Congenital microtia is a significant birth defect affecting the external ear. Currently, reconstruction of auricle has become a mature method for repairing microtia. Autologous rib cartilage is the preferred material for external ear support due to its favorable histocompatibility after implantation, no rejection, easy accessibility, facile contouring and low infection rate. Moreover, it is widely applied in the domains of ear reconstruction and rhinoplasty. Current primary approaches to external ear reconstruction include skin and soft tissue expansion, as well as non-expansion techniques. However, due to the intricate structural modifications required in these procedures, it is a challenge to avoid the complications. Postoperative complications associated with non-expansion external ear reconstruction include hematoma, infection, wire suture exposure, flap ischemia and necrosis, cartilage scaffold exposure, cartilage scaffold resorption, eczema, and cranio-auricular angle contracture. In cases of post-expansion external ear reconstruction, complications may include hematoma at the expansion site, infection, incision dehiscence, expansion flap necrosis, leakage or malfunction of the expander, expander exposure, and retraction of the expansion flap. Thoracic complications related to incised costal cartilage include deformity, pain, pneumothorax, and scarring. This study details the prevention and management of the aforementioned complications, aiming to serve as a reference for clinical treatment practices.

Objective:To analyze the application effects and safety of continuous negative pressure drainage devices in postoperative drainage of congenital microtia reconstruction of auricle.Methods:A retrospective study was conducted, including 1 211 patients with congenital microtia treated at the Plastic Surgery Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College from January 2018 to August 2021. All patients underwent auricular reconstruction surgery and were divided into two groups based on the type of negative pressure drainage device used. The study group consisted of 624 patients [315 males and 309 females, aged 6-24 (15.1±2.2) years], while the control group consisted of 587 patients [286 males and 301 females, aged 5-23 (14.7±2.3) years]. The study group used a novel negative pressure drainage ball, while the control group used a conventional negative pressure syringe for drainage. The preoperative and postoperative 1, 7 days scores of the modified Yale preoperative anxiety scale (mYPAS) and the quality of life scores postoperative 3 days (including functional activity, self-image, psychological health, satisfaction and pain) were compared between the two groups. All patients were followed up at 4, 8, 12, and 16 weeks postoperatively to compare the surgical scar area between the two groups. The incidence of adverse reactions within 12 weeks after surgery in two groups were recorded.Results:There was no significant difference in preoperative mYPAS scores between the two groups ( P=0.897). The mYPAS scores at 1 and 7 days after surgery were lower than the preoperative scores in both groups (all P<0.05), and the study group had significantly lower mYPAS scores at all time points than those of the control group (all P<0.001). The study group had higher scores in functional activity, self-image, psychological health, and satisfaction than those of the control group (all P<0.001), and a lower pain score than that of the control group ( P<0.001). Follow-up at 4, 8, 12, and 16 weeks showed that the surgical scar area was significantly smaller in the study group at all time points than in the control group (all P<0.001). The incidence of adverse reactions within 12 weeks after surgery was 9.0% (56/624) in the study group, which was lower than the 19.4% (114/587) in the control group ( P<0.001). Conclusion:The use of continuous negative pressure drainage devices in congenital microtia reconstruction of auricle is more effective and can reduce the incidence of postoperative adverse reactions.

Objective:To investigate the effect of titanium wire-absorbable suture dual line combined firm stitching technique in costal cartilage framework shaping for auricular reconstruction in congenital microtia patients.Methods:A retrospective study was conducted on 120 patients with congenital microtia who underwent auricular reconstruction surgery at the Plastic Surgery Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College from January 2020 to December 2021. Among these, 86 were male and 34 were female, with an age range of 6-15 (8.5±2.1) years. All patients underwent auricular reconstruction using the expanded skin flap method, and the titanium wire-absorbable suture dual line combined firm stitching technique was used to construct a multi-layer three-dimensional autologous costal cartilage framework. Postoperative follow-up was conducted for 1 to 3 years to evaluate the morphology, stability, patient satisfaction, and occurrence of adverse reactions.Results:Of the 120 patients, 119 (99.2%) achieved primary healing. The reconstructed auricles were lifelike with clear substructures, and the long-term shape of the auricles remained stable without significant deformation. One patient developed a local skin infection and ulceration, leading to exposure of the cartilage framework, which was successfully repaired using a temporal fascia flap and free skin graft. A total of 85.8% (103/120) of the patients were satisfied with the postoperative results, 13.3% (16/120) rated the outcome as average, and 0.8% (1/120) were dissatisfied. No cases of hematoma or flap necrosis were observed in any of the patients.Conclusion:The costal cartilage framework, constructed using the titanium wire-absorbable suture dual line combined firm stitching technique, demonstrates good clinical effects for auricular reconstruction with no severe adverse reactions.

Objective:To investigate the clinical efficacy of perforator-based bilobed flaps in the treatment of stage 4 pressure ulcers.Methods:This retrospective observational study included 29 patients (21 males, 8 females) with stage 4 pressure ulcers admitted to the Department of Burn and Plastic Surgery and Wound Repair at Xuzhou First People's Hospital from August 2021 to May 2023. The patients' ages ranged from 12 to 82 (61.3±15.7) years. For ischial tuberosity pressure ulcers, reconstruction was performed using a posterior femoral bilobed flap based on the first perforator of the deep femoral artery, combined with a small gluteus maximus muscle flap. Sacrococcygeal pressure ulcers were repaired using a bilobed flap based on the superior or inferior gluteal artery perforator. Post-operative follow-up lasted for 2-36 months, during which flap survival and complications were assessed.Results:All the 29 bilobed flaps were successfully rotated and provided for adequate coverage without the need for pedicle division or perforator vessel dissection. Primary healing was achieved in 26 cases, with suture removal occurring two weeks post-operatively. Three patients experienced partial wound dehiscence and marginal necrosis due to post-operative pressure, which healed after two weeks of debridement and dressing changes. During follow-up for 2-36 months, no pressure ulcer recurrence was observed. The flaps demonstrated excellent survival, with soft texture, good elasticity, and adequate blood supply. The donor sites healed with only linear scars, and no severe complications were reported.Conclusion:Bilobed flaps based on artery perforators demonstrate excellent clinical outcomes in the treatment of stage 4 pressure ulcers.

Objective:To evaluate the quality of life in patients with psoriasis across varying levels of psychological resilience.Methods:A cross-sectional study was conducted, employing a convenient sampling method to recruit 390 psoriasis patients from Beijing University of Chinese Medicine Dongzhimen Hospital from February to August 2023. The sample included 57 male and 333 female patients, with a mean age of (24.9±5.4) years. Participants were guided through questionnaire completion using a standardized protocol by trained investigators. Patients were stratified into three groups based on the Connor-Davidson Resilience Scale (CD-RISC-10): low ( n=53), moderate ( n=251), and high ( n=86) psychological resilience. The dermatology life quality index (DLQI) was utilized to assess quality of life across six domains: symptom perception, daily activities, leisure and recreation, work and study, interpersonal relationships, and treatment. Results:The total scores for the DLQI among psoriasis patients with low, moderate, and high psychological resilience were 10.05 (6.75, 15.00), 7.00 (4.00, 11.00), and 5.00 (2.00, 10.00), respectively. Symptom perception scores were 3.00 (2.00, 4.00), 2.00 (2.00, 4.00), and 2.00 (1.00, 3.00), respectively. Scores for daily activities were 2.00 (2.00, 4.00), 1.00 (1.00, 2.00), and 1.00 (0.00, 2.00), respectively. Leisure and recreation scores were 2.00 (1.00, 3.00), 1.00 (0.00, 3.00), and 1.00 (0.00, 2.00), respectively. Work and study scores were 1.00 (0.00, 3.00), 0.00 (0.00, 1.00), and 0.00 (0.00, 1.00), respectively. Interpersonal relationship scores were 1.00 (0.00, 2.00), 0.00 (0.00, 1.00), and 0.00 (0.00, 1.00), respectively. Treatment scores were 1.00 (0.00, 1.25), 0.00 (0.00, 1.00), and 0.00 (0.00, 1.00), respectively. Statistically significant differences were observed in the total DLQI scores and individual item scores among the three groups (all P<0.05), with patients exhibiting high psychological resilience demonstrating superior quality of life. Conclusion:This study demonstrates statistically significant differences in the quality of life among psoriasis patients with varying psychological resilience levels, and those exhibiting higher resilience demonstrate superior quality of life.

Objective:To observe the clinical efficacy of immediate repair of extracranial branch defects in the facial nerve through transplantation of the great auricular nerve.Methods:A retrospective inclusion was carried out on 17 patients with extracranial branch defects of the facial nerve caused by parotid malignant tumors and neurogenic tumors in the Department of Stomatology of Xuzhou Central Hospital from June 2021 to January 2023, including 10 males and 7 females, with the age ranged from 28 to 68 (42.4±11.4) years old. All patients underwent immediate transplantation of the greater auricular nerve during the operation. The facial nerve function was evaluated according to the House-Brackmann (HB) facial paralysis grading standard at the last follow-up. Grade Ⅰ-Ⅲ was considered effective, and grade Ⅳ-Ⅵ was considered ineffective. The quality of life was evaluated using the physical function score (FDIP) and social function score (FDIS).Results:The follow-up time was 6-30 (18.3 ±6.6) months. The facial nerve function was classified as grade Ⅰ in four cases, grade Ⅱ in six cases, grade Ⅲ in four cases, and grade Ⅳ in three cases. This resulted in an effective rate of 14/17. The FDIP score at the final follow-up was (84.7 ±9.1) points, which was higher than the (54.1 ±20.6) points recorded at the immediate moment of repair ( P<0.001). In contrast, the FDIS score was (11.8 ±8.9) points, which was lower than the (57.5 ±11.7) points recorded at the immediate moment of repair ( P<0.001). Conclusion:The transplantation of the auricular great nerve can effectively enhance facial nerve function and improve the life quality in the immediate repair of defects in the extracranial branches of the facial nerve.

The treatment of hair loss often involves the use of oral medications, topical applications and hair transplantation. However, these methods come with drawbacks such as poor effectiveness, significant side effects, high recurrence rates, or high costs. In recent years, fractional laser therapy has emerged as a new choice for hair loss treatment due to its safety, effectiveness and high tolerance. Nonetheless, its mechanism of action in treating hair loss, application protocols and therapeutic outcomes need further clarification for broader clinical application. This article summarizes the treatment principles of fractional laser therapy, elaborates on the application effects and safety of different types of fractional lasers in treating hair loss, providing these for clinical references.

Objective:To observe the effects of medical tissue glue on skin repair after facial tumor resection.Methods:A retrospective analysis was performed for 32 patients who underwent facial tumor resection in the Shenshan Medical Center, Memorial Hospital of Sun Yat-sen University from October 2021 to May 2022, including 22 males and 10 females, with a median age of 36 (2-66) years. Patients were divided into the medical tissue glue group ( n=15) and the suture group ( n=17) based on the method of skin closure after surgery. The operation time, grade A wound healing rate and Vancouver scar scale (VSS) score were compared between the two groups. Satisfaction evaluation was performed independently by patients 6 months after incision healing. Results:The operation time of the medical tissue glue group and the suture group were (44.07±7.00) and (47.41±9.06) minutes, the VSS scores were (1.93±0.96) and (1.88±0.84) points, respectively. The differences were not statistically significant (all P>0.05). The grade A wound healing rate of patients in the medical tissue glue group was 100.0% (15/15), the satisfaction rate was 100.0% (15/15), of which 10 cases were satisfied and 5 cases were relatively satisfied. The grade A wound healing rate of patients in the suture group was 100.0% (17/17), the satisfaction rate was 100.0% (17/17), of which 13 cases were satisfied and 4 cases were relatively satisfied. Conclusion:Medical tissue glue can achieve good cosmetic results in facial tumor resection.

Objective:To explore the evolution process of coping styles in patients with keloids.Methods:A purposive sampling method was used to select 35 keloid patients from the Department of Plastic Surgery, Peking Union Medical College Hospital from August 2022 to May 2024. The cohort included 13 males and 22 females, aged 12-66 (35.1±3.5) years. Semi-structured interviews were conducted with the patients based on the self-depletion theory, and themes were extracted to construct a theoretical framework.Results:During the course of keloid disease, the initiating factors leading to maladaptive coping styles in patients included symptom distress, body image disturbance, lack of support, and excessive family reactions. Under the influence of these initiating factors, patients exhibited impairments in cognition, emotion, and attention control, followed by impulsive decision-making, negative emotions and avoidance, as well as diminished willpower and submission, ultimately resulting in maladaptive coping styles.Conclusions:Maladaptive coping styles in patients with keloids are a self-depletion process triggered by multiple factors. Intervening at the cognitive, emotional, and attention control levels can help patients develop effective coping styles for their condition.

Objective:To analyze the effect of one stitch technique of transverse incision and longitudinal suture in repairing secondary nasal deformity of cleft lip.Methods:A retrospective study was conducted on 127 patients who underwent the one stitch technique of transverse incision and longitudinal suture for repairing secondary nasal deformities after unilateral cleft lip surgery in the Department of Plastic and Aesthetic Surgery at Southern Hospital of Southern Medical University from October 2010 to December 2022. There were 58 males and 69 females with a median age of 26 (18-42) years. After removing the scar on the upper lip and the cartilage of the nasal septum during surgery, the affected nasal basal area was extensively separated. The lateral groove of the nasal wing and the tail edge of the nasal septum cartilage were sutured using one stitch technique with silk thread. Subsequently, the constricted affected nostril was enlarged by M-T flap. Outpatient follow-up visits were conducted at 1, 3, 6, 12 and 18 months after surgery. Two physicians and patients subjectively evaluated the postoperative outcomes, including very satisfied, satisfied, average, and poor, and the final evaluation results were included in statistical analysis.Results:During the treatment process, the patient did not experience any complications such as infection, hematoma, or incision rupture. A total of 116 cases were followed up for more than 3 months after surgery, of which 35.3% (41/116) were very satisfied, 38.8% (45/116) were satisfied, 24.2% (28/116) were generally satisfied, and 1.7% (2/116) were not satisfied. The two patients with poor results underwent another one stitch technique for adjustment, both achieving satisfactory results.Conclusion:The effect of one stitch technique of transverse incision and longitudinal suture for repairing cleft lip and secondary nasal deformities is stable and the satisfaction of patients is high.