Objective To investigate effects of pedicle processing methods on the survival and appearance of the pedicle flaps. Methods The study involved 17 patients with soft tissue defects of extremities treated with the “exclamation mark” shaped pedicle flaps from October 2009 to January 2011.The traditional pedicled rotation flaps was designed to be a tennis racket-like shape,then the rotational pedicle was designed to small round tension reduction flap and pedicled rotation flaps,which contributed to formation of the “exclamation mark” shaped pedicle flaps.The soft tissue defects was located at the upper extremity in three patients and at lower extremity in 14,with defect areas of 4.0 cm× 7.2 cm-5.8 cm × 14.0 cm.There used two superficial radial nerve vasotrophic flaps,one ulnar artery supra-carpal cutaneous flap,eight sural neurocutaneous vasotrophic flaps and six saphenous nerve vasotrophic flaps.Results All flaps survived at Ⅰ stage except that one flap had partial distal necrosis postoperatively,which was cured after dress change.The follow-up ranged from six months to one year,which showed unobvious swelling of the survived flaps and good appearance of the rotation point of the pedicle. Conclusion The “ex(c)lamation mark” shaped pedicle flaps can reduce entrapment of the distal pedicle,promote venous drainage,improve survival and modify the appearance of the flaps.

Objective To explore the effects of reconstruction and shaping of thumb or finger defects by free second-toe transfer and one stage appearance remodeling.Methods From October,2007 to August,2013,128 thumb or finger Ⅴ degree defect of 109 cases were reconstruct with free second-toe transfer,and one stage shape remodeling at the same time.Among them,20 fingers by nail bed expand one stage; 23 fingers were nail bed expand added on toe pulp splayed resection on both sides; 29 fingers were added on embedded the philp island flap of great toe to the section of plantar side narrow part in the second digit,19 fingers were added on embedded the abdominal phil chamfered-edge-shape flap to that narrow part in the second digit,and 37 fingers added on toe pulp resection and embedded the philp island flap of great toe to that narrow part.Results All reconstructed thumb or fingers survived and appearance were good.The nail shape of reconstructed thumb or fingers were improved obviously,the shape of narrow part in middle segment was recovered satisfactorily.Seventy-nine cases (72.5％) were followed-up from 3 months to 5 years,and the other 30 cases (27.5％) were lost.The function of the reconstructed thumb or finger and hand feeling was ideal recovered.There were no claudication,no pain and no other sequelaes for donor foot.According to the Standard on Approval of Reconstructed Thumb and Finger Functional Assessment of Chinese Medical Association,43 cases excellent,26 cases good,10 cases approve.The rate of excellent and good was 87％.Conclusion Second-toe transfer and shape remodeling is a good method of thumb or finger reconstructing.The appearance of the thumb reconstruction can be improved obviously.Preoperative carefully design and the combination of the above several kinds of operation,for draw up an personalized surgical program is necessary.

OBJECTIVETo investigate the traditional VSD from one-way improvement to two-way suction drainage, meet the needs of clinical treatment, and prevent bung tube.

METHODSOne-way multi-side hole drainage tube of the traditional VSD was modified for bi-directional multi-side hole drainage, seaweed salt hydration alcohol polyethylene foam, Semipermeable membrane paste of Polyurethane and acrylic remains the same with that of the traditional VSD.

RESULTSThe applications of bi-directional multi-side hole drainage pipe can reduce the rate of plugging, rinse the complex and infection wound, create a physiological moist healing environment, and promote wound healing.

CONCLUSIONSThe improved VSD can reduce the failure rate and increase the therapeutic effect.

Drainage ; instrumentation ; methods ; Equipment Design ; Suction ; instrumentation ; methods ; Vacuum