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Long LY, Chen YW, Deng RF, Jiang ZY, Zhang YL. [Application and research advances of delayed sural neurotrophic vascular flap for diabetic foot ulcers]. Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi 2024; 40:296-300. [PMID: 38548401 DOI: 10.3760/cma.j.cn501225-20231102-00173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Diabetic foot ulcer is one of the serious complications of diabetes. Diabetic wounds are of great difficulty to repair, causing a high amputation rate and a great burden to patients and their family members and society. Researches showed that the delayed sural neurotrophic vascular flap has a great effect in repairing diabetic foot ulcers. This article mainly reviewed the clinical status and research advances of the delayed sural neurotrophic vascular flap in repairing diabetic foot ulcers, intending to provide a reference for its application and research.
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Affiliation(s)
- L Y Long
- Burn Plastic Surgery and Wound Repair Medical Center, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Y W Chen
- Burn Plastic Surgery and Wound Repair Medical Center, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - R F Deng
- Burn Plastic Surgery and Wound Repair Medical Center, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Z Y Jiang
- Burn Plastic Surgery and Wound Repair Medical Center, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Y L Zhang
- Burn Plastic Surgery and Wound Repair Medical Center, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
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Deng RF, Long LY, Chen YW, Jiang ZY, Jiang L, Zou LJ, Zhang YL. [Clinical repair strategy for ischial tuberosity pressure ulcers based on the sinus tract condition and range of skin and soft tissue defects]. Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi 2024; 40:64-71. [PMID: 38296238 DOI: 10.3760/cma.j.cn501225-20231114-00194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
Objective: To investigate the clinical repair strategy for ischial tuberosity pressure ulcers based on the sinus tract condition and range of skin and soft tissue defects. Methods: The study was a retrospective observational study. From July 2017 to March 2023, 21 patients with stage Ⅲ or Ⅳ ischial tuberosity pressure ulcers who met the inclusion criteria were admitted to the First Affiliated Hospital of Nanchang University, including 13 males and 8 females, aged 14-84 years. There were 31 ischial tuberosity pressure ulcers, with an area of 1.5 cm×1.0 cm-8.0 cm×6.0 cm. After en bloc resection and debridement, the range of skin and soft tissue defect was 6.0 cm×3.0 cm-15.0 cm×8.0 cm. According to the depth and size of sinus tract and range of skin and soft tissue defects on the wound after debridement, the wounds were repaired according to the following three conditions. (1) When there was no sinus tract or the sinus tract was superficial, with a skin and soft tissue defect range of 6.0 cm×3.0 cm-8.5 cm×6.5 cm, the wound was repaired by direct suture, Z-plasty, transfer of buttock local flap, or V-Y advancement of the posterior femoral cutaneous nerve nutrient vessel flap. (2) When the sinus tract was deep and small, with a skin and soft tissue defect range of 8.5 cm×4.5 cm-11.0 cm×6.5 cm, the wound was repaired by the transfer and filling of gracilis muscle flap followed by direct suture, or Z-plasty, or combined with transfer of inferior gluteal artery perforator flap. (3) When the sinus tract was deep and large, with a skin and soft tissue defect range of 7.5 cm×5.5 cm-15.0 cm×8.0 cm, the wound was repaired by the transfer and filling of gracilis muscle flap and gluteus maximus muscle flap transfer, followed by direct suture, Z-plasty, or combined with transfer of buttock local flap; and transfer and filling of biceps femoris long head muscle flap combined with rotary transfer of the posterior femoral cutaneous nerve nutrient vessel flap; and filling of the inferior gluteal artery perforator adipofascial flap transfer combined with V-Y advancement of the posterior femoral cutaneous nerve nutrient vessel flap. A total of 7 buttock local flaps with incision area of 8.0 cm×6.0 cm-19.0 cm×16.0 cm, 21 gracilis muscle flaps with incision area of 18.0 cm×3.0 cm-24.0 cm×5.0 cm, 9 inferior gluteal artery perforator flaps or inferior gluteal artery perforator adipofascial flaps with incision area of 8.5 cm×6.0 cm-13.0 cm×7.5 cm, 10 gluteal maximus muscle flaps with incision area of 8.0 cm×5.0 cm-13.0 cm×7.0 cm, 2 biceps femoris long head muscle flaps with incision area of 17.0 cm×3.0 cm and 20.0 cm×5.0 cm, and 5 posterior femoral cutaneous nerve nutrient vessel flaps with incision area of 12.0 cm×6.5 cm-21.0 cm×10.0 cm were used. The donor area wounds were directly sutured. The survival of muscle flap, adipofascial flap, and flap, and wound healing in the donor area were observed after operation. The recovery of pressure ulcer and recurrence of patients were followed up. Results: After surgery, all the buttock local flaps, gracilis muscle flaps, gluteus maximus muscle flaps, inferior gluteal artery perforator adipofascial flaps, and biceps femoris long head muscle flaps survived well. In one case, the distal part of one posterior femoral cutaneous nerve nutrient vessel flap was partially necrotic, and the wound was healed after dressing changes. In another patient, bruises developed in the distal end of inferior gluteal artery perforator flap. It was somewhat relieved after removal of some sutures, but a small part of the necrosis was still present, and the wound was healed after bedside debridement and suture. The other posterior femoral cutaneous nerve nutrient vessel flaps and inferior gluteal artery perforator flaps survived well. In one patient, the wound at the donor site caused incision dehiscence due to postoperative bleeding in the donor area. The wound was healed after debridement+Z-plasty+dressing change. The wounds in the rest donor areas of patients were healed well. After 3 to 15 months of follow-up, all the pressure ulcers of patients were repaired well without recurrence. Conclusions: After debridement of ischial tuberosity pressure ulcer, if there is no sinus tract formation or sinus surface is superficial, direct suture, Z-plasty, buttock local flap, or V-Y advancement repair of posterior femoral cutaneous nerve nutrient vessel flap can be selected according to the range of skin and soft tissue defects. If the sinus tract of the wound is deep, the proper tissue flap can be selected to fill the sinus tract according to the size of sinus tract and range of the skin and soft tissue defects, and then the wound can be closed with individualized flap to obtain good repair effect.
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Affiliation(s)
- R F Deng
- Medical Center of Burn Plastic and Wound Repair, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - L Y Long
- Medical Center of Burn Plastic and Wound Repair, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Y W Chen
- Medical Center of Burn Plastic and Wound Repair, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Z Y Jiang
- Medical Center of Burn Plastic and Wound Repair, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - L Jiang
- Medical Center of Burn Plastic and Wound Repair, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - L J Zou
- Medical Center of Burn Plastic and Wound Repair, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
| | - Y L Zhang
- Medical Center of Burn Plastic and Wound Repair, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China
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Zhou XL, Tu JJ, Ye H, Wang XL, Sun JF, Long LY, Ding YM. [Clinical effects of island posterior femoral composite tissue flaps in the repair of sinus cavity pressure ulcers in the areas of ischial tuberosity and greater trochanter]. Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi 2023; 39:65-70. [PMID: 36740428 DOI: 10.3760/cma.j.cn501225-20220420-00148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Objective: To explore the clinical effects of island posterior femoral composite tissue flaps in the repair of sinus cavity pressure ulcers in the areas of ischial tuberosity and greater trochanter. Methods: The retrospective observational study was conducted. From December 2018 to December 2021, 23 patients with sinus cavity pressure ulcers in the areas of ischial tuberosity and greater trochanter who met the inclusion criteria were admitted to Ganzhou People's Hospital, including 16 males and 7 females, aged 45 to 86 years. The size of pressure ulcers in ischial tuberosity ranged from 1.5 cm×1.0 cm to 8.0 cm×5.0 cm, and the size of pressure ulcers in greater trochanter ranged from 4.0 cm×3.0 cm to 20.0 cm×10.0 cm before debridement. After treatment of underlying diseases, debridement and vacuum sealing drainage for 5 to 14 days were performed. All the wounds were repaired by island posterior femoral composite tissue flaps, with area of 4.5 cm×3.0 cm-24.0 cm×12.0 cm, pedicle width of 3-5 cm, pedicle length of 5-8 cm, and rotation radius of 30-40 cm. Most of the donor site wounds were sutured directly, and only 4 donor site wounds were repaired by intermediate thickness skin graft from the contralateral thigh. The survival of composite tissue flaps, wound healing of the donor and recipient sites and the complications were observed. The recurrence of pressure ulcers, and the appearance and texture of flaps were observed during follow-up. Results: A total of 32 wounds in 23 patients were repaired by island posterior femoral composite tissue flaps (including 3 fascio subcutaneous flaps, 24 fascial flaps+fascio subcutaneous flaps, 2 fascial flaps+fascial dermal flaps, 2 fascial flaps+fascio subcutaneous flaps+femoral biceps flaps, and one fascial flap+fascio subcutaneous flap+gracilis muscle flap). Among them, 31 composite tissue flaps survived well, and a small portion of necrosis occurred in one fascial flap+fascio subcutaneous flap post surgery. The survival rate of composite tissue flap post surgery was 96.9% (31/32). Twenty-nine wounds in the recipient sites were healed, and 2 wounds were torn at the flap pedicle due to improper postural changes, and healed one week after bedside debridement. One wound was partially necrotic due to the flap bruising, and healed 10 days after re-debridement. Thirty-one wounds in the donor sites (including 4 skin graft areas) were healed, and one wound in the donor site was torn due to improper handling at discharge, and healed 15 days after re-debridement and suture. The complication rate was 12.5% (4/32), mainly the incision dehiscence of the flap pedicle and the donor sites (3 wounds), followed by venous congestion at the distal end of flap (one wound). During the follow-up of 3 to 24 months, the pressure ulcers did not recur and the flaps had good appearance and soft texture. Conclusions: The island posterior femoral composite tissue flaps has good blood circulation, large rotation radius, and sufficient tissue volume. It has a high survival rate, good wound healing, low skin grafting rate in the donor site, few postoperative complications, and good long-term effect in the repair of sinus cavity pressure ulcers in the areas of ischial tuberosity and greater trochanter.
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Affiliation(s)
- X L Zhou
- Department of Burns and Plastic Surgery, Ganzhou People's Hospital, Ganzhou 341000, China
| | - J J Tu
- Department of Burns and Plastic Surgery, Ganzhou People's Hospital, Ganzhou 341000, China
| | - H Ye
- Department of Burns and Plastic Surgery, Ganzhou People's Hospital, Ganzhou 341000, China
| | - X L Wang
- Department of Burns and Plastic Surgery, Ganzhou People's Hospital, Ganzhou 341000, China
| | - J F Sun
- Department of Burns and Plastic Surgery, Ganzhou People's Hospital, Ganzhou 341000, China
| | - L Y Long
- Department of Burns and Plastic Surgery, Ganzhou People's Hospital, Ganzhou 341000, China
| | - Y M Ding
- Department of Burns and Plastic Surgery, Ganzhou People's Hospital, Ganzhou 341000, China
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Qin YZ, Zhu LW, Lin S, Geng SX, Liu SW, Cheng H, Wu CY, Xiao M, Li XQ, Hu RP, Wang LL, Liu HY, Ma DX, Guan T, Ye YX, Niu T, Cen JN, Lu LS, Sun L, Yang TH, Wang YG, Li T, Wang Y, Li QH, Zhao XS, Li LD, Chen WM, Long LY, Huang XJ. [An interlaboratory comparison study on the detection of RUNX1-RUNX1T1 fusion transcript levels and WT1 transcript levels]. Zhonghua Xue Ye Xue Za Zhi 2019; 40:889-894. [PMID: 31856435 PMCID: PMC7342382 DOI: 10.3760/cma.j.issn.0253-2727.2019.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Indexed: 02/05/2023]
Abstract
Objective: To investigate the current status and real performance of the detection of RUNX1-RUNX1T1 fusion transcript levels and WT1 transcript levels in China through interlaboratory comparison. Methods: Peking University People's Hospital (PKUPH) prepared the samples for comparison. That is, the fresh RUNX1-RUNX1T1 positive (+) bone morrow nucleated cells were serially diluted with RUNX1-RUNX1T1 negative (-) nucleated cells from different patients. Totally 23 sets with 14 different samples per set were prepared. TRIzol reagent was added in each tube and thoroughly mixed with cells for homogenization. Each laboratory simultaneously tested RUNX1-RUNX1T1 and WT1 transcript levels of one set of samples by real-time quantitative PCR method. All transcript levels were reported as the percentage of RUNX1-RUNX1T1 or WT1 transcript copies/ABL copies. Spearman correlation coefficient between the reported transcript levels of each participated laboratory and those of PKUPH was calculated. Results: ①RUNX1-RUNX1T1 comparison: 9 samples were (+) and 5 were (-) , the false negative and positive rates of the 20 participated laboratories were 0 (0/180) and 5% (5/100) , respectively. The reported transcript levels of all 9 positive samples were different among laboratories. The median reported transcript levels of 9 positive samples were from 0.060% to 176.7%, which covered 3.5-log. The ratios of each sample's highest to the lowest reported transcript levels were from 5.5 to 12.3 (one result which obviously deviated from other laboratories' results was not included) , 85% (17/20) of the laboratories had correlation coefficient ≥0.98. ②WT1 comparison: The median reported transcript levels of all 14 samples were from 0.17% to 67.6%, which covered 2.6-log. The ratios of each sample's highest to the lowest reported transcript levels were from 5.3-13.7, 62% (13/21) of the laboratories had correlation coefficient ≥0.98. ③ The relative relationship of the reported RUNX1-RUNX1T1 transcript levels between the participants and PKUPH was not always consistent with that of WT1 transcript levels. Both RUNX1-RUNX1T1 and WT1 transcript levels from 2 and 7 laboratories were individually lower than and higher than those of PKUPH, whereas for the rest 11 laboratories, one transcript level was higher than and the other was lower than that of PKUPH. Conclusion: The reported RUNX1-RUNX1T1 and WT1 transcript levels were different among laboratories for the same sample. Most of the participated laboratories reported highly consistent result with that of PKUPH. The relationship between laboratories of the different transcript levels may not be the same.
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Affiliation(s)
- Y Z Qin
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing 100044, China
| | - L W Zhu
- Beijing Hightrust Diagnostics Co., Ltd, Beijing 100176, China
| | - S Lin
- Department of Hematology, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China
| | - S X Geng
- Department of Hematology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, China
| | - S W Liu
- Harbin Institute of Hematology and Oncology, Harbin 150010, China
| | - H Cheng
- Changhai Hospital, The Second Military Medical University, Shanghai 200433, China
| | - C Y Wu
- Institute of Hematology, Henan Provincial People's Hospital, Zhengzhou 450003, China
| | - M Xiao
- Department of Hematology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030
| | - X Q Li
- Center for Stem Cell Research and Application, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022
| | - R P Hu
- Department of Hematology, Bethune First Affiliated Hospital of Jilin University, Changchun 130021
| | - L L Wang
- Department of Hematology, Chinese PLA General Hospital, Beijing 100853, China
| | - H Y Liu
- Department of Hematology, Affiliated Hospital of Nantong University, Nantong 226001, China
| | - D X Ma
- Department of Hematology, Qilu Hospital of Shandong University, Jinan 250012, China
| | - T Guan
- Department of Hematology, Shanxi Provincial Cancer Hospital, Taiyuan 030000, China
| | - Y X Ye
- Department of Laboratory Medicine, West China Hospital of Sichuan University, Chengdu 610041, China
| | - T Niu
- Department of Hematology, West China Hospital of Sichuan University, Chengdu 610041, China
| | - J N Cen
- The First Affiliated Hospital of Soochow University, Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Disease, Suzhou 215006, China
| | - L S Lu
- Tianjin Sino-us Diagnostics Co., Ltd, Tianjin 301617, China
| | - L Sun
- Wuhan Kindstar Diagnostics Co., Ltd, Wuhan 430075, China
| | - T H Yang
- Department of Hematology, The First People's Hospital of Yunnan Province, Kunming 650034, China
| | - Y G Wang
- Department of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou 310003, China
| | - T Li
- Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
| | - Y Wang
- The First Hospital of China Medical University, Shenyang 110001, China
| | - Q H Li
- Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Clinical Research Center for Hematologic Disease, Tianjin 300020, China
| | - X S Zhao
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing 100044, China
| | - L D Li
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing 100044, China
| | - W M Chen
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing 100044, China
| | - L Y Long
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing 100044, China
| | - X J Huang
- Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing 100044, China
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Chen WM, Liu H, Li LD, Long LY, Lai YY, Shi HX, Zhao XS, Jiang H, Jiang Q, Liu YR, Qin YZ. [Clinical, molecular and cytogenetic characteristics of newly diagnosed adult acute myeloid patients with TP53 gene mutation]. Zhonghua Xue Ye Xue Za Zhi 2019; 40:528-531. [PMID: 31340630 PMCID: PMC7342400 DOI: 10.3760/cma.j.issn.0253-2727.2019.06.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
- W M Chen
- Institute of Hematology, Peking University Peoples'Hospital, Beijing 100044, China
| | - H Liu
- Xinjiang Uygur Autonomous Region People's Hospital, Urumchi 830001, China
| | - L D Li
- Institute of Hematology, Peking University Peoples'Hospital, Beijing 100044, China
| | - L Y Long
- Institute of Hematology, Peking University Peoples'Hospital, Beijing 100044, China
| | - Y Y Lai
- Institute of Hematology, Peking University Peoples'Hospital, Beijing 100044, China
| | - H X Shi
- Institute of Hematology, Peking University Peoples'Hospital, Beijing 100044, China
| | - X S Zhao
- Institute of Hematology, Peking University Peoples'Hospital, Beijing 100044, China
| | - H Jiang
- Institute of Hematology, Peking University Peoples'Hospital, Beijing 100044, China
| | - Q Jiang
- Institute of Hematology, Peking University Peoples'Hospital, Beijing 100044, China
| | - Y R Liu
- Institute of Hematology, Peking University Peoples'Hospital, Beijing 100044, China
| | - Y Z Qin
- Institute of Hematology, Peking University Peoples'Hospital, Beijing 100044, China
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