Introduction: Single or double venous anastomosis in free flap in general and ALT, in particular, is still a matter of debate between micro vascular surgeons. In this study, we will present our experience in single ve...Introduction: Single or double venous anastomosis in free flap in general and ALT, in particular, is still a matter of debate between micro vascular surgeons. In this study, we will present our experience in single vein anastomosis versus double venous anastomosis in ALT perforator flap used in leg and foot reconstruction as regarding flap outcome, complications, operation time and the need for re-exploration. Patient and Methods: We retrospectively evaluate 60 patients with post traumatic foot and leg defects in the period between January 2014 and January 2018 where free ALT flap was done. The patients were divided into two groups, Group 1 where single vein anastomosis was done and Group 2 where double venous anastomosis was done;we utilize the deep venous system for the anastomosis in all cases. Results: Complete flap survival noticed in 56 cases (93.3%), defect size ranged from 70 to 200 cm (mean 126.35 ± 33.78). There was no difference between the 2 groups as regarding Flap survival, hospital stay, flap complications, donner site morbidity and vascular insufficiency. There is statistically significant difference between both groups as regarding Ischemia time, Operation time, and overall re-exploration rate. Conclusions: Our study suggests that the use of a single venous anastomosis in the venous drainage of anterolateral thigh free flaps is as safe and feasible as the two veins anastomoses.展开更多
Diabetes mellitus has become a global health problem,and the number of patients with diabetic foot ulcers(DFU)is rapidly increasing.Currently,DFU still poses great challenges to physicians,as the treatment is complex,...Diabetes mellitus has become a global health problem,and the number of patients with diabetic foot ulcers(DFU)is rapidly increasing.Currently,DFU still poses great challenges to physicians,as the treatment is complex,with high risks of infection,recurrence,limb amputation,and even death.Therefore,a comprehensive understanding of DFU pathogenesis is of great importance.In this review,we summarized recent findings regarding the DFU development from the perspective of single-nucleotide variations(SNVs).Studies have shown that SNVs located in the genes encoding C-reactive protein,interleukin-6,tumor necrosis factor-alpha,stromal cell-derived factor-1,vascular endothelial growth factor,nuclear factor erythroid-2-related factor 2,sirtuin 1,intercellular adhesion molecule 1,monocyte chemoattractant protein-1,endothelial nitric oxide synthase,heat shock protein 70,hypoxia inducible factor 1 alpha,lysyl oxidase,intelectin 1,mitogen-activated protein kinase 14,toll-like receptors,osteoprotegerin,vitamin D receptor,and fibrinogen may be associated with the development of DFU.However,considering the limitations of the present investigations,future multi-center studies with larger sample sizes,as well as in-depth mechanistic research are warranted.展开更多
文摘Introduction: Single or double venous anastomosis in free flap in general and ALT, in particular, is still a matter of debate between micro vascular surgeons. In this study, we will present our experience in single vein anastomosis versus double venous anastomosis in ALT perforator flap used in leg and foot reconstruction as regarding flap outcome, complications, operation time and the need for re-exploration. Patient and Methods: We retrospectively evaluate 60 patients with post traumatic foot and leg defects in the period between January 2014 and January 2018 where free ALT flap was done. The patients were divided into two groups, Group 1 where single vein anastomosis was done and Group 2 where double venous anastomosis was done;we utilize the deep venous system for the anastomosis in all cases. Results: Complete flap survival noticed in 56 cases (93.3%), defect size ranged from 70 to 200 cm (mean 126.35 ± 33.78). There was no difference between the 2 groups as regarding Flap survival, hospital stay, flap complications, donner site morbidity and vascular insufficiency. There is statistically significant difference between both groups as regarding Ischemia time, Operation time, and overall re-exploration rate. Conclusions: Our study suggests that the use of a single venous anastomosis in the venous drainage of anterolateral thigh free flaps is as safe and feasible as the two veins anastomoses.
基金Supported by National Natural Science Foundation of China,No.82172197Guangdong Basic and Applied Basic Research Foundation,No.2022A1515012385Guangdong Provincial Science and Technology Project,No.2020A0505100039.
文摘Diabetes mellitus has become a global health problem,and the number of patients with diabetic foot ulcers(DFU)is rapidly increasing.Currently,DFU still poses great challenges to physicians,as the treatment is complex,with high risks of infection,recurrence,limb amputation,and even death.Therefore,a comprehensive understanding of DFU pathogenesis is of great importance.In this review,we summarized recent findings regarding the DFU development from the perspective of single-nucleotide variations(SNVs).Studies have shown that SNVs located in the genes encoding C-reactive protein,interleukin-6,tumor necrosis factor-alpha,stromal cell-derived factor-1,vascular endothelial growth factor,nuclear factor erythroid-2-related factor 2,sirtuin 1,intercellular adhesion molecule 1,monocyte chemoattractant protein-1,endothelial nitric oxide synthase,heat shock protein 70,hypoxia inducible factor 1 alpha,lysyl oxidase,intelectin 1,mitogen-activated protein kinase 14,toll-like receptors,osteoprotegerin,vitamin D receptor,and fibrinogen may be associated with the development of DFU.However,considering the limitations of the present investigations,future multi-center studies with larger sample sizes,as well as in-depth mechanistic research are warranted.
文摘目的:探究Scarf截骨术与第一跖骨双平面截骨术(Double metatarsal osteotomy,DMO)矫正中重度拇外翻畸形的疗效。方法:随机选取2020年4月-2022年4月于笔者医院就诊且接受DMO治疗的47例中重度拇外翻畸形患者(63患足)纳入对照组,随机选取同期接受Scarf截骨术治疗的51例中重度拇外翻畸形患者(67患足)纳入观察组进行回顾性分析。比较两组患者部分负重和完全负重的时间,评估其术前和术后1个月关节功能[美国足踝协会(American orthopedic foot and ankle society,AOFAS)评分]、形态学指标[拇外翻角(Hallux valgus angle,HVA)、第一跖骨相对长度(Relative length of first metatarsal,RLFM)、第一、二跖骨间角(Intermetatarsal angle,IMA)、关节面固有角(Distal metatarsal articular angle,DMAA)]、疼痛情况[视觉模拟评分(Visual analogue scale,VAS)]的变化,记录两组术后并发症发生情况。结果:观察组部分、完全负重时间显著短于对照组(P<0.05);术后1个月,观察组AOFAS评分、DMAA均显著优于对照组(P<0.05),RLFM、IMA、HVA两组比较差异均无统计学意义(P>0.05);两组术后1个月VAS均明显降低,且观察组低于对照组(P<0.05)。两组并发症发生率比较差异无统计学意义(P>0.05)。结论:Scarf截骨术与DMO均能有效治疗中重度拇外翻畸形,两者形态学改善情况相近,Scarf截骨后能显著缩短患者功能恢复时间。
