Incidence of flap procedures in the management of burn patients.

Increased survival of burn patients presents opportunities for reconstructive strategies to improve outcomes in management of acute and secondary burn injuries. To assess one such strategy, namely flap reconstruction, we reviewed cases performed during the first 4.5 years of the JMS Burn and Reconstruction Center.

The 'Ten Test': application and limitations in assessing sensory function in the paediatric hand.

Background: The Ten Test, first described in 1997 by Strauch et al., is a simple, rapid, reliable and sensitive method to evaluate hand sensibility in adults. In this study, we validated its use in children.

A case of latissimus dorsi pedicle arising from the lateral thoracic vessels.

The thoracodorsal system represents a versatile, yet reliable system for the harvest of tissues for microsurgical transplantation. Also, the donor vessel anatomy is generally thought to be highly predictable in terms of topography and branching patterns. In this article we describe for the first time the occurrence of a branching pattern during a clinical harvest of the latissimus dorsi muscle flap, previously encountered only in cadaver dissections.

Improvement of full-thickness skin graft survival by application of vascular endothelial growth factor in rats.

The effect of vascular endothelial growth factor (VEGF) on skin graft survival was studied in rats. Models of skin grafting on muscle and periosteum were designed. For the study of skin grafting on muscle model, 32 rats were divided into 4 groups.

Immediate and delayed use of arteriovenous fistulae in microsurgical flap procedures: a clinical series and review of published cases.

In microsurgical flap procedures, creation of an arteriovenous fistula (AVF) is a technique of vein grafting where the vein graft is connected to recipient vessels as a flow-through loop prior to harvest and inset of the flap. Controversy exists whether this technique can be used as a 2-stage procedure with the loop and flap transfer accomplished in sequential operations or if the loop and flap transfer should be performed in a single operation. We performed 12 consecutive 1-stage AVF-flap procedures, with 1 flap failure.

Recipient vessels for microsurgical flaps to the groin and pelvis: a review.

Reconstruction of large defects of the pelvis and groin sometimes requires microsurgical flaps when the otherwise rich supply of local options fails to be sufficient in difficult and complicated cases. Recipient vessels for microsurgical flaps to the groin and pelvis are important elements in planning such procedures. Seven groups have reported pelvis and groin microsurgical flap cases, and their recipient vessels have included the superior and inferior gluteal vessels, the femoral vessels, the deep perforators of the femoral system, the inferior epigastric vessels, intra-abdominal vessels, and interpositional vein grafts to distant recipient vessels.

Muscle flap mass preservation with end-to-side neurorrhaphy: an experimental study.

The authors examined the preservation of rat gracilis muscle flap mass after motor and sensory end-to-side neurorrhaphy. The rat gracilis muscle flap model was designed based on a previous study. Twenty-four Sprague-Dawley rats were divided into three groups.

Vascular endothelium growth factor, surgical delay, and skin flap survival.

Objective: Cytokines may be a mechanism by which surgical delay can increase flap survival. We previously found that preoperative vascular endothelium growth factor (VEGF) administration in the rat transverse rectus abdominis myocutaneous (TRAM) flap could improve skin paddle survival. In this study, we used partial elevation of the rat TRAM flap as a surgical delay to assess endogenous cytokine expression and tissue survival comparable to undelayed TRAM flaps.

Enhancement of rat sciatic nerve regeneration by fibronectin and laminin through a silicone chamber.

In this study, the authors examined the effects of fibronectin and laminin on sciatic nerve regeneration in rats. Sixty-eight Sprague-Dawley rats underwent bilateral sciatic nerve transections and silicone tubulizations, with a 10-mm gap between the proximal and distal nerve stumps. Thirty rats (n=30) received 10 microg of fibronectin injection into the right sciatic nerve chamber, while saline was injected into the left nerve chamber, serving as the control.

Effect of sodium diphenylhydantoin on skin wound healing in rats.

This study evaluated the effect of phenytoin (sodium diphenylhydantoin) on skin wound healing in a rat model. The study was divided into two parts. In part I, 20 mul of phenytoin (10 mg/ml) was subcutaneously injected into the 3-cm dorsal full-thickness incisional wounds of 14 rats on postoperative days 0, 3, and 6.

Effect of vascular endothelial growth factor on rat Achilles tendon healing.

This study evaluated the effect of exogenous vascular endothelial growth factor (VEGF) on tendon healing and regulation of other growth factors in a rat Achilles tendon model. Fifty Sprague-Dawley rats were used. In the experimental group, the left Achilles tendon was transected and repaired with the modified Kessler suture technique, and the right Achilles tendon was transected and repaired with resection of plantaris tendon.

Limited segmental resection of symptomatic lower-extremity lymphodystrophic tissue in high-risk patients.

In obese patients, lymphodystrophic tissue can create large masses that are microscopically indistinguishable from chronic lymphedema. This tissue can be disabling, especially in the lower extremities. The tissue is refractory to conservative therapy and is prone to cellulitis and abscess formation.