ABSTRACT
Objective@#To explore the clinical effects and key techniques of expanded super-thin perforator flaps in the shoulder, neck, and chest in reconstruction of extensive burn scars in the face.@*Methods@#From January 2008 to November 2018, 22 patients with extensive burn scars in the face were admitted to the Department of Plastic Surgery of Dongguan Kanghua Hospital and the Department of Plastic Surgery of Dermatology Hospital of Southern Medical University, with 3 males and 19 females, aged from 4 to 48 years. There were 16 cases of type Ⅱ and 6 cases of type Ⅲ in facial scars. Before the first stage of expansion surgery, Doppler blood flow survey meter or multi-slice CT was used to locate the perforator vessels. One to four expanders with rated capacity ranged from 100 to 600 mL were placed in the patients. We gave 20% to 30% of the rated capacity of expander intro-operation and common injection with 10% to 15% of the rated capacity of expander per week post-operation until the volume reached 1.5 to 2.5 times of the rated capacity of expander during the past 3 to 4 months. At the second stage of surgery, the perforators were located again before surgery with the same method. The size of defects after the excision of facial scars ranged from 6 cm×4 cm to 18 cm×16 cm. With perforators used as nutrient vessels, narrow pedicle flaps or random flaps ranging from 6 cm×6 cm to 22 cm×18 cm were elevated as rotating or advancing to reconstruct the defects. The donor sites were sutured directly. Some of the flaps needed stage Ⅲ operation for cutting the pedicle. The survival of flaps, post-operation complications, and follow-up were assessed.@*Results@#All flaps of 22 patients survived. All the donor sites were closed simultaneously. One patient underwent an additional surgery for 5 cm×4 cm necrosis on distal part of flap caused by subcutaneous hematoma. Two patients with epidermis blister on the flaps were healed by themselves after dressing change. Due to rapid expansion, blood capillary proliferation appeared on the central part of the flap in 3 cases, after slowing down the expansion speed properly, which had no impact on flap transfer. No ischemia or venous congestion phenomenon were observed in the other flaps. During follow-up of 5 to 48 months, the flaps of patients showed no significant bloated appearance, with good complexion and texture, and even could reproduce facial fine-grained expressions naturally.@*Conclusions@#For the reconstruction of extensive burn scars in the face, expanded super-thin perforator flaps can not only acquire large and thin flaps with high matching degree surface skin defect, but also reproduce facial fine-grained expressions. It is a simple and safe method which conforms to the facial aesthetic standard.
ABSTRACT
OBJECTIVE@#To investigate the effects of radioactive ray on transmission capability of nose mucociliary.@*METHOD@#Forty-six patients with NPC were selected and saccharin clearance time (SCT) for 7 phases were detected in both pre- and post-radiotherapy respectively.@*RESULT@#Among 46 patients with NPC, the shortest SCT was 247 seconds and the longest 601 seconds in pre-radiotherapy phases; from 4th week of introradiotherapy to 18 months of postradiotherapy, the longest SCT was in 12 months after radiotherapy, which was 903 seconds. There were no significant differences in SCT before radiotherapy and 18 months after radiotherapy. There were significant differences in SCT of preradiotherapy and introdiotherapy, post radiotherapy, after radiotherapy 3 months, 6 months, 12 months after radiotherapy.@*CONCLUSION@#Radiotherapy is the important factors in influencing transmission capability of nose cavity and sinus mucociliary and hints that gender and nasal cavity side don't affect SCT. Detection of SCT in different stages of NPC patients can be helpful to protect nasal mucous membrane effectively, and to reduce incidence rate of RNS.