61 children with the deep burn (male: 40; female: 21), avarage ages of 6.3 the avarage burn area: 33%; the avarage deep burn area: 21% were admitted after 10 days of burn participated to a study. The results have shown that the highest rate of pseudomonas aeruginosa reported, there were no change of microorganism in the burn area before and after the necrosis removal. The density of microbial per one gram of the necrosis tissues after the necrosis removal reduced in significantly. There was a linear relation between the density of microbial in the burn tissues, the clinical infective symptoms and the rate of the septicemia in the deep burn. The technique of the method of the quantitative analysis of microbials/one gram tissue had a high confidence.
burns ; surgery ; Necrosis

The study was conducted with 14 burn patients aged from 6-43 years, who underwent a cut off necrosis and a graft of skin immediately 72 hours after the burning accident, and with 11 patients aged from 12-42 years without these interventions untill the 7th days after accident. An increase of TNF level and IL-6 level were found in the blood of deep burn patients within 7 days after accident. Necrosis cutting off and skin graft in the first 72 hours after the accident decreased TNF and IL-6 blood level in deep burn patients within 5th and 7th day after the accident.
Burns ; Blood ; Necrosis ; Skin Transplantation ; Surgery ; Therapeutics

138 patients (102 males, 36 females) aged 3-71 years old with 139 deficiencies of various causes in inferior limbs underwent a surgery of free flap transfer with 144 free flaps. Survived rate reached 134/144 flaps (93.05%), full necrosis in 10/144 flaps (6.95%). All cases were sucessfully operated exculding 5/10 cases of second time transfer. Near possible complications such as obstruction of the arterial connection of 4 flap-connect sites, obstruction of the venous connection of 6 flap sites, obstruction of venous-arterial connection of 2 sites, necrotic infection in 1 flap.
Surgical Flaps ; Lower Extremity/abnormalities ; Surgery ; Necrosis

PURPOSE: Reduction mammaplasty is one of the most commonly performed operations in plastic surgery. Although secondary surgery is occasionally required for minor aesthetic problems or for treatment of the complications of the primary surgery, there are no clear operative guidelines of management. We report here two cases of secondary reduction mammaplasty using differrent pedicle from the initial ones. METHODS: One case of secondary reduction mammaplasty were performed using medial pedicle after central (19 years) pedicle reduction mammaplasty because of subsequent breast ptosis and asymmetry. The other case was performed using medial pedicle after superior (4 years) pedicle reduction mammaplasty with contralateral immediate breast reconstruction with TRAM flap because of subsequent breast ptosis and asymmetry. Care was taken to include sufficient width of pedicle and adequate soft tissue attachment beneath the nipple-areolar complex. RESULTS: There was no significant complication such as nipple-areolar necrosis or fat necrosis. The results were well maintained throughout the follow-up period. CONCLUSION: Medial pedicle reduction mammaplasty can be safely performed after central or superior pedicle reduction mammaplasty when sufficient width of pedicle and adequate soft tissue attachment beneath the nippleareolar complex are maintained.
Breast ; Fat Necrosis ; Female ; Follow-Up Studies ; Mammaplasty ; Necrosis ; Surgery, Plastic

Avascular osteonecrosis of the femoral head is a common disease in orthopedic clinics. If the diagnosis can be made before collapse of the femoral head, the hip joint may probably be preserved by means of core decompression with or without bone grafting, osteotomies, as well as nonvascularized or vascularized bone grafting. Local pedicled bone grafts and free vascularized bone grafts can transfer the vascularized bone grafts into the necrotic area of the femoral head, which not only can replace necrotic bone with healthy bone, but also establish a new source of blood supply to the femoral head. The success rate in patients with different stages of osteonecrosis of femoral head was 80% at 5 years follow up. Free vascularized bone grafting for the treatment of avascular osteonecrosis of the femoral head can obtain a higher success rate.
Bone Transplantation ; methods ; Femur Head Necrosis ; surgery ; Fibula ; transplantation ; Humans

The Chinese investigators separated bullet wounds into three zones in the beginning of 1980s: a primary wound tract, a contusion zone adjacent to prinary wound tract, and a concussion zone neighboring the contusion zone. Basing on the research results by MRI scan and pathological observation, the author and his coworkers recently proposed that the gunshot wounds should be divided into four consecutive zones: a primary wound tract, a zone of coagulative necrosis, a zone of muscle disruption, and a zone of muscle distortion. A zone of coagulative necrosis plus a zone of muscle disruption equals to a contusion zone, they are separately named because the former is irreversibly devitalized and the latter still has the ability to recover. The sectionalized method shows the range of debridement and provide reference for the conservative treatment or thoroughly debridement. However, the mechanism of each zone need to be further studied.
Debridement ; Humans ; Necrosis ; Wounds, Gunshot ; pathology ; surgery ; therapy

Incorrect treatment for femur head necrosis can cause collapse of femoral head and tresult in severe harm for the patients (especially for the patient with middle-aged and young). The structure and mechanics characteristics of tantalum rod is similar to bone tissue, it higher strength and can adapt the internal environment of organism, so it has a large potency in treating femur head necrosis. Treatment of early femur head necrosis with tantalum rod implanting had alreadly widey applied at home and abroad, the method has the advantages of simple operation, little risk, less complication and beseems the patient with stage I - II of ARCO. But reasons that the difficult diagnosis of early femur head necrosis, localized effect of tantalum rod, different experience of medical worker,caused the contentions about effect of tantalum rod implanting. With development of science, tantalum rod implanting combined with correlative biotechnology should raise the effect in treating femur head necrosis.
Femur Head Necrosis ; surgery ; Humans ; Prostheses and Implants ; Tantalum ; Treatment Failure

To solve the problems of small one-time ablation range and easy charring of the tissue around the electrode associated with the tumor radiofrequency ablation needle, based on the multiphysical field coupling analysis software COMSOL, the effects of needle material, the number of sub needles and the bending angle of sub needles on the ablation effect of radiofrequency ablation electrode needle were studied. The results show that compared with titanium alloy and stainless steel, nickel titanium alloy has better radiofrequency energy transmission efficiency and it is the best material for electrode needle. The number of sub needles has a great influence on the average necrosis depth and the maximum necrosis diameter. Under the same conditions, the more the number of sub needles, the larger the volume of coagulation necrosis area. The bending angle of the needle has a great effect on the maximum diameter of the coagulated necrotic area, but has little effect on the average necrotic depth. Under the same other conditions, the coagulation necrosis area formed by ablation increased with the increase of the bending angle of the sub needle. For the three needles with bending angles of 60 °, 90 ° and 120 ° analyzed in this paper, the one with bending angle of 120 ° can obtain the largest coagulation necrosis area. In general, the design of nickel titanium alloy with 120 ° bending 8-pin is the optimal. The average depth of radiofrequency ablation necrosis area is 32.40 mm, and the maximum necrosis diameter is 52.65 mm. The above optimized design parameters can provide guidance for the structure and material design of tumor radiofrequency ablation needle.
Humans ; Needles ; Temperature ; Catheter Ablation/methods* ; Necrosis ; Neoplasms/surgery* ; Alloys

Endoscopic drainage for pancreatic and peripancreatic fluid collections (PFCs) has been increasingly used as a minimally invasive alternative to surgical or percutaneous drainage. Recently, endoscopic ultrasound-guided transluminal drainage (EUS-TD) has become the standard of care and a safe procedure for nonsurgical PFC treatment. EUS-TD ensures a safe puncture, avoiding intervening blood vessels. Single or multiple plastic stents (combined with a nasocystic catheter) were used for the treatment of PFCs for EUS-TD. More recently, the use of covered self-expandable metallic stents (CSEMSs) has provided a safer and more efficient approach route for internal drainage. We focused our review on the best approach and stent to use in endoscopic drainage for PFCs. We reviewed studies of EUS-TD for PFCs based on the original Atlanta Classification, including case reports, case series, and previous review articles. Data on clinical outcomes and adverse events were collected retrospectively. A total of 93 patients underwent EUS-TD of pancreatic pseudocysts using CSEMSs. The treatment success and adverse event rates were 94.6% and 21.1%, respectively. The majority of complications were of mild severity and resolved with conservative therapy. A total of 56 patients underwent EUS-TD using CSEMSs for pancreatic abscesses or infected walled-off necroses. The treatment success and adverse event rates were 87.8% and 9.5%, respectively. EUS-TD can be performed safely and efficiently for PFC treatment. Larger diameter CSEMSs without additional fistula tract dilation for the passage of a standard scope are needed to access and drain for PFCs with solid debris.
Abdominal Abscess/surgery ; Drainage/*methods ; Endosonography/*methods ; Humans ; Necrosis/surgery ; Pancreas/*pathology/surgery ; Pancreatic Diseases/*surgery ; Pancreatic Pseudocyst/surgery ; *Stents ; Surgery, Computer-Assisted/*methods ; Ultrasonography, Interventional/methods

This article reviews the history and development of as well as the results using a fibular graft by vascular anastomosis for the treatment of avascular osteonecrosis of the femoral head. Vascular anastomosed fibular grafting has been reported to be successful for patients with early stages and precollapse osteonecrosis of the femoral head. The method can be used to preserve the hip joint function. Vascular anastomosed fibular grafting can be the transfer of vascularized bone grafts into the necrotic portions of the femoral head. Such a procedure, in addition to replacing necrotic bone with healthy bone, also establishes a new source of circulating blood of the femoral head. Free avascularized bone grafting for the treatment of avascular osteonecrosis of the femoral head may lead to higher rates of successful treatment and superior to those of core decompression and nonoperative treatment.
Anastomosis, Surgical ; Bone Transplantation ; Femur Head ; surgery ; Femur Head Necrosis ; surgery ; Fibula ; transplantation ; Humans ; Treatment Outcome