Skin flap necrosis in guinea pigs: limitation of glucose supply and accumulation of lactate.

The distribution of glucose and lactate within skin flaps was determined in full-thickness guinea pig skin (excluding the panniculus carnosus). The distal end of the flaps had a low glucose content (less than 50 percent of normal) but high lactate level (2 to 3 times normal) during the 3 days after flap elevation. Progressively decreasing gradients of glucose content, and increasing gradients of lactate content, were demonstrated from the mid-region to the distal end of the flaps at 3 hours postoperatively. The decrease in glucose and the accumulation of lactate may play a significant role in skin necrosis.     

Where are we going?

The foregoing study attempts to document the course of the American Society of Plastic and Reconstructive Surgeons, Inc. during the period 1964-1973, inclusive. A special attempt has been made to delineate the current trends. Trends, when recognized, may be enhanced, modified, or prevented-as deemed appropriate by the membership.     

Needle aspiration of the flexor digital sheath as an aid in diagnosing tenosynovitis.

We review our experience with needle aspiration of the flexor digital sheath in 11 digits in 6 patients. There have been no complications or false negative aspirations, and the maneuver has supplemented the clinical signs to aid in diagnosis.