scholarly journals Retrograde Island Flap Bridge Transfer of Adjacent Phalangeal Artery Combined With Vascular Pedicle Tubular Skin Grafting to Repair Finger Pulp Defect

2021 ◽  
Author(s):  
Weibin Du ◽  
Fangbing Zhu ◽  
Qiao Hou ◽  
Shenghu Hong ◽  
Guohua Ren ◽  
...  
Keyword(s):  
Hand Function ◽  
Skin Flap ◽  
Skin Grafting ◽  
Island Flap ◽  
Function Evaluation ◽  
Vascular Pedicle ◽  
Dorsal Branch ◽  
Donor Area ◽  
Functional Exercise ◽  
And Function

Abstract Objective: To investigate the surgical method and therapeutic effect of retrograde island flap bridge transfer of adjacent phalangeal artery combined with vascular pedicle tubular skin grafting to repair finger pulp defect.Methods: From June 2008 to May 2020, 14 patients (16 fingers) with severe contusion of proximal and middle phalangeal body combined with finger pulp defect, and 5 patients (5 fingers) with finger pulp defect more than distal interphalangeal joint were repaired by retrograde island flap bridge transfer of adjacent phalangeal artery combined with vascular pedicle tubular skin grafting. The dorsal branch of digital nerve was carried in the skin flap for anastomosis with the proper nerve at the stump of the injured finger. The donor area was covered with medium thickness skin of abdominal or elbow transverse stripes, and the vascular pedicle was wrapped with tubular skin. The pedicle was severed 16-22 days after surgery. The survival rate and complications of postoperative flaps were observed. The finger function was evaluated by the Michigan functional questionnaire and Dagan functional criteria, and the clinical effect was evaluated. Result: All flaps survived and all patients were followed up for a period of 6 to 46 months. The skin flap of the affected finger was of good texture, and the appearance was naturally not bloated. The two-point discrimination was 7 ~ 11mm, and no obvious complications were observed in the donor area. Evaluation of the Michigan Hand Function Questionnaire: Nineteen patients were satisfied with the overall appearance and function of the hand. Finger joint Dargan function evaluation: excellent in 15 cases, good in 4 cases.Conclusions: It is a safe and effective operation to repair finger pulp defect with the retrograde island flap of adjacent finger artery combined with vascular pedicle tubular skin grafting. the skin flap has the advantages of simple cutting, good texture and concealed donor area, which is convenient for the early functional exercise of the finger body.

scholarly journals Reverse vascular pedicle digital island flap with preservation of the dorsal branch of the digital nerve

2019 ◽  
Vol 6 (1) ◽  
pp. 74-78
Author(s):  
Takeo Osaki ◽  
Tadashi Nomura ◽  
Kazunobu Hashikawa ◽  
Hiroto Terashi
Keyword(s):  
Island Flap ◽  
Vascular Pedicle ◽  
Digital Nerve ◽  
Dorsal Branch

The Osteocutaneous Pedicle Forearm Flap

1985 ◽  
Vol 10 (2) ◽  
pp. 179-182
Author(s):  
IVAN MATEV
Keyword(s):  
Blood Flow ◽  
Radial Artery ◽  
Venous Return ◽  
Skin Flap ◽  
Island Flap ◽  
Superficial Vein ◽  
Vascular Pedicle ◽  
Venous Flow ◽  
Forearm Flap ◽  
Retrograde Blood Flow

Two patients treated by an osteocutaneous radial island flap with retrograde blood flow are described. Rotation of the flap and its distal vascular pedicle by nearly 180 degrees caused no impairment of the arterial flow, but it may interfere with the venous return through the radial veins, as observed in one of our cases. Therefore, it is safer to include in the skin flap an additional vein, suturing it to a superficial vein in the recipient zone, thus ensuring normal venous flow to the flap as well. The purpose of this paper is to present two patients treated by the use of an osteocutaneous radial artery forearm flap.

Application of a Serrated Palmar Promoted Flap to Treat Camptodactyly

2019 ◽  
Vol 9 (9) ◽  
pp. 1250-1253
Author(s):  
Juntao Wang ◽  
Lu Cao ◽  
Yuliang Sun ◽  
Qingjia Xu ◽  
Yidong Cui ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Skin Grafting ◽  
Practical Method ◽  
Lateral Side ◽  
Active Motion ◽  
Minimal Trauma ◽  
Functional Exercise ◽  
Total Active Motion ◽  
And Function

Objective: Most camptodactyly patients require surgical treatment with skin-grafting, but the result remains unsatisfactory. The serrated palmar promoted flap was explored to treat camptodactyly as a new strategy for surgical treatment. We will make a retrospective analysis of the treatment effect after serrated palmar promoted flap. Methods: A total of 12 children (five males and seven females) with camptodactyly, who had a mean age of 5.7 years old, were treated with serrated palmar promoted flaps between 2013 and 2016 in our department. Five children had little finger involvement, while seven children had multiple digital involvement. All patients (20 fingers) received a serrated palmar promoted flap, a zigzag incision was made in the lateral side, and a V-Y flap was designed in the palmar. Then, the abnormal subcutaneous fibrous cords were cut, and the palmar flap was promoted to distal end, accompanied by PDP joint extension. Skin grafting was also performed for some severely contracted fingers. The total passive motion (TPM) and total active motion (TAM) of the proximal interphalangeal joints were preoperatively measured and calculated at each follow-up. Results: At postoperative follow-up 18 months, all flaps survived. All digitals met the cosmetic and function requirement, and the flexion and extension of the digitals were significantly improved. The mean TPM and TAM was 41 and 25 degrees preoperatively, respectively, and 95 and 65 degrees at final follow-up, respectively. One patient exhibited adhesion after surgery, but improved after functional exercise. Conclusion: The application of a serrated palmar promoted flap to treat camptodactyly is a simple and practical method, which results in minimal trauma and good function. This procedure is suitable for patients with moderate-severe contractures.

scholarly journals The Application of Digital Design Combined with 3D Printing Technology in Skin Flap Transplantation for Fingertip Defects during the COVID-19 Epidemic

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Hui Lu ◽  
Hanshu Peng ◽  
Ze Peng ◽  
Dingxi Liu ◽  
Qimei Wu ◽  
...  
Keyword(s):  
3D Printing ◽  
3D Model ◽  
Hand Function ◽  
Skin Flap ◽  
Survival Rates ◽  
Hand Surgery ◽  
Digital Design ◽  
Function Evaluation ◽  
Skin Flaps ◽  
3D Printed

Objective. We aimed to evaluate the advantages of preoperative digital design of skin flaps to repair fingertip defects during the COVID-19 pandemic. We combined digital design with a 3D-printed model of the affected finger for preoperative communication with fingertip defect patients under observation in a buffer ward. Methods. From December 2019 to January 2021, we obtained data from 25 cases of 30 fingertip defects in 15 males and 10 females, aged 20-65 years old (mean 35 ± 5 years). All cases were treated by digitally designing preoperative fingertip defect flaps combined with a 3D-printed model. Preoperative 3D Systems Sense scanning was routinely performed, 3-matic 12.0 was used to measure the fingertip defect area ranging from 1.5   cm × 3.5   cm to 2.0   cm × 5.0   cm , and the skin flap was designed. The flap area was 1.6   cm × 3.6   cm to 2.1   cm × 5.1   cm . CURA 15.02.1 was used to set parameters, and the 3D model of the affected finger was printed prior to the operation. Full-thickness skin grafts were taken from donor areas for repair. Results. No vascular crises occurred in any of the 25 cases, and all flaps survived. The postoperative follow-up occurred over 3-12 months. All patients were evaluated 3 months after operation according to the trial standard of hand function evaluation of the Chinese Hand Surgery Society. The results showed that 20 cases had excellent outcomes (80%), four cases had good outcomes (16%), and one case had a fair outcome (4%). The excellent and good rate was 96%. Conclusions. During the COVID-19 epidemic, fingertip defects were treated with preoperative digital design of fingertip defect flaps combined with 3D printing. Precision design saves surgery time and improves the success rate of surgery and the survival rates of skin flaps. In addition, 3D model simulations improve preoperative communication efficiency, and the personalized design improves patient satisfaction.

Cryogenic Refrigerant Burns: A Rare Occupational Hazard

2020 ◽  
pp. 216507992096553
Author(s):  
Suvashis Dash ◽  
Vamseedharan Muthukumar ◽  
Rajkumar R ◽  
Durga Karki
Keyword(s):  
Exposure Time ◽  
Treatment Plan ◽  
Hand Function ◽  
Skin Grafting ◽  
Burn Injuries ◽  
Air Conditioners ◽  
Burn Center ◽  
Adequate Knowledge ◽  
Treatment Measures ◽  
Burn Depth

Background Cryogenic burns induced by coolant gases used in refrigerators and air conditioners are rarely encountered, despite the wide use of these gases. To date, only a few cases have been reported in the literature. This study examined the occupational circumstances leading to such injuries, relevant injury sites, types of chemicals involved, and treatment measures. Methods This study was conducted in a tertiary burn center in India between March 2015 and March 2019. The demographic details, chemicals involved, and burn regions and characteristics were analyzed. Findings There were 15 burn cases all involving injury to the hand. All injuries were managed initially with dressings and nonoperative management. One patient required anti-edema therapy with limb elevation and fingertip debridement, while another patient required skin grafting. All patients had satisfactory hand function after treatment. Conclusions/Application to Practice Cryogenic burn injuries caused by refrigerants are rare, and their etiology varies considerably. Exposure time is the primary factor that determines burn depth and severity; hence, reducing exposure time is important in first aid. Our findings suggest that after exposure, the patient should be treated in a specialized burn center. Adequate knowledge regarding the pathophysiology of these types of burn injuries and their management is necessary; otherwise, misjudgments in the treatment plan can lead to adverse consequences.

Reconstruction of Tragus and External Auditory Meatus using Remnant Auricle during Microtia Reconstruction

2018 ◽  
Vol 34 (02) ◽  
pp. 227-229
Author(s):  
Yi-gao Hu ◽  
Wei Ding ◽  
Jun Tan ◽  
Xin Chen ◽  
Tao Luo ◽  
...  
Keyword(s):  
Skin Flap ◽  
Skin Grafting ◽  
External Auditory Meatus ◽  
Reconstruction Technique ◽  
External Ear ◽  
Flap Necrosis ◽  
Second Stage ◽  
The Third ◽  
Third Stage ◽  
Thin Skin

AbstractThis article investigates an effective method with which to reconstruct the tragus and external auditory meatus for microtia reconstruction. The external ear was reconstructed using a delayed postauricular skin flap in patients with congenital microtia. After the first stage of delaying the postauricular skin flap and the second stage of otoplasty with ear framework fabricated from autogenous rib cartilage draping with the delayed skin flap, the third stage involved tragus and external auditory meatus canaloplasty. After designing the remnant auricle flap, the lower part was trimmed and the tragus was reconstructed. The upper part was trimmed into a thin skin flap, which was rotated and used to cover the hollowed wound posterosuperior to the tragus so as to mimic the external auditory meatus. If remnant wounds were present, skin grafting was conducted. In total, 121 patients with congenital microtia were treated from March 2010 to March 2016. The reconstructed tragus and external auditory meatus were well formed, and all wounds healed well. No severe complications such as flap necrosis occurred. Six months postoperatively, the morphology of the reconstructed tragus and external auditory meatus was good. Overall, the patients and their families were satisfied. The use of remnant auricle to reconstruct the tragus and external auditory meatus is an effective auricular reconstruction technique.

Functional Evaluation Based on Function Content

1996 ◽  
Author(s):  
Yoshiki Shimomura ◽  
Sadao Tanigawa ◽  
Hideaki Takeda ◽  
Yasushi Umeda ◽  
Tetsuo Tomiyama
Keyword(s):  
Design Process ◽  
Process Modeling ◽  
Process Model ◽  
Function Evaluation ◽  
Functional Evaluation ◽  
Object Modeling ◽  
Design Object ◽  
Design Process Modeling ◽  
And Function ◽  
Integrate Design

Abstract Function is a key concept to integrate design object modeling and design process modeling in design. We here propose the FEP (Functional Evolution Process) model in order to integrate design object modeling and design process modeling. In the FEP model, the model of a design object is evolved through three steps, i.e., function description, function actualization and function evaluation. Function description is the step in which a designer modifies required functions of a design object. Function actualization depicts a process to obtain physical descriptions from functional description. Function evaluation is a process to measure realizability of functions of the design object. However, among other steps, how to treat the function evaluation is one of the most important theme, because evaluation executed by designers is based on subjective, ambiguous and tacit standards. We discuss a methodology for evaluating function and propose the function content that quantifies functions and enables evaluation of functions. The function content is a similar concept of Shannon’s information content and we show an example of functional optimization based on this scheme.

scholarly journals Acupuncture of fascia points to relieve hand spasm after stroke: a study protocol for a multicenter randomized controlled trial

2019 ◽  
Author(s):  
zengqiao zhang ◽  
Wei Feng ◽  
Kun-Peng Li ◽  
Jing He ◽  
Li-Ming Jiang ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Hand Function ◽  
Sham Acupuncture ◽  
Clinical Trial Registry ◽  
Rehabilitation Therapy ◽  
Evaluation Indexes ◽  
Randomized Controlled ◽  
Multicenter Randomized Controlled Trial ◽  
Functional Exercise

Abstract Background: The loss of life ability of patients after stroke is mostly caused by the dysfunction of upper limbs, especially hands. Hand functional exercise is the premise of alleviating hand dysfunction, and the relief of hand spasm is the basis of timely and effective hand functional exercise. Previous clinical observation showed that fascial point needling could effectively alleviate hand spasm immediately after stroke, but further evidence from large sample studies is needed. The overall objective of this trial is to further evaluate the clinical efficacy of fascial point acupuncture on hand spasm after stroke. Methods/design: This multicenter randomized controlled trial will compare the efficacy of fascial point acupuncture versus sham acupuncture and routine rehabilitation therapy in stroke patients with hand spasm. Patients will be randomized to undergo either the fascial point acupuncture or the sham acupuncture or the control (routine rehabilitation therapy). We will recruit 210 stroke inpatients who meet the trial criteria and observe the remission of hand spasm and improvement of limb function after 4 weeks of intervention. The first evaluation indexes are the remission of hand spasm and the duration of spasm remission. The second evaluation indexes are the hand function of affected limbs and the ability of daily living. When the accumulative total number of cases included reaches 120, a mid-term analysis will be conducted to determine any evidence that experimental intervention does have an advantage. Discussion: Our aim is to evaluate the efficacy of fascial point acupuncture in relieving hand spasm after stroke. The results will provide more evidences for the clinical application of this therapy in the future. Trial registration: The trial has been registered at the Chinese Clinical Trial Registry（ChiCTR）on April 9, 2019. Registration number: ChiCTR1900022379 Keywords: Fascia points, Acupuncture, Spasm, Stroke

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