ABSTRACT
The management of wounds with tendon and/or bone exposure is challenging because of the insufficient blood supply to the wound bed. We describe our experience with 19 patients using a perifascial areolar tissue (PAT) graft with topical administration of basic fibroblast growth factor (bFGF) in the treatment of complex wounds with exposed tendons and/or bones in the extremities. Using a PAT graft is minimally invasive and technically easy, and the donor site is relatively preserved. However, PAT grafts for the treatment of a complex wound with large areas of exposed tendons and/or bones have sometimes failed to survive because of insufficient vascularization of the wound bed. Therefore, topical administration of bFGF, which promotes angiogenesis, was added to the graft. All grafts showed good graft survival and successfully covered the tendons and bones. Topical administration of bFGF accelerated vascularization in the PAT graft and facilitated wound healing by increasing the blood supply to the wound bed and achieved success with the PAT graft. In conclusion, using a PAT graft with topical administration of bFGF is a suitable option for the treatment of complex wounds with a large proportion of exposed tendons and/or bones. With minimal damage to the tissues near the wound, the PAT graft can be a useful option for limb salvage and could become a valuable tool for reconstructive surgeons.
Subject(s)
Fibroblast Growth Factor 2/administration & dosage , Surgical Flaps/transplantation , Wound Healing/drug effects , Wounds and Injuries/drug therapy , Wounds and Injuries/surgery , Administration, Topical , Adult , Aged , Aged, 80 and over , Cohort Studies , Graft Rejection , Graft Survival/drug effects , Humans , Japan , Male , Middle Aged , Prognosis , Plastic Surgery Procedures/methods , Retrospective Studies , Severity of Illness Index , Skin Transplantation/methods , Soft Tissue Injuries/diagnosis , Soft Tissue Injuries/drug therapy , Soft Tissue Injuries/surgery , Surgical Flaps/blood supply , Treatment Outcome , Wound Healing/physiology , Wounds and Injuries/diagnosis , Young AdultABSTRACT
A familial amyotrophic lateral sclerosis (FALS) patient with G37R mutation of superoxide dismutase 1 (SOD1) gene revealed an early onset and relatively slow progression. Neuropathological examination of this patient showed widespread neuronal degeneration extending to overall length of the spinal cord and the brainstem with extremely rare Lewy body-like inclusions (LBI), while there were no vacuoles in neurons, a characteristic feature in transgenic mice expressing G37R SOD1 mutation.
