Objective To provide a comprehensive review for development and existing problems of the perforator flaps. Methods The related home and abroad l iterature concerning perforator flaps was extensively reviewed. Results The perforator flaps are defined as the axial flaps nourished solely by small cutaneous perforating vessels (perforating arteriesand veins), which are exclusively composed of skin and subcutaneous fat. The perforator flaps have the advantages as follows: less injury at donor site, less damage to the contour of the donor site, good reconstruction and appearance of the reci pient site flexible design, and short time of postoperative recovery, which have been widely used in reconstructivesurgery. Conclusion The perforator flaps are the new development of the microsurgery, which usher an era of small axial flaps; However, the controversies of the definition, vascular classification, the nomenclature, and the cl inical appl ication of the perforator flaps still exist, which are therefore the hot spot for future study.
OBJECTIVE: To provide anatomy basis for a free latissimus dorsal muscular flap with the sensate nerve. METHODS: The structure of back and lateral chest area were dissected and the origin, alignment and distribution of the intercostals nerve within the area of latissimus dorsal muscular flap were observed in 40 adult cadaver specimens. RESULTS: The 5th to 10th lateral posterior branches of the thoracic nerve pierced from respective intercostal area near the axial anterior line and run a long distance in deep fascia. They distributed mainly in lateral latissimus skin outside the scapular line and anastomosed with the lower branch near the scapular line. Among these branchs, the 6th to 8th branches had a longer nerve distribution respectively and the pedicle of nerve and artery was parallel and long. CONCLUSION: It is possible to design a sensate latissimus dorsal muscular flap with the 6th to 8th lateral posterior branch of the intercostal nerve.
Subdermal vascular network skin flap(SVN flap)of neck- shoulder region was applied to repairthe skin defects of face and neek in 35 cases with satisfactory result.order to know better theamount of the subeutaneous fat should be removed and its optimal thickness,7SVN flaps of neck-shoulder region were taken from fresh cadavers following good porfusion with the purpose to observethe anastomosis of suedermal vascular network.Through statistical study the optimal thickness of fatin neck-shoul...
Through observation on the cast and perfused humen specimens, it was found that in some donor areas of skin flap the veins run loosely in compare with their arteris. The companionship of the axial artery and vein can be divided into 3 types: (1)One set of venous system, which runs loosely in company with the artery, such as the pedicle vessels in flaps of head and face areas; (2)Two sets of accompaned venous system, one of them did not accompany closely with the axial artery, as is the vessel in skin flaps of low abdominal areas; (3) Lack of accompanying venous system, as is found in the dorsal finger flaps. Based on these anatomical companionships of the veins with their arteries, when such flaps as mentioned above are adapted, it is preferable to take abroadened fascial pedicle in order to achieve a higher survival rate of skin flap transplantation.
Objective To analyze the expression changes of Pax7 and MyoD in satell ite cells of denervated skeletal muscle at the mRNA and protein level, and to explore the pathway concerning with denervation and regeneration of skeletal muscle. Methods Nine male SD rats of 2 months old, weighing 180-200 g were selected. The right gastrocnemius musclewas made denervation model as experimental sides, and the same operation was performed in the left sides as control. The immunofluorescence analysis was done for detecting the protein expressions of Pax7 and MyoD in muscles denervated 3, 7 and 21 days after operation. The RT-PCR analysis was used to explore the mRNA expression of MyoD and Pax7 in extracted tissues from denervated muscles. Results Nine rats survived after operation, with l imited motion of right hind l imbs, and normal motion of left l imbs. The result of immunofluorescence with the polyclonal antibody against MyoD and the monoclonal antibody against Pax7 showed that the number of MyoD positive cells in prolonged denervated muscles (experimental sides) increased gradually, and reached the peak 21 days after denervation, there was significant difference compared with that of control sides (P lt; 0.05). However, the total number of Pax7 positive cells decreased with the prolongation of denervation, the expression of Pax7 was b only at 3 days, then decreased gradually, and there was no positive cells in denervated muscles of 21 days. There were significant differences in Pax7 positive cells between experimental sides and control sides at 3 and 7 days (P lt; 0.05). The results of immunostaining showed that MyoD mRNA levels increased , and reached the peak at 21 days of denervation, there was significant difference compared with that of control sides (P lt; 0.05). Whereas, Pax7 mRNA expressed only in control, denervated muscles of 3 and 7 days, and its expression level decreased gradually. Conclusion One possible reason of the depletion of satell ite cell pool in prolonged denervated muscle is the down-regulation of Pax7.