Adaptive machining for curved contour on deformed large skin based on on-machine measurement and isometric mapping

Management of complex wounds with large skin defects presents a real challenge for orthopedic or reconstructive surgeons. We developed a simple skin stretching system associated with vacuum sealing drainage to examine the efficiency and complication. A total of 34 patients with different types of complex wounds were retrospectively included from January 2015 to March 2021. All patients in the study were underwent the treatment by 2 stages. The method was used to the wounds from 4.71 to 169.65 cm2 with a median defect size of 25.13 cm2. The median time for wound closure was 11.5 days (range: 5-32 days), although the median absolute reduction was 2.08 cm2/day (range: 0.15-25.66 cm2/day). Depending on the site of the wounds, the cause of the wound, and the rate of max-width/max-length ( W/ L), these complex wounds could be separately divided into several groups. There were statistically significant differences in the median value of the above variables ( P < .05 Kruskal–Wallis test). The results showed that different anatomical sites had different viscoelastic properties, the complex wounds caused by trauma were easier to close than caused by diabetic foot and the complex wounds in group A ( W/ L ＞ 0.5) were more difficult to close than in group B ( W/ L ≤ 0.5). No major complications were encountered in this study. In summary, the results of our study showed that the simple skin stretching system associated with vacuum sealing drainage was a safe approach for closure of complex wounds. Nevertheless, more attention should be paid to the viscoelasticity of the wounds to ensure closure and avoid undue complications when applying the method.

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Reconstruction of Extensive Soft Tissue Defects of Lower Extremity With the Extended Anterolateral Thigh Flap

The International Journal of Lower Extremity Wounds ◽

10.1177/1534734620982238 ◽

2021 ◽

pp. 153473462098223

Author(s):

Jong-Ho Kim ◽

Hyokyung Yoo ◽

Seokchan Eun

Keyword(s):

Soft Tissue ◽

Lower Extremity ◽

Distal Portion ◽

Outcome Data ◽

Anterolateral Thigh Flap ◽

Soft Tissue Defects ◽

Flap Viability ◽

Anterolateral Thigh ◽

Large Skin ◽

Tissue Defects

The anterolateral thigh flap is a classic flap used for various reconstruction defects. However, the flap viability of extended large skin paddles (ie, 240 cm2) was doubted by many surgeons. This study reports successful experience of reconstructing extensive soft tissue defects of lower extremity using extended large skin paddles. Twelve consecutive patients who had undergone reconstruction of defects using an extended anterolateral thigh flap were identified. Patient characteristics (age, sex, defect location, injured structures, and type of flap) and outcome data were analyzed retrospectively. One artery and 2 accompanying veins were anastomosed to vascularize each flap. Follow-up periods ranged from 10 to 91 months postoperatively. The average size of the flaps was 268.75 cm2 (range = 220-391 cm2). All flaps were perforator flaps with one perforator except that 2 perforators were used in 3 patients. Two patients suffered partial flap necrosis of the distal portion with delayed healing. In conclusion, the extended anterolateral thigh flap is a considerable option for massive defects requiring composite tissue coverage. This flap is advantageous for reconstructing various complex defects in the lower extremities, providing a pliable and vascularized tissue to cover exposed extensive defects including tendons, nerves, and bones.

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Neutral line-based Robust Profile Reconstruction for adaptive machining of turbine blade tip welds

International Journal of Manufacturing Research ◽

10.1504/ijmr.2009.024540 ◽

2009 ◽

Vol 4 (2) ◽

pp. 236 ◽

Cited By ~ 1

Author(s):

XiaoQi Chen ◽

Wen Jong Lin ◽

Tsong Jye Ng

Keyword(s):

Turbine Blade ◽

Neutral Line ◽

Adaptive Machining ◽

Blade Tip ◽

Profile Reconstruction

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Developed Plate Expansion Using Geodesics

Marine Technology and SNAME News ◽

10.5957/mt1.1984.21.4.384 ◽

1984 ◽

Vol 21 (04) ◽

pp. 384-388

Author(s):

John C. Clements

Keyword(s):

Differential Equation ◽

Numerical Quadrature ◽

Developable Surface ◽

Accuracy Control ◽

Isometric Mapping ◽

Variable Stepsize ◽

Mapping Algorithm ◽

Equation Solving ◽

Expansion Procedure ◽

The Relationship

This work is concerned with the application of a new isometric mapping algorithm to hull plate expansion procedures for ships with all or portions of the hull consisting of developable surfaces. The expansion procedure is based on the relationship between the ruling lines r⇀(s) generating the developable surface S⇀(s,t) and one additional geodesic g⇀(s) constructed within the surface as the solution of the differential equation det(g⇀'g⇀"n⇀) = 0 where n⇀ is the unit normal to S⇀ at g⇀. Precise accuracy control is achieved through the use of adaptive numerical quadrature and a variable stepsize differential equation solving routine.

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Classification of blade’s leading edge based on neural networks in adaptive machining of near-net-shaped blade

International Journal of Precision Engineering and Manufacturing ◽

10.1007/s12541-021-00586-y ◽

2021 ◽

Author(s):

Zikai Yin ◽

Junxue Ren ◽

Yongshou Liang

Keyword(s):

Neural Networks ◽

Leading Edge ◽

Adaptive Machining ◽

Edge Based

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The future of bioengineering personalised skin on demand for large skin defects

Journal of Wound Care ◽

10.12968/jowc.2021.30.11.878 ◽

2021 ◽

Vol 30 (11) ◽

pp. 878-879

Author(s):

Daniela Marino ◽

Vincent Ronfard

Keyword(s):

On Demand ◽

Skin Defects ◽

The Future ◽

Large Skin

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The Use of Engineered Bilayered Skin (MyDermTM) in the Management of Massive Skin Defect in Grade III Gustilo-Anderson Open Fracture

The International Journal of Lower Extremity Wounds ◽

10.1177/1534734617724974 ◽

2017 ◽

Vol 16 (3) ◽

pp. 212-216

Author(s):

Nor Hazla Mohamed Haflah ◽

Min Hwei Ng ◽

Mohd Heikal Mohd Yunus ◽

Amaramalar Selvee Naicker ◽

Ohnmar Htwe ◽

...

Keyword(s):

Soft Tissue ◽

Open Fracture ◽

Wound Closure ◽

Posterior Tibial Artery ◽

Soft Tissue Coverage ◽

Skin Defect ◽

Vascular Repair ◽

Posterior Compartment ◽

Large Defect ◽

Large Skin

Open fracture Gustilo-Anderson grade IIIC is associated with higher risk of infection and problems with soft tissue coverage. Various methods have been used for soft tissue coverage in open fractures with large skin defect. We report a case of a patient who had grade IIIC open fracture of the tibia with posterior tibial artery injury. The patient underwent external fixation and reduction. Because of potential compartment syndrome after vascular repair, fasciotomy of the posterior compartment was performed. This wound, however, became infected and because of further debridement, gave rise to a large skin defect. A tissue engineered skin construct, MyDermTM was employed to cover this large defect. Complete wound closure was achieved 35 days postimplantation. The patient then underwent plating of the tibia for nonunion with no adverse effect to the grafted site. The tibia eventually healed 5 months postplating, and the cosmetic appearance of the newly formed skin was satisfactory.

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