Correction of shortened and broaden prolabium deformity with double flag-shaped flaps following bilateral cleft lip repair / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the correction for shortened and broaden prolabium deformity following bilateral cleft lip repair.</p><p><b>METHODS</b>We designed the upper lip double flag-shaped flaps. The quadrilateral original surgical scar (flap flag pole part) was resected and the incision was made along the direction of nasolabial groove at the nostrils bottom to form two flag-shaped flaps (the section of the flag face). Lip tubercle were tracted and blunt dissection of upper philtrum were performed to form a wound, 4-6 mm in width. The flag-shaped flaps on both sides were rotated to the central, in order to form a new nasal base and new prolabium, followed by V-Y or Z plasty procedure to correct the defect of tubercle and vermilion.</p><p><b>RESULTS</b>10 cases were enrolled for the clinical application from January 2008 to December 2012. The height of the prolabium was lengthened by 4-6 mm after operation, which fundamentally corrected shortened and broaden prolabium deformity after bilateral cleft lip operation. The procedure can also correct the depression or defect of tubercle, too wide philtrum, philtrum column scar and the deformity of vermilion border continuity. The patients were followed up for a period of 3 months to 3 years with satisfactory results.</p><p><b>CONCLUSION</b>Double flag-shaped flaps of the upper lip at the nostrils bottom is a simple and good surgery method to correct the shortened and broaden prolabium deformity following bilateral cleft lip repair.</p>

Gene expression of transforming growth factor beta receptor II in the epidermis of pathological scar / 中华烧伤杂志

<p><b>OBJECTIVE</b>To study the gene expression of transforming growth factor beta receptor II (TbetaR II) in pathological scar.</p><p><b>METHODS</b>Twenty samples of pathological scar were collected from 20 burn or trauma patients hospitalized in the General Hospital of Ji'nan Military Command from 2007 to 2009. Twenty specimens of epidermal layer were obtained from the middle portion and the edge of pathological scars. Twenty normal skin specimens which were located more than 10 cm away from the lesion sites of 20 patients were collected as self-controls. Serum from 1-2 mL whole blood were obtained from each of the 20 patients for second self-control. Eight normal skin specimens from 8 patients without pathological scar, discarded from un-related operations, were also collected as negative-control. Positive expressions of TbetaR II in three different skin specimens were determined with biotin-streptavidin-peroxidase staining. Gene expressions of TbetaR II in all specimens were compared with PCR-single strand conformation polymorphism analysis and gene sequencing. Data were processed with Fisher's exact test.</p><p><b>RESULTS</b>Positive expression of TbetaR II in pathological scar epidermis was lower than that in normal skin specimen of patients with pathological scar or normal skin specimen of patients without pathological scar, and TbetaR II was mainly located in the basal layer of epidermis. Positive expressions of TbetaR II were seldom found in acanthocytes, granular cells, and cuticle or even non-existing. No abnormality of TbetaR II was found in normal skin epidermis or serum samples of pathological scar patients or normal skin epidermis of patients without pathological scar. TbetaR II expressing in 8 specimens of epidermis of pathological scar showed abnormal electrophoresis pattern at poly A fragments hand and loss of one A base in DNA fragment (P = 0.044).</p><p><b>CONCLUSIONS</b>There may he abnormal gene expression of TbetaR II in pathological scar epidermis. Replantation of epidermis of scar may increase the risk of scar recurrence, while replantation of normal skin of patients with scar on wound may not increase the risk of scar recurrence.</p>

Repairing soft-tissue defection of ankle and foot by sural neurovascular pedicle fasciocutaneous reversed island flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the clinical application of sural neurovascular pedicle fasciocutaneous reversed island flap to repair soft-tissue defection of the ankle and foot.</p><p><b>METHODS</b>From Sep. 1994 to Oct. 2004,29 patients with soft-tissue defects in the ankle and foot were repaired by use of sural neurovascular fasciocutaneous reversed island flap, including 15 cases of traumatic defects, 11 cases of burns and 3 cases of chronic ulcer. The flap area ranged from 5 cm x 7 cm to 12 cm x 20 cm, and the length of pedicle from 5 cm to 12 cm.</p><p><b>RESULTS</b>The flaps survived totally in 27 cases, the distal necrosed partially and secondary free-skin grafting were further conducted in 2 cases. Twenty-one cases were followed-up for 3 to 60 months,the circulation, color and texture of the flaps were excellent and 2-point discrimination was 10 - 15 mm. The appearance and function of ankle joints were good.</p><p><b>CONCLUSION</b>This flap has sufficient blood supply and a high survival rate; It is convenient in design, dissection and without sacrifice of major arteries. So, it is an effective method for the reconstruction of soft-tissue defects in ankle and foot.</p>