Objective To investigate the method and the curative effect of postauricular muscular fasciae-periosteal flap and modified unwrinkle incision in parotidectomy. Methods From January 2006 to August 2008, 28 patients with benign lesions of parotid gland were treated. There were 17 males and 11 females aged 19 to 79 years old (average 50 years old),including 20 cases of mixed tumor, 5 cases of adenolymphoma, 1 case of branchial cleft cyst, 1 case of eosinophil ic hyperplastic lymphogranuloma, and 1 case of myoepithel ioma. Tumor masses were all prominent, with the diameter of 2.4-3.8 cm and partial-tough texture. The course of disease was 3-18 months (average 9.5 months). Parotid gland and tumor mass were resected with postauricular incision hidden within the hairl ine, introcession defect (3.0 cm × 2.0 cm × 1.0 cm-3.5 cm × 2.5 cm × 1.5 cm) were repaired with simultaneouly adopting postauricular muscular fasciae-periosteal flap (4.0 cm × 3.0 cm × 1.0 cm-5.0 cm × 4.0 cm × 1.5 cm) by turning the pedicle flap 180°. Results All incision healed by first intention and no necrosis of postauricular muscular fasciae-periosteal flap occurred. All patients were followed up for 6-24 months (average 12 months). The incision was hidden within postauricular hairl ine and shape of parotid realm was good. No sal ivary fistula, facial paralysis, and earlobe numbness occurred. No Frey syndrome were found by local iodine-starch tests. Conclusion Because of hidden incision, good repair effect of region introcession deformity, and fewer postoperative compl ications, the modified parotidectomy with postauricular muscular fasciae-periosteal flap and modified unwrinkle incision is a better method in parotidectomy.
Objective To review and summarize the development during the last 20 years and the current status of cosmetic medicine, i.e., cosmetic surgery, in China, for the healthier development of this specialty inthe future. Methods Literature concerned was reviewed, including conferenceabstracts, papers, and publications, and the present status and problems were analyzed. Results Cosmetic medicine was recognized as an independent specialty and gained its clear definition. The development of cosmetic medicine is an inevitable trend of the changing medical modules and the developingscience and civilization. This trend fulfilled the need of the people. The related problems consisted of a high complication rate, confusion of management, andinsufficient specific knowledge in part of the providers. Conclusion The development of cosmetic medicine is an inevitable trend of the civilization development. For the healthy development of this specialty, scientific management and systemic education for the providers are crucial. Only those who have the plastic surgery background are able to participate in this practice.
【摘要】 目的 探讨脱细胞真皮基质材料应用于整形美容领域的可能性。 方法 2008年11月-2009年8月，对脱细胞真皮基质进行溶血试验、皮下埋植和肌肉埋植试验，分别于术后1、2、4周取样并评价其与血液接触反应，以及在体内的降解情况，同时与对照材料相比较，对脱细胞真皮基质的安全性和使用功能性进行初步的研究。 结果 脱细胞真皮基质具有良好的血液相容性和组织相容性，不引起机体的排斥反应;不同厚度的真皮基质具有不同的降解率，可根据使用需要进行叠加。 结论 脱细胞真皮基质可作为生物组织补片，具有应用于整形美容领域和组织修复的潜力。【Abstract】 Objective To study the potential application of xenograft acellular dermal sheets in plastic surgery field. Methods The xenograft acellular dermal sheets were estimated by hemolytic test, subcutaneous and muscular embedding animal tests.The safety and functionality as filling materials were preliminary evaluated after embedded for 1, 2 and 4 weeks, compared with the control samples. Results The xenograft acellular dermal sheets had excellent blood and tissue compatibility, without any immunoreaction;the materials with different thicknesses had different degradation rates which could be utilized by stacking if necessary in application. Conclusion The xenograft acellular dermal sheets can be applied as tissue patch, and are potential to be employed in the fields of plastic and tissue rehabilitation.
Objective To explore the interaction of postmastectomy radiotherapy （PMRT） and breast reconstruction， and elucidate how to choose the type and timing of breast reconstruction. Method Literatures about PMRT and breast reconstruction were reviewed. Results PMRT might increase the incidence of complications and impair the cosmetic satisfaction of breast reconstruction. Breast reconstruction might also compromise the effect of PMRT. Conclusions In patients who will receive or have already received PMRT， the optimal approach is delayed autologous tissue reconstruction after PMRT. If PMRT appears likely but may not be required at the time of mastectomy，delayed-immediate reconstruction may be considered， or immediate autologous tissue reconstruction may be considered in case of patients awareness of the increased complications and impaired cosmetic outcomes from PMRT.
ObjectiveTo evaluate the clinical and cosmetic outcome of patients with early breast cancer underwent oncoplastic techniques in breast conserving surgery. MethodsClinical data of 59 patients with early stage breast cancer who underwent oncoplastic techniques in the breast conserving surgery were analyzed retrospectively from January 2007 to March 2011. Cosmetic outcome score and patient satisfaction questionnaire were also assessed. ResultsThe age of the patients was (53.5±9.8) years (range, 32 to 77 years). The diameter of tumors was (1.6±0.7) cm (range, 0.5 to 4.0 cm). The foci located at upper quadrant in 38, lower quadrant in 17, central area in 4. During operation, single incision approach was used in 25 patients, two incisions approach in 34 patients. A variety of methods were used to repair breast defects including mammary gland direct suture in 9 patients, mammary gland pedicle flaps in 35, local flaps or adipofascial flap in 9, latissimus dorsi myocutaneous flaps in 2, and reduction mammaplasty with “J” or double ring incision in 4. The mean followup period was 30 months (range, 3 to 53 months), no local recurrence was detected. However, bone metastases was found in one patient on 14 months after operation. Fifty-three patients (89.8%) had good to excellent aesthetic results with cosmetic outcome score ≥26. Patient satisfaction questionnaire showed that 40 patients (67.8%) were excellent, 14 (23.7%) good, 3 (5.1%) fair, and 2 (3.4%) poor. ConclusionOncoplastic techniques in the breast conservative therapy for early stage breast cancer is a safe and effective procedure, with highly satisfactory cosmetic outcomes in the majority of patients.
目的 探讨局麻下经胸前入路行腔镜甲状腺手术的体会。方法 对2009年3月至2010年3月期间四川省南充市中心医院普外科收治的28例在局麻下行腔镜甲状腺手术患者术中及术后情况进行回顾性分析。结果 1例因术中冰冻检查发现为甲状腺癌而转开放性手术未纳入分析。视觉模拟镇痛评分（VAS）: 术中评分结果为0～5分，平均2.2分; 术后评分结果为0～3分，仅2例口服布洛芬缓释胶囊镇痛，其余25例未使用镇痛药物。手术时间为95～215 min，平均117 min; 术中出血量为50～150 ml，平均84 ml。术后引流量为25～70 ml，平均34 ml； 引流管放置时间为2～4 d。住院时间平均4.5 d。术后颈部及胸壁皮下无瘀血、肿胀，无声嘶、呛咳。经随访2~10个月（平均8个月），未见切口处明显瘢痕。结论 局麻下经胸前入路行腔镜甲状腺手术切实可行，并具有良好的美容效果。
目的 探讨乳腔镜辅助下早期乳腺癌保乳治疗的优越性。方法 乳腔镜辅助下行保乳术37例，术后均行乳腺和病灶区放射治疗，并按病理及受体情况给予相应的辅助化疗及内分泌治疗。结果 乳腔镜辅助下保乳术成功35例，2例术中因腋窝出血量多而转开放性手术。患者无明显手术并发症, 且美容效果良好。术后随访时间最长27个月, 中位随访时间为18 个月,无一例局部复发、远处转移和死亡。术后乳腺美容效果评估： 优、良者术后6个月为68.2%，术后1年为83.4%。结论 乳腔镜辅助下早期乳腺癌保乳术以不降低生存率、不增加复发率为原则，联合多学科有机配合及综合治疗为保证，具有创伤小、并发症少、外形美观、生存质量高等优点。
ObjectiveTo compare the curative effects and complications between endoscope-assisted treatment and scalp coronal incision for zygomatic complex fractures. MethodFifty zygomatic complex fracture patients treated between January 2008 to May 2014 were randomly divided into trial group (n=30) treated through endoscope-assisted procedure and control group (n=20) treated through scalp coronal incision. In the trial group, functional reduction and fixation of the fractures under endoscope were performed, and the control group was treated with coronal incision and internal fixation of the fractures. After the operation, all the patients were evaluated on the effects and complications through physical examination and CT review. ResultsThe number of grade-Ⅰ, -Ⅱ and-Ⅲ curative effects were respectively 24 (80.0%), 5 (16.7%), and 1 (3.3%) in the trial group, while those numbers in the control group were respectively 16 (80.0%), 3 (15.0%), and 1 (5.0%). There was no significant difference in the curative effects between the two groups (P>0.05). There were no cases of complications in the trial group, but there were 4 cases (20.0%) of facial nerve injury, 5 cases (25.0%) of hair loss, 4 cases (20.0%) of temporal sag, and 5 cases (25.0%) of scalp hematoma in the control group. The complication rate in the control group was significantly higher than that in the trial group (P<0.05). ConclusionsWhile the curative effects between endoscope-assisted treatment and scalp coronal incision for zygomatic complex fractures are not significantly different, endoscope-assisted technology can reduce the complications of the operation, which is a minimally invasive surgery and can promote good aesthetic appearance.