ABSTRACT
<p><b>OBJECTIVE</b>To investigate the method and indications for reconstruction of facial complicated soft tissue defects with free flaps by microsurgery.</p><p><b>METHODS</b>37 patients (16 males and 21 females, aged from 1 to 54 years) with different size of facial soft tissue defects were reconstructed with free flaps, including 10 latissimus dorsi myocutaneous flaps, 3 thoracodorsal artery perforator flaps, 9 scapular flaps, forearm flaps and 9 postauricular flaps. The defects size ranged from 1 cm x 2 cm to 25 cm x 12 cm.</p><p><b>RESULTS</b>Venous obstruction happened in 3 postauricular flaps, resulting partial necrosis in 2 flaps. All the other flaps survived completely. The cosmetic and functional results were both satisfactory.</p><p><b>CONCLUSIONS</b>The facial complicated soft tissue defects can be treated successfully with free flaps by microsurgery. The wounds can be healed primarily with short recovery time and reliable cosmetic and functional result.</p>
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Young Adult , Facial Injuries , General Surgery , Free Tissue Flaps , Microsurgery , Soft Tissue Injuries , General SurgeryABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of METH1 gene transfection on fibroblast proliferation and I, III collagen synthesis in rabbit ear scar.</p><p><b>METHODS</b>The hypertrophic scar model on the rabbit ears was reproduced. 10 days after epithelization, Ad-METH1 was injected into the scar tissue. 30 days later, the effect of METH1 gene transfection on the angiogenesis, fibroblast proliferation and the ratio of collagen I/III in the scar tissue was detected by microcirculation microscope, AgNOR particle count and collagen dyeing.</p><p><b>RESULTS</b>30 days after injection of Ad-METH1, angiogenesis, fibroblast proliferation and the ratio of collagen I/III in the scar tissue were obviously suppressed.</p><p><b>CONCLUSION</b>Early application of Ad-METH1 after epithelization can markedly inhibit the formation of the hypertrophic scar.</p>
Subject(s)
Animals , Female , Male , Rabbits , ADAM Proteins , Genetics , Angiogenesis Inhibitors , Genetics , Cicatrix, Hypertrophic , Genetics , Pathology , Disease Models, Animal , Ear , Pathology , Ear, External , Pathology , Microcirculation , Neovascularization, Pathologic , Transfection , Wound HealingABSTRACT
<p><b>OBJECTIVE</b>To explore the method to repair large scalp and face scars.</p><p><b>METHODS</b>1-3 expanders under the scalp were needed for repair the scalp scar. The expanded deltopectoral flaps were transferred to repair the face scar.</p><p><b>RESULTS</b>12 cases were treated with satisfactory results. All the flaps survived and the donor sites were closed primarily. 2 cases had expander exposure which didn't affect the treatment results. Atrophic cutaneous striae was occurred because of overexpansion.</p><p><b>CONCLUSIONS</b>Skin expansion is a good method for large scalp and face scar.</p>
Subject(s)
Adolescent , Adult , Humans , Young Adult , Cicatrix , General Surgery , Scalp Dermatoses , General Surgery , Skin Transplantation , Surgical Flaps , Tissue Expansion , MethodsABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of local application of bFGF and sucralfate during continuous tissue expansion (CTE).</p><p><b>METHODS</b>CTE combined with local administration of bFGF and sucralfate was used in twelve patients with scar and nasal tip defects. Twenty three expanders were placed in the subcutaneous pockets through intralesion short incisions. Continuous expansion began at 1-3 days after expander implantation. The histomorphological changes and epidermal cell proliferation were observed. The clinical results were investigated.</p><p><b>RESULTS</b>The average inflation time was 8.9 days. The average interval of the two operations was 13.5 days. The average hospitalization was 28.4 days. The average immediate stretch-back rate of the expanded skin was 25.7%. The clinical results were satisfactory without any complications. Histological examinations showed that the epidermal, granular and spinous layer became thicker. The basal cells increased significantly. The dermis thinned slightly and the collagen fibers became thicker. The elastic fiber regenerated significantly. Fibroblast and capillary density increased obviously. The immunohistochemistry analysis showed that the proliferation of epidemic basal cells was significant postoperatively.</p><p><b>CONCLUSION</b>Local application of exogenous bFGF and sucralfate during CTE was feasible in patients. It could accelerate tissue expansion and improve the quality of expanded skin flap.</p>