[Effects of sural nerve nutrition vess els-supported flap for reconstruction of distal lower leg and ankle soft tissue defects].

Objective: To observe the effects of sural nerve nutrition vessels-supported flap for reconstruction of distal lower leg and ankle soft tissue defects. Methods: From June 2014 to June 2017, 37 patients with calf distal and ankle soft tissue defect were repaired with sural nerve nutrition vessels-supported flap, of them 12 cases with calf distal soft tissue defect wounds and 25 cases with ankle soft tissue defect wounds.The scope of flaps was 9 cm×4 cm to 18 cm×9 cm, anti-infection, anti-freezing and dressing treatments were carried out after operation.The results of two-point discrimination among reexamination were recorded. Results: All the flaps survived without ulcer and effusion, only 1 flap for reconstruction of medial malleolus swelled and deactivated at the beginning while it recovered with proper dressings.During the follow-up periods, all the flaps kept favorable feelings, aspects and functions, and the two-point discrimination was 5 to 15 mm [averaged (11.2±1.7) mm]. Conclusion: Sural nerve nutrition vessels-supported flap brings significant effects with excellent safety and reliability in repairing calf and ankle soft tissue defects.

An eligible biological allograft patch in tension-free herniorrhaphy of swine.

Current patches made from macromolecular compounds or composix for tension-free herniorrhaphy are still unsatisfactory in biocompatibility. The ideal patch should be a biological patch with good biocompatibility. Herein allograft patches modified by tissue engineering were used in tension-free herniorrhaphy of swines. Tough membrane tissues from swine were modified with patented tissue engineering techniques to develop allograft patches for tension-free herniorrhaphy. Histological, and physical tests of the allograft patch were performed subsequently, which revealed that the allograft patch was sufficient and satisfactory for tension-free herniorrhaphy. The allograft patches were next used in tension-free herniorrhaphy of abdominal external hernia models of swines and compared to polypropylene patches. Serous CD4+, CD8+ T cells, interleukin-1ß (IL-1ß), and tumor necrosis factor α (TNF-α) were determined preoperatively and postoperatively. Local pathological changes were recorded postoperatively in swines. In vivo application of the allograft patches revealed that there were no significant serous cellular immune responses in swines, and inflammation induced by allograft patches was significantly lower compared to polypropylene patches, the allograft patches gradually degenerated and new collagen fibers appeared. Abdominal external hernias were cured with allograft patches and without relapse. The modified allograft patch with satisfactory biocompatibility was eligible and sufficient in tension-free herniorrhaphy of swine. Clinical trials should be performed for further evaluation of the allograft patch.