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Experiment study of SDF-1 expression during the survival process of the narrow pedicle flap with hypoxia and ischemia.

Li-jun WU ; Tian-lan ZHAO ; Dao-jiang YU ; Wei-bao ZHANG ; Qiang LIU

Chinese Journal of Plastic Surgery.2012;28(3):199-202.

OBJECTIVETo detect the stromal cell derived factor 1 (SDF-1) expression during the survival process of the narrow pedicle flap with hypoxia and ischemia and to investigate the role of SDF-1/ CXCR4 axis in flap neovascularization.

METHODSThe narrow pedicle flaps were formed on the bilateral back of 5 pigs. The pedicle ratio of length to width was 4:2. The flap size was 2 cm x 2 cm (group A), 3 cm x 3 cm (group B), 4 cm x 4 cm (group C), 5 cm x 5 cm(group D), 6 cm x6 cm (group E). The flaps survival rate was observed and HE staining was performed. The SDF-1 expression at the distal end of flaps was detected by ELISA during the operation and 3, 5, 7, 14 days after operation.

RESULTS(1) SDF-1 expression at the same group increased after operation until it reached the peak value at 5 days after operation; then it decreased to basic value. (2) SDF-1 expression in different groups was higher in bigger flaps until the flaps size reached 5 cm x 5 cm. Then partial necrosis happened at the distal end of flaps.

CONCLUSIONSThe SDF-1 expression may be related to the blood supply during the survival process of the narrow pedicle flap with hypoxia and ischemia.

Animals ; Cell Hypoxia ; physiology ; Chemokine CXCL12 ; metabolism ; Graft Survival ; physiology ; Ischemia ; physiopathology ; Male ; Signal Transduction ; Surgical Flaps ; blood supply ; physiology ; Sus scrofa ; Swine

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Experimental research on DNA methylation profile in congenital microtia.

Yu-peng SONG ; Lin LIN ; Bo PAN ; Qing-hua YANG ; Juan HAN ; Hai-yue JIANG ; Hong-xing ZHUANG

Chinese Journal of Plastic Surgery.2012;28(3):193-198.

OBJECTIVETo screen for abnormal methylation in CpG islands and CpG sites through whole genome of congenital microtia to identify their associated genes. To discuss the relationship between abnormal methylation level of genes and the etiology of congenital microtia.

METHODSResidual ear cartilage of 50 patients with microtia was collected with ear cartilage of 34 patients without ear malformations as control. Nimblegen CpG promoter array was chosen to screen the 28,226 CpG islands in the whole genome of both experimental and control groups. The genes with differential methylated CpG islands were selected. SpectroCHIP array was chosen to detect the methylation level of each CpG site in abnormal methyletion CpG islands of both experimental and control groups. The CpG sites with differential methylation level were selected.

RESULTSThere were 36 CpG islands with differential methylated level in whole genome between experimental group and control group, among which 29 CpG islands were connected with 29 named genes. In the abnormal methylated CpG islands of COL18A1, MYH14, RBMY1A1 and ZIC3, 6 differentially methylated CpG sites were found with statistical significance. The methylation level of these 6 CpG sites in experimental group and control group were COL18A1_2_CpG_170.9783 +/- 0.0235 and 0.9526 +/- 0.0589; MYH14_CpG_170.9600 +/- 0.0414 and 0.9284 +/- 0.0655; RBMY1A1_1_CpG_3.40.9966 +/- 0.0055 and 0.9914 +/- 0.0069; RBMY1A1_1_CpG_130.9648 +/- 0.0118 and 0.9757 +/- 0.0127; ZIC3_3_CpG_150.0867 +/- 0.0212 and 0.0543 +/- 0.0399; ZIC3_2_CpG_270.3775 +/- 0.1816 and 0.472 3 +/- 0.0439.

CONCLUSIONSThe DNA methylation profile of the entire genome is initially established. The abnormal methylated CpG islands of COL18A1, MYH14, RBMY1A1 and ZIC3 might be related to the pathogenesis of microtia.

Base Sequence ; Cartilage ; Case-Control Studies ; Congenital Microtia ; genetics ; CpG Islands ; genetics ; DNA Methylation ; Humans ; Promoter Regions, Genetic

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Reconstruction of combined skin and bilateral artey defects at palmar side of fingers by free posterior interrosseous artery flap in a bridge fashion.

Bao-cheng XU ; Gang LIANG ; Fu-sheng CHEN

Chinese Journal of Plastic Surgery.2012;28(3):190-193.

OBJECTIVETo investigate the feasibility and therapeutic effect of free posterior interrosseous artery flap in a bridge fashion for combined skin and bilateral artery defects at palmar side of fingers.

METHODS6 cases with combined skin and bilateral artery defects at palmar side of fingers were treated with long-pedicled free posterior interrosseous artery flap in a bridge fashion. The flap size ranged from 3.5 cm x 2.0 cm to 6.5 em x 3.0 cm. The wounds at donor sites were closed directly.

RESULTSAll the 6 flaps survived completely without any complication, and the wounds healed primarily. The blood supply and vein drainage in all the 6 fingers were normal. 4 cases were followed up for 1-12 months (average, 7 months). Satisfactory cosmetic and functional results were achieved. The flaps looked a little bit thicker than the surrounding tissue.

CONCLUSIONSThe long-pedicled free posterior interrosseous artery flap in a bridge fashion is a good option for reconstruction of the combined skin and bilateral artery defects at palmar side of fingers in one stage.

Arteries ; Feasibility Studies ; Fingers ; blood supply ; surgery ; Free Tissue Flaps ; blood supply ; transplantation ; Humans ; Reconstructive Surgical Procedures ; Surgical Flaps ; blood supply ; transplantation ; Transplant Donor Site ; surgery ; Veins

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Skin needle roller importing triamcinolone acetonide into scar to treat hypertrophic scars.

Chang-ming MA ; Jing-long CAI ; Fu-you NIU ; Xian-lei ZONG ; Ying CHEN ; Lin-bo LIU

Chinese Journal of Plastic Surgery.2012;28(3):185-189.

OBJECTIVETo evaluate the effect of importing triamcinolone acetonide into hypertrophic scars with skin roller needles.

METHODSThirty-two cases with burn hypertrophic scar were treated. The skin roller needles were moved back and forth on the hypertrophic scars with triamcinolone acetonide dropping on the scar surface at the same time. So the triamcinolone acetonide could be imported into the scar through needles and needle holes. The effect was evaluated as cured, effective, and no effect. The Vancouver scaring criteria and visual analogue scale was used to assess the scar color, thickness, texture and feeling before and after treatment, as well as at the untreated scar area (control).

RESULTSThirty-two cases were treated 1-3 times, including 28 cases with cured result and 4 cases with effective result. The total effective rate was 100%. The scar color, thickness, texture and feeling was significantly different between the scar before and after treatment, or between the treated and untreated scar (P < 0.05).

CONCLUSIONSImporting triamcinolone acetonide into hypertrophic scars with skin roller needles is effective. It is a new method for the treatment of large hypertrophic scar with medicine.

Burns ; complications ; Cicatrix, Hypertrophic ; drug therapy ; etiology ; Humans ; Injections, Intralesional ; instrumentation ; Needles ; Treatment Outcome ; Triamcinolone Acetonide ; administration & dosage

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Application of slender narrow pedicle flap in facial skin cancer treatment.

Tian-lan ZHAO ; Dao-jiang YU ; Xiao-ming XIE ; Yun-tao ZHANG ; Qi CHEN ; Wen-ya HAN

Chinese Journal of Plastic Surgery.2012;28(3):181-184.

OBJECTIVETo introduce the application of slender narrow pedicle flap in repairing facial tissue defects after skin carcinoma excision, and investigate its survival mechanism.

METHODSThe slender narrow pedicle iateral maxillocevical flap was designed with its pedicle including skin fascia or only the fascia located in front of auricle or behind of it, repaired 26 cases of facial defects, including 5 temporal skin basal cell carcinoma, 6 skin squamous cell carcinoma, and 1 facial skin malignant melanoma, 8 skin basal cell carcinoma, 5 skin squamous cell carcinoma, 1 skin mucinous carcinoma. In 26 cases, 24 cases their pedicles in front of the auricle, 2 cases behind of the auricle; 4 cases their pedicles only including fascia. The size of the flaps ranged from 3.0 cm x 2.5 cm to 10.0 cm x 8.0 cm. The width and length of the pedicle ranged 1.0-1.5 cm and 2-6 cm.

RESULTS26 cases of the slender narrow pedicle flaps all survived and the results were satisfactory except 5 cases of distal congestion, then gradual recovery.

CONCLUSIONSThis slender narrow flap don't include any major blood vessel, without dissecting the blood vessels in operating. Due to its slender pedicle, the whole flap looks like "pingpang bat", the flap rotation is easy and its coverage area is very large, without cat ears. The postoperative appearance (color, texture, cosmetic aspect) is satisfactory. This slender narrow flap is an extraordinary new flap design and is ideal for the repair of the facial tissue defect after skin carcinoma excision.

Carcinoma, Basal Cell ; surgery ; Carcinoma, Squamous Cell ; surgery ; Ear Auricle ; Ear, External ; Facial Neoplasms ; surgery ; Fascia ; transplantation ; Humans ; Melanoma ; surgery ; Skin Neoplasms ; surgery ; Surgical Flaps ; transplantation

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Scalp flaps pedicled with superficial temporal vessel and hair removal for reconstruction of facial skin defects.

Shi-hai CHEN ; Hai-sheng YU ; Qing-feng LIU ; Hui MAI ; Qiang WEI ; Ming-de LIAO

Chinese Journal of Plastic Surgery.2012;28(3):177-180.

OBJECTIVETo investigate the therapeutic effect of scalp flaps pedicled with superficial temporal vessel and hair removal for reconstruction of facial skin defects.

METHODSFrom Jan. 2010 to Dec. 2011, 6 cases with large facial skin defects were treated with scalp flaps pedicled with superficial temporal vessel and hair removal. At the first stage, the skin expanders were implanted subcutaneously at the homolateral side according to the defect size. After the expansion was finished, the expanded flaps pedicled with superficial temporal vessel were used to reconstruct the facial skin defects at the second stage. 2 weeks after operation, hair removal was performed to remove the hair on flaps. 4-6 treatments were needed.

RESULTSSeven flaps in 6 cases were survived completely. The wounds at donor sites were closed directly. The effect of hair removal was reliable. The patients were followed up for 6 months to 1 year. The flap color, texture and thickness had a good match with surrounding skin tissue.

CONCLUSIONSIt is a good option to reconstruct facial skin defects with scalp flaps pedicled with superficial temporal vessel and hair removal.

Adolescent ; Face ; surgery ; Hair Removal ; Humans ; Reconstructive Surgical Procedures ; Scalp ; transplantation ; Surgical Flaps ; blood supply ; transplantation

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Penile augmentation and elongation using autologous dermal-fat strip grafting.

Zhe YANG ; Yang-qun LI ; Yong TANG ; Wen CHEN ; Qiang LI ; Chuan-de ZHOU ; Mu-xin ZHAO ; Chun-mei HU

Chinese Journal of Plastic Surgery.2012;28(3):172-176.

OBJECTIVETo investigate the effect of autologous dermal-fat strip grafting in penile augmentation and elongation.

METHODSFrom May 2004 to December 2010, 24 patients underwent penile enhancement with free dermal-fat strip grafting. Through suprapubic incision, the superior suspensory ligament and part deep suspensory ligament are cutted off to lengthen the penis. The resulted dead space is filled with the autologous dermal-fat strip (6.0-9.5 cm in length, 1.2-1.5 cm in width and 0.6-0.8 cm in depth) to enhance the penis.

RESULTSPrimary healing was achieved in 23 cases. Incisional fat liquefaction happened in one case which healed after dressing change. The penile appearance was satisfactory both at rest or erection. The penile length and circumference increased by 2.5-4.8 cm (average, 3.2 cm) and 1.8-3.0 cm (average, 2.4 cm), respectively. 18 patients were followed up for 3 months to 5 years. All the patients were satisfactory on the cosmetic and functional results. No complication happened.

CONCLUSIONSIt is safe and effective for penile augmention and elongation with autologous dermal-fat strip grafting and disconnection of penile suspensory ligament.

Adipose Tissue ; transplantation ; Humans ; Ligaments ; surgery ; Male ; Organ Size ; Penile Erection ; Penis ; anatomy & histology ; surgery ; Reconstructive Surgical Procedures ; methods

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Combined injection of pingyangmycin & dexamethasone for the treatment of maxillofacial and cervical venous malformations.

Jun ZHAI ; Xiao-dong ZHAI

Chinese Journal of Plastic Surgery.2012;28(3):168-171.

OBJECTIVETo investigate the therapeutic effect of combined injection of pingyangmycin (PYM) & dexame thasone (DXM) for the treatment of maxillofacial and cervical venous malformations.

METHODSFrom August 1995 to October 2008, 116 cases with maxillofacial and cervical venous malformations were retrospectively analyzed. The injection dilute was made with PYM 8 mg, DXM 10 mg and 2% lidocaine 2.0 ml (PYM 2 mg/ml). The PYM diluent 1.0-4.0 ml (including the PYM 2-8 mg) was injected into the tumor according to the patients age, tumor size and location. For children, PYM 2-4 mg was injected for one treatment. The needle should be inserted into tumor perpendicularly or from the edge of tumor. After withdrawing blood, the drug was injected into the tumor slowly. The injection could be repeated every 7-10 days. The clinical signs were recorded; ultrasonography and chest X-ray were performed to evaluate the therapeutic effect.

RESULTS1-5 treatments of injection were performed in the 116 patients. The tumor shrinked and disappeared after treatment with PYM 2-40 mg and DXM 5-50 mg. The patients were followed up for 3-5 years with no occurrence and complication.

CONCLUSIONSIt's safe, effective and practical to treat maxillofacial and cervical venous malformations by combined injection of PYM and DXM. The cosmetic appearance and function can be preserved at the most.

Adolescent ; Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; Bleomycin ; administration & dosage ; analogs & derivatives ; Child ; Dexamethasone ; administration & dosage ; Humans ; Injections ; Maxilla ; Neck ; Retrospective Studies ; Vascular Malformations ; drug therapy ; Veins ; abnormalities

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The therapeutic effect of propranolol with 1064 nm Nd: YAG laser on proliferating hemangioma in body surface.

Ming TAN ; Bo DUAN ; Chun-mei ZHOU ; Hao GONG

Chinese Journal of Plastic Surgery.2012;28(3):164-168.

OBJECTIVETo observe the therapeutic effect of propranolol with 1 064 nm Nd:YAG laser on proliferating hemangioma in body surface.

METHODS97 patients with proliferating hemangiomas in body surface were randomly assigned to three groups: A group (32 patients were treated by propranolol with 1064 nm Nd:YAG laser), B group (35 patients were treated by 1064 nm Nd:YAG laser), C group (30 patients were treated by propranolol). Their visual analog scores, clinical outcomes and adverse events were compared respectively.

RESULTS18 weeks later, A group had a mean visual analog score of 65.50 +/- 16.55, compared with 54.03 +/- 20.13 in B group, 28.08 +/- 30.34 in C group (P < 0.05); 24 weeks later, the mean visual analog scores of three groups were 76.88 +/- 19.05, 63.89 +/- 19.43 and 45.48 +/- 31.86 (P < 0.05). After 24 weeks' treatment, 9 cases (28.1%) in A group, 3 cases (8.6%) in B group, 1 cases (4.0%) in C group obtained complete healing (P < 0.05). To effect of adverse events in body surface, the mean score of B group was higher than the scores of A group and C group (P < 0.05).

CONCLUSIONSPropranolol with 1064 nm Nd:YAG laser is effective and safe in the treatment of proliferating hemangioma.

Angiogenesis Inhibitors ; therapeutic use ; Combined Modality Therapy ; methods ; Hemangioma ; therapy ; Humans ; Lasers, Solid-State ; therapeutic use ; Propranolol ; therapeutic use ; Skin Neoplasms ; therapy

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Topical timolol in the treatment of periocular superficial infantile hemangiomas: a prospective study.

Xiao-xiao YE ; Yun-bo JIN ; Xiao-xi LIN ; Gang MA ; Xiao-dong CHEN ; Ya-jing QIU ; Hui CHEN ; Xiao-jie HU

Chinese Journal of Plastic Surgery.2012;28(3):161-164.

OBJECTIVETo investigate the efficacy and side effect of topical beta-blocker (Timolol Maleate) in the treatment of periocular hemangioma in a prospective study.

METHODS432 outpatients with infantile hemangioma visited our special clinic service in Shanghai Ninth People's Hospital from July 2010 to December 2011. Among them, 12 superficial periocular lesions were selected in the study. Timolol was used topically on the lesion in every 12 hours. Two independent special doctors evaluated the results according to the pictures before and after four-week application of timolol.

RESULTSWere categorized into four levels: continuous growth (the lesion continues to grow), stable (no visible change), moderate (0-50% of regression) , perfect (more than 50% of improvement). Result of the 12 outpatients, 4 showed perfect result, 2 moderate, 4 stable and 2 continuous growth. No side effect was observed.

CONCLUSIONSTopical timolol is effective and safe in the treatment of superficial periocular infantile hemangioma. It could be considered as the first line treatment of proliferative superficial hemangioma.

Administration, Topical ; Angiogenesis Inhibitors ; therapeutic use ; China ; Facial Neoplasms ; drug therapy ; pathology ; Hemangioma ; drug therapy ; pathology ; Hemangioma, Capillary ; drug therapy ; pathology ; Humans ; Infant ; Prospective Studies ; Skin Neoplasms ; drug therapy ; pathology ; Timolol ; therapeutic use ; Treatment Outcome

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