In three isolated organs, spleen, cardiac and skeletal muscles, kinetic studies of red cell washout were carried out by using perfusion of the cell-free, oxygenated Ringer's solution. It is found that in each organ there are slow components for red cells to be emptied out from the vascular lumens ranging 30 to 50 minutes as the desaturation half-time. The slowest decay constants (K) are -1.48 X 10(-3) for spleen, -2.33 X 10(-3) for gastrocnemius muscle, and -4.0 X 10(-3) for cardiac muscle.
Animal ; Cats ; Coronary Vessels* ; Erythrocytes/physiology* ; Microcirculation ; Muscles/blood supply* ; Spleen/blood supply*

OBJECTIVETo investigate the clinical application of expanded flap based on cutaneous branch of transverse cervical artery for reconstruction of cervical cicatricial contracture.

METHODSBased on the clinical anatomy of cutaneous branch of transverse cervical artery flap, we design the corresponding subclavicular area for expansion. The incision was usually located at the anterior axillary fold, 5-8 cm in length. The expander was implanted under the deep fascial layer, without injury of the vascular pedicle. Fixation sutures were put about 1 cm apart from the incision to prevent the expander from transposition and exposure. After expansion, the cervical cicatricial contracture was excised and released. According to the defect, the expanded flap based on the cutaneous branch of transverse cervical artery was designed, with the pedicle located at the posterior margin of sternocleidomastoid and 1. 8 cm above median point of clavicle. "S" shape incision was made at the location of vascular pedicle. Subcutaneous dissection was performed 1.5 cm in width along the incision on both sides. Then the flap was harvested under the deep fascial layer and rotated to cover defect without tension. It was not necessary to dissect the vascular pedicle further. The defect at donor site was closed directly.

RESULTS17 cases were treated with the island flap. The contracture of the cervical scar was corrected completely with aesthetic appearance.

CONCLUSIONSExpanded flap based on cutaneous branch of transverse cervical artery has reliable blood supply. It' s an ideal flap for the treatment of cervical cicatricial contracture.

Arteries ; Cicatrix ; surgery ; Clavicle ; Contracture ; surgery ; Dissection ; methods ; Fasciotomy ; Humans ; Neck ; blood supply ; Neck Muscles ; anatomy & histology ; Surgical Flaps ; blood supply

OBJECTIVETo explore the possibility that the free latissimus dorsi musculo-cutaneous flap to repair the forearm leg wound.

METHODSTo design latissimus dorsi musculo-cutaneous flap which is foundation on T form thoracodorsal artery stalk. To set the short arm into the receiver artery break and anastomos them. It is not only reassure the blood of free musculo-cutaneous flap, but also reconstruct the continuation of the receiver main artery.

RESULTSIn 16 patients, 15 patients success completely, 1 patient main success. The blood supply of receiver is adequate.

CONCLUSIONSThe free T form thoracodorsal artery stalk musculo-cutaneous flap free grafting is a good method to repair the skin and soft tissues defection of forearm and leg.

Anastomosis, Surgical ; methods ; Arteries ; Forearm ; Free Tissue Flaps ; blood supply ; transplantation ; Humans ; Leg ; Lower Extremity ; Reconstructive Surgical Procedures ; Skin ; Superficial Back Muscles ; blood supply ; transplantation ; Wound Healing

Strabismus surgery results in the permanent interruption of anterior ciliary blood flow, predisposing the eye to anterior segment ischemia (ASI). A primate model was used to assess the effectiveness of a new muscle-scleral tuck for preserving anterior ciliary artery circulation. The model consisted of removing 3 rectus muscles from both eyes of 2 rhesus monkeys, then performing a tuck on the inferior rectus (IR) right eye while leaving the left IR as a control. Four weeks later, a modified tuck was performed on the virgin left IR. Fluorescein iris angiograms of both eyes were obtained, and preoperative angiograms at 5-15 sec. showed normal 360 degrees perfusion. Postoperative follow-up angiograms showed segmental superior temporal filling defects and preservation of perfusion in the distribution of the IR. Comparison of fellow eyes tucked vs control IR showed no difference in the filling pattern in both monkeys. Comparison of the same eye before and after tuck also showed essentially the same filling pattern in all 4 eyes with preservation of inferior circulation. Our conclusion is that the modified tuck preserves the anterior ciliary blood flow and may be useful as a muscle-strengthening procedure in patients predisposed to developing ASI.
Animals ; Anterior Eye Segment/*blood supply ; Ciliary Body/*blood supply ; Disease Models, Animal ; Fluorescein Angiography ; Follow-Up Studies ; Iris/blood supply ; Ischemia/*prevention & control ; Macaca mulatta ; Oculomotor Muscles/physiology/*surgery ; Perfusion

OBJECTIVETo investigate the effect of vascularized composite flap with iliac crest and nternal oblique muscle of abdomen for half mandibular reconstruction.

METHODSFrom July 2009 to Sept. 2013, 14 cases with half mandibular defect after tumor resection were treated with composite flap of iliac crest and internal oblique muscle of abdomen pedicled by deep circumflex iliac vessels. During operation, one group performed tumor resection and got the recipient area vessels ready for anastomosis. The other group performed harvesting of composite flap. Then the flap was trimmed and fixed to construct the defect with vessel anastomosis.

RESULTSAll the 14 composite flaps survived with local infection only in 1 case. The size of harvested iliac crest ranged from 6 cm x 3 cm to 9 cm x 3 cm. The size of harvested internal oblique muscle of abdomen ranged from 5 cm x 4 cm to 7 cm x 5 cm. The patients were followed up for 6 months to 26 months (mean, 13 months) with satisfactory results and no complication. Mandibular panoramic radiographs showed new bone formation and good union.

CONCLUSIONSVascularized composite flap with iliac crest and internal oblique muscle of abdomen has the advantages of abundant bone volume, as well as soft tissue reconstruction in one stage. The reconstructed mandible can attain normal function and appearance.

Abdominal Muscles ; transplantation ; Abdominal Wall ; Humans ; Ilium ; transplantation ; Mandibular Reconstruction ; methods ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; blood supply ; transplantation

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

OBJECTIVETo evaluate the vascularized (deep circumflex iliac vessels) iliac crest graft with internal oblique muscle as a method for reconstruction of composite mandibular defect.

METHODSVascularized iliac crest graft with internal oblique muscle was used to reconstruct the composite mandibular defects in 10 patients. All clinical data were analyzed retrospectively. A detailed inspection of the case-notes was undertaken to ascertain the presenting diagnosis, the surgery, the complications and the outcome. The type of mandibular defect was recorded.

RESULTSOf the 10 patients with composite mandibular defects including mandibular body, mandibular angle, mandibular ramus and the soft tissue around them, 7 patients were recorded with the defects of mandibular condyles. During the follow-up period from 3 months to 24 months, primary wound healing was observed in all patients, except one patient with minor muscular necrosis. All patients were satisfied with their facial contour and mandibular shape, without tumor recurrence. Donor site problems important enough to be recorded in the notes were minimal.

CONCLUSIONSThe vascularized iliac crest graft with internal oblique muscle offers a useful solution for reconstruction of composite mandibular defect. There is sufficient height and depth of bone to maintain a facial contour and mandibular shape. It can be used as a routine surgical technique to reconstruct composite mandibular defect.

Abdominal Muscles ; transplantation ; Adolescent ; Adult ; Female ; Humans ; Ilium ; blood supply ; transplantation ; Male ; Mandibular Injuries ; surgery ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; Young Adult

OBJECTIVETo investigate the application of pedicled expanded flaps for the reconstruction of facial soft tissue defects.

METHODSThe expanded skin flaps, pedicled with orbicularis oculi muscle, submental artery, the branch of facial artery, superficial temporal artery, interior upper arm artery, had similar texture and color as facial soft tissue. The pedicled expanded flaps have repaired the facial soft tissue defects.

RESULTSBetween Jan. 2003 to Dec. 2013, 157 cases with facial soft tissue defects were reconstructed by pedicled expanded flaps. Epidermal necrosis happened at the distal end of 8 expanded flaps, pedicled with interior upper arm artery(4 cases), orbicularis oculi muscle(3 cases) and submental artery(1 case), which healed spontaneously after dressing. All the other flaps survived completely with similar color and inconspicuous scar. 112 cases were followed up for 8 months to 8 years. Satisfactory results were achieved in 75 cases. 37 cases with hypertrophic scar at incisions need secondary operation.

CONCLUSIONSIsland pedicled expanded flap with similar texture and color as facial soft tissue is suitable for facial soft tissue defects. The facial extra-incision and large dog-ear deformity could be avoided.

Cicatrix, Hypertrophic ; surgery ; Eyelids ; Face ; surgery ; Facial Muscles ; Humans ; Reconstructive Surgical Procedures ; Skin Pigmentation ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply

The combination of pure motor hemiplegia and horizontal gaze palsy is a rare but identifiable lacunar syndrome. Among horizontal gaze palsies, one-and-a-half syndrome and abducens nerve palsy are reported to be associated with pure motor hemiplegia in pontine lacunar infarction. Although conjugate lateral gaze palsy is also hypothesized, pure motor hemiplegia with conjugate lateral gaze palsy has never been reported. We present a 75-year-old man who showed right hemiparesis and impaired left horizontal conjugate eyeball movement. Both the findings of the brain CT scan and those of the MRI study were consistent with a small infarction in the left midpontine tegmentum. Magnetic resonance angiography revealed no stenotic narrowing of the vertebrobasilar artery. Radiological findings suggested that pure motor hemiplegia with conjugate lateral gaze palsy, in our patient, might have been produced by the occlusion of a single penetrating branch of the basilar artery.
Aged ; Case Report ; Cerebral Infarction/*complications/diagnosis ; Hemiplegia/*complications/physiopathology ; Human ; Magnetic Resonance Imaging ; Male ; *Movement ; *Oculomotor Muscles ; Paralysis/*complications ; Pons/*blood supply

OBJECTIVETo investigate the treatment outcomes of modified sternocleidomastoid myocutaneous flap with a pedicle containing superior thyroid artery in repairing postoperative hypopharyngeal defect.

METHODSFrom Dec. 2003 to Sep. 2010, the modified sternocleidomastoid myocutaneous flap was used to restore defect postoperation of hypopharynx defect for twelve patients with pyriform sinus carcinoma, age range from 47 to 72 years old. No patients had treated by radiotherapy before operation. Of 12 patients, 5 cases in T2N0M0, 5 cases in T3N1M0 and 2 cases in T4N1M0.

RESULTSTwo cases in T4 with thyroid invasion and 2 cases in T3 with vocal cord fixation had total laryngectomy, and the other 8 cases were non reserved with laryngeal functions. To shape flap with middle and lower segment of sternocleidomastoid muscle and with superior artery as pedicle. All flaps survived after operation. The following-up time was 7-88 months (median 30 months). Four patients died of recurrence or metastasis of tumor during following-up.

CONCLUSIONSModified sternocleidomastoid myocutaneous flap with pedicle is easy to harvest, with smaller damage and a higher survival rate, which is a good flap for the repair of the hypopharyngeal defect after resecting tumour.

Aged ; Carcinoma, Squamous Cell ; surgery ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Hypopharynx ; surgery ; Male ; Middle Aged ; Pectoralis Muscles ; transplantation ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; blood supply