Objective: To demonstrate the advantages of performing medial sural artery perforator flap compared with forearm flap. Methods : Between April 2010 and April 2011, 20 clinical cases were reconstructed using the medial sural artery perforator flap technique and compared with 20 forearm flap cases. Data on recent complications (in 2 weeks) and late complications (after 3 months) were collected. Results : Of the 20 medial sural artery perforator flaps, Only 1 case needed a skin graft, while 19 cases were primarily closed, and 1 case occurred muscle necrosis. Only linear scar was found in the postoperative donor area, and the effect on appearance and function was slight. Of the 20 forearm flaps, all cases needed a skin graft. For the recent complications, 3 cases of effusion under the skin graft, 2 cases of partial necrosis and 2 cases of wound dehiscence were observed. For the late complications of the forearm, 16 cases of an abnormal sensation were observed in the forearm group and 5 cases of an abnormal sensation were observed in the medial sural artery perforator flap group, and these differences were statistically significant (P <0.05). Significant differences were not observed in the other subjective contrasts(P >0.05). Scarring and pigmentation were much more serious in the forearm cases than the medial sural artery cases (P <0.05), and significant differences in the functional objective examination results were not observed between the two groups (P >0.05). Conclusion The medial sural artery perforator flap represents a good alternative for oral and maxillofacial reconstructions of small- and medium-sized defects, and it presents advantages over the forearm flap since it has less donor-site morbidity.

BACKGROUNDThe clinical applications of fibrin glue span over several surgical modalities. The aim of this study was to evaluate the biocompatibility and biodegradation of different formulations of platelet-rich fibrin glue in vivo and examine its effects on the neovascularization of wound sites.

METHODSHuman-derived single-unit fibrin glue was prepared. Incisions were made on the backs of rats, and these were coated with homemade glues containing different concentrations of aminomethylbenzoic acid (Groups A-F) or commercial adhesives (Group G). A sham control group was included (Group H). The wounds were examined by histological analysis and immunohistochemistry at several time points.

RESULTSSuccessful wound closure was achieved in all groups by day 12. Acute inflammation occurred during the first six days, but gradually disappeared. The longest sealant duration was achieved using the lowest concentration of anti-fibrinolytic agent in a 1:10 volume ratio with cryoprecipitate. Expression levels of the platelet endothelial cell adhesion molecule-1 were significantly higher in Groups A and C compared to the control groups (Groups G and H) on day 3 (P < 0.05).

CONCLUSIONSSingle-unit platelet-rich fibrin glue has excellent biocompatibility and is associated with the upregulation of neovascularization. The addition of aminomethylbenzoic acid could prevent the degradation of fibrin glue.

Animals ; Female ; Fibrin Tissue Adhesive ; adverse effects ; therapeutic use ; Humans ; Immunohistochemistry ; Platelet Endothelial Cell Adhesion Molecule-1 ; metabolism ; Rats ; Rats, Sprague-Dawley ; Wound Healing ; drug effects