local blood supply， inhibit the production and expression of inflammatory mediators， reduce oxidative stress and apoptosis， relieve ischemia-reperfusion injury （IRI）， and promote rapid healing after flap repair. By consulting a large number of modern medical research literature， this study reveals that both Chinese medicine monomers and Chinese medicine compounds can promote revascularization， restore blood perfusion， and accelerate healing after flap repair by regulating the expression of key protein molecules in the above-mentioned signaling pathways. This study summarized the research status in China and abroad， aiming to provide references for the in-depth study and clinical application of Chinese medicine to promote the healing of skin flaps after repair.

Repair of Atrial Septal Defect Using Pedicled Right Atrial Wall Flap — A Retrospective Observational Study of a Novel Surgical Technique in a Tertiary Care Hospital in Eastern India

Introduction : In our institute, we have used the pedicled right atrial wall flap as an alternative to a free patch to close Atrial Septal Defect (ASD) in a series of patients. We hereby, report its results. Methods : Between January, 2016 and September, 2018, 24 patients (mean age 25.2 ± 12.43 years; range 5 years to 51 years), underwent closure of ASD with pedicled right atrial wall flap. All the patients who underwent this procedure had ostium secundum type of ASD without any other Intra-cardiac anomaly. Results : The intraoperative and postoperative period was uneventful in all the patients. The mean aortic crossclamp (X- clamp) time was 13 ± 2.99 minutes (Mean ± SD) and the mean duration for Cardiopulmonary Bypass (CPB) was 46.5 ± 10.23 minutes (Mean ± SD). There was no mortality. All the patients were discharged either on 3rd or 4th postoperative day. The pre-discharge and latest follow-up Transthoracic Echocardiographic Evaluation was found satisfactory in all the patients. None of them revealed any residual shunt, peri-flap Thrombosis, Flap dehiscence or shrinkage, or Cardiac Dysfunction. Conclusions : The Pedicled Right Atrial Wall Flap can be safely used as an alternative for pericardial patch for ASD closure. It is a novel technique with several advantages.

Repair and treatment with local skin flap after primary surgical resection of non melanoma skin cancer / 局解手术学杂志

Objective To investigate the clinical effect of treatment with local skin flap after primary surgical resection of non melanoma skin cancer.Methods A total of 176 patients with head and facial skin cancer who were admitted into our hospital from September 2008 to September 2015 were divided into three groups according to different repair plans.Namely,the suture group (41 cases),the local skin flap group (81 cases) and the skin graft group (54 cases).The repair effect of the three groups were compared after the operation.Results The good rate was 68.39%(28/41) in the suture group,98.77%(80/81) in the local skin flap group,and 83.33%(45/54) in the skin graft group,and it was significantly higher than any of the other two groups with statistically significant difference(P0.05).The 3 groups were followed up for a period of 1 year,as a result,there was no recurrence and distant metastasis.Conclusion For patients with head and facial non melanoma skin cancer,repaired with local skin flap healing treatment after primary surgical resection can not only get high healing rate but also significant improvement of patient satisfaction rate.In addition,it can lower the rate of recurrence and distant metastasis after operation.

Perioperative care to patients with extramammary Paget’s disease treated with resection of tumor of vulva expansion and flap repair / 现代临床护理

Objective To summarize perioperative points for nursing patients with extramammary Paget’s disease undergoing resection of tumor of vulva expansion and flap repair.Method Eleven patients with extramammary Paget’s disease were managed with resection of tumor of vulva expansion and flap repair,and with perioperative care as well.Results The tumors in all of the patients were removed completely and the flaps survived.All patients were discharged for hospitalization of(4.5±0.7)days.No flap infection or necrosis occurred.Conclusion The measures for nursing the patients with extramammary Paget’s disease undergoing resection of tumor of vulva expansion and flap repair may include preoperative preparation,mental care,postoperative observation of flaps, prevention of complications,health education,instruction on nutrition and formation of proper life style,which may be beneficial for the smooth manipulation of resection as well as for the postoperative rehabilitation.

Perioperative nursing of patients with tongue cancer undergoing resection and flap repair / 中国实用护理杂志

Objective To investigate the skin flap in the repair of tongue cancer resection surgery and perioperative nursing measures.Methods 36 patients with tongue cancer undergoing resection of primary lesion of tongue,floor of the mouth,the cervical lymph node in combination with free flap transfer for repair,and during the preoperative,intraoperative and postoperative period nursing measures were implemented.Results The masticatory function,aspiration rate and functions of language of patients 6months after discharge showed obvious improvement compared with those upon discharge.The difference was statistically significant.The UW-QOL quality of life score ranged from 320 to 1200 points,with an average score of (960.21 +146.84)points.One of the highest scoring items was pain,followed by anxiety,saliva was the lowest.Conclusions For patients with tongue cancer undergoing resection and skin flap repair,nursing methods are very important,which were the guarantee of improving the quality of life of patients.

A Review of Treatments of Keloids with Intramarginal Surgical Excision and Postoperative Irradiation to Prevent Recurrences

No abstract available.