Repeated expanded bilateral deltopectoral flap for resurfacing severe facial-cervical scar / 中华医学美学美容杂志

Objective To investigate the application of the repeated expanded bilateral deltopectoral flap for resurfacing severe facial cervical scar, with review of relating articles to discuss issue of repeated expanding flap.Methods Nine patients suffered from hyperplastic facial and cervical scar.Two soft tissue expanders were implanted into the anterior chest region at both sides of sternum.The center of inner border of the expander was at the cross of second intercostal and parasternal line, and the lengthways axe of the expander was located at the ligature of the second intercostals and mammary areola.After two weeks when the expander was filled, expanded flap was transferred to cervical defect.The transferred flap was repeated expanded after half a year and transferred to resurface facial defect.Results In the first expansion stage, 600 or 800 ml expander were implanted in each side of sternum.In the second stage, 400 or 500 ml were used.The first stage of expanding process was smooth, and 2 of the expanding flaps were ruptured during the second expansion period.400-520 cm2 (average 440 cm2) additional expanded flap was acquired during two stages of expanding.Conclusions The repeated expanded bilateral deltopectoral flap gives us greater opportunity to repair severe facial-cervical scar.The best interval time of the two-stage expansion is over half a year.The speed of second expansion should be lower than that in the first stage, and protecting the expanding flap carefully from external force compression is needed during the second expasion.

The correlation of CAGs repeat size with age of onset in patients with Kennedy's disease / 中华内科杂志

Objective To investigate the correlation of CAGs repeat size and age of onset in patients with Kennedy's Disease (KD).Methods We detected the number of CAG repeats in the androgen receptor genes in 30 patients with KD.The correlation of CAGs repeat size with age of onset was analyzed.At the same time,the Appel scale that could represent the degree of motor functional impairment was scored in every patient.The correlation of Appel scale with CAGs repeat size and the course of disease were analyzed.Results Significant correlation was found between the number of CAGs with age of onset (r= -0.671,P <0.01 ).There was also correlation between the Appel score and the course of disease (r=0.855,P<0.01 ),but no correlation between the Appel score and the number of CAGs (r =0.100,P =0.601 ).Conclusions It is found that in Kennedy' disease,as well as in other CAG repeat diseases,the length of polyglutamine tract determines the age of onset ,but has no correlation with the severity of the disease.

Repeated expansion of skin tissues:clinical,biomechanical and histological studies / 中华医学美学美容杂志

Objective To summarize the experiences of repeated expansion surgery,to evaluate the changes of skin histological and biomeehanical properties,and to afford rationale for its application and popularization.Methotis Skin soft tissues were repeatedly expanded to repair the massive skin defection.All the 31 cases were divided into children group and adult group according to their ages.In each group the treatment experiences were summarized.The biomechanical and pathological properties were investigated and compared after samples had been made.Resuits A total of 31 cases were treated by serial tissue expansion.Complication incidences of every expanded procedure were 10%and 17%respectively.After 6-12months postoperative follow-up,most of the curative effects were satisfactory.The repeated expanded skin had lower enlarged rate,depressed stress-relaxation and stress-strength character,so was the deceased proliferation of the epidermal cells.The changes were significant in the adult group.Conclusions Repeated expansion is a feasible method of repairing the massive skin defection.Its curative effect is more satisfactory in children than adult.Due to the increase of the risk and skin quality decline,enough attention must be paid in clinical application.

Repeated tissue expansion in head and neck / 中华医学美学美容杂志

Objective To summarize the experiences in treating 30 cases of skin soft tissue defects in head and neck by applying repeated expansion, and to explore an effective and satisfactory method of massive defect repair in head and neck. Methods Skin soft tissues were repeatedly expanded for 1 to 3 times after the first expansion. Massive skin defects in head and neck were repaired several times by useing repeated expansion of flap. The size of the skin defects ranged from 29cm?24cm to 10cm?8cm. The indications, complications and experiences in the treatment were discussed. Results A total of 30 cases were treated. Complication incidences of every expansive procedure were 27%, 15%, 14% and 0% respectively . After 6～12 months postoperative follow-up, the appearance and functional restoration was satisfactory. Conclusion Repeated expansion is an excellent method of repairing massive defects in head and neck.