Treatment of superficial infantile hemangiomas with topical propranolol / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of 1% propranolol ointment in the treatment of superficial infantile hemangiomas (IHs).</p><p><b>METHODS</b>A retrospective chart review was performed on 49 children (34 female and 15 male) with a median age of 4.1 months (range, 1-10 months). A total of 58 superficial IHs were treated with 1% propranolol ointment. Topical propranolol was applied three times daily for a mean duration of 21.1 weeks (range, 5-59 weeks). Changes in the size, texture, and color of the tumor were monitored and recorded at regular intervals. The treatment response was evaluated using a 3-point scale system: good, partial, and no response. Adverse effects after medication were evaluated and managed accordingly.</p><p><b>RESULTS</b>Of the 49 cases, 26 (53.1%) demonstrated good response, 17 (34.7%) showed a partial response, and 6 (12.2%) had no response. The total effective rate was 87.8% . No systemic complication was observed in any of the patients.</p><p><b>CONCLUSIONS</b>Topical therapy with 1% propranolol ointment may be a safe and effective method for the treatment of superficial IHs and can be used as an adjuvant treatment measure during the wait-and-see period.</p>

Maggot therapy for repairing serious infective wound in a severely burned patient / 中华创伤杂志(英文版)

The larvae of musca domestica were put in use to discard the dead tissue of a case of severe burn. A total of 50 000 aseptic maggots were put onto the infective wound surface, and aseptic dressings overlaid the surface. Three days later, another 20 000 maggots were put onto the wound for the second therapy. After twice maggot debridement, most necrotic muscle tissues of the wound were cleaned up, and eventually fresh granulation tissue grew and later the wound was covered and healed by 3 times of skin grafting. The result demonstrates that maggot therapy is safe and effective with no adverse complications except pain.

Oral propranolol in the management of periorbital proliferating phase infantile hemangioma / 中华整形外科杂志

<p><b>OBJECTIVE</b>To observe the efficacy and safety of oral propranolol in the treatment of periorbital proliferating phase infantile hemangioma.</p><p><b>METHODS</b>A retrospective review of patient medical records was performed. 12 patients (9 female, 3 male; 1.5-8.5 months, average 3.3 months) with periorbital proliferating phase infantile hemangioma underwent oral propranolol therapy. The dosage was slowly increased to 2 mg/kg daily in divided doses for a mean duration of 16 weeks (range 4 weeks-41 weeks). Therapeutic outcomes and safety were established by evaluating colour, size of lesion, duration of treatment and side-effects of treatment before and after treatment.</p><p><b>RESULTS</b>Of these, 9 had a signification reduction in colour and size of the lesions, 2 had no further growth. 1 is stopped therapy due to hypotension after drug administration. 11 other patients, although mild adverse effects were noted, no symptoms were severe enough to discontinue treatment.</p><p><b>CONCLUSIONS</b>Propranolol appears to be a safe and effective treatment in the management of periorbital proliferating phase infantile hemangioma.</p>

The change of serum vascular endothelial growth factor and matrix metalloproteinases-9 in proliferative hemangioma treated with propranolol / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the level of serum vascular endothelial growth factor, matrix metalloproteinases-9 in the proliferative hemangioma before and after propranolol treatment.</p><p><b>METHODS</b>The serum VEGF, MMP-9 was detected with ELISA assay before treatment and after 4 weeks and 8 weeks of propranolol treatment. The relationship between the serum VEGF, MMP-9 and the prognosis was analyzed.</p><p><b>RESULTS</b>The serum VEGF (295.4 +/- 158.1) pg/ml was high before treatment, then decreased after 4 weeks and 8 weeks of treatment (255.7 +/- 130.4) pg/ml, (224.2 +/- 120.6) pg/ml. The serum VEGF was significantly lower after 8 weeks of treatment (P < 0.05). The serum MMP-9 was also decreased after treatment, showing a positive relationship with VEGF.</p><p><b>CONCLUSIONS</b>Propranolol can treat the proliferative hemangioma through decreasing the serum VEGF and MMP-9.</p>

The expression of CEACAM-1 and CXCL-14 in infantile hemangioma / 中华整形外科杂志

<p><b>OBJECTIVE</b>To examine the expression of CEACAM-land CXCL-14 in the different stages of infantile hemangioma and to explore the role of CEACAM-1 and CXCL-14 in the occurrence and development of infantile hemangioma.</p><p><b>METHODS</b>The expression of CEACAM-1 and CXCL-14 was detected by immunohistochemical technique and Western Blot in cases of proliferating hemangiomas, involuting hemangiomas, involuted hemangiomas. The mean optical density was measured by image analysis system.</p><p><b>RESULTS</b>The expression of CEACAM-1 in early stage of proliferating hemangiomas was weak or negative, while it was strong in involuting hemangiomas and positive in the involuted stage. The differences between different stages had a statistically significance (P < 0.05). The expression of CXCL-14 was weak or negative in stage of proliferating hemangiomas, positive in involuting hemangiomas and strong in the involuted stage. The differences between different stages had a statistically significance (P < 0.05).</p><p><b>CONCLUSIONS</b>CEACAM-1 and CXCL-14 are involved in the occurrence and development of infantile hemangioma.</p>

Histologic analysis and long-term effect of acellular dermal matrix combined with autologous thin split-thickness skin graft / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate the long-term therapeutic effect and histologic result of ADM combined with autologous thin split-thickness skin graft.</p><p><b>METHODS</b>23 patients were treated with acellular dermal matrix (ADM) combined with autologous thin split-thickness skin graft. The patients were followed up at 3, 6, 12, and 18 months after operation. The histological analysis was also performed.</p><p><b>RESULTS</b>3, 6, 12, 18 months after operation, the composite skin grafts became smooth with no hypertrophic scar and hyperpigmentation. It was soft and elastic. The joints could move randomly. The histologic study showed the composite skin graft had a similar appearance as the normal skin.</p><p><b>CONCLUSION</b>As for the treatment of wound, the composite skin graft with ADM is smooth and soft with good elasticity after transplantation, but it has no perspiration.</p>