Objective To summarize the injury characteristics of the whole hand degloving injury and to explore its classification and treatment. Methods Between December 1999 and May 2010, 41 cases of the whole hand degloving injury were admitted for treatment. There were 28 males and 13 females with an average age of 35 years (range, 18-58 years). The causesof injury included mangled injury in 28 cases and crush injury in 13 cases. The interval between injury and surgery was 1-10 hours (mean, 3 hours). According to self-made classification standard for whole hand degloving injury, 11 cases were rated as type I, 5 cases as type II, 4 cases as type III, 8 cases as type IV, and 13 cases as type V. Type I injury was treated by replantation surgery with vascular anastomosis, type II by reconstruction with thumb flap and the second toe containing dorsal skin flap, type III by reconstruction with the second toe containing dorsal skin flap of both feet, type IV by replantation surgery with vascular anastomosis, and type V by reconstruction with thumb flap containing dorsal skin flap (8 cases) or repairing with abdominal flap (5 cases). The size of the dorsal flap was between 9 cm × 6 cm and 17 cm × 11 cm and the dorsal donor site was covered with free skin grafting. Results After surgery, partial necrosis occurred at fingers in 6 patients with type I injury, and at fingers and palm skin in 6 patients with type IV injury; the flaps, the reconstructed fingers, and replanted skin all survived in the others. The grafted skin at donor sites successfully healed. Forty cases were followed up from 6 months to 7 years (mean, 14 months). The skin color and texture were close to normal hand in the cases undergoing replantation, who had the best function restoration with S2-S4 sensory recovery; the hand function was basically restored with S2-S3 sensory recovery in the cases undergoing finger reconstruction with thumb and toe flaps; and the restoration of the hand function was not satisfactory with S1-S2 sensory recovery in the cases undergoing abdominal flaps. Conclusion Whole hand degloving injury can be classified into different types according to injury degree and this will help choose the cl inical treatment plan. The appropriate treatment based on these types can obtain better cl inical effectiveness.
Objective To investigate the consistency of regions of interest (ROI) volume among different radiological treatment planning systems (TPS) for the same group of patient data, and analyze the tendency and degree of differences caused by data transfer. Methods Between October 2010 and December 2013, the data of 10 nasopharyngeal carcinoma patients treated in West China Hospital were transferred from Monaco TPS into various other treatment planning systems. Based on different ROI volumes, they were divided into 8 groups. We counted the volume differences between these TPS and Monaco TPS, and carried out the statistical analysis. Results For small ROI volume, the calculated difference reached up to 65% in our study. As a general trend, differences became less and less with the increasing of volumes. But for single ROI, the volume difference was likely to vary randomly. The percentage of ROI volumes which were smaller than that of Monaco TPS was 70% for Raystation TPS, 38.75% for Pinnacle TPS, 88.75% for Eclipse TPS, 97.5% for Masterplan TPS, and 83.13% for iPlan TPS. Conclusions ROI volume differences exist generally among different treatment planning systems when ROIs are transferred among them by DICOM protocol. The volume variations may be affected by multiple factors. The volume consistency should be evaluated before any direct comparison of dose volu me histogram parameters which are done between different systems.