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1.
Chinese Journal of Burns ; (6): 291-295, 2022.
Article in Chinese | WPRIM | ID: wpr-936008

ABSTRACT

In recent years, as a powerful supplement to the randomized controlled trial (RCT), real world study (RWS) has received more and more attention. However, in the field of chronic wounds, most of the patients have complex condition, and the strict inclusion and exclusion criteria of RCT were lack of practical application values. The RWS provides data closer to the real medical environment in clinical medical practice, drug and medical device supervision, and health technology evaluation. However, RWS has some problems that need to be resolved, such as inconsistent diagnostic criteria and unclear research endpoints. In addition, RWS in chronic wound research in China seems to have not really started yet, and institutions at all levels need to work together to promote the development of RWS.


Subject(s)
Humans , China , Wound Healing
2.
Chinese Journal of Traumatology ; (6): 88-92, 2019.
Article in English | WPRIM | ID: wpr-771628

ABSTRACT

This paper systematically reviewed and analyzed the recent publications of robotic-assisted surgeries in the field of tissue repair and reconstruction. Surgical robots can elevate skin flap more accurately and shorten the time of tissue harvest. In addition, robotic-assisted surgery has the advantage of minimal tissue trauma and thus forms minimal scar. The utilization of surgical robots reduces the occurrence of complications after oral radical tumor resection while achieving cosmetic sutures. Robotic-assisted radical mastectomy could radically remove invasive breast cancer lesions and achieve breast reconstruction in the first stage through the small incisions in the operation areas. Surgical robots enable precise microvascular anastomosis and reduce tissue edema in the surgical field. Robotic-assisted technology can help appropriately locate the target tissues at different angles during sinus and skull base surgeries and accurately place tissues during urethroplasty. The robotic-assisted technology provides a new platform for surgical innovation in the field of tissue repair and reconstruction. However, the uncertainty in the survival rate after tumor radical surgery, the increase of operating time, and the high costs are barriers for its clinical application in tissue repair and reconstructive surgery. Nevertheless, robotic-assisted technology has already demonstrated an impact on the field of tissue repair and reconstruction in a meaningful way.


Subject(s)
Humans , Breast Neoplasms , General Surgery , Cicatrix , Minimally Invasive Surgical Procedures , Methods , Mouth Neoplasms , General Surgery , Operative Time , Plastic Surgery Procedures , Methods , Robotic Surgical Procedures , Methods , Skull Base , General Surgery , Surgical Flaps , Tissue and Organ Harvesting , Urethra , General Surgery
3.
Chinese Journal of Plastic Surgery ; (6): 435-439, 2013.
Article in Chinese | WPRIM | ID: wpr-343494

ABSTRACT

<p><b>OBJECTIVE</b>To present a method of quantitative diagnosis of craniofacial skeleton deformities based on three-dimensional computed tomography (3D CT).</p><p><b>METHODS</b>20 cases with facial asymmetric deformities underwent 3D CT and the 3D images were reconstructed by Mimics 10.0 (Belgium). Anatomical landmarks were located and the coordinate of the landmarks obtained. Axial images of 1 patient with Romberg disease was used as representative case. The differences in the distance between the right landmarks and the left were calculated and analyzed.</p><p><b>RESULTS</b>The measurement results were not significantly different between two stages with an interval of 4 weeks ( P > 0.05), showing a reproducible resutls. The deviation of landmarks at facial midline increased gradually from upward to downward, reaching (2.63 +/- 0.54) mm at menton point. Paired landmarks showed asymmetry in three dimensions, especially gonion point on the left side, which was deviated 10.21 mm inward, 9.26 mm forward, 6.30 mm upward, compared to the opposite side.</p><p><b>CONCLUSIONS</b>The method of 3D CT quantitative analysis can provide precise information in the diagnosis and treatment planning of facial asymmetry deformity.</p>


Subject(s)
Humans , Anatomic Landmarks , Diagnostic Imaging , Cephalometry , Craniofacial Abnormalities , Diagnostic Imaging , Facial Asymmetry , Diagnostic Imaging , Imaging, Three-Dimensional , Methods , Tomography, X-Ray Computed , Methods
4.
Chinese Journal of Burns ; (6): 4-5, 2013.
Article in Chinese | WPRIM | ID: wpr-284148

ABSTRACT

Rehabilitation medicine is an emerging discipline. At present, there are many problems in rehabilitation of pediatric burn patients in China, including idea lag, weak technical force, lack of standardized technology, disunity in evaluation indexes, etc. The new era of reformation of health system and development and flourish of medical insurance business bring good opportunity for the development of rehabilitation medicine.


Subject(s)
Child , Humans , Burns , Rehabilitation , China
5.
Annals of Dermatology ; : 365-367, 2013.
Article in English | WPRIM | ID: wpr-131862

ABSTRACT

Hypertrichosis refers to increased vellus hair growth and is independent to androgen excess. The acquired localized hypertrichosis (ALH) is one of the typical hypertrichosis, which mainly results from chronic irritation, inflammation, friction, and occlusion by plaster of Paris. Here, we report a young boy who had ALH on his right hand following a closed fracture with internal fixation and plaster cast application. The case is unusual because the hairy area is limited to the operative region of internal fixation. We suggest that the local vascular changes and skin inflammation induced by internal fixation and plaster cast application may be associated with ALH.


Subject(s)
Calcium Sulfate , Casts, Surgical , Fractures, Closed , Friction , Hair , Hand , Hyperemia , Hypertrichosis , Inflammation , Internal Fixators , Skin
6.
Annals of Dermatology ; : 365-367, 2013.
Article in English | WPRIM | ID: wpr-131859

ABSTRACT

Hypertrichosis refers to increased vellus hair growth and is independent to androgen excess. The acquired localized hypertrichosis (ALH) is one of the typical hypertrichosis, which mainly results from chronic irritation, inflammation, friction, and occlusion by plaster of Paris. Here, we report a young boy who had ALH on his right hand following a closed fracture with internal fixation and plaster cast application. The case is unusual because the hairy area is limited to the operative region of internal fixation. We suggest that the local vascular changes and skin inflammation induced by internal fixation and plaster cast application may be associated with ALH.


Subject(s)
Calcium Sulfate , Casts, Surgical , Fractures, Closed , Friction , Hair , Hand , Hyperemia , Hypertrichosis , Inflammation , Internal Fixators , Skin
7.
Chinese Journal of Burns ; (6): 291-293, 2012.
Article in Chinese | WPRIM | ID: wpr-257780

ABSTRACT

The delayed healing of diabetic ulcer has been haunting the surgeons and researchers for a long time. Although we have been researching and exploring the effective therapies for many years, the progress has been limited. Bone marrow-derived mesenchymal stem cells (BMSCs) have gradually won worldwide attention for their characteristics of differentiating into tissue repair cells and secreting multiple cytokines as well as growth factors. In recent years, the role of BMSCs in the treatment of diabetic ulcer has been drawing more and more attention. This article reviewed the advancement in the research of BMSCs in promoting the healing of diabetic ulcer. Through a discussion of the treatment of diabetic ulcer, the related research in BMSCs, as well as its role in diabetic ulcer treatment, the mechanism of BMSCs in promoting healing of diabetic ulcers is discussed. We expect through further research, unified criteria for the quality of BMSCs, application approach and dosage of BMSCs could be established.


Subject(s)
Humans , Bone Marrow Cells , Diabetes Complications , Therapeutics , Mesenchymal Stem Cells , Ulcer , Therapeutics , Wound Healing
8.
Chinese Journal of Burns ; (6): 370-373, 2012.
Article in Chinese | WPRIM | ID: wpr-284164

ABSTRACT

With the rapid development of modern science and technology, various kinds of new therapy and technology have widely been used in rehabilitation medicine. This review summarizes those new therapies and principles in rehabilitation and their application during treatment of burn injury, in order to provide more ways and methods to improve the rehabilitation of mentation, motor function, and the quality of life of burn patients.


Subject(s)
Humans , Burns , Rehabilitation , Therapeutics , Rehabilitation , Methods
9.
Chinese Journal of Plastic Surgery ; (6): 376-380, 2011.
Article in Chinese | WPRIM | ID: wpr-246921

ABSTRACT

<p><b>OBJECTIVE</b>To examine the effect of RhoA/Rho kinase signal pathway on TGF-beta1-induced phenotypic differentiation of human dermal fibroblasts.</p><p><b>METHODS</b>The 4th generation of primary cultured human dermal fibroblasts were stimulated with TGF-beta1, (10 ng/ml). The expression of alpha-SMA was detected after treatment with TGF-beta1, for 0, 3, 6, and 24 h. The expression of alpha-SMA was also detected after treatment with different concentration of TGF-beta1 (0, 2, 10, 50 ng/ml). Then the human dermal fibroblasts (4th generation) were stimulated with TGF-beta1, (10 ng/ml) after being treated with the RhoA/Rho kinase signaling pathway inhibitor Y-27632 (10 umol/ml). The fibroblasts were treated with nothing as sham control, or with Y-27632 (10 umol/L) only as negative control group, or with TGF-beta1 (10 ng/ml) only as positive control group. The expression of alpha-SMA was detected in all the groups. Protein expression was analyzed with ANOVA statistical method.</p><p><b>RESULTS</b>alpha-SMA expression in fibroblasts with 10 ng/ml TGF-beta1 stimulation for 0, 3, 6, 24 h was 1.0, 1.9 0.2, 2.1 +/- 0. 1, 3. 1 +/- 0.1, respectively. Alpha-SMA expression in 24 h group was significantly higher than that in other three groups (n = 4, P < 0.05). alpha-SMA expression in human dermal fibroblasts after stimulation with different concentration of TGF-beta1 (0, 2, 10, 50 ng/ml) was 1.0, 1.4 +/- 0.2, 3.2 + 0.1, 3.1 +/- 0.2, respectively. alpha-SMA expression in 10 ng/ ml group was significantly higher than that in 2 ng/ml group and control group (n = 4, P < 0.05). There was no statistical difference in alpha-SMA expression between 10 ng/ml group and 50 ng/ml group (n = 4, P > 0.05). With both Y-27632 (10 micromol/L) and TGF-beta1 stimulation, the cell phenotype differentiation was inhibited. Alpha-SMA expression in experimental group (1.2 +/- 0.2) was significantly reduced, when compared with that in positive control group (2.9 +/- 0.1) (n = 5, P < 0.05). There was no significant difference (n = 5, P > 0.05) in alpha-SMA expression between control group (1.0) and negative control group (1.1 +/- 0.1).</p><p><b>CONCLUSIONS</b>RhoA/Rho kinase signaling pathway should be involved in TGF-beta1-induced phenotypic differentiation of human dermal fibroblasts.</p>


Subject(s)
Adolescent , Humans , Male , Actins , Metabolism , Cell Differentiation , Cells, Cultured , Fibroblasts , Cell Biology , Signal Transduction , Skin , Cell Biology , Transforming Growth Factor beta1 , Pharmacology , rho-Associated Kinases , Metabolism , rhoA GTP-Binding Protein , Metabolism
10.
Chinese Medical Journal ; (24): 525-529, 2009.
Article in English | WPRIM | ID: wpr-311829

ABSTRACT

<p><b>BACKGROUND</b>Mass burn casualties are always a great challenge to a medical team because a large number of seriously injured patients were sent in within a short time. Usually a high mortality is impending. Experiences gained from successful treatment of the victims may be useful in guiding the care of mass casualties in an armed conflict.</p><p><b>METHODS</b>Thirty-five burn victims in a single batch, being transferred nonstop by air and highway from a distant province, were admitted 48 hours post-injury. All patients were male with a mean age of (22.4 +/- 8.7) years. The burn extent ranged from 4% to 75% ((13.6 +/- 12.9)%) total body surface area. Among them, thirty-two patients were complicated by moderate and severe inhalation injury, and tracheostomy had been performed in 15 patients. Decompression incisions of burn eschar on extremities were done in 17 cases before transportation. All the thirty-five patients arrived at the destination smoothly via 4-hour airlift and road transportation. Among them, twenty-five patients were in critical condition.</p><p><b>RESULTS</b>These thirty-five patients were evacuated 6 hours from the scene of the injury, and they were transferred to a local hospital for primary emergency care. The patients were in very poor condition when admitted to our hospital because of the severe injury with delayed and inadequate treatment. Examination of these patients at admission showed that one patient was suffering from sepsis and multiple organ dysfunction syndrome. Dysfunction of the heart, lung, liver, kidney, and coagulation were all found in the patients. Forty-eight operations were performed in the 23 patients during one month together with comprehensive treatment, and the function of various organs was ameliorated after appropriate treatment. All the 35 patients survived.</p><p><b>CONCLUSIONS</b>A well-organized team consisting of several cooperative groups with specified duties is very important. As a whole, the treatment protocol should be individualized, basing on the extent of the injury and the care that the patient had received at the spot. During airlift, the stretchers should be arranged perpendicular to the longitudinal axis of the cabin. The treatment protocol in our hospital consisted mainly of prompt effective relief of all life-threatening complications, followed by early closure of burn wounds, appropriate use of anti-infection therapy, emphasis on nutritional support, correction of metabolic disorders, alleviation of immunosuppression, correction of coagulopathy, and effective support and protection of organ function.</p>


Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Burns , Drug Therapy , Pathology , General Surgery , Therapeutics , Emergency Medical Services , Emergency Service, Hospital , Hospitals , Time Factors , Transportation of Patients , Treatment Outcome
11.
Chinese Journal of Burns ; (6): 437-440, 2009.
Article in Chinese | WPRIM | ID: wpr-305637

ABSTRACT

<p><b>OBJECTIVE</b>To observe the differentiation and distribution of epidermal stem cell (ESC) after skin soft tissue expansion, and to initially probe into the growth mechanism of expanded skin tissue.</p><p><b>METHODS</b>Samples of normal skin and expanded skin (mean effusion period 45 days) were harvested from head and cervical region in 15 patients who underwent II stage surgery after skin expansion. Samples were divided into scalp adjacent to the center of expander group (expanded scalp, 3 cm from the vertical axis of the expander), scalp from lateral part of the expander group (expanded scalp, 5 - 7 cm lateral to the vertical axis of the expander), cervical skin expansion group, un-expanded scalp control group, and un-expanded cervical skin control group, according to the position of skin harvested. The tissue structure of skin in each group was observed with HE staining, and the differentiation and distribution characteristics of cytokeratin 19 (CK19) positive cells were observed with immunohistochemical staining.</p><p><b>RESULTS</b>Compared with those in the un-expanded control groups, uneven, relatively thickened and obviously folded epidermis with more cell layers and cells with obvious aggregation close to the basal layer were observed in the expanded groups, but those cells were not well-arranged and the transition of polarity was not obvious. The continuity of CK19 positive cells in the basal layer of skin was observed in each of the expanded group with immunohistochemical staining, and positive cells increased obviously and arranged in multilayer in certain parts of basal layer. Clustered or dispersed CK19 positive cells were also observed outside the basal layer. No above-mentioned phenomenon was observed in the un-expanded control group.</p><p><b>CONCLUSIONS</b>The proliferation and differentiation of ESC with ectopic distribution may enhance the repair process after skin soft tissue expansion.</p>


Subject(s)
Humans , Cell Proliferation , Dermis , Cell Biology , Epidermis , Cell Biology , Stem Cells , Cell Biology , Tissue Expansion , Wound Healing
12.
Chinese Journal of Burns ; (6): 84-86, 2009.
Article in Chinese | WPRIM | ID: wpr-257441

ABSTRACT

Chinese Medical Association (CMA) is an academic society and the Chinese Medical Doctor Association (CMDA) is an administrative organization with academic character. The main functions of CMDA are setting up the system for specialty training, training for residents of different disciplines, establishing training bases, and safeguarding interests of doctors. The author also analyzes the drawbacks in this regard in field of burn surgery in China at the present time, and venture to put forward new suggestions for strengthening and perfecting the frame of CMDA.


Subject(s)
Humans , Burns , Therapeutics , Hospitals, Special , Workforce , Inservice Training , Physicians , Societies, Medical
13.
Chinese Journal of Burns ; (6): 355-358, 2008.
Article in Chinese | WPRIM | ID: wpr-257484

ABSTRACT

To explore new measures for functional reconstruction of multiple severe deformities as a result of extensive deep burn (total burn surface area > or = 90% TBSA, including deep burn > or = 70%TBSA) in late stage. Twelve severe burn patients with above-mentioned deformities were hospitalized in our ward during 1960--2005, the scars resulted from burns were distributed from head to foot with 173 deformities, including 27 scar ulcers. All patients lacked of self-care ability, among them some could not stand. Due to inadequate skin source, deformities were corrected by skin from matured scars expanded with subcutaneous balloon at late postburn stage. Following our former clinical experience, anatomic investigation and experimental research, we chose the following methods to correct deformities and restore functions: application of split-thickness scar skin after expansion (88 wounds); use of scar skin flap/scar-Achilles tendon flaps (59 wounds); combination of thin split-thickness skin grafts from scar and allogeneic acellular dermal matrix (composite skin, 40 wounds). All grafts survived, the appearance and function were improved obviously without complications. Follow-up 1-40 years, all patients could take care themselves with satisfactory function and appearance, and among them 8 patients returned to work (one had worked for 40 years), 2 patients married and had children. The above-mentioned measures are safe, reliable and effective for functional reconstruction of deformities.


Subject(s)
Adult , Female , Humans , Male , Middle Aged , Burns , General Surgery , Cicatrix , General Surgery , Contracture , General Surgery , Plastic Surgery Procedures , Methods , Recovery of Function , Skin Transplantation , Skin, Artificial , Surgical Flaps , Wound Healing
14.
Chinese Journal of Burns ; (6): 39-41, 2008.
Article in Chinese | WPRIM | ID: wpr-347643

ABSTRACT

<p><b>OBJECTIVE</b>To observe the distribution of epidermal stem cell (ESC) after soft tissue expansion, and to explore dynamic change in ESC under mechanical stress and kinetic mechanism of skin expansion.</p><p><b>METHODS</b>Skin samples were collected from patients after expansion of the scalp. They were divided into three groups: A group (scalp harvested 3 cm away from the center of dilator), B group (scalp tissues at the edge of dilator), and control group (scalp without dilatation). The tissue structures were observed with optical microscope with HE staining. The distribution and differentiation characteristics of cell keratin 19 (CK19) positive cells were observed with inverted phase contrast microscope after immunohistochemistry staining.</p><p><b>RESULTS</b>HE staining showed that the epidermis was thickened and distributed densely with uneven, rugged and increased layers in A, B groups. With immunohistochemistry staining, CK19 positive cells appeared in multilayers in basal membrane, a few of them were in cluster or dispersed , with" hollowing" structure formation. These phenomena were not seen in control group.</p><p><b>CONCLUSION</b>ESC can proliferate with abnormal distribution and "hollowing" structure formation after mechanical dilatation, which may be related to dynamic changes in basal layer cells.</p>


Subject(s)
Adolescent , Adult , Humans , Male , Young Adult , Cell Proliferation , Cellular Structures , Epithelial Cells , Cell Biology , Keratin-19 , Metabolism , Stem Cells , Cell Biology , Stress, Mechanical , Tissue Expansion
15.
Chinese Journal of Burns ; (6): 112-116, 2007.
Article in Chinese | WPRIM | ID: wpr-331513

ABSTRACT

<p><b>OBJECTIVE</b>To seek ideal strategies in saving a patient with very extensive deep burns, and measures for functional reconstruction after convalescence.</p><p><b>METHODS</b>A patient with 99. 5% TBSA flame burn injury (III degrees 80%, deep second degree 14.5% and superficial II degrees 5%), complicated with hypernatremia and hyperchloraemia was admitted 76 hours after the injury. Early escharectomy and alloskin grafting were performed. Because of the lack of autoskin donor site, the skin grafting of autologous skin was only undertaken whenever there was an available source, and the remaining wounds were temporarily covered with allografts. Finally the patient survived. After healing of all the wounds, contractures were corrected with skin from scars, flaps of scarred skin or composite skin, and more than 30 cicatricial contracture deformities were corrected after convalescence.</p><p><b>RESULTS</b>After initial treatments and extensive early escharectomy, the patient's condition became stable gradually, without adverse complications. After 7 operations, the wounds finally healed completely after 106 days. The function of all joints were restored well and external appearance improved after 15 plastic and reconstructive operations during convalescence period. The patient was fully rehabilitated and resumed his original work 26 months after the injury.</p><p><b>CONCLUSION</b>For those patients with massive burns and short of donor site, alloskin grafting after early escharectomy, and persistent repeated microskin grafting whenever any small amounts of own skin is available, is essential to stabilize the patients' condition, and reduce complications. Covering the wounds as the result of shedding off of eschar with alloskin can protect the undamaged cells in skin appendages to promote re-epithelization and wound healing. It is feasible to harvest skin grafts from scars, and use scar skin flaps and composite skin to repair contractures after convalescence with good outcome in function and external appearance.</p>


Subject(s)
Adult , Humans , Male , Burns , General Surgery , Therapeutics , Cicatrix , General Surgery , Contracture , General Surgery , Plastic Surgery Procedures , Skin Transplantation , Surgical Flaps , Wound Healing
16.
Chinese Journal of Burns ; (6): 428-431, 2007.
Article in Chinese | WPRIM | ID: wpr-347660

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the protective effect of insulin on oxygen-radical induced hepatic injury in severely scalded rats in early stage of severe scald.</p><p><b>METHODS</b>Eighty-four male Sprague-Dawley rats were randomly divided into three groups: i. e, normal group, saline group, and insulin group, with 28 rat in each group. The rats in the latter two groups were subjected to 30% TBSA full-thickness scald on the back, and received intra-peritoneal injection of 40ml/kg isotonic saline, and subcutaneous injection of 3 IU/kg insulin, respectively. The total anti-oxygen capability (T-AOC), the expression of superoxide dismutase (SOD), reactive oxygen species (ROS) and intercellular adhesion molecule (ICAM-1) in hepatic tissue, and serum alanine transaminase (ALT) were determined in each group at 6, 12, 24, 48 post-scald hours (PSH) with corresponding methods.</p><p><b>RESULTS</b>The hepatic T-AOC and SOD content were obviously decreased, while the ROS content were markedly increased at 6 PSH in saline group compared with that in normal group (P < 0.05 or P < 0.01). The expression of ICAM-1 and serum content of ALT were significantly higher than that in normal group at 12 PSH and 48 PSH (P < 0.01). At 24 PSH, the hepatic T-AOC (386 +/- 75) U/g and SOD content (210 +/- 39 ) U/g were obviously higher in insulin group than those in saline group [(124 +/- 18), (111 +/- 9) U/g, respectively, P < 0.01), but the ROS content (154 +/- 29 ) U/g was much lower than that in saline group [(351 +/- 41) U/g, respectively, P < 0.01]. At 48 PSH, the serum content of ALT and hepatic expression of ICAM-1 in insulin group exhibited obvious difference when compared with those in saline group (P < 0.01). Meanwhile, Pathological examination showed that hepatic injury was alleviated by insulin administration after scald.</p><p><b>CONCLUSION</b>Insulin administration early after severe scald exhibits protective effect on liver function by improving anti-oxygen radical ability of rat liver.</p>


Subject(s)
Animals , Male , Rats , Alanine Transaminase , Blood , Burns , Metabolism , Pathology , Insulin , Pharmacology , Liver , Metabolism , Pathology , Random Allocation , Rats, Sprague-Dawley , Reactive Oxygen Species , Metabolism , Superoxide Dismutase , Metabolism
17.
Chinese Journal of Burns ; (6): 444-446, 2007.
Article in Chinese | WPRIM | ID: wpr-347656

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the gene expression of matrix metalloproteinases (MMP-2, MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in proliferative and mature hypertrophic scars.</p><p><b>METHODS</b>Total RNA from 8 normal skin samples and from 16 human hypertrophic scar samples of different maturing stage was respectively extracted, and then mRNA was isolated. The gene expressions of MMP-2, MMP-9 and TIMP-1 in these samples were examined with reverse transcription-polymerase chain reaction (RT-PCR).</p><p><b>RESULTS</b>The gray scale ratio of MMP-2, MMP-9 and TIMP-1 transcription in normal skin were (3.8 +/- 0.7)%, (5.8 +/-4.4)%, (30.3 +/- 3.0)%, respectively, which were obviously higher than those in proliferative hypertrophic scar [(14 +/- 5)%, (18 +/- 5)%, (38 +/- 4)%, P < 0.05]. The expression of MMP-2 and MMP-9 genes in mature hypotrophic scar returned to normal level, but that of TIMP-1 remained high when compared with that of normal level (P < 0. 05).</p><p><b>CONCLUSION</b>The increase in MMP-2, MMP-9 and TIMP-1 gene expression might be involved in the formation of hypertrophic scars, while the lowering of MMP-2 and MMP-9 gene expression might be associated with the maturation of hypertrophic scars.</p>


Subject(s)
Female , Humans , Male , Cicatrix, Hypertrophic , Genetics , Metabolism , Pathology , Gene Expression , Matrix Metalloproteinase 2 , Genetics , Metabolism , Matrix Metalloproteinase 9 , Genetics , Metabolism , RNA, Messenger , Metabolism , Skin , Metabolism , Pathology , Tissue Inhibitor of Metalloproteinase-1 , Genetics , Metabolism
18.
Chinese Journal of Burns ; (6): 19-22, 2006.
Article in Chinese | WPRIM | ID: wpr-312515

ABSTRACT

<p><b>OBJECTIVE</b>To explore the better clinical methods for the management of deep facial burn with optimal quality. Methods Fifty-four patients with deep facial burns were enrolled in the study and were divided into delayed skin grafting group (n=48) and early escharectomy group (n=6). In delayed grafting group, after the erosion of new born granulation tissue to the basal layer with blade holder or with peel or eschar shaving method at 3 postburn weeks (PBW) according to the eschar separation and granulation growth status, the whole face of the patients were divided into 10 regions and were then covered by split thickness auto skin. The same treatment was performed on the patients in early escharectomy group at 1 PBW. Physical therapy and plastic surgery were applied after skin grafting, and the patients were followed up from 3 month to 11 years. The first operation time, postburn facial operation time, operation times to repair the whole face, blood content of Hb, the amount of blood transfusion and hemorrhage and the prognosis were compared between the two groups.</p><p><b>RESULTS</b>There was no difference between the two groups in regards to the first operation time, the total operation times,blood concentration of Hb before and after operation,and the amount of blood transfusion during the operation (P > 0.05). The operation time in delayed grafting group (21.9 +/- 3.2) d was obviously later than that in early escharectomy group (12.6 +/- 1.3) d, (P < 0.05). And there was evidently less amount of hemorrhage during operation(98 +/- 52) ml/100 cm2 than that in early escharectomy group (331 +/- 121) ml/100 cm2 (P < 0.01). The facial appearance of the patients in delayed grafting group was plump with more elasticity and richer expression compared with those in early grafting group. There exhibited different degrees of microstomia and both eyebrow defect in both groups during and after 1 postoperative year. In addition, mild to moderate ectropion and hypertrophic scar on the conjunction of grafted skin could appear in 80% of these patients. These deformities might be corrected by several times of plastic surgery.</p><p><b>CONCLUSION</b>Based on the principle of arranging skin grafts according to the cosmetic and functional area units, split thickness skin grafting can provide satisfactory results for the repair of deep burn injury involving whole face when the wounds were treated with eschar peeling, tangential excision, escharectomy, granulation tissue scaling, or early escharectomy. In comparison with early escharectomy, eschar peeling, tangential excision, escharectomy, or granulation tissue scaling can get better results with less bleeding, full and round facial appearance, more elasticity of grafted skin and richer facial expression appearance after the operation. Meanwhile, effective physical therapy and scheduled plastic surgery after skin grafting can also be very important in achieving cosmetic results in the repair and reconstruction of whole facial deep burn.</p>


Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Burns , General Surgery , Facial Injuries , General Surgery , Follow-Up Studies , Plastic Surgery Procedures , Skin Transplantation , Transplantation, Autologous , Wound Healing
19.
Chinese Journal of Burns ; (6): 38-41, 2006.
Article in Chinese | WPRIM | ID: wpr-312510

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the quality of reports of clinical results concerning burn injury, in order to raise the standard of clinical study of burn care in accordance to the standard of evidence-based medicine (EBM), with the aim of improving clinical research in burn care of this country.</p><p><b>METHODS</b>All the papers of clinical study published in Chinese Journal of Burns (CJB) from 2000 to 2004 were evaluated according to EBM standard.</p><p><b>RESULTS</b>There were 89 papers about clinical trials published in the past 5 years, in which 43 (48.3%) of the studies were carried out with random control trials (RCT), and 46 (51.7%) were clinical control trials (CCT). RCT papers increased year by year, while the number of CCT papers fluctuated greatly. The disparity in the quality of research was found as follows. In all the RCT and CCT papers, blinded research was adopted only in 5 papers (5.6%). Strict diagnostic standard including inclusion and exclusion standards were reported in 53 articles (59.6%). The comparison with baselines was not provided in 64 articles (71.9%). P value was given in 10 papers but statistical method was not mentioned (11.2%). Follow-up visits and lost information were only recorded in 2 articles, but no detailed follow-up visiting data were provided. Side effects were reported in 10 articles (11.2%). There were analysis and explanation of mixed interfering factors only in 5 papers (5.6%). There was no explanation of the evaluation of sample size in any one paper.</p><p><b>CONCLUSION</b>In summary, the literature concerning clinical studies published in CJB in the past five years has become more extensive. However, the present study indicates that many clinical trials are not designed and ethical consideration is often missing. Therefore, it is deemed imperative to improve the quality of the clinical studies by improving the planning of the protocols of the study and statistical analysis of the research results in future.</p>


Subject(s)
Humans , Burns , Therapeutics , Controlled Clinical Trials as Topic , Reference Standards , Evidence-Based Medicine , Reference Standards , Periodicals as Topic
20.
Chinese Journal of Burns ; (6): 285-287, 2006.
Article in Chinese | WPRIM | ID: wpr-331579

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the current situation of animal experiments by analysis and evaluation of relevant articles published in the Chinese Journal of Burns during 2000 to 2004.</p><p><b>METHODS</b>All articles concerning the results of animal experiments related to the treatment and medical studies in the past 5 years were analysed according to the international standard , especially in serval aspects, such as sample size, randomization method, sample choice, comparison measure, baseline comparability, estimate index, statistics method, and so oN.</p><p><b>RESULTS</b>During 2000 to 2004, totally 1 116 papers were published in the journal, among them 81 papers were (accounted for 7.3% ) of all articles were reports of treatment related experiments. Out of 81 papers, in 69 experiments ( accounted for 85. 2% ) there was randomized control group, and the main problems lay in calculation of the number of samples, the application of randomization method, and analysis of statistics.</p><p><b>CONCLUSION</b>Application of the randomized control modality in animal experiment is popular in our country, but the design of some studies is not so rigorous. Therefore, we should improve the design of every research project before the experiment is carried out.</p>


Subject(s)
Animals , Animal Experimentation , Reference Standards , Burns , Evaluation Studies as Topic , Periodicals as Topic
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