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Sant'Ambrogio di Torino, Italy

Toia F.,University of Palermo | Marchese M.,Presidio | Boniforti B.,Ortopedia e Traumatologia Ospedale S. Andrea | Tos P.,UOD Reconstructive Microsurgery | Delcroix L.,Reconstructive Microsurgery Unit
Surgical and Radiologic Anatomy

Purpose: The aim of this study was to explore the cutaneous vascularization of the hypothenar region and investigate the anatomical basis for perforator propeller flaps for coverage of the flexor aspect of the little finger. Methods: The area between the pisiform and the base of the little finger was studied in 14 hands of fresh cadavers injected with red latex. An oval flap 1.5 cm large was raised along the axis between these two points. Perforators going into the flap were dissected up to their origin from the ulnar palmar digital artery of the little finger, and their distance from the proximal edge of the A1 pulley was recorded. Results: The mean number of perforator arteries entering the flap was 5.8 (range 4-8). A constant sizeable perforator was identified within 0.7 cm from the proximal margin of the A1 pulley in all 14 specimens. In the majority of cases (64 %), the most distal perforator was located at this level. Dissection of the flap was carried out suprafascially on the most distal perforator and 180 rotation allowed the flap to reach the flexor surface of the fifth finger. The donor site was closed primarily. Conclusion: Distal perforators of the ulnar palmar digital artery of the little finger are constantly found. Our anatomical findings support the possibility of raising a propeller perforator flap from the hypothenar region for coverage of the flexor aspect of the little finger. Its clinical application could provide a quick and straightforward single-stage option with a negligible donor-site morbidity for reconstruction of such defects. © 2013 Springer-Verlag France. Source

Tos P.,Reconstructive Microsurgery Unit | Catalano F.,Messina University
Musculoskeletal Surgery

Compared with flexor digitorum profundus (FDP) tendon injury, the isolated rupture of flexor digitorum superficialis (FDS) tendon in a finger is a rare report in the literature. The pathogenesis is still unclear if we consider only tendon rupture without congenital anomalies or other diseases. The diagnosis is clinical, but it can be confirmed by ecography or magnetic resonance imaging (MRI). We report the case of a flexor superficialis (FS) tendon closed rupture of the ring finger of right hand in a 57-year-old patient. The diagnosis was confirmed by MRI. No surgical repair was used, given the limited clinical repercussions. © 2011 Springer-Verlag. Source

Marrelli M.,University of Calabria | Menichini G.,Reconstructive Microsurgery Unit | Provenzano E.,Operative Unit of Dermatology | Conforti F.,University of Calabria
Current Medicinal Chemistry

Despite significant advances in early diagnosis and treatment, skin cancer is one of the leading causes of death. Photodynamic therapy (PDT) is a new therapeutic modality that is emerging as an important resource against malignant tumors. This strategy is based on the action of photosensitizers, i.e. of molecules which may accumulate preferentially inside tumor cells where they exert a cytotoxic effect after excitation by light at appropriate wavelengths. Some forms of skin cancers and also some non-tumor pathologies are now treated with PDT. Several compounds with photosensitizing activity have been identified, and some of these molecules are commercially available. Many photoactive principles are natural compounds. Numerous reviews in the last decade have focused on photodynamic therapy, its effects and applications, but less attention has been paid to plant extracts or molecules of natural origin studied for their phototoxic activity to date.This review critically examines the potential role of various plant extracts and naturally occurring compounds in the treatment of skin cancer. Both in vitro and in vivo effects of these agents, together with their known related cellular and molecular mechanisms, are presented and discussed. © 2014 Bentham Science Publishers. Source

Crosio A.,Reconstructive Microsurgery Unit | Valdatta L.,University of Insubria | Cherubino M.,University of Insubria | Izzo M.,University of Insubria | And 4 more authors.
Journal of Neuroscience Methods

Background: Perineural fibrotic adhesions are among the major complications of peripheral nerve surgery. While different experimental models have been used for the pre-clinical testing of anti-adherential strategies, the methods used so far to induce scar tissue appear to be poorly standardized and reproducible. New method: Thirty adult mice were used. Two methods were tested: the first one is based on burning the perineural muscular bed with a diathermocoagulator, while the second is based on direct scratching of the nerve surface with a cotton swab. After 3 weeks, the fibrotic reaction was assessed by measuring the peak pull out force of the nerve from muscular bed by means of a new tool specifically devised for biomechanical assessment of scar tissue formation. Moreover, histological analysis with specific collagen stain was also carried out. Results: Both methods produced fibrotic reaction. Statistical analysis of biomechanical data showed a significant difference between burning and scratching group compared to the control sham operated group. No significant differences were detected between burning and scratching group. Histological analysis showed the presence of perineural scar tissue in both groups, though with a different distribution pattern. Comparison with other methods: This protocol is easier to perform. The tool used for biomechanical evaluation is reliable and cheap. Conclusions: Both methods for perineural scar formation are effective and simple. They represent reproducible models for the study of the anti-adherential strategies. Yet, biomechanical testing with the device that we have developed proved to be a reliable and simple method for the quantitative assessment of the degree of perineural adhesion formation. © 2014 Elsevier B.V. Source

Tos P.,Reconstructive Microsurgery Unit | Crosio A.,Reconstructive Microsurgery Unit | Pellegatta I.,University of Insubria | Valdatta L.,University of Insubria | And 3 more authors.
Muscle and Nerve

Introduction: Perineural scar formation is responsible for pain and loss of function after surgical procedures. Neurolysis and application of anti-adhesion gels are required to restore a gliding surface. We tested a carboxymethylcellulose (CMC) and polyethylene oxide (PEO) gel on mouse sciatic nerve to describe its safety and efficacy. Methods: Adult mice underwent a surgical procedure in which we burned the muscular bed of the sciatic nerve bilaterally (Burned group) and applied anti-adhesion gel to 1 of the nerves (Burned+gel group). After 3 weeks, we studied scar tissue by biomechanical and histological evaluation. Results: Both histological and biomechanical analysis showed that the gel reduced perineural scarring. The difference between the Burned and Burned+gel groups was statistically significant. Conclusions: CMC-PEO gel can reduce perineural scar tissue. In histological section, scar tissue was present in both groups, but in the Burned+gel group a gliding surface was identified between scar and nerve. © 2016 Wiley Periodicals, Inc. Source

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