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

Unlabelled: The aim of this study was to analyze epidemiological characteristics of burn caused by severe fire disaster. The results of this study showed that a total 21,228 people were burned, 10,428 cases died and RMB 3320 millions yuan were lost in those fire disasters occurring in five years (from 1989 to 1993) in this country. The principal causes of the fire disaster were faults in administration and operations against regulations.

Conclusion: In order to prevent fire disaster propaganda should be carried out, jurisdiction should be enforced, active "law of fire control" and the program of constructive administration should be implemented. Those who are working in burn care should also participate in work of fire control and devote much attention to the investigation of burn epidemiology.

In order to meet the need for one-stage repair of large defects and organ reconstruction, the author designed and used the flap with multiple blood supply (MBSF) on 18 patients with 23 flaps in recent 8 years. All the flaps survived. The flap, nourished by 2 or 3 known arteries, was created from different regions including forehead, neck, ilio-abdominal region, medial lower leg and Achilles tendon region. The flaps were used in the following operations: nasal reconstruction, cervical defect covering, penis reconstruction, repair of the lower abdominal wall, wrist defect (4/5 circle) covering, treatment of osteomyelitis of the lower leg, exposure and infection of the ankle joint and the traumatic drop foot, etc. These difficult cases were successfully treated. It is anticipated that the MBSF will be developed and utilized on the other region of the body in the future.

A retrospective study was carried out, aiming at a proper treatment to the chronic radiation ulcer that is often difficult to deal with. Thirty-two cases of chronic radiation ulcer have been treated in the department since 1983. The cause, site, features and method of treatment were summarized. Thirty-one cases were cured, 26 cases healed by the first intention, 5 cases healed by the second intention. One died. It is emphasized that more knowledge should be gained for understanding and treatment of the chronic radiation ulcer. Different methods of debridement and repair should be performed according to the site, depth and pathologic features of the ulcer. To improve local circulation, an island flap is the first choice of treatment.

To observe the anatomy of the island flap based on the submental vessels for clinical applications, the blood supply in the submental region was studied on 51 cadavers by microsurgical dissection and dye injection. It was found that the submental region is supplied by the submental artery, which is a constant branch of the facial artery (100% rate of occurrence). The vessel was 60.0 +/- 7.9 mm in length with a diameter of 1.75 +/- 0.15 mm (mean +/- s) at its origin. There were rich anastomoses between submental arteries of both sides. Based on the reliable pedicle, the flap dimension can be as large as 130 mm x 65 mm.

This study was conducted to determine the relationship between abnormalities of cell-mediated immunity and gut-derived endotoxemia in rats following burns. Animals were subjected to a 40% full-thickness scald injury, and randomly divided into control and selective decontamination of the digestive tract (SDD) treated groups. It was found that thermal injury resulted in marked reductions in splenocyte proliferative response to concanavalin A or phytohemagglutinin, interleukin 2 (IL-2) production, and T helper/suppressor (Th/Ts) cells ratio. Prophylactic treatment with SDD significantly reduced the incidence of endotoxemia, prevented suppressive mitogenic response and inadequacy in IL-2 production (P < 0.05-0.01), but did not affect the abnormal ratio of Th/Ts in blood (P > 0.05). We conclude that bacteria/endotoxin translocation from the gastrointestinal tract appears to be involved in cellular immune dysfunction after thermal injury. Pretreatment with SDD might attenuate systemic immunosuppression by preventing translocation events.

We observed the changes in wound histopathology and fibrinolysis of rats with deep partial thickness burns during 10 days after scalding in order to study the relations of early progressive damage of deep partial thickness burn wound and the healing of the wound to fibrinolysis. Using Masson's trichrome stain of collagen, we demonstrated that partial thickness burn wound progressively deteriorated within 72 hours postburn, and epidermal cells on wound edge proliferated, creeping between necrotic and residual collagen by 10th day postburn. The results of assays of fibrinolytic parameters in plasma and 24 hour exudate from wound showed that fibrinolysis activated at 2 hour postburn but had been suppressed by 24 hour postburn till last day (10 day postburn) of the observation. The analysis of dynamic changes and relations in fibrinolytic parameters revealed that the suppressive factors of fibrinolysis might be enhanced activities of PAI, alpha 2-antiplasmin and antithrombin II after injury. Results suggested that suppression of fibrinolysis might protect fibrin deposited in the wound from lysis and play an important role in early progressive deterioration of deep partial thickness burn and regulation of its healing.

In order to investigate the effects of early enteral feeding on the gut after burn, 21 cases (mean burn area 45%) were randomly divided into early feeding group (EF group) and delayed feeding group (DF group). The results showed that the levels of plasma endotoxin and MDA in EF group were much lower on PBD 4, 8, 14 than those of DF group (P < 0.05-0.01), and plasma SOD was much lower in DF group on PBD 4, 8 (P < 0.01). The contents of serum gastrin and plasma motilin were obviously increased, and TNF IL-8 much lower in EF group at most time points (P < 0.05-0.01). Therefore, it seems that the early enteral feeding can decrease the level of plasma endotoxin in blood, reduce reperfusion injury of the gut, and blunt the chain reaction of "endotoxin-inflammatory mediator-gut mucosa injury."