The"like with like"and the"flap thinning"are two workhorse principles the surgeon must keep in mind to achieve a functional and cosmetic reconstruction of the hand.These principles are underpinned ...The"like with like"and the"flap thinning"are two workhorse principles the surgeon must keep in mind to achieve a functional and cosmetic reconstruction of the hand.These principles are underpinned by a thorough knowledge of anatomy and functional hand units,with a wide range of reconstructive procedures that must be finalized to the necessity of the impaired structures."Like with like"means that a lost tissue must be replaced with another one that can be compared in appearance and function.In addition,good cosmetic is often associated with good function because the complex attempt to get a proper aesthetic always traduces itself into a better functional reconstruction."Flap thinning"is essential because soft tissue injuries of the hand represent a more difficult reconstructive challenge than similar injuries elsewhere,and the need for thin tissue to wrap the superficial noble structures of the hand is constant.However,the procedure of thinning a flap can be dangerous and must adhere to the vascular architecture of the flap.This paper aims to review and briefly summarize the current literature in this field.展开更多
Traumatic injuries resulting in peripheral nerve lesions lead to important morbidity with devastating social and economic consequences.When the lesioned nerve cannot be sutured directly,a nerve graft is generally requ...Traumatic injuries resulting in peripheral nerve lesions lead to important morbidity with devastating social and economic consequences.When the lesioned nerve cannot be sutured directly,a nerve graft is generally required to bridge the gap.Although autologous nerve grafting is still the first choice for reconstruction,it has the severe disadvantage of the sacrifice of a functional nerve.Research in tissue engineering and nerve regeneration may have a dramatic impact on clinical and surgical treatment of such nerve lesions.The authors review the latest concepts in tissue engineering for nerve repair,including scaffold engineering of neural guides,biomaterial modification,cell therapy,growth factors delivery,and electrical stimulation.Recent literature is reviewed in detail,pointing out the most interesting present achievements and perspectives for future clinical translation.Electronic search of the literature was performed using MEDLINE,Embase,and the Cochrane Library to identify research studies on peripheral nerve regeneration through tissue-engineered conduits.The following medical subject headings were used to carry out a systematic search of the literature:“nerve regeneration”,“stem cells”,“biomaterial”,“extracellular matrix”,“functional regeneration”,“growth factors”and“microchannels”.Included literature was published between 1991 and 2014.The reference lists from the retrieved articles were also reviewed for additional articles.In total,76 articles were included in this study.展开更多
文摘The"like with like"and the"flap thinning"are two workhorse principles the surgeon must keep in mind to achieve a functional and cosmetic reconstruction of the hand.These principles are underpinned by a thorough knowledge of anatomy and functional hand units,with a wide range of reconstructive procedures that must be finalized to the necessity of the impaired structures."Like with like"means that a lost tissue must be replaced with another one that can be compared in appearance and function.In addition,good cosmetic is often associated with good function because the complex attempt to get a proper aesthetic always traduces itself into a better functional reconstruction."Flap thinning"is essential because soft tissue injuries of the hand represent a more difficult reconstructive challenge than similar injuries elsewhere,and the need for thin tissue to wrap the superficial noble structures of the hand is constant.However,the procedure of thinning a flap can be dangerous and must adhere to the vascular architecture of the flap.This paper aims to review and briefly summarize the current literature in this field.
文摘Traumatic injuries resulting in peripheral nerve lesions lead to important morbidity with devastating social and economic consequences.When the lesioned nerve cannot be sutured directly,a nerve graft is generally required to bridge the gap.Although autologous nerve grafting is still the first choice for reconstruction,it has the severe disadvantage of the sacrifice of a functional nerve.Research in tissue engineering and nerve regeneration may have a dramatic impact on clinical and surgical treatment of such nerve lesions.The authors review the latest concepts in tissue engineering for nerve repair,including scaffold engineering of neural guides,biomaterial modification,cell therapy,growth factors delivery,and electrical stimulation.Recent literature is reviewed in detail,pointing out the most interesting present achievements and perspectives for future clinical translation.Electronic search of the literature was performed using MEDLINE,Embase,and the Cochrane Library to identify research studies on peripheral nerve regeneration through tissue-engineered conduits.The following medical subject headings were used to carry out a systematic search of the literature:“nerve regeneration”,“stem cells”,“biomaterial”,“extracellular matrix”,“functional regeneration”,“growth factors”and“microchannels”.Included literature was published between 1991 and 2014.The reference lists from the retrieved articles were also reviewed for additional articles.In total,76 articles were included in this study.
