ABSTRACT
Raman-active modes of human skin and pork belly have been studied systematically by a near-infrared Raman spectrometer with an exciting laser of 1064 nm. The main components and quantitative determination of pork belly are extracted by fitting the Raman spectra with the normalized Raman spectra of biochemical reagents such as collagen, elastin, triolein, fibronectin, fibrin, and hyaluronic acid. It demonstrates that the main components and quantity are various at different locations of pork belly, while the main components of human skin are similar to those of pig skin. In a further step, the evolution of the heating time-dependent Raman modes of isolated pig skin has been investigated for the mechanism of burnt skin. One can find that the spatial structure and main components of skin have an excellent thermal stability in the temperature range from -120 to 200 ∘C, which is confirmed by the temperature dependent Raman spectra of isolated pig skin, microporous acellular dermal matrix (MADM) as well as their corresponding biochemical reagents (collagen, elastin, triolein, etc.). These results help understand the mechanism of the living skin burnt by fire or hot water, and supplies an alternative technology for surgeons to diagnose the depth of a burn injury in time.
ABSTRACT
BACKGROUND: Skin and soft-tissue defects around the foot and ankle remain a challenge for orthopedic and plastic surgeons. Anterolateral thigh (ALT) flap and sural neurofasciocutaneous (NFC) flap are both used to reconstruct lower-extremity soft-tissue defects. The purpose of this study was to compare outcomes of the two flaps and attempt to provide an optimal strategy. METHODS: A retrospective study was conducted, reviewing data from 93 patients who underwent reconstruction of wounds around the foot and ankle with ALT flap (42 cases) or NFC flap (51 cases) from January 2014 to January 2020. Patients' demographics, characteristics of the defect, complications, cosmetic appearance, and functional outcome were analyzed, and statistical analysis was performed. RESULT: There was no difference in gender and etiology; however, NFC flaps were more frequently used in elderly patients. Mean size of the flap in the ALT group was significantly larger in comparison with the NFC group. The ALT group had longer operation and hospitalization time than the NFC group (P < 0.05). The incidence of partial necrosis in ALT group was significantly lower than that in NFC group, while its general complications rate was higher. In long-term follow-up, esthetic appearance of the reconstructed site was comparable in both groups, the ALT group had a higher ratio of revision surgery. Moreover, the ALT group showed better overall esthetic outcomes in the donor site. CONCLUSIONS: The study showed that anterolateral thigh flaps in wound coverage of foot and ankle achieved better outcomes than neurofasciocutaneous flaps in terms of recipient benefits and donor-site compromise with a special indication for larger and more distally located defects.