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: To appraise the effect of certain pro-inflammatory mediators on the pathogenesis of acute gastric mucosal lesion in early burn stage.

Methods: 21 patients with burn injuries of over 30% TBSA were divided into A and B groups according to the main clinical indexes during shock resuscitation and hemodynamic parameters. Fiberoptic endoscopic examination, determination of intramucosal pH (pHi) and measurement of some mediators were done immediately after admission to the hospital and 4 and 7 days after burn injury.

Results: It was demonstrated that the level of LPS in plasma, the content of TNF-alpha, IL-8 and ET in group B at 4 and 7 days postburn were significantly higher than those of group A, while the value of pHi in group B was markedly lower than that of group A. Damaging index of gastric mucosa was negatively correlated with pHi (r = -0.89, P < 0.05), but positively with ET (r = 0.91, P = 0.05).

Conclusions: These findings suggest that the inflammatory mediators and cytokines promoted secondary damage to gastric mucosa during early postburn. It was believed that pHi was a sensitive index, and it played an important role in the development of stress ulceration.

Objective: This work was to provide an advanced operation method for square face correction.

Methods: The method is characterized by resecting hyperostosis of the mandibular angle, the bulky masseter and the buccal fat pad through intraoral or combined extra-intraoral approach.

Results: Good results were obtained in 10 cases after follow-up of 4 to 28 months.

Conclusion: This operative method proved to be quite ideal and applicable to treat square face.

Objective: This study was to explore the pathological action of the adjacent connective tissues of alar cartilage in unilateral cleft lip nose.

Methods: Anatomic-histological and pathoanatomical study was carried on 40 normal cadavers and 30 patients with secondary deformities of unilateral cleft lip during their operations.

Results: Six kinds of connective tissues with different histological features were found between the alar cartilage and adjacent skin, cartilage or bone. There was no histological difference in each connective tissue between the normal and the cleft lip nose. In the cleft lip nose, due to histological differences among the six connective tissues, there existed various changes of pathological dislocations between the alar cartilage and adjacent skin, cartilage or bone.

Conclusion: The authors suggest that the surrounding connective tissues of the alar cartilage play an important role and be the intrinsic basis to produce the characteristic deformities of the cleft lip nose. The result is helpful in understanding the anatomical and histological features of the connective tissues around the alar cartilage and the deformities of the unilateral cleft lip nose so as to select a reasonable operation method.

Objective: A method is introduced to obtain good aesthetic and functional results in repairing complicated defects on the face and neck, or total skin defects of the upper limb.

Methods: Two to four expanders are implanted in different areas where the color and texture of skin are similar to that of the defects, expanded simultaneously. During the second operation, several flaps corresponding to the defect areas are created and employed in one procedure.

Results: Six patients of 4-41 years old were treated with this technique. All of them have been followed up for 12-18 months with satisfactory results.

Conclusion: Carefully planned, this maneuver shows better effects than the conventional method in repairing the skin defects of face, neck and upper limb.

Objective: This study examined the changes in myocardial calcium transport function and what roles it played in cardiac dysfunction after severe burn injury.

Methods: Contraction relaxation properties of the left ventricule (LV) were studied in isolated heart preparations of Wistar rat 3, 8, 24 hours after 30% TBSA full thickness burn. Sarcoplasmic reticulum (SR) calcium transport function was measured by millipore filtration technique.

Results: The maximal rates of LV pressure elevation (+ dp/ dtmax) and depression (-dp/dtmax) in burn group were significantly lower than that in control group (P < 0.01). The initial rate and capacity of calcium uptake by SR decreased markedly in burn group than in control group (P < 0.01). In addition, calcium dependent ATPase activity and coupling ratio of SR were also markedly depressed.

Conclusion: SR calcium transport function depression was closely related to cardiac contractile dysfunction, and the former is one of the important mechanism for cardiac contractile dysfunction after severe burn injury.

Objective: The purpose of this paper is to provide the experience in using the pedicled buccal fat pad (BFP) graft in cleft palate repair when healing by secondary intention may need to be considered due to the width of the cleft; the qualitative or quantitative tissue constraints, the dead cavity between the oral and nasal layers or single layer closure of the hard palate with the vomer and marginal pedicled mucosoperiosteal flap.

Methods: The body and buccal extension of BFP is gently torn out from its bed and advanced into the palate vault around the posterior aspect of the maxilla to cover the raw surface of the hard palate cleft and/or fill the dead cavity between the oral and nasal tissue layers, specifically in the conjunction of the hard and soft palate.

Results: Six cleft palates were repaired with the BFP graft. The postoperative course was uneventful. The BFP graft is viable without the occurrence of fistula or infection.

Conclusion: The pedicled BFP graft has provided an excellent soft tissue support for secondary epithelialization when primary dehiscence has or would have otherwise thwarted ultimate closure of the palatal defect. The pedicled BFP graft permits closure of palatal defects that could not be repaired by conventional procedures.

Objective: This anatomic study was carried out in a bid to decrease damage of the temporal branch of the face nerve in endoscopic temporal lifting.

Methods: We dissected the frontal-temporal region and located the temporal branch on 36 sides of adult head specimens.

Results: It was found that the temporal branch is deep to the temporoparietal fascia and frontal muscle. The temporal branch has one to four branches in general. The first one is 8.1 +/- 2.1 mm anterior to articular tubercle and 33.8 +/- 4.9 mm superior to the bony lateral canthus. The temporal branches locate below a line drawn from the articular tubercle to 40 mm above the bony lateral canthus.

Conclusion: It is suggested that the operation incisions in the temporal region be selected above this line.

Objective: Mandibular hypertrophy is a subjective diagnosis to some extent. The authors tried to find a way for true objective diagnosis of mandibular hypertrophy.

Methods: Radiographic cephalometry was performed in 39 randomly selected adults. The degree of the mandibular angle was measured and summarized. According to measurement of the mandibular angle and the extent to be amputated, we designed and made various molds.

Results: With this pre-made mold, we amputated semi-blindly and exactly the desirable size and shape of the mandibular angle. This technique has been used in 6 patients for mandibular amputation and masseter thinning. In three patients shaving of the out layer of the hypertrophied mandible was also done.

Conclusion: The new technique using the pre-made operative mold shortens operating time, reduces surgical bleeding and tissue swelling, and can help to remove the bony block precisely.