Objective To reconstruct the soft tissue defect in the back or neck after excision of hypertrophoc scar or giant nevus by using transmidline pre expanding scapula flap vascularied by ipsilateral circumflex scapular artery. Methods The reconstruction can be accomplished in two stage procedures. First, scapular flaps were expanded for 4 6 weeks prior to transfer in 8 patients. Second,the pedicled flaps were designed across the entire back to incorporate both scapular territories but were rotated on a single vascular pedicle. Results All flaps survived. Only two flaps had marginal necrosis, and the wound healed well by dressing. Conclusion Flap expansion produces a delay that augments blood supply and increases the area of skin that survives on a single vascular pedicle. This technique may be useful in selected patients in whom a large and thin fasciocutaneous flap is required and there is sufficient time to allow flap expansion prior to thansfer. It is easy to harvest, and donor site morbidity is negligible. The patients can get better functions and quality of life.

Objective To study urethral epithelium cu lt ure in vitro as a basic role in the further study on tissue engineering urethra. Methods A bit of urethral mucosa was taken from a young male New Zealand hare and was digested by enzyme into single cell liquid.The ce ll was then cultured in a still condition.The medium was renewed regularly and t he cells were subcultured and studied. Results All the c utured cells were urethral diploid cells without fibroblasts.The cells could be subcultured 11～13 generations with a surviving period of 50～60 days. Conclusions The urethral epithelium the cultured cells of young N ew Zealand hare can be cultured in vitro and is able to proliferate within a cer tain period.This provides a strong foundation for the further study on tissue en gineering urethra.

Objective To study the changes of muscle being injected with botulinum toxin A in different period of time,helping for chemically denervated muscle transplantation.Methods Sixteen rabbits were divided into 4 groups.The extensor carpi radialis muscle in one side was chosen for experimental group with the opposite muscle for control group.Morphological changes,histological changes and electron microscopic changes of muscle being injected with botulinum toxin A were observed from the first week to the fouth week.Results The quantity of glycogen and mitochondria in the muscles reduced in the first week.But it was obvious in the third week.We also found some necrotic areas in the fouth week with the muscles restoring.Conclusions The effect of metabolism slowing down and the volume of muscle reducing after botulinum toxin A injection is obvious in third weeks.It could help us choose the best time of chemically denervated muscle transplantation.

OBJECTIVETo explore an effective method to diagnose and treat the congenital recessive cleft palate.

METHODSFor the treatment of congenital recessive cleft palate, an operation was designed to recover the anatomic length and function mobility of the soft palate. The operation procedure includes incising vertically the midline mucous membrane of the soft palate, creating and pushing back the mucosal flap of the hard palate, making Z-plasty on the nasal mucosa, reconstructing the sling of the levator veli palatini muscle and repairing the palatal defects with the buccinator muscularis mucosae flap. 12 cases of congenital recessive cleft palate have treated with this method.

RESULTSAll of the 12 cases obtained good results. Their pronunciation improved obviously.

CONCLUSIONThe method is effective for diagnosis and treatment of congenital recessive palate, which is worthy of further application.

Adolescent ; Child ; Cleft Palate ; diagnosis ; surgery ; Female ; Humans ; Male

OBJECTIVETo purpose of study aimed at investigating the technique of culturing oral epithelia in vitro and to set up an experimental model for further reconstructing oral mucosa in vitro.

METHODSThe oral mucosa was taken from young New Zealand rabbits, and the mucosa was digested with enzyme and suspended in liquid to form cellular suspension. Being seeded, the cells were cultured motionlessly. The medium was changed regularly and the cells were subcultured.

RESULTSThe cultured cells were all epithelial cells without fibroblasts, and they were proved to be diploid cells. The cells were subcultured in 1-13 generations which survived for 50-60 days.

CONCLUSIONThe oral epithelium of young New Zealand rabbit can be cultured in vitro, maintaining the ability to proliferate in a certain period. It is a pilot study to reconstruct oral tissue in vitro.

Animals ; Animals, Newborn ; Cells, Cultured ; Coculture Techniques ; Epithelial Cells ; cytology ; Female ; L Cells (Cell Line) ; Male ; Mice ; Mouth Mucosa ; cytology ; Rabbits ; Tissue Engineering

OBJECTIVETo investigate the microvascular structure of the transmidline scapular flap pedicled with the unilateral circumflex scapular artery.

METHODSLatex and ink mixture was injected into the unilateral circumflex scapular artery of 6 fresh cadavers. The transmidline scapular flap was dissected and the pellucid specimen was made. The artery perforators were traced to their underlying parent vessels that accompanied the segmental arteries. A series of cross-sectional studies were undertaken in one subject to illustrate the course of the perforators in the tissues of different depth.

RESULTSIn deep and superficial fascia, the subdermal and dermis layer, rich microvascular connection was found which showed in three patterns: the vascular arch, communicating branches, and the arterial rate. They interrelated to form a three-dimensional framework. The vascular tree not only passed the midline but also reached the contralateral acromion. The densest vessels were exhibited at the injection side of the back. In the midline area the vessels were in less density and at the contralateral side, the vessels mainly concentrated in the upper part of the back.

CONCLUSIONThe result evidenced the vascular pattern and the applicable safety of the transmidline scapular flap. In elevating a transmidline scapular flap, the distal part should mainly locate at the upper part of the back.

Adult ; Arteries ; anatomy & histology ; surgery ; Cadaver ; Humans ; Male ; Scapula ; blood supply ; Surgical Flaps ; blood supply

OBJECTIVETo introduce and evaluate the technical feasibility and anatomical and functional outcomes of one-stage vaginoplasty with autologous buccal micromucosa combined with acellular allogenic dermis.

METHODSWe retrospectively reviewed our experiences with 17 patients with Mayer- Rokitansky-Kuster-Hauser syndrome treated with primary surgery from September 2010 to April 2013. All patients underwent vaginoplasty with autologous buccal micromucosa combined with acellular allogenic dermis. We describe the details of this technique, observe the time of epithelization and evaluate the long- term anatomical, functional, and sexual outcomes.

RESULTSThe time of epithelization was 13 d (range: 12-15 d). At a mean follow-up of 15 months (range: 12-24 months), the mean postoperative dependence on the vaginal stent was 11.7 ± 1.64 months (range: 9-15 months), the mean depth of the neovagina was (9.0 ± 0.94) cm (range: 7-11 cm), the mean circumference was (12.3 ± 1.36) cm (range: 10.0-14.5 cm) and the mean volume was (105 ± 10) ml (range 85-120 ml). The mean female sexual function index score of the 12 sexually active patients was 29.5 ± 2.6. No spouse reported discomfort during intercourse.

CONCLUSIONSVaginoplasty with autologous buccal micromucosa combined with acellular allogenic dermis is an effective and feasible approach for patients with Mayer-Rokitansky-Kuster-Hauser syndrome. The procedure has satisfactory long-term anatomical and functional results. The use of the acellular allogenic dermis is limited by the high price and the potential infection.

46, XX Disorders of Sex Development ; surgery ; Acellular Dermis ; Coitus ; Congenital Abnormalities ; surgery ; Feasibility Studies ; Female ; Humans ; Mouth Mucosa ; transplantation ; Mullerian Ducts ; abnormalities ; surgery ; Postoperative Period ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Vagina ; abnormalities ; surgery

OBJECTIVETo provide ideal materials for repair of penile wounds in penis lengthening.

METHODSA skin incision was made between the penis and mons pubis. Penis lengthening was performed by complete releasing of the superficial suspensory ligament and partial releasing of the deep suspensory ligament of the penis. Resurfacing of the defects at the penile base was accomplished by transferring a scrotal dartos musculocutaneous flap pedicled on the anterior scrotal vessels.

RESULTS16 patients with short penis were treated with the method. All scrotal dartos musculocutaneous flaps survived and 4-4.5 cm extra length of the penile shaft was achieved. Appearance and function of the penis were improved.

CONCLUSIONSThe scrotal dartos musculocutaneous flap is one of the best materials to repair the penile skin defects in penile lengthening operation. The advantages of the flap are: 1. good blood supply; 2. thin and lacking of subcutaneous fat; 3. extensibility with the scrotal dartos muscle.

Adolescent ; Adult ; Follow-Up Studies ; Humans ; Male ; Penis ; abnormalities ; surgery ; Scrotum ; Surgical Flaps ; Treatment Outcome ; Wounds and Injuries

OBJECTIVEThe purpose of this study was to provide the guidelines with respect to the location of the facial vessels, observe the potential reversed flow of the facial artery, and reemphasize the value of color Doppler ultrasound studies in flap planning.

METHODSA study was carried out to investigate the location and dynamics of the facial artery and vein using color Doppler ultrasonography in 12 adults.

RESULTSThe facial artery and the vein were located together at the lower border of the mandible. Around the oral commissure and under the nasal ala, they run apart from each other at variable distances. The reverse flow was observed in the 12 patients after the blood flow of the facial artery was blocked by applying pressure manually at the lower border of the mandible.

CONCLUSIONSThe divergence of the facial vein from the artery is important information in planning of axial pattern flaps. Observation of the reversed flow confirms the possibility of safe elevation of a retrograde flow-arterialized flap based on the distal portion of the facial artery.

Adolescent ; Adult ; Arteries ; diagnostic imaging ; Face ; blood supply ; Female ; Humans ; Male ; Middle Aged ; Ultrasonography, Doppler, Color ; methods ; Veins ; diagnostic imaging

OBJECTIVETo investigate the methods of dealing with chordee without hypospadias.

METHODSFrom November 1982 to December 2000, 18 cases of chordee without hypospadias were treated using the methods of urethra extension, urethra elongation with a pedicled transverse prepuce entoplastron flap, a longitudinal prepuce flap or a scrotum mediastinum flap.

RESULTSOne case was cured with the first method; 5 cases with the second method; 6 cases with the third method; 6 cases with the fourth method. Fistula occurred in one case treated with the second method.

CONCLUSIONThe essential defect of chordee without hypospandias is short of urethral tissue. The principal treatment is repairing the urethra using tissue transplatation. Different method should be used based on the characteristics of the defects.

Adolescent ; Adult ; Child ; Humans ; Hypospadias ; surgery ; Male ; Penis ; abnormalities ; surgery ; Reconstructive Surgical Procedures ; methods ; Scrotum ; surgery ; Surgical Flaps ; Treatment Outcome