OBJECTIVETo investigate the application and therapeutic effect of frontal muscle fascia compound flap suspension for congenital blepharoptosis in children.

METHODSFrom July 2010 to March 2012, 21 children (23 eyes) with congenital blepharoptosis were treated with frontal muscle fascia compound flap suspension. The therapeutic effect was observed and followed up.

RESULTS17 patients were followed up for 3-6 months with relapse in one case. The ptosis was corrected in the other 1 cases.

CONCLUSIONThe frontal muscle fascia compound flap suspension is effective and practical with minimal morbidity and lower complication for the correction of congenital blepharoptosis.

Blepharoplasty ; methods ; Blepharoptosis ; congenital ; surgery ; Child ; Facial Muscles ; Fascia ; transplantation ; Frontal Bone ; Humans ; Oculomotor Muscles ; Recurrence ; Surgical Flaps ; transplantation

OBJECTIVETo investigate the application and therapeutic effect of advanced orbicularis oculi muscle (OOM ) flap for eyelid defect.

METHODSUni-pedicle or bi-pedicle advanced OOM flaps were designed according to the location, depth and size of the eyelid defects. The resulted wounds in the donor sites were closed directly. The flap size ranged from 1.5 cm x 0.5 cm - 6.0 cm x 3.5 cm.

RESULTS120 cases were treated. All the flaps survived except for 3 flaps with epidermis necrosis at the end of flaps, which healed after dressing. The patients were followed up for 3 -36 months with inconspicious scar in donor sites. The flap color, texture had a good match with surrounding skin.

CONCLUSIONSThe OOM flap is ideal for eyelid defect with reliable blood supply, satisfied color and texture. The wound at donor site can be closed directly with less morbidity.

Blepharoplasty ; methods ; Cicatrix ; Eyelids ; surgery ; Facial Muscles ; transplantation ; Humans ; Surgical Flaps ; transplantation ; Transplant Donor Site ; surgery

OBJECTIVE: To explore the correlation of limb muscle mass and acute graft-versus-host disease. METHODS: Clinical data from 144 patients treated by allo-HSCT in Guangzhou First People's Hospital were collected and analyzed retrospectively. The age, sex, diagnosis, donor age, sex of the donors, preparative regimen, ATG dose, HLA match, graft source, and number of infused stem cells of the patients were collected as baseline information. Meanwhile, bioelectrical impedance principle (BIA) was used to measure the limb muscle mass, body weight, body mass index (BMI), waist-to-hip ratio, upper arm muscle circumference, triceps skinfold thickness, and body fat rate of the patients before and after transplantation, so as to compare the changes of limb muscle mass and investigate its correlation with aGVHD. RESULTS: It was found that 61.11% of allo-HSCT patients showed muscle mass loss, and the proportion of male and female was 35.42% and 25.69%, respectively. There were reduction in the body weight, BMI, upper arm muscle circumference and muscle mass of limbs after transplantation as compared with those before transplantation (P<0.05). By comparing with the cumulative incidence of aGVHD between the patients in low muscle mass group and normal muscle mass group, it was found that the cumulative incidence of Ⅱ-Ⅳdegree aGVHD in patients with low muscle mass (30.38%) was higher than those with normal muscle mass (8.93%), which showed statistical difference (P<0.05). Univariate analysis showed that muscle mass, the sex of the donors, and preparative regimen were the influencing factors of aGVHD (P<0.05). Binary logistic regression showed that low muscle mass was the independent risk factor affecting aGVHD (P<0.05). CONCLUSION Patients treated by allo-HSCT shows a decline in muscle mass after transplantation, and the incidence of aGVHD is high in patients with low muscle mass. Therefore, the assessment of muscle quality in early stage in patients with HSCT can facilitate earlier detection of aGVHD.
Female ; Graft vs Host Disease ; Hematopoietic Stem Cell Transplantation ; Humans ; Male ; Muscles ; Retrospective Studies ; Transplantation, Homologous

OBJECTIVETo evaluate the therapeutic effect of pedicled muscular flaps combined with partial thoracotomy for treatment of pythorax-resulted wounds and defects.

METHODS35 cases with pythorax-resulted refractory infected wound and dead space, were retrospectively analyzed. The wound and dead space were eliminated with pedicled muscular flaps, including latissimus dorsi muscular flaps and serratus anterior muscle flaps in 21 patients, pectoralis major muscle flaps with rectus muscle flaps in 8 patients, latissimus dorsi muscul flaps and vertical rectus muscle flaps in other 6 patients.

RESULTS34 flaps survived completely except for 1 verticle rectus muscular flap with partial necrosis at distal end. Primary healing was achieved in 29 cases. The other 6 cases were discharged with drainage. Among the 6 cases, 3 cases healed spontaneously, 2 cases underwent reoperation, 1 case need long-term drainage in the fistula.

CONCLUSIONPedicled muscular flap, combined with partial thoracotomy can effectively treat refractory wound and dead space resulted by pythorax.

Combined Modality Therapy ; methods ; Empyema, Pleural ; surgery ; Humans ; Myocutaneous Flap ; transplantation ; Pectoralis Muscles ; transplantation ; Reoperation ; Retrospective Studies ; Superficial Back Muscles ; transplantation ; Thoracotomy ; methods ; Wound Healing

OBJECTIVETo investigate the effect of vascularized composite flap with iliac crest and nternal oblique muscle of abdomen for half mandibular reconstruction.

METHODSFrom July 2009 to Sept. 2013, 14 cases with half mandibular defect after tumor resection were treated with composite flap of iliac crest and internal oblique muscle of abdomen pedicled by deep circumflex iliac vessels. During operation, one group performed tumor resection and got the recipient area vessels ready for anastomosis. The other group performed harvesting of composite flap. Then the flap was trimmed and fixed to construct the defect with vessel anastomosis.

RESULTSAll the 14 composite flaps survived with local infection only in 1 case. The size of harvested iliac crest ranged from 6 cm x 3 cm to 9 cm x 3 cm. The size of harvested internal oblique muscle of abdomen ranged from 5 cm x 4 cm to 7 cm x 5 cm. The patients were followed up for 6 months to 26 months (mean, 13 months) with satisfactory results and no complication. Mandibular panoramic radiographs showed new bone formation and good union.

CONCLUSIONSVascularized composite flap with iliac crest and internal oblique muscle of abdomen has the advantages of abundant bone volume, as well as soft tissue reconstruction in one stage. The reconstructed mandible can attain normal function and appearance.

Abdominal Muscles ; transplantation ; Abdominal Wall ; Humans ; Ilium ; transplantation ; Mandibular Reconstruction ; methods ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps ; blood supply ; transplantation

OBJECTIVETo analyze a producing method for modified pectoralis major myocutaneous (PMM) flap, with maintaining the function of pectoralis major muscle.

METHODSThe skin island was designed according to the anatomical features of pectoralis major myocutaneous flap. The pedicle of PMM flap did not contain any muscle, making PMM flap into an accurate island flap. The clavicle of pectoralis major muscle as well as most of lateral part fiber was well maintained.

RESULTSFrom 2002 to 2005, 29 PMM flaps were performed by this modified method, 20 flaps used to reconstruct defect of oral, 4 flaps to reconstruct defect of neck, 3 flaps to reconstruct defect of parotid gland and 2 flaps to reconstruct laryngopharynx. All flaps were survival postoperation. The speaking and swallowing functions were satisfactory after 6 months approximately 2 years' follow-ups.

CONCLUSIONSThe application of modified pectoralis major myocutaneous flap overcomes the disadvantage of outdated method, improving the feasibility and availability of blood supply of muscle flap. Besides, it almost maintains the function of pectoralis major muscle and the appearance features of chest. Thus, this modified technique turns this flap more reliable and versatile in head and neck.

Adult ; Aged ; Female ; Head and Neck Neoplasms ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Pectoralis Muscles ; transplantation ; Skin Transplantation ; Tissue Transplantation

OBJECTIVETo investigate the technique of lower face and neck lifting with parotid fascia-SMAS-platysma flap.

METHODSTo improve the lifting strength of SMAS and the cosmetic result, the traditional SMAS-platysma flap was modified as parotid fascia-SMAS-platysma flap. The modified flap was folded and suspended step by step to lift the lower face and neck.

RESULTSFrom Oct. 2004 to Oct. 2008, 78 patients were treated with this method. The patients' age ranged from 40 to 65 years old. There were 2 cases of male and 76 cases of female. All the patients were followed up for 6 months to 4 year with satisfactory results.

CONCLUSIONSFolding and suspension of the parotid fascia-SMAS-platysma flap step by step can effectively lift the saggy tissue of lower face and neck.

Adult ; Aged ; Cheek ; surgery ; Fascia ; transplantation ; Female ; Humans ; Male ; Middle Aged ; Neck Muscles ; transplantation ; Parotid Gland ; surgery ; Rhytidoplasty ; methods

OBJECTIVETo investigate the feasibility of immediate breast and nipple-areola reconstruction after skin-sparing mastectomy.

METHODS24 patients who received skin-sparing mastectomy underwent immediate breast reconstruction with or without breast implants. The nipple-areola complex is also reconstructed with the skin paddle of the latissimus dorsi flap in one stage.

RESULTSAll the latissimus dorsi myocutaneous flaps survived completely. Partial necrosis happened in two reconstructed nipples which healed after dress changing. The follow-up period ranged from 6 to 12 months. 3 patients presented with capsular contracture (Baker I), with no necessary of surgical revision. The retraction rate of reconstructed nipples projection is 35.4% at 6 months postoperatively and 38.6% at 12 months postoperatively. 91.7% of patients were satisfied or very satisfied with the breast shape, while 83.3% were satisfied or very satisfied with the breast volume. All the patients considered the reconstructed nipple very good, while 91.6% were satisfied with the nipple projection. 91.7% considered immediate nipple reconstruction to be very important, and 8.3% considered it to be important. 66.7% considered the new breast could replace the breast they had lost, and 8.3% considered that it could not.

CONCLUSIONFor skin-sparing mastectomy, immediate breast and nipple reconstruction can achieve good aesthetic results.

Breast Neoplasms ; surgery ; Esthetics ; Female ; Humans ; Mammaplasty ; methods ; psychology ; Myocutaneous Flap ; transplantation ; Nipples ; surgery ; Superficial Back Muscles ; transplantation

OBJECTIVETo investigate the technique and therapeutic effect for correction of sunken eyes combined with ptosis.

METHODSIn order to adjust the levator muscle tension and the relationship between levator aponeurosis and tarsus plate, multiple individualized treatment was selected, including levator aponeurosis restoration, levator aponeurosis plication, or shorten, or combination. Then the orbital fat was transferred to the depressed area, or autologous fat particles were collected and injected into the depressed area within the orbital fat fascia. After the orbital septum fascia was restored, the incision was closed primarily.

RESULTS15 cases (30 eyes) were treated. 11 cases were followed up for 6-40 months (average, 9.5 months) with satisfactory cosmetic and functional result. No recurrence of ptosis happened.

CONCLUSIONSOne-stage correction of sunken eyes combined with ptosis can be achieved with autologous fat injection or orbital fat transposition. Good cosmetic and functional result can be achieved.

Adipose Tissue ; transplantation ; Aged ; Blepharoplasty ; methods ; Blepharoptosis ; surgery ; Eyelids ; Fasciotomy ; Humans ; Oculomotor Muscles ; surgery ; Orbit

PURPOSE: To compare a processed nerve allograft, laminin derived peptide incorporated nerve conduit, and autograft in terms of electrodiagnostic testing and nerve histomorphometry for peripheral nerve regeneration in a rabbit sciatic nerve defect model. MATERIALS AND METHODS: Thirty New Zealand white rabbits were divided into three groups, and a unilateral 15 mm sciatic nerve defect was made. Group I, II and III was repaired with a reversed autograft, a processed acellular nerve allograft, and a laminin derived peptide incorporated nerve conduit, respectively. At twelve weeks, the animals were evaluated with the compound muscle action potential, wet muscle weight, and nerve histomorphometric parameters such as nerve area, number of axons, and myelin thickness. RESULTS: At twelve weeks, the compound muscle action potential for group I, II and III was 54.1%, 38.2% and 26.4%, respectively. Significant differences were found between the three groups (p<0.001, group I vs II; p<0.001, group I vs III; p<0.001, group II vs III). The wet muscle weight for group I, II and III was 57.8%, 54.4% and 43.9%, respectively. Group I had significantly more muscle weight than group III (p<0.001), but the difference was not significant with group II (p=0.256). Group II and III showed a significant difference (p=0.002). The number of axons in group III decreased and the shape of the axon was irregular, even though the nerve area and myelin thickness were similar in the three groups. CONCLUSION: An autograft remains the gold standard to repair a segmental nerve defect. Processed allograft demonstrated superior nerve recovery compared to the laminin derived peptide incorporated nerve conduit.
Action Potentials ; Animals ; Axons ; Laminin ; Muscles ; Myelin Sheath ; Peripheral Nerves ; Rabbits ; Regeneration ; Sciatic Nerve ; Transplantation, Homologous