BACKGROUND:Macrophage migration inhibitory factor is involved in the process of a variety of diseases, and plays a very important role in the tumor, autoimmune diseases, inflammation, angiogenesis, fibrotic diseases and so on. These biological characteristics are similar to keloids. OBJECTIVE: To compare the distribution and number of macrophage migration inhibitory factor in normal skin, hypertrophic scar and keloid. METHODS: We colected 40 clinical pathological scar specimens after surgery, including 20 hypertrophic scars and 20 keloids. Another 10 samples of the normal skin were used as control group. Hematoxylin-eosin staining and immunohistochemistry staining were performed to test the expression of macrophage migration inhibitory factor in pathological scars and normal skin. RESULTS AND CONCLUSION:Macrophage migration inhibitory factor was positively expressed in the normal skin, hypertrophic scar and keloid, and the expression of macrophage migration inhibitory factor in keloid was significantly higher than that in hypertrophic scar and normal skin (P < 0.01). It means that the abnormal infiltration of macrophage migration inhibitory factor may be associated with the formation of keloid.

OBJECTIVETo explore a combined application of tissue expansion, perforator flaps and super-thin flaps in reconstruction of extensive face and neck scars.

METHODSIn the first stage, the position and course of the perforators were confirmed with the multi-detector computed tomography ( MDCT) and color Doppler ultrasound. The expanders were implanted between subdermal vascular plexus and superficial fascia. In the second stage, the expanded super-thin perforator flaps were transferred to resurface the extensive defects and deformities in the face and neck.

RESULTS26 cases with extensive facial and cervical scars were included in this study. Except for one case with necrosis at the distal end, the other 25 flaps survived completely. The maximum flap size was 35 cm x 10 cm with a pedicle of 8 cm x 4 cm. Long-term follow-up showed that this combined application provided thinner flap than the conventional pre-expanded flap, thus avoiding secondary flap debulking and revisions. All the patients got improvement in contours, facial features and emotional expression.

CONCLUSIONSThe combined application of tissue expansion, perforator flaps and super-thin flaps is a practical method which has advantages in feature recontouring and recovery of delicate emotions in reconstruction of extensive face and neck scars.

Cicatrix ; surgery ; Face ; surgery ; Humans ; Multidetector Computed Tomography ; Neck ; surgery ; Perforator Flap ; transplantation ; Reconstructive Surgical Procedures ; Tissue Expansion ; methods

Objective:To introduce a modified stent technique of nasal septal extension graft (SEG) with auricle cartilage, and to explore its effect on rhinoplasty.Methods:For 116 patients that underwent rhinoplasty, the cartilage of bilateral auricula was sutured with shell alignment and the dovetail was modified to prepare SEG stent; PTFE or silicone prosthesis was used for nasal dorsal graft. The patients were follow up for 6-18 months after surgery. A number of indicators including length of nose, tip projection, nasal tip and nasolabial angle morphology were used to assess surgical outcomes.Results:The 116 patients obtained satisfactory appearance immediately after operation. Length of nasal extension was 3-6 mm, tip projection was extended by 2-5 mm. Following up for 6-18 months showed stable effect (0.5-1.5 mm retraction) and satisfactory nose tip and nasolabial angle. The skin color was normal. No deformity occured in the ear cartilage donor area existed with no obvious scar.Conclusions:The modified SEG stent of auricle cartilage has good support and stability. It has a good effect on the slight and moderate extension of the short nose. In addition, the elevation of the nasal tip and the severe short nose of the first rhinoplasty and secondary rhinoplasty with mild contracture are also improved.