Skin Coverage Considerations in a Mutilating Hand Injury.

The foremost goal of managing a mutilated hand is provision of adequate skin coverage. The most suitable method is free tissue transfer. The specific role of volar surface requires replacement tissue to have similar texture for aesthetically satisfactory and functionally acceptable outcomes.

Challenges in fingertip replantation.

Fingertip amputation is a challenging injury to manage. Among various reconstructive procedures, replantation results in superior outcome, but is seldom considered in many institutions. From the identification of vessel ends to reanastomosis of the submillimeter vessels, fingertip's highly specialized anatomy requires technical excellence.

The radial artery superficial palmar branch flap: a modified free thenar flap with constant innervation.

The free thenar flap is useful for coverage of volar finger defects but has an inconstant innervation based on the presence of either the lateral antebrachial cutaneous nerve (LABC) or the superficial sensory branch of the radial nerve (SSRN). A detailed anatomic study on 30 adult fresh frozen cadavers preinjected with silicone rubber compound to demarcate arterial anatomy documented locations, numbers, and diameters of arteries and skin perforators with surrounding nerves. The palmar cutaneous branch of the median nerve (PCMN) was present within the flap in all cases.

Involvement of protein kinase A in nitric oxide stimulating effect on a BK(Ca) channel of human dermal fibroblasts.

We reported previously that a large-conductance Ca2+-activated K+ (BK(Ca)) channel constitutes a significant fraction of the K+ current in human dermal fibroblasts, and that nitric oxide (NO) increases the open-channel probability (NPo) of BK(Ca) channels via a soluble guanylate cyclase (sGC)/cyclic guanosine monophosphate (cGMP)/protein kinase G (PKG) pathway. The purpose of this study was to investigate whether the adenylate cyclase (AC)/cAMP/protein kinase A (PKA) pathway may also be involved in NO action on BK(Ca) channels in human dermal fibroblasts. Electrophysiological single-channel recordings were performed on fifth-passage cells of human penile skin cultures.