Laparoscopic small intestinal flap colpopoiesis / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the possibility of Laparoscopic reconstruction of vagina using pedicled ileal autograft and provide a new procedure of colpopoiesis.</p><p><b>METHODS</b>The abdominal and perineal approaches were performed simultaneously under a sufficiently deep general anaesthesia. Laparoscopically, a 15-18 cm segment of the ileum on its vascular pedicle, ileal branches of the superior mesenteric artery and its concomitant veins, was selected and isolated for transplantation using ultrasonically-powered instruments. The distal of the transferred ileal segment was 15cm apart from the ileocecal junction. The ileum continuity was restored immediately by end-to-end anastomosis and the distal oral of the transplant was closed using a curved intraluminal stapler. Meanwhile, a neovaginal tract was completed to dissect from the perineum into the peritoneum and the tract widened laterally. Then the ileum transplant was reversed to reach the perineum through the peritoneal incision at the top of the neovaginal tract without subjecting the mesenteric neurovascular pedicle to undue tension and subsequent necrosis. The oral edge of the ileum transplant was sutured to the perineal skin.</p><p><b>RESULTS</b>Followed up for over 1-53 months postoperatively, 36 patients who received laparoscopic vaginoplasty by transferring ileal segment flaps got satisfactory neovaginal function similar to a normal vagina with mucus and moistness.</p><p><b>CONCLUSIONS</b>The advantages of using a laparoscopic ileum colpopoiesis are that (1) satisfactory neovaginal function similar to a normal vagina with mucus and moistness, (2) no disturbance of bowel function, (minimal scarring in abdominal wall and less secondary deformity in perineum and (3) no need for frequent dilation or stent wearing to the reconstructed vagina. And so laparoscopic vaginoplasty was a preferable alternative of vaginoplasty.</p>

The dynamic expression of TNF-alpha mRNA of hypertrophic scars and its roles / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the role of tumor necrosis factor alpha: TNF-alpha in the hypertrophic scar and find a valid way to treat the hypertrophic scars with gene therapy.</p><p><b>METHODS</b>TNF-alpha mRNA expression was tested with a semiquantitative reverse polymerase chain reation (RT-PCR) method in the different period of a hypertrophic scar.</p><p><b>RESULTS</b>There was a significant increase of TNF-alpha mRNA as the hypertrophic scar was getting mature (P < 0.01). However, the ratios of TNF-alpha mRNA was significantly in a lower level than the normal scar.</p><p><b>CONCLUSIONS</b>The results suggest that TNF-alpha may play an important role in normal would healing, but the hypertrophic scar may result from the shortage of the TNF-alpha. This indicates that to increase the TNF-alpha with gene therapy may be a good way to treat the hyphertrophic scar.</p>

Autogenous costal cartilage with Medpor: a compound auricular framework applied to one-stage total ear reconstruction / 中华整形外科杂志

<p><b>OBJECTIVE</b>To introduce a compound external ear framework characterized by few complications, simplicity and very low rate of implant exposure or absorption.</p><p><b>METHODS</b>A compound auricular framework, being composed of the ninth autogenous costal cartilage as ear rim and Medpor ear base, was used in one-stage total ear reconstruction. All patients were followed up postoperatively.</p><p><b>RESULTS</b>Nine cases have been performed clinically using this compound framework and all of them achieved satisfactory efficacies. The reforged ears looked natural and achieved superior cosmesis, and none of them experienced ear rim fracture or implant exposure or distortion.</p><p><b>CONCLUSION</b>This compound auricular framework has advantages of practicability, simplicity and minimal complications. It may be an ideal framework for the reconstruction of total external ear at present.</p>

One-stage reconstruction of postburn whole auricle defect with MEDPOR ear scaffold covered with superficial temporoparietal fascia flap / 中华烧伤杂志

<p><b>OBJECTIVE</b>To study the effect and the key points in the operative procedure of the one-stage reconstruction of postburn whole auricle defect with medpor car scaffold covered with superficial temporoparietal fascia (TPF) flap.</p><p><b>METHODS</b>Medpor car scaffold was embedded under the superficial temporal (TFP) fascia. Razor-thin skin was grafted onto the surface of the fascia flap.</p><p><b>RESULTS</b>Fifteen patients with postburn whole auricle defect were treated by one-stage reconstruction with Medpor ear scaffold during the last four years. It was successful in all the patients with satisfactory appearance of the reconstructed ears.</p><p><b>CONCLUSION</b>Medpor possessed friendly biological compatibility. The reconstruction gave satisfactory results, and its advantages consisted of short operational time, easy manipulation, less injury to patients and good auricular contour.</p>

The significance and the expression of homeobox genes during human burn wound healing / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the expression of several homeobox genes during the wound healing in fetal and adult skin and their roles in fetal scarless wound healing.</p><p><b>METHODS</b>The expressions of PRX-2, HOXB13, HOX2.2 and HOX2.3 during wound healing in fetal and adult skin were determined with in situ hybridization.</p><p><b>RESULTS</b>(1) PRX-2 positive expression could be identified in normal fetal and adult skin, especially in the fetus. But there was difference in location sites of the genes. The positive expression in normal fetal skin was mainly found in the peripheral cells at the hair shafts within dermal papilla layers and was also found in the epithelium. Nevertheless, weak positive expression of PRX-2 was found in the epithelial basal layer cells in normal adult skin but not in dermal tissue. There was strong positive expression of the PRX-2 in the tissue around the wound in fetus but not of that in adults except the epithelial basal layers. (2) Positive expression of HOXB13 could be identified in both normal fetal and adult skins. And the expression was concentrated mainly in hair follicle cells in the dermis and in the basal layer cells in the epithelium. Furthermore, the expression became weak after trauma, especially in fetal skin. (3) The positive expression of HOX2.2 and HOX2.3 in normal fetal skin was observed mainly in the whole layer of the epithelium and especially in the epithelial basal layers. Weak positive expression could be found in the dermis and strong expression found in the tissue near the wound. But there was no positive expression of the HOX genes in normal adult skin and wounds.</p><p><b>CONCLUSION</b>The difference in the HOX expression in fetal and adult skin wound healing might be the key factor leading to different wound healing. Homeobox genes might be closely related with the developmental biology.</p>