Objective To report the technique and effect of distally based, cross-leg, anterolateral thigh flap for reconstructing the soft tissue defects in middle and distal thirds of the contralateral leg. Methods Five patients of soft tissue defects in lower legs associated with injuries to the eontralateral legs were treated with distally based, cross-leg, anterolateral thigh flaps of the contralateral limbs. Results After the pedicle division at 6 weeks postoperatively, the 5 flaps all survived. And the blood supply of flaps remained steady when followed up for 12 to 15 months. The flaps possessed favorable contours, and allowed successful secondary repair of injured bones or tendons. The donor sites healed primarily, and no influence was observed to the donor limbs. Conclusion For the soft tissue defects in middle and distal thirds of leg associated with damage to the surrounding tissues and arterial injury of the contralateral leg, cross-leg transplantation of the contralateral distally based anterolateral thigh flap is a good option of reconstruction.

Objective To discuss the effect of the appointment checkup process optimized with the theory of constraints in shortening the appointment waiting time. Methods The patients who underwent ultrasonography, magnetic resonance imaging examination, and CT examinations were selected from the First Hospital of Shanxi Medical University from March 2017 to February 2018. Firstly, we applied the theory of constraints to investigate and analyze the status of medical technology examinations. Secondly, we optimized the process according to the results of the investigation. Finally, we compared the appointment duration of medical examinations before and after the optimization. Results Thanks to support of departments involved, the longest ultrasonography appointment waiting time was reduced from 3. 74 days to 1. 32 days. The longest appointment time for magnetic resonance imaging examination was reduced from 3. 74 days to 1. 33 days. The longest appointment waiting time for CT was reduced from 2. 62 days to 1. 55 days, and the goal of completing the checkup the day after the prescription was reached in the continuous improvement phase. Conclusions The optimization of the medical technology examination appointment process based on the constraint theory can effectively shorten the checkup appointment duration, maximize utilization of medical resources and optimize the services.