ABSTRACT
Objective:To observe the lipogenic or osteogenic differentiation of decellularized adipose matrix (DAM) in the periosteal microenvironment.Methods:From June 2020 to December 2020, adipose tissue obtained by human liposuction was prepared as DAM at the National Institute of Plastic Surgery. Six male SD rats of 4 to 6 weeks were selected and implanted into the subperiosteum of the rat parietal bone according to the same initial volume. After 12 weeks, adipogenesis and osteogenic differentiation of DAM were observed by gross specimens, histological staining, and immunofluorescence staining. Label-free quantitative protein mass spectrometry was used for detection of osteogenic-associated proteins in DAM.Results:Vascularization around the DAM was evident. Adipogenesis and angiogenesis were observed in DAM by H&E and Masson staining, while OCN immunofluorescence staining confirmed osteogenic differentiation of DAM. The osteogenic differentiation related proteins were screened by mass spectrometry.Conclusions:In the microenvironment of periosteum, DAM mainly differentiates towards adipose tissue, but a few of them havs the potential to differentiate towards osteogenesis, which might be related to some of the osteogenesis-related proteins contained in DAM.
ABSTRACT
Objective To investigate the method and effectiveness of the digital artery series and parallel of island flap for repairing degloved injuries of the fingertip of thumb or adjacent finger Methods Between September 2008 and July 2012,the finger artery series retrograde island flaps tiled in the repair of finger degloving injury in 13 cases,repair of adjacent finger tip degloving injury in 11 cases; 8 cases of degloved injuries of the fingertip were tiled with the digital artery parallel island flap from ulnaris middle finger and radialis ring finger of arteria digitalis communis pedicled which were from the same palm side.The size of skin and soft tissue defect ranged from 2.0 cm × 1.8 cm-7.2 cm ×5.5 cm,gutted flap minimum ranged from 1.1 cm × 1.0cm-1.5 cm × 1.3cm,and the maximum ranged from 3.0 cm × 2.2 cm-5.5 cm × 4.5 cm.The donor sites were repaired with the intermediate split thickness free skin grafts and performed with pressure dressing.Results The group of 32 cases,in 1 case the flap vasospasm occurred in operation of free process,the symptoms disappeared after local application of papaverine and hot compress ; 1 case of flap occurred disturbance of blood circulation after operation because of tight suturing for pedicle,the symptoms relieved after removing the stitches at intervals; 2 cases blisters appeared after operation,disappeared after a week.All skin flaps were survived,incision and skin graft donor sites healed by first intention.Twenty patients were followed-up from 6 to 12 months after operation.All flaps presented the satisfactory appearance and texture,recovered protective feeling.At last follow-up,the two-point discrimination was 7 to 10mm,and the flexion and extension function of wounded fingers recovered to normal.According to the functional assessment criteria of upper limb formulated by the Hand Surgery Branch of Chinese Medical Association,there were excellent in 19 cases,good in 10 cases,and moderate in 3 cases.No significant loss to the donor shape and function.Conclusion The surgery by adopted the digital artery series or parallel of island flap for repairing degloved injuries of the fingertip of thumb or adjacent finger,not only has the advantages of simpleness,safety and reliability,but also can satisfy the patients who aren't willing to accept or because of physical reasons can't accept the treatment of abdominal skin tube or nail flap from hallux toe,which performs in both high-end and low level hospitals,and deserves of general application.