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: This study was to investigate the in vitro cultivation, biological characteristics and ultrastructure of the fibroblasts derived from normal skin, hypertrophic scar and keloid, to elucidate the value of their application.

Method: A comparative study was performed on cell proliferation, cell morphology, cytogenetic feature and cell ultrastructure of fibroblasts from normal skin, hypertrophic scar and keloid by means of the technique of in vitro culture.

Result: The results indicated that the fibroblasts isolated from normal skin, hypertrophic scar and keloid exhibited similar morphology and growth rates. The cytogenetic feature and cell ultrastructure were also alike.

Conclusion: According to our study and that of others, we conclude that it is entirely feasible to establish an in vitro culture model of fibroblasts from normal skin for investigation, prevention and treatment of scars.

Objective: To correct hallux valgus in the young or middle-aged female.

Method: Through dissecting foot specimens with hallux valgus we found that the intrinsic factor that caused hallux valgus was a "capstan" like mechanism of pressure. In order to eliminate the mechanism of the deformity, we cut off the link between the adductoris hallucis and the hallux completely. The tendon of adductoris hallucis was sutured to the fascial flap of hallucis bursa passing through a hole in the caput of the metatarsus. By this way the adductoris hallucis was fixed to the 1st metatarsus strongly, thus it pulled the 1st metatarsus directly.

Results: Twenty feet received this operation. 18 feet were followed up for 0.5-4 years. The rate of excellent and good results was 100%.

Conclusion: This operation by suturing the adductoris hallucis with the fascial flap of the hallucis bursa not only can relieve pain but also restore the normal appearance of the foot.

Objective: To investigate the feasibility of free transference of the posterior leg flap which is supplied by the lateral popliteal cutaneous artery.

Methods: Anatomical dissection is performed in twenty-two freshly amputated adult lower extremities.

Results: The discovery rate of the lateral popliteal cutaneous artery is 100%. The vessel is 20.0 +/- 5.7 cm in length with an exterior diameter of 1.28 +/- 0.25 mm at the junction of the popliteal artery. The course of the artery is constant, and it is usually accompanied by the lateral sural cutaneous nerve. Seven operations using this free flap have been performed successfully.

Conclusion: The flap is suitable for repairing medium-sized soft tissue defects or for functional reconstruction.

Objective: This study was to compare the content of fibronectin messenger RNA in the normal skin and hypertrophic scars.

Methods: The mRNA levels of fibronectin were measured by quantitative RT-PCR.

Result: The study revealed that in vivo, the content of fibronectin messenger RNA was higher in hypertrophic scars than in normal skin.

Conclusion: It indicates that altered regulation of extracellular matrix components is an important factor for abnormal human wound healing.

Objective: The purpose of this study was to investigate the capillary distribution characteristics of the human skin.

Method: The alkaline phosphatase enzyme histochemical and stereological methods were used to measure the length density (Lv) of capillaries of normal skin. One hundred and twenty specimens were taken from 20 different sites in 6 children cadavers.

Result: The results showed: 1. The capillary Lv of the human skin varied with the body region. Statistically significantly (P < 0.01) greater capillary Lv was found in the head-face/neck region both in the papillary and reticular dermis than in the other parts of the body (excluding palm and sole). The smallest dermal capillary Lv was noted in the lower limb. 2. Statistically significantly (P < 0.001) higher capillary Lv was found in the papillary dermis than in the reticular dermis.

Conclusion: The study confirms the regional and laminal differences in capillary density of the normal human skin, and it demonstrates more accurately rich blood supply in the head-face/neck region, which supports the hypothesis that longer random-pattern skin flaps can be safely raised in the head-face/neck than in other parts of the body.

Objective: Based on the histomorphologic differences of three parts of keloid, i.e., invasive, proliferative and senile regions, the study was carried out to explore the differences of expression of type I and type III procollagen mRNAs in the three different parts of keloid and normal skin.

Method: Four samples of keloid from four patients and two samples of normal skin were collected. The expression of pro alpha 1 (I) and pro alpha 1 (III) procollagen mRNAs in keloid and normal skin was investigated by in situ hybridization techniques.

Result: Both type I and III procollagen mRNAs levels increased in keloid, especially type I, resulting in elevated ratios of type I to III procollagen mRNA. In keloid, expressive intention of type I and type III procollagen mRNAs was higher in the papillary layer than in the reticular layer. Also the expressive intention of type I and type III in keloid was higher in invasive and proliferative regions than in the senile region. However, expressive intention of type I and type III procollagen mRNAs in the invasive region of keloid was similar to that in the proliferative region.

Conclusion: The differences of expression of type I and type III procollagen mRNAs in different pathological regions of keloid and normal skin is one cause of forming different pathological regions in keloid.

Objective: To evaluate the effect of fluid resuscitation with addition of anisodamine (Ani) on myocardial function in severely burned rabbits.

Methods: III degree burn injury covering 25% total body surface area (TBSA) was produced on rabbits. LVSP, LV +/- dp/dtmax were measured with fluid resuscitation alone, administration of Ani alone, and fluid resuscitation plus Ani before burn, immediately after burn and 1, 3, 5, 7 h after burn.

Results: It was showed that myocardial contractility and relaxation were depressed 1 h after burn. Fluid resuscitation alone and administration of Ani alone could significantly improve myocardial contractility and relaxation only within 3 h postburn. With fluid resuscitation plus Ani (5 mg.kg-1), myocardial contractility and relaxation were improved statistically significantly as compared with control group without treatment (P < 0.01), with the values approaching the normal level.

Conclusion: Our data demonstrate that the administration of Ani (5 mg.kg-1) in addition to fluid resuscitation is beneficial to burn injury, especially to myocardial function, and it provides a promising approach for the future treatment of burns.

Objective: This is to introduce a method for repairing and restoring the elbow joints and their function of the patients suffering from serious high-voltage electric burns in upper extremity.

Methods: We designed the transposition of latissimus dorsi myocutaneous flap (MCF) to repair the wounds of elbow, as well as restore the joint's flexion function by the motor power of the muscle. This procedure salvaged the elbow joints, which would have to be amputated before.

Results: 8 cases, 10 limbs were involved. All flaps survived completely and 6 of them had primary healing while the other 4 flaps healed after dressing changing. The elbow joints and their functions were satisfactorily restored in 5 limbs and the functions were also regained through further elbow joint release procedures in 2 limbs. The other 3 limbs (2 cases) lost contact with us and so the results were not clear.

Conclusion: This method has evident advantages and satisfactory results.

Objective: To determine the wound healing effect of rHGH in adult burn patients.

Methods: 16 patients with burn wounds covering over 60% of total body surface (TBSA) were enrolled in this placebo controlled prospective study. They were comparable in nutrient intake, TBSA, and full thickness burn area. rHGH group patients were given rHGH subcutaneously in the dose of 0.3u.Kg-1 at 8 am each morning for 10 days beginning from POD 1. The control group patients were given normal saline as placebo. All the patients received scar excision within 4 days postburn, and the excision wounds were covered with autologous skin pulp grafting. Serum amino acid profile was analyzed at day 1 and day 20 post burn. Healing time of burn wound area and donor site was recorded. Wound healing rate was assessed at day 30 after day.

Results: 1. The healing time of autologous skin pulp grafting and donor site, and the length of hospital stay were significantly shorter in GH group patients than control group. 2. The amino acid profile showed no difference between two groups at day 1 and was significantly better in GH group at day 20.

Conclusion: rHGH could enhance the wound healing rate, improve amino acid profile, and reduce the length of hospital stay of severe burn patients.

Objective: The experiment was designed to solve the problem that free fat transplantation survived at low percentage.

Methods: Based on physiochemical and biological characteristics of bFGF, fibrinogen was used as its carrier of sustained delivery. We applied bFGF and fibrinogen in pearl adipose transplantation. Different concentrations of bFGF and fibrinogen were used. The relation between the concentration of bFGF and fibrinogen and their effects on fat graft maintenance were observed.

Results: At three months after transplantation, the weight of the fat graft varied from 98% to 225%. The latter was approximately consistent with synchronous increase of the body weight of the animal. Weight increase of the graft was closely related to the concentration of bFGF and the sustained delivery carrier. When bFGF in the concentration of 4000 U/10 microliters and fibrinogen of 1000 mg% were applied, the fat graft obtained the greatest weight increase. Histologically, the structure of the transplanted fat was normal with fibrotic envelope and mature adipocytes.

Conclusion: bFGF with fibrinogen as its carrier of sustained delivery favors the survival of fat graft and weight increase. The effects of bFGF and fibrinogen depend on their concentration.