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Objective To discuss clinical curative effects of using Forehead skin expansion combine with auricular cartilage for repairing nose alar full-thickness defects.Methods From August 2010 to August 2010,36 patients with nose alar full-thickness defects in the second affiliated hospital of kunmin medical university,The defect range exceed 1.5 cm× 1.2 cm.50-80 ml expander was implanted in forehead and injected saline water to expand in order to acquire extra skin.We Turn around the skin of defect as the lining of nose,harvest ipsilateral auricular cartilage for nose ala framework,Expanded forehead pedicle flap was transferred to cover framework.The donor area was sutured directly.The pedicle of flap was cut and trimmed after 2 months.Results Follow-up time of 3-18 months after the operation,All flaps are survive,nose alar defects are repaired successfully.Some cases were performed second surgery,postoperative,nose alar color,thickness,nostril size and shape the same with the contralateral side.Donor site healed with linear scar.Conclusions This method could be easy to obtain excess skin,for repairing large sides nose alar full-thickness defect.Frontal scar is not obvious,It is a practical.
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[Objective]To investigate the feasibility of the dermal pluripotent stem cells in the repairing of cartilage defects.It was aimed to provide experimental basis in view of cartilage defects of expanding the repair of cartilage defects seed cells selection. [Method]Neonatal cyanotic blue rabbits were used.Dermal tissue directly isolated through mechanical method and cells through enzymatic digestion were obtained.The growth characteristics of adherent adhesion of stem cells were used to obtain high cloned cells,which were subcultured.The cell concentration of 1?106/ml was cultured with polylactic acid scaffold for one weeks,and the obtained result was implanted into full-thickness articular cartilage defects of rabbits.Thirty cyanotic blue rabbit(60 joints)for about 3~5 months were randomly divided into three groups:dermal pluripotent stem cell / scaffold polylactic acid in group A,polylactic acid scaffold in group B,controls in group C.Twenty joints for each group.The rabbits were killed by air embolization at 12 weeks,restoration organization was extracted and stained by HE and toluidine blue.According to the repairing result of cartilage defect,gross and histologic scoring was made,and analyzed by statistics.The comparison of score difference between each groups was performed statistically.[Result]Gross and histological observation demonstrated that in group A organizations had smooth surface,appeared transparent,good integration with surrounding cartilage and subchondral bone.In group B there was a tiny transparent cartilage,and the fiber cartilage repair accounted for much proportion.The surface of group C showed some defects,mainly characterized by fibrous cartilage repair.After gross and histological observations statistics score analysis was performed.Results showed that group A is the most optimal(P
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Objective To validate if the continuous passive motion instrument we developed is practical and sta- ble for animal experiment.Methods Ten New Zealand male rabbits were used to establish the animal model of full- thickness defect of articular cartilage in the facies patellaris of femur with their both knees.The rabbits were then randomly divided into groups A and B(10 in each group).The rabbits in group A were administered with CPM of both knees daily for 4 weeks,while those in group B remained normal cage activity only.At the end of the treatment,all the animals were sacrificed,and their articular cartilage was harvested for HE staining and observation.Results It was found that group A had a significantly better repair of the full-thickness defects of articular cartilage than that of the group B,as reflected by the range of motion and morphological observation of the knees(P
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Objective To study the effect of continuous passive motion (CPM) on the healing of man made full thickness defects of articular cartilage in the knee of rabbit. Methods A diameter of 3.2mm full thickness defect of articular cartilage in the facies patellaris of femur were made in 60 knees of rabbits. Then the rabbits were randomly divided into groups A,B and C. The animals in groups A and B were treated with CPM for 8 hours and 2 hours daily, respectively, for 4 weeks, while those in group C kept in cage for free activity only. Half of the animals of every group were sacrificed at the end of the 4th and 12th weeks. The H.E. staining, safranin O staining and immunohistochemical analysis of collagens I and II were conducted, the gross appearance and histological change were observed and scored. Results There was significant difference with regard to the score of gross appearance and histological change among groups A, B and C. Conclusion The healing of full thickness defects of articular cartilage in rabbits treated by CPM is better than that in rabbits without CPM treatment. CPM can promote tissue repair and stimulate synthesis of collagenⅡand the glycosaminoglycan.
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There are many controversies in ability of articular cartilage to heal full thickness defect. Generally, it is reported that full thickness defects of articular cartilage filled with organizing hematoma and granulation tissues, which converted to chondroid tissues. It is clear that the size of defect was related to the repair of articular cartilage. Though cartilagenous material fills the defect and restores the surface continuity, it may undergo degeneration, and lead to localized focus of osteoarthritis. Multiple drilling through subchondral bone could be a kind of treatment in articular cartilage defect. Author conducted an experiment for the full thickness defect of articular cartilage in rabbit. After multiple drilling of articular cartilage, the repair of defect was examined histologically until eighth week. Results were as followings ; l. At lst. week, the defect was repaired by fibrovascular proliferation and granulation tissue. 2. At 3rd. week, hyaline cartilage consisted of normal chondrocyte was formed. 3. At 8th. week, subchondral plste was regenerated completely. 4. All defects that were less than 3 mm. in diameter were healed. More repairs were observed in case with the wider defects if the defects were within 3mm. in diameter. 5. The metachromasia was observed with toluidine blue stain. The reformed cartilage shows slight purple(Grade II) to moderate purple(Grade III) at third week and near normal (Grade IV) at fourth week. In conclusion, multiple drilling may be an effective method of treatment in articular cartilage defect. It is considered that multiple drilling with a 3mm. Steinmann pin may be the most convenient and effective method of the cartilage healing.