Background and aims. The aim of this study is to find the most suitable protocol based on an animal experimental model, through the use of a fluorescent dye, determining also its minimal concentration needed to stain the skin after arterial injection, in order to be evidence the functional perforasome by visual examination. Methods. Methylene blue solution was used in order to determine the territory vascularized by one perforator  on fresh cadavers in many studies which introduced, as a final result, the concept of perforasome. One of the most frequent complications of perforator flaps is partial flap necrosis which could be avoided by correctly assessing pre-operatively the functional perforasome surface. Two groups of seven rats were used in order to establish a proper surgical protocol to evaluate the functional perforasome in vivo by injecting the dye. Also, the minimal concentration for methylene blue was experimentally determined. Results. The direct injection into the femoral artery of the proper concentration of dye, 1mM for methylene blue and the clamping of all the branches except the medial branch of the superficial epigastric artery is a reliable model to study the functional perforasome. Conclusions. Our study demonstrates that the intraoperative assessment with fluorescent dye of the functional perforasome by intra-arterial injection of methylene blue is an easy, affordable and very efficient method to reduce the number of partial necrosis of the perforator flaps.

was assessed every 100 cycles. Samples were tested to failure at the completion of 500 cycles. Results were compared to previously published data using the same model for testing other repair techniques. Results: Mean gap formation after 500 cycles was 1.84 mm. Mean load to failure was 47.5 N. This compared favourably with data for other repair modalities. Clinical evaluation of patients following repair of distal FDP division confirmed comparable outcome to other repair modalities. Conclusion: Our results demonstrate that this repair technique is biomechanical sound and has comparable in vitro strength compared to other techniques of repair at this site. The repair can be used clinically with good results and is technically straightforward, having the advantage of not requiring suturing over a button, and not requiring suture anchor technology.Introduction: The lesions of the distal extensor aponeurosis (Mallet finger) due to various types of injuries represent an intruding and disabling disease of the fingers. This can lead, despite treatment, to joint modifications and movement impairment. Various methods of repair were recommended from splint immobilization for long periods to tendon reconstruction by different techniques. We describe possible new method consisting in reconstruction by dermical bandelets. Material and methods: Our technique is based on a long and narrow (2-3 cm/2-3 mm) de-epithelized skin bandelet harvested from one border of the longitudinal incision made to explore the lesion. This bandelet remains pedicled on its proximal end. It is reinserted distally at the base of the distal phalanx through a transosseous hole using a steel wire 4/0-5/0 and is also sutured to the remnants of the aponeurosis. The bandelet is then buried subcutaneous. The DIP joint is maintained in extension by a intramedullary K-wire. The DIP joint is also immobilized using a splint. The Kwire is removed after 3 weeks and the steel wire after 4 weeks. The splint is maintained one more week, followed by controlled mobilization. Results: We used this method in 97 cases. We had recurrence of the deformity in 10 cases, from which three cases required arthrodesis. The functional restoration is 75% to 90% in DIP stability and mobility, with an extension deficit of 5 to 10 degrees.

Tissue defects still determine a high surgical interest in finding new and more efficient methods of covering. Perforator flaps are considered one of the most important methods of reconstruction, for defects all over the body. Anatomists, surgeons, radiologists are fervently searching ways to improve their reliability and also strategies to ensure that the chosen flap to be used is the best for that case. It has been proven that tissue defects’ reconstruction involves knowing the exact anatomy and physiology of various vascular sources, but there are still unknown factors that sometimes induce perforator flaps failure. Objective: The aim of this study is to identify and evaluate by two imagistic methods the perforator vessels in an experimental model of perforator flaps in pig. Methods: The imagistic method employed was the X-ray angiography and Color Doppler vascular ultrasonography with high performance equipment. The explored perforators were located on the body of the experimental model, that was divided in 9 regions and the comparison was made between the perforators identified by imagistic methods and by microsurgical careful dissection. Results: This study revealed that the average sensibility of ultrasound per region was 52.66% and the average sensibility of angiography per region was 35.30% on the entire lot. Conclusion: The Color Doppler ultrasonography is a very reliable method for detection of the perforator vessels, with better results compared with X-ray angiography, detecting even the smaller perforators. So, the surgeon can rely the operative planning on this preoperative vascular exploration.