In this study, 8 pigs, weight ranged from 25 to 30kg, were used. Island skin flaps with the deep circumflex iliac artery were designed as pedicle on both buttocks. In the distal half of the island skin flap, which had been made on the right buttock, a subdermal vascular network island skin flap was made by preserving the subdermal vascular network. Blood supply between the two types of skin flap was compared by skin temperature, laser Doppler, fluorescent stain, histological examination, ink perfusion microangiography and transparent specimen technique. The observation showed thatthe blood supply of the subdermal vascular network island skin flap was decreased prominently in comparison with that of the conventional island skin flap. The subdermal vascular network skin flap was actually a combination of axial pattern skin flap with randomized skin flap.
ObjectiveTo compare the effectiveness of anterior subcutaneous pelvic internal fixator (INFIX) and plate internal fixation in treatment of unstable anterior pelvic ring fractures.MethodsThe clinical data of 48 patients with unstable anterior pelvic ring fractures who met the selection criteria between June 2014 and December 2019 were retrospectively analyzed. Among them, 21 cases were treated with INFIX (INFIX group), and 27 cases were treated with plate (plate group). There was no significant difference in gender, age, body mass index, cause of injury, time from injury to operation, Injury Severity Score (ISS), and fracture type between the two groups (P>0.05). The operation time, intraoperative blood loss, fracture healing time, partial weight-bearing time, and complete weight-bearing time were recorded and compared between the two groups. Matta standard was used to evaluate the quality of fracture reduction, and Majeed score system was used to evaluate the functional recovery of pelvic fracture after operation.ResultsThe patients in both groups were followed up for an average of 12.5 months (range, 6-16 months). The operation time and intraoperative blood loss in INFIX group were significantly lower than those in plate group (t=−11.965, P=0.000; t=−20.105, P=0.000). There was no significant difference in the quality of fracture reduction, fracture healing time, partial weight-bearing time, and complete weight-bearing time between the two groups (P>0.05). At 14 weeks after operation, there was no significant difference in the scores of pain, working, standing and walking, and total scores between INFIX group and plate group (P>0.05), but there were significant differences in sitting and sexual intercourse scores (t=−4.250, P=0.003; t=−6.135, P=0.006). The incidences of lateral femoral cutaneous nerve injury, femoral nerve injury, and heterotopic ossification were significantly higher in INFIX group than in plate group (P<0.05), while the incidence of incision infection was lower in INFIX group than in plate group (P<0.05).ConclusionCompared with the plate internal fixation, the INFIX internal fixation can obtain the similar effectiveness for the unstable anterior pelvic ring fracture and has the advantages of shorter operation time, less blood loss, and lower risk of infection.
ObjectiveTo explore the efficacy of thrombin in treatment of subcutaneous effusion after radical resection of breast cancer. MethodsOne hundred and ninety patients underwent radical resection of breast cancer from July 2008 to July 2013 in this hospital were divided into postoperative observation group and postoperative control group according to the operation time. A daily injection of thrombin by drainage tube was performed on day 3 after operation in the postoperative observation group, the negative pressure drainage only was performed in the postoperative control group. The drainage volume in 72 h after operation, time of extubation, cases of subcutaneous effusion were counted after operation. Then the patients with subcutaneous effusion were divided into subcutaneous effusion observation group and subcutaneous effusion control group according to the time of extubation, the thrombin was injected into cavity after pumping subcutaneous effusion with pressing and dressing in the subcutaneous effusion observation group and only pressed after pumping subcutaneous effusion in the subcutaneous effusion control group, respectively. The healing time of subcutaneous effusion was counted in these two groups. ResultsCompared with the postoperative control group, the drainage volume in 72 h after operation was less(P < 0.001), the time of extubation was earlier(P < 0.001), the rate of subcutaneous effusion was lower(P < 0.05), color of drainage fluid on day 2 after mastectomy was lighter(P < 0.001)in the postoperative observation group. Compared with subcutaneous effusion control group, when subcutaneous effusion was 20-50 mL or > 50 mL, the healing time of subcutaneous effusion was significantly shorter in the subcutaneous effusion observation group(P < 0.05). ConclusionsInjecting thrombin by drainage tube after operation can reduce the drainage volume, decrease the rate of subcutaneous liquid, and shorten the time of extubation. Injecting thrombin into cavity of subcutaneous liquid can shorten the healing time of patients with middle and large subcutaneous effusions after radical resection of breast cancer.
Objective To explore the incidence of lipohypertrophy in patients with diabetes by meta-analysis, and provide a reference for preventing and reducing its occurrence. Methods A computer search was performed on PubMed, Embase, Web of Science, China National Knowledge Infrastructure, Wangfang Data and Chongqing VIP databases, supplemented by literature retrospective method and manual search. Relevant documents related to lipohypertrophy in diabetic patients were searched until September 2021. After conducting independent literature screening, data extraction and quality evaluation, the researchers used RevMan 5.4.1 and R 3.3.1 softwares for meta-analysis. Results Ten articles were included, including 0 in Chinese and 10 in English, and 20277 patients in total. The incidence of lipohypertrophy in patients with diabetes was 53% [95% confidence interval (44%, 62%)]. The heterogeneity among studies was statistically significant (I2=99%, P<0.00001). Meta-regression analysis of single covariates and multiple covariates found that publication year, research scope, research area, sample source, research center, and sample size could explaine 51.6% of the heterogeneity. Conclusion The incidence of lipohypertrophy in patients with diabetes is high, and effective intervention measures are urgently needed to prevent, diagnose and treat the problem of lipohypertrophy in patients with diabetes.
OBJECTIVE: To investigate the effect of subcutaneous tissue trimming on the survival skin area of avulsion skin flap. METHODS: Degloving injury was created in bilateral hind limbs of 7 pigs with avulsion injury machine, 4 cm x 10 cm avulsion skin flaps were elevated in degloving areas. Skin flaps in one side were replanted as control without any treatment. Subcutaneous tissue in the skin flaps of another side was partially excised and replanted by trimmed skin flaps. Survival skin flaps was calculated with computer at 7 days after operation. RESULTS: In the control group, the survival skin area was (40.41 +/- 9.23)%, while in the experimental group, the survival skin area was (60.90 +/- 15.26)%. There was significant difference between the two groups (P lt; 0.05). CONCLUSION: Trimming off subcutaneous tissue does improve the survival area of avulsion skin flap.
目的:研究糖尿病围手术期应用胰岛素泵持续皮下输注胰岛素的临床疗效。方法:68例糖尿病围手术期患者随机分为33例采用胰岛素泵持续皮下输注胰岛素治疗(CSII组),对照组35例采用常规多次皮下注射胰岛素治疗(MSII组),分别对术前、术后的相关指标进行对比研究。结果:治疗后两组各时点血糖均较治疗前显著下降(Plt;0.01)。CSII组达到目标血糖所用的时间明显少于MSII组(2.9比7.2天)(Plt;0.05),血糖达标率优于MSII组(93.%比77.1%)(Plt;0.05),低血糖发生率低于MSII组(9.1%比34.3%)(Plt;0.01)。待手术时间(4.2比9.4天)和住院时间(16比24天)明显缩短(Plt;0.05),但两组住院总费用无差异(Pgt;0.05)。〖结论:CSII在糖尿病患者围手术期中应用疗效及安全性方面优于MSII。