1.Analysis on mycoplasma infection and drug sensitivity of female urogenital tract
Huihai CHEN ; Yan ZHANG ; Lin SHEN
International Journal of Laboratory Medicine 2015;(19):2824-2825
Objective To investigate the incidence and the drug-sensitivity results of mycoplasma infection in genital tract from the gynecological outpatients,in order to provide a laboratory evidence for clinical rational use of drug.Methods The drug sensitiv-ity kit was used for isolation and culture of mycoplasma,reproductive tract secretions samples of 1 067 cases of gynecological pa-tients were collected to do mycoplasma identification and drug sensitivity test.Results In 1 067 samples,the positive rate of myco-plasma were 659 samples,including ureaplasma urealyticum(Uu)positive rate was 72.99%(481/659),mycoplasma hominis (Mh) positive rate was 3.79%(25/659),Uu and Mh positive rate accounted for 23.22%(1 53/659).The drug sensitivity results of 12 kinds of antimicrobial agents showed that single infection Uu was more sensitive to josamycin,doxycycline,minocycline,tetracy-cline,clarithromycin,azithromycin and roxithromycin.Single infection Mh was more sensitive to doxycycline,josamycin,minocycline and tetracycline.Mixed infection of Uu and Mh was more sensitive to josamycin,minocycline and doxycycline.Conclusion The main pathogen isolated from patients infected with plasma in our hospital is Uu,whether single Uu or Uu,Mh mixed infection,there are differences in the sensitivity of antimicrobial,clinicians should use drug rationally according to the conditions of patients and drug sensitivity results to reduce drug resistance rate.
2.Clinical efficacy of different flaps for repairing soft tissue defects of heels
Hongxiang ZHOU ; Tao ZHOU ; Mingming MA ; Junjie LI ; Jiehao ZHOU ; Tao NING ; Yongbing FU ; Huihai YAN
Chinese Journal of Trauma 2017;33(8):750-755
Objective To evaluate the clinical outcomes of different flaps for repairing the soft tissue defects of heels.Methods A total of 26 patients with soft tissue defects around the heel treated modified propeller perforator flap,medialis pedis flap,or anterolateral thigh flap from March 2012 to June 2016 were analyzed retrospectively.There included 19 males and 7 females,aged 4-64 years (mean,38.1 years).There were 9 patients with posterior heel defect,3 with weight-bearing defect,6 with posterior medial defect and 8 with posterolateral defect.The wound areas were from 6.0 cm × 4.0 cm to 12.0 cm × 9.5 cm,while the flap areas were from 7.0 cm × 5.0 cm to 13.5 cm × 10.5 cm.According to the principle of flap selection,the pedicled skin flap instead of free skin flap was selected in order to minimize damage to the donor site area.Modified propeller perforator flap was applied in 13 patients,medialis pedis flap in 3 patients and anterolateral thigh flap in 14 patients.The flap donor site was directly sutured in 23 patients and a simultaneous skin graft was applied in 3 patients.The survival rate,appearance,texture and feeling recovery of flaps,complications,walking ability,and the status of donor sites were compared.Besides,postoperative functions of all cases were estimated according to foot scoring scale of American Orthopaedic Foot and Ankle Society (AOFAS).Results All flaps survived well in 26 patients.The wounds of flaps and flap donor sites were healed at Ⅰ stage.A total of 24 patients were followed up for 12-36 months (average 16 months).The appearance,color and texture of the flaps were good.There was no ulcer in flaps or flap donor sites.The protective feeling of flaps was recovered and the feeling of distinguishing two points was 6-13 mm.Modified propeller perforator flap donor site was directly sutured,the wound of which showed a linear healing.There was no fat deformity or obvious scar formation around ankle.The skin graft of the medialis pedis flap donor site was healed well,without scar hyperplasia,rupture,or deformity of arch.The anterolateral thigh flap was healed linearly without scar,and the anterolateral skin felt slightly depressed.The muscle strength of the four biceps femoris muscle was 4.According to AOFAS score,the feet's functions were evaluated as excellent in 5,good in 16,fair in 4,and poor in 1,with excellence rate of 81%.Conclusions For different soft tissue defects of the heels,propeller perforators flap,medial plantar flap or anterolateral thigh flap can not only attain appearance reconstruction of the defects and good functional recovery,but also minimize the injury of flap donor site.
3.Anterolateral thigh perforator flap combined with fascia lata transfer in reconstruction of complex tissue defects of hand or foot
Junjie LI ; Wei JIAO ; Huihui GUO ; Wei HE ; Bin LUO ; Qiwei SONG ; Mingming MA ; Huihai YAN ; Tao NING
Chinese Journal of Microsurgery 2024;47(4):423-429
Objective:To investigate the clinical effect of anterolateral thigh perforator flap (ALTPF) combined with transfer of fascia lata in reconstruction of complex tissue defects of hand and foot.Methods:From July 2021 to October 2023, 9 patients with complex tissue defects of hand and foot were treated with ALTPF combined with fascia lata in the Department of Orthopaedic Microsurgical Repair and Reconstruction of Fuyang People's Hospital Affiliated to Anhui Medical University. There were 2 males and 7 females with an average age of 28.1 (range, 4-65) years old. Three patients had extensor tendon defects in 6 digits of dorsal hands, 5 had extensor tendon defect in 10 toes of dorsal foot, 1 had a defect of anterior tibial tendon and 1 had Achilles tendon defect in posterior ankles. The sizes of soft tissue defect ranged from 8.0 cm×6.0 cm to 15.0 cm×10.0 cm, and the lengths of tendon defect ranged from 6.0 to 13.0 cm. Preoperative Doppler ultrasound was used to locate the distribution of perforating branches in the anterolateral thigh region. According to the characteristics of wound, ALTPFs and fascia lata were designed and harvested. Fascia lata with an appropriate size of 1.5 cm×8.0 cm-4.5 cm×15.0 cm were taken to bridge the defects of the tendon and the Achilles tendon. The wounds were reconstructed with flaps sized 9.0 cm×6.5 cm-18.0 cm×7.5 cm. Nine fascia lata donor sites and 8 flap donor sites were sutured directly. One donor site was treated with a skin graft of ipsilateral ilioinguinal region. The survival and complications of the flaps and donor sites were observed through outpatient follow-up visits, WeChat reviews and home visits, etc. The hand function was assessed according to the Evaluation Standard of Upper Limb Functional of Hand Surgery of Chinese Medical Association, and the foot and ankle function was assessed according to the Mazur score standard of joint range of motion and motor function.Results:All patients were included in follow-up for 4-24 (mean, 13.4) months with complete clinical data being collected. All 9 ALTPFs survived and healed primarily. A linear scar left in donor sites in 8 patients, and mild lamellar scar at skin graft in 1 patient. Texture and colour of the flaps were similar to the surrounding tissue without secondary flap thinning surgery. Combined with postoperative rehabilitation training, satisfactory function recoveries were achieved. Hand function of 3 patients were evaluated according to Evaluation Standard of Upper Limb Functional of Hand Surgery of Chinese Medical Association, 2 patients were excellent and 1 was good. Ankle and foot functions in 6 patients were evaluated according to the range of motion of ankle and foot and Mazur score standard for motor function, 4 patients were excellent and 2 were good.Conclusion:ALTPF combined with fascia lata transfer can reconstruct the complex tissue defects of hand and foot. Of which, 1 donor site can meet the requirements of 2 types of tissues reconstruction at the same time, and with minimal damage to the donor site as well as an precise reconstruction of the recipient site. It avoids staged surgery, shortens the treatment time and reduces the cost of treatment.