Objective To investigate the development made in the reparation and reconstruction of the postburn deformity and functional disability in the advanced-stage patients. Methods Based on the reviewedliterature at home and abroad and combined with our clinical experience, the new reparative and reconstructive techniques for the patients with advanced stagedeformity and functional disability were evaluated. Results The reparative and reconstructive microsurgical techniques achieved a significantdevelopment in treating the following pathologic changes after burn: deformity due to proliferation and contracture of the scars, severe hand deformity, defects occurring in the muscle tendons and nerves due to electricity burn, and defects occurring in the long tubular bones of the extremities. Concl usion Although there has been a great achievement in this field, there is still a hard task of finding out newer therapeutic approaches and achieving more effective results in the future.
Based on the dye injection investigation, the territory of blood supply through the superficial temperal artery system was defined. Vascularized grafts, composed of temperal-parietal fascia, periosteum and outer-table of calvarial bone, can be transferred by microvascular anastomosis or transposed to repair full-thickness defects of skull bone was demonstrated. Six of such cases following electrical burn were successfully treated. The average size of skull bone defects was 50cm2. The largest one among them was 80cm2.
The surgical treatment of 20 cases (58 fingers) of swan-neek deformity of fingers after burns was reported. The operativc techniques included: (1) The cicatrix at the dorsal aspect of the finger was relcased and the raw surface thus formed was covered by skin graft, while the palmar skin was tightened; (2) Thc extensor mechanism of the finger was partially resected with relcase of the interosscous muscles and shortening of tcnodesis of the tendon of flexor digitorum superficialis; and (3) Fusion of the interphalangeal joint. The results of various methods of treatment were analyzed, and the pathogenesis of swan-neck deformity of fingers was discussed. The importance of prevention of its occurrence was emphasized.
OBJECTIVE: To evaluate the effect of vascular endothelial growth factor(VEGF) 165 or basic fibroblast growth factor (bFGF), which was slowly-released in fibrin glue patch, on expanded prefabricated flaps in rabbits to facilitate the neoangiogenesis process. METHODS: A total of 53 rabbits were divided randomly into 6 groups. The central auricular vascular bundle of the ear was implanted into the expanded prefabricated flap as the pedicle. Fibrin glue, sandwiched between the expander and the implanted vessels, was adopted for topical delivering and slow-releasing of VEGF(625 ng) or bFGF(2880U). After 14 days, the island flap with the implanted vascular bundles as the pedicle was elevated, sutured back to its original position and then harvested more 3 days later. Neoangiogenesis was measured by digital recording of survival area, laser Doppler flowmetry, PCNA immunohistochemistry, TUNEL, ink and PbO infusions. RESULTS: When compared with the other groups, flap survival improved; neoangiogenesis of flaps increased, together with the blood flow enhanced in the groups applied growth factors. The reduced cellular apoptosis and the increased proliferation were also observed. CONCLUSION: VEGF or bFGF slowly-released by fibrin glue shows the potential to facilitate neoangiogenesis and accelerate maturation of the expanded prefabricated flap.
OBJECTIVE To review the fundamental research and the experimental study of vascular endothelial growth factor (VEGF). METHODS The laboratory information and experimental study of VEGF were extensively reviewed. RESULTS VEGF, as a mitogen specifically for endothelial cells, could bly stimulate angiogenesis as well as vascular permeability, especially in hypoxia state. Experimentally, survival area and viability of flaps could be increased significantly when exogenous VEGF was applied in the form of protein or cDNA. CONCLUSION VEGF provides a new way for therapeutic angiogenesis in reparative and reconstructive surgery.