术后遗留的瘢痕,尤其是位于面部、颈部等明显部位时,会给患者带来外貌焦虑和心理负担,因此预防术后切口瘢痕增生是整形外科医师需要探索攻克的难点。近年来,A型肉毒毒素(botulinum toxin type A, BTXA)在预防瘢痕增生方面得到广泛应用...术后遗留的瘢痕,尤其是位于面部、颈部等明显部位时,会给患者带来外貌焦虑和心理负担,因此预防术后切口瘢痕增生是整形外科医师需要探索攻克的难点。近年来,A型肉毒毒素(botulinum toxin type A, BTXA)在预防瘢痕增生方面得到广泛应用。现就BTXA在面部手术切口瘢痕增生的预防机制、临床有效性和安全性作一综述,为其在术后瘢痕预防中的临床应用提供参考。展开更多
Objective： To determine the efficacy of polylactic acid glue in preventing epidural scar adhesion after laminectomy in rabbits. Methods： Twenty-four Japanese white rabbits underwent laminectomy （including the atta...Objective： To determine the efficacy of polylactic acid glue in preventing epidural scar adhesion after laminectomy in rabbits. Methods： Twenty-four Japanese white rabbits underwent laminectomy （including the attached ligaments） at Lz and Ls. After laminectomy at Ls, polylactic acid glue was sprayed on the dura and nerve roots and this segment was taken as the experimental group. After laminectomy at Lz, nothing was used and this segment was enrolled as the self control group. Four rabbits were killed every two weeks postoperatively till the end of the experiment at 12 weeks. Then the operated spine was observed grossly, histologically and ultrastructurally to check the degree of scar formation, the status of epidural scar adhesion, the absorption of the glue, and the intraceHular structure of fibroblasts. Results： The glue coagulated immediately after spraying and showed excellent hemostatic effect. The glue membrane was easy to be taken away from the dura mater of the samples for 2 weeks and there were no cells in the epidural space in the experimental group. But the dura mater was covered by hematoma in the control group,which formed mild adhesion, with fibroblasts proliferating actively. In the 4th week, some glue shivers remained in the epidural space with fibroblasts increasing a little, and the dura mater was smooth in the experimental group. However, in the control group, the formed scar was fragile and conglutinated with the dura mater diffusely and fibroblasts were much more than those in the experimental group. In the 6th-12th weeks, there was a potential interspace between the scar and the dura mater, and the polylactic acid glue was absorbed completely in the experimental group. Much tough scar was found in the control group, which was very difficult to dissect from the dura mater and the surrounding tissues. From the ultrastructural observation of the fibroblasts, the nucleus became much bigger and the rough endoplasmic reticulum was much more plentiful in the control group than that in the experimental group. Conclusions： Polylactic acid glue can effectively reduce epidural cicatrization and adhesion.展开更多
文摘术后遗留的瘢痕,尤其是位于面部、颈部等明显部位时,会给患者带来外貌焦虑和心理负担,因此预防术后切口瘢痕增生是整形外科医师需要探索攻克的难点。近年来,A型肉毒毒素(botulinum toxin type A, BTXA)在预防瘢痕增生方面得到广泛应用。现就BTXA在面部手术切口瘢痕增生的预防机制、临床有效性和安全性作一综述,为其在术后瘢痕预防中的临床应用提供参考。
文摘Objective： To determine the efficacy of polylactic acid glue in preventing epidural scar adhesion after laminectomy in rabbits. Methods： Twenty-four Japanese white rabbits underwent laminectomy （including the attached ligaments） at Lz and Ls. After laminectomy at Ls, polylactic acid glue was sprayed on the dura and nerve roots and this segment was taken as the experimental group. After laminectomy at Lz, nothing was used and this segment was enrolled as the self control group. Four rabbits were killed every two weeks postoperatively till the end of the experiment at 12 weeks. Then the operated spine was observed grossly, histologically and ultrastructurally to check the degree of scar formation, the status of epidural scar adhesion, the absorption of the glue, and the intraceHular structure of fibroblasts. Results： The glue coagulated immediately after spraying and showed excellent hemostatic effect. The glue membrane was easy to be taken away from the dura mater of the samples for 2 weeks and there were no cells in the epidural space in the experimental group. But the dura mater was covered by hematoma in the control group,which formed mild adhesion, with fibroblasts proliferating actively. In the 4th week, some glue shivers remained in the epidural space with fibroblasts increasing a little, and the dura mater was smooth in the experimental group. However, in the control group, the formed scar was fragile and conglutinated with the dura mater diffusely and fibroblasts were much more than those in the experimental group. In the 6th-12th weeks, there was a potential interspace between the scar and the dura mater, and the polylactic acid glue was absorbed completely in the experimental group. Much tough scar was found in the control group, which was very difficult to dissect from the dura mater and the surrounding tissues. From the ultrastructural observation of the fibroblasts, the nucleus became much bigger and the rough endoplasmic reticulum was much more plentiful in the control group than that in the experimental group. Conclusions： Polylactic acid glue can effectively reduce epidural cicatrization and adhesion.
