OBJECTIVES: To observe the changes of skin blood flow perfusion at Waiguan (TE 5) caused by mild moxibustion with moxa stick and infrared mild moxibustion using laser speckle contrast imaging technology, and to compare the microcirculatory effect during and after both moxibustion methods and explore the dose-response relationship of moxibustion. METHODS: Twenty-four healthy participants were treated with mild moxibustion with moxa stick and infrared mild moxibustion at left Waiguan (TE 5). The record started when the skin temperature reached (44±1) °C, and both moxibustion methods were provided within this temperature range. The 20-minute moxibustion process was divided into four stages (5, 10, 15, and 20 min) using interpolation method, and each participant completed eight interventions with a minimum 24-hour interval between different interventions. The skin surface temperature of the left Waiguan (TE 5) was monitored when both moxibustion interventions were given for 10 min using a TES1306 thermocouple thermometer. The skin microcirculatory blood perfusion units (MBPU) of left Waiguan (TE 5) was measured using a PSIN-01087 laser speckle blood flow imager 1 min before moxibustion, at 5, 10, 15, 20 min during moxibustion and continuously for 20 min after moxibustion in each intervention. RESULTS: The skin surface temperature of the left Waiguan (TE 5) remained within the range of (44±1) °C during both moxibustion methods, with no statistically significant difference (P>0.05). Compared with that before moxibustion, the MBPU of the left Waiguan (TE 5) was increased significantly at 5, 10, 15, and 20 min of both moxibustion methods (P<0.05, P<0.01). Compared with moxibustion for 10, 15 and 20 min, the MBPU of the left Waiguan (TE 5) of moxibustion for 5 min was lower in both moxibustion methods (P<0.01). For both moxibustion methods with the same moxibustion course, the MBPU of the left Waiguan (TE 5) 20 min after intervention was significantly higher than that at 1 min before moxibustion (P<0.001), and there was no significant difference in MBPU between 1 min before moxibustion and 20 min after moxibustion among different groups (P>0.05). Within the same moxibustion method, the MBPU of the left Waiguan (TE 5) 20 min after moxibustion with the intervention of 5 min was lower compared to that of 10, 15, and 20 min of moxibustion (P<0.001), with no significant differences between 10, 15, and 20 min of moxibustion (P>0.05). CONCLUSIONS When controlling the skin temperature at Waiguan (TE 5) within (44±1) °C, infrared mild moxibustion has similar effects on skin microcirculatory blood perfusion as traditional mild moxibustion with moxa sticks. From a dose-response perspective, microcirculation reached a stable state after 10 min of moxibustion, and moxibustion interventions lasting for more than 10 min shows better therapeutic effects.
Humans ; Moxibustion/methods* ; Microcirculation ; Skin/blood supply* ; Skin Temperature

OBJECTIVE: To investigate the effects of intermittent negative pressure therapy on the skin microcirculation perfusion of quadriceps in male rowers, and to provide basis for the practical application of this method. METHODS: Fourteen male rowers were selected from the national rowing team and randomly divided into experimental and control groups. The daily training plans of two groups were the same. The recovery intervention for experimental group was implemented by 20 minutes in the cube of Vacusport Regeneration System (German), 5 times per week for 4 weeks, no recovery intervention for control group. Microcirculation markers were collected by PeriFlux5000 system before and after the 4-week intervention. The markers included microcirculatory blood perfusion(MBP), average velocity of blood cells(AVBC), concentration of moving blood cells (CMBC), and values of the markers included basic values and post-heating values (44℃), difference before and after heating of the values was considered as the reserve capacity of those markers. RESULTS: The test results before the 4 weeks intervention showed there was no statistical difference between the two groups(P＞0.05). After the 4 weeks intervention: ①MBP: The post-heating value and the difference of the experimental group were significantly higher than those of the control group (P＜0.05). But there was no statistical inner-group difference. ②AVBC: The post-heating values and the difference in the experimental group were significantly lower than those in the control group (P＜0.05). Intra-group comparison found that the post-heating values after post-intervention were significantly reduced, compared with those of pre-intervention (P＜ 0.01); the difference after post-intervention was reduced significantly, compared with those in the pre-intervention (P＜0.05). ③CMBC: The post-heating values and the difference in the experimental group were significantly higher than those in the control group (P＜0.01). There were no statistical significant inner-group difference. CONCLUSION Lower limb intermittent negative pressure therapy can improve the skin microcirculation of the quadriceps of the male rowers, which has a positive effect on the rapid recovery of physical fitness.
Humans ; Lower Extremity ; Male ; Microcirculation ; Pressure ; Quadriceps Muscle ; blood supply ; Skin ; blood supply ; Water Sports

The cupping spot is considered as one kind of skin change due to cupping treatment. With literature regarding cupping spot, the influencing factors and value of cupping spot in clinical diagnosis and treatment were analyzed, which could make a further exploration on the action mechanism of cupping treatment. The literature showed that the formation of cupping spot was related with cupping temperature, pressure, cup-retaining time, cupping area, individual difference and health condition, etc; cupping spot had the ability to assist diagnosis, prevent disease, cure disease and evaluate clinical efficacy. Previous studies on cupping spot have already made some progress, and played a positive significance on finding cupping rule and studying its mechanism. However, the research for this area is still in the primary stage, which needed deeper study to reveal scientific connotations of cupping spot.
Acupuncture Therapy ; instrumentation ; Humans ; Skin ; anatomy & histology ; blood supply

OBJECTIVETo present the operation for nose defect reconstruction using a retroauricular free flap and the auricle cartilage.

METHODSBased on the anatomy and blood supply of the retroauricular region, a flap was designed and harvested with the posterior auricular vessels as its pedicle. The flap was used to repair nose defects in five patients. Of them, three had unilateral subtotal alinasal defects, one had nasal apex defect, and one had defects on nasal apex and bilateral ala. The size of the defect ranged from 2.5 cm x 1.5 cm to 3.0 cm x 4.0 cm. The flap varied between 3.0 cm x 2.0 cm and 4.5 cm x 3.5 cm. In 4 cases, the auricular cartilage of 2.0 cm x 1.5 cm to 1.5 cm x 1.0 cm was taken along with the flap. The posterior auricular vessels were anastomosed with the facial vessels. The donor site was covered with full-thickness skin graft.

RESULTSPostoperatively, the blood supply to the flaps was fairly good in 3 cases, while there was various venous stasis in 2 cases during the first 4 days. However, the postoperative results of the 5 cases were satisfactory.

CONCLUSIONSThe retroauricular free flap is a good choice for partial nose reconstruction, which had the merits of well-hidden donor site, good color match, and one-stage operation.

Humans ; Nose ; abnormalities ; surgery ; Skin Transplantation ; Surgical Flaps ; blood supply

OBJECTIVETo investigate the relationship between the blood flow of the exceedingly expanded skin and the viability of the flap.

METHODSThe piglets were set up as the animal model. They were divided into 7 groups according to different injection volume of the tissue expander, i. e. injection to 1/2 content, 3/4 content, full content, 50% over content, 100% over content, sham-operation control and normal control. At different stages of expansion, the blood flow and the amplitude of the expanded skin were examined by laser Doppler. The survival length of the expanded flap was measured. Furthermore, statistical analysis was performed.

RESULTSAs the expansion volume increasing, the blood flow and the amplitude of the expanded skin increased, the survival length of the expanded flap increased also. In the meantime, the amplitude instability and vessel permeability increased. When the injection volume exceeded to 100%, the blood flow and the survival length of the expanded flap decreased.

CONCLUSIONSIn soft tissue and skin expansion, increasing injection volume could increase the survival length of the expanded flap, while over-expansion to 100% content may cause blood flow disturbance.

Animals ; Graft Survival ; Models, Animal ; Skin ; blood supply ; Skin Transplantation ; Surgical Flaps ; blood supply ; Swine ; Swine, Miniature ; Tissue Expansion Devices

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

OBJECTIVETo study the anatomy of lateral crural skin flap nourished by cutaneous branches of peroneal artery and its clinical application as vascularized skin flap transfer.

METHODSIn 20 cadavers specimen with 40 lower limbs, the cutaneous branches of the peroneal artery were dissected and their measurements were recorded. In the other 30 adult legs, their perforating points of the cutaneous arteries of peroneal artery were detected with supersonic Doppler flow meter. With the aid of anatomic and supersonic Doppler flow meter study, vascularized transfer of lateral crural skin flap pedicled by cutaneous branches of peroneal artery were successfully performed in 21 clinical cases.

RESULTSIn altogether 40 legs studied, 140 cutaneous branches were found. One to seven branches were found on one specimen, the average was 3.5 branches, in one leg was a high perforating skin branch. The perforating points of the cutaneous branches were mostly (76% cases) appeared within 7 - 21 cm length below the protruding point of head of fibula. The external diameter of the thickest cutaneous branch of each leg was (1 .4 - 2.9) mm, (1.8 +/- 0.4) mm, while the external diameters of two vena concomitants were (3.0 +/- 0.5) mm and (2.4 +/- 0.4) mm. 145 artery perforating points in 30 legs were detected by Doppler, with an average points of 4.8. The skin flaps taken in the 21 clinical cases were 5.0 cm x 3.5 cm - 28 cm x 11 cm in size. All the transferred free flaps survived uneventfully.

CONCLUSIONSThe lateral crural skin flap is nourished by a variable number of cutaneous branches of peroneal artery. The main branch can meet the demand of microvascular anastomosis. The free transfer of lateral crural flap by anastomosis of cutaneous branch of peroneal artery is superior to lateral skin flap transfer by anastomosis of main trunk of peroneal artery with the merit of simple procedure, minimal trauma and more physiological circulation established.

Adult ; Aged ; Arteries ; anatomy & histology ; surgery ; Humans ; Leg ; blood supply ; Middle Aged ; Skin ; anatomy & histology ; blood supply ; Skin Transplantation ; methods ; Surgical Flaps ; blood supply ; Young Adult

Observation of microcirculation plays an important role on the basic research and clinical diagnosis. However, an observation as such on the anesthetized patient will cause stress reaction, thus it will affect normal physiological state and interfere experimental results. At present, a method adopting dorsal microcirculatory chamber (DMC) to do in vivo observation in an unanesthetized state can eliminate the influence of anesthesia. Based on the research reports and practical applications of this method abroad, we summarize, in here, the configuration, function, observation techniques; the application of DMC; and the research states of microcirculation observation.
Animals ; Back ; blood supply ; Blood Flow Velocity ; Diffusion Chambers, Culture ; Humans ; Microcirculation ; physiology ; Monitoring, Physiologic ; methods ; Skin ; blood supply

OBJECTIVETo observe the effects of surgical delay procedure on the survival of perforator flap with three angiosomes in rat, and to explore its possible mechanism.

METHODSThe flap model was a perforator flap with three angiosomes which located on the right dorsal side of a rat based on the right deep circumflex iliac vessel. The two connection areas between the three angiosomes were successively named choke zone (CZ) 1 and CZ 2 beginning from the pedicle to the remote area. A total of 110 SD rats were divided into routine flap group (RF, n = 40), delay only group (DO, n = 30), and delay flap group (DF, n =40) according to the random number table. (1) In group RF, 30 rats were selected according to the random number table, and flap surgery was performed directly. Six rats were sacrificed on post operation day (POD) 0, 1, 2, 3, 7 respectively to collect the full-thickness skin samples at both CZs for HE staining to measure the vascular density and diameter. The rest 10 rats underwent flap surgery immediately after a catheter was successfully implanted into their external jugular vein. A volume of 1.5 mL sodium fluorescein solution (100 g/L) was injected to the 10 rats on POD 0 (5 rats) or POD 1 (5 rats) each time with a 2-day interval to learn the change in flap circulation. Each rat was injected for 4 times. The flap survival rate of the 10 rats was calculated on POD 7, and the configuration and distribution of the vessels in the flap were observed through angiography with the improved perfusion method of lead oxide-gelatin. (2) In group DO, the right thoracodorsal perforators of all the rats were surgically ligated through a small skin incision, and 6 rats were sacrificed on POD 0, 1, 2, 3, 7 respectively. The skin samples of each rat at the same area as in group RF were harvested to measure the vascular density and diameter. (3) In group DF, rats were treated with ligation surgery as in group DO, and then they were assigned and treated as in group RF on POD 7 with corresponding indexes detected later. Data were processed with group t test, analysis of variance with factorial design, and SNK test.

RESULTS(1) Significant differences of vascular density at both CZ 1 and CZ 2 were found on POD 7 among the three groups ( with F values respectively 2. 69 and 2. 76, P values below 0.05). The vascular density values of CZ 1 and CZ 2 of rats in group DF were (29 ± 7) and (31 ± 8) per mm on POD 7, which were significantly higher than those of group RF [(23 ± 5) and (23 ± 3) per mm2, with q values respectively 5.67 and 6.01, P values below 0.05] and those within group DF on POD 0 (with q values respectively 6.42 and 7. 14, P values below 0. 05). On POD 3 and 7, the vascular diameter values of CZ 1 of rats in groups RF and DF were significantly higher than those of group DO (with q values from 8. 15 to 11.13, P values below 0.05). The vascular diameter values of CZ 2 of rats in group DF onPOD 0, 1, 2, 3,7 [(65 ± 8), (63 ± 13), (69 ± 9), (67 ± 8), (64 ± 13) 230m] and in group DO on POD 3 and 7 were significantly higher than those in group RF [respectively (46 ± 10) , (40 ± 9), (43 ± 13), (46 ± 12), (47 ± 11) µm on POD 0, 1,2, 3, 7 ] at corresponding time point (withqval- ues from 7.29 to 10.79, P values below 0.05). The difference in vascular diameter between CZ 1 and CZ 2 was statistically significant in groups RF and DO on POD 3 and 7, and in group DF on POD 0, 1 , and 2 (with q values from 5.32 to 9.56, P values below 0.05). Compared with that on POD 0 within each group, the vascular diameter of CZ 1 in groups RF and DF and that of CZ 2 in group DO increased significantly on POD 3 or 7 (with q values from 6.12 to 8.13, P values below 0.05). (2) In groups DF and RF, blood from the pedicle ran through CZ 1 and covered the dynamic territory successfully within POD 7. On POD 0, the blood within all flaps was blocked for about 3 min after going through CZ 1 at 1 cm distal from CZ 2 in group DF and around CZ 2 in group RF. (3) Flap survival rate of rats in group DF was (95 ± 12) % , which was statistically higher than that of group RF [(80 241 9) % , t = 2.91, P <0.01]. All the partial flap necrosis occurred in potential territory. (4) Compared with the vessels in the left dorsal side without surgery, the vessels of CZ 1 in group RF were dilated obviously, and the boundary between vascular trees became indistinct, but the vessels in CZ 2 changed slightly; the vessels in both CZs in group DF were dilated dramatically.

CONCLUSIONSThe delay method could enhance the survival of potential territory in perforator flap with three angiosomes, and it acted mainly by dilating the choke vessels in CZ 2 before flap surgery.

Angiography ; Animals ; Graft Survival ; physiology ; Male ; Necrosis ; Perforator Flap ; blood supply ; physiology ; Rats ; Skin ; blood supply ; Surgical Flaps ; blood supply ; physiology ; Time Factors

OBJECTIVETo investigate the blood supply and the clinical application of the posterior calf fasciocutaneous flap for repairing the frontal defect of knee joint.

METHODSBased on the article review and the anatomical study of the posterior calf in 8 cadavers (16 sides), 10 cases with frontal defects of knee joints were repaired with island fasciocutaneous flaps which had pedicles of lateral superficial sural artery and the lateral sural nerve.

RESULTSThe anatomical study showed there were three systems of superficial sural blood supply- medial, middle and lateral systems. They are originated from popliteal artery or from the bilateral sural artery. The lateral superficial sural artery was present in 100% of the cadavers. The flaps survived completely in 9 cases, except one case with partial necrosis at the one-fourth distal end of the flap. The patients were followed up for 6-12 months with good aesthetic and functional results.

CONCLUSIONSThe posterior calf island fasciocutaneous flap has an reliable blood supply and protective sense nerve. The flap is ideal for the reconstruction of soft tissue defect around knee joint.

Adolescent ; Adult ; Female ; Humans ; Leg ; blood supply ; surgery ; Male ; Muscle, Skeletal ; blood supply ; transplantation ; Skin Transplantation ; methods ; Surgical Flaps ; blood supply ; Young Adult