[Clinical application of prefabricated super-thin perforator flaps after expansion in the reconstruction of facial and cervical scar].

OBJECTIVE: To explore a combined application of tissue expansion, perforator flaps and super-thin flaps in reconstruction of extensive face and neck scars. METHODS: In the first stage, the position and course of the perforators were confirmed with the multi-detector computed tomography ( MDCT) and color Doppler ultrasound. The expanders were implanted between subdermal vascular plexus and superficial fascia. In the second stage, the expanded super-thin perforator flaps were transferred to resurface the extensive defects and deformities in the face and neck. RESULTS: 26 cases with extensive facial and cervical scars were included in this study. Except for one case with necrosis at the distal end, the other 25 flaps survived completely. The maximum flap size was 35 cm x 10 cm with a pedicle of 8 cm x 4 cm. Long-term follow-up showed that this combined application provided thinner flap than the conventional pre-expanded flap, thus avoiding secondary flap debulking and revisions. All the patients got improvement in contours, facial features and emotional expression. CONCLUSIONS: The combined application of tissue expansion, perforator flaps and super-thin flaps is a practical method which has advantages in feature recontouring and recovery of delicate emotions in reconstruction of extensive face and neck scars.

[The use of diammonium glycyrrhizinate in the treatment of hepatic dysfunction in burn patients].

OBJECTIVE: To observe the protective effect of diammonium glycyrrhizinate on hepatic function in burn patients. METHODS: Twenty burn patients with hepatic dysfunction were enrolled in the study and were randomly divided into 2 groups, i. e. treatment (T, n = 10, with conventional treatment and intravenous infusion of 150 mg diammonium glycyrrhizinate per day for 14 days), and control (C, n = 10, with conventional treatment) groups. The blood samples in both groups were collected before and 7 and 15 days after the treatment. The serum contents of ALT, AST, GGT, ALP and PA in the blood samples were determined and analyzed comparatively. RESULTS: There was obvious difference in the serum contents of ALT, AST, GGT, ALP and PA in the T group before treatment (168 +/- 46 U/L, 104 +/- 29 U/L, 162 +/- 37 U/L, 149 +/- 17 U/L, 310 +/- 35 mg/L, respectively) and 15 days after treatment (51 +/- 9 U/L, 31 +/- 3 U/L, 56 +/- 10 U/L, 103 +/- 9 U/L, 372 +/- 44 mg/L, respectively, P < 0.05). There was no difference in these indices in the C group before and after treatment (P > 0.05). CONCLUSION: Diammonium glycyrrhizinate seemed to be beneficial to the management of postburn hepatic dysfunction with obvious rapid depression of hepatic enzymes.