ABSTRACT
Objective To explore the repair effect of the superficial iliac island flap for the hypertrophic scar of mons pubis after burned.Methods From July 2013 to July 2016,the author had treated 26 patients with mons pubis hypertrophic scar after burned.There were 19 males and 7 females among them.The age was from 1 year and 5 months to 10 years old.The scar area was of 6 cm ×5 cm-15 cm ×8 cm.Some of the patients had external genital malformations caused by scar contracture.Surgery removed the scar and completely released the basic shape of the vulva.It had to expand the superficial iliac island flap of 1 cm according to the size of the wound,and sufficient length of vascular pedicle according to the distance from the wound to the flap.The flap was cut in the superficial of the deep fascia,and reserved about 2cm wide fat along the superficial iliac artery.The superficial vein was located in the fat.The wound was covered by the flap,which was rotated directly or through a subcutaneous tunnel.Results Twenty six patients were treated with a single operation and no vascular crisis occurred.All the flaps survived.One patient delayed incision healing due to the high incision tension,and the remaining patients were in primary healing.The postoperative follow-up found that all the flaps had thin thickness,similar color to the surrounding skin,soft texture and feeling.Conclusions There are obvious signs of scarring in the mons pubis area after deep burns,and scar contracture can cause vulvar deformity.The superficial iliac island flap,which has a thin thickness,soft texture,similar color,and can be sutured directly for the donor site,is a good choice to repair the mons pubis hypertrophic scar.
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Objective To investigate the effects of local application of NGF combined with Insulin on wound healing with Ⅱ degree deep scald and the expression of HIF-1α and VEGF in diabetic rats. Methods 60 male Wistar rats were used in the study by intraperitoneal injection of streptozotocin (STZ). Deep partial thickness scalding was engendered on the back of the rats after one month. Then these rats were random divided into group B (scalding of the rats with diabetes, n = 15), C (insulin control, n = 15), D ( NGF control, n = 15) and E ( NGF and insulin supplementation, n = 15). And group A ( nomal control,n = 15) was created by normal rats of partial thickness scalding. The wound area, wound healing rate, and grey of HIF-1α and VEGF immunohistochemistry staining were determined on the 3rd, 7th, 15th, and 21st day post scalding days (PSDs). Results Compared to those in groups A, B, C and D, the wound healing rate in group E increased significantly since the 7th PSD [(25.33 ± 2. 32 ) %, P ＜ 0.05]. The wound healing rate in group C and D increased significantly compared with group B [( 16. 68 ± 1.95 ) %, ( 18.29±1. 70)%, P ＜0.05]. Compared to group A, the group D increased significantly since the 15th PSD [(54. 84 ±3.60)%, P ＜0. 05]. The expression of HIF-1α and VEGF in group E began to increase slower than other groups after the 7th day ( P ＜0. 05 ). Conclusion Local application of NGF combined with Insulin could be beneficial to the regeneration of capillary vessel in the burn wounds of the rats with diabetes,as well as to accelerate wound healing by redress anoxia and decrease the expression of HIF-1α and VEGF.
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Objective To investigate the changes of the expressions of heat shock proteins 70 (HSP70) and insulin and HSP70 protect effect on the gastric mucosa of rats with scald injury, and explore the relationship between insulin and HSP70 . Methods With a model of 30 total body surface area (TBSA) full-thickness burned rats,the expression and distribution of HSP70 in the gastric mucosa was detected with immunohistochemical method and analyzed by a micro-image analysis system, and at the same time the pathological changes of the gastric mucosa tissue of each group were analyzed by Western blot and immunohistochemistry at the 3rd,6th,12th,24th and 48th hour postburn. Results The expression of HSP70 obviously decreased at the 48th hour post scald injury. The expression of HSP70 in the treatment group was significantly higher than that in the scalded group at most time points except the 12th(9.40±1.52,P＝0.065) hour and at equal parallel time［(6.80±1.10,8.60±0.55,10.80±1.64,11.40±1.34),P＜0.05］. The gastric mucosal injury index in the scalded group was significantly higher than that in the treatment group and at equal parallel time ［(4.05±0.36,11.97±1.15,20.98±2.83,13.92±0.94,1.60±0.55),P＜0.05］. In pathological observation, the control group manifested the intact gastric mucosal tissue formation, the scalded group showed obvious gastric mucosal tissue injury in the early phase of scald injury, while the treatment group showed less severe injury than the scald group. A positive correlationwas found in the gastric mucosal injury index and HSP70(r＝0.904,P＜0.01) and also between the serum glucose and HSP70(r＝0.961,P＜0.01).Conclusions Insulin increased the expression of HSP70 and decreased the gastric mucosal injury index in the gastric mucosal tissue of SD rats in the phase of scald injury. It may be one of the vital mechanisms of insulin protecting the gastric mucosal tissue.
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Objective To investigate the expression pattern of Nrf2 in the lung of septic rat and preliminary analysis of the role of Nrf2 in the development of sepsis. Methods Wistar rats were used in this study, it was divided into 4 groups, including normal control group, pure burn group, burn with staphylococcus sepsis group, burn with pseudomonas sepsis group. According to the different time intervals such as 2 hours, 8 hours, and 24 hours, it was divided into three sub-group after injection of bacteria. The expression of Nrf2 in the lung at different time intervals was determined. Results Nrf2 mRNA in the lungs of normal rats was high expression （74.0±7.0）, Nrf2 mRNA in the lungs of pure burns rats obviously down-regulated, respectively as 34.5±1.9,50.4±2.2,32.1±1.4, （t＝5.69～14.63,P＜0.01）. Nrf2 mRNA in burn sepsis caused by Staphylococcus aureus in lung tissue of rats down-regulated expression, respectively as 53.1±5.0,14.4±1.6,48.5±1.9,and reached peak at 8 h（t＝5.59～29.3,P＜0.01）. Pseudomonas aeruginosa burn sepsis didn't induced Nrf2 mRNA in the lung tissue, but it showed a downward trend at 2h（71.0±8.1,P＞0.05）and markedly reduced after 8, 24 h（24.8±2.1,4.1±2.0,t＝21.33,68.1,P＜0.01）.Conclusions The distribution of Nrf2 mainly localized in immune organ, and it directly took part in the post burn immune response.