ABSTRACT
<p><b>OBJECTIVE</b>To investigate the application of medpor and split-thickness skin graft in formation of cranioauricular sulcus during auricular reconstruction with Nagata method.</p><p><b>METHODS</b>The first stage operation was fulfilled according to the Nagata two-stage method which involves fabrication and grafting of the costal cartilage framework. The second-stage ear elevation operation was undertaken 6 months later to form the cranioauricular sulcus. Split-thickness skin was taken from temporal and accipital area. After releasing the auricular framework and transplanting C shaped medpor at the rear side of framework, the temporaparietal fascia flap was transferred to cover postauricular medpor and framework. Then the split-thickness skin graft was implant on the fascia surface.</p><p><b>RESULTS</b>From July 2010 to August 2012, 20 cases (22 ears) were treated. Partial necrosis of temporaparietal fascia flap and framework exposure happened in 1 case. Successful ear reconstruction was achieved in other cases with satisfactory cranioauricular sulcus during the follow-up period of 6-18 months (average, 13 months).</p><p><b>CONCLUSIONS</b>The application of medpor and split-thickness skin graft in the ear elevation of Nagata method for auricular reconstruction for microtia can achieve satisfactory results. It not only avoids the obvious scar in the donor site due to harvesting full-thickness and intermediate-thickness skin, but also reduces chest trauma due to harvesting costal cartilage.</p>
Subject(s)
Humans , Costal Cartilage , Transplantation , Dermatologic Surgical Procedures , Methods , Ear Auricle , General Surgery , Fascia , Polyethylenes , Therapeutic Uses , Skin Transplantation , Surgical Flaps , TransplantationABSTRACT
Objective To detect the expression level of Ang-1, Ang -2 and Tie-2 receptor mRNAs in the hemangioma tissuses and to explore the effects of Ang-1, Ang-2, and Tie-2 receptor on the angio-genesis in the hemangioma. Methods By use of semiquantinative reverse transcription polymerase chain reaction, we detected the expression level of Ang-1 mRNA, Ang-2 mRNA and Tie-2 mRNA in 30 cases of hemangioma (17 specimens of proliferating hemangioma, and 13 involuting hemangioma )together with 10 cases of normal skin as control, and the expression level of Ki-67 protein was also detected by an im-munohistochemica method. Results The expression of Ang-2 mRNA and Tie-2 mRNA in the prolifera-ting hemangiomas was higher than that in involuting hemangiomas (P<0.01) . The expression of Ang-1 mRNA in hemangiomas was negative. Conclusion The unbalance of Ang-Tie-2 system is probably impor-tant for the pathogenesis and development in hemangiomas.
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Objective To study a simple surgical method for continuous rapid tissue expansion and its clinical application. Methods The operation was accomplished in two-stage procedures. First, expanders were placed in the subcutaneous pocket through interlesional perpendicular short incisions. Continuous expansion by trace syringe pump began from the second day after expander placement. The speed of water injection was set according to patient's algesthesia reaction and vascularity of skin. The second operation was carried out at the third to fifth day after the expansion completed.Results The method was put into clinical practice in 22 cases (16 cases of scar, 2 cases of capillary angioma, and 4 cases of black nevus), and 35 expanders were placed. The speed of water injection was set in 0.2～0.8ml/hr/100ml.The mean time of water injection was 15.3 days. In the process of expansion, all cases were satisfactory except 1 case, in which the expander exposed in the incision. After the second operation, all flaps survived except one showing distal skin necrosis. The result was satisfactory after 3 months to 1 year follow-up. Conclusion The procedure consists of expander placement through interlesional perpendicular short incisions and continuous expansion in advance, which maximally shortens the time of expansion and hospitalization. This expansion method is a simple, safe, reliable, and ideal rapid tissue expansion technique.
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Objective To investigate the function of estrogen in the proliferative and involuting stages of infantile hemangioma. Meothods Expression of estrogen receptor(ER),VEGF and bFGF were detected with SP immunohistochemical method in 42 cases of hemangiomas and 17 cases of vascular malformations.Results The label index(LI) of ER,VEGF and bFGF in the hemangioma was significantly higher than those in the vascular malformation and normal skin(P