Prevention of eyelid malposition by three-step supporting technique in the transcutaneous lower blepharoplasty.

BACKGROUND: To investigate the effectiveness of the three-step supporting technique for prevention of eyelid malposition in the transcutaneous lower blepharoplasty. METHODS: It was a chart review of more than 10-year experiences of our method. From 2006 to 2017, a total of 697 patients underwent the three-step supporting technique in the transcutaneous lower blepharoplasty. The three steps included septum tightening, orbicularis canthopexy, and muscle plication. The assessment of outcome was made at 6 months. The results were assessed by evaluating pre- and postoperative appearance with Garcia-McCollough scale for lower eyelid overall appearance evaluation. The complication of eyelid malposition was evaluated in accordance with the grading system for post blepharoplasty eyelid malposition. RESULTS: Among the 697 patients, 285 patients underwent fat excision and 412 received fat repositioning for correction of the trough deformity. The follow-up ranged from 6 to 36 months: 94.2% of the patients had improvement, 4.4% no improvement, and 1.4% poor results; 95.1% (n = 663) had almost normal position, 3.2% (n = 22) scleral show, only 1.7% (n = 12) mild eversion, no patient frank eversion. All the 12 patients with slight malposition recovered through conservative treatment. CONCLUSION: Three-step supporting technique is safe and effective for lower blepharoplasty with minimal chance of eyelid malposition.

Rhinoplasty With Hyaluronic Acid: A Standard 5-step Injection Procedure Using Sharp Needle.

OBJECTIVE: To explore the clinical effect of rhinoplasty with a standard 5-step injection procedure of hyaluronic acid using sharp needle in correction of deficient features of the Chinese nose. METHODS: Between January 2016 and December 2018, hyaluronic acid was injected with the sharp needle by a standard procedure in the anterior nasal spine, nasal columella, nasal tip, nasal root, and dorsum, as well as the junction region of nasal root and brow in 198 Chinese patients. The postoperative curative effect was analyzed, and the adverse reactions were observed. RESULTS: The nasal shape in all patients was significantly improved, obtaining the stereoscopic appearance, and satisfactory results. During a 6-month follow-up, 4 patients developed local subcutaneous congestion and bruising in the nasal dorsum after treatment, which disappeared within 2 weeks. No patients suffered from complications such as infection, embolism, necrosis, transparent nasal dorsum, and widened nasal roots. CONCLUSIONS: Injection of hyaluronic acid with the sharp needle by a standard 5-step procedure is a safe technique that can effectively correct the deficient features of the Chinese nose.

Objective and Subjective Evaluation of Lipoinjection for Correction of Temporal Depression.

BACKGROUND: Temporal depression is commonly found among people. OBJECTIVE: Objective and subjective evaluation of lipoinjection for correction of temporal depression. METHODS: From November 2012 to January 2018, 34 healthy female subjects underwent temporal augmentation by lipoinjection on both sides. Efficacy was assessed by objective and subjective parameters. The quantitative measurement of the temporal defect was obtained using molded plasticine preoperatively and 12 months after treatment. The subjective assessment consisted of excellent, good, fair, and poor results based on the patients' self-evaluations. The adverse events were recorded. RESULTS: The follow-up period ranged from 12 to 36 months. It was found that a statistically significant difference existed between the preoperative and postoperative defect on both temples. Regarding the patients' self-evaluations, 17 patients (50.0%) reported feeling excellent, 15 patients (44.1%) as good, and 2 patients (5.9%) as fair, and no patient as poor. After the statistical analysis, it was found that the volumetric restoration rate of the grafted fat decreased as the temporal defect generally increased during the aging process. Injection-site swelling and bruising were commonly found complications; other complications were not found. CONCLUSION: Autologous fat is inexpensive and readily available. Fat grafting is an alternative for correction of temporal depression.

Adipocyte-derived stem cell-based gene therapy upon adipogenic differentiation on microcarriers attenuates type 1 diabetes in mice.

BACKGROUND: Insulin replenishment is critical for patients with type 1 diabetes; however, current treatments such as pancreatic islet transplantation and insulin injection are not ideal. In addition to stem cell or gene therapy alone, stem cell combined with gene therapy may provide a new route for insulin replenishment, which could avoid an autoimmune reaction against differentiated ß cells or systematic viral vector injection. METHODS: In this study, human adipocyte-derived stem cells (ADSCs) were transducted with lentiviral vectors expressing a furin-cleavable insulin gene. The expression levels of insulin were measured before and after adipogenic differentiation in the presence or absence of an adipocyte-specific promoter AP2. In vitro proliferation and in vivo survival of cells were examined on cytodex and cytopore microcarriers. The effect of ADSC-based gene therapy upon adipogenic differentiation on microcarriers was evaluated in the streptozotocin-induced type 1 diabetic mouse model. RESULTS: We found that differentiation of ADSCs into adipocytes increased insulin expression under the EF1 promoter, while adipocyte-specific AP2 promoter further increased insulin expression upon differentiation. The microcarriers supported cell attachment and proliferation during in vitro culture and facilitate cell survival after transplantation. Functional cells on the cytopore 1 microcarrier formed tissue-like structures and alleviated hyperglycemia in the type 1 diabetic mice after subcutaneous injection. CONCLUSIONS: Our results indicated that differentiation of ADSC and tissue-specific promotors may enhance the expression of therapeutic genes. The use of microcarriers may facilitate cell survival after transplantation and hold potential for long-term cell therapy.

Liposuction-assisted circumferential trimming in treatment of axillary osmidrosis (AO).

BACKGROUND: The study is to investigate the effectiveness and safety of the minimally invasive treatment for axillary osmidrosis by liposuction assisted circumferential trimming. METHODS: It was a retrospective study. From July 2014 to July 2017, 79 patients underwent superficial liposuction and circumferential trimming for bilateral axillary osmidrosis. The preoperative and postoperative degree of axillary malodor was measured by doctors and the patients themselves. In the doctor's evaluation, the odor levels were scored by the sniffing method before and 1 year after treatment. In the patient's self-assessment, each patient selected a scale value to convey his/her satisfaction during the visits after 1 year. The complications were recorded. RESULTS: The follow-up period ranged from 12 to 24 months after surgery, and the mean follow-up period was 16 months. 75 (94.9%) had good results, four (5.1%) had moderate malodor or recurrence after one year. When considering patient's own satisfaction, 93.7% (74/79) of patients were satisfied with the outcomes after one year. The partial epidermis necrosis was observed in four patients, it healed spontaneously without scarring. Three patients had a small amount of hematoma which was easily evacuated through the central primary incision. There was no other serious side effect. CONCLUSIONS: The liposuction assisted circumferential trimming technique is proved reliable and safe in treatment for axillary osmidrosis.

Excision of sebaceous cyst by intraoral approach: A case report.

RATIONALE: Surgical removal of a sebaceous cyst is usually accomplished through an external incision, which inevitably results in a scar. Herein, we described an intraoral approach for excising sebaceous cysts located in the lip or cheek near lip commissure, to avoid a skin scar. PATIENT CONCERNS: Removal of the cyst but without leaving a scar on the face. DIAGNOSES: Six patients were diagnosed with a subcutaneous cyst located in the lip or cheek near lip commissure. INTERVENTIONS: We implemented an intraoral approach to excise the cyst, wherein an intraoral incision was made and blunt dissection was performed through the buccinator muscle or orbicularis oris muscle until the cyst wall was seen. The cyst was then dissected from the surrounding subcutaneous tissue by careful blunt dissection with a hemostat and completely removed through the intraoral incision. OUTCOMES: All patients had complete recovery, with no recurrence or complaints for at least 6 months after the surgery. LESSONS: A sebaceous cyst located in the lip or cheek near lip commissure can be excised by an intraoral approach through the mouth, which avoids a visible scar on the skin.

Percutaneous Myotomy With a Small Needle-Knife and Lipoinjection for Treatment of Glabellar Frown Lines.

BACKGROUND: Glabellar frown lines are a common aesthetic concern, and minimally invasive techniques to treat frown lines have become popular. OBJECTIVES: The authors developed a technique to minimize frown lines by means of percutaneous myotomy with a small needle-knife and lipoinjection. METHODS: Sixty-nine patients underwent treatment of the glabellar frown lines in a prospective study. Percutaneous myotomy of the corrugator supercilii and procerus was conducted with a small needle-knife, and autologous fat was transferred to the glabellar region. Two independent investigators assessed improvement of the glabellar frown lines by applying the Merz Facial Wrinkle Scale preoperatively and 6 months postoperatively. Improvement by ≥1 point was regarded as a response to treatment. Patients also conducted a self-assessment based on the Global Aesthetic Improvement Scale. RESULTS: The mean follow-up period was 8 months. The evaluators determined that the glabellar frown lines of 62 patients (89.9%) responded to treatment. For 4 patients (5.8%), the frown lines were partially improved, and the frown lines did not improve for 3 patients (4.3%). In a self-assessment, 64 patients (92.8%) perceived improvement in their frown lines 6 months postoperatively. No serious complications were recorded. CONCLUSIONS: Treatment of glabellar frown lines by percutaneous myotomy with a small needle-knife and lipoinjection is reliable and minimally invasive. LEVEL OF EVIDENCE: 4.

Comparative study of autologous fat vs hyaluronic acid in correction of the nasolabial folds.

OBJECTIVE: In the article, comparison of the hyaluronic acid (HA) and autologous fat is conducted to evaluate the effectiveness and safety in correction of the nasolabial folds (NLFs). METHODS: From November 2012 to December 2015, a single-blinded, randomized study was conducted. Sixty-two patients were included in the study, and 57 of them completed the whole procedure. The patients were randomly allocated to receive the treatments of HA or fat in both NLFs. The Wrinkle Severity Rating Scale (WSRS) and Global Aesthetic Improvement Scale (GAIS) were used for assessment. Efficacy was assessed using two parameters: evaluation of final improvement by blinded evaluator and patient-self using photographs. The effectiveness endpoint was improvement of scores at 1, 3, 6, 9, and 12 months from baseline. The adverse events (AEs) were recorded. RESULTS: In the blinded evaluator scores for NLF in accordance with WSRS, there were no significant differences between the two methods within 9 months. A statistically significant difference between the lipoinjection and HA groups was found at 12-month follow-up period. Subjects' self-assessment was similar to the results seen for the evaluator scores. The difference of AEs between the HA and fat group was obvious in the early stage of recovery. In the later stage, the AEs of the HA and fat group were similar. CONCLUSIONS: Both HA gel and autologous fat provide augmentation of NLFs. The magnitude and duration of NLF correction appear to be similarly effective and safe within a period.

Reconstruction of Skin Defects on the Mid and Lower Face Using Expanded Flap in the Neck.

BACKGROUND: The reconstruction of major burn and other deformities resulting from significant soft tissue deficits of the face is a continuing challenge for surgeons. In the study, the authors introduce our 5-year experiences using expanded flap in the neck for reconstruction on the mid and lower face. METHODS: From 2008 and 2013, 12 tissue expanders were used in 12 patients for face resurfacing. The operation consisted of 2 steps. In the first step, the expander was placed subcutaneously under the skin of the neck and they were expanded timely to create adequate superfluous skin and soft tissue. In the second step, the expanded flap was transferred to reconstruct the defects on the mid and lower face after excision of the lesions. RESULTS: All 12 patients with lesions on the mid and lower face underwent successful facial resurfacing with the described technique in the last 5 years. The follow-up ranged from 6 to 24 months. Flaps did not shrink after the operations, and subsequent contractures did not recur. The cervicomental angle appeared normal. All flaps survived well except 2 patients developed slight necrosis at the distal edge and no other major complication was observed. Esthetic outcomes were rated to be very good in 10 patients (83.3%) and good in 2 patients (16.7%). CONCLUSION: The application of expanded flaps in the neck is proved to be an effective way of repairing facial defects on the mid and lower face. The technique is remarkably reliable in resurfacing the peripheral facial esthetic units.

Endoscopic facelift of the frontal and temporal areas in multiple planes.

INTRODUCTION: The detachment planes used in endoscopic facelifts play an important role in determining the results of facial rejuvenation. In this study, we introduced the use of multiple detachment planes for endoscopic facelifts of the frontal and temporal areas, and examined its outcome. METHODS: This study included 47 patients (38 female, 9 male) who requested frontal and temporal facelifts from January 2009 to January 2014. The technique of dissection in multiple planes was used for all 47 patients. In this technique, the frontal dissection was first carried out in the subgaleal plane, before being changed to the subperiosteal plane about 2 cm above the eyebrow line. Temporal dissection was carried out in both the subcutaneous and subgaleal planes. After detachment, frontal and temporal fixations were achieved using nonabsorbable sutures, and the incisions were closed. During follow-up (ranging from 6-24 months after surgery), the patients were shown their pre- and postoperative images, and asked to rate their satisfaction with the procedure. Complications encountered were documented. RESULTS: All 47 patients had complete recovery without any serious complications. The patient satisfaction rate was 93.6%. Minor complications included dimpling at the suture site, asymmetry, overcorrection, transitory paralysis, late oedema, haematoma, infection, scarring and hair loss. These complications resolved spontaneously and were negligible after complete recovery. CONCLUSION: Dissection in multiple planes is valuable in frontal and temporal endoscopic facelifts. It may be worthwhile to introduce the use of this technique in frontal and temporal facelifts, as it may lead to improved outcomes.

A modified mini-incisional technique for double-eyelid blepharoplasty.

BACKGROUND: Double-eyelid blepharoplasty is one of the most popular cosmetic surgeries in Asia. OBJECTIVE: To introduce a modified mini-incisional technique to form a double eyelid. METHODS: A total of 372 patients (325 women, 47 men) were involved in the study between July 2008 and August 2014. Their age ranged from 16 to 34 years, with a mean age of 24 years. All patients underwent the modified mini-incisional upper blepharoplasty. In the technique, four 2 mm incisions were made along the designed fold. The orbicularis muscle overlying the levator aponeurosis was removed. The removal of the lateral fat pad was completed accordingly. The medial fat pad was also removed if necessary. Suture was used to fix the skin to pretarsal fascia along the double-eyelid line. The double-eyelid crease was formed after the operation. RESULTS: The follow-up period was three to 12 months (mean nine months). Most of the double eyelids were natural. During the follow-up period, 92% (342 of 372) patients were satisfied with the blepharoplasty. The most common complications were swelling within first week after the operation, which subsided spontaneously. Asymmetries occurred in 17 patients; six patients had multiple eyelids and seven patients experienced shifting of the fold. These were corrected six months after the operation. Disappearance of the fold was not observed. The scars of the stab incision became invisible after one full year of recovery. No other severe complications were found. CONCLUSION: The four mini-incisional blepharoplasty technique was successful for the formation of a natural-appearing and long-lasting double eyelid. Except for individuals with obvious skin redundancy, patients with a single eyelid are suitable candidates for the technique.

HISTORIQUE: La blépharoplastie asiatique est l'une des chirurgies plastiques les plus populaires en Asie. OBJECTIF: Présenter une technique de mini-incisions modifiée pour former un pli palpébral. MÉTHODOLOGIE: Au total, 372 patients (325 femmes, 47 hommes) ont participé à l'étude entre juillet 2008 et août 2014. Ils avaient de 16 à 34 ans, pour un âge moyen de 24 ans. Ils ont tous subi une blépharoplastie asiatique par mini-incisions modifiées. Les chirurgiens ont pratiqué quatre incisions de 2 mm le long du pli désigné. Ils ont effectué l'exérèse du muscle orbiculaire recouvrant l'aponévrose du muscle releveur et celle des tissus graisseux latéraux, puis ont procédé à celle des tissus médians, au besoin. Ils ont réalisé une suture pour fixer la peau au fascia prétarsal le long de la ligne du pli. Le pli palpébral a été formé après l'opération. RÉSULTATS: La période de suivi était de trois à 12 mois (moyenne de neuf mois). La plupart des plis palpébraux avaient un aspect naturel. Pendant la période de suivi, 92 % des patients (342 sur 372) étaient satisfaits de la blépharoplastie. Les principales complications étaient une enflure pendant la première semaine suivant l'opération, qui s'est résorbée spontanément. Dix-sept patients ont présenté une asymétrie; six patients avaient de multiples plis et sept patients ont présenté un déplacement du pli, qui a été corrigé six mois après l'opération. Aucun pli n'a disparu. Après une année complète de convalescence, les cicatrices des incisions étaient devenues invisibles. Aucune autre grave complication n'a été observée. CONCLUSION: La technique de blépharoplastie par quatre mini-incisions permet de former un pli palpébral supérieur d'aspect naturel à long terme. À part chez les personnes qui présentent une redondance cutanée évidente, les patients qui ont des paupières asiatiques sont de bons candidats à cette intervention.

Minimally traumatic midface lift approach for patients in their early 30s and 40s.

BACKGROUND: To evaluate the effectiveness of the minimally traumatic midface lift approach in combination with the Wrinkle Severity Rating Scale (WSRS) criteria. METHODS: From July 2007 to September 2009, 21 female patients underwent the minimal incision midface lift procedure. The procedure was mainly composed of a small arrow-like incision just superior to the top of the auricle, a fanlike subcutaneous dissection, and 3 suspension sutures. After 6 months, objective and subjective criteria were recorded, photos were taken for documentation and the WSRS scale system was used. Postoperative adverse effects were also recorded. RESULTS: All 21 patients completed more than a 6-month postoperative follow-up, and all the patients gained complete recovery. In the doctor's evaluation for using the WSRS system, 3 patients (14.3%) felt fair, the remaining 18 patients (85.7%) felt good, and no patients (0%) had poor results 6 months after the operation. In patient self-evaluation, 5 patients (23.8%) felt fair, the remaining 16 (76.2%) felt good, and no patient (0%) had poor results after 6 months. No serious operative complications including facial nerve palsy and skin slough were found. CONCLUSION: The minimally traumatic midface lift is a simple, reliable, and effective approach for the aging face of women in their 30s and 40s.

Comprehensive surgical approaches to management of various facial nevi.

OBJECTIVE: To investigate the effects of the flexible surgical approaches on therapeutic and cosmetic outcomes of facial nevi. METHODS: From August 2002 to January 2008, 16 cases with facial nevi had been treated in our wards with the selected approaches. Surgical approaches including serial excision or one-time radical excision, free skin graft, and expanded flap were adopted in accordance with the individual size and location of the facial nevi. RESULTS: All cases experienced complete excision and had satisfactory cosmetic appearance in the end. CONCLUSION: The flexible surgical measures help to minimize the risk of malignant transformation and achieve good cosmetic results.

Clinical evaluation of three total ear reconstruction methods.

OBJECTIVE: To investigate relative indications for three different surgical techniques used in total ear reconstruction. METHODS: A total of 1864 cases requiring complete ear reconstruction were performed. In 1485 cases reconstruction was effected by skin expansion and subsequent grafting of autogenous rib cartilage frameworks. In 355 cases skin expansion was followed by insertion of a Medpor framework. Twenty-four cases were repaired with titanium dowel retained prosthesis. Clinical results of these three surgical techniques were evaluated. RESULTS: All three methods were successfully used in total ear reconstruction and showed a satisfactory appearance. For patients less than 30 years old and with intact mastoid skin, the rib cartilage grafting methods were preferred. A Medpor framework was suitable for cases over 30 years old, despite the appearance of mild inflammation in the skin flap. We resorted to a prosthetic reconstruction in patients whose mastoid skin was seriously damaged when they were unwilling to accept more complex methods of ear reconstruction. CONCLUSIONS: The three methods described provide satisfactory clinical results and are each indicated for specific patient cohorts.

[Clinical application of three methods for total ear reconstruction].

OBJECTIVE: To investigate the indication and results of three methods for total ear reconstruction. METHODS: 960 cases of total ear defect were treated with skin expansion and autogenous rib cartilage framework (n = 786), or skin expansion and Medpor framework (n = 150), or ear prosthesis (n = 24). The indication and results of the three methods were analysed. RESULTS: Good cosmetic results were achieved with all three methods. Autogenous rib cartilage framework was suitable for patients under 30 years old with unaffected skin at mastoid region. Medpor framework was good for grown-up, especially over 30 years old, or with mild infection at mastoid region. Patients with severe skin injury at mastoid region or unwilling to accept surgery should choose ear prosthesis. CONCLUSIONS: Satisfactory results can be achieved with suitable methods for total ear reconstruction.

[External ear reconstruction using expanded postauricular scar flap and Medpor framework].

OBJECTIVE: To investigate the possibility of external ear reconstruction using expanded postauricular scar flap and Medpor framework in burn cases. METHODS: External ear reconstruction using expanded postauricular scar flap in combination with Medpor framework was performed in 17 cases whose ear had burn injury. RESULTS: Of the 17 cases, 15 cases achieved success; 2 cases experienced partial exposure of the framework due to inadequate wrapping of the subcutaneous fascia flap and later injury. The longest follow-up was three years, and the final result was satisfactory. CONCLUSIONS: External ear reconstruction using expanded postauricular scar flap in combination with Medpor framework is a reliable method for adult (over 25 years) who has ear defect from burn injury.

[Clinical study and pathological examination on the treatment of deep partial thickness burn wound with negative charge aerosol].

OBJECTIVE: To investigate the effect of negative charge aerosol (NCA) on the treatment of burn wound. METHODS: Patients with superficial or deep partial thickness burn only were enrolled in the study, and they were randomly divided into trial group (T, including 180 cases of superficial thickness burn and 100 cases of deep partial thickness burn), control group (C, including 30 cases with superficial thickness burn and 30 with deep partial thickness burn), and self control group (SC, including 10 cases with superficial thickness burn and 10 with deep partial thickness burn). The patients in T and SC groups were treated with NCA for 1.5 hours, 1-2 times a day, from 6 postburn hour (PBH) to 2 postburn day (PBD), while those in C group received conventional treatment. For those in SC group, some of the wounds were covered with sterile schissel, while other wounds without schissel covering. The general changes in the wounds during NCA treatment were observed, and bacterial culture before and after NCA treatment was performed. The healing time was recorded and the blood biochemical parameters were determined. Rat model with deep partial thickness scald was established, and the rats were also divided into T and C groups, and received treatment as in human. Tissue samples were harvested from the wounds of rats in the 2 groups before and 1, 2, 3 weeks after treatment for pathological examination. RESULTS: There was no infection and little exudation in the patients in T group. No bacteria were found in the wound before and after NCA treatment. The healing time of the wounds of patients with superficial and deep partial thickness burn in T group was 6.3 +/- 1.6 d and 15.1 +/- 3.1 d, respectively, which was obviously shorter than those in C group (11.3 +/- 1.4 d and 21.2 +/- 1.4 d, P < 0.01). In SC group, the healing time of those with sterile schissel coverage was also significantly shorter than those without covering (P < 0.01). There was no obvious change in the liver and kidney functions and blood biochemical parameters among the patients. Pathological examination showed that the skin structure was almost recovered in the rats in T group 3 weeks after treatment, while those in C group was not. CONCLUSION: Negative charge aerosol is safe and effective in promoting wound healing of the patients with partial thickness burns.

[Correction of cupped ear by using a stainless steel wire suspension technique].

OBJECTIVE: To evaluate a new reliable surgical technique for correction the congenital cupped ear. METHODS: With 96 patients, a stainless steel wire was introduced to suspend auricular cartilage on the pericranium after the cupped ear was corrected. The follow-ups were carried out after the operation. RESULTS: Up to 3 years follow-ups with 52 cases, the results were satisfactory and durable. CONCLUSIONS: The above mentioned technique could be a reliable way to correct mild and moderate cupped ear abnormalities.

[Treatment of helical keloid with retroauricular skin expansion].

OBJECTIVE: To introduce a new technique for the treatment of helical keloid. METHODS: The procedure consisted of two steps. In the first step, a kidney-shaped expander of 50 ml was placed subcutaneously in the retroauricular area. Routine inflation with normal saline followed. In the second step, about two months afterwards, the expander was taken out and the helical keloid was excised. The expanded flap was advanced to cover the wound. RESULTS: The operation has been performed on 12 patients of 16 sites of helical keloid since 2000. Postoperative follow-up from 3 months to 2 years revealed satisfactory results. The reconstructed ear maintained a good contour. CONCLUSION: The technique creates a retroauricular flap rich in blood supply, which can be used to close the defect left by helical keloid excision. It provides a good treatment for the helical keloid replaced with normal skin from the mastoid region.

[Comparison of the effects of rhEGF with rhbFGF on the acceleration of wound healing].

OBJECTIVE: To investigate the mechanism and the accelerating effect of rhEGF and rhbFGF on wound healing. METHODS: Twelve New Zealand rabbits with 72 incised wounds on ventral side of 24 ears were randomly divided into two therapeutic groups (rhEGF of 10 ug/cm(2) and rhbFGF of 100 AU/cm(2)) and a control group (1% silver sulfadiazine cream, SD-Ag). The general conditions of the wound healing was observed grossly. Biopsies were harvested at different time points for the pathomorphological examination, the electron microscopic examination, and for assessment of integrin beta1 mRNA expression by in situ hybridization. RESULTS: The expressions of integrin beta 1 mRNA in two therapeutic groups were significantly higher than that of control group. The quality of the wound healing was improved in therapeutic group with its healing time shortened when compared with that in control group (P < 0.05). There was an obvious difference in the number of fibroblasts and capillary gemmules between the therapeutic and control groups (P < 0.05). CONCLUSION: The wound healing and quality could be improved by both rhEGF and rhbFGF, but rhbFGF seemed better to be employed during the early and middle stages of the wound repair for the growth of granulation tissue, while rhEGF should be applied at the late stage of wound repair to accelerate the re-epithelialization of the wound. Combined application of rhEGF with rhbFGF according to time effect could be more beneficial to the wound repair.