Aim:Traditional donor site closure from radial forearm free flap(RFFF)has been associated with esthetic and functional morbidity.To avoid complications,such as color mismatch and secondary donor site morbidity,a new t...Aim:Traditional donor site closure from radial forearm free flap(RFFF)has been associated with esthetic and functional morbidity.To avoid complications,such as color mismatch and secondary donor site morbidity,a new technique named‘‘Iberic graft’’for covering the RFFF donor site was described previously by our team.Methods:A study of patients who underwent reconstruction of head and neck defects using a RFFF was conducted to assess postoperative complications of the RFFF donor site and also to evaluate the morbidity in terms of aesthetics and function following the use of the“Iberic graft”.The donor site was covered by the use of a combined local triangular full-thickness skin graft.Color match,quality of the scar,presence of necrosis,dehiscence of the suture or tendon exposure were recorded and analyzed.Results:One hundred and twenty-five consecutive patients undergoing RFFF harvesting were included.RFFF donor site defects ranged from 15 cm2 to 70 cm2;9 patients(7%)had small dehiscences of the forearm skin graft,whereas 2 cases(1.6%)presented tendon exposure.Otherwise,partial skin graft loss occurred in a few patients.In all cases,these sites healed secondarily by conservative management,with no final impairment of function.Assessment of the forearm donor site at 1 to 3 months after the primary surgical procedure showed complete defect coverage,good color match,and no scarring along the graft line.Conclusion:The“Iberic graft”is a reliable method for closing most of RFFF donor site defects as it provides excellent color match and pliability,while obviates the need for a second surgical site.展开更多
目的:通过模拟皮肤损伤修复过程中局部微环境的变化,了解脂肪来源干细胞(adi pose t i ssue deri ved st em,cAeSCl)l的表型改变对细胞功能的影响。方法:由手术废弃皮肤和脂肪组织获取实验所需细胞,并培养扩增。对不同传代数的ASC细胞...目的:通过模拟皮肤损伤修复过程中局部微环境的变化,了解脂肪来源干细胞(adi pose t i ssue deri ved st em,cAeSCl)l的表型改变对细胞功能的影响。方法:由手术废弃皮肤和脂肪组织获取实验所需细胞,并培养扩增。对不同传代数的ASC细胞进行脂肪细胞诱导分化,了解细胞的可诱导分化性能;构建ASC细胞-胶原凝胶,贴壁或悬浮培养,对ASC凝胶进行α-SMA免疫组化染色;培养基中添加TGF-β1,观察TGF-β1对ASC细胞表型和可诱导分化能力的影响;收集培养上清液,El i sa法测定比较成纤维细胞和ASC细胞的细胞生长因子分泌水平,以及经TGF-β1作用,ASC细胞表型发生变化后细胞生长因子分泌水平的变化。结果:ASC细胞可以多次传代,仍保持较好的可诱导分化特性;在培养过程中,张力和TGF-β1可以使ASC获得α-SMA阳性表型;ASC细胞相比成纤维细胞,有较高的VEGF和KGF分泌水平,但TGF-β1分泌水平极低(未测到),获得α-SMA阳性表型的ASC细胞的VEGF分泌水平继续大幅上升,而且也分泌了较高水平的TGF-β1。结论:ASC细胞在创伤局部环境的刺激下或经体外人工诱导,可以产生更有利于创伤愈合的表型。对ASC细胞特性的了解和调控,将有利于ASC细胞在组织修复再生方面的应用。展开更多
文摘Aim:Traditional donor site closure from radial forearm free flap(RFFF)has been associated with esthetic and functional morbidity.To avoid complications,such as color mismatch and secondary donor site morbidity,a new technique named‘‘Iberic graft’’for covering the RFFF donor site was described previously by our team.Methods:A study of patients who underwent reconstruction of head and neck defects using a RFFF was conducted to assess postoperative complications of the RFFF donor site and also to evaluate the morbidity in terms of aesthetics and function following the use of the“Iberic graft”.The donor site was covered by the use of a combined local triangular full-thickness skin graft.Color match,quality of the scar,presence of necrosis,dehiscence of the suture or tendon exposure were recorded and analyzed.Results:One hundred and twenty-five consecutive patients undergoing RFFF harvesting were included.RFFF donor site defects ranged from 15 cm2 to 70 cm2;9 patients(7%)had small dehiscences of the forearm skin graft,whereas 2 cases(1.6%)presented tendon exposure.Otherwise,partial skin graft loss occurred in a few patients.In all cases,these sites healed secondarily by conservative management,with no final impairment of function.Assessment of the forearm donor site at 1 to 3 months after the primary surgical procedure showed complete defect coverage,good color match,and no scarring along the graft line.Conclusion:The“Iberic graft”is a reliable method for closing most of RFFF donor site defects as it provides excellent color match and pliability,while obviates the need for a second surgical site.
文摘目的:通过模拟皮肤损伤修复过程中局部微环境的变化,了解脂肪来源干细胞(adi pose t i ssue deri ved st em,cAeSCl)l的表型改变对细胞功能的影响。方法:由手术废弃皮肤和脂肪组织获取实验所需细胞,并培养扩增。对不同传代数的ASC细胞进行脂肪细胞诱导分化,了解细胞的可诱导分化性能;构建ASC细胞-胶原凝胶,贴壁或悬浮培养,对ASC凝胶进行α-SMA免疫组化染色;培养基中添加TGF-β1,观察TGF-β1对ASC细胞表型和可诱导分化能力的影响;收集培养上清液,El i sa法测定比较成纤维细胞和ASC细胞的细胞生长因子分泌水平,以及经TGF-β1作用,ASC细胞表型发生变化后细胞生长因子分泌水平的变化。结果:ASC细胞可以多次传代,仍保持较好的可诱导分化特性;在培养过程中,张力和TGF-β1可以使ASC获得α-SMA阳性表型;ASC细胞相比成纤维细胞,有较高的VEGF和KGF分泌水平,但TGF-β1分泌水平极低(未测到),获得α-SMA阳性表型的ASC细胞的VEGF分泌水平继续大幅上升,而且也分泌了较高水平的TGF-β1。结论:ASC细胞在创伤局部环境的刺激下或经体外人工诱导,可以产生更有利于创伤愈合的表型。对ASC细胞特性的了解和调控,将有利于ASC细胞在组织修复再生方面的应用。
