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 nasal musculature and its relationship with the deformities of the unilateral cleft lip nose.

Method: The anatomic and histological examination and comparison of the musculus depressor septi nasi (MDSN) were performed in 33 normal cadavers and 30 patients with unilateral cleft lip undergoing the operation for secondary nasal deformities.

Result: It was found that the MDSN in the cleft side of a unilateral cleft lip nose is lacking.

Conclusion: Because of the anatomic deficiency on the cleft side, the function of the normal side is pathologically increased. The functional imbalance between the normal and abnormal side may bring about dislocation and malformation of the base of nasal columella as well as the septal structures.

Objective: To improve surgical results we have applied the free parascapular flap in children for facial or cervical burn scar contracture.

Method: Eight children aged from 6 to 9 years received free flap transfer. Based on the defect and the distribution of the cutaneous branches of the circumflex scapular vessels, the flap was designed with its size ranging from 15 cm x 8 cm to 22 cm x 6.5 cm.

Result: Free flap transferring with microvascular anastomosis was successful in all cases. The average operation time was 5 hours with average blood loss being about 100 ml.

Conclusion: Free flap transplantation is safe and beneficial in children when the technique and skill of microsurgery and plastic and reconstructive surgery are mastered and intraoperative blood loss is controlled under 1% of the total blood volume. The vertically oriented parascapular flap can not only provide proper tissue for reconstraction but also minimise the donor site morbidity.

Objective: A method of photographic standardization for rhinoplasty is presented.

Method: To delineate the nose objectively before and after rhinoplasty, we designed a method to standardize picturing by using the points and lines in the face and camera in nasal photography.

Result: With the help of anatomic points in the face and lines in the camera, we can maintain the camera at a constant position to the face. In this way, the nasal picture is more comparable and instructive.

Conclusion: This method has been proved to be helpful in rhinoplasty.

Objective: We introduce the experience of treating 10 cases with excessive hyperplasia of skin keratosis at the limb end. There were 9 cases of palmar and plantar keratosis and 1 case of epidermodysplasia verruciformis.

Method: All cases received the operation of lesion excision and skin grafting except 2 cases who received skin flap for defect covering after lesion excision because of deep tissue exposure and postradiation ulcer.

Result: The operative effects were satisfactory after 8 years of follow-up. No recurrence was found in all cases and all patients resumed normal activity.

Conclusion: The effect of the skin flap is better than skin graft at the plantar area. Because of lack of fibrous septum in the subcutaneous tissue, the flap, often moving during walking, is liable to trauma and ulceration. The operation area must be well protected.

Objective: A method for cleft palate repair was used for the purpose of diminishing surgical interference with maxillary growth.

Method: Sixteen cases of cleft palate were repaired with bilateral buccal musculomucosal flaps.

Result: The operation results in all cases were satisfactory.

Conclusion: It is concluded: 1. The method does not traumatize the periosteum of the hard palate, thus alleviating postoperative maxillary deformity; 2. The buccal musculomucosal flap is generally long enough to reach across the incisive foramen and maintain good blood circulation; 3. The method benefits reconstruction of the levator sling and facilitates velopharyngeal closure.

Objective: To evaluate the effects of different concentration of hydrofluoric acid (HF) on local skin and calcium level of serum.

Methods: SD rats were divided into two groups which were wounded by 20% and 40% percent of HF respectively. Samples of blood and wound tissue were harvested at different postburn time for the analysis of the calcium level of the serum and histological study.

Results: It was found that twenty percent of HF was enough to cause a skin damage, and might bring about fatal hypocalcemia after a prolonged contact. High concentration of HF (40%) could cause deep tissue necrosis within a short time, and result in a fatal hypocalcemia within 24 hour even in the case of a small area injury.

Conclusion: It is important to treat the patient with HF injury as early as possible. Sufficient calcium must be applied guided by laboratory study in order to prevent the fatal hypocalcemia.

Objective: To provide practical clinical guidelines to doctors who have no hemodynamic monitoring facilities in performing escharectomy during the shock period in extensively burned patients.

Methods: We analyzed our clinical experiences in 60 patients with extensive burn.

Results: Puting forward several clinical indexes for timing of escharectomy during burn shock stage: 1. Amount of fluids in the first 24 h postburn 2.6-3.0 ml.kg-1.1% TBSA-1; 2. Output of urine 80-100 ml/h; 3. Mentally fully conscious; 4. Thirst significantly alleviated and there is no nausea and vomiting; 5. Pulse 100/min; 6. Hb < or = 150 g/L; 7. Hct < or = 0.50.

Conclusion: With the clinical indexes as guidelines, we assume that escharectomy could be performed during burn shock stage with reasonable safety.

Objective: To observe influence of escharectomy during and after burn shock stage upon the changes in plasma ET and NO.

Methods: 35% TBSA full-thickness burn was produced in pigs, which were divided into two groups. Group S was a group undergoing escharectomy during burn shock stage at 24 h postburn. Group C was a group receiving escharectomy at 96 h after injury. ET and NO were determined and ET/NO was calculated.

Results: The levels of ET and NO were higher after injury than before injury in both groups. The level of ET was lower significantly in group S than in group C from 96 h postburn on. The level of NO was higher in group S than in group C. The ET/NO was lower in group S than in group C from PBH 24 on.

Conclusion: Escharectomy during burn shock stage was beneficial in reducing injury of endothelial cells, decreasing exudation and edema, decreasing tissue hypoxia and improving microcirculation.

Objective: To investigate bacterial resistance to antimicrobial agents in the background of extensive employment of third-generation cephalosporins in the treatment of burn infection.

Methods: Bacterial susceptibility testing was carried out using Kirby-Bauer method.

Results: Out of 259 Gram negative bacilli isolates, 31% of these strains were all resistant to cefotaxime, ceftriaxone, cefoperazone and ceftazidime. In vitro test, susceptibility of 52% third-generation cephlosporins resistant strains were restored by cefoperazone/sulbactum. 23.8% of P. aeruginosa were resistant to imipenem, 51.2% to ciprofloxacin. 28.6% of A. anitratum were resistant to imipenem, 21.4% to ciprofloxacin. 9.9% of enterobacteriaceae were resistant to imipenem, 20.4% to ciprofloxacin. 26.9% of MRSA were resistant to imipenem, 73% to ciprofloxacin. No norvancomycin resistance was detected. 2.7% of E. faecalis were resistant to norvancomycin.

Conclusion: It is likely that the observed resistance to third-generation cephalosporins may be partially due to chromosome-mediated type-1 beta- lactamase.