The Effect of Modified Postoperative Treatment on Finger Replantation Survival Rate

Objective:To explore the clinical effect of modified treatment after finger replantation and its impact on the survival rate of replantation.Methods:The research was conducted from March 2022 to March 2023.A total of 58 patients who underwent finger replantation at our hospital were selected.These patients were divided into two groups using the digital table grouping method:the research group(n=29)and the control group(n=29).Patients in the control group received standard treatment following finger replantation,while patients in the study group received modified treatment after the procedure.The incidence of vascular crisis and the survival rate of replantation were compared between the two groups.Results:The incidence of vascular crisis in the study group was lower than that in the control group(P<0.05);the replantation survival rate in the study group was higher than that in the control group(P<0.05).Conclusion:Modified treatment after replantation of severed fingers can reduce the incidence of vascular crisis replantation and improve the survival rate of replantation,so it should be popularized and applied in medical institutions.

Evaluation of sensory function and recovery after replantation of fingertips at ZoneⅠin children

Sensory function is the most significant criterion when evaluating the prognosis of replanted fingers. Current clinical research has focused on surgical techniques and indications for finger replantation; however, few studies have focused on recovery of finger sensory function af- ter replantation. This study retrospectively assessed data of eight patients who had undergone nine Zone I replantations of the fingertips in the First Affiliated Hospital of Sun Yat-sen University of China from July 2014 to January 2016. Variations in the extent of damage, with the residual vessels or nerves in some fingers being too short or even missing, prevented tension-free suture repair in some patients. Thus, re- pair of four of the nine fingertips included arteriovenous anastomosis, the remaining five undergoing arterial anastomosis during replanta- tion of the amputated fingers. Three patients underwent nerve repair, whereas the remaining six cases did not. Fingertip replantations were successful in all eight patients. Compared with the patients without vascular anastomosis, no obvious atrophy was visible in the fingertips of patients who did undergo vascular anastomosis during replantation and their sensory function did recover. Fingertip replantation pro- vides good sensory function and cosmetic outcomes when good artery and vein anastomoses have been created, even when digital nerves have not been repaired.

Intentional replantation combined root resection therapy for the treatment of typeⅢradicular groove with two roots:A case report

BACKGROUND A radicular groove is an anatomic malformation that usually initiates at the central fossa,extending along the root at varying lengths and depths and predisposes the involved tooth to a severe periodontal defect.Severe grooves that extend to the root apex often lead to complex combined periodontal-endodontic lesions.They are a serious challenge for doctors to diagnose and treat.CASE SUMMARY In this report,we described a patient with a maxillary lateral incisor with a deep palatogingival groove with two roots,which led to complex combined periodontal-endodontic lesions.Suggested treatment modalities included curettage of the affected tissues,elimination of the groove by grinding and/or sealing with a variety of filling materials,and surgical procedures.In this case,a combination of endodontic therapy,intentional replantation,and root resection were used,which resulted in periodontal/periradicular healing after 12 mo.CONCLUSION Intentional replantation and root resection offer a predictable procedure and should be considered a viable treatment modality for the management of palatogingival grooves,especially for two-rooted teeth.

Supermicroscopy and arterio-venolization for digit replantation in young children after traumatic amputation: Two case reports

BACKGROUND To report the application of supermicroscopy combined with arterio-venolization without venous anastomosis for replantation of digits following traumatic amputation in young children.CASE SUMMARY In March 2016,we treated two children aged 2 years and 7 years with traumatic digit amputation,no venous anastomosis,and bilateral digital inherent arteries on the palmar side.Supermicroscopy combined with an arteriovenous technique was adopted to improve the replantation surgery.Postoperative management involved auxiliary treatments such as anticoagulation,composure,antiinflammatory drugs,and insulation.After treatment,the amputated fingers survived completely without major complications,with good recovery.CONCLUSION Supermicroscopy combined with arterio-venolization is a safe and effective approach to treat traumatic digit amputation in young children without venous anastomosis.

Management of type IIIb dens invaginatus using a combination of root canal treatment,intentional replantation,and surgical therapy:A case report

BACKGROUND TypeⅢb dens invaginatus(DI)with a lateral canal located at the mid-third of the root is rarely reported.Here,we report a rare case of typeⅢb DI in the left upper anterior tooth with a lateral canal that led to persistent periodontitis.CASE SUMMARY A 15-year-old female patient presented with a chief complaint of pain associated with recurrent labial swelling in the area of the left anterior tooth.A diagnosis of typeⅢb DI and chronic periodontitis was made.Intentional replantation was performed after conventional endodontic treatment failed.After 6 mo,the patient was asymptomatic,but a sinus tract was observed.Cone-beam computed tomography images showed bone loss in the mesial of the mid-root.Based on methylene blue staining and microscopy images,the lateral foramen located at the middle third of the root was surgically treated.After 3 years of follow-up,the clinical findings and radiographic assessment presented a favorable prognosis of bone healing without root absorption or ankylosis.CONCLUSION TypeⅢb DI with a lateral canal can be successfully treated by root canal treatment,intentional replantation,and surgical therapy.

Clinical Investigation and Experience with Distal phalanx Replantation

Objective： To explore the measures and methods for improving distal phalanx replantation. Methods： One hundred and forty-eight cases with distal phalanx replantation from Sep 2004 to Sep 2007 were investigated. The indication for surgery and the operative program was determined by the trauma type and the degree of injury. As many microcirculation pathways as possible were reconstructed during the operation, and postoperative tissue decompression was also performed. Results： The survival rate of distal phalanx replantation was 89.9% （169/148）. Conclusion： To improve the survival rate of distal phalanx replantation it is essential to reconstruct an effective local blood circulation, determine the degree of injury in cases with ecchymosis, and employ comprehensive postoperative measures.

Mechanism of the inhibition of neuroma formation by autogenous nerve replantation in situ after amputation in rabbits

Two experimental patterns of autogenous nerve replantation in situ and centrocentralnerve suture were performed on the rabbit median and ulnar nerves.The results of light andtransmission electron microscopy as well as immunohistochemistry showed that autogenous nervereplantation in situ could inhibit the formation of neuroma.The mechanism might be that twoproximal stump axons could touch within the interpolated graft segment.Simple end-to-endnerve suture failed to inhibit neuroma development because of a lack of proper environment forthe touching between two proximal stump axons.

Two-stage transcrestal sinus floor elevation-insight into replantation: Six case reports

BACKGROUND Transcrestal sinus floor elevation(TSFE)has been widely used in the oral clinic when the residual bone height(RBH)exceeds 5 mm.However,when there is insufficient RBH in the posterior maxilla,two-stage TSFE may be an option.CASE SUMMARY This article introduces the concept of two-stage TSFE.Six patients had osseointegration failure after TSFE.For the first-stage surgery,we restricted the vertical bone augmentation as much as possible.At the second-stage surgery,the increased RBH was 3.28±1.55 mm,which was beneficial for surgery.Five implants functioned successfully on schedule,but one implant failed again during the healing period.A third surgery was performed,and the implant functioned successfully.CONCLUSION When RBH was less than 5 mm,two or more procedures of TSFE might result in a higher RBH.

Using the parietal branch of superficial temporal vessels:A good approach to total ear replantation

Although ear reconstruction is a mature procedure,emergency microsurgical replantation has still been regarded as the optimal treatment for ear amputation due to its cost-effectiveness and aesthetically pleasing results.Successful microsurgical ear replantation is rare because of the difficulty in identifying suitable vessels for anastomosis.We describe two cases of total ear microsurgical replants using the parietal branch of the superficial temporal vessels(STV)as the recipient vessels.The STV parietal branch was dissected up to a sufficient length after thorough debridement,and the amputated ears were revascularized using end-to-end anastomosis.Our experience shows that the parietal branch of the STV is an ideal recipient vessel option for total ear replantation.

Replantation of the amputated complex mass of fingers.

Objective To study the replantation methods of the amputated complex tissue mass of fingers. Methods Nine cases were replanted using the routine method and the artery-vein bridge grafting method respectively. Results All 9 cases survived. At 1 year postoperation, the length of the replanted finger was comparable to that of the healthy side with satisfactory appearance. The average finger function increased 30% when compared with pre-operation one. Conclusion For the amputated complex tissue mass of fingers, routine replantation should be carried out if there was one or two digital proper arteries. If a defect was present, the artery-vein bridge grafting method was chosen accordingly. 5 refs,2 figs.

Efficacy evaluation for the treatment of unstable lumbar disc herniation by traditional and modified lamina osteotomy replantation

Background The traditional lamina osteotomy replantation method is prone to nerve root injury and low back pain recurrence. Our team has proposed a modified approach that improves the osteotomy site and its fixation procedure. The aim of this study was to evaluate the clinical efficacy of traditional and modified lamina replantation methods in treating unstable lumbar disc herniation. Methods From March 2008 to August 2011, 124 patients with unstable lumbar disc herniation were enrolled and randomly divided into the following two groups according to random digital table： group A （traditional group） consisting of 61 patients who underwent traditional laminectomy replantation, and group B （modified group） consisting of 63 patients who underwent modified lamina replantation. Both surgeries were performed by the same surgeons. The two groups had no significant difference in gender, age, symptoms, time of onset and the prominent segment. Visual analogue scale （VAS）, Oswertry disability index （ODI）, and Japanese Orthopaedic Association （JOA） scores, operative time, blood loss, complication rate, radiographic healing rates, and low back pain recurrence rates were compared between the two groups. Results There were 121 patients followed up for more than one year, and the follow-up rate was 97.6%. Nerve injury occurred in two patients （3.3%） in the modified group and 12 patients （20.0%） in the traditional group. Dural injury occurred in one patient （1.6%） in the modified group and seven patients （11.7%） in the traditional group. Pseudarthrosis occurred in two patients in the modified group and in 18 patients in the traditional group with 1-year fusion rates of 96.7% and 70.0%, respectively. Recurrence of lower back pain after one year was noted in three patients （4.9%） in the modified group, and in 15 （25.0%） in the traditional group. Leg pain recurrence was noted in one patient （1.6%） in the modified group and in three cases （5.0%） in the traditional group. The one-year healing rates of nerve injury, dural injury, replantation lamina and low back pain recurrence rates after one year were significantly different （P〈0.05） between the two groups. At two weeks, three months, six months and one year postoperatively, both groups had significant improvement in VAS, ODI, and JOA scores from their preoperative values （P〈0.05）. No significant difference was detected between the short term postoperative scores between groups A and B （P〉0.05）. However, a significant difference was found one year later （P〈0.05）. Conclusions Compared to the traditional approach, the modified technique for lamina replantation showed lower rates of dural and nerve damage, a higher lamina healing rate, a lower back pain recurrence rate, and better clinical scores. It is a safe and effective operation for lumbar spine surgery.

Biochar alleviates apple replant disease by reducing the growth of Fusarium oxysporum and regulating microbial communities

Apple replant disease(ARD)negatively affects plant growth and reduces yields in replanted orchards.In this study,biochar was applied to apple replant soil with Fusarium oxysporum.Our aim was to investigate whether biochar could promote plant growth and alleviate apple replant disease by reducing the growth of harmful soil microorganisms,changing soil microbial community structure and improving the soil environment.This experiment included five treatments:apple replant soil(CK),methyl bromide fumigation apple replant soil(FM),replant soil with biochar addition(2%),replant soil with F.oxysporum spore solution(8×10^(7)spores·mL^(-1)),and replant soil with biochar and F.oxysporum spore solution addition.Seedling biomass,the activity of antioxidant enzymes in the leaves and roots,and soil environmental variables were measured.Microbial community composition and community structure were analyzed using 16SrDNA and ITS2 gene sequencing.Biochar significantly reduced the abundance of F.oxysporum and increased soil microbial diversity and richness.Biochar also increased the soil enzyme activities(urease,invertase,neutral phosphatase,and catalase),the biomass(plant height,fresh weight,dry weight)and the activity of antioxidant enzymes(superoxide dismutase,peroxidase,and catalase).The root indexes of apple seedlings was also increased in replant soil by biochar.In sum,biochar promoted the growth of plants,improved the replant soil environment,and alleviated apple replant disease.

The Utility of the Galea in Scalp Reconstruction

Total scalp avulsion is a time-sensitive, catastrophic injury requiring quick, complex decision-making. Traditionally, these injuries were treated with split-thickness skin grafts. With advancements in microsurgery, treatments evolved to scalp replantation, becoming the standard of care in scalp reconstruction. Although the integrity of the scalp’s blood vessels is pivotal for successful replantation, the authors believe that scalp replantation should be considered at all costs. In the presented case, a 54-year-old female presented to the emergency room following an incident with an auger that completely avulsed her scalp. She was taken back to the operating room, where scalp replantation was performed. Following replantation, scalp necrosis led to serial debridings in the operating room, and eventually, all of the scalp was debrided down to healthy tissue. Surprisingly, the galea survived despite this, which provided a healthy base for skin grafts. Before definitive coverage was placed, it was decided to utilize a bilaminar acellular dermal matrix along with negative pressure wound therapy to create a more robust bed of granulation tissue. After three weeks of this treatment plan, the patient returned to the operating room, where a healthy, viable bed of granulating tissue was revealed beneath the dermal matrix. Split-thickness skin grafts were taken from her thighs bilaterally and sewn together in a quilt-like fashion to cover the wound bed. The entirety of the graft healed without complication except for one small area that required full-thickness skin grafting in an outpatient setting. Even though the replantation ultimately failed, it allowed the galea to survive, which saved the patient from undergoing a free tissue transfer and allowed her scalp to be reconstructed with split-thickness skin grafts. Even in the setting of polytrauma, the authors hope that anyone treating a scalp avulsion would consider scalp replantation at all costs.

Changes in the root system of the herbaceous peony and soil properties under different years of continuous planting and replanting

The herbaceous peony(Paeonia lactiflora Pall.)has high ornamental value.Replanting problems occur when seedlings are replanted into previous holes.We studied the root system and soil environment of the'Dongjingnvlang'variety under a continuous planting regime of one,four,and seven years,and a replanting regime of one and four years.Under the condition of continuous planting,with the increase of number of years,pH,ammonium nitrogen,and nitrate nitrogen decreased in the rhizosphere and non-rhizosphere soils,whereas organic matter,available phosphorus and potassium,enzyme activities,and the number of bacteria,fungi,and actinomycetes increased.Under the condition of replanting,with the increase of number of years,fungi and actinomycetes in both soils increased,while pH,organic matter,nutrients,enzyme activities,and bacterial number decreased.pH,organic matter,nutrient content,enzyme activity and the number of bacterial were lower in soil replanted for four years,whereas the abundance of fungi and actinomycetes was higher,altering the soil from“bacterial high-fertility”to“fungal low-fertility”with increasing years of replanting.The activity of antioxidant enzymes and MDA content in roots of peony in replanting were higher than those in continuous planting,while the content of osmotic regulatory substances in replanting was lower than that in continuous planting.The results showed that there were no obvious adverse factors in soil during seven years of continuous planting,and herbaceous peony could maintain normal growth and development.However,soils after four years of replanting were not suitable for herbaceous peony growth.Benzoic acid increased with years of replanting,which potentially caused replanting problems.This study provides a theoretical basis for understanding the mechanism of replanting problems in the herbaceous peony.

Characterization of the microbial community response to replant diseases in peach orchards

This study attempted to monitor the development of microbial communities and reveal the correlation between the soil microbial community and soil nutrient factors over different years following the replanting of peach trees.The replanted soil(RS)and nonreplanted soil(NRS)were collected from peach orchards with different growth years(1,3,5,7,9,11,and 13 years)in the same region.The soil bacterial and fungal community diversities were analyzed by high-throughput sequencing technology.Redundancy analysis(RDA)was used to show the correlation between the soil microbial community and environmental variables.The alpha diversities of the bacterial and fungal communities indicated that RS contained a higher abundance of bacterial and fungal operational taxonomic units(OTUs)than NRS.NMDS and ANOSIM analyses showed that the soil bacterial and fungal communities were significantly(P<0.01)affected by planting years,and that the main changes occurred in the first and ninth planting years.The presence of the bacterial orders Sphingobacteriales,Burkholderiales and Actinomycetales changed significantly after replanting.Some bacteria associated with bioremediation,such as Burkholderiales and Intrasporangiaceae,and some harmful pathogens,such as Penicillium and Ophiostomatales,significantly increased after replanting(LDA score>3.0).In addition,the soil nutrient contents were lower in RS than in NRS in the early stage(1–5 years),and the RDA showed that bacterial and fungal phyla are closely associated with environmental variables,including the potential of hydrogen(pH),ammonium nitrogen(AN),available phosphorus(AP)and available potassium(AK).These results lead to a deeper understanding of the microbial responses to replanting in peach orchards.

Isolation of phloridzin-degrading,IAA-producing bacterium Ochrobactrum haematophilum and its effects on the apple replant soil environment

We isolated and identified a bacterium that could produce IAA and degrade phloridzin in the rhizosphere soil of healthy replanted apple(the rootstock is M9T337 and the scion is Yanfu 3),providing a theoretical basis for reducing the obstacles associated with apple replant disease(ARD).Isolates were screened using Salkowski colorimetry and screening medium for phloridzin.The isolate of interest(W6)was identified as Ochrobactrum haematophilum based on morphological analysis,physiological and biochemical tests,and 16S rDNA sequencing.In a laboratory experiment,W6 produced auxin and promoted the growth of Arabidopsis thaliana roots,and its degradation rate of 100 mg.L^(-1 )phloridzin was 62.0%.In a pot experiment,W6 significantly reduced the phenolic acid contents of replanted soil,lowered the abundance of the harmful fungus Fusarium solani,and increased soil enzyme activities,thereby improving the micro-ecological environment of replant soil.W6 increased the root antioxidant enzyme activity and leaf photosynthetic pigment content of replanted Malus hupehensis Rehd.seedlings,effectively alleviating the decrease in net photosynthetic rate,transpiration rate and stomatal conductance caused by ARD.In a field experiment,W6 also promoted the growth of replanted apple(the rootstock is M9T337 and the scion is Yanfu 3)saplings.Therefore,W6 can promote apple growth and degrade phenolic acids,and it can be used as an effective treatment for the reduction of ARD.

Maximizing Oil Palm Yield: Innovative Replanting Strategies for Sustainable Productivity

This paper examines the significance of innovative replanting strategies in maximizing oil palm yield while ensuring sustainable productivity.Through a comprehensive review of literature and analysis of current practices,the major findings of this research highlighted the importance of advanced breeding and clonal selection in developing high-yielding and disease-resistant oil palm varieties.Precision agriculture technologies,including IoT devices,drones,and sensors,were identified as critical tools for data-driven decision making,optimizing resource efficiency,and reducing environmental impact.Sustainable land use planning and agroforestry integration emerged as key strategies to balance productivity with environmental conservation.The broader impacts of this work extend to other agricultural sectors and land use planning,offering valuable insights for policymakers and stakeholders to promote responsible and resilient agricultural practices.By embracing innovative replanting strategies,the oil palm industry can contribute to a more sustainable and prosperous future,balancing economic growth with environmental stewardship.Continued research and collaboration are essential to achieve these goals and foster a harmonious coexistence between productivity and sustainability,integrating precision agriculture technologies for resource optimization and reduced environmental impact,promoting sustainable land use planning and agroforestry integration to enhance biodiversity and ecosystem services.Strengthening collaborations between governments,industry players,and research institutions for innovation and knowledge exchange is essential.

Maxillary first molar with an O-shaped root morphology:report of a case

This case report is to present a maxillary first molar with one O-shaped root, which is an extended C-shaped canal system. Patient with chronic apical periodontitis in maxillary left first molar underwent replantation because of difficulty in negotiating all canals. Periapical radiographs and cone-beam computed tomography （CBCT） were taken. All roots were connected and fused to one root, and all canals seemed to be connected to form an O-shape. The apical 3 mm of the root were resected and retrograde filled with resin-modified glass ionomer. Intentional replantation as an alternative treatment could be considered in a maxillary first molar having an unusual O-shaped root.

New approach for the treatment of vertical root fracture of teeth:A case report and review of literature

BACKGROUND Vertical root fracture(VRF)is one of the most common reasons for tooth extraction,although various methods have been applied for saving teeth with VRF.CASE SUMMARY This case report describes a woman who had a sinus tract on the labial gingiva of the left maxillary central incisor for past two months.Periodontal probing revealed an 8–10 mm deep,narrow,isolated pocket on the palatal side of the tooth.Clinical and radiographic examination confirmed a longitudinal root fracture.A new approach using a combination of resin and iRoot BP Plus through intentional replantation was used for the treatment of the tooth.At one-year follow-up,the tooth remained asymptomatic with normal periodontal probing depth,and radiographic images showed almost normal bone and periodontal structures around the root.CONCLUSION This new approach may be developed as an effective method for saving teeth with VRF.

帕瑞昔布钠超前镇痛联合臂丛麻醉对断肢(指)术后镇痛的疗效研究

目的:研究帕瑞昔布钠联合臂丛麻醉对断肢(指)术后镇痛的临床疗效。方法:选择择期进行上肢断肢(指)再植手术的患者60例,按照双盲法随机分为两组:超前镇痛组(30例)为麻醉成功后立即给予帕瑞昔布钠40mg(生理盐水稀释2m L);对照组(30例)给予安慰剂生理盐水2m L作对照,观察两组患者术后PCIA的芬太尼用量、MAP、HR、疼痛(NRS)评分及不良反应发生率。结果:超前镇痛组的芬太尼用量明显低于对照组,镇痛有效率较对照组高,且不良反应发生率显著低于对照组。结论:瑞昔布钠联合臂丛麻醉对断肢(指)术后镇痛在效果和安全性上均有明显的优势。