Post-Auricular Skin Expansion for Microtia Reconstruction / 昆明医科大学学报

Objective To evaluate the effect of retroauricular skin expansion forthe purpose of ear reconstruction.Methods In this technique called three-stage method:1st soft tissue expander implantation under the skin close to the microtic ear,2nd the autogenous rib cartilage is harvested,the ear framework is prepared and covered with expanded skin.3rd the pseudomeatus,tragus and lobule are formed.Results 50 patients out of 55 patients were satisfied with their result and patients were followed up from 6 months to 2 years and no complain were received,There were few case with minor complication of (Exposure of expander,Deflation or Infection,Exposure of framework,Steel wire extrusion,Hypertrophic scar,Chest wall deformities) and the complications were treated accurately and carefully and patients were discharged after recoveries.Conclusion The three-stage method is very useful in microtia by using costal autogenous rib cartilage.

Lower capsular contracture of miniprostheses as compared with the conventional silicone implant / 中华整形外科杂志

<p><b>OBJECTIVE</b>To determine if miniprostheses would form a capsule of significantly different biophysical, biochemical and histologic properties than the conventional silicone implant.</p><p><b>METHODS</b>Four miniprostheses (experimental group) and one big silicone implants (control 1 group) were separately implanted beneath the panniculus carnosus muscle of 30 rabbits. After 3 months, measures related to contracture and capsular histology were performed on anesthetized animals.</p><p><b>RESULTS</b>Baker ranking, capsular incision width and capsular thickness of the control groups were evidently higher than that of experimental groups (P < 0.01). Implant compression of the control groups was evidently lower than that of the experimental group. Histology revealed a thinner, more flexed capsule around the miniprostheses as compared with big silicone implants.</p><p><b>CONCLUSIONS</b>The miniprostheses form a looser and thinner capsule than the conventional silicone implant.</p>

Application of integra for reconstruction of burn scar contracture / 中华整形外科杂志

<p><b>OBJECTIVE</b>Introducing a comprehensive technique to reconstruct burn scar contracture or deformities using integra (artificial dermis) with large epidermal skin grafting or ulth-thin split-skin.</p><p><b>METHODS</b>The wounds following contracture scar or deformities excised or loose were covered with the integra which was flattened and fixed perfectly, after a 2 approximately 4-week period, the out layer was removed then covered with large sheets of epidermal grafts, which was of thickness from 0.0028 inc to 0.0048inc (0.07 approximately 0.12 mm), or ulth-thin split-skin of about 0.006inc (0.15 mm) thickness, harvested using the electric or air power dermatome, the edge of the graft sheet attached together with the borders of wound using nanoparticles-Ag-gauze stripe adding sutures of the 5-0 threads or the skin stapler, dressed with vaseline gauzes in the inner layer and the nano-particles Ag gauze on the outer surfaces.</p><p><b>RESULTS</b>Nineteen sites of 15 cases including 5 sites in trunk and 14 sites in extremities from 1999.8 to 2003.6 were treated using this technique in this study, the wound areas following scar excised was about 10 cm x 25 cm approximately 30 cm x 75 cm, of them 12 cases covered with a large sheet of ultr-thin split-skin (in early time) and 7 cases with a large sheet of epidermal grafting and all of them was survival. The colour and texture of the reconstruction sites were very good and can be compared favorably with normal skin after a half year-four year following up period, because all donor sites healing without scarring, the appearance in the epidermal graft donor is better than that in split-thickness skin donor.</p><p><b>CONCLUSIONS</b>Integra with large sheets of epidermal grafts applied for scar contracture disformities is an effective and useful method, especially the epidermal grafts offered a satisfying result in the donor healing.</p>

The experimental researches on the use of triamcinolone acetonide for the prevention of implant capsular contracture / 中华整形外科杂志

<p><b>OBJECTIVE</b>To explore the use of triamcinolone acetonide for the prevention of implant capsular contracture.</p><p><b>METHODS</b>20 rabbits were randomly undivided into 2 groups of 10 animals each. Every 10 ml silicone implant was implanted beneath the panniculus carnosus muscle of one rabbit. At the same time, a modified expander catheter was mounted on the implant. This catheter has many lateral holes and the end was blind. Triamcinolone acetonide (10 mg/3 ml) was infused through the expander pot and catheter as the experimental groups. On the other hand, 3 ml saline was used as the control group at 1, 2, and 3 months. At 6 months, measures related to contracture and capsular histology examinations were performed on anesthetized animals.</p><p><b>RESULTS</b>Baker scores, capsular incision width and capsular thickness of the saline groups were evidently higher than that of triamcinolone acetonide groups (P < 0.01). Implant compression of the saline groups was evidently lower than that of triamcinolone acetonide group. Histology revealed a thinner capsules and less fibrous tissue deposition around the triamcinolone acetonide group, as compared with saline group.</p><p><b>CONCLUSIONS</b>It is effective to deliver triamcinolone acetonide to reduction of capsular contracture through the catheter and its pot.</p>

Preventing scarring in split-thickness skin donor sites with epidermal grafting / 中华整形外科杂志

<p><b>OBJECTIVE</b>Introducing a new technique for preventing the scar growthing in split thickness skin donor sites using the great sheets of epidermis covering.</p><p><b>METHODS</b>The donor sites of split thickness skin were grafting with the great sheets of the epidermis, of the thickness about 0.07 approximately 0.12 mm, harvested by electrical power dermatome and fixed the edges of the epidermal sheet with the verges of donor wound together using the nanoparticles-Ag-gauze stripes adding the sutures or skin stapler, dressing the wounds with the nanoparticles-Ag-gauze using the tie-over technique, left the dressing entire for a 5-day period.</p><p><b>RESULTS</b>This method were used in a total of 209 donor sites of both the split-thickness skin and epidermis for 133 reconstructed sites of 118 cases from November 1999 to November 2003, and the smooth, near normal skin appearance without scarring were obtained in the split thickness skin donor sites, and the epidermal donor sites healed good enough 5 days after surgery, and skin appearance is near normal in 3 months later.</p><p><b>CONCLUSIONS</b>Covering the donor sites of split thickness skin with the large sheets of epidermis is an effective and useful method for preventing the scarring in the split thickness skin donor sites.</p>

Breast reconstruction with multiple miniprostheses / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate a new technique for breast reconstruction with multiple miniprostheses,</p><p><b>METHODS</b>Each silicone miniprosthesis(10 approximately 15 ml) was implanted one by one beneath the prepared muscle pocket until the desired volume was achieved.</p><p><b>RESULTS</b>Seven patients were treated with the above mentioned technique, including five after gland fibroadenoma excision, one hemangioma excision and one reduction mammoplasty. The results were satisfactory.</p><p><b>CONCLUSION</b>The above mentioned technique with the miniprostheses may be another good way for breast augmentation and breast reconstruction with many advantages such as smaller incision, easy intraoperative assessment of the ideal size of the breast, easy handling the technique, perhaps low incidence of capsular contracture.</p>