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See detailCombined reconstruction of the diabetic foot including revascularization and free-tissue transfer
Verhelle, N. A.; Despret, Vinciane ULg; Nelissen, Xavier ULg et al

in Journal of Reconstructive Microsurgery (2004), 20(7), 511-517

Diabetic patients, presenting with both peripheral vascular disease and large soft-tissue defects, are too often treated by primary amputation. A combined revascularization and free-tissue transfer ... [more ▼]

Diabetic patients, presenting with both peripheral vascular disease and large soft-tissue defects, are too often treated by primary amputation. A combined revascularization and free-tissue transfer procedure can extend limb salvage in these patients. The authors report their experience over 4 years with 19 diabetic patients with peripheral vascular disease and large soft-tissue defects of the foot requiring free-tissue transfer. Although there was a 100 percent flap survival, early local wound problems occurred in three patients (16.6 percent). The recurrence rate was about 18.7 percent, but no complementary flap procedures were mandatory. With a mean follow-up of 38 months (range: 23 to 55 months), the limb salvage rate was 94.4 percent. Although there was one limb loss and one patient with ambulation difficulties, 16 patients (84.2 percent) were fully rehabilitated and were able to function independently. Despite a rather small series, this study confirms that in selected diabetic patients, a combined approach of vascular and reconstructive surgeons can reduce the limb amputation rate with acceptable complication rates. This combined approach offers major benefits to these patients, especially stable coverage and preservation of ambulation, and should always be considered before amputation. [less ▲]

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See detailNew approach to vascular injection in fresh cadaver dissection.
Heymans, Olivier Y; Nelissen, Xavier P; Peters, Stephane et al

in Journal of Reconstructive Microsurgery (2004), 20(4), 311-5

Vascular injection techniques for anatomic studies are often complementary. Use of colored gelatinous mixtures with methylene blue provides precious data about descriptive anatomy by the contrast that it ... [more ▼]

Vascular injection techniques for anatomic studies are often complementary. Use of colored gelatinous mixtures with methylene blue provides precious data about descriptive anatomy by the contrast that it produces in the tissues. The introduction of radiopaque medium, such as lead oxide, into the gelatinous mixture can be used as a complement by means of x-ray examination, in order to facilitate and to reduce the time of investigation. Addition of rhodamine B to the radiopaque mixture keeps the advantages of the contrast medium, but also permits further dissection to demonstrate some details shown by prior x-ray examination. This article compares these different injection techniques in the study of the nasal vascular network. Moreover, it depicts a new injection approach that allows the investigation of vascular territories depending on thin caliber arteries by selective reinjection, defining microangiosomes. Each above-cited technique was used in ten facial territories of fresh cadavers. The patterns of the vessels shown by these techniques were identical, with a constant visualization of infra-millimetric arteries. However, selective reinjection was the only method that permitted characterization of the proper vascular territory of the lateral nasal artery. [less ▲]

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