ObjectiveTo summary the application and effectiveness of the posterior radial collateral artery (PRCA) compound flap in reconstruction of soft tissue defect after tongue cancer excision. MethodsBetween August 2011 and October 2011, 5 patients with squamous cell carcinoma underwent tongue defects reconstruction with compound flap with extended lateral arm free flap (ELAFF) and triceps muscle flap (TMF) after ablation in one-stage. All patients were male with an average age of 59 years (range, 43-71 years). The disease duration was 25-60 days (mean, 42 days). After extended resection, 3 cases had 1/3 tongue and mouth floor defect, and 2 cases had 1/2 tongue and mouth floor defect. The size of ELAFF ranged from 7 cm × 5 cm to 9 cm × 5 cm, and the size of TMF ranged from 3 cm × 3 cm to 4 cm × 4 cm. The donor sites were directly sutured. ResultsAll compound flaps survived. The wounds at donor sites and recipient sites healed primarily. The patients were followed up 6 months. After operation, the tongue had good appearance and motion; the patients had clear voice and no dysphagia. No recurrence was observed during follow-up. Local numbness appeared at the donor sites, but the function of the elbows was normal. ConclusionThe application of the compound flap of ELAFF and TMF based on PRCA perforator is a better option to reconstruct tongue defects for its reliable blood supply, appropriate thickness, easy operative procedures, and less complication.
Objective To investigate the effect of autologous osteochondral tissue and periosteum transplantation on tendon-bone healing of rotator cuff in rabbits. Methods Twenty-four male New Zealand white rabbits were randomly divided into autologous osteochondral tissue and periosteum transplantation group (experimental group, n=12) and simple suture group (control group, n=12). Both groups were subjected to acute supraspinatus tendon injury and repaired with corresponding techniques. At 4, 8, and 12 weeks after operation, 4 specimens from each group were taken from the right shoulder joint for histological examination (HE staining, Masson staining, and Safranin O-fast green staining), and the left shoulder was subjected to biomechanical tests (maximum tensile load and stiffness). Results Both groups of animals survived until the completion of the experiment after operation. At 4 weeks after operation, both groups showed less collagen fibers and disorder at the tendon-bone junction. At 8 weeks, both groups showed reduced inflammation at the tendon-bone junction, with more organized and denser collagen fibers and chondrocytes. The experimental group showed better results than the control group. At 12 weeks, the experimental group showed typical tendon-bone transition structure, with increased generation of collagen fibers and chondrocytes, and the larger cartilage staining area. Both groups showed an increase in maximum tensile load and stiffness over time (P<0.05). The stiffness at 4 weeks and the maximum tensile load at 4, 8, and 12 weeks in the experimental group were superior to control group, and the differences were significant (P<0.05). There was no significant difference between the two groups at other time points (P>0.05). Conclusion Autologous osteochondral tissue and periosteum transplantation can effectively promote the fiber and cartilage regeneration at the tendon-bone junction of rotator cuff and improve the biomechanical effect of shoulder joint in rabbits.