OBJECTIVETo explore the curative effect of reverse bi-pedicle posterior interosseous artery perforator flap in repairing skin and soft tissue defects on the wrist.

METHODSSeven patients with soft tissue defects on the wrist, including simple skin and soft tissue defects in 4 cases and skin and soft tissue defects combined with radial tendon injury in 3 cases, were hospitalized from December 2010 to March 2012. The area of skin defect on the volar side of the wrist ranged from 4.8 cm x 4.0 cm to 6.2 cm x 4.5 cm, while that on the dorsal side ranged from 3.5 cm x 3.2 cm to 6. 5 cm x 5.4 cm. These wounds were respectively caused by traffic injury (3 cases), reamer injury (2 cases), burn (1 case), and tumor resection (1 case). Reverse bi-pedicle posterior interosseous artery perforator flaps were used to repair these defects, with area of one pedicle ranging from 2.5 cm x 2.0 cm to 3.5 cm x 2.5 cm and the area of the other pedicle ranging from 2.5 cm x 2.5 cm to 4.0 cm x 3.0 cm. The donor sites were closed by suturing.

RESULTSAll flaps survived completely. Patients were followed up for 6 to 36 months. The color, texture, and appearance of all flaps were satisfactory. At last follow-up, distances of two-point discrimination of flaps ranged from 9 to 13 mm. The dorsal extension and palmar flexion functions of wrist were satisfactory. The results of function evaluation of 7 wrists were excellent in 6 cases and good in 1 case according to the tentative standards for the evaluation of upper extremity function of Society of Hand Surgery of Chinese Medical Association. A linear scar was formed at the donor site.

CONCLUSIONSThe reverse bi-pedicle posterior interosseous artery perforator flap, with advantages of flexible design, easy to achieve, less injury to donor site, and reliable blood supply, etc., is another choice for repairing skin and soft tissue defects over the wrist.

Burns ; Cicatrix ; Humans ; Perforator Flap ; blood supply ; Range of Motion, Articular ; Reconstructive Surgical Procedures ; methods ; Skin ; Skin Transplantation ; methods ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; blood supply ; Tendon Injuries ; Treatment Outcome ; Ulnar Artery ; Wound Healing ; Wrist Injuries ; surgery

Objective To assess the filtration efficiency of two N95 filtering-facepiece respirators(FFRs)for the decomposition products of sulfur hexafluoride (SF6).Methods Two types of N95 FFRs (the particulate and the acid-proof respirators) were selected in this study.The decomposition products of SF6,including particles,hydrogen fluoride (HF) and sulfur dioxide (SO2),were measured under experimental condition by using TSI PortaCount Plus,fluorine ion-selective electrodes and spectrophotometer separately.The filtration efficiency was then calculated and compared.Results Both two models of N95 respirators had lowest filtration efficiency larger than 95％ for particles under airflow ranged from 10 to 95 L/min.When exposed to different concentrations of HF (low:0.00～ 1.99 mg/m3,middle:2.00～3.99 mg/m3,high:＞4 mg/m3),the acid-proof N95respirator was more effective than the particulate respirator (P＜0.05) with a filtration efficiency of 98.83％,99.08％,and 99.03％ versus 48.44％,45.71％,and 47.31％.For four SO2 concentration ranges (0.00～2.49 mg/m3,2.50～4.99 mg/m3,5.00-9.99 mg/m3,and ＞10.00 mg/m3),the acid-proof respirator showed a high filtration efficiency within exposure to 1.5 hours:95.73％,98.67％,98.14％,and 97.78％,respectively,when exposure duration extended to 4 hours,the filtration efficiency of the acid-proof respirator decreased to 91.97％,82.28％,70.12％,and 58.56％,respectively.Conclusion Both the particulate and the acid-proof N95 FFRs met national standards on the particulate filtration efficiency.The acid-proof N95 respirator demonstrates to be more effective in filtering HF and SO2 than the particulate respirator.The filtration efficiency could decrease to an unsafe condition under longer exposure duration,timely replacement of respirator is recommended at the workplace.

Objective:To develop an air particulate protective mask filter test device that can simulate the dynamics process of human breathing.Methods:The new device used two air pumps working alternately to simulate the dynamics process of human breathing. On March 4th to 17th, 2017, the new device and the traditional one-way airflow mask filtration test device were used to measure the internal and external particle levels of 39 masks of 13 models of 6 brands, and then the filtration efficiency of the mask was calculated and the test results were compared.Results:For the mask without breathing valve, there was no statistically significant difference between the filter efficiency test results of the new device and the traditional unidirectional airflow filter performance test device ( P>0.05) . For masks with breathing valves, the new device detected that three of them had lower filtration efficiency (99.50% vs 98.63%, P<0.01) . After sealing the mask breathing valve with glue, the filtering efficiency of the mask with a breathing valve detected by the new device significantly improved (98.63% vs 99.50%, P<0.01) . Conclusion:This new device can simulate the dynamic process of human exhalation and inhalation, and measure the filtration efficiency of the mask. For masks with breathing valves, the new device makes it easier to detect the decrease in the filtering efficiency of the mask caused by the breathing valve.

Objective To assess the filtration efficiency of two N95 filtering-facepiece respirators(FFRs)for the decomposition products of sulfur hexafluoride (SF6).Methods Two types of N95 FFRs (the particulate and the acid-proof respirators) were selected in this study.The decomposition products of SF6,including particles,hydrogen fluoride (HF) and sulfur dioxide (SO2),were measured under experimental condition by using TSI PortaCount Plus,fluorine ion-selective electrodes and spectrophotometer separately.The filtration efficiency was then calculated and compared.Results Both two models of N95 respirators had lowest filtration efficiency larger than 95％ for particles under airflow ranged from 10 to 95 L/min.When exposed to different concentrations of HF (low:0.00～ 1.99 mg/m3,middle:2.00～3.99 mg/m3,high:＞4 mg/m3),the acid-proof N95respirator was more effective than the particulate respirator (P＜0.05) with a filtration efficiency of 98.83％,99.08％,and 99.03％ versus 48.44％,45.71％,and 47.31％.For four SO2 concentration ranges (0.00～2.49 mg/m3,2.50～4.99 mg/m3,5.00-9.99 mg/m3,and ＞10.00 mg/m3),the acid-proof respirator showed a high filtration efficiency within exposure to 1.5 hours:95.73％,98.67％,98.14％,and 97.78％,respectively,when exposure duration extended to 4 hours,the filtration efficiency of the acid-proof respirator decreased to 91.97％,82.28％,70.12％,and 58.56％,respectively.Conclusion Both the particulate and the acid-proof N95 FFRs met national standards on the particulate filtration efficiency.The acid-proof N95 respirator demonstrates to be more effective in filtering HF and SO2 than the particulate respirator.The filtration efficiency could decrease to an unsafe condition under longer exposure duration,timely replacement of respirator is recommended at the workplace.

Objective:To develop an air particulate protective mask filter test device that can simulate the dynamics process of human breathing.Methods:The new device used two air pumps working alternately to simulate the dynamics process of human breathing. On March 4th to 17th, 2017, the new device and the traditional one-way airflow mask filtration test device were used to measure the internal and external particle levels of 39 masks of 13 models of 6 brands, and then the filtration efficiency of the mask was calculated and the test results were compared.Results:For the mask without breathing valve, there was no statistically significant difference between the filter efficiency test results of the new device and the traditional unidirectional airflow filter performance test device ( P>0.05) . For masks with breathing valves, the new device detected that three of them had lower filtration efficiency (99.50% vs 98.63%, P<0.01) . After sealing the mask breathing valve with glue, the filtering efficiency of the mask with a breathing valve detected by the new device significantly improved (98.63% vs 99.50%, P<0.01) . Conclusion:This new device can simulate the dynamic process of human exhalation and inhalation, and measure the filtration efficiency of the mask. For masks with breathing valves, the new device makes it easier to detect the decrease in the filtering efficiency of the mask caused by the breathing valve.