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Objective:To evaluate the clinical effect of ultrapulse fractional CO 2 laser in the treatment of mild to moderate orbital aging in Asians. Methods:From January 2018 to December 2018, 36 patients (72 eyes) with mild to moderate orbital aging were enrolled, 22 women and 14 men, with an average age of 32.4 years. Each patient was randomly divided into two groups. In the traditional operation group, 36 eyes received blepharoplasty through traditional inferior conjunctival approach. In the ultrapulsed fractional CO 2 laser group, 36 eyesunderwent blepharoplasty through the lower eyelid conjunctival approach assisted by optoelectronics. Both groups were treated with ultrapulsed fractional CO 2 laser for periorbital aging. The operation time, detumescence time and postoperative complications were compared. At the same time, the periorbital skin relaxation was treated by the combination of the two groups. The patients were followed up for 12 months. Results:In the traditional operation group, 11 cases were evaluated as Barton grade Ⅰ preoperatively, and the efficacy score was 0.64±0.21. In 25 cases of Barton grade Ⅱ the efficacy score was 1.34±0.34. 17 cases were Barton Ⅰ in photoelectric assisted group, and the efficacy score was 0.92±0.18. In 19 cases of Barton grade Ⅱ, the efficacy score was 1.71±0.42. There was a statistically significant difference between the two groups in Barton Ⅰ efficacy score, P<0.05 ( P=0.016); There was also a statistically significant difference between the two groups in efficacy score of Barton Ⅱ, P<0.05 ( P=0.039). The operation time of the photoelectric assisted group was (12.00±1.82) minutes, and the edema duration was (4.0±1.8) days. The duration of operation in the conventional surgery group was (16.00±3.75) minutes, and the duration of edema was (7.0±2.4) days. The operation time and edema duration in the photoelectric assisted group were both shorter than those in the traditional operation group, and the differences were statistically significant ( P<0.05). Conclusions:The blepharoplasty through traditional inferior conjunctival approach assisted with ultrapulsed fractional CO 2 laser has no obvious bleeding, with shorter operation time, swelling reduction time and the number of complications than the traditional operation.This method can solve the symptoms of blepharoplasty, lower eyelid skin relaxation and wrinkles around eyes. This method is worthy of promotion in the treatment of patients with mild to moderate periorbital aging.
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Objective@#To explore the clinical application of ultra-pulsed CO2 laser skin abrasion combined with micro-skin graft in the treatment of skin depigmentation.@*Methods@#From January 2010 to June 2014, depigmented skin specimens were used for ultra-pulsed CO2 laser skin abrasion treatment, at 0, 10, 20, 30, 40, 50, 60 mJ. HE stain was performed to observe the abrasion depth under the 100 times microscope view. The most appropriate parameter was set to completely remove the epidermis, and leave dermis undamaged. From January 2011 to December 2017, 16 patients with skin depigmentation, 12 males and 4 females, aged 12-47 years, were treated with super-pulsed carbon dioxide laser and autologous microdermis transplantation. At 1, 3, 6 and 12 months after the operation, patients′ photos were record. The color improvement was analyzed using Image-Pro Plus 6.0 software.@*Results@#The laser energy for complete epidermis removal is different at different sites. It is 50 mJ for back skin, 40 mJ for face and hand skin and 30 mJ for neck skin. After one year of follow-up, there was no hypertrophy scar caused by over-abrasion in all 16 patients. Combined with the micro-skingrafting, 15 patients with skin depigmentation were completely resolved, with more than 90%color improvement rate. The improvement rate was 75% in a patient with un-uniform appearance, due to part failure of micro-skin graft. The neck movement and uncertain fixation were the reasons.@*Conclusions@#The appropriate energy parameters can control the abrasion depth to avoid the hypertrophic scar. Combined with micro-skin graft, the depigmentation area can be improved with uniform color and reliable effect.
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Objective@#To explore the subunit strategy for perineal defect reconstruction and flap selection.@*Methods@#This is a respective study of 21 patients, with perineal defect, during January 2008 to December 2018. All patients were admitted to the fifth section of Burn and Plastic Surgery in the Fourth Medical Center of the People′s Liberation Army General Hospital. There were 10 males and 11 females, aged from 4 to 68 years old, with the mean age of 26.4 years. The causes of injury included burn (n=11), trauma (n=2), Paget′s disease (n=2), Brown′s disease (n=2), perineal squamous cell carcinoma (n=3)and hemangioma (n=1). The perineum is divided into 4 subunits, according to the anatomical structure: a front area monsveneris or pubic symphysis, 2 middle areas (labia or scrotum) and a posterior area (anal). The defects ranged 23 cm×11 cm-5 cm×3 cm after perineal lesions were removed. Appropriate flaps were selected based on tissue defect.@*Results@#Nine patients were repaired with superficial inferior epigastric artery flap, 3 patients were repaired with superficial circumflex iliac artery flap, and 2 patients were repaired with combined superficial inferior epigastric artery flap and superficial circumflex iliac artery island flap. Internal pudendal arterial perforator flap was performed in 5 patients, and anterolateral thigh perforator flap in 2 patients. The size of flap was 25 cm×12 cm-6 cm×3 cm. All flaps survived, and incisions were primary healing. Patients were followed up for 6 months to 9 years, with an average of 13 months. The patients were satisfied with the appearances and functions of the recipient and doner sites. Scars were concealed well.@*Conclusions@#Appropriate flap can be chosen to repair perineal defects, based on the subunit principle in perineum, in order to restore function and appearance, and achieve satisfactory clinical outcomes.
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Objective To explore a method for repairing the appearance and function of the cheek aesthetic unit.Methods A single volume of 100 ml to 150 ml of tissue expander was implanted at the lower edge of the injury area on the cheek.The first injection was performed 5 days after the operation and twice a week after the injection.It took an average of about 4 months to complete the expansion,with 3-5 times over expanded.The lesions were resurfaced with the expanded flaps,and long term follow-up was observed for flap survival.Results 17 cases of cheek lesions had been successfully reconstructed,with the color,texture of the expanded flaps well matched to the surrounding skin after 3-12 months follow-up.The facial expression functions and configurations were satisfied.Conclusions Excessive expansion of the prefabricated skin flap of the jaw and neck can repair the cheek aesthetic unit successfully,which is a practical method and meets the needs of aesthetic unit repair.
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Tissue-engineered skin plays an important role in clinical applications,and even the rapid development of science and technology promotes the research about it.Choosing an appropriate animal model for wound repair is the prerequisite for the objective evaluation of the object of study.In this paper,the research progress of animal models of wound repair was introduced from several aspects,such as selection of experimental animals,making of wound models,skin-related cells and materials,wound healing evaluation indexes,etc.,hoping to provide reference for later research work.
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Objective@#To investigate the effects of PRX-2 gene on phenotype changes in epidermal stem cells differentiating into sweat gland cells.@*Methods@#Epidermal stem cells and sweat gland cells separated and cultured from healthy foreskin and adult full-thick skin respectively, were identified by immunofluorescence staining. Lentiviral vector-mediated overexpression and knockdown of PRX-2 gene in epidermal stem cells were performed respectively, with empty vector-mediated epidermal stem cells as a control group. Overexpression、blank control and knowdown group′s PRX-2 expressions in gene and protein levels were detected using RT-PCR and Western blot technology. The ESCs of each group were co-cultured with sweat gland cells through transwell plate, and the expressions of CEA and β1 integrin in epidermal stem cells were determined by flow cytometry before and after co-culturing.@*Results@#Epidermal stem cells and sweat gland cells were in line with their respective specific antigens. Before co-cultured, epidermal stem cells highly expressed β1 integrin (98.69±0.67)%, hardly expressed CEA (6.20±3.15)%. After co-cultured, β1 integrin expression levels were showed as knockdown group (19.30±0.53)%<blank control group (65.77±2.32)% <overexpress group (92.63±10.97)%, and CEA expression levels as knockdown (95.43±2.36)%> blank control group (51.20±0.79)%> overexpress group (45.91±0.93)%. There had significant differences between those of each two groups.@*Conclusions@#PRX-2 gene can inhibit the phenotypic change of Epidermal Stem Cells differentiating into Sweat Gland Cells and improve the ability to maintain their own specific antigens.
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Objective To explore a method of large cranial bone defect reconstructed by titanium implant with computer aided design(CAD)/computer aided manufacture(CAM)technique.Methods From April 2006 to June 2008,7 cases of cranial bone defect due to tumor and trauma were admitted.The data of skull bone defects were obtained by CT.The resin model was designed and manufactured with rapid prototyping technique.Results The CT data could be used by image software directly.The resin model was manufactured accurately by RP technique.The titanium implant design could be completed by CAD/CAM.7 patients achieved one stage healing.After a follow-up of 6 months to 1 year,cranial bone defect was reconstructed satisfactorily.Conclusion Individual design and repair of large cranial bone defect with CAD/CAM technique is worth extending application clinically.It is a quite ideal and very simple method for the surgical treatment of the cranial bone defect.
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Objective To explore the application range of expand er s and its clinical efficacy in repair and reconstruction after burn. Methods Two hundred and eighty-six expanders were implanted in 80 burned patients. Volume of the smallest expander was 80cc, and that of the bi ggest one was 800cc. The expansive time ranged from 3 weeks to 2 months. In the second operation, expansive flaps were created and used in the de fected lesion where the scar was removed. Results 7 5 patients were followed up for at least one year with satisfactory results and only 3 patients showed complications that expanders exposed during expan sion. Conclusion Reasonable application of expanders coul d get satisfactory results in repair and reconstruction of severe scar, especia lly for scar at extremities and special sites after burn.
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Objective To explore the efficacy of prefabricated expanded cervico-scapulo-dorsal reverse axial flap combined with cervico-thoracic skin flap to repair cicatricial contracture of lateral neck. Methods Ten patients with cicatricial contracture of lateral neck were repaired by prefabricated expanded cervico-scapulo-dorsal reverse axial flap combined with cervico-thoracic skin flap. The flaps were transferred to repair the wound caused by excision of the scar on the lateral side of the neck. Results All the twenty skin flaps survived in first intention. Both the configuration and function were satisfactory after 6 to 18-month follow-up. Conclusion Prefabricated expanded cervico-scapulo-dorsal reverse axial flap combined with cervico-thoracic skin flap is an ideal method to repair the cicatricial contracture of lateral neck.
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Objective To repair and reconstruct severe burn wounds on face,hands and joints with the principles and techniques of plastic and aesthetic surgery.Methods Twenty three burn victims in a single batch were transferred from a remote area to our Burns Institute on post burn day 2,June 28,2006.All the patients were males aged from 17 to 46 years,with a mean of 24.4?6.3 years,the mean total burn area was 15.7%?13.9% TBSA(ranged from 6% to 75%),with moderate to severe inhalation injury,and fourteen of them had received tracheostomy.The burn areas on face ranged from 0.5% to 3% TBSA,and all of them were deep second or third degree burn.The burn areas on hands ranged from 1% to 4% TBSA of deep second or third degree.On post burn day 3,the patients received escharectomy or tangential excision of eschar on hands followed by split thickness skin grafting with the principles and techniques of plastic and aesthetic surgery.During post burn week 2 to 3,the eschar on the faces were peeled off,followed by split-thickness skin grafting according to the principles and techniques of plastic and aesthetic surgery.Results All the wounds on the face and joints were repaired successfully,the configuration and functions were satisfactory.Conclusion It is feasible to repair the burn wounds on face and joints with the principles and techniques of plastic and aesthetic surgery for the burn patients of mass fire catastrophe.
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Objective To construct recombinant adenovirus vector carrying vascular endothelial growth factor 165(Ad-VEGF165),amplify the adenovirus vector in 293T cells,transfect Ad-VEGF165 into the bone marrow stromal cells(bMSCs) of Wistar rats,and then to assay the expression of VEGF165.Methods VEGF165 obtained by PCR was digested and inserted into adenovirus shuttle plasmid pAdTrack-CMV to generate recombinant plasmid pAdTrack-VEGF165,and then the Pme I-linearized plasmid pAdTrack-VEGF165 was electroporated into E.coli BJ5183 cells that had been electroporated adenovirus backbone plasmid pAdEasy-1.The identified recombinant plasmid pAdEasy-VEGF165 DNA was digested with Pac I and transfected into 293T cells to package adenovirus,followed by identification of the recombinant adenovirus by means of observation of the enhanced green fluorescence protein(EGFP) expression under fluorescent microscope.After amplified in 293T cells,the obtained adenovirus were transfected into 293T cells again,and EGFP expression was detected.Ad-VEGF165 transfected bMSCs were cultured in vitro.The expression of VEGF165 in bMSCs after transfection was determined by observing the expression of EGFP and detected by RT-PCR.ELISA method was applied to assay the secretion of VEGF165.Results Recombinant adenoviral VEGF165 was constructed successfully,which was confirmed by restriction enzyme digestion,gene sequencing and EGFP expression.EGFP expression could be observed under fluorescent microscope,and the expression of VEGF165 was confirmed by RT-PCR.ELISA analysis showed the quantity of expression of VEGF165 in transfection group was higher than that in control group(P