Digital nerve injuries are the mostly detected nerve injury in the upper extremity. However, since the clinical phenomenon of crossover innervation at some degree from uninjured digital nerve to the in- jured side occ...Digital nerve injuries are the mostly detected nerve injury in the upper extremity. However, since the clinical phenomenon of crossover innervation at some degree from uninjured digital nerve to the in- jured side occurs after digital nerve injuries is sustained, one could argue that this concept might even result in the overestimation of the outcome of the digital nerve repair. With this knowledge in mind, this study aimed to present novel, pure, focused and valuable clinical data by comparing the outcomes of bilateral and unilateral digital nerve repair. A retrospective review of 28 fingers with unilateral or bilateral digital nerve repair using end-to-end technique in 19 patients within 2 years was performed. Weber＇s two-point discrimination, sharp/dull discrimination, warm/cold sensation and Visual Analog Scale scoring were measured at final 12-month follow ups in all patients. There was no significant difference in recovery of sensibility after unilateral and bilateral digital nerve repairs. Though there is crossover innervation microscopically, it is not important in the clinical evaluation period. According to clinical findings from this study, crossover innervations appear to be negligible in the estimation of outcomes of digital neurorrhaphy.展开更多
Background:Generally,advanced wound care resources are applied for complex wounds that pose a challenge to the medical and nursing teams.In this report,the use of leukocyte-and platelet-rich fibrin(L-PRF)is emphasized...Background:Generally,advanced wound care resources are applied for complex wounds that pose a challenge to the medical and nursing teams.In this report,the use of leukocyte-and platelet-rich fibrin(L-PRF)is emphasized for complex wounds as an alternative,simple,inexpensive,time-saving process that does not require hospitalization and has a healing potential over that of bare soft tissue,including bone,tendon,and ligaments.The aim of this study is to extend the use of L-PRF in small-to-moderate-sized complex wounds of lower extremities in which L-PRF maintains the sensitive structures viable.Methods:Between January 2016 and December 2017,17 small-to-moderate-sized complex wounds of lower extremities treated with L-PRF were recruited from the plastic and reconstructive surgery clinic in Aydin State Hospital,Turkey.The treatment was administered twice per week in the outpatient clinic.Depending on the size and extension of the complex wound,two to five blood samples were collected into 8.5 ml dry,glass vacuum tubes with no anticoagulant,and samples were immediately centrifuged at 1630×g for 5 min to obtain L-PRF.Complete healing was defined as the day of complete wound epithelialization.Results:The median values of the initial wound size and wound duration were 12 cm^(2)(interquartile range,6 to 23 cm^(2))and 8 months before first admission(interquartile range,4 to 18 months),respectively.All wounds showed significant improvements after L-PRF therapy and full closure after a median of 18months,with an interquartile range of 11 to 34 months of L-PRF applications.There were recurrences of wounds during the first 6 months after therapy.No adverse events were observed.Conclusions:Our results add to the growing evidence that L-PRF treatments protect and maintain bare soft tissue structures viable,facilitate the formation of granulation tissue and epithelization,and remarkably reduce the need for additional soft tissue surgeries in small-to-medium-sized complex wounds.展开更多
文摘Digital nerve injuries are the mostly detected nerve injury in the upper extremity. However, since the clinical phenomenon of crossover innervation at some degree from uninjured digital nerve to the in- jured side occurs after digital nerve injuries is sustained, one could argue that this concept might even result in the overestimation of the outcome of the digital nerve repair. With this knowledge in mind, this study aimed to present novel, pure, focused and valuable clinical data by comparing the outcomes of bilateral and unilateral digital nerve repair. A retrospective review of 28 fingers with unilateral or bilateral digital nerve repair using end-to-end technique in 19 patients within 2 years was performed. Weber＇s two-point discrimination, sharp/dull discrimination, warm/cold sensation and Visual Analog Scale scoring were measured at final 12-month follow ups in all patients. There was no significant difference in recovery of sensibility after unilateral and bilateral digital nerve repairs. Though there is crossover innervation microscopically, it is not important in the clinical evaluation period. According to clinical findings from this study, crossover innervations appear to be negligible in the estimation of outcomes of digital neurorrhaphy.
文摘Background:Generally,advanced wound care resources are applied for complex wounds that pose a challenge to the medical and nursing teams.In this report,the use of leukocyte-and platelet-rich fibrin(L-PRF)is emphasized for complex wounds as an alternative,simple,inexpensive,time-saving process that does not require hospitalization and has a healing potential over that of bare soft tissue,including bone,tendon,and ligaments.The aim of this study is to extend the use of L-PRF in small-to-moderate-sized complex wounds of lower extremities in which L-PRF maintains the sensitive structures viable.Methods:Between January 2016 and December 2017,17 small-to-moderate-sized complex wounds of lower extremities treated with L-PRF were recruited from the plastic and reconstructive surgery clinic in Aydin State Hospital,Turkey.The treatment was administered twice per week in the outpatient clinic.Depending on the size and extension of the complex wound,two to five blood samples were collected into 8.5 ml dry,glass vacuum tubes with no anticoagulant,and samples were immediately centrifuged at 1630×g for 5 min to obtain L-PRF.Complete healing was defined as the day of complete wound epithelialization.Results:The median values of the initial wound size and wound duration were 12 cm^(2)(interquartile range,6 to 23 cm^(2))and 8 months before first admission(interquartile range,4 to 18 months),respectively.All wounds showed significant improvements after L-PRF therapy and full closure after a median of 18months,with an interquartile range of 11 to 34 months of L-PRF applications.There were recurrences of wounds during the first 6 months after therapy.No adverse events were observed.Conclusions:Our results add to the growing evidence that L-PRF treatments protect and maintain bare soft tissue structures viable,facilitate the formation of granulation tissue and epithelization,and remarkably reduce the need for additional soft tissue surgeries in small-to-medium-sized complex wounds.
