The Application of Reverse Z-Plasty Design in Medial Canthal Skin Redundancy Reconstruction Surgery.

PURPOSE: To investigate the clinical outcomes of reverse Z-plasty in the reconstruction of epicanthal fold. METHODS: We conducted a retrospective analysis on clinical data from patients who underwent medial canthal skin redundancy reconstruction surgery from September 2019 to January 2023. The surgical procedure involved a preoperative design for the incision line, suborbicularis oculi dissection to create a muscle flap, and the use of a reverse Z-flap for the reconstruction of the lateral canthal fold. Postoperative follow-up assessments focused on the intercanthal distance, positional changes of the medial canthus point, alterations in the medial canthus angle, and patient satisfaction levels. The statistical evaluation was carried out utilizing paired t -tests, with a P -value of less than 0.05 denoting statistical significance. RESULTS: Postsurgery, the lacrimal prominences were less exposed, and inner canthal angles naturally reshaped. Inconspicuous scarring with diminished reverse Z-plasty marks was noted within 3 months. The average ICD has increased by 3 to 6 mm, corresponding to elongation ratios of 9.09% to 28.30%. Preoperatively, the ICD averaged 31.25±2.32 mm, expanding postoperatively to 35.19±2.26 mm. The canthal angle enlarged significantly from 49.031±6.627 to 62.188±6.662. Inner canthal points shifted notably postsurgery, with a decrease in x-value and an increase in y-value, signalling a movement upwards and away from the nose. Patient satisfaction is high. CONCLUSION: The reverse Z-plasty technique has proven to be an effective approach for reconstructing the epicanthal fold. The clarity and precision of the incision design, coupled with the stability of postoperative results, demonstrate that this method can reliably achieve successful epicanthal fold reconstruction.

Observation of curative effect of treatment of varicose veins of lower extremity with polyurethane foam sclerosing agent under fluoroscopic guidance / 中国生化药物杂志

Objective To investigate and analyze the effect of polyurethane foam sclerotherapy on varicose veins of lower extremity under the guidance of fluoroscopy. Methods 90 patients with varicose veins treated in our hospital from February 2015 to May 2017 were selected and randomly divided into the control group and the experimental group, with 45 patients in each group. The patients in the control group were given conventional high ligation and stripping of the great saphenous vein. The patients in the experimental group were treated with fluoroscopic guided polyurethane foam sclerotherapy. The therapeutic effects of the 2 groups were compared and analyzed. Results After operation, 2 patients relapsed in the experimental group, and the recurrence rate was 4.4％. In the control group, 6 patients relapsed. The recurrence rate (13.3％) in the control group was significantly higher than that in the experimental group, with statistical difference. After the corresponding treatment, the intraoperative blood loss in the experimental group was (10.23±1.52) mL, and the bleeding volume in the control group was (32.19±2.34) mL. The bleeding volume in the experimental group was significantly less than that in the control group, with statistical difference. In addition, the average length of stay, length of operation and length of incision in the experimental group were significantly better than those in the control group, with statistical difference. Conclusion The clinical effect of fluoroscopy guided lauromacrogol foam sclerosing agent in the treatment of varicose vein of lower limb is better, the recurrence rate is low, can significantly reduce the amount of bleeding, shorten operation time, has clinical significance.

Stump Ulcer Repairing in People Affected by Leprosy / 中国康复理论与实践

@#Objective To observe the effect of stump ulcer repairing in people affected by leprosy (PALs). Methods Bone shortening and osteophyte removal were performed in 73 PALs amputees with stump ulcers. Results All the incisions were healed without any delay. During a follow-up period of 3～12 years, no relapse or new ulcers were found in 70 PALs. 3 PALs developed new ulcers, which were healed after debridement, resting, and prosthesis repairing. Conclusion Surgical revision of the bone in amputation stump can change the local distribution of pressure. Postoperative self-care teaching to the PALs and their sustaining daily self-care will finally prevent them from stump ulcer recurring.

Psychological Status of the Leprosy People with Disabilities before Surgery / 中国康复理论与实践

@#Objective To investigate the psychological status of leprosy people with disability and their expectation towards surgical outcomes before surgical operation.Methods 937 cases from nine provinces，which were covered by the China National Commonweal funded surgical camps, were surveyed by a structure questionnaire designed by the Department of Leprosy Control and Rehabilitation, Institute of Dermatology, the Chinese Academy of Medical Sciences (CAMS).Results Reasons for the patients to refuse the surgical operation included concerns in medical cost (79.19%), unawareness of the free medical surgery program (64.78%), scaring of surgery (48.88%), unwilling to expose their disabilities (46.43%), unwilling to expose their history of leprosy (45.57%), despairing with disability (43.86%), having no ideas on surgical Results (37.46%), believing that disability is an inevitable outcome of the disease (32.98%), and rejecting the operation becasue of age(30.63%). More than 90% of PALs who are willing to accept surgery expected that surgery can improve their physical ability and they may contribute more to their family or become less independent after surgery; however, they thought there was little opportunity to return to work after surgery.Conclusion It is helpful and necessary to understand the psychological status of the leprosy people with disability before surgery.

How long can hair follicle units be preserved at 0 and 4 degrees C for delayed transplant?

BACKGROUND: Preservation of hair follicle units for the purpose of delayed transplant will help us graft thousands of hair grafts at one session, even in a clinic with fewer assistants and less equipment. OBJECTIVE: This study was undertaken to evaluate and compare the viability of hair follicle units preserved at 0 and 4 degrees C for various periods. MATERIALS AND METHODS: Cell cultures and transplant of hair follicle units into athymic mice were performed. RESULTS: Outer root sheath cells could be cultivated in 96% (0 degrees C group) and 92% (4 degrees C group) of the hair follicles after 24 hours of preservation, whereas 85% (0 degrees C group) and 79% (4 degrees C group) of the follicles implanted into the mice regrew well after the same period of preservation. Then, in both the 0 degrees C and the 4 degrees C group, these rates decreased significantly with length of preservation in cell cultures and mice transplant; however, 0 degrees C seems better than 4 degrees C for preservation of grafts (p<.05). CONCLUSION: Grafts are better preserved at 0 degrees C instead of 4 degrees C. When delayed transplant is an option, it should be completed within 24 hours and no later than 48 hours.

Rehabilitation awareness and needs in patients with disability due to leprosy / 中国康复理论与实践

@#ObjectiveTo determine the rehabilitation awareness and needs in patients with disability due to leprosy.Methods4353 patients in 23 fields of 7 provinces were surveyed by interview and questionnaire.Results80% of patients knew general knowledge of disability prevention and rehabilitation, and believed that the self-care could prevent disability; but they seldom carried out the daily self-care practice.90% of patients lacked awareness in early manifestation of leprosy, treatment of the disease, basic cause of disability, and the way to prevent such as plantar ulcers. For needs of rehabilitation education, teaching by medical staff(86%), booklet(81%), video tape(70%) and recording(52%) had been selected.ConclusionThe awareness of rehabilitation and the practice must be combined together. Rehabilitation education should be carried out in advance systemically through different ways.