Tongue flap combined with local mucosal flap for repairing palate fistulae / 中华医学美学美容杂志

Objective To introduce a modified surgical technique for repairing palate fistulae.Methods Based on the clinical categories of palate fistulae,local mucosal flap was designed,if possible,to reduce the area of the fistulae and reshape the fistulae.Then the thin tongue flap with anterior pedicle was designed for repairing the palate fistulae,without much limitation of tongue movement and excessive tension of tongue flap pedicle short lingual frenulum correction was performed firstly to release the motion of tongue,if necessary.The donor site was closed directly.Three weeks later division of the tongue flap,as well as detailed appearance correction of tongue,was carried out at the same time.Results 12 cases were treated,and followed up for 6-12 months.For all the cases,the defect of fistulae was totally repaired,while aesthetics appearance of tongue was satisfactory,and no interference with speech with the use of tongue as donor site.Oral hygiene and mastication were unimpaired.No patient described disability of sensory or gustatory postoperatively.Conclusions Tongue flap has sufficient blood supply,while impairment of donor site is minimal.The planning and procedure of surgery are relatively simple.It is an ideal flap in treatment of palate fistulae.

Autologous fat graft and bone marrow-derived mesenchymal stem cells assisted fat graft for treatment of Parry-Romberg syndrome.

BACKGROUND: Progressive facial hemiatrophy, also called Parry-Romberg syndrome (PRS), is characterized by slowly progressive atrophy of one side of the face and primarily involves the subcutaneous tissue and fat. The restoration of facial contour and symmetry in patients affected by PRS still remains a challenge clinically. Fat graft is a promising treatment but has some shortcomings, such as unpredictability and low rate of graft survival due to partial necrosis. To obviate these disadvantages, fat graft assisted by bone marrow-derived mesenchymal stem cells (BMSCs) was used to treat PRS patients and the outcome was evaluated in comparison with the conventional treatment by autologous fat graft. METHODS: Autologous fat graft was harvested by tumescent liposuction. Bone marrow-derived mesenchymal stem cells were then isolated by human Lymphocytes Separation Medium through density gradient centrifugation. Twenty-six patients were treated with autologous fat graft only (group A), whereas 10 other patients were treated with BMSC-assisted fat graft (group B). The Coleman technique was applied in all fat graft injections. RESULTS: The follow-up period was 6 to 12 months in this study, In group A, satisfactory outcome judged by symmetrical appearances was obtained with 1 injection in 12 patients, 2 injections in 8 patients, and 3 injections in 4 patients. However, the result of 1 patient was not satisfactory and 1 patient was overcorrected. In group B, 10 patients obtained satisfactory outcomes and almost reached symmetry by 1 injection. No complications (infection, hematoma, or subcutaneous mass) were observed. CONCLUSIONS: The results suggest that BMSC-assisted fat graft is effective and safe for soft tissue augmentation and may be superior to conventional lipoinjection. Additional study is necessary to further evaluate the efficacy of this technique.

Application of tissue expansion in simultaneous reconstruction of nasal-lip defects / 中华医学美学美容杂志

Objective To investigate the operative technique and outcome of the expanded flap to repair the full thickness defects of nose and upper lip simultaneously.Methods Three kinds of ex panded flaps were chosen to reconstruct the full thickness defects of nose and upper lip.They were designed according to the location and the size of the defects,and also the circumstances of the donor site.Treatment effectiveness were observed by long-term follow-up.Results 7 patients were treated with the expanded flap.All cases received satisfactory results with no complications such as flap necrosis.And for male patients,the frontal expanded flap could reconstruct upper lip and beard simultaneously that reached better shape.Conclusions It is an ideal approach of repairing nasal-lip defects by the tissue expanded flap.

The influence of Matrine on apoptosis of fibroblasts and the expression of apoptotic modulation related protein in hypertrophic scar of rabbit ear / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the effects of Matrine on apoptosis of fibroblasts and the expression of apoptotic modulation related protein in the hypertrophic scar.</p><p><b>METHODS</b>Hypertrophic scar was produced on the ear of 24 New Zealand white rabbits, which were employed as the model, and were randomly and equally divided into control (CC) and Matrine (M) groups (12 in each group). Matrine (50 g/L) was injected into the ear scar in M group and with normal saline in C group once every four days. At 2, 4, 6, 8 and 12 weeks after the injection, the apoptotic fibroblast count in the scar was determined by TUNEL method, and the expressions of apoptosis related modulation proteins p53, bcl-2, bax were detected by immunohistochemistry method.</p><p><b>RESULTS</b>The apoptotic fibroblast count was much larger in M group than that in C group at all test time points (P < 0.05). Furthermore, the bax expression was increased and that of p53 and bcl-2 was decreased significantly in M group. In adding, the scar became flat in M group.</p><p><b>CONCLUSION</b>Matrine might obviously enhance the fibroblast apoptosis in rabbit ear hypertrophic scar, and up-regulate the expression of apoptosis related modulation protein bax and down-regulate the expression of p53 and Bcl-2.</p>