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Table of Content

    23 July 2020, Volume 6 Issue 4 Previous Issue    Next Issue
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    Original article
    Repair of Mandibular Defect by Using Tissue Engineered Bone:A Report of 3 Cases
    ZHOU Xiao,CAO Yilin,CUI Lei,YU Jianjun,LI Zan,CHEN Jie,ZUO Chaohui,LIU Guangpeng,MO Yi,HU Bingqian,WU Shengqi
    2010, 6 (4):  183-187.  DOI: 10.3969/j.issn.1673-0364.2010.04.002
    Abstract ( 486 )  
    Objective To explore the feasibility of hBMSCs acting as seeding cell for tissue engineered bone in the repairing of mandibular after tumor surgery.Methods Three patients with mandibular defect were treated by tissue engineered bone after tumor surgery.The hBMSC were isolated by percolling gradient centrifugation from patient''s bone marrow aspirated from iliac crest.The hBMSC were cultured in vitro and induced.The osteogenic induced hBMSC were in partly demineralized allogenic bone scaffold and cultured for 1 month.The defects were repaired with the cell-scaffold construct.All cases were followed up for half a month,3 months,2 years postoperatively by PET-CT.Results PET-CT demonstrated that tissue engineered bone was formed in 3 months postoperatively.The tissue engineered bone can repair bone defect,and maintained stable effect.Conclusion The tissue engineered bone from hBMSCS can be formed in human body stably and used for repairing mandibular defect with satisfactory results.
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    Use of Mucosal Flaps at Lip Margin in the Repair of Nasal Floor Defect of Unilateral Complete Cleft Lip
    DING Wenxiong,CHANG Lei,ZHU Chang,YU Li,ZHANG Bo,WANG Jian
    2010, 6 (4):  188-189.  DOI: 10.3969/j.issn.1673-0364.2010.04.003
    Abstract ( 300 )  
    Objective To explore a simple and reliable method to decrease tension of the nasal floor and guarantee closure of the nasal floor in the treatment of unilateral complete cleft lip.Methods Two mucosal flaps were made at the lip margin to close the nasal floor with little tension,and vestibular oronasal fistula as well.Results Total 37 patients showed healing by first intention at the incision site without obvious scar,good closure at the nasal floor,and fullness of nasal sill and floor.Conclusion Mucosal flaps at lip margin can repair nasal floor defect effectively in unilateral complete cleft lip.
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    Repair of Soft Tissue Defect of Leg Using Thoracodorsal Perforator Flap by Bridge Transfer
    ZHANG Gonglin,DING Faming,GUO Ao,CHEN Keming,ZHENG Liangjun
    2010, 6 (4):  190-192.  DOI: 10.3969/j.issn.1673-0364.2010.04.004
    Abstract ( 361 )  
    Objective To summarize clinical results of free thoracodorsal perforator flaps or muscle flaps by the bridge transplantation in the repair of soft tissue defect of the leg.Methods From September 2006 to January 2009,11 patients with soft tissue defect of the leg underwent reconstruction with free thoracodorsal perforator flap or muscle flap by the bridge transplantation.Soft tissue defect ranged from 4 cm × 8 cm to 8 cm × 22 cm.The thoracodorsal artery perforator flaps or muscle flaps were elevated with subscapular and circumflex scapular vessels forming a T pedicle.The T shaped vascular pedicle of the thoracodorsal artery perforator flaps or muscle flaps were anastomosed to the two vascular ends of the posterior tibial artery of normal leg by end-to-end anastomosis.Immediate coverage of the vascular pedicle were performed by a meshed split-thickness skin graft.Results One flap developed minor superficial skin infection and distal part,the wound healed after change dressing.The thoracodorsal artery perforator flaps or muscle flaps survived completely without major complications and with satisfactory clinical results.Follow-up period ranged from 9 months to 3.6 years(mean 2.9 years).There was no remarkable donor site morbidity.All cases had good appearance in recipient and donor site.The patency of the posterior tibial artery of contralateral legs were demonstrated by Doppler examination.Conclusion This technique is particularly useful in the reconstructive of the leg.The patency of the posterior tibial artery of contralateral leg are preserved in clinical application of the bridge free thoracodorsal artery perforator flaps or muscle flaps.This technique can reduce the injury at the donor site.
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    Repair of Complex Wound with Modified Opposed Reversed Fascial Flap of Medial Leg
    WANG Banghe,WANG Chunlan,CAO Dongshen,DING Hao,ZHANG Lin
    2010, 6 (4):  193-195.  DOI: 10.3969/j.issn.1673-0364.2010.04.005
    Abstract ( 451 )  
    Objective To evaluate the clinical effects of the modified opposed reversed fascial flap of medial leg for repairing complex wound.Methods Twelve patients with complex wound were treated with modified opposed reversed fascial flaps of medial leg.There were tibia exposure in 7 cases,discontinuous wounds in 3 cases and pressure insoles in 2 cases.Results Twelve patients were followed up 1-3 years.All 17 flaps survived and incision healed primarily.The appearance and function of the flaps were all satisfactory.Conclusion The treatment of complex wound with the modified opposed reversed fascial flap of medial leg is recommendable.It can be easily and conveniently performed for more cases.
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    Anterolateral Thigh Perforator Flap for Repair Soft Tissue Defects of Anterior Tibial
    ZHOU Rong,JIN Guangzhe,JU Jihui,WEI Cheng,LIU Yufei,ZHAO Qiang,LI Lei,LI Jiangning,LIU Xinyi,HOU Ruixing
    2010, 6 (4):  196-198.  DOI: 10.3969/j.issn.1673-0364.2010.04.006
    Abstract ( 403 )  
    Objective To explore the clinical results of applying free anterolateral thigh perforator flap to repair skin and soft tissue defects in anterior tibial.Methods Fourteen cases of skin and soft tissue defect of anterior tibial with exposed bone using free anterolateral thigh perforator flap.The size of the flaps ranged between 14 cm × 6 cm and 23 cm × 12 cm.The donor area was directly closed or full-thickness skin grafting.Results All flaps survived in 14 cases.All patients were available for follow-up 3-24 months.The repaired tissue was in good match with surrounding tissue.Eight cases achieved protective sensation.Conclusion Anterolateral thigh perforator flap could be used to repair the soft tissue defects of anterior tibial and obtain good colour,contour.
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    Reversed Peroneal Perforator Superficial Sural Nerve Nutrient Vessel Flap Pedicled with Peroneal Vessel for Reconstruction of Soft Tissue Defect in Ankle and Foot
    DU Zhijun,GUO Shaoyong,MU Shimin,WANG Xinjiang,ZHAO Zuogong,JIA Hongwei,YAO Junna,XIAO Zhenjie
    2010, 6 (4):  199-200.  DOI: 10.3969/j.issn.1673-0364.2010.04.007
    Abstract ( 491 )  
    Objective To explore the clinical effect of reversed peroneal perforator superficial sural nerve nutrient vessel flap pedicled with peroneal vessel for reconstruction of soft tissue defects in ankle and foot.Methods Twenty five patients with soft tissue defects in ankle and foot were treated by superficial sural nerve nutrient vessel flap.Nineteen flaps were supplied by the ascending branch of the terminal peroneal perforator,while 6 flaps were supplied by the descending branch of the terminal peroneal perforator.The area of tissue loss ranged from 4 cm × 3 cm and 10 cm × 9 cm,and the flaps were measured from 6 cm × 5 cm and 11 cm × 9.5 cm in size.Results Twenty three flaps survived completely,while 2 flaps occurred necrosis distally which were treated by debridement and skin graft coverage.Mild swelling was observed in the early postoperative days,without severe venous congestion.The follow-up ranged from 6 to 18 months,and the cosmetic and plastic aspects of the flaps were evaluated as acceptable in all cases.The donor site healed uneventfully.Conclusion The reversed superficial sural nerve nutrient vessel pedicled with flap peroneal perforator provides a reliable tool for repairing soft-tissue defects of ankle and foot.
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    Clinical Application of Rotation-Advancement Fasciocutaneous Flap in the Treatment of Skin Defect
    HUANG Yixiong,JIA Wanxin,SHEN Zunli
    2010, 6 (4):  201-202.  DOI: 10.3969/j.issn.1673-0364.2010.04.008
    Abstract ( 423 )  
    Objective To study the clinical effectiveness of using rotation-advancement fasciocutaneous flap in repairing tissue defect.Methods The nature contour line according to the wound diameter was made about 4 times as long as diameter.The cephalic part of the flap was harvested initially at superficial fascia and the incision was elongated to the lateral.Results There were 30 rotation-advancement fasciocutaneous flaps.The colour and texture of the flaps were excellent with satisfactory cosmetic results.All free flaps survived.Conclusion Rotation-advancement fasciocutaneous flap has advantages of simple dissection,satisfactory appearance,normal sensation and good function.It is an effective procedure in the treatment of skin defect.
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    Clinical Application of Vacuum Sealing Drainage in Severe Degloving Injury of the Hand
    JIANG Fangzheng,HU Xueqing,SHAO Zheren,MA Qi
    2010, 6 (4):  203-205.  DOI: 10.3969/j.issn.1673-0364.2010.04.009
    Abstract ( 413 )  
    Objective To evaluate the clinical results of Vacuum Sealing Drainage in repair of severe degloving injury of the hand.Methods Since 2008,10 patients with severe degloving injury of the hand(typeⅡ) were treated by full-thickness skin graft in palm and dorsum of the hand with VSD and fingers embedding in abdominal wall in first stage and skin transplantation in second stage with VSD.Results All skin graft in palm and dorsum of the hand survived well except 3 cases of local necrosis with secondary healing.Skin graft in fingers survived in 9 cases except 1 case of finger tip necrosis in three fingers.Conclusion Vacuum Sealing Drainage in the treatment of severe degloving injury of the hand works conveniently with short treatment cycle and less pain.All patients obtained satisfactory shape and function.
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    The Application of Vacuum Sealing Drainage in the Large Defect with Infection
    HAN Jiahong,LEI Chulin,LI Renpeng
    2010, 6 (4):  206-207.  DOI: 10.3969/j.issn.1673-0364.2010.04.010
    Abstract ( 396 )  
    Objective To evaluate the clinical effects of the vacuum sealing drainage(VSD) in treating large defect of lower limb combing with infection.Methods Fourteen patients with large skin avulsion were treated by mesh skin grafting combining with VSD.Results The average duration of VSD is 8.5 days.13 patients survived all skin wound healing,and 1 patient skin graft survival of 95%.After dressing,the wound healing,limb motor function and appearance of a good recovery.Conclusion Mesh skin grafting with VSD for treatment of large defect with infection can provide better wound drainage,control infection and promote skin graft survival.
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    Application of Vacuum Sealing Drainage in the Osteo-Fascial Compartment Syndrome
    DU Zhijun,MU Shimin,WANG Xinjiang,GUO Shaoyong
    2010, 6 (4):  208-210.  DOI: 10.3969/j.issn.1673-0364.2010.04.011
    Abstract ( 413 )  
    Objective To explore the clinical application of vacuum sealing drainage(VSD) in the patients of osteo-fascia compartment syndrome(OCS) with fasciectomy.Methods A total of 11 patients with OCS were treated by 18 fasciectomies with VSD.The area of wound was 26 cm × 10 cm-12 cm × 6 cm.Results Fasciectomy wounds of 18 patients were primarily closed and VSD without skin graft.Five cases were closed by one course of drainage,10 cases were closed by two courses of drainage,and the others were closed by three courses of drainage.The time of treatment ranged from 7 to 21 days,with 13 days in average.One case occurred infection but healed after debridement and dressing.After 3 to 6 follow-up,the wound were healed successful without any complications.Conclusion Fasciotomy wound can be closed successfully by vacuum sealing drainage.
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    Endovascular Therapy of Venous Malformations:Evaluation of Safety and Efficacy
    JIN Yunbo,LIN Xiaoxi,LI Wei,HU Xiaojie,MA Gang,CHEN Hui,FAN Xindong,WANG Wei,ZHOU Zhaoping,WANG Wei
    2010, 6 (4):  211-215.  DOI: 10.3969/j.issn.1673-0364.2010.04.012
    Abstract ( 358 )  
    Objectives To evaluate endovascular therapy for venous malformations and its safety and efficacy of the treatment.Methods Six hundred and twenty eight sclerotherapy sessions were performed on 211 patients,aged 2-54 years(mean,14.5 years).There were 104 females and 107 males.All patients had a pre-procedure magnetic resonance imaging(MRI) study.Lesions were categorized as limited venous malformations and infiltrating venous malformations on the basis of MRI feature.Percutaneous endovascular therapy by direct injection was performed.After embolization of drainage vein with absolute ethanol,the following Bleomycine was injected.Results All patients were followed up for 12 months to 69 months with an average of 43 months.According to major symptoms,the results were excellent in 60 cases,good in 42 cases,fair in 62 cases and poor in 1 case.The better response was among the patients with limited venous malformations.Among of them 116 cases(95%) showed at least marked improvement.There were 6 sessions of tissue necrosis,5 sessions peripheral nerve palsy,10 sessions pigmentation,5 sessions blistering,and 89 sessions transient side effects related to Bleomycine such as fever and gastrointestinal irritation.No major complications such as cardio-pulmonary collapse and pulmonary fibrosis were reported.Conclusion Endovascular therapy for venous malformations was found to be safe and effective,which may be one of the techniques in the treatment of venous malformations.
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    One Stage Operation for Temporomandibular Joint Ankylosis with Microgenia
    HU Pei,WU Zhengqing,MA Li
    2010, 6 (4):  216-217.  DOI: 10.3969/j.issn.1673-0364.2010.04.013
    Abstract ( 318 )  
    Objective To explore the ideal one-stage method in the treatment of temporomandibular joint(TMJ) ankylosis complicated with microgenia.Methods One stage operation surgery is performed to treat TMJ ankylosis complicated with chin deformity.Pseudo-arthro-plasty is performed with autogenous tensor fascia lata muscle and with horizontal osteotomy forward in mandible chin area for microgenia.Results From March 2003 to March 2008,11 cases were treated.For all the patients,one stage TMJ and chin plastic methods were used to restore joint function and repair external shape of the face.Exercise of joint flexibility was done after operation.Patients were followed for 6-12 months.Oral function is restored and patients can chew normally.For 9 cases,the opening of the mouth is above 2 fingers with satisfactory external shape.Conclusion One stage operation is an ideal therapy to treat TMJ ankylosis complicated with microgenia.It can restore the oral function and external shape.
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    Repair of Skull Defect by 3-Dimensional Computer-Aided Design Titanic Mesh in One Stage
    Qi Xin,SHEN Gan,WANG Zengliang,CHANG Jian,ZHANG Yanrui,LIU Peng
    2010, 6 (4):  218-219.  DOI: 10.3969/j.issn.1673-0364.2010.04.014
    Abstract ( 426 )  
    Objective To investigate the approach and the therapeutic effect by using 3-D Titanic mesh of moulding to repair skull defect caused by depressed and splintered fracture of cranial bone.Methods Forty three patients were used 3-D Titanic mesh moulding in this study primary repairing skull defect.Results All incisions obtained healing by first intension.Patients were followed up for 6-12 months.Good symmetry of the skull was achieved after operation.Conclusion Designing the 3-D Titanic mesh in one stage operation guarantees excellent functional and cosmetic results for the patients with craniofacial deformity.
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    Study of Cause and Prevention on the Sebaceous Cysts at the Incision Site after Mastopexy and Reduction Mammaplasty
    MU Dali,LUAN Jie,MU Lanhua,LIU Chunjun,XIN Minqiang
    2010, 6 (4):  220-221.  DOI: 10.3969/j.issn.1673-0364.2010.04.015
    Abstract ( 372 )  
    Objective To investigate the cause and prevention of such sebaceous cysts.Methods Sixty patients undergoing mastopexy or reduction mammaplasty were randomly divided into two groups.Peri-areolar de-epithelialization was performed to a depth of less than one-third of the dermis in group A and nearly the full thickness of the dermis in group B,and the incidence of sebaceous cysts was compared between these two groups.Results Patients were followed-up for 2 to 4 years.In group A,sebaceous cysts at the incision site were found in 4 patients(13.3%);however,no sebaceous cysts occurred in group B.Conclusion Increasing the thickness of de-epithelialization appears to decrease the incidence of sebaceous cysts at the incision site,which would not affect the blood supply to nipple-areola complex.
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    Effect of Rising on Fat Viability
    WANG Lijun,QIN Tao,MA Shaolin
    2010, 6 (4):  222-224.  DOI: 10.3969/j.issn.1673-0364.2010.04.016
    Abstract ( 276 )  
    Objective To investigate the effect of rinsing with different fluids and times on fat viability in autologous fat transfer.Methods Fat was obtained by tumescent liposuction and then rinsed by normal saline or balanced fluid for 0,1,3,5,and 10 times.Fat viability was determined by glucose transportation test.Results The number of glucose transportation was higher in normal saline group,as compared with that in balanced fluid group(P<0.05).In both the groups,the number of glucose transportation in 3-time rinsing subgroup was lower than 0-and 1-time rinsing subgroups(P<0.01).In normal saline group,the number of glucose transportation showed no statistical difference between 3-time and 5-time rinsing subgroups(P>0.05),and was lower in 10-time rinsing subgroup as compared with 3-time and 5-time rinsing subgroups(P< 0.05).In balanced fluid group,there were no significant differences in the number of glucose transportation between 3-,5and 10-time rinsing subgroups(P >0.05).Conclusion Rinsing can improve the viability of fat following tumescent anesthesia.The increase in fat viability will be higher with normal saline rinsing,as compared with balanced fluid rinsing.Fat should be fully rinsed for 3 times with normal saline.
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    Clinical Application of Botulinum Toxin Type A in Treating Facial Wrinkle
    GUO Xiaobo,ZHANG Yixin,ZHANG Zhen,JIN Rong
    2010, 6 (4):  225-226.  DOI: 10.3969/j.issn.1673-0364.2010.04.017
    Abstract ( 294 )  
    Objective To investigate the clinical efficacy of botulinum toxin type A for facial wrinkle patients.Methods Fifty-six patients with facial wrinkle were treated by injection of botulinum toxin type A with <100 U in total dose every time in the different injective sites.Results Among 56 cases the results were excellent in 54 cases and good in 2 cases.Good rate was 100%.Conclusion Botulinum toxin type A injection was one of effective way in the treatment of facial wrinkle.
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    Effects of Remifentanyl Combined with Midazolam on Sedation and Analgesia in Liposuction under Tumescent Anesthesia
    ZHU Meiling,WENG Huiying,JIANG Hong
    2010, 6 (4):  227-229.  DOI: 10.3969/j.issn.1673-0364.2010.04.018
    Abstract ( 456 )  
    Objective To explore the effects of Remifentanyl combined with Midazolam on sedation and analgesia in liposuction under tumescent anesthesia.Methods Thirty selective patients(ASAⅠ-Ⅱ) were treated by liposuction under tumescent anesthesia.All the patients were given Midazolam 0.3 mg/Kg + Remifentanyl 0.6 μg/Kg·min through venous for 30 seconds as loaded dose before tumescent anesthesia,then Remifentanyl at the rate of 0.1-0.3 μg/Kg·min was infused through venous pump.The Ramsay and VAS for scoring at the point before anesthesia(T0),the point before given the tumescent fluid(T1),the point of given the tumescent fluid(T2),the point of the beginning of liposuction(T3),the ending point of liposuction(T4),and 30 minutes after the liposuction(T5) were all recorded.The change of hemodynamic during anesthesia and liposuction as well as incidence were observed and recorded.Results The VAS grades were lower less than 5 in all patients.Compared with T0,the patients'' Ramsay grades,HR,SBP,DBP were higher(P<0.05),RR were lower(P<0.05).There was no significant difference at T2-T5(P >0.05).Two patients had the symptom like drowsiness and respiratory depression(RR<8 times/min) and SpO2 declined to 90%,while the SpO2 could recover to the normal level by the instruction ventilation and decreasing the volume of Remifentanyl.Conclusion Effective sedation and analgesia can be accomplished by using Remifentanyl combined with Midazolam in liposuction under tumescent anesthesia.The recovering time for recovery could be shortening,so this method can be considered to develop in daytime abdominal liposuction.
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