Topically applied liposome encapsulated superoxide dismutase reduces postburn wound size and edema formation.

The overproduction of biochemical mediators, and activation of leukocytes and endothelial cells, generated in thermally injured tissue, gives rise to both local and distant effects. The formation of short-lived, highly reactive metabolites, such as oxygen free radicals, increases with increasing tissue ischemia, and causes further cell damage. Human recombinant Cu/Zn-superoxide dismutase (rh-Cu/Zn-SOD), an enzyme which captures these radicals, may have a beneficial effect on the postburn inflammation processes. In this study, the influence of rh-Cu/Zn-SOD application to thermally injured tissue of rabbit backskin was examined. Three different delivery strategies were compared, pure or liposomally encapsulated enzyme, or intralesionally injected rh-Cu/Zn-SOD. For control, one animal group was treated with plain gel and another group was kept untreated. At 24 h following trauma a statistically significant difference in lesion sizes between the enzyme treated and control groups was observed. After 72 h tissue swelling had diminished significantly more in the rh-Cu/Zn-SOD treated groups as compared to the control animals. The best results were achieved by spreading liposomes encapsulating the enzyme onto the wounds. Our results suggest that local treatment of burn wounds with enzymatic radical scavengers such as rh-Cu/Zn-SOD has a beneficial effect on the extent of the postburn damage.

[Reconstruction of facial contour in hemifacial atrophy (Romberg disease) using a free revascularized scapula-fat-fascia flap]. / Der Konturaufbau bei hemifazialer Atrophie (M. Romberg) mit dem freien mikrovaskulär transplantierten Skapula-Fett-Faszienlappen.

Presented is a case of progressive hemifacial atrophy. The reconstruction of the deficient left face-contour was performed by a free microsurgical transplanted fat-fascia flap from the scapular region. The position of the fascial layer of the inlay, facing skeletal and muscular structures, enables fixation of the transplanted tissue to zygomatic periosteum and fascia of the temporalis muscle. Thus we have advantage to avoid sagging of the transplanted tissue in upright position and to remove over-correcting applied amounts of fatty tissue during the first corrective operation.

Experience with "isovolaemic" haemodilution in extensive surgery for oro-facial tumours.

Pre-operative "isovolaemic" haemodilution using 6% hydroxyethyl-starch was used in 7 patients with tumours involving the mouth. While the value of isovolaemic haemodilution in terms of reducing transfusion requirements with donor blood was confirmed, this positive effect was found to be offset by the narrow margin within which blood pressure can be reduced intra-operatively and by the resultant higher blood loss. Wound healing was optimal by clinical evidence. Defective wound healing or necroses due to local hypoxaemia appear to be less likely after isovolaemic haemodilution.