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 elucidate the significance of endothelins in visceral injury at the early stage of burn.

Methods: By use of a 30% (III degree) total body surface area (TBSA) burn rat model, we measured the concentration of endothelins in plasma, heart, liver, lung, kidney, and observed the effects of PD145065, a kind of non-selective ETA-ETB receptor antagonist, on visceral impairment.

Results: Not only did the endothelin concentration in plasma of burnt rat elevated significantly, showing a peak at 6 hours postburn, but also the endothelin contents in internal organs apparently increased. The changes in endothelin in liver or kidney were negatively correlated with the alteration in renal or hepatic blood flow. Moreover, administration of endothelin receptor antagonist PD145065, without affecting the arterial blood pressure, could revert the decrease of renal or hepatic blood flow to some extent, reduce the water contents of heart, liver, lung, kidney postburn.

Conclusion: The abnormal changes in endothelins postburn contribute to visceral injury in the early postburn stage in rats.

Objective: To investigate the role of nitric oxide (NO) in burn shock.

Methods: A model of 40% TBSA deep II burn injury in rats was used. The effects of L-NAME, the inhibitor of NO synthase, and L-Arg, the precursor of NO synthesis, on the mean arterial pressure (MAP), microcirculation of muscle, concentration of NO2(-)/NO3(-) in plasma and the survival time of animals were observed.

Results: The results showed that the synthesis of nitric oxide was increased significantly, accompanied with the decrease of MAP and the disturbances of microcirculation of muscle after burn. L-NAME inhibited the decrease of MAP, but aggravated the disturbances of microcirculation and shortened the survival time of animals, while L-Arg produced the contrary effects.

Conclusion: The results indicated that the large amount of NO in blood after burn may play an early protective role to injury.

Objective: The multiple-layer composite rhytidectomy is presented in this paper for correction of the facial aging.

Methods: The operative procedures include multiple-layer dissection, suspension reconstruction of the zygomatic ligament, and thinning of the zygoma.

Results: The method has produced a good result in 28 patients since 1993.

Conclusion: Study of clinical cases and cadaver dissections had led to better understanding of the aging face. With advancing age, all tissues of the face lose their balanced relationship. These changes occur in their volume shape, position, and consistency. With the multiple-layer dissection and suspension, the soft tissues of the check, forehead, nasolabial fold, lateral canthus and eyebrow can be lifted to reestablish their previously youthful relationship with the underlying skeleton.

Objective: Experimental fetal surgery has been a popular way to study growth and development and wound healing. The rabbit continues to be a reasonable animal model. The key to success of the experiment lies in keeping the survival rate of the operated animal above 80 percent. In this paper a simple experimental method for fetus surgery in rabbits is described.

Methods: Intravenous thiopental sodium is used for general anesthesia. Surgery is performed inside the uterus through hysterotomy or with the caudal part of the fetus out of the uterus. Amniotic fluid is restituted by instillation of warm saline at 37 degrees C. Special care is taken to suture the amnion.

Results: Using these techniques carefully, we have had 90 percent of success in fetal surgery experiment.

Conclusion: A technically simple procedure has been developed for fetal rabbit surgery.

Objective: This is to report the clinical application of photodynamic therapy (PDT) combined with non-coherent light (red light) for the treatment of port wine stains (PWS).

Methods: Eleven cases with PWS have been treated with PDT combined with non-coherent light since Dec. 1995.

Results: The facial lesions of PWS in the 11 cases disappeared completely without any scarring.

Conclusion: PDT combined with red light that has strong skin-penetrating ability and irradiation just after intravenous injection of photosensitizing drugs are effective to embolize the malformative vasculature in pink lesions, especially in dark purple lesions and purple lesions with proliferation.

Objective: This study was to compare skin viability of the free skin flap and the island skin flap in the pig.

Methods: The comparison was made between the 8 cm x 11 cm surgically denervated free skin flap and the pedicle island skin flap raised contralaterally on the buttock of 50 pigs. The free flap and the pedicle flap were subjected to 2 h of primary warm ischemia followed by 12 h of reperfusion and 0, 2, 4, 6, 10 h of secondary warm ischemia (n = 10). Skin viability was assessed 7 days after secondary ischemia.

Results: Pedicle skin flaps tolerated up to 10 h secondary ischemia without skin necrosis. However, incidences of flap failure (partial or total) in free flaps subjected to 0, 2, 4, 6, 10 h of secondary ischemia were 0, 10%, 50%, 80%, 100%, respectively. In a separate experiment, skin blood flow was studied in contralateral free skin flaps and pedicle island flaps (n = 20) subjected to 4 h of secondary ischemia. The skin reperfusion was very slow in 8 out of 20 free skin flaps at 1, 5 h after secondary is chemia, and the mean skin blood flow measured by 15 microns microspheres in these 8 free skin flaps was only 8% of their contralateral pedicle skin flaps. The mean skin blood flow in the remaining 12 free skin flaps was 76% of their contralateral pedicle skin flap.

Conclusion: These observations were interpreted to indicate that buttock free skin flaps in the pig were less tolerant to secondary ischemia compared with their contralateral pedicle skin flaps subjected to the same ischemic protocol, and this reduced ischemic tolerance in free skin flaps was associated with compromised skin blood flow.

Objective: The purpose of this study was to explore the responses of fibroblasts from keloids and normal skin to interleukin-1 beta and interleukin-6.

Methods: Six samples of keloids and 6 samples of normal skin were collected as the experimental and control group respectively. The means of cell culture was used to investigate the responses of fibroblasts from three different parts of keloids and normal skin to interleukin-1 beta (200 U/ml) and interleukin-6 (100 U/ml).

Results: Interleukin-1 beta could inhibit the growth of fibroblasts from the proliferative part of keloids but stimulate growth of those from normal skin, while it did not affect the growth of those from other parts of keloids. Fibroblasts from different parts of keloids and normal skin were all inhibited by interleukin-6.

Conclusion: The responses of fibroblasts from three parts of keloids and normal skin to interleukin-1 beta and interleukin-6 were not much similar.

Objective: To investigate the mechanism of hemorrhagic tendency after phosphorus poisoning.

Methods: 45% phosphoric acid and 20 mg/cm2 phosphorus were used to produce burn injury in rabbits. The total content of phosphorus remaining on the wound and 7-day mortality were similar in both groups.

Results: The results showed that plasma free calcium contents were significantly lower in both phosphorus groups than healthy and thermal burn controls (0.80 vs 1.40 mol/l, P < 0.01). The free calcium content of platelet was lowered to 116-140 nmol/l, which was significantly lower than that of healthy control (285 nmol/l) and thermal injury group (480-504 nmol/l). Concomitantly, the platelet aggregation rate was lowered to 1.29% and 10.78% in phosphoric acid group and phosphorus group, respectively, while it was 67.01% in healthy control and 82.1%-84.9% in thermal injury group; the difference was statistically significant.

Conclusion: Calcium therapy brought back intracellular and extracellular free calcium contents to normal in phosphorus burn group. Also platelet aggregation rate approached normal level after calcium therapy. The results suggest that the bleeding tendency after phosphorus burn is due to combination of phosphorus with intracellular and extracellular calcium of platelets, thus inhibiting aggregation of platelets.

Objective: The aim of the work was to improve the operative result of eye socket reconstruction after enucleation.

Methods: The hydroxyapa tite implant of eyeball shape was buried in the scleral shell, which was stitched to the extraocular muscles at the points of muscle attachment so as to create a rotatable eye seat connector.

Results: One hundred and two patients have received eye socket reconstruction of this method with improved results. The prosthetic eyes move freely. Follow-up for 6 to 38 months reveals that the results are stable and satisfactory.

Conclusion: The indigenous hydroxyapa tite implant is a good biomaterial for socket reconstruction.

Objective and methods: A modification technique for reduction mammaplasty with an inferior dermal-glandular pedicle was designed.

Results: The paper reports the operation results of 132 breasts in 67 patients, who received reduction mammaplasty in "Chirurgic Esthetique Europeenne," Strasbourg, France, from Jan, 1994 to Nov, 1995.

Conclusion: Clinical applications showed aesthetic and safe results with reliable nipple areola survival and preservation of nipple sensitivity.