OBJECTIVETo study the effect of island flap from dorsoulnar side of thumb in repairing deep wound on thumb.

METHODSTwenty-two patients with deep wound on thumb were hospitalized from May 2007 to December 2013. The wounds ranged from 2.0 cm x 1.5 cm to 4.0 cm x 2.5 cm in area. Island flap of dorsoulnar thumb was used to repair these defects, with flap area ranging from 2.1 cm x 1.6 cm to 4.1 cm x 2.6 cm. All the donor sites were closed by transplantation of full-thickness skin from upper medial arm.

RESULTSAll flaps survived with good blood supply. All deep wounds of thumb were closed. Skin grafts of donor sites all survived. Patients were followed up for 6 to 12 months. The texture, color, and shape of all flaps were satisfactory, and functions of injured thumbs recovered well.

CONCLUSIONSTransplantation of island flap from dorsoulnar side of thumb can be performed easily with high survival rate and satisfactory configuration, and it is suitable for repairing deep wound of thumb.

Arm ; Burns ; surgery ; Follow-Up Studies ; Graft Survival ; Humans ; Reconstructive Surgical Procedures ; methods ; Recovery of Function ; Skin ; Skin Transplantation ; Soft Tissue Injuries ; surgery ; Surgical Flaps ; Thumb ; injuries ; surgery ; Treatment Outcome ; Wound Healing

Ten patients with perianal necrotizing fasciitis were admitted to our department from June to December 2016. There were 8 men and 2 women among the patients, aged 42 to 69 years. Early and complete debridement surgery and comprehensive supportive treatment during perioperative period were carried out to quickly stabilize the patient′s overall condition, and wounds were sutured directly or repaired with autologous scalps and or adjacent local random flaps. After debridement, wound areas ranged from 10 cm×8 cm to 54 cm×21 cm, and area of the flap was about 8 cm×5 cm. The donor site of flap was sutured directly. After the operation, all skin grafts and the flap survived, and wounds of all patients healed. During follow-up of six months to one year, there was no recurrence of perianal necrotizing fasciitis, and functions of the involved lower extremities didn′t be influenced.

One elderly patient with extremely severe burn was admitted to our department on 4th August, 2017. The patient suffered multiple sustained ventricular tachycardia from post injury day 2 to 4 due to relatively high input volume during shock stage. Amiodarone could not be given through intravenous injection because of his low blood pressure. After consultation with cardiologist, ventricular tachycardia was corrected by electrical cardioversion of several times. According to this case, the first treatment is electrical cardioversion when elderly patient with extremely severe burn shows sustained ventricular tachycardia which can not be corrected with medicine.