It is recommended that the VC be used for congested pedicled flaps instead of leech therapy, as VC is more effective, easy, and safe in blood removal, and it has less complication.
The main aim of the treatment in fingertip amputations is to establish the functional and aesthetic construction of the fingertip. The aim of this study is to discuss how to use purse-string suture as a complementary technique accompanying conventional flaps repair in fingertip amputation. Fifty-four patients with fingertip amputations on the nail bed referred to our center for fingertip reconstruction. From which 41 patients who had at least one-third of their nail remained (to preserve the nail) were chosen to undergo this new technique. Patient's satisfaction of the achieved functional results (in case of pain and motion) was as follows: 32 responded excellent, 8 good, and 1 fair. Also, patient's satisfaction of the achieved aesthetic results were Excellent = 7 and Good = 2 in females (n = 9) and Excellent = 19, Good = 7 and Fair = 6 in males (n = 32). 93% (38 patients) of the patients had two-point discriminationof less than 3 mm. No flap necrosis was observed in this study. The flap donor site was covered by primary closure (in 24 cases), secondary intention (in 11 cases), and skin graft (in 6 cases). The nail and finger contour are important for achieving a satisfying aesthetic and functional result. We believe that this new complementary technique could be an easy way for reaching this end. It is recommended that this technique be applied to all fingertip injuries to preserve the nail.
Flexor tendon lacerations still represent a challenging problem for the hand and the plastic surgeon, particularly in zone II. Many techniques have been devised accordingly to make the surgery of this zone easier. Hence, we too have devised an added complementary technique (ie, the parachute technique) to the common surgical techniques of the tendon repair to ease the repairing process and improve the outcomes. In this study, 79 patients, from whom 21 patients had 2 injured fingers, with flexor tendon injury in zone II (ie, 100 fingers) underwent this new technique. Finally, the results were hopeful. Thus, this complementary parachute technique combined with an early active mobilization with almost full range of flexion and extension, starting on the first postoperative day, resulted in improved outcomes compared with both passive mobilization and gentle active mobilization with a limited range of motion (ie, "controlled"). The Strickland formula (total active motion) system was used to evaluate the functional results of the flexor tendon repair. Finally, this technique is applicable for tendon repairs, and is shown to produce good results in their hands.
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