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OBJECTIVE@#To investigate effectiveness of transconjunctival lower eyelid blepharoplasty with "super released" orbital fat in correction of lower eyelid pouch protrusion and tear trough and palpebromalar groove depression.@*METHODS@#A clinical data of 82 patients (164 sides) with lower eyelid pouch protrusion and tear trough and palpebromalar groove depression, who met the selection criteria between September 2021 and May 2022, was retrospectively analyzed. Of the included patients, 3 were males and 79 were females, with an average age of 34.5 years (range, 22-46 years). All patients had varying degrees of eyelid pouch protrusion and tear trough and palpebromalar groove depression. The deformities were graded by the Barton grading system as gradeⅠ in 64 sides, grade Ⅱ in 72 sides, and grade Ⅲ in 28 sides. The orbital fat transpositions were performed through the lower eyelid conjunctival approach. The membrane surrounding the orbital fat was completely released, allowing the orbital fat to fully herniate until the herniated orbital fat did not retract significantly in a resting and relaxed state, which is regarded as the "super released" standard. The released fat strip was spread into the anterior zygomatic space and the anterior maxillary space, and percutaneous fixed to the middle face. The suture that penetrates the skin was externally fixed by adhesive tape pasting without knotted.@*RESULTS@#There were 3 sides with chemosis after operation, 1 side with facial skin numbness, 1 side with mild lower eyelid retraction at the early stage after operation, and 5 sides with slight pouch residue. No hematoma, infection, or diplopia occurred. All patients were followed up 4-8 months, with an average of 6.2 months. The eyelid pouch protrusion, tear trough, and palpebromalar groove depression were significantly corrected. At last follow-up, the deformity was graded by Barton grading system as grade 0 in 158 sides and grade Ⅰ in 6 sides, with a significant difference compared to the preoperative score ( P<0.001). Patient's self-evaluation satisfaction reached very satisfied in 67 cases (81.7%), satisfied in 10 cases (12.2%), generally satisfied in 4 cases (4.8%), and dissatisfied in 1 case (1.2%).@*CONCLUSION@#The "super released" orbital fat can effectively prevent the retraction of orbital fat, reduce the probability of residual or recurrence of eyelid pouches, and improve the correction effect.
Subject(s)
Male , Female , Humans , Adult , Blepharoplasty , Retrospective Studies , Depression , Eyelids/surgery , Face/surgery , Adipose Tissue/transplantationABSTRACT
BACKGROUND@#Keloids are benign fibrous growths that are caused by excessive tissue build-up. Severe keloids exert more significant effects on patients' quality of life than do mild keloids. We aimed to identify factors associated with the progression from mild keloids to severe keloids, as distinct from those associated with the formation of keloids.@*METHODS@#In this retrospective case-control study, 251 patients diagnosed with keloids at West China Hospital between November 2018 and April 2021 were grouped according to the severity of lesions (mild [n = 162] or severe [n = 89]). We collected their basic characteristics, living habits, incomes, comorbidities, and keloid characteristics from Electronic Medical Records in the hospital and the patients' interviews. Conditional multivariable regression was performed to identify the independent risk factors for the progression of keloids.@*RESULTS@#Eighty-nine patients (35.5%) were classified as having severe keloids. We found the distribution of severe keloids varied with sex, age, excessive scrubbing of keloids, family income, the comorbidity of rheumatism, disease duration, characteristics of the location, location in sites of high-stretch tension, the severity and frequency of pain, the severity of pruritus, and infection. Multivariable analysis revealed significant associations between severe keloids and infection (odds ratio [OR], 3.55; P = 0.005), excessive scrubbing of keloids (OR, 8.65; P = 0.001), low or middle family income (OR, 13.44; P = 0.021), comorbidity of rheumatism (OR, 18.97; P = 0.021), multiple keloids located at multiple sites (OR, 3.18; P = 0.033), and disease duration > 15 years (OR, 2.98; P = 0.046).@*CONCLUSION@#Doctors should implement more active and thorough measures to minimize the progression of mild keloids in patients who have any of the following risk factors: infection, excessive scrubbing of keloids, low or middle family income, comorbidity of rheumatism, multiple keloids located at multiple sites, and disease duration > 15 years.
Subject(s)
Humans , Case-Control Studies , Keloid/epidemiology , Quality of Life , Retrospective Studies , Rheumatic Diseases , Risk FactorsABSTRACT
Impaired healing of diabetic wounds is mainly attributed to its pathological mechanism, and refractory diabetic wounds bring heavy burdens to patients and society. Exosomes derived from stem cells possess the similar ability as stem cells in promoting tissue regeneration and more clinical advantages and are gradually playing important roles in wound healing. In recent years, researches have shown that exosomes derived from adipose-derived mesenchymal stem cells (ADSC-EXOs) can promote the healing of diabetic wounds by participating in various processes of wound healing. This article reviews the pathological mechanism leading to impaired healing of diabetic wounds, the related mechanism and the application prospect of ADSC-EXOs in promoting diabetic wound healing.
Subject(s)
Humans , Diabetes Mellitus , Exosomes , Mesenchymal Stem Cells , Stem Cells , Wound HealingABSTRACT
Objective:To probe into the causes, reconstructive strategies, and repair outcomes of asymmetric eyelid configuration after blepharoplasty.Methods:All 73 patients (14 males and 59 females) with asymmetric double eyelid after blepharoplasty were recruited between July 2013 and June 2018 from Department of Plastic and Burns Surgery, West China Hospital, Sichuan University. The patients aged from 18 years to 42 years with the median age of 27 years. The new double eyelid line was designed pre-operation. Releasing subcutaneous adhesion of upper eyelid entirely, trimming inferior orbicularis oculi, adjusting and comparing the attachment position of bilateral levator aponeurosis were performed during surgery. Patients and surgeons marked the appearance of double eyelid both before and after repair operation, results of which were analyzed by t-test.Results:All 73 patients obtained improved double eyelid with primary healing. During follow-up from 8 to 12 months, repaired double eyelid showed satisfactory configuration with smooth natural double eyelid line and symmetric bilateral double eyelid. Of the 73 patients, 3 (4.1%) complaint rough double eyelid line, for whom re-fixation through small incision were adopted and no complication was observed during follow-up time. Scores by patients and surgeons were both significantly better after surgery.Conclusions:Analyzing the causes of asymmetric eyelid after double-eyelid blepharoplasty and repairing it contribute to aesthetic pleasing reconstructed double eyelid.
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Scars formed by various injuries can affect the appearance and psychology of patients. Therefore, more and more people pay attention to the prevention and treatment of scar. With the development of the autologous fat grafting, it has been gradually applied to the prevention and treatment of scar. At present, it has been confirmed by scholars that the autologous fat grafting could be an effective method to prevent and treat scar from basic research and clinical practice. At the same time, the deficiency of autologous fat grafting in the prevention and treatment of scar was also pointed out. This paper reviews the application, mechanism, and deficiency of autologous fat grafting in scar prevention and treatment.
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Scar formation is the abnormal healing process of skin after being damaged. The mechanism of scar formation is not clear, and many studies have shown that it is affected by many factors. Based on the over deposition of collagen in scars, many researchers have carried out studies on the mechanism, pathological manifestation, and treatment method of scars. In the treatment aspect of scar, the combination of traditional and new treatment methods has been well accepted and achieved good results. To understand the new advances of scar research and combine it with clinical treatment transformation could lead to the development of more effective prophylactic and therapeutic strategies for scar treatment in the future.
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Burn medicine of China started in 1958. Over the past 60 years, through the efforts of numerous burn discipline scholars, China′s burn clinical and scientific research have reached the world′s advanced level. Department of Burns and Plastics Surgery of West China Hospital of Sichuan University was founded in 1963. Department of Burns of our hospital was established earlier in China. In the past 60 years, professor Yu Baoliang, Ren Linsen, and Cen Ying had been working hard for the development of our department. Department of Burns and Plastic Surgery in West China Hospital of Sichuan University has developed from a pure therapeutic specialty group into one of the burn centers with strong technical force, first-class medical level, advanced instruments and equipment, rich scientific research achievements, and integrated medicine, teaching, and research in southwestern China, which enjoys high prestige at home and abroad.
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Objective@#In order to achieve superior aesthetic outcomes of reconstructed ear, analyze and summarize clinical therapeutic effect in completely applying expanded retroauricular flap to encapsulate cartilage scaffold in total auricular reconstruction.@*Methods@#From January 2016 to October 2017, fifty-three congenital microtia patients were treated. A kidney-shaped tissue expander with 50 ml capacity was embedded under retroauricular skin in the first-stage. After excessive expansion to 70 ml and remaining stable for 4 weeks, secondary operation was performed to completely encapsulate cartilage scaffold with expanded retroauricular skin. Postoperative follow-up was carried out on a routine basis.@*Results@#All patients had undergone operations successfully with primary healing of incision. Blood supply of the retroauricular flaps was excellent, and cartilage scaffolds totally survived with no infection and absorption. Satisfactory aesthetic outcome along with clear structure, reasonable symmetry and suitable auriculocephalic angle was acquired in all cases. No color aberration was observed between the front and back side of reconstructed ear. Scars of retroauricular incisions and costal cartilage harvesting incisions were unconspicuous.@*Conclusions@#Only using expansive retroauricular flap to fully cover reconstructed cartilage scaffold is reasonable and simple without skin grafting, which is worthy of more application in microtia treatment.
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Heat-shock proteins (HSPs) are the protective proteins expressed by cells under stress. Heat-shock factors (HSFs) are the key factors to regulate HSPs. Researches about the effects of HSF1 and HSPs in cells after stress and the mechanism have become the important entry point to explore the cell response in wound healing after trauma. This article reviews the effects of HSPs and HSF1 which regulate the proteins on wound healing and the mechanism, so as to deliver message for studying effects of intervening HSF1 on expression of HSPs and wound healing and the mechanism.
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BACKGROUND:Moderate to severe burn and trauma, treatment of which has been paid equal attention to wound surface, is always a difficulty of clinical systemic treatment and has a poor prognosis. Anabolic hormones have acquired secure and good results in the treatment of burns in both animals and clinical patients. Although use of anabolic hormones is restricted by the doping management, but its androgen receptor and nuclear receptor coregulators are the newly emerging areas of interests in the field of gene regulation mechanism in recent years. OBJECTIVE:To investigate the effect of nandrolone phenylpropionate on androgen receptor-mediated transcriptional regulation of target gene in rat scald models. METHODS: Thirty-six rats were randomly divided into nandrolone phenylpropionate, model and control groups. In the nandrolone phenylpropionate and model groups, rats were subjected to a 20% total body surface area second-degree scald injury by hot water. Two days after model preparation, rats in these two groups were intramuscularly injected with nandrolone phenylpropionate and saline, once every other day, for a total of 21 days. RESULTS AND CONCLUSION:The gene expression levels of steroid receptor coactivator-1 and insulin-like growth factor 1 in the rat livers and gonads (testes, ovaries) were significantly different between the nandrolone phenylpropionate and model groups (P < 0.05), except steroid receptor coactivator-1 in the liver. There were no significant differences in steroid receptor coactivator-1, c-myc and insulin-like growth factor 1 in the rat livers and gonads (testes, ovaries) between model and control groups (P < 0.05). The results demonstrate that nandrolone phenylpropionate has different effects on the gene expression of steroid receptor coactivator-1, c-myc and insulin-like growth factor 1 in different tissues under different physiological and pathological conditions.
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<p><b>OBJECTIVE</b>To observe the efficacy of biased constitution patients treated by auricular point therapy on the basis of "preventive treatment" theory.</p><p><b>METHODS</b>By means of self-control, 1477 cases of biased constitution were regulated by auricular point sticking therapy or acupuncture, and follow-up and statistical analysis were conducted to observe the efficacy.</p><p><b>RESULTS</b>There were 322 markedly effective patients, 914 effective patients, 241 failed patients and the total effective rate was 83.7% (1236/1477).</p><p><b>CONCLUSION</b>The comprehensive auricular treatment which is easy to operate and acceptable for patients has obvious effect in biased constitution patients. As a new direction of the "preventive treatment" theory, it can be promoted to be a new intervention way of health care.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Acupuncture Points , Acupuncture Therapy , Acupuncture, Ear , Preventive MedicineABSTRACT
This article reviews the advances in the research of the structural characteristics and the activating process of heat shock factor 1 (HSF-1), the factors that influence the expression of HSF-1, and the relationship between HSF-1 and the expression levels of NF-κB and heat shock protein (HSP). The expression of HSF-1 could be regulated in several stages in the course of interconversion between its active and inactive status. Unusual expression of HSF-1 mediated by NF-κB can lead to the quantitative and functional change of HSP. The quantitative and functional variation of HSP caused by regulation of HSF-1 could influence the normal synthesis and the pathological changes induced by excessive synthesis of protective proteins in cells under stress. We expect that further research would help elucidate novel pathways about the genesis and evolution mechanism of keloid, and it may finally help to find a novel strategy in the treatment of keloid.
Subject(s)
Animals , Humans , DNA-Binding Proteins , Metabolism , Heat Shock Transcription Factors , Heat-Shock Proteins , Metabolism , Transcription Factors , MetabolismABSTRACT
ObjectiveTo analysis the clinical efficacy of using lateral homodigital flaps based on digital artery perforator to repair the fingertip defects. MethodsFrom October 2008 to August 2010,nine patients with twelve fingertip defects,including 5 thumbs,2 index fingers,3 middle fingers,2 ring fingers,underwent repair with lateral homodigital flaps based on digital artery perforator.The size of the flaps ranged from 2.7 cm× 1.4 cm to 3.1 cm× 1.8 cm.The donor site were covered by skin graft. ResultsEleven flaps survived.One case met with partial necrosis.The follow-up time ranged from 3 to 6 months(average of 4.5 months).The finges had good appearance.Ten cases had gained full postoperative sensory recovery and the two-point discrimination was 4-Smm at 3 months after operation.ConclusionUsing the flaps pedicled with digital artery perforator is a feasible solution for treatment of fingertip defects.
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<p><b>OBJECTIVE</b>To investigate the appropriate extubation time and treatment of late complications after early tracheotomy in patients with moderate or severe inhalation injury.</p><p><b>METHODS</b>One hundred and fifty patients (105 males and 45 females) with inhalation injury were admitted to our hospital from January 2000 to January 2009. Among them, 109 out of 129 cases with moderate inhalation injury received early tracheotomy, and all 21 cases with severe inhalation injury received early tracheotomy. Data were collected for analysis as follows: (1) incidence of re-intubation due to suffocation and pneumonia incidence after extubation within 2 weeks or after 2 weeks post inhalation injury (PII), and mortality rate within the first week after injury were recorded. (2) Conservative treatments including expectorant, oral antibiotics, and absolute bedrest were recommended for patients who had severe cough, hoarseness or poor pulmonary function after late extubation and closure of tracheostomy wound. Fiberoptic bronchoscopy findings (tracheostenosis degree, granuloma formation rate, vocal cord paralysis rate) and pulmonary function index (FEV(1)) data were collected and analyzed in 30 cases with moderate inhalation injury and 10 cases with severe inhalation injury within 3 months after injury for follow-up. Data were processed with t test or chi-square test.</p><p><b>RESULTS</b>There was no obvious difference in the rate of re-intubation after extubation in patients with moderate inhalation injury between those done within 2 weeks PII (15/70, 21.4%) and those done after 2 weeks PII (2/25, 8.0%) (χ(2) = 1.52, P > 0.05). Pneumonia incidence in patients of moderate inhalation injury with extubation within 2 weeks PII (21/70, 30.0%) was lower than those with extubation after 2 weeks PII (15/25, 60.0%) (χ(2) = 7.04, P < 0.05). Levels of above-mentioned indexes in patients with severe inhalation injury extubated in different stages were similar to those of patients with moderate inhalation injury. Within the first week after injury, mortality rate of patients with severe inhalation injury was higher than that of patients with moderate inhalation injury (χ(2) = 11.90, P < 0.05). During follow-up, tracheostenosis rate in patients with moderate or severe inhalation injury was 100.0%; granuloma formation rate and vocal cord paralysis rate in patients with severe inhalation injury were higher than those of patients with moderate inhalation injury (with χ(2) value respectively 4.59, 13.47, P values all below 0.05). The FEV(1) value of patients with moderate inhalation injury in the 1st, 2nd, 3rd month after injury was respectively higher than that of patients with severe inhalation injury (with t value respectively 5.48, 12.10, 6.25, P values all below 0.05). The values recovered to normal level in the 3rd month after injury.</p><p><b>CONCLUSIONS</b>Extubation time of tracheotomy for patients with moderate or severe inhalation injury within 2 weeks or after 2 weeks PII has its own advantage and disadvantage, and it should be performed according to specific conditions of each patient. Conservative treatment is optional for late complications of respiratory system.</p>
Subject(s)
Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Young Adult , Burns, Inhalation , General Surgery , Follow-Up Studies , Intubation, Intratracheal , Postoperative Complications , TracheotomyABSTRACT
BACKGROUND: Ginsenoside Rb1 has been extensively used in the protection and treatment of heart, encephalon, lung, kidney and liver damage. However, its application in skin flap is rare.OBJECTIVE: To investigate the effects of intraperitoneal injection of ginsenoside Rb1 on the survival of the dorsal random-pattern skin flap with large length-to-width ratio in rats.METHODS: Healthy adult SD rats were randomly divided into experimental and control groups. A caudally based dorsal random pattern skin flap, 80 mmx20 mm (length: width = 4:1), was symmetrically made. Ginsenoside Rb1 (2 mg/kg) was intraperitoneally injected into the experimental group rats, and the same volume of normal saline was injected into the control group. Malonyl dialdehyde (MDA) and nitric oxide (NO) level of the flaps were tested 1 day after operation; the amount of viable tissues of the flaps were examined by planimetry 10 days after operation. Specimens from the proximal, middle and distal flaps were harvested for HE staining to examine the microstructure.RESULTS AND CONCLUSION: At the first day after operation, NO level was higher in the experimental group than the control group (P< 0.01), while MDA level was lower than the control group (P< 0.01). At the 10th day after operation, the survival rate of the flap was significantly greater in the experimental group than the control group (P < 0.001). Histological observation showed that compared with the control group, the edema and inflammatory cells infiltration were less, while the fiber hyperplasia and the microvascular growth were more obvious in the experimental group. Results show that intraperitoneal injection of ginsenoside Rb1 can enhance the blood supply of the flaps and improve the survival of the random-pattern skin flaps with large length-to-width ratio in rats. This may involve its effects of improving NO activity, decreasing lipid peroxidation, and promoting angiogenesis of skin flaps.
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Objective To study the significance of HSP47 gene in keloid formation after in vivo study with RNAi technology and the recombinant HSP4 7 siRNA against heat shock protein 47 to keloid in a nude mice model.Methods We injected RNAi mixture into the keloid of a nude mice model in experimental group and PBS water(0.25 ml)into control group at the 16th days after establishing the models.After interference we observed the specimens and harvested specimens at 7th days for biochemical and pathological analysis.Results The expression of HSP47 mRNA reduced obviously and the collagen content also reduced in the experimental group.The rusults had statistical significance.Conclusion We can suppress the expression of HSP47 gene and then reduce the production of collagen after in vivo interfering experiment with HSP4 7 siRNA in keloid nude mice models using RNAi technique.This study cornfirms the mechanism that HSP47 promotes the keloid formation,which provides a new target to treat keloid.
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<p><b>OBJECTIVE</b>To study the significance of HSP47 gene in the development of pathological scar.</p><p><b>METHODS</b>The nude mice were used to reconstruct animal model of pathological scar. 16 days later, the mixture of recombinant HSP47siRNA and liposome was injected into the pathological scar in experimental group. In the control group, 0.25 ml PBS was injected intraperitoneally. 7 days after injection, the specimens were collected for detection of mRNA of HSP47, the collagen and for immunohistochemical study.</p><p><b>RESULTS</b>In the control and experimental group, the collagen content was (91.71 +/- 1.24)% and (82.12 +/- 4.79)%, respectively; the expression of HSP47mRNA was 1 042 862.01 +/- 604 194.36 and 306 123.68 +/- 105 857.08, respectively; the expression of collagen I mRNA was 10 228 614.70 +/- 2 532 879.04 and 6 011 841.97 +/- 2 886 897.17, respectively;the scar volume was (255.60 +/- 21.34) mm3 and (132.99 +/- 24.06) mm3, respectively. All the above results showed significant difference between the two groups (P < 0.05).</p><p><b>CONCLUSIONS</b>The collagen production can be reduced through suppression of the expression of HSP47 gene. It indicates that HSP47 gene enhance the development of keloid and could be used as the target of treatment.</p>
Subject(s)
Animals , Mice , Cicatrix , Genetics , Pathology , Therapeutics , Collagen , Genetic Therapy , Genetic Vectors , HSP47 Heat-Shock Proteins , Genetics , Therapeutic Uses , Liposomes , Therapeutic Uses , Mice, Nude , RNA, Messenger , Genetics , RNA, Small Interfering , Therapeutic UsesABSTRACT
<p><b>BACKGROUND</b>Keloids have a predilection for the aural region because of the special shape of the pinna. It is difficult to resect keloids entirely and maintain a satisfactory pinnal shape. Surgical excision in combination with radiotherapy is considered to be the most efficacious treatment available for severe keloids. This study was conducted to evaluate the treatment of aural keloids with intralesional excision and immediate postoperative adjuvant radiotherapy.</p><p><b>METHODS</b>Forty-six patients with a combined total of 74 aural keloids were treated by intralesional excision and immediate postoperative adjuvant radiotherapy. All patients received a total dose of 20 Gy in 10 consecutive days. The time interval between keloid excision and delivery of the first radiotherapy fraction was < 24 hours in all cases. The median follow-up was 2.2 years.</p><p><b>RESULTS</b>Twenty-nine patients with 48 keloids (64.9%) were highly satisfied with their outcome, and were rated as good by the surgeon. Six patients with 12 keloids (16.2%) showed general satisfaction but wanted aesthetic refinement, and these patients were rated as fair by the surgeon. Three patients with four keloids (5.4%) showed no evidence of recurrence after surgery, but disliked the result because of the discoloration and irregularity of the scar surface. These patients were rated as poor by the surgeon. Partial recurrence occurred in 8 patients with 10 keloids (13.5%). No major complications were observed.</p><p><b>CONCLUSION</b>Intralesional excision and immediate postoperative adjuvant radiotherapy is well tolerated and very effective in preventing recurrence of aural region keloids.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Combined Modality Therapy , Ear Diseases , Therapeutics , Keloid , TherapeuticsABSTRACT
<p><b>OBJECTIVE</b>To investigate the bad effect of breast augmentation with PAAH injection and the technique to remove PAAH from breast effectively and safely.</p><p><b>METHODS</b>43 cases (86 sides) underwent operation to remove the PAAH from breast through submammary incision, followed by dressing with pressure for 3 days. The patients received colored doppler ultrasonography and immunologic test before and 3 months after operation.</p><p><b>RESULTS</b>Postoperative ultrasonography showed residual PAAH in breast in one case. Among the 20 cases who had preoperative breast pain, the pain relieved completely in 10 cases and improved in the other 10 cases. All the patients had some abnormal results in immunologic test which improved 3 months after operation.</p><p><b>CONCLUSIONS</b>Breast augmentation with PAAH injection can result in breast pain and other complications. It may also have bad effect on the immune system. PAAH should be removed as soon as possible. The technique through submammary incision to remove PAAH is one of the safe and reliable methods.</p>
Subject(s)
Adult , Female , Humans , Young Adult , Breast , General Surgery , Breast Implantation , Breast Implants , Device Removal , Methods , MammaplastyABSTRACT
AIM:Researches have shown that musculocutaneous flap or fascial flap could well treat refractory bedsore in a long term. This study observed the clinical experience in the treatment of sacrococcygeal ulcers. METHODS:From January 2000 to January 2006,19 patients with sacrococcygeal ulcers,who received myocutaneous flap transposition in Department of Burns and Plastic Surgery,West China Hospital of Sichuan University,were selected. The informed consent was obtained from all patients. The surgery included two stages. At the first stage,debridement and eschar excision were performed. At the second stage,the surgery was undergone after selecting the myocutaneous flap type according to the patients' age,ulcer position,and ulcer extent. Twenty-one wounds were repaired by gluteus maximus myocutaneous flaps,and the flap size was 13 cm ?11 cm-17 cm?14 cm;8 by long-head of biceps femoris flaps of 10 cm?6 cm-13 cm?6 cm. After operation,the patients were placed on turn-over bed for 14 days and followed regularly. RESULTS:All flaps survived and the wounds in 18 cases healed at the first stage. Hematocele underlying flap occurred in one patient with urinemia,and healed by dressing exchange. After a follow-up of 5 months to 3 years,no patient had a recurrence;the color and texture of the flaps were good,and he appearance was satisfactory. CONCLUSION:The technique of two period operation treatment of myocutaneous flap transposition can accelerate the healing of sacrococcygeal ulcers and improves the success rate of operation.