Repair of circular scar in the forearm by expanded double-pedicle Ω-shaped flap at the rear flank of bottom-waist

Objective To discuss the method for repairing the circular scar in the forearm.Methods Large expander (400-600 ml) were implanted subcutaneously at the rear flank of bottom-waist in the way of overlapping or continued expansion. After expansion was completed, the horizontal opened Ω-shaped flap was formed by advancement of expanded skin with the two pedicles at the two sides. Then the forearm was tunneled under flap with the wound covered by flap. The pedicles were cut off at the third stage. Results From April 1998 to June 2009, 8 cases were treated with no flap necrosis. The patients were followed up for1 to 3 years with good flap color and thickness. Flap sensory was partially recovered.Linear atrophic scar was left in the donor sites. Conclusions It is feasible to repair forearm circular scar by expanded double-pedicle Ω-shaped flap at the rear flank of bottom-waist.     

Repair of circular scar in the forearm by expanded double-pedicle Ω-shaped flap at the rear flank of bottom-waist

Objective To discuss the method for repairing the circular scar in the forearm.Methods Large expander (400-600 ml) were implanted subcutaneously at the rear flank of bottom-waist in the way of overlapping or continued expansion. After expansion was completed, the horizontal opened Ω-shaped flap was formed by advancement of expanded skin with the two pedicles at the two sides. Then the forearm was tunneled under flap with the wound covered by flap. The pedicles were cut off at the third stage. Results From April 1998 to June 2009, 8 cases were treated with no flap necrosis. The patients were followed up for1 to 3 years with good flap color and thickness. Flap sensory was partially recovered.Linear atrophic scar was left in the donor sites. Conclusions It is feasible to repair forearm circular scar by expanded double-pedicle Ω-shaped flap at the rear flank of bottom-waist.     

几丁糖对扩张后皮瓣纤维包膜影响的实验研究

Objective To investigate the effect of chitosan on the capsule inside the expanded flap. Methods The expanders were implanted in animals with the treatment of chitosan(experimental group, n=15) or without(control group, n=15). After taking out the expanders, the flap contraction rate was calculated. The samples were observed through HE, Masson dyeing and CD34 immunohistochemical study. The thickness of capsule inside the expanded flap was measured under microscope. The samples were also studied under electron microscope. Results The thickness of capsule was 516.000±128.491 μm in the experimental group, and 833.000±227.379 μm in the control group(P < 0.05). The number of microvessels was 8.200±2.150 per visual in experimental group, and 7.900±1.729 per visual in control group(P > 0.05). Under the electron microscope, the rough endoplasmic reticulum(RER) in the capsule in experimental group decreased and enlarged with degranulation. The mitochondria emerged or disappeared. The number of ribosome was reduced. In the control group, the PER enlarged without degranulation, the mitochondria was intact. The number of ribosome was not reduced. Conclusions The chitosan can effectively reduce the contraction of expanded flap through collagen secretion of fibroblast, delaying the differentiation from fibroblast to fiber cell, inhibiting thansform from fibroblast to myofibroblast. It has no effect on the microvascular generation and expansion, so the flap blood supply will not be affected with thicker capsule.     

兔股动脉和静脉预构轴型扩张皮瓣的实验观察

Objective To study the microcirculation and structural changes, surviving area of expanded prefabricated flaps. Methods A total of 40 New Zealand rabbits were divided randomly into expanded prefabricated, expender lined, simple prefabricated and free flap groups, each consisting of 10 rabbits. For the expanded prefabricated, expender lined and simple prefabricated groups, after the femoral artery and vein were transplanted into subcutaneous tissues of abdomen, and expanders were implanted into the deeper dartos. The free flap group was a blank control group. For the expanded prefabricated group, the expansion was carried out on 7th day postoperatively. On postoperative day 52, when the expander was fully expanded, island flaps with the prefabricated vessels as the pedicles were formed. The flaps were measured by laser Doppler flowmetry, light microscopy and digital re-cording of survival arca. Results When compared with the other groups, the perfusion volume of mi-crocirculation enhanced, flaps survival improved (97.54±2.73) %, blood capillary were stronger, to-gether with microscopic changes were significant in the expanded prefabricated groups (P<0.05). Conclusion Expandedprefabricated flaps can increase the survival size of the flaps and the safety of flap transplantation.     

兔股动脉和静脉预构轴型扩张皮瓣的实验观察

Objective To study the microcirculation and structural changes, surviving area of expanded prefabricated flaps. Methods A total of 40 New Zealand rabbits were divided randomly into expanded prefabricated, expender lined, simple prefabricated and free flap groups, each consisting of 10 rabbits. For the expanded prefabricated, expender lined and simple prefabricated groups, after the femoral artery and vein were transplanted into subcutaneous tissues of abdomen, and expanders were implanted into the deeper dartos. The free flap group was a blank control group. For the expanded prefabricated group, the expansion was carried out on 7th day postoperatively. On postoperative day 52, when the expander was fully expanded, island flaps with the prefabricated vessels as the pedicles were formed. The flaps were measured by laser Doppler flowmetry, light microscopy and digital re-cording of survival arca. Results When compared with the other groups, the perfusion volume of mi-crocirculation enhanced, flaps survival improved (97.54±2.73) %, blood capillary were stronger, to-gether with microscopic changes were significant in the expanded prefabricated groups (P<0.05). Conclusion Expandedprefabricated flaps can increase the survival size of the flaps and the safety of flap transplantation.     

兔股动脉和静脉预构轴型扩张皮瓣的实验观察

Objective To study the microcirculation and structural changes, surviving area of expanded prefabricated flaps. Methods A total of 40 New Zealand rabbits were divided randomly into expanded prefabricated, expender lined, simple prefabricated and free flap groups, each consisting of 10 rabbits. For the expanded prefabricated, expender lined and simple prefabricated groups, after the femoral artery and vein were transplanted into subcutaneous tissues of abdomen, and expanders were implanted into the deeper dartos. The free flap group was a blank control group. For the expanded prefabricated group, the expansion was carried out on 7th day postoperatively. On postoperative day 52, when the expander was fully expanded, island flaps with the prefabricated vessels as the pedicles were formed. The flaps were measured by laser Doppler flowmetry, light microscopy and digital re-cording of survival arca. Results When compared with the other groups, the perfusion volume of mi-crocirculation enhanced, flaps survival improved (97.54±2.73) %, blood capillary were stronger, to-gether with microscopic changes were significant in the expanded prefabricated groups (P<0.05). Conclusion Expandedprefabricated flaps can increase the survival size of the flaps and the safety of flap transplantation.     

兔股动脉和静脉预构轴型扩张皮瓣的实验观察

Objective To study the microcirculation and structural changes, surviving area of expanded prefabricated flaps. Methods A total of 40 New Zealand rabbits were divided randomly into expanded prefabricated, expender lined, simple prefabricated and free flap groups, each consisting of 10 rabbits. For the expanded prefabricated, expender lined and simple prefabricated groups, after the femoral artery and vein were transplanted into subcutaneous tissues of abdomen, and expanders were implanted into the deeper dartos. The free flap group was a blank control group. For the expanded prefabricated group, the expansion was carried out on 7th day postoperatively. On postoperative day 52, when the expander was fully expanded, island flaps with the prefabricated vessels as the pedicles were formed. The flaps were measured by laser Doppler flowmetry, light microscopy and digital re-cording of survival arca. Results When compared with the other groups, the perfusion volume of mi-crocirculation enhanced, flaps survival improved (97.54±2.73) %, blood capillary were stronger, to-gether with microscopic changes were significant in the expanded prefabricated groups (P<0.05). Conclusion Expandedprefabricated flaps can increase the survival size of the flaps and the safety of flap transplantation.     

兔股动脉和静脉预构轴型扩张皮瓣的实验观察

Objective To study the microcirculation and structural changes, surviving area of expanded prefabricated flaps. Methods A total of 40 New Zealand rabbits were divided randomly into expanded prefabricated, expender lined, simple prefabricated and free flap groups, each consisting of 10 rabbits. For the expanded prefabricated, expender lined and simple prefabricated groups, after the femoral artery and vein were transplanted into subcutaneous tissues of abdomen, and expanders were implanted into the deeper dartos. The free flap group was a blank control group. For the expanded prefabricated group, the expansion was carried out on 7th day postoperatively. On postoperative day 52, when the expander was fully expanded, island flaps with the prefabricated vessels as the pedicles were formed. The flaps were measured by laser Doppler flowmetry, light microscopy and digital re-cording of survival arca. Results When compared with the other groups, the perfusion volume of mi-crocirculation enhanced, flaps survival improved (97.54±2.73) %, blood capillary were stronger, to-gether with microscopic changes were significant in the expanded prefabricated groups (P<0.05). Conclusion Expandedprefabricated flaps can increase the survival size of the flaps and the safety of flap transplantation.     

兔股动脉和静脉预构轴型扩张皮瓣的实验观察

Objective To study the microcirculation and structural changes, surviving area of expanded prefabricated flaps. Methods A total of 40 New Zealand rabbits were divided randomly into expanded prefabricated, expender lined, simple prefabricated and free flap groups, each consisting of 10 rabbits. For the expanded prefabricated, expender lined and simple prefabricated groups, after the femoral artery and vein were transplanted into subcutaneous tissues of abdomen, and expanders were implanted into the deeper dartos. The free flap group was a blank control group. For the expanded prefabricated group, the expansion was carried out on 7th day postoperatively. On postoperative day 52, when the expander was fully expanded, island flaps with the prefabricated vessels as the pedicles were formed. The flaps were measured by laser Doppler flowmetry, light microscopy and digital re-cording of survival arca. Results When compared with the other groups, the perfusion volume of mi-crocirculation enhanced, flaps survival improved (97.54±2.73) %, blood capillary were stronger, to-gether with microscopic changes were significant in the expanded prefabricated groups (P<0.05). Conclusion Expandedprefabricated flaps can increase the survival size of the flaps and the safety of flap transplantation.     

兔股动脉和静脉预构轴型扩张皮瓣的实验观察

Objective To study the microcirculation and structural changes, surviving area of expanded prefabricated flaps. Methods A total of 40 New Zealand rabbits were divided randomly into expanded prefabricated, expender lined, simple prefabricated and free flap groups, each consisting of 10 rabbits. For the expanded prefabricated, expender lined and simple prefabricated groups, after the femoral artery and vein were transplanted into subcutaneous tissues of abdomen, and expanders were implanted into the deeper dartos. The free flap group was a blank control group. For the expanded prefabricated group, the expansion was carried out on 7th day postoperatively. On postoperative day 52, when the expander was fully expanded, island flaps with the prefabricated vessels as the pedicles were formed. The flaps were measured by laser Doppler flowmetry, light microscopy and digital re-cording of survival arca. Results When compared with the other groups, the perfusion volume of mi-crocirculation enhanced, flaps survival improved (97.54±2.73) %, blood capillary were stronger, to-gether with microscopic changes were significant in the expanded prefabricated groups (P<0.05). Conclusion Expandedprefabricated flaps can increase the survival size of the flaps and the safety of flap transplantation.