Objective To compare the efficacy and complication between harmonic scalpel and traditional electric knife in open thyroidectomy. Methods A total of 160 thyroid disease patients who underwent open thyroidectomy in The Fifth Affiliated Hospital of Southern Medical University from February 2016 to January 2017, were collected and divided into harmonic scalpel group and traditional electric knife group randomly, each group enrolled 80 patients. The efficacy of thyroidectomy, postoperative pain, and complication between the 2 groups were compared and analyzed. Results Compared with the traditional electric knife group, the operation time, intraoperative blood loss, postoperative drainage volume, postoperative drainage time, length of incision, and hospital stay were all significantly lower in the harmonic scalpel group (P<0.05). The incidences hoarseness, wound bleeding, hypoparathyroidism, and total complication in the harmonic scalpel group were all lower than those of the traditional electric knife group (P<0.05). The pain scores after operation in the harmonic scalpel group were significant lower than corresponding pain scores of the traditional electric knife group (P<0.05). Conclusion The harmonic scalpel could effectively improve the efficacy of open thyroidectomy, reduce the pain degree and the incidence of complication in thyroid disease patients.
ObjectiveTo explore the surgical method and effectiveness of the great toenail bed flap supplied with the fibular dorsal artery of great toe in repair of the finger nail bed central longitudinal defect.MethodsBetween May 2012 and February 2017, 7 cases (7 fingers) with the finger nail bed central longitudinal defects were repaired with the great toenail bed flap supplied with the fibular dorsal artery of great toe. There were 3 males and 4 females; the age ranged from 17 to 35 years (mean, 27 years). The cause of injury included cutting injury in 2 cases, electric shaving injury in 3 cases, and frictional injury in 2 cases. The defect located at thumb in 3 cases, index finger in 3 cases, and middle finger in 1 case. The defect area ranged from 12 mm×8 mm to 21 mm×13 mm. The time from injury to admission was 1-2 hours (mean, 1.5 hours). The area of the great toenail bed flap ranged from 14 mm×10 mm to 23 mm×15 mm. The wound of donor site was directly sutured in 3 cases and repaired with full thickness skin graft in 4 cases.ResultsAll the great toenail bed flaps and skin grafts at the donor sites survived; and all wounds healed by first intention. All patients were followed up 9 to 36 months (mean, 23 months). The finger nails were smooth and shiny and recovered ideal appearance. At 9 months after operation, the two-point discrimination of the skin ranged from 7 to 9 mm (mean, 8 mm). According to the standard evaluation for nail bed repair issued by Zook etc., 6 cases were rated as excellent and 1 case as good, and the excellent and good rate was 100%.ConclusionIt is an ideal method to repair the finger nail bed central longitudinal defect with the great toenail bed flap supplied with the fibular dorsal artery of the great toe.