Changes of muscle induced with injection of botulinum toxin type A in different period of time / 中华医学美学美容杂志

Objective To study the changes of muscle being injected with botulinum toxin A in different period of time,helping for chemically denervated muscle transplantation.Methods Sixteen rabbits were divided into 4 groups.The extensor carpi radialis muscle in one side was chosen for experimental group with the opposite muscle for control group.Morphological changes,histological changes and electron microscopic changes of muscle being injected with botulinum toxin A were observed from the first week to the fouth week.Results The quantity of glycogen and mitochondria in the muscles reduced in the first week.But it was obvious in the third week.We also found some necrotic areas in the fouth week with the muscles restoring.Conclusions The effect of metabolism slowing down and the volume of muscle reducing after botulinum toxin A injection is obvious in third weeks.It could help us choose the best time of chemically denervated muscle transplantation.

Combined surgery of facial fat tissue remodel with SMAS-suspended rhytidectomy / 中华医学美学美容杂志

ObjectiveTo evaluate the effect of facial fat tissue grafting and remodeling with SMAS suspension in facial rejuvenation.MethodsThe treatment process of 12 patients with facial fat tissue grafting and SMAS-suspended rhytidectomy were reviewed retrospectively,the surgical operative procedure and treatment results of facial liposuction and autologous fat grafting with SMAS-suspended rhytidectomy were analyzed and evaluated.Results12 patients underwent facial liposuction,SMAS-suspended rhytidectomy and autologous free fat tissue grafting and remodeling.All the followed-up cases obtained good results without complications.ConclusionsCombined surgery of facial fat tissue remodel with SMAS-suspended rhytidectomy not only corrects the soft tissue laxity,but also modifies the faical volume loss.It solves the aging problems in different angles through soft tissue lift and volume restoration.It is a relatively ideal surgical method of facialplasty for those aged patients.

Endoscopic resection of frontal benign tumors / 中华医学美学美容杂志

ObjectiveTo explore the clinical results of endoscopic resection of the frontal benign tumors.MethodsNineteen cases of benign tumors in the frontal area were rcsected using endo scopic techniques.The tumors were diagnosed as benign according to complaint,history and physical examination.ResultsAll 19 tumors were totally resected.The pathological examination revealed 11cases of lipoma,3 cases of sebaceous cyst,3 cases of sebaceous cyst and 2 cases of dermoid cyst.During 6 months to 2 years of follow-up,no tumor recurred.Local concavity was noticed in all patients but all resolved within 6 months except 2 patients.They received granular fat graft of the concavities 6months late and were satisfied with the results.ConclusionsBenign tumors near eyebrows and in glabella area can be treated by minimally invasive endoscopic technique.Compared with traditional surgery,this technique offers inconspicuous scar and fast recovery.

Microvascular structure of the transmidline scapular flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the microvascular structure of the transmidline scapular flap pedicled with the unilateral circumflex scapular artery.</p><p><b>METHODS</b>Latex and ink mixture was injected into the unilateral circumflex scapular artery of 6 fresh cadavers. The transmidline scapular flap was dissected and the pellucid specimen was made. The artery perforators were traced to their underlying parent vessels that accompanied the segmental arteries. A series of cross-sectional studies were undertaken in one subject to illustrate the course of the perforators in the tissues of different depth.</p><p><b>RESULTS</b>In deep and superficial fascia, the subdermal and dermis layer, rich microvascular connection was found which showed in three patterns: the vascular arch, communicating branches, and the arterial rate. They interrelated to form a three-dimensional framework. The vascular tree not only passed the midline but also reached the contralateral acromion. The densest vessels were exhibited at the injection side of the back. In the midline area the vessels were in less density and at the contralateral side, the vessels mainly concentrated in the upper part of the back.</p><p><b>CONCLUSION</b>The result evidenced the vascular pattern and the applicable safety of the transmidline scapular flap. In elevating a transmidline scapular flap, the distal part should mainly locate at the upper part of the back.</p>

Treatment of chordee without hypospadias / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the methods of dealing with chordee without hypospadias.</p><p><b>METHODS</b>From November 1982 to December 2000, 18 cases of chordee without hypospadias were treated using the methods of urethra extension, urethra elongation with a pedicled transverse prepuce entoplastron flap, a longitudinal prepuce flap or a scrotum mediastinum flap.</p><p><b>RESULTS</b>One case was cured with the first method; 5 cases with the second method; 6 cases with the third method; 6 cases with the fourth method. Fistula occurred in one case treated with the second method.</p><p><b>CONCLUSION</b>The essential defect of chordee without hypospandias is short of urethral tissue. The principal treatment is repairing the urethra using tissue transplatation. Different method should be used based on the characteristics of the defects.</p>

Clinical applications of the scrotal skin flaps pedicled on lateral branches of the posterior scrotal arteries / 中华整形外科杂志

<p><b>OBJECTIVE</b>To provide ideal materials for resurfacing penile ventral wounds.</p><p><b>METHODS</b>For hypospadias with scrotal fissure and penile-scrotal transposition, scrotal skin flaps based on lateral branches of posterior scrotal arteries were utilized to resurface penile ventral wounds when urethral reconstruction were finished.</p><p><b>RESULTS</b>9 cases of hypospadias of different types have been treated with the method mentioned above. All flaps survived and good results achieved.</p><p><b>CONCLUSION</b>For hypospadias with scrotal fissure and penile-scrotal transposition, scrotal skin flaps pedicled on lateral branches of posterior scrotal arteries can not only resurface penile ventral wounds, but also correct scrotal fissure and penile-scrotal transposition simultaneously.</p>

Clinical study of the hemodynamics of both ends (proximal and distal) of internal mammary artery and its following-up / 中华整形外科杂志

<p><b>OBJECTIVE</b>To verify the value of retrograde flow of Internal Mammary Artery (IMA) used as one of the supplying arteries and to develop a new method of applying IMA in breast reconstruction.</p><p><b>METHODS</b>During breast reconstruction with free bilateral transverse rectus abdominis myocutaneous (TRAM) flap, the pressures and velocities of the two ends (proximal and distal) of internal mammary artery as well as the according perfusion unit (PU) of TRAM were measured in two patients who suffered from mammectomy because of carcinoma.</p><p><b>RESULTS</b>The pressure at distal end was 66 or/and 58 mmHg, the pressure at proximal end was 88 or/and 75 mmHg, the former is 75%-77% of the later. The immediate rate of blood flow of distal anastomotic stoma was 74 or/and 52 ml/min, that of proximal was 94 or/and 70 ml/min, the former is 74%-78% of the later after anastomosed to the two sides of deep inferior epigastric arteries (DIEA) separately. Under condition that both ends (proximal and distal) of IMA contributing as the supplying blood vessels simultaneously, the PU of TRAM was the best. The rates of blood flow at the two anastomotic stomas are similar to each other in late stage (evaluated at the fifth year follow-up).</p><p><b>CONCLUSION</b>The distal end of internal mammary artery can supply blood flow in a considerable level, similar with the proximal end.</p>

Repair of penile wounds in penis lengthening with the scrotal dartos musculocutaneous flaps / 中华整形外科杂志

<p><b>OBJECTIVE</b>To provide ideal materials for repair of penile wounds in penis lengthening.</p><p><b>METHODS</b>A skin incision was made between the penis and mons pubis. Penis lengthening was performed by complete releasing of the superficial suspensory ligament and partial releasing of the deep suspensory ligament of the penis. Resurfacing of the defects at the penile base was accomplished by transferring a scrotal dartos musculocutaneous flap pedicled on the anterior scrotal vessels.</p><p><b>RESULTS</b>16 patients with short penis were treated with the method. All scrotal dartos musculocutaneous flaps survived and 4-4.5 cm extra length of the penile shaft was achieved. Appearance and function of the penis were improved.</p><p><b>CONCLUSIONS</b>The scrotal dartos musculocutaneous flap is one of the best materials to repair the penile skin defects in penile lengthening operation. The advantages of the flap are: 1. good blood supply; 2. thin and lacking of subcutaneous fat; 3. extensibility with the scrotal dartos muscle.</p>

Evaluation of the facial artery and vein using color Doppler imaging / 中华整形外科杂志

<p><b>OBJECTIVE</b>The purpose of this study was to provide the guidelines with respect to the location of the facial vessels, observe the potential reversed flow of the facial artery, and reemphasize the value of color Doppler ultrasound studies in flap planning.</p><p><b>METHODS</b>A study was carried out to investigate the location and dynamics of the facial artery and vein using color Doppler ultrasonography in 12 adults.</p><p><b>RESULTS</b>The facial artery and the vein were located together at the lower border of the mandible. Around the oral commissure and under the nasal ala, they run apart from each other at variable distances. The reverse flow was observed in the 12 patients after the blood flow of the facial artery was blocked by applying pressure manually at the lower border of the mandible.</p><p><b>CONCLUSIONS</b>The divergence of the facial vein from the artery is important information in planning of axial pattern flaps. Observation of the reversed flow confirms the possibility of safe elevation of a retrograde flow-arterialized flap based on the distal portion of the facial artery.</p>