Zhonghua zheng xing shao shang wai ke za zhi = Zhonghua zheng xing shao shang waikf [i.e. waike] zazhi = Chinese journal of plastic surgery and burns最新文献

Objective: In order to research the effects of supplement Zn on wound healing, the changes of Zn in serum and skin, growth hormone and hydroxyproline of skin were observed in burn rats.

Method: 80 SD rats were randomly divided into four groups: Control group of 8 rats, N group (diet containing Zn 40 micrograms/g), W group (application of Zn on burn skin), H group (diet containing Zn 80 micrograms/g). 8 rats of each group were killed on 1, 3, 7 days after burn.

Results: The levels of serum Zn declined on 1 day postburn in N and W groups, whereas the content of serum Zn in H group elevated and were 2.4, 2.0 times as much as that of N and W groups respectively (P < 0.01). Zn in burn skin increased significantly on 3, 7 days in W group and was 1.3, 1.5 times as much as that of N group. Serum growth hormone increased in all groups postburn. The highest level appeared in H group. Hydroxyproline in burn skin decreased in all groups, but it began to increase on 7 day postburn in W group.

Conclusion: Supplementation of Zn by diet rapidly raises the levels of Zn in serum, burn skin and growth hormone. It is beneficial to apply Zn to the wound to improve wound healing. Hydroxyproline increased significantly with application of Zn to burn wound. It is better to supply Zn by diet and topical application simultaneously.

Objective: To measure the content of substance P in human hypertrophic scar.

Method: The method of radioimmunoassay was used to determine the content of substance P in human hypertrophic scar, non-hypertrophic scar and normal skin.

Result: The content of substance P in hypertrophic scar was significantly higher than that in non-hypertrophic scar and normal skin (P < 0.01).

Conclusion: Substance P may play an important role in the process of hypertrophic scar development.

Objective: This study was conducted to determine the changes in PMN adhesive capacity to endothelial cells and transmigration through endothelial cell (CEC) sheet in the presence of the serum from rats with smoke inhalation injury (SII). The effects of adhesion molecules CD11a, CD11b, and ICAM-1 on the PMN adhesion and transmigration were also studied.

Method: In the present study fluorescent assay, EC sheet cultured on the 5 microns permeable membrane and antibody blocking technique were used to study the PMN adhesion and transmigration in vitro.

Result: It was found that the serum from SII rats could promote PMN adhesion to CEC sheet. After being cultured with the serum for 12-24 h, PMN adhesion to CEC was more than three times of that in control. The serum also enhanced PMN transmigration through the CEC sheet in vitro, doubling the amount observed in control when the sheet was cultured with the serum for 24 h. Based on the above data it was believed that the SII rat serum could enhance PMN adhesion to and transmigration through lung capillary, and the percentages of PMN adhesion and transmigration were found to be positively correlated (r = 0.975). Furthermore, the antibodies against CD11a, CD11b, and ICAM-1 reduced PMN adhesion 44%, 55% and 51%, respectively, and at the same time decreased PMN transmigration 39%, 65%, and 58%, respectively.

Conclusion: In the presence of serum obtained from SII rats PMN adhesion to and transmigration through CEC sheet increased, which is the possible underlying mechanism responsible for PMN infiltration in vitro. Moreover, the adhesion molecules such as CDA11a, CD11b, and ICAM-1 play an important role in the process. Infiltrated PMN could release oxygen free radicals and protease to injure lung tissue.

Objective: The study was designed to investigate the changes in some rheological parameters and ET-1 in venous blood following electrical burns.

Methods: One of the hind limbs of rabbits was subjected to 3000 V, 2.5 A charge of alternative electric current for 3 seconds. Rheological parameters such as red cell deformability (RED) and platelet aggregation rate (PAR), as well as endothelin-1 (ET-1) in venous blood drained from electrical burn wounds and contents of ATP in damaged muscle were measured at time intervals of 2 h, 24 h, 48 h and 72 h postburn.

Results: The changes in the parameters mentioned above were significant following electrical injury. The administration of PGE1 showed an advantageous effect in prevention of thrombosis and muscle "progressive necrosis" through improvement in RCD, reduction of PAR and the content of ET-1 in local circulation.

Conclusion: RCD, PAR and the content of ET-1 in local circulation changed significantly following electric injury and may play an important role in the process of "progressive necrosis". The potential use of PGE1 in the treatment of electrical injury is proposed.

Objective: To improve the design and application of the flag flap.

Method: Based on the anatomical characteristics of the dorsal digital veins and the venous arch, the flag flap pedicled with the veins in the dorsum of the finger was used to repair the skin defects of the ventral finger and hand in six cases.

Results: All flaps survived with primary healing. Three months' follow-up showed that the function and appearance of the finger were satisfactory.

Conclusion: The design of the flap broadens its application in repairing the defects on the ventral finger and hand.

Objective: The experiment was to investigate the effects of respiratory airflow on gas exchange.

Method: Eight healthy dogs were anesthetized with thiopentone. A 3-D partial dynamic analyzer was used to determine the inspiratory and expiratory flow velocity, and arterial blood samples were collected for blood-gas analysis during spontaneous respiration. Intravenous muscle relaxant was given quickly and the animals were kept apneic and then vapor (105 degrees C) was inhaled for 5 seconds. HFJV was carried out at random under 5 different conditions, each for 20 minutes. Changes in inspiratory velocity (Vi), expiratory velocity (Ve), Reynole's number, PaCO2, PaO2, and PIP were observed.

Result: 1. During spontaneous respiration, airflow was in form of laminar flow when Re < 1000, and expiratory airflow was either laminar or turbulent when 1000 < Re < 1500. 2. During HFJV, both expiratory and inspiratory airflow were turbulent when Re > 1500. 3. The expiratory velocity with HFTJV increased significantly (P < 0.05). PaCO2 decreased significantly (P < 0.05) compared with HFJV. Obvious negative correlation was found between them (r = -0.9216, P < 0.05), meanwhile inspiratory velocity had an increasing tendency.

Conclusion: 1. HFJV could maintain normal ventilation of dogs with inhalation injury. The mechanism might be associated with turbulent flow. 2. On the basis of HFJV, HFTJV increases inverse jet airflow, thus the respiratory airflow velocity may be increased and CO2 elimination improved.

Objective: To investigate the characteristics of the burn injury caused by coal mine explosion so as to enhance the cure rate.

Methods: Analyse the therapeutic result after planned standard treatment of clinical patients and review historical patients.

Results: 1. Coal mine explosion includes two types, i.e., gas explosion and coal dust explosion. 2. This kind of burn is a combined injury with pathologic changes of burns as the main feature. Mechanical injury is the chief cause of early death. Blast injury mainly damages the lungs. The occurrence of carboxyhemoglobinemia is not often. 3. The amount of fluid infusion in the first 24 h in exudation phase is 8% less of the traditional formula. Alkaline balanced salt solution is supplied as electrolyte solution, which can provide 45% of necessary HCO3- for correction of acidosis. 4. No thorough debridement is imposed in the treatment of burn wound. Baking with electric bulb with topical SD-Ag in semi-exposure state can be used. 5. Inhalation injury chiefly occurs in upper respiratory tract. The main bacterial species causing complicated lung infection are Pseudomonas aeruginosa and Staphylococcus aureus. 6. When MSOF occurs, the most frequently involved organ and system are the kidney and respiratory system. 7. The main bacteria causing systemic invasive infection are enteric bacilli and Pseudomonas aeruginosa. Enteric bacilli infection may be enterogenic. The latter infection is chiefly the result of cross infection in hospital.

Conclusion: The burn caused by coal mine explosion is a combined injury characterized by pathologic changes of burn as the main issue. This kind of burn has two types, i.e., gas-explosion-burn and coal-dust-explosion-burn.

Objective: To study the best method in repairing the defect with a large area of bare tibia.

Method: Three hundred and twenty-two cases of large bare tibia defects were treated by three microsurgical methods.

Results: The bare tibiae in the 322 cases ranging from 12 x 3 cm to 24.0 x 3.5 cm were covered with myocutaneous flaps. Primary wound healing was achieved in 300 cases and delayed healing in 22 cases. All the cases were followed-up for 1 to 5 years. The function of the lower limbs was evidently improved. None of them was amputated due to deficit of skin coverage. The patients were all satisfied with the operative results.

Conclusion: Transposition of the bridging skin flap pedicaled with the contralateral posterior tibial blood vessels can cover extensive bare tibia to avoid amputation. Other myocutaneous flaps from thoraco-umbilical, tensor muscle of fascia lata and scapular-lateral chest areas are good options too.