Research progress of allogeneic abdominal wall transplantation / 中国修复重建外科杂志

OBJECTIVE@#To summarize the research progress of surgical technique and immunosuppressive regimen of abdominal wall vascularized composite allograft transplantation in animals and clinical practice.@*METHODS@#The literature on abdominal wall transplantation at home and abroad in recent years was extensively reviewed and analyzed.@*RESULTS@#This review includes animal and clinical studies. In animal studies, partial or total full-thickness abdominal wall transplantation models have been successfully established by researchers. Also, the use of thoracolumbar nerves has been described as an important method for functional reconstruction and prevention of long-term muscle atrophy in allogeneic abdominal wall transplantation. In clinical studies, researchers have utilized four revascularization techniques to perform abdominal wall transplantation, which has a high survival rate and a low incidence of complications.@*CONCLUSION@#Abdominal wall allotransplantation is a critical reconstructive option for the difficulty closure of complex abdominal wall defects. Realizing the recanalization of the nerve in transplanted abdominal wall to the recipient is very important for the functional recovery of the allograft. The developments of similar research are beneficial for the progress of abdominal wall allotransplantation.

Efficacy of conjoint fascial sheath and frontalis muscle flap suspension in treatment of congenital severe blepharoptosis: a systematic review and meta-analysis / 中华医学美学美容杂志

Objective:To evaluate the efficacy of combined fascia sheath suspension (CFS) and frontalis muscle flap suspension in the treatment of severe congenital blepharoptosis.Methods:We searched PubMed, EMbase, Cochrane Library, web of science and Chinese Hownet, Wanfang, VIP, CBM and other databases to collect randomized and non-randomized controlled trials comparing the efficacy of CFS and frontalis muscle flap suspension in the treatment of severe congenital ptosis, from the establishment of literature retrieval database to March 2020; two researchers used RevMan 5.3 software to select and exclude the literature, extract the data and evaluate the quality, set up appropriate effect index and conduct Meta-analysis.Results:Eleven studies included 661 patients, There were 312 cases in study group and 349 cases in control group. The results of Meta analysis showed that the OR of the two groups was 4.88 with 95% CI (2.69, 8.85); the OR of failure rate was 0.20, with 95% CI (0.11, 0.37); the OR of complications was 0.22, with 95% CI (0.14, 0.34). All three groups of data were statistically significant ( P<0.05). Conclusions:The available evidence shows that the combined fascia sheath suspension (CFS) is effective in the treatment of severe congenital blepharoptosis compared with frontalis muscle flap suspension, but the complications of CFS are lower and the satisfaction is higher; these findings have yet to be validated by more high-quality studies due to limitations in the quality and quantity of studies included.

Research progress of methods to promote the survival of cryopreserved ovarian tissue auto-transplantation / 器官移植

With the technology development of cancer treatment, the survival rate of patients with cancer has been significantly improved. However, chemotherapy and radiation therapy may lead to premature ovarian failure and infertility in young women with cancer. Cryopreserved ovarian tissue auto-transplantation is an effective method to preserve fertility of such female patients. At present, the biggest challenge of this technique is mass loss of follicles after transplantation. In this article, the influencing factors and improvement methods of survival of cryopreserved ovarian tissue auto-transplantation were reviewed.

3D-printed models improve surgical planning for correction of severe postburn ankle contracture with an external fixator / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Gradual distraction with an external fixator is a widely used treatment for severe postburn ankle contracture (SPAC). However, application of external fixators is complex, and conventional two-dimensional (2D) imaging-based surgical planning is not particularly helpful due to a lack of spatial geometry. The purpose of this study was to evaluate the surgical planning process for this procedure with patient-specific three-dimension-printed models (3DPMs). In this study, patients coming from two centers were divided into two cohorts (3DPM group vs. control group) depending on whether a 3DPM was used for preoperative surgical planning. Operation duration, improvement in metatarsal-tibial angle (MTA), range of motion (ROM), the American Orthopedic Foot and Ankle Society (AOFAS) scores, complications, and patient-reported satisfaction were compared between two groups. The 3DPM group had significantly shorter operation duration than the control group ((2.0±0.3) h vs. (3.2±0.3) h,

Recent progress in cosmetic lateral canthoplasty / 中华整形外科杂志

The lateral canthus is the junction of the upper and lower eyelids, which is located at the temporal side. The distance from the lateral orbit rim to the lateral canthal angle is 5-7 mm. Cosmetic lateral canthoplasty, as an important surgical method for the rejuvenation of the eyes, was developed in recent year. Along with the development of anatomic study of the lateral canthus, the cosmetic lateral canthoplasty was modified and improved. The purpose of this review is to summarize the anatomy of the lateral canthus, indications for cosmetic lateral canthoplasty and surgical procedures, so as to provide a useful reference for clinicians.

Clinical features of patients with massive transfusion during plastic surgery / 中华医学美学美容杂志

Objective To review the clinical features of the patients received massive transfusion (MT) in plastic surgery department.Methods Ten cases were reviewed.The reason of massive transfusion,the type and dosage of transfusion,the reaction of patients were included.For all the patients,consultation of related department preoperatively was necessary.Based on the through and detailed analysis of the patients' condition,necessary blood product should be prepared ahead of operation.During the therapy,adjustment of treatment plan was made from time to time,according to the patient's condition.Therefore efficient and prompt therapeutic result was achieved.Results In all the 10 MT cases suffered from acute blood loss,2 of them were in hemorrhagic shock before administration.Coagulation disorders happened in 2 patients,and recovered after appropriate treatment.RBC,which was 58.3％ of total amount of transfusion,used most commonly;the second was fresh frozen plasma (FFP),which was 38.6％ according to the total amount.All the patients had satisfactory recovery,without hemolysis or any other functional disorder.Conclusions For MT patients in the Department of Plastic Surgery,the main proposes are to restore and maintain an effective circulatory blood volume,while preventing the coagulation disorder.Also,detailed analysis,through consultation and timely adjustment are of great importance for the MT patients.It is also the essential of an effective perioperative management.

Early application of tissue expansion in repair of traumatic soft tissue defects in the head and face / 中华医学美学美容杂志

Objective To explore a novel strategy to repair traumatic soft tissue defects in the head and face by tissue expansion in the early stage.Methods Eighteen patients with traumatic soft tissue defects were treated with thorough debridement leaving the wound unclosed or simply closed with thin split-thickness scalp skin grafting,and adjacent expander implantation in the early stage and expanded flap transposition in the second stage.Results There were 11 male patients and 7 female patients ranging in age from 3.5 to 40 years [mean,(19.4±12.2) years],with average 15 months follow-up (range,3-67 months).The average expansion time was 74.3 days (range,53-96 days).The total of 18 patients with 22 expanders were treated with satisfactory results.All the flaps survived and the skin color,texture and contour well matched to those of the peripheral tissue.Only one complication of infection happened in the 18 cases (5.56％) and total 22 expanders (4.55％),which was similar to the rate reported in the literature.There were no any other complications related to the expander.Conclusions Debridement and tissue expansion in the early stage have been proved a more effective strategy to repair traumatic soft tissue defects in the head and face,which can not only achieve satisfactory color,unbulky and well matched texture similar to normal,but also can avoid unnecessary donor site injuries and does not increase the infection rate of tissue expansion.

Thinning of the free muscle flaps for the treatment of hand and foot defects / 中华整形外科杂志

Objective@#To investigate the feasibility of one-stage thinning of latissimus dorsi muscle, rectus abdominis muscle and gracilis flap in reconstruction of the hand and foot defects.@*Methods@#From June 2009 to April 2015, 24 free muscle flaps were thinned during transfer operation by removing their superficial muscle layers on the basis of their vessel pedicles running in the deep surface of flaps. The surface of the muscle flaps were covered by split-thickness skin grafts. There were 16 latissimus dorsi muscle flaps, 4 gracilis flaps and 4 rectus abdominis muscle flaps. Flap size ranged from 6 cm×4 cm to 20 cm×12 cm. Thinned muscle flaps were used to resurface 7 hand defects and 17 foot defects.@*Results@#All muscle flaps survived the thinning procedures without any circulation problems except for one case which suffered total flap necrosis due to venous thrombosis. Skins grafts on muscle flaps also took well. One patient experienced partial skin loss. Two patients underwent secondary debridement and thinning procedure for infection and bulkiness. During the 0.3-20 months follow-up, the contour of thinned muscle flaps matched well with the recipient areas. Reconstructed feet are able to wear regular shoes.@*Conclusions@#Intraoperative immediate thinning of free muscle flaps can be safely accomplished during the primary reconstruction procedure. This procedure prevents the limitations of muscle flap bulkiness and may provide an alternative for surface coverage.

Reconstruction of soft tissue defect of the foot dorsum with trimmed latissimus dorsi free muscle flap with skin grafting / 中华显微外科杂志

Objective To discuss the clinical application of using trimmed latissimus dorsi free muscle flap together with skin grafting to resurface soft tissue defects on the dorsum of the foot. Methods From June 2005 to October 2011,eleven patients (8 males and 3 females,aged from 4-46 years) with large soft tissue defects of the foot dorsum were treated in our department. The size of the defects after debridement ranged from 5.0 cm × 6.0 cm-8.0 cm × 12.0 cm,all with exposed tendons or bones.Trimmed free latissimus dorsi muscular flap with split thickness skin grafting was used for reconstruction for all the 11 patients. Results All the flaps survived with no complications after surgery.During 3-10 months' follow-up,the appearance and walking function were satisfying, no further debulking procedures were needed. Conclusion Trimmed latissimus dorsi free flap with skin grafting is a good option for dorsal defect reconstruction.

Modified epicanthoplasty combined with same stage small incision blepharoplasty / 中华医学美学美容杂志

Objective To investigate the possibility of performing epicanthoplasty with same stage small incision blepharoplasty. Methods At the same stage of designing small incision blepharo-plasty, modified "Z" plasty without flap transposition was designed. The upper lid incisive line of epi-canthoplasty was bided in the double eyelid fold, while the lower eyelid incision located at the edge of eyelid. Results A series of 56 patients were treated with this method. Satisfactory esthctical result of double eyelid fold and inner canthus shape was achieved. Conclusion This modified method including epicanthoplasty combined with same stage small incision blepharoplasty has the advantages of minimal scar formation, easy to design perform and in accordance with physiology.

Application of deltopectoral skin flap in the repair of extensive facial wound secondary to massive scar re-vision / 中华医学美学美容杂志

Objective To explore the technique of massive facial scar revision. Methods All 12 patients in the group were treated with expanded deltopectoral skin flap. In the primary surgery, expander was implanted underneath deltopectoral flap region through an incision inferior to the clavi-cle. The skin perforators of transverse cervical artery and thoracoacromial artery were ligated during surgery, and the internal thoracic artery was carefully preserved. After the deltopectoral skin flap was fully expanded, the second surgery was performed and the facial scar was released and the normal ana-tomic position of eyes, nose and month was restored. The deltopectoral skin flap was planed according to the size of the defect. The excised facial scar was converted to the flap pedicle and a hinge-like con-nection was formed. The flap was delayed and three weeks after the second surgery, the pedicle was divided. The flap from the pedicle was applied for the mental region scar revision. Results Unilateral or bilateral dehopectoral skin flaps were employed for the repair of extensive facial scar in 12 patients. Satisfactory results were achieved in all these patients. Conclusion Expanded deltopectoral skin flap is a good technique for the repair of extensive facial scar.

Influence of Ad-METH-1 on microvessel and relative cytokine of hypertrophic scar / 中华医学美学美容杂志

Objective To investigate the influence of gene transfection antiangiogenesis on microvessel and relative cytokine of hypertrophic scar of rabbits' ear.Methods The hypertrophic scar of rabbtis' ear was reproduced.On the 10th day after epithelization,Ad-METH-1 was injected into tissue of scar.30 days later,the microvessel of scar-tissue was detected by microcirculation microscope.Meanwhile.H&E and immunohistochemical stains were performed.Then the results were analyzed.Results 30 days after Ad-METH-1 injection.in experimental groups,the microvascular count of scar tissue was 12.38±2.56,the percentage of VEGF positive cells was 17.64%,and the percentage of bFGF positive cell was 18.24%:while in the control groups,the microvascular count of scar tissue was 48.12±6.46.the percentage of VEGF positive cell was 31.34%.and the percentage of bFGF positive eell was 28.26%.Results revealed that the count of microvessel of scar tissue in the experimental groups was lower than that in the control groups,between which there was the difference in statistics(P＜0.01).and that the percentage of VEGF and bFGF positive cells of scar tissue in the expenmental groups were lower than that in the control groups.between which there was the difference in statistics(P＜0.05).Conclusion Ad-METH-1 has marked inhibitory effects on scar tissue hyperplasia of rabbits' ear,angiogenesis and expression of VEGF and bFGF.Using antiangiogenesis therapy at the early phase could inhibit the formation of hypertrophic scar.Gene transfection antiangiogenesis therapy could bid fair to become an effective method to prevent and treat hypertrophic scar.