Breaking the technical barrier of microvascular anastomosis with high-speed videography: A prospective cohort study

Bao, Bingbo; Gao, Tao; Li, Xingwei; Wei, Haifeng; Lin, Junqing; Sun, Yinghao; Shen, Junjie; Zhu, Hongyi; Zheng, Xianyou

doi:10.1016/j.ijsu.2021.106214

Cited by 8 publications

(6 citation statements)

References 18 publications

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“…); and replantation surgery characteristics (e.g. surgeon’s experience and quality of vascular anastomosis) 25 . A huge challenge for hand surgeons in selecting a treatment plan for an individual amputated digit is to estimate accurately the likelihood of replantation failure for each patient.…”

Section: Discussionmentioning

confidence: 99%

Development and external validation of a prediction model for digit replantation failure after traumatic amputations based on a prospective multicenter cohort

Gao,

Bao,

Lin

et al. 2024

International Journal of Surgery

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Background: Failure of digit replantation after traumatic amputation is difficult to predict. We aimed to develop a prognostic model to better identify factors that better predict replantation failure following traumatic digit amputation. Materials and methods: In this multicenter prospective cohort, we identified patients who had received digit replantation between January 1, 2015, and January 1, 2019. Univariable and multivariable analyses were performed successively to identify independently predictive factors for failure of replanted digit. To reduce overfitting, the Bayesian information criterion was used to reduce variables in the original model. Nomograms were created with the reduced model after model selection. This model was then internally validated with bootstrap resampling and further externally validated in validation cohort. Results: Digit replantation was failed in 101 of 1062 (9.5%) digits and 146 of 1156 digits (12.6%) in the training and validation cohorts, respectively. We found that six independent prognostic variables were associated with digit replantation failure: age, mechanism of injury, ischemia duration, smoking status, amputation pattern (complete or incomplete), and surgeon’s experience. The prediction model achieved good discrimination, with concordance indexes of 0.81 (95% CI, 0.76-0.85) and 0.70 (95% CI, 0.65-0.74) in predicting digit failure in the training and validation cohorts, respectively. Calibration curves were well-fitted for both training and validation cohorts. Conclusions: The proposed prediction model effectively predicted the failure rate of digit replantation for individual digits of all patients. It could assist in selecting the most suitable surgical plan for the patient.

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Section: Discussionmentioning

confidence: 99%

Development and external validation of a prediction model for digit replantation failure after traumatic amputations based on a prospective multicenter cohort

Gao,

Bao,

Lin

et al. 2024

International Journal of Surgery

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“…1 However, it is technically demanding and warrants specialized microsurgery services. 14 The bilobed flap is a local transposition flap made of two flaps that are separated by an angle. It was originally designed to cover a small defect on the nose tip.…”

Section: Discussionmentioning

confidence: 99%

A Novel Utility of Bilobed Flap for Amputation Stump Coverage

Hasan

Aprilya

Surya

2023

Plastic and Reconstructive Surgery - Global Open

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Amputations are catastrophic events in someone's life. The amputation stump can be problematic, which may lead to soft tissue loss. Varieties of stump defect closure have been reported, ranging from the simplest to advanced soft tissue closure requiring microsurgical skills. 1 Aiming to provide a well-padded, stable, sensate, and painless soft tissue coverage to allow for the wearing of a well-fitted prosthesis, we chose a simple technique of using the bilobed flap.The bilobed flap is a local transposition flap designed for small-to moderate-sized defects on the facial region. 2 Since its first introduction by Esser 3 in 1918 for nasal tip reconstruction, numerous modifications have been made. Tissiani et al 4 describe the use of the bilobed flap in 42 cases in a wide range of anatomical sites, including the cheek, lip, thumb, and foot. Other literature reported its utilization for small foot ulcers and other small pathologies such as mucoid cysts. [5][6][7] We aimed to utilize this technically easy flap for better management of defect closure on amputated limb stumps that can benefit patients in areas without microsurgery service. To our knowledge, this is the first report of its utilization for large defects, particularly for stump defect closure. 8 METHODSTwenty-eight cases were treated with bilobed flaps as soft tissue defect closure from 2018 to 2022 in our center. Cases of the amputation stump coverage were included, and patients with a follow-up time less than 6 months or lost to follow-up were excluded. The main objective of this Reconstructive

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“…( 1 ) Leak-tight sealing of fluid-containing structures, including blood vessels and organs of the gastrointestinal tract after diseased part resectioning, are pivotal yet technically demanding surgical tasks. ( 2, 3 ) While sutures and staples are well-accepted and routinely used to re-connect tissues, their mechanical mismatch with biological soft tissue and invasiveness contribute to wound healing complications, infections, and fluid leakage after surgery. ( 4 ) Leaks and infections can rapidly deteriorate the patient’s condition and are significant causes of mortality.…”

Section: Introductionmentioning

confidence: 99%

Nanothermometry-enabled intelligent laser tissue soldering

Cipolato

Dosnon

Rosendorf

et al. 2023

Preprint

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While often life-saving, surgical resectioning of diseased tissues puts patients at risk for post-operative complications. Sutures and staples are well-accepted and routinely used to reconnect tissues, however, their mechanical mismatch with biological soft tissue and invasiveness contribute to wound healing complications, infections, and post-operative fluid leakage. In principle, laser tissue soldering offers an attractive, minimally-invasive alternative for seamless soft tissue fusion. However, despite encouraging experimental observations, including accelerated healing and lowered infection risk, critical issues related to temperature monitoring and control during soldering and associated complications have prevented their clinical exploitation to date. Here, we introduce intelligent laser tissue soldering (iSoldering) with integrated nanothermometry as a promising yet unexplored approach to overcoming the critical shortcomings of laser tissue soldering. We demonstrate that adding thermoplasmonic and nanothermometry nanoparticles to proteinaceous solders enables heat confinement and non-invasive temperature monitoring and control, offering a route to high-performance, leak-tight tissue sealing even at deep tissue sites. The resulting tissue seals exhibit excellent mechanical properties and resistance to chemically-aggressive digestive fluids, including gastrointestinal juice. The iSolder can be readily cut and shaped by surgeons to optimally fit the tissue defect and can even be applied using infrared light from a medically approved light source, hence fulfilling key prerequisites for application in the operating theatre. Overall, iSoldering enables reproducible and well-controlled high-performance tissue sealing, offering new prospects for its clinical exploitation in diverse fields ranging from cardiovascular to visceral and plastic surgery.TeaserIntelligent solders containing nanothermometers and thermoplasmonics offer new route to high-performance tissue sealing.

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Breaking the technical barrier of microvascular anastomosis with high-speed videography: A prospective cohort study

Cited by 8 publications

References 18 publications

Development and external validation of a prediction model for digit replantation failure after traumatic amputations based on a prospective multicenter cohort

Development and external validation of a prediction model for digit replantation failure after traumatic amputations based on a prospective multicenter cohort

A Novel Utility of Bilobed Flap for Amputation Stump Coverage

Nanothermometry-enabled intelligent laser tissue soldering

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