Plastic surgery for costal chondritis after thoracotomy

To explore the surgical treatment technique for costal chondritis after thoracotomy.Methods For those with chondritis of a single rid,the involved costal cartilage is directly cut from the obvious pressure pain spot.For those with chondritis of many ribs,cut the ribs from the scar of thoracotomy.For those with chondritis in inferior chest and arcus costalis,make an incision at the median of chest,resect the infected costal cartilage along the arcus costalis,harvest the flap with superior pedicle to close the defects.For those with chondritis in stemoclavicular joint,remove the involved ribs and joints,make the pectoralis major musculocutaneous flap on one side of the chest,then transfer the flap to cover the defects.For all the patients,instillation and drainage are performed and antibiotics should be applied.Results All of the 7 patients show good results,the wounds healed completely after 2 weeks.Conclusion Thorough excision of the infected costal cartilage is an effective technique for the treatment of chondritis after thoracotomy.5 refs.

Treatment for long-term poorly closed incisions after hepatobiliary surgery

BACKGROUND: Effective measures are lacking to treat long-term poorly closed incisions after hepatobiliary surgery, including chronic sinus tract and keloid. This study aimed to introduce the treatment experiences with the abdominal wall and costal margin complications after hepatobiliary surgery, and to investigate the method for prevention of this kind of complication. METHODS: We retrospectively studied 26 patients with complications of abdominal wall and costal margin after hepatobiliary surgery, who had been admitted to our hospital since 1998. The 26 patients were classified according to complications into 3 groups: chronic ulcer with costal chondritis (5 patients), single chronic ulcer (3), and keloid (18). According to the symptoms of patients, treatments given included focal removal regional flap transfer restoration and focal removal dermatoplasty combined with glucocorticoid injection, anti-scar medication, external application of silicone gel film, and pressure therapy after surgery to inhibit recurrence. RESULTS: Satisfactory results were observed in the 26 patients after the treatments. Focal and regional ache and itching disappeared, and 2-3-year follow-up revealed no recurrence. CONCLUSIONS: Attention should be paid to patients with complications of abdominal wall and costal margin after hepatobiliary surgery. Combined treatment or mainly operations produce satisfactory result.

The surgical treatment of severely injured vagina

To investigate the surgical methods of treating severely injured vagina.Methods A retrospective study was carried out on the clinical materials and results of 7 patients suffered from severe vaginal injury.Results Different surgical approaches such as trans-suprapubic,transperineal or both approaches were applied according to the position of the atresia,meanwhile,different surgical methods such as skin graft,free flap transplantation,vaginal mucous flap advancement,direct anastomosis of the two ends,“Z” plasty was used to repair the vagina according to the different defect of the vagina,except for 1 cases complicated with vaginorecturs fistula,all the other cases were achieved satisfactory results.Conclusion The accurate judgment of the severity of the vaginal injury and the understanding of the changed anatomy around the injured vagina was the key points to the success of the surgical treatment of traumatic vaginal atresia.4 refs,3 figs,1 tab.

Application of autogenous nasal septal cartilage in the plasty of nasal tip and columella

Objective To evaluate the effect of anlogenous septal cartilage in repair of nasal tip and columella. Methods Nasal septal cartilage was transplanted between medial angles of greater alar cartilage at the nasal columella as a support,and a scutellate cartilage was transplanted to the nasal tip. Results All 108 cases were followed up for 1 ～ 2 years,they were satisfied with

Effects of mouse NIH3T3 cells transfected with VEGF gene on neovascularization of ischemic flaps

Objective To investigate the feasibility of applying NIH3T3 cells transfected by VEGF gene to the treatment of ischemic random skin flaps.Methods Plasmid PcDNA3.1（-）/VEGF165 containing VEGF gene was transduced into the mouse NIH3T3 cells by liposome.Immunohistochemistry was used to detect the expression of VEGF protein of mouse NIH/3T3 cells in vitro.The NIH3T3 cell were stained with CM-DiI before the transplantation.

Breast ptosis correction with a knitted polypropylene mesh

Objective To evaluate a knitted polypropylene mesh used for mammapexy in correcting the breast ptosis. Methods Twenty-one patients with the mild or moderate breast ptosis were undergoing the mammapexy with a knitted polypropylene mesh. The operation was performed through the periareolar incision and a monofilament knitted polypropylene mesh was subcutaneously implanted on the surface of the gland and fixed up-ward. Results All of the patients were satisfactory of the appearance with the follow-ups from 2 to 16 months. No secondary ptosis, hypemophic scars and foreign body reactions were found. Conclusion The above-mentioned technique could be a good, safe and reliable method for correcting breast ptosis. 13 refs,3 figs.

Autologous buccal mucosal graft for urethral reconstruction

Objective To search for a new method for urethra reconstruction using autologous buccal mucosal graft while lacking of local skin. Methods Since 1998, a total of 25 patients with complex hypospadias have been treated using buccal mucosal grafts for urethral reconstruction. The reconstructed urethra was anastomosed with the meatus half year later. Results All the reconstructed urethra survived without contracture or stricture except one infection, which healed with no adverse consequence. Conclusion The key points for operation success is rich capillary network, thick epidermis and thin lamina propria of the buccal mucosa. Buccal mucosa is an excellent tissue for urethral reconstruction. 5 refs,3 figs.

The neurovascular anatomy and its clinical implication of the rectus femoris muscle

Objective The objective of this anatomic study was to investigate the intramuscular neurovascular configuration and to evaluate whether the muscle could be split into two functinal units in transplantation. Methods Ten fresh cadavers and ten preserved cadavers were used in the study. A mixture of lead oxide, gelatin and water was injected to the femoral artery of the fresh cadaver. The rectus femoris musde with its neurovascular pedicles was dissected and radiographed. Results Three vascular patterns of the rectus femoris musde were found in the 40 cadaver legs. The musde received its blood supply through a single vascular pedicle (12.5% ),or a dominant pedide with 1-2 ramified(80%), or two dominant vascular pedicles(7.5%). Conclusion The study provided a detailed description on the intramuscular neurovascular teritories of the rectus femoris musde. Based on the neurovascular supply of the musde, it is possible to subdivide the musde into two functional units for segmental musde transfer. 11 refs,1 fig.

Treatment of soft tissue defects at the dorsum of hand by hand by retrograde isiand neurocutaneous flap pedicled with lateral antebrachial cutantous nerve

Objective To report the therapeutic effect of retrograde island neurocutaneous flap pedicled with lateral antebrachial cutaneous nerve for the treatment of soft tissue defect at the dorsum of hand,Methods 11 cases with soft tissue defects at the dorsum of hands were treated.

Local application of bFGF and sucralfate during continuous tissue expansion

Objective To investigate the effect of local application of bFGF and sucralfate during continuous tissue expansion (CTE). Methods CTE combined with local administration of bFGF and sucralfate was used in twelve patients with scar and nasal tip defects. Twenty three expanders were placed in the subcutaneous pockets through intralesion short incisions. Continuous expansion began at 1 - 3 days after expander implantation. The histomorphological changes and epidermal cell proliferation were observed. The clinical results were investigated. Results The average inflation time was 8.9 days. The average interval of the two operating was 13.5 days. The average hospitalization was 28.4 days. The average immediate stretch-back rate of the expanded skin was 25. 7%. The clincal results were satisfactory without any complications. Histolcgical examinations showed that the epidermal, granular and spinous layer became thicker. The basal cells increased significantly. The dermis thinned slightly and the collagen

Fabrication of a Mood vessel scaffold with a combined polymer for tissue enginerring

Objective To investigate the possibility to fabricate a blood vessel scaffold with a combined polymer for tissue engineering. Methods A blood vessel scaffold was designed with a combined polymer composed of rabbit vascular smooth muscle cells ( VSMCs), collagen and a non-spinning fabric mesh of polyglycolic acid(PGA). VSMQ were implanted into collagen gel and their growth was observed. The mixed solution of VSMQ and collagen was dropped into the tubular scaffold, followed by 7-day culturing. Results VSMQ formed many prominences after culturing in gelatinous collagen for 3 - 4 hours. With cells extending, some cells became shuttle-or spindle-shaped. After VSMQ-collagen complex was implanted into the PGA mesh, most of VSMCs remained in the pore of PGA mesh with the formation of gelation. VSMCs could adhere to and grow on the PGA fiber. Conclusion The non-spinning PGA porous biodegradable material coated with collagen is a good carrier for VSMCs to adhere and grow. 5 refs,3 figs.

Systemic influece after an island flap with venous congestin-reperfusion injury

Objective To investigate the systemic influence after an island flap with venous congestion-reperfusion. Methods An island flap was formed in a Rat model. The vein in the pedicle was clamped for 2 hours,6 hours and 10 hours and released. The ear microcirculation, levels of TNFα and IL-10 were measured, and the neutrophils sequestration in tissues were counted. The vascular structure of the lung and intestine were evaluated Results There were significant changes in the ear microcirculation, neutrophils sequestration of the lung and the intestine in the 2 hours, 6 hours and 10 hours groups, and became more serious by the time increasing. The TNFα level reached in maximum at 1 hour after the reperfusion, while the IL- 10 became to the lowest level at 3 hours after the reperfusion. However, the TNFa and IL -10 levels were significant high in the 6 hour and 10 hours groups, compared with the 2 hours group and the control, but there was no difference between the 2 hours group and the control. Conclusion

Intro-extro carnial approach treatment serious post fronto-orbital fracture deformities

Objective To explore the method of treating serious secondary fronto-orbital fracture deformities through intro-extra cranial approach. Methods The fronto-orbital fracture was divided into two types according to whether there were any large scale fronto-otbital bone defects; typeⅠ: Large scale fronto-orbital bone defect; type Ⅱ: Concave fronto-orbital fracture deformity without large scale bone defect. Both types were treated throuth intro-extra cranial approach to expose the fracture site. For typel deformity, the bone defects were repaired and reconstructed with outer table of cranial bone and artificial bone. For type Ⅱ, the deformity was repaired by osteotomy, bone reposition and internal rigid fixation. Results 18 cases were treated from June 1998 to October 2000, include typeⅠ, 12 cases, and typeⅡ, 6 cases. All the patients recovered well and the post-operative appearance were greatly improved. Conclusion Intro-extra cranial approach can June 2003 Vol12 No2 expose the fractured site better

Effects of tobacco extract on adhesion and proliferation of human osteoblasts on titanium implants

Objective To investigate effect of smokingless tobacco extract ( ST) on number,adhesion,morphology and proliferation of human osteoblasts on titanium implants in vitro. Methods Human osteoblasts on titanium implants were cultured in presence of ST at various concentrations. The morphologic changes of osteoblasts

The mutation study of the FOXL2 gene in a big Chinese family with blepharophimosis-ptosis-epicanthus inversus syndrome

Objective We have studied 4 generations 12 patients in a family which has blepharophimosis-ptosis-epicanthus-inversus syndrome （BPES） for the gene,FOXL2,the group also have 12 normal members in this family and other 80 normal individuals for contrast.Methods The FOXL2 gene was amplified by polymerase chain reaction and then analyzed by direct genomic sequencing.

Repairing of upper cicatricial ectropion with orbicularis oculi myocutancous flap in construction of double eyelid

Objective To investigate a method for upper cicatricial ectropion correction using a rotated orbicularis oculi myocutaneous flap in the unsatisfied pre-operative construction of double eyelid.Methods In construction of double eyelid,orbicularis oculi myocutaneous flap made by relaxed skin and orbicularis oculi was used to correct ectropion.

Clinical application of dorsal carpometacarpal reversed island flap with dorsal metacarpal nerve to reconstruct finger

To investigate the clinical effect of dorsal carpometacarpal reversed island flap with dorsal metacarpal nerve to reconstruct finger.Methods We designed the dorsal reverse carpal and metacarpal island flaps with nerve by using the adjacent two dorsal matacarpal arteries as blood-supply and applied the stand of bone and tendon in waste finger or the free iliac transplantation to reconstruct the every sensory finger.Results Eighten cases were survived completely,and the skin degloving injuries of the finger in 3 cases.The maximum of the flap was 9 cm by 8 cm.Patients were followed up 3 months to 2 years,7 weeks later pain sense of reconstructed finger was recovered.Sensation over S3 amounts to 89% of the digits.Two-point-discrimination of the digits was 5～10 mm.After the operation,the reconstructed finger obtained good appearance,the sensory recovery approach normally.The patients have ability to fulfil daily activities.Conclusion This methods has advantages as follow:simple and practical,high survival rate,low impairment,sensible and good appearance.7 refs,3 figs.

The design and transposition principles of expanded flap for treatment of cheek skin-soft tissue defect

Objective To explore an ideal method for repairing the skin-soft tissue defects according to the different anatomical units of cheek, and find reasonable design principles to transfer the expanded flaps. Methods Acoording to the location of the defect, we placed 1-3 appropriate expanders nearby, when the flap expanded enough we adopted advanced skin flaps,

Experimental study of gene transfer of insnlin-like growth factor Ⅰ on wound healing of scald rats

Objective To probe into the effect of IGF-I gene transfer on wound healing of scald rats.Methods Eukaryotic recombinant plasmid of pcDNA3.1/IGF-I （successfully constructed by our study group earlier） transported by liposome were injected subdermally in wound region of scald rats.Changes of body weight and tendency of wound healing were observed carefully with in 5 weeks postburn.

Reverse flap based on the end dorsal branches of the digital artery

Objective To introduce the treatment outcome of the reverse flap of the end dorsal branches of the digital artery for coverage of fingertip soft tissue loss and exposed digital bone. Methods The reverse flap from the dorsal of the middle phalanx was harvested for coverage of the distal phalanx for 5 cases. Results All cases survived completely and had a satisfactory appearance. Conclusion The procedure was one of the pedicled flaps named with the finest vascular branches presently. It can avoid injury of the digital proper artery with simple procedure. 8 refs.