OBJECTIVETo evaluate the result of subdermal vascular network skin flap raised from the upper arm to interchange with a facial skin flap carrying a scar resulted from previous burn.

METHODSA transit flap was designed in the anterior medial aspect of the upper arm according to the reverse design method. The subdermal vascular network flap in the upper arm with length-width ratio less than 1.5:1 was raised with the pedicle located outside of the intermuscular septum of musculus biceps/triceps brachialis. The length-width ratio of the facial scar flap should be less than 1.2:1. The two flaps were cross-grafted to repair the facial wound left by raising the scar flap. The pedicles of the flaps were divided on 14 approximately 15 post-operative days (PODs).

RESULTSThe two flaps survived with satisfactory appearance in 9 patients with this method.

CONCLUSIONInterchange of facial scar flap with subdermal vascular network skin flap from the upper arms could be a new, reliable and effective method for the facial plastic surgery.

Adolescent ; Adult ; Arm ; Cicatrix ; surgery ; Facial Injuries ; surgery ; Female ; Humans ; Male ; Skin ; blood supply ; Skin Transplantation ; Surgical Flaps ; blood supply

This study was undertaken to determine the effect on blood gas determinations of an incomplete purging of the heparinized flush solution from an indwelling arterial catheter and pressure tubing. Arterial blood gases were measured serially after withdrawing 2,4,6,8,10, and 12 ml of flush-blood solution from a 20-gauge radial artery catheter which was connected to one of two kinds of pressure tubing (4-ft and 6-ft Cobe pressure lines). In those samples from the 4-ft Cobe pressure tubing the pH was nearly unchanged in samples 2 thru 6, while the PaCO2, PaO2, actual bicarbonate, and base excess remained approximately constant in samples 3 thru 6. The results of samples taken from the 6-ft tubing were that the pH remained unchanged from samples 3 to 6, and PaCO2, actual bicarbonate, and base excess remained the same from samples 4 onward. PaO2 was unchanged in all sample. In conclusion we suggest that at least 4 ml of blood from a 4-ft Cobe pressure tubing and 6 ml from a 6-ft tubing should be withdrawn prior to arterial blood gas measurements.
Arm/blood supply ; Arteries ; Blood Gas Analysis/instrumentation* ; Catheters, Indwelling* ; Female ; Human ; Male ; Middle Age

No abstract available.
Adolescent ; Adult ; Aged ; Arm/blood supply ; *Exertion ; Human ; *Hypertension ; *Ischemia ; Middle Aged

OBJECTIVETo investigate the effect of chronic endurance exercise on microcirculatory reserve capacity of biceps brachii in Chinese rowers and provide a certain basis for the date standard foundation of monitoring of functional status and the foundation of database of reserve capacity of blood of Chinese rowers.

METHODSEmpty stomach in the morning, 77 rowers from different groups and 24 common health people were noninvasive tested by using PeriFlux System 5000, the test indexes include the microcirculatory reserve capacity and other related indexes of biceps brachii. The test sites of all athletes were the same space in biceps brachii of the right side of body, there was no space differences of all athletes . All athletes were tested in the relatively stable functional status, common people were healthy. The test value included basic values and heating values, put the before and after heating of microcirculatory blood perfusion (MBP) as the microcirculatory reserve capacity.

RESULTSHeavyweight female (198. 97 ± 98. 81) > heavyweight male (183. 45 ± 64. 31) > lightweight male (151. 01 ± 65. 96) > lightweight female(140.53 ± 43.22) > common male people(127.21 ± 56.38) > common female people(103.54 ± 33.41), the microcirculatory reserve capacity of each group athletes were higher than common people, except the comparison between lightweight female and common male people, and there was no significant difference among the different group athletes.

CONCLUSIONChronic endurance exercise can improve the microcirculatory reserve capacity of rowers, especially the heavyweight rowers; the normal value of microcirculatory reserve capacity of heavy weight rowers should be more than 160, and lightweight rowers should be more than 120. There was no significant difference among different sex athletes, if the value of microcirculatory reserve capacity is significant lower than normal, it shows that athletes are in the state of fatigue.

Arm ; Athletes ; Female ; Humans ; Male ; Microcirculation ; Muscle, Skeletal ; blood supply ; Sports

OBJECTIVETo study the anatomy and preparation methods of an improved lateral arm free flap (LAFF) for the future clinical application.

METHODSTwenty-two adult upper extremities from cadavers after injected with red latex through common carotid arteries were used. The course, branches, distribution and variations of the blood vessels and nerves of the improved LAFF were observed. The outer diameters of the vessels were measured.

RESULTSThe mean length of vascular pedicle of the improved LAFF was (14.85 ± 1.28) cm, significantly more than that (5.46 ± 2.60) of traditional LAFF (t = -8.483, P < 0.001). The mean outer diameters of pedicle arteries and veins in the improved LAFF were (2.24 ± 0.66) mm and (2.22 ± 0.52) mm, significantly more than those (1.15 ± 0.21 and 1.26 ± 0.23) in traditional LAFF (t = -8.690, P < 0.001; t = -15.057, P < 0.001), respectively.

CONCLUSIONThe improved LAFF has a longer vascular pedicle and larger artery and vein in diameter than conventional LAFF, and is more suitable for the repair of the small and medium-sized defects of the head and neck.

Adult ; Arm ; anatomy & histology ; Free Tissue Flaps ; blood supply ; innervation ; Humans ; Reconstructive Surgical Procedures ; Skin ; anatomy & histology ; Skin Transplantation

The superficial brachial artery (SBA), a branch of the axillary artery, is one of the most common arterial variations in this area. While it is more vulnerable to accidental arterial injection or injury, it could be useful for the nourishment of a medial arm skin free flap. To analyze the relationship between the SBA of axillary origin and segmental variation of the axillary artery, we dissected 304 arms of Korean cadavers. We found an SBA of axillary origin in 12.2% of cadaveric arms. Unilateral occurrence was detected in 16 cadavers and bilateral in 10. SBAs gave rise to radial and ulnar arteries in the cubital fossa (8.9%), continued in the forearm as the radial artery (2.3%), or ended in the upper arm (1.0%). The SBA ended as ulnar artery was not found in any of the cadavers. The bifurcation of the SBA into the radial and ulnar arteries, presence of an SBA that ends in the upper arm, and the lack of continuation as the ulnar artery are characteristics of SBAs in Korean cadavers.
Arm/*blood supply ; Axillary Artery/anatomy & histology ; Brachial Artery/*anatomy & histology/*physiology ; Cadaver ; Female ; Humans ; Korea ; Male ; Median Nerve/blood supply ; Models, Anatomic ; Radial Artery/anatomy & histology ; Ulnar Artery/anatomy & histology

OBJECTIVETo explore a surgical model of utilizing consecutive free scapular flap and adjacent pedicled flap transfer for repairing massive soft tissue defects on the dorsum of the hand while minimizing the donor site morbidity.

METHODSSix patients with massive soft tissue injuries on the opisthenar and forearm were treated with free scapular flaps. Afterwards, a pedicled flap adjacent to the donor site was transferred to cover the donor site defect by direct closure.

RESULTSAll six free scapular flaps survived without signs of infection. Three adjacent pedicled flaps presented minor signs of insufficient blood flow on the distal apex, which resolved after six weeks with only conservative therapy. All the incisions healed without other complications. At six-month follow-up, the patients regained full shoulder function.

CONCLUSIONWith the assistance of an adjacent pedicled flap, the scapular flap is a highly applicable approach in repairing massive soft tissue defects in the opisthenar. It can achieve positive outcomes in both reconstructive and aesthetic aspects.

Adult ; Arm Injuries ; surgery ; Debridement ; Drainage ; Female ; Hand Injuries ; surgery ; Humans ; Male ; Reconstructive Surgical Procedures ; methods ; Scapula ; blood supply ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; Treatment Outcome

OBJECTIVETo describe an operative method for the repair of electric burn wound in the upper limbs with lateral intercostal perforator-based pedicled flap, and to observe its clinical effect.

METHODSIntercostal artery perforator-based pedicled abdominal flap with the blood supply originating from the lateral perforator branches of the 7th-10th intercostal arteries were used to repair the wounds of 6 patients with burn wounds in elbows, forearm, wrists and palms. The pedicles were (16. 0 cm x 12. 0 cm) - (9. 0 cm x 7.0 cm) in area, and the pedicles were severed 18 to 21 days after the operation. The survival and the appearance of the flaps were observed after operation.

RESULTSThe procedure was easy and safe, and there was reliable and adequate blood supply in the lateral intercostal perforator-based pedicled flap. All the flaps survived in 5 patients, except marginal necrosis (3.5 cm x 2. 0 cm) was found in the distal portion of flap because flap cutting exceeded the paraumbilical line. The appearance was satisfactory after operation.

CONCLUSIONThis flap is suitable for the repair of deep wounds in hands, forearms, and elbows.

Adolescent ; Adult ; Aged ; Arm Injuries ; surgery ; Burns, Electric ; surgery ; Child ; Hand Injuries ; surgery ; Humans ; Intercostal Muscles ; blood supply ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; blood supply ; Thoracic Arteries ; transplantation ; Upper Extremity ; injuries ; Young Adult

Ergotamine-induced limb ischemia is an extremely rare case. We present a case of a 64-year-old man, who developed ischemia on the right upper extremity due to long-term use of Ergot for migraine headache. Angiography revealed diffused, smooth, and tapered narrowing of the brachial artery. The patient was successfully treated with intravenous nitroprusside.
Arm/*blood supply ; *Brachial Artery/radiography ; Ergotamine/*adverse effects ; Humans ; Infusions, Intravenous ; Ischemia/*chemically induced/drug therapy/radiography ; Male ; Middle Aged ; Migraine/drug therapy ; Nitroprusside/administration & dosage

OBJECTIVETo study the influence of actual defect length and gap width of the limbs main artery on the method selection of repairing and reconstruction.

METHODSRetrospective study was carried out for 32 patients with extremity main artery injury from 1996 to 2009, including 30 males and 2 females; 30 adults with an average age of 36 years old ranging from 18 to 51 years, 2 children of 4 and 5 years old respectively. Injured body parts involved axillary artery in 4 cases,brachial artery in 7 cases,radial artery in 2 cases, femoral artery in 4 cases, popliteal artery in 13 cases, posterior tibial artery in 2 cases. Main arterial injury defect gap width of all cases were observed and the reasons were analyzed. All cases were repaired by the method of end to end anastomosis after vessels stretch.

RESULTSThe artery defect width was 3 cm to 7 cm with an average of (4.375 +/- 1.200) cm. Defect width of the upper extremity brachial artery and axillary artery group was (5.73 +/- 0.63) cm,the lower extremity femoral and popliteal artery group (3.80 +/- 0.73) cm, the posterior tibial artery group (3.25 +/- 0.35) cm, the radial artery group (3.00 +/- 0.00) cm. Defect width of upper extremity brachial artery and axillary artery group was larger than that of the other three groups (P < 0.01). End to end anastomosis was performed successfully in all cases. Blood supply recovered well. Because of the severe limb infection 2 patients had amputation in the late. All patients received follow-up. The patients without fracture were followed up to 2 weeks postoperatively, all patients with fractures were followed up to 1 year at least. Limb blood supply was good in all patients during the follow-up.

CONCLUSIONBlood vessel defect gap width is different from the actual vessel defect, but is larger than the actual vessel defect. Misjudgment of the vascular defect length will lead to more vascular transplantation. The vast majority of vascular defect can be directly repaired by the method of end to end anastomosis after the vessel free and stretch.

Adolescent ; Adult ; Arm ; blood supply ; surgery ; Axillary Artery ; injuries ; surgery ; Female ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Retrospective Studies ; Vascular Surgical Procedures ; Young Adult