There is long-standing debate about sensate versus non-sensate free microvascular flaps among microsurgeons. The principle of connecting not only the vascular supply, but also sensitive nerves, in free tissue transfer...There is long-standing debate about sensate versus non-sensate free microvascular flaps among microsurgeons. The principle of connecting not only the vascular supply, but also sensitive nerves, in free tissue transfer is attractive. However, increased operating time and partial spontaneous innervation led to the common decision to restrict microsurgical tissue transfer to the vascular anastomosis and to leave the nerves ＂untreated＂. Nevertheless, in special cases such as breast reconstruction or extremity reconstruction, the question about sensory nerve coaptation of the flaps remains open. We present our experience with free microvascular tissue transfer for breast and extremity reconstruction and compare the data with previous literature and conclude that most free flap surgeries do not benefit from nerve coaptation.展开更多
in the paper the results of reconstruction of thumb and first matacarpus of 10 cases are reported. All the 10 transplantations were successful and revealed fine recovery of function and appearance.It was considered th...in the paper the results of reconstruction of thumb and first matacarpus of 10 cases are reported. All the 10 transplantations were successful and revealed fine recovery of function and appearance.It was considered that the method of simultaneous removal of the second toe and metatarsus,first web space of the foot and the dorsal pedis flap for reconstruction of thumb and metacarpus to be superior to traditional methods in many aspects.Revascularization by anastomosis between the dorsalis pedis artery and the proximal end of the radial artery and that between the first plantar metatarsal artery and the distal end of the radial artery is effective to overcome ischemia of transplants because of variation of the first dorsal metatarsal artery.展开更多
文摘There is long-standing debate about sensate versus non-sensate free microvascular flaps among microsurgeons. The principle of connecting not only the vascular supply, but also sensitive nerves, in free tissue transfer is attractive. However, increased operating time and partial spontaneous innervation led to the common decision to restrict microsurgical tissue transfer to the vascular anastomosis and to leave the nerves ＂untreated＂. Nevertheless, in special cases such as breast reconstruction or extremity reconstruction, the question about sensory nerve coaptation of the flaps remains open. We present our experience with free microvascular tissue transfer for breast and extremity reconstruction and compare the data with previous literature and conclude that most free flap surgeries do not benefit from nerve coaptation.
文摘in the paper the results of reconstruction of thumb and first matacarpus of 10 cases are reported. All the 10 transplantations were successful and revealed fine recovery of function and appearance.It was considered that the method of simultaneous removal of the second toe and metatarsus,first web space of the foot and the dorsal pedis flap for reconstruction of thumb and metacarpus to be superior to traditional methods in many aspects.Revascularization by anastomosis between the dorsalis pedis artery and the proximal end of the radial artery and that between the first plantar metatarsal artery and the distal end of the radial artery is effective to overcome ischemia of transplants because of variation of the first dorsal metatarsal artery.
