Objective To investigate the anatomic basis of the temporal flap pedicled with the orbicularis oculi muscle. Methods The morphology and the blood supply of the orbicularis oculi muscle were studied on 15 cadavers by surgical dissection and vascular cast.Using digital subtraction angiography (DSA),we observed the branches of the superficial temporal artery in 15 patients.The data was then analysed by the computed image analysis system. Results The orbicularis oculi muscle was wide and thin and located superficially.It was supplied by the branches of many arteries and the branches have numerous connections with the branches of superficial temporal artery.The position of the zygomaticoorbital artery was unvaried .The diameter of the artery was up to 1.0 mm. Conclusion Zygomaticoorbital artery is the most important vessel for the temporal flap pedicled with the orbicularis oculi muscle.

AIM:To observe the postoperative effect of the application of expanded artery island skin flap on the treatment of injuries of face.METHODS:Totally 20 patients,who were treated with expanded artery island flap transplantation for face injury at Cosmetic and Plastic Institute,Weifang Medical College,were selected between January 1997 and September 2004.Patients knew the trial and agreed to participate in it.All patients received two phases operation:During the first period of the treatment,according to the different characteristics and requirements of the patients,suitable expander was implanted and water was input regularly.During the second period,the expanded island skin flap was used to cure the injuries on the face or do organ reconstruction.The skin flap was 2.5 cm? 3.5 cm-5.0 cm?7.5 cm,and vessel pedicle was 12.5 cm at most.Follow up was done regularly after operation.RESULTS:A total of 20 patients were involved in the result analysis,no drop out.Follow-up was done for 6-24 months in 20 patients.There were 4 cases of at least 6 months and less than 12 months,7 cases of at least 12 months and less than 18 months,9 cases of at least 18 months and less than 24 months.After expandor implantation in the first period,the expanded skin received skin repair or organ reconstruction in the second period.The healing of the injuries was good and scars of the skin and organ displacement were not clearly seen.Their function was recovered well and shape was ameliorated.CONCLUSION:The expanded island skin flap can provide comparatively large-region flap and long vessel pedicle to increase the angle and flexibility of flap rotation,and make the repair looks closer to the normal area.

Lipedema is secondary to local fat deposition, a disease characterized by the symmetric thickening of lower limbs, mostly occurs in women, especially in adolescence and pregnancy. In its early stage, it could be easily confused with lymphedema. Extensive literature review on primary fat edema in recent years, as well as a summary of the clinical symptoms and signs and diagnosis and treatment of lipedema were conducted, so as to provide a useful reference for clinicians.

Objective To explore the effect of adipose-derived stem cells (ASCs) on the skin expansion rate in rabbit.Methods The rabbit ASCs were isolated from fat tissue and cultured in vitro.The ADSCs were identified by cell immunofluorescence and marked by Edu staining.20 new Zealand rabbits were randomly divided into experimental(n =10) and control group(n =10).An area of 1.5 cm ×1.5 cm on the one side back of each rabbit was tattooed and one 30 ml round expander was implanted subcutaneously.ASCs suspension (1 ml) was injected subcutaneously in the experimental group,while serum free DMEM medium(1 ml) in control group.The expansion was proceeded regularly under constant pressure for 4 weeks.The expanded tattooed square area was measured on the 7th,14th,28th day and analyzed statistically.The expanded skin was harvested for histological study.Immunohistochemical staining was used to detect the expression of vascular endothelial cell marker CD31,and the microvessel density determination.The expression of epidermal growth factor (EGF) and vascular endothelial growth factor(VEGF)was detected by ELISA for skin tissue specificity.Western Blot was used for detection of CK19 in the epidermal cells.Results The expanded skin thickness and expansion rate in experimental group were significant higher than those in control group (P ＜ 0.05).Compared with control group,the expression of CK19,CD31 and EGF,VEGF,as well as the microvessel density were all markedly increased in experimental group(P ＜0.05).Conclusions ASCs can increase the expansion rate of skin tissue by promotion of angiogenesis and tissue regeneration.

Objective To explore the effect of adipose-derived stem cells (ASCs) on the skin expansion rate in rabbit.Methods The rabbit ASCs were isolated from fat tissue and cultured in vitro.The ADSCs were identified by cell immunofluorescence and marked by Edu staining.20 new Zealand rabbits were randomly divided into experimental(n =10) and control group(n =10).An area of 1.5 cm ×1.5 cm on the one side back of each rabbit was tattooed and one 30 ml round expander was implanted subcutaneously.ASCs suspension (1 ml) was injected subcutaneously in the experimental group,while serum free DMEM medium(1 ml) in control group.The expansion was proceeded regularly under constant pressure for 4 weeks.The expanded tattooed square area was measured on the 7th,14th,28th day and analyzed statistically.The expanded skin was harvested for histological study.Immunohistochemical staining was used to detect the expression of vascular endothelial cell marker CD31,and the microvessel density determination.The expression of epidermal growth factor (EGF) and vascular endothelial growth factor(VEGF)was detected by ELISA for skin tissue specificity.Western Blot was used for detection of CK19 in the epidermal cells.Results The expanded skin thickness and expansion rate in experimental group were significant higher than those in control group (P ＜ 0.05).Compared with control group,the expression of CK19,CD31 and EGF,VEGF,as well as the microvessel density were all markedly increased in experimental group(P ＜0.05).Conclusions ASCs can increase the expansion rate of skin tissue by promotion of angiogenesis and tissue regeneration.

Objective To investigate the effects of local injection of rabbit adipose-derived mesenchymal stem cells (ADSCs) on the healing of skin deep partial-thickness scald wound of rabbit.Methods ADSCs were isolated from adipose tissue of one New Zealand rabbit and then sub-cultured.ADSCs of the third passage were used in the following experiments.Twenty-four rabbits were divided into ADSCs group (n =12) and control group (n =12) according to the random number table,and one deep partial-thickness scald wound with diameter of 5 cm on the two sides of the back near the buttocks was made.From post injury day (PID) 2,2 mL suspension of EdU-labeled ADSCs with the number of 5 × 105 per mL was subcutaneously injected in wounds of rabbits in ADSCs group,while the rabbits in control group were given 2 mL serum-free DMEM until the wounds were healed.Wound healing processes of rabbits in two groups were observed every day,and the healing time was recorded.On PID 7,14,21,and 28,areas of wound of three rabbits in two groups were measured and the healing rates were calculated,respectively.The healed wound tissue was harvested to observe the morphology by HE staining,and the expression of collagen fiber was observed by Masson staining.The distribution of EdU-labeled ADSCs in healed wound tissue on PID 28 was observed by inverted fluorescence microscope.The expressions of vascular endothelial growth factor (VEGF) and epidermal growth factor (EGF) of healed wound tissue on PID 7,14,and 21 were detected by enzymelinked immunosorbent assay.Data were processed with analysis of variance of factorial design and paired samples t test.Results (1) The wound healing time of rabbits in ADSCs group was (19.5 ± 1.1) d post injury,which was significantly shorter than that in control group [(23.3 ± 1.5) d,t =4.50,P ＜ 0.05].On PID 7,wounds of rabbits in two groups were dry with no obvious exudation,and redness and swelling around wounds disappeared gradually,the wound healing rate of rabbits in ADSCs group was (15.1 ± 2.4)％,which was close to that in control group [(13.7±3.1)％,t =1.20,P ＞0.05].On PID 14,wounds of rabbits in ADSCs group were dry and scabbed obviously,and the wound healing rate was (73.1 ± 5.7) ％,while wounds of rabbits in control group were little scabbed with little exudation,and the wound healing rate was significantly lower than that in ADSCs group [(52.9 ± 5.1)％,t =8.06,P ＜ 0.01].On PID 21,wounds of rabbits in ADSCs group were generally healed,and the wound healing rate was (95.6 ± 3.0) ％,while a few wounds still existed in rabbits of control group,and the wound healing rate was significantly lower than that inADSCs group [(78.6±3.7)％,t =9.73,P ＜0.01].On PID 28,wounds of rabbits in two groups were totally healed with the healing rate of 100％,and texture and microvascular responses of healed wound tissue in ADSCs group were better than those in control group.(2) On PID 7,fibroblasts in healed wound tissue of rabbits in two groups were all increased,and there were little vascular and collagen fiber proliferation with no obvious differences.On PID 14,the number of fibroblasts in healed wound tissue of rabbits in ADSCs group was more than that in control group,and the collagen fibers in healed wound tissue of rabbits in ADSCs group were arranged in dense and uniform,while those in control group were sparse and irregular.On PID 21,skin layers were differentiated in healed wound tissue of rabbits in two groups,and collagen fibers in healed wound tissue of rabbits in ADSCs group were still denser than that in control group.On PID 28,newborn skin was well differentiated in healed wound tissue of rabbits in ADSCs group,which was better than that in control group.There were a lot of thick collagen fibers in healed wound tissue of rabbits in two groups,and EdU-labeled ADSCs were involved in skin texture of rabbits in ADSCs group.(3) The expressions of VEGF and EGF in healed wound tissue of rabbits in two groups were similar on PID 7 (with t values respectively 0.70 and 0.91,P values above 0.05),which in ADSCs group were significantly higher than those in control group on PID 14 and 21 (with t values from 2.85 to 4.81,P values below 0.01).Conclusions The transplantation of ADSCs can promote the wound healing of skin deep partial-thickness scald wound of rabbit and shorten the wound healing time.