Objective To investigate the clinical effects of surgical treatment for varied types of cicatricial blepharon deformities. Methods Eleven patients (16 eyes) suffering from cicatricial blepharon deformities underwent surgical procedures. 4 cases (7 eyes) were treated with free skin flap transfer; 1 case with free skin flap transfer and amniotic membrane grafting, 2 cases with Z plasty; 1 case with pedicled skin flap; 1 case with orbicularis oculi musculocutaneous flap; 1 case (2 eyes) with wedged tarsal excision and blepharoplasty, and 1 case with allografe of keratoconjunctiva and reconstraction of conjunctival sac. Results All of 11 cases (16 eyes) showed satisfactory appearance and eyelid function to certain extent after operations. Conclusion The repair of skin defect and conjunctival sac integrality is the key step in correction of cicatricial blepharon deformities, which may offer good eyelid position and function.

Objective To seek new skin flap donor sites beyond face to repair deformity of nose. Methods Seven patients underwent reconstruction of nasal tips and columellae with dorsal forefinger sk in flap based on proper palmar digital artery and reverse forearm skin flap base d on tiny cutaneous branches of radial artery. Results Al l flaps survived. Similar external appearance in color and texture compared with adjacent normal skin was achieved for 1～4 years follow-up. Conclus i on Remarkable advantage without second deformity in face is archeive d due to contribution of skin flap. These two methods of correction can be more acceptible by patients than usual ones.

OBJECTIVE: To explore the effect of reparation and restitution of head tissue deletion with autologous fascia lata and local flap. METHOD: The clinical data of 8 cases with scalp squamous celled carcinoma from 2003 to 2010 were summarized retrospectively. All patients carcinoma were removed almost, cerebral dura mater deletion and skin deletion from 5 cm to 15 cm, repaired cerebral dura mater with autologou fascia lata; and restitution scalp with local flap, the area of local flap were planted with free skin graft. RESULT: The outcomes of the treatment with fascia lata were very well, and the local flap of all cases were survival the free skin graft were survival from 85% to 100%. There was no leakage of cerebrospinal fluid or intracranial infection during follow-up. CONCLUSION The method of repairation and reconstruction of head tissue deletion with fascia lata and local flap is effective, the out comes are satisfying.
Carcinoma, Squamous Cell ; surgery ; Dura Mater ; surgery ; Fascia Lata ; transplantation ; Female ; Head and Neck Neoplasms ; surgery ; Humans ; Male ; Retrospective Studies ; Scalp ; surgery ; Skin Neoplasms ; surgery ; Skin Transplantation ; Surgical Flaps ; transplantation ; Treatment Outcome

Objective Island scapular flap (ISF) based on transverse branch of circumflex scapular artery is less reported than ISF based on ascending or descending branch. This article presented authors' experiences in correction of severe axillary burn scar contracture with ISF based transverse branch of circumflex scapular artery. Methods ISFs based transverse branch was harvested in 12 patients with 15 severe axillary burn scar contracture, rotating an arc of about 180°. Flap size was between 12 cm× 5cm to 20 cm × 10 cm. The donor site was closed primarily. Results All 15 flaps survived completely and axillary burn scar contracture was corrected successfully. 8 patients were satisfied with both the functional and aesthetic results after 1-3 years' follow-up. Conclusion ISF based transverse branch of circumflex scapular artery is a good choice for reconstruction of severe axillary burn scar contracture, especially for female patients or ones whose ISF based on ascending or descending branch could not be harvested because of formation of hypertrophic scar in donor site.

Objective To analyze the curative effect of super-early keyhole surgery in treatment of hypertensive cerebral hemorrhage. Methods Clinical data of patients with hypertensive cerebral hemorrhage who received treatment in our hospital from April 2010 to October 2012 were retrospectively analyzed. Patients were divided into the observation group ( keyhole surgery group) and the control group ( routine group) by different therapeutic methods. The operation time, rate of hematoma clearance, postoperative complications, and recovery of neu-ral function of the two groups were compared. Results The observation group had a shorter operation time than the control group, and the difference was statistically significant(P<0. 001). There was no singnificant difference between the two groups in rate of hematoma clear-ance at the time of tube drawing(P>0. 05). The observation group had less postoperative complications than the control group, and the difference was statistically significant(P<0. 05). The observation group had a lower rate of metabolic disorders than the control group with a statistically significant difference(P<0. 05). Patients of the observation group had a higher scores of SSS than patients of the control group 28 days after operation, and the difference was statistically significant(P<0. 05). 6 months after operation, the observation group had a bet-ter ADL than the control group, and the difference was statistically significant(P<0. 05). Conclusion Super-early keyhole surgery which has less intraoperative injury, postoperative complication, and metabolic disorders, can achieve a better effect than routine operation. And it is of better neural functional recovery.

Objective To prepare porcine acellular dermal matrix(PADM) without cytotoxicity,to evaluate its biological safety,and investigate its end result in vivo.Methods A piece of porcine split-thickness skin of 0.3-0.4mm was obtained,the epidermis was removed by hypertonic saline immersion,and then the skin was immersed in sodium hydroxide solution,and dermal cells were removed by shaking water bath at normal temperature to harvest PADM.After cross-linking and sterilization,bacteria and porcine virus were examined in the PADM.The PADM were embedded beneath the Sprague-Dawley(SD) rat's skin,and then the general and histological changes were observed after transplantation.Result The obtained PADM was soft and elastic,easy to be moulded,and convenient for operation.No cellular component was found in PADM,the collagen was regularly arranged and elastic fibers were abundant.Bacteria and virus examination of all specimens was negative.No immunologic rejection of PADM was found after being embedded beneath the skin of SD rat.The PADM adhered to the wound firmly,and it was difficult to detach 3 weeks after implantation,and the general structures of PADM beneath rat skin were discernible 24 weeks after implantation.The PADM was infiltrated by inflammatory cells in the early stage,fibroblasts and capillary vessels increased in number along with the time,and collagen fibers gradually gained a regular and compact arrangement in PADM.Conclusions The PADM prepared by hypertonic saline/sodium hydroxide method is a simple preparation process,and there is no cytotoxicity.It has a high biological safety and can be used as dermal scaffold with long-term existence in vivo.

Objective To explore a method of large cranial bone defect reconstructed by titanium implant with computer aided design(CAD)/computer aided manufacture(CAM)technique.Methods From April 2006 to June 2008,7 cases of cranial bone defect due to tumor and trauma were admitted.The data of skull bone defects were obtained by CT.The resin model was designed and manufactured with rapid prototyping technique.Results The CT data could be used by image software directly.The resin model was manufactured accurately by RP technique.The titanium implant design could be completed by CAD/CAM.7 patients achieved one stage healing.After a follow-up of 6 months to 1 year,cranial bone defect was reconstructed satisfactorily.Conclusion Individual design and repair of large cranial bone defect with CAD/CAM technique is worth extending application clinically.It is a quite ideal and very simple method for the surgical treatment of the cranial bone defect.

Objective To explore a method for repairing the appearance and function of the cheek aesthetic unit.Methods A single volume of 100 ml to 150 ml of tissue expander was implanted at the lower edge of the injury area on the cheek.The first injection was performed 5 days after the operation and twice a week after the injection.It took an average of about 4 months to complete the expansion,with 3-5 times over expanded.The lesions were resurfaced with the expanded flaps,and long term follow-up was observed for flap survival.Results 17 cases of cheek lesions had been successfully reconstructed,with the color,texture of the expanded flaps well matched to the surrounding skin after 3-12 months follow-up.The facial expression functions and configurations were satisfied.Conclusions Excessive expansion of the prefabricated skin flap of the jaw and neck can repair the cheek aesthetic unit successfully,which is a practical method and meets the needs of aesthetic unit repair.

Objective:To evaluate the clinical effect of ultrapulse fractional CO 2 laser in the treatment of mild to moderate orbital aging in Asians. Methods:From January 2018 to December 2018, 36 patients (72 eyes) with mild to moderate orbital aging were enrolled, 22 women and 14 men, with an average age of 32.4 years. Each patient was randomly divided into two groups. In the traditional operation group, 36 eyes received blepharoplasty through traditional inferior conjunctival approach. In the ultrapulsed fractional CO 2 laser group, 36 eyesunderwent blepharoplasty through the lower eyelid conjunctival approach assisted by optoelectronics. Both groups were treated with ultrapulsed fractional CO 2 laser for periorbital aging. The operation time, detumescence time and postoperative complications were compared. At the same time, the periorbital skin relaxation was treated by the combination of the two groups. The patients were followed up for 12 months. Results:In the traditional operation group, 11 cases were evaluated as Barton grade Ⅰ preoperatively, and the efficacy score was 0.64±0.21. In 25 cases of Barton grade Ⅱ the efficacy score was 1.34±0.34. 17 cases were Barton Ⅰ in photoelectric assisted group, and the efficacy score was 0.92±0.18. In 19 cases of Barton grade Ⅱ, the efficacy score was 1.71±0.42. There was a statistically significant difference between the two groups in Barton Ⅰ efficacy score, P<0.05 ( P=0.016); There was also a statistically significant difference between the two groups in efficacy score of Barton Ⅱ, P<0.05 ( P=0.039). The operation time of the photoelectric assisted group was (12.00±1.82) minutes, and the edema duration was (4.0±1.8) days. The duration of operation in the conventional surgery group was (16.00±3.75) minutes, and the duration of edema was (7.0±2.4) days. The operation time and edema duration in the photoelectric assisted group were both shorter than those in the traditional operation group, and the differences were statistically significant ( P<0.05). Conclusions:The blepharoplasty through traditional inferior conjunctival approach assisted with ultrapulsed fractional CO 2 laser has no obvious bleeding, with shorter operation time, swelling reduction time and the number of complications than the traditional operation.This method can solve the symptoms of blepharoplasty, lower eyelid skin relaxation and wrinkles around eyes. This method is worthy of promotion in the treatment of patients with mild to moderate periorbital aging.

Objective: To explore the clinical application of ultra-pulsed CO₂ laser skin abrasion combined with micro-skin graft in the treatment of skin depigmentation. Methods: From January 2010 to June 2014, depigmented skin specimens were used for ultra-pulsed CO₂ laser skin abrasion treatment, at 0, 10, 20, 30, 40, 50, 60 mJ. HE stain was performed to observe the abrasion depth under the 100 times microscope view. The most appropriate parameter was set to completely remove the epidermis, and leave dermis undamaged. From January 2011 to December 2017, 16 patients with skin depigmentation, 12 males and 4 females, aged 12-47 years, were treated with super-pulsed carbon dioxide laser and autologous microdermis transplantation. At 1, 3, 6 and 12 months after the operation, patients′ photos were record. The color improvement was analyzed using Image-Pro Plus 6.0 software. Results: The laser energy for complete epidermis removal is different at different sites. It is 50 mJ for back skin, 40 mJ for face and hand skin and 30 mJ for neck skin. After one year of follow-up, there was no hypertrophy scar caused by over-abrasion in all 16 patients. Combined with the micro-skingrafting, 15 patients with skin depigmentation were completely resolved, with more than 90%color improvement rate. The improvement rate was 75% in a patient with un-uniform appearance, due to part failure of micro-skin graft. The neck movement and uncertain fixation were the reasons. Conclusions The appropriate energy parameters can control the abrasion depth to avoid the hypertrophic scar. Combined with micro-skin graft, the depigmentation area can be improved with uniform color and reliable effect.