With the development of the society,a frontier overlapping subject named music treatment theory has sprung up,which contains music,medical science and psychology.And it makes the function of music be widely applied and developed besides the traditional area of art and beauty appreciation.

In order to improve the bonding strength of the hydroxyapatite (HA) coatings on the metal substrate, we prepared the HA-Ti/HA composite coatings by two-step electrodeposited method, and then we studied the component, microstructure, surface morphologies and the bonding strength of the HA-Ti/HA composite coatings. SBF test and cell culture in vitro were carried out to evaluate the biological properties of the composite coatings. The results showed that the bonding strength of the HA-Ti/HA composite coating (Ti, 51.2wt%) was as high as 21.2 MPa which was 3 times that of pure HA coatings. The coatings' surface was covered by carbonate-apatite layer after being immersed in SBF, and the bone marrow cells attached firmly and proliferated well on the surface of composite coatings. These findings indicate that the composite coatings possess good bioactivity and excellent biocompatibility.
Animals ; Bone Marrow Cells ; cytology ; Cell Adhesion ; Cells, Cultured ; Coated Materials, Biocompatible ; chemistry ; Dogs ; Durapatite ; chemistry ; Electrochemistry ; Surface Properties ; Tissue Engineering ; methods ; Titanium ; chemistry

Objective: To explore the feasibility and clinical effect of autologous fat concentrate combined with split-thickness skin grafts in the repair of venous ulcer. Methods: From January 2015 to December 2018, a total of 16 patients diagnosed with venous ulcer were admitted to our department, and all patients received symptomatic and supportive treatment such as local debridement and dressing change. After the granulation tissue grew well, all patients received autologous adipose concentrate combined with spilit-thickness skin graft for repair. Results: All the grafted skin survived well, and the survival rate of grafted skin at 2 weeks after surgery was 86% to 99%. All patients were followed up to 6 months after surgery. The wounds of all patients were healed during the follow-up period. One patient suffered local ulcer recurrence due to repeated friction after healing and the ulcer recovered after dressing changing treatment. All the other patients had no recurrence during the follow-up period. The scar hyperplasia in the skin transplantation area was not obvious and the healing quality was good. No significant surgical complications occurred. Conclusions Autologous lipoconcentrate combined with split-thickness skin grafts is an effective and safe method in the repair of venous ulcer, and the application of autologous lipoconcentrate can effectively improve the survival rate and healing quality of skin grafts.

Objective:To investigate the method, feasibility and clinical effect of scrotal flap in the immediate repair of penoscrotal Paget disease after excision.Methods:From January 2008 to September 2018, a total of 21 patients (age 42-74) diagnosed with penile scrotal Paget disease were admitted and treated in our department. All patients underwent local expanded resection, and intraoperative frozen section examination confirmed a negative margin. All patients used the scrotal flap or scrotal flap combined with other surgical methods to repair the defect.Results:Scrotal flaps were used in ten cases, scrotal flaps combined with other flaps in seven cases, and scrotal flaps combined with skin grafting in four cases. All the scrotal flaps had good blood supply, two cases had small partial skin graft necrosis, and one case had delayed healing of the flap donor area, and all the others had good wound healing. All patients were followed up for six months to 60 months, with an average follow-up time of 30.6 months. Most of the patients (95.2%, 20/21) were satisfied with the appearance of the penis and scrotum, and all the transferred flaps showed no edema. Local recurrence occurred in four patients within two years. Local recurrence and inguinal lymph node metastasis occurred in one patient within three years with a total local recurrence rate of 23.8% (5/21). Due to the small local recurrence lesion, the recurrence lesion was successfully repaired with the adjacent scrotal flap after expanding local excision, and the patients with inguinal lymph node metastasis received ipsilateral inguinal lymph node dissection.Conclusions:The scrotal flap has the characteristics of a large cutting area, flexible design, convenient transfer of flap, enough blood supply, simple, safe, and effective. Using this method can obtain a satisfactory shape of the penis and scrotum after the operation. Those defects that are difficult to use scrotal flap for a complete repair can be repaired with other flaps or skin grafts. A good therapeutic effect can be obtained as well. For the majority of recurrent lesions, scrotal skin flap can be reapplied.

Objective:To evaluate the feasibility and clinical effect of resection and repairing the neurofibromatosis type 1 (NF1).Methods:Retrospective analysis was performed with the data of patients diagnosed with NF1 in the Department of Plastic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, from January 2000 to December 2020. All of these patients underwent resection and repair procedures with flap-transferringor skin-grafting.Results:A total of 34 patients with NF1 were included (16 patients with macrosomia NF1, including two patients with cephalic and facial macrosomia NF1 and 14 patients with extremities and somatic macrosomia NF1). There were 14 males and 20 females, aged from 16 to 46 years, with an average age of 30.4 years. The size of the tumor was 65-2 080 cm 2, with an average of 252 cm 2. Nine patients underwent preoperative interventional embolization of the main blood supply artery after consultation with the interventional department. All patients successfully resected the labeled tumor according to the preoperative plan, among which 33 patients underwent one-stage resection and repair. One female patient with large facial neurofibroma experienced uncontrollable bleeding after partial resection of the tumor during the first surgical resection, and the resection and repair were performed by staged surgery after pressurized bandaging for hemostasis. The bleeding during the operation of other patients was controllable. Fourteen cases were sutured directly after tumor resection. Among which, two cases appeared wound dehiscence within one week after the surgery but recovered well after resutured under local anesthesia. Sixteen cases were repaired by transferring skin flaps, of which five patients suffered from insufficient blood supply of the distal end of the flap and underwent debridement and suturing. Four patients were repaired by skin grafting, of which one patient underwent second skin grafting due to poor survival of part of the grafted skin and recovered well. All patients were followed up for 6 to 36 months (mean 22.6 months). Except for one patient with malignant change and one patient with evident tumor recurrence, no recurrence or malignant change occurred in the other patients, and the surgical effect was satisfactory. Conclusions:The resection and repair of NF1, especially giant NF1, should be based on the location and size of the tumor so as to achieve the one-stage resection and repair as far as possible under the premise of controlling bleeding. Different types of repair methods can be applied according to the location, size, and morphology of the lesion to achieve the purpose of removing the lesion and protecting the morphology and function.

Objective:To investigate the feasibility of early treatment of congenital giant melanocytic nevus (CGMN).Methods:From October 2013 to December 2021, the clinical data of children with giant nevus treated with skin soft tissue expansion in the Plastic Surgery Department of Sun Yat-sen Memorial Hospital were analyzed retrospectively. A renal expander was implanted in the first stage, including single and repeated expansion. The giant nevus was removed and repaired in the second stage with an expanded skin flap. The occurrence of complications, such as wound infection, expander exposure, expander rupture, and flap congestion, were recorded. Children’s mental health problems and their parents’ satisfaction were also analyzed. The χ2 between children of different ages and the infection rate between children with an internal and external pot. Results:A total of 58 children, 24 males and 34 females, aged from 3 months to 3 years, with an average age of 1.45 years, were enrolled. A total of 190 expanders were implanted. The patients were followed for 5 to 106 months, averaging 42.43 months. In the first stage, 29 cases of wound infection, 41 cases of expander exposure, two cases of flap congestion, and 6 cases of expander rupture occurred. The flap transfers were not affected by these complications after appropriate treatment. The comparison of complication rates among 3 months~<1 year、1~<2 years、2~<3 years、3 years was 37.34%(31/83)、56.75% ((21/37) ), 33.33% (13/39) and 41.94%(13/31), respectively, No statistically significant difference ( χ2=5.21, P=0.157). The incidence of wound infection was 16.67% (6/36) and 14.94% (23/154), respectively, for the internal and external dilators. There was no significant difference in the location of the dilator pot and the incidence of wound infection ( χ2=0.07, P=0.795). The appearance of all children has been significantly improved. Thirty-nine children’s families are particularly satisfied, and 20 are generally satisfied with the treatment effect, and no mental health problems were found. Conclusions:Skin and soft tissue expansion is a reliable method for early treatment of congenital giant nevus.

Objective:To explore the indications, selection, and effect of flap application in repairing scar carcinoma in the lower leg and ankle.Methods:A retrospective cohort study was conducted. From June 2008 to December 2018, six male patients with scar carcinoma in the lower leg and ankle were treated in Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, aged 48-64 years, with the area of lesion ranging from 3 cm×2 cm to 15 cm×6 cm. After extended resection, the defect area ranged from 8 cm×5 cm to 22 cm×9 cm, with tissue of tendon or bone exposed. Free anterolateral thigh perforator flap, latissimus dorsi myocutaneous flap, or pedicled sural neurovascular flap was selected to repair the wound according to the location of wound in the lower extremity, selection of operation position, the location of the anastomotic vessels in the recipient area, and whether there was good skin and soft tissue available in the lower leg. The size of flap was 11 cm×8 cm-26 cm×10 cm. The donor site of free flap or myocutaneous flap was closed directly by suturing in 5 cases, and the donor site of pedicled flap was repaired with full-thickness skin graft in 1 case. The blood supply and survival of flap, quality of skin graft survival, and complication were observed postoperatively. During the follow-up period, the recurrence and metastasis of scar carcinoma, and the appearance and function of donor and recipient sites were observed.Results:All the patients completed the operation successfully, all the transplanted flaps survived with good blood supply, and the skin graft in one donor site survived well. The wounds in the donor and recipient sites of all the patients healed well without infection, effusion, or dehiscence, etc. All the patients were followed up for 1-5 years. No local recurrence or distant metastasis of scar carcinoma was found. The quality of the transplanted flaps was good. The shape of the recipient area was quite good, and the function of the affected limb was fine. The appearance of the donor area was good without dysfunction.Conclusions:Flap transplantation is suitable for the patients with tendon and bone exposure after the excision of scar carcinoma in the lower leg and ankle. The flap can be selected according to the location of scar carcinoma, operation position, the location of anastomotic vessels in the recipient area, and whether there is good skin and soft tissue available in the lower leg. The free anterolateral thigh perforator flap or latissimus dorsi myocutaneous flap is an ideal choice for repair, which can be obtained in a large area, and the donor site can be directly sutured without affecting the function.

Objective:To investigate the feasibility of early treatment of congenital giant melanocytic nevus (CGMN).Methods:From October 2013 to December 2021, the clinical data of children with giant nevus treated with skin soft tissue expansion in the Plastic Surgery Department of Sun Yat-sen Memorial Hospital were analyzed retrospectively. A renal expander was implanted in the first stage, including single and repeated expansion. The giant nevus was removed and repaired in the second stage with an expanded skin flap. The occurrence of complications, such as wound infection, expander exposure, expander rupture, and flap congestion, were recorded. Children’s mental health problems and their parents’ satisfaction were also analyzed. The χ2 between children of different ages and the infection rate between children with an internal and external pot. Results:A total of 58 children, 24 males and 34 females, aged from 3 months to 3 years, with an average age of 1.45 years, were enrolled. A total of 190 expanders were implanted. The patients were followed for 5 to 106 months, averaging 42.43 months. In the first stage, 29 cases of wound infection, 41 cases of expander exposure, two cases of flap congestion, and 6 cases of expander rupture occurred. The flap transfers were not affected by these complications after appropriate treatment. The comparison of complication rates among 3 months~<1 year、1~<2 years、2~<3 years、3 years was 37.34%(31/83)、56.75% ((21/37) ), 33.33% (13/39) and 41.94%(13/31), respectively, No statistically significant difference ( χ2=5.21, P=0.157). The incidence of wound infection was 16.67% (6/36) and 14.94% (23/154), respectively, for the internal and external dilators. There was no significant difference in the location of the dilator pot and the incidence of wound infection ( χ2=0.07, P=0.795). The appearance of all children has been significantly improved. Thirty-nine children’s families are particularly satisfied, and 20 are generally satisfied with the treatment effect, and no mental health problems were found. Conclusions:Skin and soft tissue expansion is a reliable method for early treatment of congenital giant nevus.

Objective:To investigate the method, feasibility and clinical effect of scrotal flap in the immediate repair of penoscrotal Paget disease after excision.Methods:From January 2008 to September 2018, a total of 21 patients (age 42-74) diagnosed with penile scrotal Paget disease were admitted and treated in our department. All patients underwent local expanded resection, and intraoperative frozen section examination confirmed a negative margin. All patients used the scrotal flap or scrotal flap combined with other surgical methods to repair the defect.Results:Scrotal flaps were used in ten cases, scrotal flaps combined with other flaps in seven cases, and scrotal flaps combined with skin grafting in four cases. All the scrotal flaps had good blood supply, two cases had small partial skin graft necrosis, and one case had delayed healing of the flap donor area, and all the others had good wound healing. All patients were followed up for six months to 60 months, with an average follow-up time of 30.6 months. Most of the patients (95.2%, 20/21) were satisfied with the appearance of the penis and scrotum, and all the transferred flaps showed no edema. Local recurrence occurred in four patients within two years. Local recurrence and inguinal lymph node metastasis occurred in one patient within three years with a total local recurrence rate of 23.8% (5/21). Due to the small local recurrence lesion, the recurrence lesion was successfully repaired with the adjacent scrotal flap after expanding local excision, and the patients with inguinal lymph node metastasis received ipsilateral inguinal lymph node dissection.Conclusions:The scrotal flap has the characteristics of a large cutting area, flexible design, convenient transfer of flap, enough blood supply, simple, safe, and effective. Using this method can obtain a satisfactory shape of the penis and scrotum after the operation. Those defects that are difficult to use scrotal flap for a complete repair can be repaired with other flaps or skin grafts. A good therapeutic effect can be obtained as well. For the majority of recurrent lesions, scrotal skin flap can be reapplied.

Objective:To evaluate the feasibility and clinical effect of resection and repairing the neurofibromatosis type 1 (NF1).Methods:Retrospective analysis was performed with the data of patients diagnosed with NF1 in the Department of Plastic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, from January 2000 to December 2020. All of these patients underwent resection and repair procedures with flap-transferringor skin-grafting.Results:A total of 34 patients with NF1 were included (16 patients with macrosomia NF1, including two patients with cephalic and facial macrosomia NF1 and 14 patients with extremities and somatic macrosomia NF1). There were 14 males and 20 females, aged from 16 to 46 years, with an average age of 30.4 years. The size of the tumor was 65-2 080 cm 2, with an average of 252 cm 2. Nine patients underwent preoperative interventional embolization of the main blood supply artery after consultation with the interventional department. All patients successfully resected the labeled tumor according to the preoperative plan, among which 33 patients underwent one-stage resection and repair. One female patient with large facial neurofibroma experienced uncontrollable bleeding after partial resection of the tumor during the first surgical resection, and the resection and repair were performed by staged surgery after pressurized bandaging for hemostasis. The bleeding during the operation of other patients was controllable. Fourteen cases were sutured directly after tumor resection. Among which, two cases appeared wound dehiscence within one week after the surgery but recovered well after resutured under local anesthesia. Sixteen cases were repaired by transferring skin flaps, of which five patients suffered from insufficient blood supply of the distal end of the flap and underwent debridement and suturing. Four patients were repaired by skin grafting, of which one patient underwent second skin grafting due to poor survival of part of the grafted skin and recovered well. All patients were followed up for 6 to 36 months (mean 22.6 months). Except for one patient with malignant change and one patient with evident tumor recurrence, no recurrence or malignant change occurred in the other patients, and the surgical effect was satisfactory. Conclusions:The resection and repair of NF1, especially giant NF1, should be based on the location and size of the tumor so as to achieve the one-stage resection and repair as far as possible under the premise of controlling bleeding. Different types of repair methods can be applied according to the location, size, and morphology of the lesion to achieve the purpose of removing the lesion and protecting the morphology and function.