Clinical application of subdermal areolar tissue and superficial fascia graft as a new material for coverage of small exposure of bone cortex or orthopaedic fixation device.

Background: The presence of cortical bone, tendon that has been exposed by defects, may result in infection or osteomyelitis. In such cases, perifascial areolar tissue grafting (PATG) may be performed as a minimally invasive surgical procedure. However, perifascial areolar tissue (PAT) is located deep in the subcutaneous layer.

Syndactyly correction using a venous flap with the plantar cutaneous venous arch.

A combination of skin grafts and local flaps is widely used in the reconstruction of syndactyly of the toes. Covering the skin defect without skin grafts on the unilateral side of the toe is preferred, and for this purpose, a rotated flap from the plantar area is typically used. However, the flap can become ischemic or congested in some cases.

Measurement of vancomycin hydrochloride concentration in the exudate from wounds receiving negative pressure wound therapy: a pilot study.

It has been reported that negative pressure wound therapy (NPWT) is effective in the treatment of contaminated wounds. We hypothesised that systemically administered antibiotics migrate to wound site effectively by NPWT, which provides the antibacterial effect. We measured and compared the concentrations of vancomycin in the exudate and blood serum.

Flexor tendon repair with barbed suture: an experimental study.

Various suture materials have been used for tendon repair. Barbed suture in particular has been demonstrated to be effective for both wound closure and tendon repair. Ten fresh-frozen flexor digitorum profundus tendons of pig were transected and repaired using the two-strand modified Kirchmayr-Kessler technique.

[Aged burn victims: its special features and treatment].

The percentage of aged patients in burns are enlarged today. Usually they have some physiological disorders and less reserve organic functions. In treatment for aged burn victims, special care should be taken to keep their general conditions.

Chronological histological findings of cultured epidermal autograft over bilayer artificial dermis.

The application of cultured epidermal autograft (CEA) over bilayer artificial dermis theoretically should minimize surgical stress and donor site morbidity in severe burn patients. However, CEA over regenerated dermis is very fragile and easily detaches soon after application, because the very weak attachment. We performed chronological histological studies of the wounds of a 29 year-old patient, which was reconstructed using CEA (JACE(®)) and bilayer artificial dermis (Integra™).

The estimation of tissue loss during tangential hydrosurgical debridement.

The preservation of healthy tissue during surgical debridement is desirable as this may improve clinical outcomes. This study has estimated for the first time the amount of tissue lost during debridement using the VERSAJET system of tangential hydrosurgery. A multicenter, prospective case series was carried out on 47 patients with mixed wound types: 21 (45%) burns, 13 (28%) chronic wounds, and 13 (28%) acute wounds.

Evaluation of pain intensity measurement during the removal of wound dressing material using 'the PainVision™ system' for quantitative analysis of perception and pain sensation in healthy subjects.

Reducing pain caused by the removal of adhesive wound dressing materials is very important in clinical practice and is also one of the factors to consider when choosing dressing materials. A visual analogue scale is the most popular method for assessing pain, but it is subjective and is difficult to evaluate quantitatively or statistically. Recently, a new method for the quantitative measurement of pain intensity using a painless electrical stimulation system, PainVision™, has been developed.

Quantification of the physical properties of keloid and hypertrophic scars using the Vesmeter novel sensing device.

There is still no objective method or reliable device to measure and assess the physical properties of keloid and hypertrophic scars. Using the Vesmeter, we measured the physical properties of keloid and hypertrophic scars, and investigated how their physical properties changed during the process of clinical follow-up. We followed up 11 patients with keloid (n = 6) and hypertrophic (n = 5) scars for 4 months, and measured their physical properties three times over a 2-month period using the Vesmeter.

A case of eyelid paraffinoma that developed after endoscopic sinus surgery.

Paraffin has been used as a liquid prosthesis for medical purposes, and is still the base material in some ointments. However, it sometimes causes foreign-body reaction resulting in paraffinoma. We present a case of paraffinoma in a 64-year-old woman, which occurred in the eyelid after endoscopic sinus surgery for chronic sinusitis.

Anatomical study of the perforators from the ulnar palmar digital artery of the little finger and clinical uses of digital artery perforator flaps.

Our aim was to explore the anatomical features of the cutaneous perforators from the ulnar palmar digital artery of the little finger and to establish the anatomical basis of the ulnar palmar digital artery perforator flap for reconstruction of the ulnar aspect of the palm and fingers. We found that at least one perforator is present between the metacarpophalangeal (MCP) joint and 9 mm proximal to the MCP joint. This finding establishes the anatomical basis of the distal base ulnar palmar digital artery perforator flap for reconstruction of the ulnar aspect of the palm and fingers.

Comparison of Doppler sonography and multidetector-row computed tomography in the imaging findings of the deep inferior epigastric perforator artery.

Background: Multidetector-row computed tomography (MDCT) has been recently introduced to detect the perforator vessels. The aim of this study is to compare the MDCT with Doppler ultrasound and assess the usefulness of the MDCT for the preoperative planning.

Methods: Five healthy adult men were first assessed for the perforators and marked with rubber using the Doppler ultrasound before MDCT was performed.

Perioperative hemodilutional autologous blood transfusion in burn surgery.

It is important to avoid or minimise allogeneic blood transfusion, because of possible alloimmunisation or disease transmission. In burn cases these risks are high, and predonated autologous transfusion is not practical. Perioperative haemodilutional autologous blood transfusion is considered applicable in burn surgery.

An anatomic study of the intermuscular septum of the lower leg; branches from the posterior tibial artery and potential for reconstruction of the lower leg and the heel.

The anatomy of the intermuscular septum (IMS) of the lower leg has been studied in 10 legs of 10 cadavers. The IMS was well developed in the distal half of the lower leg and its vascular supply from the posterior tibial artery was frequently seen at 60mm proximal from the tip of the medial malleolus. We advocate that these anatomical features contribute to clinical applications of the IMS flap.

High-tension electrical injury to the heart as assessed by radionuclide imaging.

To evaluate cardiac complications associated with electrical injury, 7 patients with high-tension electrical injury (6,600 V alternating current) underwent 201Tl and 123I-metaiodobenzylguanidine (MIBG) imaging in addition to conventional electrocardiographic and echocardiographic assessments. Electrocardiography showed transient atrial fibrillation, second degree atrioventricular block, ST-segment depression, and sinus bradycardia in each patient. Echocardiography showed mild hypokinesis of the anterior wall in only 2 patients, but 201Tl and 123I-MIBG myocardial scintigraphy showed an abnormal scan image in 6/7 and 5/6 patients, respectively.