Animal models of vascularized nerve grafts:a systematic review

The aim of this review is to present and compare the various animal models of vascularized nerve grafts described in the literature as well as to summarize preclinical evidence for superior functional results compared to non-vascularized free nerve grafts. We also will present the state of the art on prefabricated vascularized nerve grafts. A systematic literature review on vascularized nerve graft models was conducted via the retrieval with the Pub Med database on March 30, 2019. Data on the animal, nerve, and vascularization model, the recipient bed, the evaluation time points and methods, and the results of the study results were extracted and analyzed from selected articles. The rat sciatic nerve was the most popular model for vascularized nerve grafts, followed by the rabbit;however, rabbit models allow for longer nerve grafts, which are suitable for translational evaluation, and produced more cautious results on the superiority of vascularized nerve grafts. Compared to free nerve grafts, vascularized nerve grafts have better early but similar long-term results, especially in an avascular bed. There are few studies on avascular receiving beds and prefabricated nerve grafts. The clinical translation potential of available animal models is limited, and current experimental knowledge cannot fully support that the differences between vascularized nerve grafts and free nerve grafts yield a clinical advantage that justifies the complexity of the procedure.

Transdermal Nitroglycerine Patch: An Optional Device to Reduce Flap Venous Congestion? A Case Report

Sometimes in free flap there is a venous congestion without an obstruction of the venous anastomosis or other organic causes of reduction venous drainage (haematoma, seroma compressing the pedicle). In these cases the authors suggest the application of nitroglycerine patch in the congested area of the flap few hours before the surgical exploration of the anastomosis. If there is a fast improvement of the clinical feature of the flap, the surgical exploration could be avoided. The authors underline that applying the nitroglycerin patch should not be regarded in any way as a therapy of a free flap venous thrombosis but only as an useful device, an option to be taken only when the surgeon is undecided whether to revisit the anastomosis or not.

面部提升SMAS折叠瓣修复颞部巨大缺损：再造外科与美容外科的交汇

背景颞区巨大缺损可以采用皮片、带蒂或游离瓣修复重建。但由于皮片移植形似补丁、局部可用的组织瓣缺乏以及游离瓣与周围皮肤色差较大的原因，致使这些方法的效果不尽人意。本文应用浅表肌肉腱膜系统（SMAS）折叠术以局部皮瓣修复颞区巨大缺损，拓展了面颈部皮瓣的应用范围。方法颞区缺损手术切口采用面部提升术手术切口，以便组织瓣的提升。荷包缝合使SMAS瓣折叠，

重新讨论锁骨上区的血管解剖学：游离锁骨上穿支皮瓣的可行性

背景锁骨上皮肤已被广泛的研究，并在面部和颈部再造术中作为带蒂皮瓣使用。锁骨上皮肤作为游离皮瓣的使用不像带蒂皮瓣那么广泛。作者对锁骨上区实施了解剖研究，目的是评估获得供区瘢痕位于锁骨上折痕处的游离锁骨上皮瓣的可行性。本文描述了作者的解剖研究和初步的临床应用结果。方法对25例（巴黎笛卡尔大学15例新鲜尸体，利用彩色乳胶注射；因斯布鲁克医科大学10例甲醛溶液固定，不注射）尸体进行解剖研究，分析游离锁骨上穿支皮瓣的血管化和可行性。皮瓣用于巴勒莫大学整形外科的2例患者，1例面部修复术，1例癌症切除后口内修复术。结果在锁骨上区域平均发现4个来自颈横动脉的穿支。静脉穿支流人表浅静脉丛，而非颈横动脉的并行静脉。2例皮瓣均成功移植。结论锁骨上皮肤的血管化依赖来自颈横动脉的皮肤穿支，并流人表浅静脉丛。以这些血管为基础，游离的锁骨上皮瓣可安全获取，瘢痕隐藏在锁骨上折痕处。此皮瓣的初步临床应用取得满意效果，提示临床应用的可能性。