To overcome the disadvantages of the artificial materials, to design pedicled demucosal small intestinal sheet to repair full-thickness abdominal wall defect. Methods The porcine model of full-thickness abdominal wall defect by resecting 10 cm × 7 cm abdominal wall tissue (from skin to peritoneum) in 20 female animals, which were randomizedto jejunum and ileum sheet groups(n=10). Defect of abdominal wall were repaired with pedicled demucosal jejunum/ileum sheet respectively and immediate spl it-thickness free skin grafting. The general condition was observed and the tension strength of the repaired abdominal wall was measured 30 days postoperatively. In another 5 models, defect was repaired with pedicled demucosal small intestinal sheets and immediate spl it-thickness free skin grafting. The histological change and tissue thickness of the pedicled demucosal small intestinal sheet, spl it-thickness free skin graft and the repaired abdominal wall were observed and measured respectively after 30 days of operation. Results The operations were successful and no operative death occurred in all animals. All pedicled demucosal small intestinal sheets primarily healed to the edge of defected abdominal walls. Neither infection nor wound dehiscence occurred. All the spl it-thickness free skin grafting were successful. Regeneration of the intestinal mucosa occurred 4 days to 5 days postoperatively in 3 animals (2 of jejunum sheet group and 1 of ileum sheet group) at the initial stage andwere successfully treated. No postoperative herniation occurred in all animals. The cel iac pressure of herniation of the repaired abdominal wall jejunum/ileum sheet was (24.8 ± 3.4) kPa in jejunum sheet group and (21.3 ± 2.8) kPa in ileum sheet group, and the difference was significant (P lt; 0.01). No rupture of the repaired abdominal wall occurred in jejunum and ileum sheet groups when the cel iac pressure was 40 kPa. Before repairing the abdominal wall defects, there was a l ittle residual mucosal tissue on the surface of all pedicled demucosal small intestinal sheets. At the 30th day after operation, conspicuous hyperplasia and thickening occurred in all parts of tissue of the repaired abdominal walls and the residual mucosal tissue disappeared completely. Conclusion Because of simple operation, satisfactory achievement ratio, good effect, no important compl ication, and no use of expensive prosthetic materials, it is a feasible method to repair the full-thickness abdominal wall defect with pedicled demucosal small intestinal sheet.
Objective To explore the number variation trend of inpatients with traumatic brain injury (TBI) in high altitude and plain areas. Methods The first page information in medical records of TBI patients, who were admitted to military hospitals from 2001 to 2007, was searched and extracted from the Chinese Trauma Database. Two military hospitals in high altitude area and another two in the same hospital level in plain area were selected. Then, the number variation trend of TBI inpatients in those two areas was compared. Results In high altitude area, the proportion of male patients and their median inpatient days were higher, while the age, proportion of Han patients and surgery rate were lower than those in plain area (all Plt;0.001). During 2001-2007, there were 9 141 TBI patients discharged from the four hospitals, and the average annual growth rate was 13.15%. In high altitude area, the average annual growth rate of discharged inpatients was 24.00%, while in plain area, it was just 7.09%. The 4 common categories of TBI were intracranial injury, open wound of the head, neck and trunk, skull fracture, and other injuries. Conclusion Compared with the plain area, there are significant differences in the demographics, hospital stay and surgery of inpatients in high altitude area. The average annual growth rate of TBI inpatients discharged from hospitals in high altitude area is faster than that in plain area, to which should be paid attention by relevant departments.