End-to-end and end-to-side neurorrhaphy between thick donor nerves and thin recipient nerves: an axon regeneration study in a rat model.

During nerve reconstruction, nerves of different thicknesses are often sutured together using end-to-side neurorrhaphy and end-to-end neurorrhaphy techniques. In this study, the effect of the type of neurorrhaphy on the number and diameter of regenerated axon fibers was studied in a rat facial nerve repair model. An inflow-type end-to-side and end-to-end neurorrhaphy model with nerve stumps of different thicknesses (2:1 diameter ratio) was created in the facial nerve of 14 adult male Sprague-Dawley rats.

Repair of a huge vesicocutaneous fistula with the rectus femoris musculocutaneous flap and VAC.

Adequate drainage is a prerequisite for closing a vesicocutaneous fistula, but the continued exposure to urine makes this impossible. Here, VAC was successfully used as a preoperative therapy before flap transplantation.

Breast reconstruction using tissue expander and TRAM flap with vascular enhancement procedures.

The transverse rectus abdominis myocutaneous (TRAM) flap can create a good breast shape, however, the patchwork-like scar obviously shows that the breast has been reconstructed. To reconstruct a breast without the patchwork-like appearance, we used a two-stage procedure using a tissue expander before transplanting a de-epithelialised TRAM flap. In addition, to avoid fat necrosis and resorption in a large TRAM flap, we performed two vascular enhancement procedures, surgical delay and supercharging microvascular anastomosis.

Combination of hypoglossal-facial nerve jump graft by end-to-side neurorrhaphy and cross-face nerve graft for the treatment of facial paralysis.

The cross-face nerve graft and the interpositional jump graft were performed simultaneously for 13 patients with facial paralysis. The period between the onset of paralysis and surgery ranged from 3 to 32 weeks. In nine patients, surgery was performed within 3 months of the onset of paralysis.