A series of 15 consecutive patients with various hand defects requiring flap coverage was reviewed in this study. The defects were all covered with the distally based posterior interosseous flap. Its main indications were in complex hand trauma, severe burn injury, or skin cancer ablation, either acute or postprimary. In 12 of the patients, flaps survived completely. In 3 patients, there was partial necrosis of the distal part of the flap, which did not require additional surgical procedure. Radial nerve palsy was noted in one of the cases, with a complete recovery after 3 months. Donor site was closed directly in up to 4-cm-wide flaps, while larger flaps required skin grafting. No major anatomic variation was observed. Distally based posterior interosseous flap is a reliable choice for various types and areas of hand defects, with very low donor-site morbidity, and should be more commonly considered in clinical practice.
Diabetes mellitus, a complex metabolic disorder, leads to many health complications like kidney failure, diabetic heart disease, stroke, and foot ulcers. Treatment approaches of diabetes and identification of the mechanisms underlying diabetic complications of the skin have gained importance due to continued rapid increase in the diabetes incidence. A thick and pre-vascularized in vitro 3D type 2 diabetic human skin model (DHSM) was developed in this study. The methacrylated gelatin (GelMA) hydrogel was produced by photocrosslinking and its pore size (54.85 ± 8.58 μm), compressive modulus (4.53 ± 0.67 kPa) and swelling ratio (17.5 ± 2.2%) were found to be suitable for skin tissue engineering. 8% GelMA hydrogel effectively supported the viability, spreading and proliferation of human dermal fibroblasts. By isolating dermal fibroblasts, human umbilical vein endothelial cells and keratinocytes from type 2 diabetic patients, an in vitro 3D type 2 DHSM, 12 mm in width and 1.86 mm thick, was constructed. The skin model consisted of a continuous basal epidermal layer and a dermal layer with blood capillary-like structures, ideal for evaluating the effects of anti-diabetic drugs and wound healing materials and factors. The functionality of the DHSM was showed by applying a therapeutic hydrogel into its central wound; especially fibroblast migration to the wound site was evident in 9 d. We have demonstrated that DHSM is a biologically relevant model with sensitivity and predictability in evaluating the diabetic wound healing potential of a therapeutic material.
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