A ring avulsion results from a longitudinal traction to a digit. We discuss practical microsurgical techniques essential in achieving good functional outcomes in these challenging cases, including aggressive debridement of the affected tissues and vessels, liberal use of vein grafts and arterialized venous flow through flaps when needed, and a meticulous microsurgical technique. We have found that patient selection is key in digit salvage and a good outcome is often achieved with the winning triad of optimal patient factors, surgical factors, and intensive hand therapy. We also include a case performed by our senior author to illustrate what can be achieved.
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http://dx.doi.org/10.1097/GOX.0000000000003771 | DOI Listing |
Aesthetic Plast Surg
December 2024
J.P. Hospital, Zirakpur, Punjab, India.
Background: Nasal ala defects present significant reconstructive challenges due to their complex anatomy and functional importance. Auricular composite grafts, incorporating both skin and cartilage, are particularly suited for this purpose because they can replace the multilayered structure of the nasal ala in a single surgical procedure, thereby restoring both form and function. Clinical outcomes of these grafts in the reconstruction of ala defects have been highly promising with studies indicating near complete survival rates.
View Article and Find Full Text PDFAnn Chir Plast Esthet
October 2024
Department of Plastic and Reconstructive Surgery, Institut Universitaire Locomoteur et du Sport, Pasteur 2 Hospital, University Côte d'Azur, Nice, France. Electronic address:
Introduction: Complete hand degloving injuries are traumatic avulsion injuries causing the skin to pull away from the underlying tissues and are most often caused by industrial machinery. We present the case of a degloving trauma of the whole fingers, hand, and wrist resulting in a "watch hand" by analogy with the "ring finger" and discuss alternatives and recommendations from the rare cases described of similar traumas.
Case Presentation: A 33-year-old manual worker, a non-smoker with no significant medical or surgical comorbidities, was admitted for a complete skin avulsion of the left hand and wrist following a work-related accident with a trommel-type industrial roller.
Hand Surg Rehabil
September 2024
Department of Plastic and Reconstructive Surgery, Institut Universitaire Locomoteur et du Sport, Pasteur 2 Hospital, Côte d'Azur University, Nice, France.
Introduction: Despite the progress in microsurgery in recent decades, neurovascular bundle defects during ring finger injuries still pose challenges for the surgeon. Usually, a reversed venous graft and a non-vascularized nerve graft are utilized to reconstruct this defect. One of the most common challenges encountered when using a venous graft is the caliber mismatch between the graft and the digital arterial ends.
View Article and Find Full Text PDFSci Rep
July 2024
Shanghai Institute for Minimally Invasive Therapy, School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, 200093, China.
An implantable electrode based on bioresorbable Mg-Nd-Zn-Zr alloy was developed for next-generation radiofrequency (RF) tissue welding application, aiming to reduce thermal damage and enhance anastomotic strength. The Mg alloy electrode was designed with different structural features of cylindrical surface (CS) and continuous long ring (LR) in the welding area, and the electrothermal simulations were studied by finite element analysis (FEA). Meanwhile, the temperature variation during tissue welding was monitored and the anastomotic strength of welded tissue was assessed by measuring the avulsion force and burst pressure.
View Article and Find Full Text PDFOrthop Surg
August 2024
Department of Hand & Reconstructive Microsurgery, Singapore General Hospital, Singapore, Singapore.
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