Objective To explore the clinical application effects of cervical advancement flaps in repairing mandibular scars. Methods A retrospective analysis was performed on the clinical data of patients with mandibular scars admitted to the Department of Plastic and Burn Surgery of West China Hospital of Sichuan University between January 2018 and July 2020. The lateral X-ray images of the patients were analyzed before and 2 weeks after surgery, and the differences in the mento-cervical angles and the cervico-mental angles before and after surgery were compared. Results A total of 21 patients were included, including 7 males and 14 females. At admission, all patients had a mandibular scar area of (3-7) cm × (3-6) cm, and underwent primary repair with cervical advancement flaps. All patients had good postoperative skin flaps survival, primary wound healing, and obvious mento-cervical angle and cervico-mental angle. The preoperative mento-cervical angle was (110.24±9.47)°, and at 2 weeks post surgery, the mento-cervical angle was (98.39±4.95)°, with a statistically significant difference (P<0.05). The preoperative cervico-mental angle was (134.15±6.00)°, and at 2 weeks post surgery, the cervico-mental angle was (126.44±3.60)°, with a statistically significant difference (P<0.05). Conclusion The neck advancement flap is an effective surgical method for treating simple mandibular scar, which is simple and can improve the appearance of the jaw and neck.
【摘要】 目的 探讨中成药参附注射液对大鼠深Ⅱ度烧伤创面愈合的影响。 方法 选用16只Sprague-Dawley（SD）大鼠，随机分为实验组、对照组，每组各8只，建立20%体表面积深Ⅱ度烫伤模型。烫伤后即刻及此后每天，实验组大鼠以参附注射液20 mL/kg腹腔注射给药，1次/d，连续给药5 d；对照组给予注射等剂量的生理盐水。分别于致伤后的7、14 d取创面组织块，光学显微镜观察成纤维细胞及胶原纤维生长情况，电子显微镜观察致伤后14 d成纤维细胞细胞器情况，分别计算烧伤后第7、14天两组的创面愈合率，并观察比较两组创面愈合的时间。 结果 所有选入实验的SD大鼠均存活至实验结束。实验组、对照组术后第7天创面愈合率分别为（36.34±2.55）%及（33.13±2.62）%，两组差异有统计学意义（t=2.486，P=0.027）；实验组、对照组术后第14天创面愈合率分别为（75.71±2.29）%及（72.36±2.85）%，两组差异有统计学意义（t=2.590，P=0.022）；实验组、对照组创面愈合时间分别为（20.88±1.36）、（22.94±2.16） d，两组差异有统计学意义（t=-2.286，P=0.0395）。伤后7、14 d创面组织块切片光学显微镜观察发现，实验组肉芽组织及胶原纤维较多，排列更有序，表皮基底细胞增殖活跃，炎症反应较轻；伤后14 d时电子显微镜观察发现，实验组成纤维细胞的细胞器更丰富，分泌胶原更多，实验组创面愈合情况优于对照组。 结论 腹腔注射参附注射液可以促进烧伤创面的愈合，其可能的机制为清除氧自由基，抗脂质过氧化。【Abstract】 Objective To explore the effect of Shenfu injection on promoting healing of deep partial-thickness burn wound in rats. Methods Sixteen Sprague-Dawley (SD) rats were randomly selected, and deep partial-thickness burn with 20% of the body surface was inflicted. The rats were randomly divided into experimental group and control group with eight in each group. Rats in the experimental group were treated with abdominal injection of Shenfu injection at a dose of 20 mL/(kg•d) for five days continually, and rats in the control group were treated with the same dose of 0.9% saline solution. The growth of granulation tissue and collagen fibers were evaluated under light microscope at the seventh and the fourteenth day. The growth of fibroblast was observed under transmission electron microscope at the fourteenth day. The cure rate of both groups of rats at the seventh and fourteenth day was calculated. Then we compared their healing time and the cure rate of the traumatic wound respectively. Results All rats had survived until wound healing. The cure rate at the seventh day for the experimental group and the control group was (36.34±2.55)% and (33.13±2.62)%, and their difference was statistical (t=2.486, P=0.027); At the fourteenth day, the cure rate was respectively (75.71±2.29)% and (72.36±2.85)% with a significant difference between each other (t=2.590, P=0.022). The healing time of the experimental group (20.88±1.36) was significantly shorter than that of the control group (22.9±2.16) (t=-2.286, P=0.040). At the seventh and fourteenth day, light microscope observation showed that the growth of granulation tissue and collagen fibers for rats in the experimental group were much more than that in the control group, the basale cell proliferation was more active, and inflammation was slighter. Through transmission electron microscope, we observed more fibroblast and collagen in the experimental group, which showed a better cure than the control group. Conclusion Shenfu injection can significantly promote wound healing of deep partial-thickness burn. It may possibly get this effect through anti-oxidation.
【Abstract】 Objective To summarize the recent progress in related research on transforming growth factor β1 （TGF-β1）/Smad3 signal transduction pathway and post-traumatic scar formation. Methods Recent related literature at home and abroad on TGF-β1/Smad3 signal transduction pathway and post-traumatic scar formation was reviewed and summarized. Results TGF-β1 is an important influence factor of fibrotic diseases, and it plays biological effects by TGF-β1/Smad3 signal transduction pathway. The pathway is regulated by many factors and has crosstalk with other signal pathways at cellular and molecular levels. The pathway is involved in the early post-traumatic inflammatory response, wound healing, and late pathological scar formation. Intervening the transduction pathway at the molecular level can influence the process of fibrosis and extracellular matrix deposition. Conclusion TGF-β1/Smad3 signal transduction pathway is an important way to affect post-traumatic scar formation and extracellular matrix deposition. The further study on the pathway will provide a theoretical basis for promotion of wound healing, as well as prevention and treatment of pathological scar formation.