Natural History of Seroma Following the Immediate Latissimus Dorsi Flap Method of Breast Reconstruction / 中华医学杂志(英文版)

<p><b>Background</b>The latissimus dorsi (LD) flap procedure remains a popular and useful breast reconstruction tool in China and Western countries, and donor site seroma formation is the main complication. This study was conducted in Chinese patients to determine whether stable cases of seromas would resolve without treatment.</p><p><b>Methods</b>A.</p><p><b></b>retrospective review of 45 consecutive cases of immediate breast reconstruction with LD flap from April 2012 to February 2017 was conducted. The scope of the seroma was demarcated with a marker pen, and cases that remained stable over time (i.e. the size of the seroma did not increase) were observed without treatment. The measured outcomes included the incidence of seromas, the volume and duration of postoperative wound drainage, and other demographic characteristics.</p><p><b>Results</b>Twenty-four patients (53.3%) developed a seroma at the donor site. Of these, 21 patients (87.5%) did not require treatment, and the seroma resolved over time. The mean duration of a sustained seroma was 6.8 ± 1.4 weeks (range: 4-9 weeks).</p><p><b>Conclusions</b>This study observed the scope and progression of the seromas and found that seromas at the LD donor sites resolved over time without treatment.</p>

Effect of botulinum toxin type A injection into the masseter muscle on mandibular development in rats / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the effect of Botulinum toxin type A (Botox) injection into the masseter muscle on mandibular development in rats.</p><p><b>METHODS</b>12 28-day-old Wistar rats were divided into two groups as Botox group (n= 6) and control group (n = 6) which received anesthesia only. In Botox group, Botox was injected into the right masseter muscle, while only sterile saline into the left muscle. When the rats were 75-day-old, CT scan and 3D reconstruction were performed for cephalometry. The masseter muscles at both sides were weighed. Histologic study of masseter muscle and mandible was also performed.</p><p><b>RESULTS</b>The weight of right masseter muscle was (0.4575 +/- 0.0940) g in Botox group, and (0.8899 +/- 0.1030) g in control group (< 0.05). The mandibular height II and III was (10.8 +/- 0.8) mm and (9.5 +/- 0.6) mm in Botox group and (12.5 +/- 0.6) mm and (10.7 +/- 0.4) mm in control group, respectively (P < 0.05). The intergonial distance was (11.6 +/- 0.6) mm and (12.4 +/- 0. 6) mm in Botox and control group, respectively (P > 0.05).</p><p><b>CONCLUSIONS</b>When the rats receive Botox injection into the masseter muscle at young age, the grown-up rats have a decreased mandibular height, but the mandibular length and intergonial distance are not affected.</p>

Analysis of the complications resulted from intraoral mandibular angle reduction / 中华整形外科杂志

<p><b>OBJECTIVE</b>To discuss the treatment and prevention of the complications resulted from intraoral mandibular angle reduction.</p><p><b>METHODS</b>From July 2002 to August 2008, 672 cases underwent intraoral mandibular angle reduction. The 59 cases with postoperative complications were treated and followed up.</p><p><b>RESULTS</b>No severe complication happened. In 18 cases with asymmetry, 13 cases improved through soft tissue adjustment, 5 cases were reoperated with good results. Intraoperative precise osteotomy was needed to prevent asymmetry. 3 cases with infection healed with drainage and anti-inflammatory treatment. Intraoperative aseptic manipulation and adequate drainage were necessary to prevent infection. 20 cases with labial numbness recovered 3 - 6 weeks later. 5 cases with temporary facial nerve injury recovered 2 - 3 months later. 12 cases with bleeding and hematoma were treated by dressing with pressure and drainage and healed 3 weeks later. Skin necrosis resulted from tight dressing occurred in one case, which were treated with skin graft. Intraoperative protection of nerve and vessels, as well as the dressing were very important.</p><p><b>CONCLUSIONS</b>Most of the complications can be treated and recovered well. Preoperative design, precise manipulation and postoperative reliable dressing are the key points to prevent complications.</p>

Effect of intense pulsed light on transforming growth factor-beta1 mRNA expression in rat skin / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the effect of intense pulsed light (IPL) on transforming growth factor-beta1 mRNA (TGF-beta1 mRNA) expression in rat skin and explore the molecular mechanisms of photorejuvenation.</p><p><b>METHODS</b>Fifteen SD rats were exposed to IPL in 3 dermal regions with triple pulses (duration of 4, 5, and 6 ms) at the energy density of 34 J/cm2 and pulse delay of 20 or 25 ms. On days 1, 3, 5, 7, 15, and 30 after the treatment, skin specimens from the treated and non-treated areas were obtained to detect TGF-beta1 mRNA expression with in situ hybridization.</p><p><b>RESULTS</b>In the UPL-exposed skin areas, TGF-beta1 mRNA expression was detected in the epidermal keratinocytes and dermal cells 1 day after the exposure, reaching the highest expression level on day 7 followed by gradual decrement since day 15, and till day 30, only weak expression was found in the dermal cells. In the non-exposed regions, the cells remained negative for TGF-beta1 mRNA.</p><p><b>CONCLUSION</b>IPL can enhance TGF-beta1 mRNA expression in the skin, suggesting that TGF-beta1 plays an important role in dermal remodeling in photorejuvenation.</p>

Intraoral Reduction Malarplasty with Simultaneous Zygomatic Soft Tissue Lifting: Prevention of the Mid-Face Sag

No abstract available.

Anatomic reduction of midfacial sag after intraoral reduction malarplasty / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the technical refinements of intraoral reduction malarplasty to prevent postoperative drooping of the cheek.</p><p><b>METHODS</b>Twenty-four patients with prominent zygomatic complex underwent reduction malarplasty from January 2005 to January 2006. In all these cases, the osteotomized malar complex was repositioned superioposteriorly, and the perioral muscles and periosteum were redraped accordingly and fixed on deep temporal fascia.</p><p><b>RESULTS</b>Symmetry between the left and right complexer were achieved, with a decreased midfacial width of 10.22-/+1.97 mm. During postoperative follow-up of 4 to 6 months, all the patients had satisfactory operative results, and reported no postoperative drooping of cheek.</p><p><b>CONCLUSION</b>This method of superioposterior reduction of the perioral muscles and periosteum is simple and effective, but the long-term result needs to be observed.</p>

The anatomic study and clinical observation of the neurectomy of the nerve to the medial gastrocnemius muscle for calf reduction / 中华整形外科杂志

<p><b>OBJECTIVE</b>To introduce a method to reduce the volume of medial gastrocnemius for calf reduction.</p><p><b>METHODS</b>Tibial nerve and nerve branches were dissected and explored at popliteal region for morphometry in 20 cadaver-legs. The length, width and the origination position of the nerve to the medial gastrocnemius were measured and recorded. During surgery, the nerve to the medial gastrocnemius muscle were explored and cut off. The circumference and the shape of the leg were measured and recorded.</p><p><b>RESULTS</b>The nerve innervating the medial gastrocnemius originates from the tibial nerve which lies in the fat tissue of popliteal space. In 8 cases (40%) there is only 1 branch to the medial gastrocnemius, and in 4 cases (30%) there are 2 branches. In other 4 cases (30%) the medial sural cutaneous nerve originate from the nerve to the medial gastrocnemius. The nerve to the medial gastrocnemius muscle branch off at (- 6.6 +/- 13.7) mm; the width is (2.3 +/- 0.4) mm; the length is (42 +/- 12) mm. Neurectomy of the nerve to the medial gastrocnemius was performed in 16 cases. After operation, the circumference of the leg was reduced (3.5 +/- 1.1) cm averagely and the curve of the medial line of the calf was reduced. There is no obvious swelling in these cases and the patients were able to walk immediately after operation. The function of the leg was not obviously influenced.</p><p><b>CONCLUSIONS</b>Neurectomy of the nerve to the medial gastrocnemius muscle was a safe and effective method for calf reduction.</p>

The changes of micrangium density of the reverse-flow random flap with a superficial venous trunk: an experimental study using stereological methods / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the effects of the superficial venous trunk (SVT) and its nourishing vessels on early revascularization of the reverse-flow random flap in order to provide theoretical evidences for clinical applications.</p><p><b>METHODS</b>The morphologic changes of micrangium of the reverse-flow random flap with SVT and without SVT were observed at different phases and compared by optical microscopy and stereological methods.</p><p><b>RESULTS</b>The micrangium density of the flaps with SVT and without SVT showed a tendency of increasing at 3 days after the operation. At 5 to 10 days, the micrangium density of the flap with SVT was much higher than the flap without SVT. There was significant difference between the two groups, which was proved by the optical microscopy observation.</p><p><b>CONCLUSIONS</b>This study suggests that SVT and its nourishing vessels could promote early revascularization of the flap after transplantation. The SVT can be of benefit to the survival of the reverse-flow random flap.</p>

Genioplasty with morselized autologous bone graft / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate a new method of genioplasty for treatment of a prominent mandibular angle with mandibular malformation.</p><p><b>METHODS</b>According to the different types of the mandible, the prominent mandibular angle was grinded with the masseter muscle kept intact. Autologous micromorselized bone of the grinded mandibular angle was collected and implanted into the chin for augmentation mentoplasty, and the chin was fixed with gypsum after operation.</p><p><b>RESULTS</b>Fifteen patients receiving the surgery were followed up for 6 -12 months, and satisfactory effects were achieved in 12 patients. One patient requested modification of the shape of the chin 10 days after the operation, and another two sustained chin distortion due to external forces and underwent subsequent shape adjustment of the chin.</p><p><b>CONCLUSION</b>The procedure described avoids graft rejection and causes less complications for genioplasty with easy moulding and satisfactory outcome.</p>

Edge detection and modeling in frontal facial contour image for plastic surgery / 南方医科大学学报

<p><b>OBJECTIVE</b>To find a new method for edge detection and modeling in frontal facial contour image.</p><p><b>METHODS</b>Searching circle-based edge detection algorithm was developed on the basis of Sobel edge detector. Apriori knowledge of the facial contour and searching limitations as the minimum curvature radius, concave-convex property, and maximum edge disconnected distance were used to detect the edge of frontal facial contour. The frontal facial contour model was established with least squares curve fitting methods, and the relationship between the model rank and model precision was analyzed.</p><p><b>RESULTS</b>The edge detected by the new method was consistent with the actual edge of the facial contour and the irrelevant edge was well eliminated. Variation of the 2,4,10 time models from the actual image were compared, which identified the 10 time model as the best one.</p><p><b>CONCLUSION</b>The effectiveness and practicability of this new method for edge detection and modeling has been tested, which provides a theoretic basis for designing facial contouring image system.</p>

Establishment of rabbit orbital hypertelorism model and evaluation of effects of surgical correction / 南方医科大学学报

<p><b>OBJECTIVE</b>To establish a rabbit model of orbital hypertelorism for plastic and reconstructive surgery and evaluate the surgical effects.</p><p><b>METHODS</b>Orbital osteotomies and medial translocation was performed in 16 New Zealand rabbits (4 to 6 months old) by combined intracranial-extracranial approach. The interorbital distance (IOD) and bone healing between the orbits were evaluated with gross measurement. X-ray and histological examinations were performed immediately and 12 weeks after the operation.</p><p><b>RESULTS</b>The average IOD of the rabbits was 0.74 cm after completion of the operation, but increased to 0.96 cm 12 weeks after the operation, showing significant relapse of orbital hypertelorism (P<0.01).</p><p><b>CONCLUSION</b>The IOD can be decreased successfully in this rabbit model.</p>

Experimental study on skin flap angiogenesis promotion using bone marrow derived endothelial progenitor cells / 上海第二医科大学学报

0.05).The survival area and capillary density were more favorable in the EPCs-injection sites than the controls(P