Effect of Pentoxifyiline on necrosis rate and hemorrheology of free flap

Objective To investigate effect of Pentoxifylline on free flap. Methods Forty Wistar rats were chosen as experimental models and free flaps were harvested from the back of rats,which as pect ratio was 3: 1. Then they were divided into two groups randomly. Group A was as the experimental group,receiving drug treatment.

Study on Different Types of Skin Flap Transplantation to Repair Forefoot Damaged Injury

Objective To investigate the clinical effect of different types of skin flap transplantation in repairing forefoot lesion.Methods From January 2016 to June 2019,62 patients with forefoot damage were selected and their clinical data were retrospectively analyzed.All the selected patients received skin flap transplantation and repair,of which 26 patients received free myocutaneous flap transplantation and repair,and were treated as group A.The other 36 patients underwent retrograde foot flap transplantation and repair.They were taken as group B,and the clinical treatment methods and curative effects were summarized.Results Among the 26 patients in group A,the skin flaps of 21 patients survived completely,while those of the other 5 patients showed partial necrosis at the edge of the skin flaps.They were treated with free skin grafting and healed after regular dressing change.All the skin flaps survived.Follow-up for at least 6 months showed that 11 patients had mild claudication and skin flap sensation was slightly poor.Among the 36 patients in group B,only 2 cases suffered from distal partial necrosis after the operation,which was caused by large tension after dorsum pedis flap transplantation.After systematic treatment and regular dressing change by doctors,the flaps of 2 patients healed.In addition,venous reflux disorder occurred in 3 patients with medial saphenous nerve nutrient vessel flap of the foot,which was related to swelling factors.The flaps of other patients survived,healed well and did not show infection symptoms.Conclusion According to the actual condition of patients with forefoot damage,the flap repair method is formulated,which has good short-term and long-term therapeutic effects and plays an important role in repairing forefoot damage.

Origins and Recovery from Superinfections and Soft Tissue Necrosis

The aim of the study was to gather further information regarding the reasons for superinfections and soft tissue necrosis, and to compare them with common gingivitis and periodontitis. A further aim is to see if there are differences in the recovery from these diseases which all are associated with microorganisms. The information was gathered retrospectively from 250 patients and altogether 4022 visits to a specialist. The material was chosen randomly according to the first letter of the patient’s surname, among the 250 patients that were selected. The treatments of 155 patients took place between 1987-2016. The treatment of some patients had started earlier, but the controls had been continued for a long time after 1987. The examinations have been clinical, microbiological, and based on anamnesis, roentgenograms and histopathological examinations. The follow-up time was between 1 to 40 years. The patients who had periodontitis or superinfection were treated in the same way. Antibiotic therapy was prescribed for recurring infections, or if the patient had a difficult disease. In periodontal-endodontic infections, root canals were treated. Periapical lesions were surgically treated. Both periodontitis and superinfections occurred predominantly in the age group between 41 and 60 years. Narcotic- or snuff-addicts were not included in the material, nor were alcoholics, although 6 patients did report moderate use of alcohol. Diseases and other infections had been treated both in patients with periodontitis and in the superinfection group. Oral symptoms were the same, except that the superinfections were violent. The difference in diagnosis was based on the anamnestic information of the antibiotics which induced the acute reaction, on the clinical and microbiological studies. The patients had received 12 different antibiotics, from which 10 induced superinfection. Extraction of teeth did not prevent normal infection, nor superinfection. The infections appeared as ulcers, white coverings or the flush of mucosa, and if the teeth remained, gingival pockets were purulent. The found micro-organisms were yeasts, mould, bacteria, also periodontopathogens. In the superinfection group, some multiply resistant organisms were found. The prognosis of the treatment was good both for patients with periodontitis and superinfection. Flap necrosis is a local, rare surgical complication, in which one factor is superinfection. Incorrect treatment of soft tissue did not lead to flap necrosis in this study. Superinfection is a different disease to periodontitis or gingivitis, because it is induced by antibiotics, and it is linked with multiply resistant microorganisms that are not sensitive to the antibiotics used. Normal periodontal, surgical and endodontic treatments are suitable for patients with periodontal-endodontic problems or superinfection. Superinfection can be very severe, locally or in the whole periodontium, if the infection is bacterial. When the infection was due to yeasts or moulds, local infection was not found. The recovery prognosis is good both in periodontitis and in superinfection. The connection to other diseases is not clear. Cardiovascular diseases, rheumatoid arthritis, diabetes mellitus, accidents and other infections were in anamnesis both in patients with periodontitis and in patients with superinfection. Patients with urinary tract infections who were prescribed antibiotic treatments were more prone to superinfection. Anyone can contract a superinfection. In a healthy gingival, it appears as ulcers, coverings, flushing or gingival bleeding, whereas in patients with periodontitis, the superinfection is mainly purulent. Endodontic superinfection is also possible.

Chest complications in autologous breast reconstruction

Complications from autologous free flap reconstruction of the breast can present with both common surgical complications and unique complications at the chest recipient site.This review covers complications at the chest recipient site,including chest wall deformity,chronic pain,mastectomy skin flap necrosis,infection,pyoderma gangrenosum,bleeding complications,pneumothorax,chyle leak,and positive internal mammary lymph node metastasis.

Management of post-operative complications in open ventral hernia repair

Hernia repair is the most common general surgical procedure performed in the United States;however,historically,there has been a surprising lack of consensus regarding hernia complications and their management.The development of international,prospectively-collected databases such as the Americas Hernia Society Quality Collaborative has introduced a new era of evidence-based practice around the prevention and management of these complications.This review seeks to equip surgeons with evidence-based techniques for prevention and management of the most common complications of open ventral hernia repair.