Which vessel, the artery or the vein is more important in vascular supercharge: an investigation of vascular changes on rat abdominal supercharging flap models / 中华整形外科杂志

<p><b>OBJECTIVE</b>The study was to reveal the vascular changes in three different supercharging flap models. From this study, we want to investigate which vessel, the artery or the vein is more important in elongating perforator flap survival and why.</p><p><b>METHODS</b>Twelve rats were divided into three experimental groups. The left side flaps in all groups were pedicle using xiphoid perforator as control group. The right side flaps were supercharging experimental group. Group I, flap supercharged based on artery and vein of pubis perforator. Group II, flaps supercharged based on artery of pubis perforator. Group III, flaps supercharged based on vein of pubis perforator. Near-infrared fluorescent angiography was performed using SPY imaging system pre-and-aft operation and all angiography videos were compared and analyzed.</p><p><b>RESULTS</b>Showed in angiography video of SPY, in control group and vein supercharging group, blood supply could be observed the immediately reducing, and almost be disappeared the amount of perfusion to distal area. It shows relatively constant necrosis in the distal side of control group and vein supercharging group, and the necrosis of vein supercharging group smaller than these of control group. In artery, vein supercharging group and artery supercharging group, blood perfusion could be observed separately perfusion in the upper and low area of flap. There are complete survival showed on the artery supercharging group and artery and vein supercharging group.</p><p><b>CONCLUSIONS</b>These findings indicated that congestive flap necrosis attribute to insufficiency of arterial blood. Arterial inflow was demonstrated more important for improved survival of distal flap than venous outflow.</p>

Applied anatomy of cervico-acromial crossing skin flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the applied anatomy of the blood supply of the cervicoacromial crossing flap and its feasibility in clinical application.</p><p><b>METHODS</b>5 fresh adult and 10 forman fixed adult cadaver specimens were used. The arteries, veins, cutaneous arteries, subdermal vascular network, and vascular network of the superficial layer of deep fascia in the cervico-acromial area were observed and studied under the microscope. The frontier border of the cervico-acromial area is clavicle, the posterior border is the spine of scapula, the outer border is acromion and the inner border is cervical base.</p><p><b>RESULTS</b>(1) The perforator branches concentrate at the front edge of trapezius muscle; (2) The vessel network around the front edge of trapezius muscle is abundant. Among the anastomosis, two or three anastomosis which across the area from the base of the neck to acromion can be observed in the axial of every cervico-acromial area. Abundant vessel network can be observed in the superficial layer of deep fascia.</p><p><b>CONCLUSIONS</b>The blood supply of the cervico-acromial flap is abundant, which constains constant perforator point. The cervico-acromial crossing skin flap can be applied with the rich blood supply and abundant vessel network in the superficial layer of deep fascia.</p>

Penile augmentation and elongation using autologous dermal-fat strip grafting / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of autologous dermal-fat strip grafting in penile augmentation and elongation.</p><p><b>METHODS</b>From May 2004 to December 2010, 24 patients underwent penile enhancement with free dermal-fat strip grafting. Through suprapubic incision, the superior suspensory ligament and part deep suspensory ligament are cutted off to lengthen the penis. The resulted dead space is filled with the autologous dermal-fat strip (6.0-9.5 cm in length, 1.2-1.5 cm in width and 0.6-0.8 cm in depth) to enhance the penis.</p><p><b>RESULTS</b>Primary healing was achieved in 23 cases. Incisional fat liquefaction happened in one case which healed after dressing change. The penile appearance was satisfactory both at rest or erection. The penile length and circumference increased by 2.5-4.8 cm (average, 3.2 cm) and 1.8-3.0 cm (average, 2.4 cm), respectively. 18 patients were followed up for 3 months to 5 years. All the patients were satisfactory on the cosmetic and functional results. No complication happened.</p><p><b>CONCLUSIONS</b>It is safe and effective for penile augmention and elongation with autologous dermal-fat strip grafting and disconnection of penile suspensory ligament.</p>

Anatomy correction of penile epispadias / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the pathological characters and anatomic correction of penile epispadias.</p><p><b>METHODS</b>The urethra was formed by local urethra plate mucosa flaps. The contracture on dorsum of penis was released by cutting off the superficial suspensory ligament to reposition the penile and urethral sponge.</p><p><b>RESULTS</b>From Jun. 2004 to Dec. 2010, 26 cases with penile epispadias were treated. 18 cases were followed up for 6 months to 5 years. 10 cases were treated successfully with good cosmetic and functional results. Urinary incontinence happened in 8 cases, which healed after tightening operation.</p><p><b>CONCLUSIONS</b>The anatomic correction of penile epispadias can recover the normal anatomic structure, resulting good cosmetic and functional results.</p>

Tubed oral mucosa for staged treatment of congenital hypospadias in infancy / 中华整形外科杂志

<p><b>OBJECTIVE</b>To discuss the treatment of congenital hypospadias in infancy.</p><p><b>METHODS</b>After correction of chordee, the tubed oral mucosa was used to prefabricate urethra in penis as free graft. The urethral anastomosis was performed at the second stage. The scrotum fascia flap, pedicled with scrotal artery, was transferred to cover the penile defect.</p><p><b>RESULTS</b>From Jan. 2007 to May 2010, 42 cases were treated. The tubed oral mucosa was 3.0-4.0 cm in length, and 0.6-0.8 cm in diameter. The maximum size of scrotum flap was 1.5 cm x 3.0 cm. Urethral fistula happened in two cases due to necrosis at the distal end of scrotal flap, which was healed spontaneously after dressing for 1-2 weeks. Primary healing was achieved in all the other cases. After operation, the 26 cases have been visited for 6 months to 3 years, no urethra fistula , narrow and the penis curved. There is an universal urinate for oneself and a good form.</p><p><b>CONCLUSIONS</b>The tubed oral mucosa can be used to prefabricate urethra, which is anastomosed at the second stage. The tubed oral mucosa combined with scrotal fascial flap which has a reliable blood supply, is very suitable for hypospadias in infancy.</p>

Application of temporal-zygomatic expanded flaps pedicled with orbicularis oculi muscle for sub-orbital defects / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the therapeutic effect of temporal-zygomatic expanded flaps pedicled with orbicularis oculi muscle (00M) for sub-orbital defects.</p><p><b>METHODS</b>16 cases with sub-orbital defects were treated. The expanders were implanted at temporal-zygomatic region at the first stage. At the second stage, temporal-zygomatic expanded flaps pedicled with OOM were designed and transferred to repair the suborbital defects.</p><p><b>RESULTS</b>All the expanded flaps survived completely. 11 cases were followed up for 3 months to 3 years. The flaps had no contracture with a good match of color and texture with surrounding tissue. The scar was also inconspicious.</p><p><b>CONCLUSIONS</b>The temporal-zygomatic expanded flaps can be used for large size defects below orbit. It is very flexible, leaving minimal morbidity for the whole face.</p>

Application of tissue granule of oral mucous in plastic surgery / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the application of tissue granule of oral mucous in plastic surgery.</p><p><b>METHODS</b>Tissue granule of oral mucous was placed on glutin sponge and they were used for urethral (12 cases) and vaginal (14 cases) reconstruction in 26 cases.</p><p><b>RESULTS</b>Satisfactory results were achieved in 24 cases. One case of urethral fistula and one case of urethral meatus stricture were happened. The two cases underwent secondary operation.</p><p><b>CONCLUSIONS</b>Tissue granule of oral mucous membrane is good supply for repairing mucous defect. It has the advantages of high growth and survival rate, and less shrinkage. It is useful for urethral or vaginal reconstruction which are covered with mucous membrane.</p>

Clinical application of expanded submental island flap in facial soft tissue defect / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the application of the expanded submental island flap in facial soft tissue defect.</p><p><b>METHOD</b>12 patients with facial soft tissue defects were treated with the expanded submental island flaps during September 2004 to September 2008. At the first stage, soft tissue expander was implanted in the neck. At the second stage, the submental island flap was designed to repair the facial soft tissue defect. The largest size of the flap was about 16 cm x 9 cm.</p><p><b>RESULT</b>All flaps survived well except for one case of partial epidermal necrosis at the distal part of the flap. The wound healed with dressing. 4 patients were followed up for 6-24 months with satisfactory results.</p><p><b>CONCLUSION</b>The submental artery was a constant branch of facial artery. Large cervical flap with high quality tissue can be provided after expansion. The expanded submental island flap is a good choice for repairing the facial soft tissue defect.</p>