Objective:To explore the method and clinical effect of repairing neck radiation ulcer with superficial cervical artery flap.Methods:January 2016 to June 2019, 11 cases of neck radiation ulcer were repaired with superficial cervical artery flap. The ulcer occurred 13.4 years after radiotherapy on average, with an area between 1 cm×2 cm and 3 cm×7 cm, extensive fibrosis.After pathological examination, surgical removal of ulcer and surrounding fibrotic tissue, and avoid injuring the neck’s main blood vessels. Wound size after debridement: 6 cm×9 cm-8 cm×13 cm. The flap rotation point is 4-5 cm beside the spine on the acromion level.The flaps were designed along the skin branch of the superficial cervical artery which located by the Doppler blood flow detector.The distance from the rotation point to the flap’s proximal edge is about 2 cm longer than that of the wound’s proximal edge.The size of the flap is about 2 cm larger than the wound.Then the flaps were excised from far to near after exposing the pedicle. The flap was then transferred to the neck to repair the defect formed by the radiation ulcer’s excision. If the tension is low, the donor sites were dissociated about 2-3 cm, then sutureddirectly after reducing tension.If the tension is high, part of the donor site was sutured to reduce the area and then grafted with medium-thickness skin.The postoperative changes of the patient were carefully observed.Among them, 7 cases underwent one-stage operation, 4 cases underwent two-stage operation after the donor area’s pre-expansion.Results:All patients with radiation ulcers were healed completely.The appearance and function of the operation area were good.Followed up for 6-24 months, no recurrences of radiation ulcer were observed. Among them, the flaps of 10 cases survived completely, and the wound healed in one stage.The distal area of the flap necrosed in one case, and repaired by dressing change and skin grafting.Conclusions:Radiation ulcer of the neck is a serious long-term complication after radiotherapy. Once it occurs, it is difficult to heal by conservative treatment. Skin grafting is difficult to survive as well. The superficial cervical artery flap has a constant and abundant blood supply and a hidden donor area, which is a feasible method for the treatment of radiation ulcer of the neck and reconstruction of the function.

Objective:To explore the method and clinical effect of repairing neck radiation ulcer with superficial cervical artery flap.Methods:January 2016 to June 2019, 11 cases of neck radiation ulcer were repaired with superficial cervical artery flap. The ulcer occurred 13.4 years after radiotherapy on average, with an area between 1 cm×2 cm and 3 cm×7 cm, extensive fibrosis.After pathological examination, surgical removal of ulcer and surrounding fibrotic tissue, and avoid injuring the neck’s main blood vessels. Wound size after debridement: 6 cm×9 cm-8 cm×13 cm. The flap rotation point is 4-5 cm beside the spine on the acromion level.The flaps were designed along the skin branch of the superficial cervical artery which located by the Doppler blood flow detector.The distance from the rotation point to the flap’s proximal edge is about 2 cm longer than that of the wound’s proximal edge.The size of the flap is about 2 cm larger than the wound.Then the flaps were excised from far to near after exposing the pedicle. The flap was then transferred to the neck to repair the defect formed by the radiation ulcer’s excision. If the tension is low, the donor sites were dissociated about 2-3 cm, then sutureddirectly after reducing tension.If the tension is high, part of the donor site was sutured to reduce the area and then grafted with medium-thickness skin.The postoperative changes of the patient were carefully observed.Among them, 7 cases underwent one-stage operation, 4 cases underwent two-stage operation after the donor area’s pre-expansion.Results:All patients with radiation ulcers were healed completely.The appearance and function of the operation area were good.Followed up for 6-24 months, no recurrences of radiation ulcer were observed. Among them, the flaps of 10 cases survived completely, and the wound healed in one stage.The distal area of the flap necrosed in one case, and repaired by dressing change and skin grafting.Conclusions:Radiation ulcer of the neck is a serious long-term complication after radiotherapy. Once it occurs, it is difficult to heal by conservative treatment. Skin grafting is difficult to survive as well. The superficial cervical artery flap has a constant and abundant blood supply and a hidden donor area, which is a feasible method for the treatment of radiation ulcer of the neck and reconstruction of the function.

Objective:To explore the clinical effects of flaps with cervical cutaneous branch of transverse cervical artery in repairing neck radiation ulcer.Methods:The retrospective observational research was conducted. From January 2016 to December 2019, 8 cases with neck radiation ulcer were admitted to Guangzhou Red Cross Hospital of Jinan University and repaired with flaps based on cervical cutaneous branch of transverse cervical artery. There were 6 males and 2 females, aged 52-75 years. The ulcers occurred 14.5 years after radiotherapy on average, with ulcer areas of 5.0 cm×3.0 cm-7.0 cm×6.0 cm on admission. The wound areas were ranged from 6.0 cm×5.0 cm to 13.0 cm×6.5 cm after ulcers and fibrotic tissue around were resected. Seven cases underwent resection of flaps and wound repair operation on the first stage, and the other 1 case underwent pre-expansion of flap donor area on the first stage and resection of flap and wound repair operation on the second stage, with flap sizes of 8.0 cm×7.0 cm-15.0 cm×8.5 cm. The wounds in the donor areas of flaps in 7 patients were sutured directly, and the wound in the donor area of flap in the other 1 patient was repaired with thin split-thickness skin graft from thigh after being sutured partially. The preoperative ulcer tissue was collected for pathological examination, and the postoperative survival of the flaps and healing of the flap donor areas were observed. The flaps, the recurrence of the neck ulcers and neck function, and the scar hyperplasia in the donor areas of flaps were observed during follow-up.Results:Preoperative pathological examination of ulcer tissue showed that full-thickness necrosis occurred in ulcer skin, obvious fibrotic tissue hyperplasia, collagenization, and small-scale calcification in the base and surrounding tissue of the ulcers, and a large amount of chronic inflammatory cells and a small amount of acute inflammatory cells infiltration were observed in intercellular substance, which excluded the recurrence of tumor. All the flaps in 8 cases survived, the wounds were repaired effectively, and the postoperative donor areas of flaps healed well. During postoperative follow-up of 6-24 months, the flaps had good appearances without recurrence of ulcer, the movement function of neck was significantly improved, and no obvious scar hyperplasia was observed in the donor areas of flaps.Conclusions:Radiation ulcer in the neck is a serious long-term complication of neck after radiotherapy, which is difficult to heal with conservative treatment. The flap with cervical cutaneous branch of transverse cervical artery is close to the neck, with rich blood supply, constant anatomy, and is easy to cut. Neck radiation ulcers treated with the flaps showed good wound healing and improved functions, with no obvious scar hyperplasia.

Objective To investigate the effect of 15d-PGJ2 on the expression of collagen type,CTGF and a-SMA in the hypertrophic scar in the rabbit ear,and the possibility of hypertrophic scar treated by 15d-PGJ2.Methods 18 New Zealand white rabbits were used to establish a hypertrophic scar model on the rabbit ear.The wounds were established as follows:2 cm × 3 cm wounds with total skin loses on the ventral side,2 wounds for each ear,totally 72 wounds.The wounds were randomly divided into the 15d-PGJ2 treatment group and NS control group.20μl 15d-PGJ2 or NS was injected into the ear scar once a day for 7 days.At 7,14 and 21 days after the injection,12 scars of each group were harvested.The expression of collagen type Ⅰ,CTGF and a-SMA was detected by immunohistochemical method.Results Excessive dermal scars on rabbit ears that were similar to human hypertrophic scar appeared in the two groups.Compared with the NS-treated scars group,the 15d-PGJ2-treated scars appeared to be smaller,softer,flatter and lighter in color.The expression of collagen type Ⅰ,CTGF and a-SMA in the 15d-PGJ2 group was significantly decreased as compared with that in the control group at different time points(P＜0.05).Conclusion 15d-PGJ2,the ligand of PPAR-r,can reduce the expression of collagen type Ⅰ,CTGF and a-SMA of hypertrophic scar in the rabbit ears and plays an important role in the prevention and treatment of hypertrophic scar.It may provide a new approach for the treatment of hypertrophic scar in clinical setting.

OBJECTIVE To observe the bacterial content on the suspension bed sheet in burns intensive care unit.METHODS To detect the bacterial content on the suspension bed sheet and the common sickbed sheet(20 sheets in each group) after sampling them before use and 12 and 24 hours after use and to compare them.RESULTS The bacterial content on two sorts of the sheets before use was accorded with the Ministry of Health standards.but 12 hours after use the significant bacterial content on the common sickbed sheet [(4.9?2.1) CFU/cm2] was much higher than that on the suspension bed [(3.2?1.1) CFU/cm2,P0.01].CONCLUSIONS Using suspension bed could reduce bacterial content on the sheet and ease nurse workload.