Super-thin anterolateral thigh flap for reconstruction of the medial plantar artery perforator flap donor site.

BACKGROUND: The medial plantar artery perforator (MPAP) flap is widely used to reconstruct the weight-bearing area of the foot. Traditionally, its donor site is closed using a skin graft, which is associated with several complications, including walking disability. This study aimed to examine our experience with using a super-thin anterolateral thigh (ALT) flap to reconstruct the MPAP flap donor site. METHODS: We examined 10 patients who underwent reconstruction of the MPAP flap donor site using a super-thin ALT flap between August 2019 and March 2021. The vascular pedicle was anastomosed to the proximal end of the medial plantar vessels or the end of the posterior tibial vessels. RESULTS: All reconstruction flaps survived and all patients were satisfied with the aesthetic appearance. No blisters, ulcerations, hyperpigmentation, or contractures occurred. All patients gained protective sensation in the super-thin ALT flap. The average visual analog scale score for the aesthetic appearance of the reconstructed foot was 8.5 ± 0.7 (range, 8-10). All patients were able to ambulate without aids and could wear regular shoes. The average revised Foot Function Index score was 26.4 ± 4.1 (range, 22-34). CONCLUSION: Reconstruction of the MPAP flap donor site using a super-thin ALT flap is reliable and provides satisfactory functional recovery, aesthetic appearance, and protective sensation while minimizing postoperative morbidity.

Propofol-based total intravenous anesthesia decreases the incidence of postoperative nausea and vomiting without affecting flap survival in free flap breast reconstruction.

BACKGROUND: Postoperative nausea and vomiting (PONV) may cause undesirable effects after microsurgical breast reconstruction. Although total intravenous anesthesia (TIVA) with propofol has been demonstrated to be effective in reducing PONV, it has not been assessed in autologous free flap breast reconstruction. The purpose of this study was to investigate the antiemetic prophylaxis effect and safety of TIVA in microvascular breast reconstruction. METHODS: Eighty-three patients undergoing microsurgical breast reconstruction with propofol (31 patients) or sevoflurane (52 patients) were retrospectively reviewed. The incidence of PONV was assessed at 2, 6, and 24 hours after surgery. Mean arterial blood pressure (MAP) was compared at T1 (after flap elevation but before transfer), T2 (15 minutes after revascularization), and T3 (at the end of surgery). RESULTS: The incidence of nausea was significantly reduced in the TIVA group over 0 to 2 hours period (P=0.017), and over 2 to 6 hours period (P=0.033). The incidence of vomiting was significantly reduced in the TIVA group over 0 to 2 hours period (P=0.006), and over 2 to 6 hours period (P=0.005). MAP was higher in the TIVA group at T1 (P=0.018), T2 (P=0.005), and T3 (P=0.007). The incidence of flap failure was similar between the two groups (P=0.373). CONCLUSIONS: Compared with sevoflurane maintaining anesthesia, propofol-based TIVA improves PONV with less fluctuation of MAP, and did not affect flap survival.

Fasting inhibits aerobic glycolysis and proliferation in colorectal cancer via the Fdft1-mediated AKT/mTOR/HIF1α pathway suppression.

Evidence suggests that fasting exerts extensive antitumor effects in various cancers, including colorectal cancer (CRC). However, the mechanism behind this response is unclear. We investigate the effect of fasting on glucose metabolism and malignancy in CRC. We find that fasting upregulates the expression of a cholesterogenic gene, Farnesyl-Diphosphate Farnesyltransferase 1 (FDFT1), during the inhibition of CRC cell aerobic glycolysis and proliferation. In addition, the downregulation of FDFT1 is correlated with malignant progression and poor prognosis in CRC. Moreover, FDFT1 acts as a critical tumor suppressor in CRC. Mechanistically, FDFT1 performs its tumor-inhibitory function by negatively regulating AKT/mTOR/HIF1α signaling. Furthermore, mTOR inhibitor can synergize with fasting in inhibiting the proliferation of CRC. These results indicate that FDFT1 is a key downstream target of the fasting response and may be involved in CRC cell glucose metabolism. Our results suggest therapeutic implications in CRC and potential crosstalk between a cholesterogenic gene and glycolysis.

Synthesis of carbon-14 labeled ZJ0712, a novel strobilurin fungicide.

ZJ0712, a broad-spectrum fungicidal ingredient of strobilurin, exhibits a high protective and curative activity against plant pathogenic fungi. To support the study on its metabolism, residue, environmental behavior, and fate for safety evaluation, two versions of carbon-14 labeled ZJ0712, methyl (E)-2-(2-((2,5-dimethylphenoxy)methyl)phenyl)-3-methoxy[2-14 C]acrylate (2) and methyl (E)-2-(2-((2,5-dimethyl[phenyl-U-14 C6 ]phenoxy)methyl)phenyl)-3-methoxyacrylate (3), were synthesized from barium [14 C]carbonate in 6-step yield of 47% and from 2,5-dimethyl[phenyl-U-14 C6 ]phenol in the yield of 91%, respectively.

[Screening and inhibition of antagonistic endophytic bacteria isolated from soybean (Glycine max)nodules against Alternaria longipes.] / çƒŸè‰èµ¤æ˜Ÿç— èŒæ‹®æŠ—æ€§å¤§è±†æ ¹ç˜¤å† ç”ŸèŒçš„ç­›é€‰åŠæŠ‘åˆ¶ä½œç”¨.

Using Alternaria longipes as tested phytopathogen, endophytic bacteria isolated from soybean nodules were selected to study antagonistic effects by confrontation and metabolic liquid culture methods. The inhibited hyphae were determined by microscopic observation, and the screened strains were characterized by cell culture, physiological and biochemical tests, 16S rDNA sequencing, phylogenetic analysis and inoculation trials in greenhouse. The results indicated that the seven of the endophytes exerted more than 42% inhibitory effects after the first and the second screening. These strains belonged to genus Bacillus, Pseudomonas, Sinorhizobium and Stenotrophomonas, respectively. Microscopic observation showed that the affected hyphae ends of A. longipes appear deformity of coralline branch, spherical expansions and so on. Antagonistic experiments with metabolites showed that the inhibition of endophytic bacteria against pathogenic fungus played an effective role mainly by bacteria producing extracellular substances. Confrontation tests suggested that endophytic Bacillus rapidly produced biofilm to effectively hinder the growth and extension of pathogen hyphae. Inoculation experiments showed that the disease index of treatment group was significantly lowered compared with the control, suggesting it could be utilized as a biological control resource inhibiting tobacco brown spot.

[Screening probiotic endophytic bacteria from medicinal plant flex cornuta and the phytopathogen-inhibiting effect].

Culturable endophytic bacteria were isolated from medicinal plant Ilex cornuta by plate-spreading method, strains with strong inhibitory effect on phytopathogen were screened by confrontation culture and fermentation filtrate culture methods, and the morphological changes of phytopathogen hyphae treated with endophytic bacteria were examined by microscopy and micrograph. Their phylogenetic relationships were determined by homology analysis of the 16S rDNA sequences of PCR products and the taxonomic status of the selected strains was determined based on their morphology, physiology, biochemical test results and 16S rDNA sequence analysis. A total of 85 endophytic bacteria were isolated from the healthy roots, stems, leaves and fruits of I. cornuta, and 10 strains of them showed strong inhibitory effect on Alternaria alternata, Magnaporthe grisea, Fusarium oxysporum, and were preliminarily identified belonging to four genera and seven species. Three strains with the strongest inhibitory effect, GG78 (60.3%), GG31 (48.1%) and GG13 (61.0%) belonged to Enterobacter cloacae, Enterobacter ludwigii and Bacillus cereus, respectively. Microscopic analyses showed that the inhibited phytopathogen hyphae became deformed, distorted, and partially expanded forming plasma concentration and hair-like branch on the hyphae base. These morphological changes could be caused by the extracellular metabolic substances secreted by the endophytic bacteria, such as antibiotics, hydrolytic enzymes, alkaloids and so on.

[Risk factors of the failure in digit replantation].

OBJECTIVE: To explore the relative factors on the failure in digit replantation in order to take preventions to control the risk factors. METHODS: From January 2013 to December 2013, 236 consecutive patients (311 fingers) underwent digit replantation were collected to analyze retrospectively, involving 183 males and 53 females with an average age of 34.5 years old ranging from 2 to 62 years old (6 cases under 6 years old and 230 cases elder than 6 years old). There were 51 thumbs, 87 index fingers, 78 middle fingers, 63 ring fings and 32 little thumbs. Forty cases(forty fings) who were failured as the observation group, the others as the control group. The factors of age, gender, finger, cause of injury, smoking history, ischemia duration, plane of division, condition of venous drainage and condition of arterial repair we assessed. RESULTS: All 236 cases with 311 fingers were replanted, 40 fingers were failured after operation. The relative factors on the failure in digit replantation included smoking history, cause of injury, plane of division, condition of venous drainage and condition of arterial repair (P< 0.05). There were no significant correlation between the failure and age, gender, finger and ischemia duration (P>0.05). CONCLUSION: Smoking history, causes of injury, plane of division, condition of venous drainage and condition of arterial repair are risks of failure in digit replantation. Before choosing the type of operation, it should be think about the patient's general conditions, injury status, grasp firmly the operative indications and actively carry out surgical treatment.

[Volume fraction of gas vesicle and floating characteristics of cyanobacteria in Taihu Lake under different pressures].

In order to ascertain the volumetric change of gas vesicles in cyanobacteria and the floating characteristics, capillary pressure method and image analysis method were used to study burst situation and remanent volume fraction of gas vesicles in cyanobacteria under different pressures. The reform situation after pressuring was also analyzed in this research. The results showed that the volume fraction of gas vesicles in Taihu Lake were 29.52%, 5.73%, 4.43%, 2.71%, 2.46%, 2.19% under 0 MPa, 0.3 MPa, 0.4 MPa, 0.5 MPa, 0.6 MPa, 0.7 MPa determined by the image analysis, and were 10.93%, 1.14%, 0.90%, 0.27%, 0.14%, 0.04% determined by the capillary pressure method; cyanobacteria sank due to the gas vesicles' bursting when the pressure was greater than 0.4 MPa. Gas vesicles and structure after pressure were reformed with the lapse of time, under 1 000 lx, 25 degrees C, after 8 h, 24 h, 48 h, the reformed gas vesicles accounted for 31.02%, 45.68%, 81.05% of total gas vesicles before pressuring. Image analysis method is more accurate in the determination for cyanobacteria gas vesicles' volume, while the volume is smaller measured by traditional capillary pressure method.

[Variation of water DOC during the process of pre-pressure and coagulation sedimentation treatment].

The aim of the study was to explore whether the pre-pressure and coagulation sedimentation process would result in algal cell disruption, leading to increased dissolved organic carbon (DOC) in water, based on which, the pressure application mode would be optimized and safe and efficient pre-pressure algae removal process would be obtained. The changes in DOC during the process of pre-pressure and preoxidation treatment, the distribution of molecular weight in water as well as the removal efficiency of algae, turbidity and DOC after coagulation and sedimentation were investigated. The results showed that the DOC in water did not increase but decreased, and the molecular weight decreased after treated with 0.5-0.8 MPa pressure. While KMnO4 and NaClO pre-oxidation both increased the DOC, in the meanwhile, the distribution of molecular weight showed no obvious change. After the pre-pressure coagulation and sedimentation process, the removal rate of algae was 96.23% and that of DOC was 29. 11%, which was by 10% - 30% higher than the rate of pre-oxidation coagulation and sedimentation process.

[Effects of quercetin in pregnant and lactation period on weight and expression of insulin-like growth factors-1 mRNA of obese female rats offspring].

OBJECTIVE: To study the effect of quercetin given during pregnancy and lactation period of obese rats on weight and expression of insulin-like growth factors-1 (IGF-1) mRNA of the offspring. METHODS: In the study, 8 healthy weaning female SD rats were randomly selected to feed the basal diet and as blank control group, and the others were fed with high-fat diet. When the average weight of the high-fat diet rats was 20% as many as the average weight of the control group, we believed the model succeeded. Then the female SD rats were mated and the pregnant rats were randomly divided into 5 groups, 8 rats in each. They were fed with high fat diet during pregnancy and lactation, and the obese pregnant rats were respectively irrigated with 0 mg/kg body weight (high-fat control), 50 mg/kg body weight,100 mg/kg body weight, and 200 mg/kg body weight quercetin. The blank control group was fed with basic diet throughout the experimental period. The birth weight, the weights during the development of d7, d21, d56, and d98, and the expressions of IGF-1 mRNA in livers tissue of the F1 generation were measured. RESULTS: The average birth weight of the F1 generation of high fat diet (HFD) group was significantly higher than that of the blank control group. Decreased offspring birth weight was observed with the intervention of quercetin, which effect remained to the delectation. The quercetin also reduced the expression of IGF-1 mRNA in livers of the F1 generation, and this effect remained to the adulthood. The 200 mg/kg body weight quercetin was most significantly effective. CONCLUSION: The averaged birth weight of the F1 generation of obese pregnant rats was significantly increased, and quercetin could effectively inhibit the expression of IGF-1 mRNA in livers of F1 generation to decrease cell proliferation and cell differentiation.

Correlative factors for organic psychotic symptoms in patients following traumatic brain injury.

OBJECTIVE: To investigate the correlative factors for organic psychotic symptoms following traumatic brain injury (TBI). METHODS: In the current study, 391 subjects who had undergone forensic identification of the organic mental disorders due to TBI were included, both the demographic and post-traumatic information collected. The relevant data were statistically analyzed in those confirmed as organic psychotic syndrome according to Chinese Classification of Mental Disorders 3rd version (CCMD-3). RESULTS: Fifty-two subjects (13.3%) were identified as organic psychotic symptoms. The chi-square test showed that the detectable organic psychotic symptoms were associated with the marriage status, damage nature, injury severity and treatment, and the multivariate logistic regression analysis revealed good fitness of treatment and injury severity with the regression model (OR = 0.044, 95% CI: 0.017-0.114; OR = 2.145, 95% CI: 1.201-3.832, respectively). CONCLUSION: The risks of organic psychotic symptoms following TBI can be involved in the alternative of craniotomy for the cases with trauma and moderate brain injury.

Exogenous nucleotides antagonize the developmental toxicity of ethanol in vitro.

The objective of this study was to assess whether nucleotides supplementation in vitro could suppress ethanol-induced developmental toxicity in mouse. The models of whole embryo culture (WEC) and midbrain (MB) cell micromass culture were used in this study. In WEC system, exposure to 4.0 mg/mL ethanol for 48 h yielded various developmental malformations of the mice embryos. Nucleotides supplementation (0.16, 0.80, 4.00, 20.00, and 100.00 mg/L) improved the growth parameters to some extent, and the protective effects peaked at 4.00 mg/L. In MB cell micromass culture system, exposure to 4.0 mg/mL ethanol for 5 days resulted in suppression of proliferation and differentiation. Supplementation of nucleotides (0.16, 0.80, 4.00, 20.00, and 100.00 mg/L) showed some protective effects, which peaked at 4.00 mg/L, too. The present research indicated that nucleotides supplementation might be of some benefit in the prevention of ethanol-induced birth defects; however, appropriate dosage requires attention.

Colonization and plant growth promoting characterization of endophytic Pseudomonas chlororaphis strain Zong1 isolated from Sophora alopecuroides root nodules.

The endophytic strain Zong1 isolated from root nodules of the legume Sophora alopecuroides was characterized by conducting physiological and biochemical tests employing gfp-marking, observing their plant growth promoting characteristics (PGPC) and detecting plant growth parameters of inoculation assays under greenhouse conditions. Results showed that strain Zong1 had an effective growth at 28 ºC after placed at 4-60 ºC for 15 min, had a wide range pH tolerance of 6.0-11.0 and salt tolerance up to 5% of NaCl. Zong1 was resistant to the following antibiotics (µg/mL): Phosphonomycin (100), Penicillin (100) and Ampicillin (100). It could grow in the medium supplemented with 1.2 mmol/L Cu, 0.1% (w/v) methylene blue and 0.1-0.2% (w/v) methyl red, respectively. Zong1 is closely related to Pseudomonas chlororaphis based on analysis the sequence of 16S rRNA gene. Its expression of the gfp gene indicated that strain Zong1 may colonize in root or root nodules and verified by microscopic observation. Furthermore, co-inoculation with Zong1 and SQ1 (Mesorhizobium sp.) showed significant effects compared to single inoculation for the following PGPC parameters: siderophore production, phosphate solubilization, organic acid production, IAA production and antifungal activity in vitro. These results suggest strains P. chlororaphi Zong1 and Mesorhizobium sp. SQ1 have better synergistic or addictive effect. It was noteworthy that each growth index of co-inoculated Zong1+SQ1 in growth assays under greenhouse conditions is higher than those of single inoculation, and showed a significant difference (p < 0.05) when compared to a negative control. Therefore, as an endophyte P. chlororaphis Zong1 may play important roles as a potential plant-growth promoting agent.

[Efficacy of iron saturated recombinant human lactoferrin on alleviating iron deficiency anemia in rats].

OBJECTIVE: To investigate the effect of iron saturated recombinant human lactoferrin (Fe-rhLf) on treating iron deficiency anemia (IDA). METHODS: SD rats received iron deficient diet and deionized water during the whole experiment. After 4 weeks, the rats with hemoglobin less than 100 g/L were selected and divided into 5 groups randomly. IDA group received 100 mg/(kg×d) casein dissolved in deionized water intragastrically; FeSO4 group received 5.43 mg/(kg×d) [2.0 mg/(kg×d) iron]+100 mg/(kg×d) casein intragastrically; low dose Fe-rhLf group received 75.53 mg/(kg×d) Fe-rhLf [0.5 mg/(kg×d) iron] +75 mg/(kg×d) casein intragastrically; middle dose group received 151.06 mg/(kg×d) Fe-rhLf [1.0 mg/(kg×d) iron]+50 mg/(kg×d) casein intragastrically; high dose group received 302.11 mg/(kg×d) Fe-rhLf [2.0 mg/(kg×d) iron] intragastrically. After 30 days of intervention, the rats' blood was collected and used to do the routine blood test, serum iron and serum anti-oxidants test. The liver hepcidin and ferroportin mRNA expression was tested by real time PCR. RESULTS: Compared with the animals in the IDA group, Fe-rhLf could increase weight significantly (P<0.05), hematological parameters, like hemoglobin (P<0.01) and red blood cell count (P<0.01) recovered significantly. Compared with animals in FeSO4 group, high dose Fe-rhLf could improve hemoglobin significantly (P<0.05). The liver hepcidin expression was up regulated and ferroportin down regulated. CONCLUSION: Fe-rhLf has a significant effect on treating iron deficiency anemia.

[Application of thenar perforator flaps for the narrow cicatricial contracture at thumb and the first web].

OBJECTIVE: To discuss the therapeutic effect of thenar perforator flaps for the narrow cicatricial contracture at thumb and the first web. METHODS: From Aug. 2010 to Jan. 2012, 9 cases with narrow cicatricial contracture at thumb and the first web, were treated. The defect size after releasing the contracture ranged from 8 mm x 20 mm to 15 cm x 30 mm. The bilateral thenar perforator flaps beside the wound were designed which size was 10 mm x 25 mm to 15 mm x 35 mm. The wounds at donor sites were closed directly. RESULTS: All the 9 flaps survived completely with primary healing. The patients were followed up for 6-18 months. The flaps had soft texture and good appearance. The shape of flaps and function of the fingers were satisfied after 6-18 months of follow-up. There was no scar contracture at incisions in thenar. The thumb motion was really normal. The abduction of first web was 70 degrees - 90 degrees degrees. CONCLUSIONS: The thenar perforator flaps is one of the ideal methods for the treatment of narrow cicatricial contracture at thumb and the first web. The main artery is not sacrified.

Colonization and plant growth promoting characterization of endophytic Pseudomonas chlororaphis strain Zong1 isolated from Sophora alopecuroides root nodules

The endophytic strain Zong1 isolated from root nodules of the legume Sophora alopecuroides was characterized by conducting physiological and biochemical tests employing gfp-marking, observing their plant growth promoting characteristics (PGPC) and detecting plant growth parameters of inoculation assays under greenhouse conditions. Results showed that strain Zong1 had an effective growth at 28 ºC after placed at 4-60 ºC for 15 min, had a wide range pH tolerance of 6.0-11.0 and salt tolerance up to 5% of NaCl. Zong1 was resistant to the following antibiotics (µg/mL): Phosphonomycin (100), Penicillin (100) and Ampicillin (100). It could grow in the medium supplemented with 1.2 mmol/L Cu, 0.1% (w/v) methylene blue and 0.1-0.2% (w/v) methyl red, respectively. Zong1 is closely related to Pseudomonas chlororaphis based on analysis the sequence of 16S rRNA gene. Its expression of the gfp gene indicated that strain Zong1 may colonize in root or root nodules and verified by microscopic observation. Furthermore, co-inoculation with Zong1 and SQ1 (Mesorhizobium sp.) showed significant effects compared to single inoculation for the following PGPC parameters: siderophore production, phosphate solubilization, organic acid production, IAA production and antifungal activity in vitro. These results suggest strains P. chlororaphi Zong1 and Mesorhizobium sp. SQ1 have better synergistic or addictive effect. It was noteworthy that each growth index of co-inoculated Zong1+SQ1 in growth assays under greenhouse conditions is higher than those of single inoculation, and showed a significant difference (p < 0.05) when compared to a negative control. Therefore, as an endophyte P. chlororaphis Zong1 may play important roles as a potential plantgrowth promoting agent.

[Protective effect of exogenous nucleotides on the developmental toxicity of alcohol].

OBJECTIVE: To investigate the preventive effect of exogenous nucleotide (EN) on the developmental toxicity of alcohol. METHODS: C57BL/6J pregnant mice were divided into 6 groups randomly: the control group, the alcohol group, the low (0.01%EN), middle (0.04%EN), high (0.16%EN) and higher (0.64% EN) intervention groups. From the 6th gestational days (GD) to the 15th GD, pregnant animals except those in the control group were administrated with 5 g (per kg body weight) alcohol intragastrically. Normal mouse forage was provided to the animals in the control group and alcohol group, while forage containing different quantities of EN was provided to the animals in the intervention groups. On GD 18, all the dams were killed, their blood samples were collected for further analysis, and fetal developmental indexes were observed. RESULTS: Compared with the animals in the alcohol group, offspring's body weight and placenta weight of EN intervention groups improved a lot; superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activity increased significantly (P<0.05), malondialdehyde (MDA) levels decreased significantly (P<0.01); the live birth rate of animals in the interventions groups has increased significantly and the absorbed embryo rate of them has decreased significantly (P<0.01); the forepaw phalanges, hindpaw phalanges and caudal vertebrae ossification point increased significantly (P<0.01); the anomalies of both occipital and sternum have decreased significantly in 0.04%EN group (P<0.05). CONCLUSION: EN has a significant protective effect on the developmental toxicity of alcohol.

[Application of V-Y flap pedicled with superior malleolus cutaneous branch for small skin defect at the dorsal side of foot].

OBJECTIVE: To investigate the therapeutic effect of V-Y flap pedicled with superior malleolus cutaneous branch for small skin defect at the dorsal side of foot. METHODS: From Aug. 2008 to Aug. 2010, 9 cases with skin defects at the dorsal side of feet were treated by V-Y flaps pedicled with superior malleolus cutaneous branch. The flap size ranged from 6.0 cm x 5.5 cm to 12.0 cm x 6.5 cm. The defects at the donor sites were closed directly. RESULTS: All flaps survived completely. 9 cases were followed up for 6-12 months after operation. The flaps had good texture and color match. The 2-point discrimination distance at the flap was 10-14 mm. The function of ankle was normal. CONCLUSIONS: The V-Y flap pedicled with superior malleolus cutaneous branch is ideal for the treatment of small skin defect at the dorsal side of foot.

[Repair of soft tissue defect at finger tip with square island flap pedicled with skin perforator of digital artery on the distal interphalangeal joint].

OBJECTIVE: To investigate the repair of soft tissue defect at finger tip with square island flap pedicled with skin perforator of digital artery on the distal interphalangeal joint (DIP). METHODS: From Jun. 2009 to Mar. 2010, 15 cases with soft tissue defects at 15 fingers tip were treated with this island flaps. The flap size ranged from 1.2 cm x 0.8 cm to 2. 0 cm x 3.0 cm. The defects at donor sites were covered with skin grafts from forearm. RESULTS: All the flaps and skin grafts survived. 10 fingers in 10 cases were followed up for 6-12 months. The color, texture and contour of the flaps were good. The two-point discrimination distance was 5-6 mm on the directed island flaps, and 7-10 mm on the reverse island flaps. No obvious functional problem was found in DIP motion. The hand function was assessed as excellent in 8 fingers, good in 1 finger and medium in 1 finger. CONCLUSIONS: The main artery and nerve will not be sacrificed when the island flap is used. The operative procedures are easily performed for the treatment of fingertip skin defect.