OBJECTIVE: To sum up the experimental development and clinical application of prefabricated flap. METHODS: The reported experimental results and clinical application of prefabricated flap extensively reviewed. RESULTS: Previous studies had proved that the revascularization of prefabricated flap mainly through anastomoses of implanted vessels and the original vessels of the flap, the implanted vessels slowly formed a new and complete blood vessel network, which could dominate the whole flap, three to four weeks later, the new vessels were mature and the flap could be transferred. Clinically, the superficial temporal vessels, gastroepiploic vessels, circumflex femoral vessels and thoracodorsalis vessels could be harvested for prefabricated flap with satisfactory results. CONCLUSION: Prefabricated flap provides a new method for the treatment of complicated defects.
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.
Objective To study the effect of dexamethasone to protect flaps from an ischemia-reperfusion injury and elucidate its mechanism of regulating the death course of the neutrophils.Methods The rats were randomly divided into 3 groups.The vein of the rat was clamped for 8 h after the flap had formed. Group A: the normal flap; Group B: the saline control flap; Group C: the treatment flap with dexamethasone. The survival area of the flaps was measured at 7 days; the apoptotic and necrotic neutrophils,tumor necrosis factor α （TNF-α）, and interleukin 10 （IL-10） concentrations were measured. Results The flap survival areas in Groups A and C were larger than those in Group B. The apoptotic neutrophils in Group B were fewer than those in Groups A and C on the 1st and 3rd days after operation; however, they were more in number in Group B than in groups A andC on the 6th day. The necrotic cells in Group B were more in number than those in Groups A and C. In Group B, the plasma TNF-α concentration reached the maximum level at 1 h,while the IL-10 level reached the lowest 3 h after the reperfusion. In Group C, the TNF-α concentration was lower than that in Group B and decreased dramatically at 6 h. The IL-10 concentration was the lowest at 1 h, and increased rapidly at 3 h. Thus, ischemia reperfusion could injure the flaps, probably through the abnormal action of the neutrophils, such as the disordered secretion of the cytokines and abnormal death course of the neutrophils. Conclusion Dexamethasone can protect the flap from an ischemia-reperfusion injury by its regulation for the neutrophil function.
OBJECTIVE: To study the hemorheology of island flap after ischemia-reperfusion injury and modulation of dexamethasone. METHODS: Sixty Wister rats were made ischemia-reperfusion injury model, and divided into two groups randomly(Group I: intraperitoneal injection of normal saline 2 ml/kg as control group; Group II: intraperitoneal injection of dexamethasone 5 mg/kg as experimental group). Flap survived areas were measured and neutrophil necrosis numbers in flaps were counted. Erythrocytes and neutrophil hemorheology were observed. RESULTS: Area survived flap in group II was larger than that in group I. Neutrophil necrosis numbers were less in group II than in group I (P lt; 0.05). Whole blood hyposhear viscosity, erythrocyte aggregation, Casson yield stress and nerutrophil adhesion ability were higher in group I than in group II (P lt; 0.05); and the neutrophil deformability was lower in group I than in group II. CONCLUSION: Flap inchemia-reperfusion can increase erythrocyte aggregation index and neutrophil adhesion ability. Dexamethasone can improve these and decrease neutrophil necrosis numbers, so as to prevent flap from ischemia-reperfusion injury.