【Abstract】 Objective To explore the effect of early scrotal dermatoplasty on spermatogenic functional rehabilitation of testis in juvenile pigs with third degree burn wound of the scrotum. Methods Thirty healthy male Guizhou miniature pigs (weighing 10-15 kg, 2-month-old) were divided into 3 groups: control group (group A, n=10), natural healing group (group B, n=10), and dermatoplasty group (group C, n=10). In group A, the pig was not given any treatment; after third degree burn model of the scrotum was prepared, wounds were not treated in group B and the burn skin was excised and whole hypogastric pachydermia was used for dermatoplasty in group C. At 3 months and 1 year after model preparation, bilateral testis were collected from 5 pigs, respectively. HE staining was performed to observe the effects of different repair method on the morphology of spermatogenic cells and immunohistochemical staining was used to detect Survivin protein expression. Results All pigs survived to the end of the experiment and the wound healed successfully. Histological observation showed that spermatogenic cells had normal shape at all stages and mature sperms were seen in lumens in group A; the thickness of seminiferous epithelium was thinner, having one layer or two layers of spermatogenic cells in group B; the spermatogenic cells in group C were slightly more than that in group B with some spermatids; and in groups B and C, the spermatogenic cells at 1 year were more than that at 3 months. Immunohistochemistry staining showed that the Survivin protein expression in groups B and C was less than in group A, and group B was less than group C, showing significant differences at 3 months and 1 year (P lt; 0.05), but no significant difference between 3 months and 1 year in the same group (P gt; 0.05). Conclusion Dermatoplasty has inhibitory effect on spermatogenic functional rehabilitation of testis. Dermatoplasty can decrease spermatogenic cells and reduce Survivin protein expression, but some spermatids still survive in seminiferous tubule.
To explore the effect of burying testis in inguinal pocket on spermatogenesis. Methods Sixty New Zealand rabbits of 6-8 months old included 36 males and 24 females, weighing 2.5-2.7 kg. The male rabbits were randomly divided into the experimental group (n=18)and the control group (n=18). The model of repairing skin defect of scrotum were establ ished by burying testes in inguinal region subcutaneously in the experimental group. The rabbits were not treated in the control group. The sperms were collected and the surface temperature of testis was measured in both groups after 8 weeks. Testes biopsies were harvested from 6 rabbits of 2 groups randomly respectively. The apoptosis of spermatogeniccells was detected with TUNEL. The other 12 male rabbits in two groups were fed respectively with female rabbits to observe the fertil ity. Results The semen density and the spermid activity ratio were (237.3 ± 39.7) × 109/L and 76.9% ± 3.8% in the control group, and were (4.7 ± 2.7) × 109/L and 0 in the experimental group respectively; showing statistically significant difference between two groups (P lt; 0.05). The average superficial temperature of testes was (38.02 ± 0.36)℃ in the experimental group and (36.15 ± 0.64) in the control group (P lt; 0.05). TUNEL results showed: The spermatogenic epithel ium became thin and obvious apoptotic spermatogenic cells were found in experimental group; the spermatogenic epithel ium was normal and few apoptotic spermatogenic cells were found in the control group. The apoptotic index (AI) was 89.69% ± 3.76% in the experimental group and 7.73% ± 4.95% in the control group (P lt; 0.05). The Pairing results showed that the female rabbits pairing with male rabbits of the experimental group were all not pregnant, and those of the control group were all pregnant (P lt; 0.05). Conclusion As the same as the scrotum was reconstructed with skin flaps, it will induce the rabbit infertil ity that the testes were buried in inguinal region subcutaneously to repair defect of scrotum skin. The main reason is the excessive apoptosis of spermatogenic cell by the high testes environmental temperature.
Objective To summarize the effect of free skin graft for repairing scrotal avulsion injury, and to investigate the repair impact of the method on spermatogenesis. Methods Between June 2001 and June 2010, 8 cases of complete avulsion injury of the scrotal skin were treated with the free skin graft, aged 22 to 64 years (mean, 29 years). The causes of injury included machine twisting in 4 cases, animal attack in 3 cases, and traffic accident in 1 case. The time between injury and hospital ization was 1-7 hours (mean, 3.5 hours). Five cases compl icated by avulsion of penile skin, 3 by perineal lacerationwith exposure of testes and spermatic cord, and 1 by avulsion of leg skin. Results After 10 days, 80% to 95% grafted skinsurvived. The reconstructed scrotum had shrinks and the wound healed by first intention after dressing change. Eight patients were followed up 12 to 24 months (mean, 16 months). At last follow-up, the patients had relaxed and droop scrotum, and penile erection was normal. Semen qual ity analysis showed: semen volume of 2-6 mL (mean, 4.2 mL); complete l iquefaction with l iquefaction time of 15-30 minutes (mean, 23 minutes); sperm density of (12-27) × 106/mL (mean, 16 × 106/mL); sperm motil ity of 45%-65% (mean, 56%); and sperm motil ity (grade A) of 25%-42% (mean, 32%). Conclusion Complete avulsion of the scrotal skin can be repaired by free skin graft, which has no significant effect on spermatogenesis.
ObjectiveTo discuss the feasibility and effectiveness of link-pattern lateral popliteal artery perforator flap in repairing popliteal fossa scar contracture in children or teenagers. MethodsBetween January 2009 and January 2013, 12 patients with popliteal fossa scar were admitted. Of them, 7 cases were male and 5 cases were female, aged from 3 to 17 years (median, 12 years). The disease duration was from 6 months to 5 years (median, 3 years). Wound was repaired with link-pattern lateral popliteal artery perforator flap after remission of popliteal fossa scar. The wound ranged from 6 cm×4 cm to 10 cm×7 cm, and the flap size ranged from 7 cm×4 cm to 12 cm×9 cm. The flap was with lateral sural cutaneous nerve in 5 cases, and lateral sural cutaneous nerve was retained at the donor area of 7 cases. The donor site was repaired using split-thickness skin graft. ResultsAll pedicled flaps and skin graft survived smoothly after operation. The wound at donor site healed by first intention. All the cases were followed up 12-36 months, with an average of 18 months. The flaps had good color, texture, and shape; scar obviously became softened, without hyperplasia or ulceration. The patients were free from lameness with knee range of motion of 0-180°. The squatting function was normal. Grafting skin was smooth in the donor area of the calf, without depression or scar hyperplasia. The senses of posterior-inferior calf and lateral of foot decreased or disappeared in 5 cases of flaps with lateral sural cutaneous nerve; at 6 months after operation, two-point discrimination was 12-14 mm (mean, 13 mm). The posterior-inferior calf was numb and discomfort in 7 cases of flaps with retained lateral sural cutaneous nerve; but after 3-6 months, the sense was obviously recovered, with no sense loss; at 6 months after operation, two-point discrimination was 5-7 mm (mean, 6 mm). ConclusionLink-pattern lateral popliteal artery perforator flap has reliable blood supply and the operation was simple. The cutaneous nerve can be retained in donor area. It is an ideal method for repairing wound after remission of popliteal fossa scar in children or teenagers.
ObjectiveTo investigate the feasibility and effectiveness of repairing temporal skin and soft tissue defects and reconstructing sideburns with superficial temporal artery composite perforator flap.MethodsBetween January 2018 and January 2019, 12 patients with temporal tumors were treated. There were 5 males and 7 females with an average age of 51 years (range, 37-68 years). There were 8 cases of basal cell carcinoma and 4 cases of squamous cell carcinoma. The disease duration ranged from 3 months to 4 years (mean, 13 months). The area of residual wound after tumor resection was 3.8 cm×2.5 cm-5.2 cm×3.5 cm. The superficial temporal artery composite perforator flap was designed. The hairy superficial temporal artery frontal branch perforator flap was used to repair the hair growing area and reconstruct the sideburn; and the area of the flap was 2.5 cm×1.0 cm-4.2 cm×3.0 cm. And the superficial temporal artery descending branch perforator flap without hair was used to repair the hair-free area; and the area of the flap was 2.5 cm×1.5 cm-7.5 cm×4.0 cm. The donor sites were sutured directly.ResultsAll flaps survived, and the incisions at the donor and recipient sites healed by first intention. Eleven patients were followed up 6-12 months (mean, 9 months). The incisions were not obvious. The flaps were flat and the color of the flaps were not significantly different from the surrounding skin. The reconstructed sideburns were consistent with the healthy side and the facial appearance was satisfactory. No local tumor recurred during follow-up.ConclusionFor the temporal skin and soft tissue defects involving the sideburn, the superficial temporal artery composite perforator flap can be used to repair subunits with different aesthetic characteristics in sections and has the advantages of operating simply, obtaining satisfied facial appearance, and little effect on the donor site.