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 is to introduce a method for vagina reconstruction using the pudendal-thigh skin flap.

Methods: The pudendal-thigh skin flap has been used for vagina reconstruction in 70 cases since 1989.

Results: All the operations were successful and the method has become a mature technique.

Conclusion: The advantages of the method are 1. the reconstructed vagina has good sensation and stable in maintaining its dimensions; 2. the linear scars of the donor site are hidden and inconspicuous; 3. the appearance of the perineum looks well; 4. the procedure is simple and favors its application.

Objective: This study was to compare the proliferative activity of endothelial cells of various types of hemangiomas and vascular malformations in different phases.

Methods: Forty-one specimens of hemangiomas or vascular malformations from biopsy or operative resection were stained with immunohistochemical method for proliferating cell nuclear antigen (PCNA). The proliferative activity of endothelial cells was expressed by labeling index (LI).

Results: PCNA was positive in all of proliferating strawberry, composite hemangiomas and some of cavernous hemangiomas in children. PCNA was negative in all of adult involuted hemangiomas and some of cavernous hemangiomas in children. There were no statistically significant differences in labeling indices of PCNA between various types of proliferating hemangiomas in children while there were statistically significant differences between child proliferating hemangiomas and involuted hemangiomas in children or all of adult hemangiomas.

Conclusion: The results may be helpful to answer some bewildering questions about hemangiomas and provide a basis for new classification.

Objective: Our previous studies have proved that early enteral feeding could improve intestine blood flow after burn injury. But the mechanism was far from being clarified. This study was attempted to explore the effects of early enteral feeding on nitric oxide synthase (NOS) activity in burned rat small intestine and the relationship between the intestine mucosa blood flow (IMBF) and the activity of NOS.

Methods: The rats were randomly divided into three groups: burned control (B), burned and early enteral feeding (EF), and normal control (C). The activity of NOS including constitute NOS(cNOS) and inducible NOS(iNOS), and the IMBF were determined at postburn 0, 3, 6, 12, 24, 48 hours.

Results: It was found that cNOS activity and IMBF were decreased markedly postburn, and there was positive correlation between cNOS and IMBF (r = 0.97, P < 0.01). But the activity of iNOS, total NOS were increased significantly postburn, they had no correlation to the IMBF. In EF group cNOS activity and the IMBF were significantly higher, the iNOS was obviously lower than that of B group and there was no significant difference of total activity of NOS between two groups.

Conclusion: Our results suggested that NOS which is catalyzed from cNOS may play main role in adjusting IMBF. By using early enteral feeding the activity of cNOS is increased and the ischemic state in small intestine is improved after burn injury.

Objective: This is to introduce the experience in clinical applications of the island and myocutaneous flaps.

Methods: Since 1985 fifteen types of vascularized island and myocutaneous flaps have been applied in 52 cases (21 positions) for the following purposes: repairing traumatic soft tissue defects on the limb, scar contracture, congenital recto-vaginal fistula, reconstructing congenital nasal deformity and rehabilitating function. The non-major artery island flap was used in 47 cases (90.38%) and the retrograde island flap was used in 24 cases (46.15%). The size of the flap ranged from 2.5 cm x 1.5 cm to 15 cm x 12 cm.

Results: All the flaps survived with primary healing. Follow-up for 8 months to 11 years showed aesthetically and functionally satisfactory results in all cases.

Conclusion: These island and myocutaneous flaps have rich blood supply and are highly anti-infective. The operation is easy and the success rate is high.

Objective and methods: We studied expression of messenger RNAS for endothelin-1 (ET-1) and its receptor subunits (ETA, ETB) by northern blot hybridization and in situ hybridization in rat kidney following 30% TBSA full thickness burns.

Results: Expressions of that ET-1, ETA, and ETB mRNA expression are all evidently increased at 1 hour postburn. ET-1 and ETA reached its maximal mRNA expression at 3 hour postburn. ET-1 mRNA distributed primarily on glomerular endothelial cells and tubular epithelial cells in cortex. ETA mRNA predominantly presented on smooth muscle cells of small arterioles in renal cortex. However, the peak time of ETB mRNA expression is at 6 hour postburn and mainly localized on renal medullary tubular epithelial and collecting duct cells.

Conclusion: These findings suggest that 1. ET-1 acts principally as a local paracrine/autocrine peptide. 2. Increased ET-1 that activated ETA receptors accentuated expression on vascular smooth muscle cells will result in renal cortex ischemia. 3. Accentuated expression of ETB receptor on tubular epithelial cells may induce renal natriuretic action and reduction of water execretion. 4. Increased ET-1 and its receptors in kidney play an important role in the pathogenesis and development of renal function impairment following severe burn.

Objective: This study was to investigate the role of leukocyte and leukocyte adhesion in tissue injury from ischemia and reperfusion.

Methods: The experiment utilized the monoclonal antibody (mAb) directed to the leukocyte adhesion glycoprotein CD18 to block leukocyte adhesion and aggregation in an island flap model in rats. Tissue content of myeloperoxidase (MPO) and malondialdehyde (MDA) were detected after transient treatment with either saline or mAb directed to CD18. Flap survival was assessed 7 days afterwards.

Results: The content of both MPO and MDA was significantly increased with 8 h ischemia and 1 h reperfusion of the flap. The treatment with anti-CD18 mAb significantly decreased the levels of MPO and MDA and also significantly improved the survival of flaps compared with the saline-treated controls.

Conclusion: CD18-mediated leukocyte adhesion plays an important role in tissue injury from ischemia and reperfusion. Blocking leukocyte adhesion can attenuate leukocyte-mediated injury, providing protective effects on island flaps.

Objective: To evaluate the growth and contraction of different composite skin grafts.

Methods: The status of the following composite skin grafts was evaluated over 2 years: allogeneic sucking pig dermis and autologous epidermis (group 1, n = 19), allogeneic young pig dermis and autologous epidermis (group 2, n = 7), autologous epidermis (group 3, n = 8). The effects of gestation on the composite skin grafts were also assessed.

Results: It showed that composite skin grafts had smooth surface and no scar formation during 2 to 124 weeks after transplantation. After week 36, the surface area of each group enlarged with different growth rates: group 1 > group 2 > group 3 (P < 0.01). Whole piece grafting was significantly better than joining together of smaller pieces after week 24 (P < 0.001). During pregnancy, CS had good growth ability and elasticity (P < 0.01). Histological study showed that group 1 had rapid growth of skin papillae and epidermal ridges similar to normal skin at week 24.

Conclusion: As CS graft with trypsin treated allogeneic sucking pig dermis as a substitute for dermis showed the advantages of rapid growth, good elasticity and stability, it is suggested that it could be used in clinical practice.

Objective: To investigate the effect of abnormal Ca2+ distribution on impairment of myocardial mechanics in the early stage of thermal injury.

Methods: Calcium (Ca2+) changes were observed within subcellular distribution in situ in rat heart with calcium cytochemical probe and electron probe microanalysic technique. Meanwhile, myocardial mechanics and energy metabolic changes were investigated after thermal injury.

Results: The results demonstrated that levels of cytoplasmic Ca2+ in cardiomyocytes increased at 1 hour, followed by enhanced mitochondrial Ca2+ at 3 hour after burn injury. Parallel to the changes in Ca2+, there were decrease of myocardial contraction, relaxation capacity and increase of ventricular wall stiffness in burned rats. A lower level of heart energy changes was observed from 6 to 12 hours, compared with control group.

Conclusion: The results indicate that subcellular Ca2+ abnormal distribution in myocardium caused by burn injury may be associated with rigor contraction and decreased relaxation of myocardium.