Effect of Human Placental Extract Treatment on Random-Pattern Skin Flap Survival in Rats

Background: Human placental extract (HPE), prepared from the placentas of healthy, postpartum females, displays various physiological activities, including antioxidative properties. In this study, a dorsal skin flap model was used to investigate the effect of HPE on flap viability in rats. Materials and methods: Forty male Sprague-Dawley rats underwent random-pattern skin flap surgeries. The animals were randomly divided among a control group and three treatment groups (localized injection (LI), 10 mg/kg/d localized HPE injections; low-dose treatment (LT), 10 mg/kg/d systemic HPE injections; high-dose treatment (HT), 40 mg/kg/d systemic HPE injections). Surviving skin flap areas were measured 7 days after surgery and tissue samples were stained with hematoxylin and eosin; vascular endothelial growth factor expression was determined immunohistochemically. To evaluate the antioxidant and antiapoptotic effects of HPE, malondialdehyde, glutathione peroxidase, and caspase-3 levels were examined. Results: Seven days after surgery, HPE-treated animals had significantly reduced necrotic areas, rats receiving the highest HPE dose demonstrated the greatest flap survival. In the HPE groups, the histopathological scores were lower than for the control group. Immunohistochemistry showed markedly more numerous vascular endothelial growth factor-positive cells in the HT group than in the C group. Malondialdehyde levels were significantly lower and glutathione peroxidase levels were higher in the HT group than in the C group. HPE treatment significantly inhibited apoptosis by lowering caspase-3 activity. Conclusions: HPE treatment yielded positive effects on flap survival, due to its antioxidant and antiapoptotic properties. These results suggest a new therapeutic approach for enhancing flap viability and accelerating wound repair.     

腺病毒介导基因转染提高大鼠皮瓣成活力的实验研究

目的 探讨局部应用腺病毒介导人血管内皮细胞生长因子,对大鼠全厚随意型皮瓣、轴型皮瓣成活率的影响.方法 按照皮瓣类型将SD大鼠分为随意型皮瓣与轴型皮瓣两组,每组随机分为腺病毒治疗组(AdCMCV-VEGF组)、半乳糖苷酶组(AdCMV-Gal组)与生理盐水组3组(每组10只).分别于大鼠背侧正中设计蒂在尾侧的随意皮瓣(8cm×2cm),于腹部设计双侧腹壁下动脉为蒂的联合轴型皮瓣.在AdCMCV-VEGFA组,在设计皮瓣远端真皮下注射1012pfu的重组复制缺陷型腺病毒;AdCMV-Gal组,同法注入1012pfu的重组复制缺陷型腺病毒AdCMV-Gal;生理盐水组注入生理盐水1ml.注射后3天,皮瓣按原设计掀起并原位缝合,轴型皮瓣同时行右侧腹壁下动静脉结扎.分别与7天(随意型皮瓣)、14天(轴型皮瓣)后计算皮瓣成活率.结果 与AdCMCV-VEGF组和盐水组相比,AdCMV-VEGF组皮瓣成活率明显增高,免疫组化染色检测证明VEGF表达.组织学检测证明AdCMCV-VEGF组肉芽组织形成与血管增生明显增多.结论 腺病毒介导的局部应用VEGF cDNA可明显提高缺血皮瓣的成活.     

枸橼酸西地那非对雄性大鼠性活动能力的影响

目的 :为了获得与临床相关的药物动力学资料 ,本实验通过给雄性大鼠枸橼酸西地那非灌胃后观察它们性活动的变化。　方法 :4 0只雄性SD大鼠 ,分成阴性对照组 (蒸馏水 )、枸橼酸西地那非低剂量组 ( 0 .0 8% )、中剂量组( 0 .2 4 % )和高剂量组 ( 0 .72 % )共 4组 ,与雌性大鼠成对合笼 ,观察并记录雄性大鼠捕捉潜伏期、爬高潜伏期、6 0min内捕捉次数和 6 0min内爬高次数。　结果 :与阴性对照组相比 ,西地那非高、中剂量组能极显著性提高雄性大鼠的捕捉次数 ,缩短捕捉潜伏期 (P <0 .0 1) ;高、中、低剂量组均能极显著性提高雄性大鼠的爬高次数 ,缩短爬高潜伏期(P <0 .0 1)。　结论 :西地那非能够显著提高雄性大鼠的性活动能力。     

VEGF Application on Rat Skin Flap Survival

ABSTRACT

Background: Induction of angiogenesis has been shown to be mediated by a number of glycoproteins called growth factors. Growth factors control the growth, differentiation, and metabolism of cells. Vascular endothelial growth factor (VEGF) is believed to be the most potent regulator of this process. The effect of its exogenous administration on the distal third of a long random skin flap was examined. Materials and Methods: Eighteen Wistar rats were divided into two groups of nine. Rats were anesthetized, and a skin flap, measuring 1.5 × 7.5 cm, was elevated at their dorsum. The flap was standardized by centering the pedicle between the lower angles of the scapulae and by using a frame with the previously mentioned dimensions. The length of the flap was five times greater than its width. In group A (n = 9), the flap was elevated, one milliliter of normal saline was injected subdermally, at the distal third, and it was sutured back at its original place. In group B (n = 9), the flap was elevated, injections of 10 μg of VEGF were administrated subdermally, at the distal third, and it was again sutured back. Rats were euthanized a week later and flaps were excised. All specimens were measured, photographed, put in formalin 10%, and were sent for image and histological analysis. Image analysis was used both for the estimation of viable area and for the calculation of mean vessel density per mm². Results: Necrotic areas of the flaps were clearly demarcated within a week's time. In group A, the mean flap survival percentage was 38.9%. In group B, the percentage was 80.4%. Histological analysis demonstrated angiogenesis in group B, with mean vessel density per mm² being higher in group B than in group A. Conclusions: Administration of VEGF injections at the distal part of a long random skin flap (length to width ratio 5:1) has been shown to improve the survival rate of the flap and thus contributing to the salvage of greater peripheral segment of the flap. Neovascularization induced by exogenous VEGF seems to be the biological mechanism, which leads to the improvement of flap survival.     

Effects of Traditional Chinese Medicine,Dilong Injection,on Random Skin Flap Survival in Rats

Background: Dilong injection as a medicinal preparation extracted from earthworm in traditional Chinese medicine, is used to activate blood circulation and remove blood stasis. In this research, we aim to investigate its potential effect on random skin flap survival in rat models. Materials and methods: McFarlane flaps were established in 60 male Sprague–Dawley rats randomly divided into two groups: the control group and the Dilong injection group. Diong injection group was injected with the Diong injection (4 mL/kg) once a day for seven days, and the control group was given an equal volume of saline solution. After seven days, flaps were obtained and stained with Hematoxylin and Eosin. Histological examination was done to determine changes in histology such as thickness of granulation tissue, tissue edema, neutrophil infiltration, and the microvascular density (MVD). In addition, immunohistochemical detection was carried out to show vascular endothelial growth factor (VEGF) expression level. Results: Compared with the control group, the Dilong group exhibited more fibroblastic proliferation, thinner neutrophil infiltration with less edema through histological examination. The MVD and the VEGF expression of flaps were significantly higher. The mean superoxide dismutase activity was evidently higher in the Dilong group than in the control group, while the mean MDA level was lower. Conclusions: According to the comparison made between the two groups for histological and immunohistochemical evaluation, the Dilong injection group has potential effects on the survival of random skin flaps in rat models.     

腹部带血管蒂皮瓣修复术用于手部外伤患者皮肤缺损治疗的效果及影响分析

目的 分析腹部带血管蒂皮瓣修复术用于手部外伤患者皮肤缺损治疗的效果。方法 选取2019年1月-2023年1月我院收治的100例手部外伤患者作为研究对象,对所有患者均实施腹部带血管蒂皮瓣修复术方案,根据治疗效果进行分组,分析影响疗效的相关危险因素。结果 100例手部外伤患者皮肤缺损治疗中,治疗效果理想占比89.00%,高于治疗效果较差的11.00%（P＜0.05）;治疗效果理想与治疗效果较差患者手部外伤受损原因、年龄比较,差异无统计学意义（P＞0.05）;治疗效果理想与治疗效果较差患者外伤患肢、存在并发症、手部外伤受损面积、受伤到就诊时间比较,差异有统计学意义（P＜0.05）;手部外伤患肢、存在并发症、手部外伤受损面积、受伤到就诊时间是影响手部外伤患者皮肤缺损治疗效果主要危险因素（P＜0.05）。结论 手部外伤临床较为常见,选择腹部带血管蒂皮瓣修复术对皮肤缺损治疗效果较为理想,但外伤患肢为右侧、术后存在并发症、手部外伤受损面积过大、受伤到就诊时间过长可降低治疗效果,需提高重视度,做好相关干预策略进而达到提升疗效目的。     

Effects of Asiaticoside Treatment on the Survival of Random Skin Flaps in Rats

Abstract

Background: Asiaticoside (AS) is extracted from the traditional herbal medicine Centella asiatica, and has angiogenic, antioxidant, anti-inflammatory, and wound-healing effects. We investigated the effects of AS on skin flap survival. Methods: Dorsal McFarlane flaps were harvested from 36 rats and divided into two groups: an experimental group treated with 40?mg/kg AS administered orally once daily, and a control group administered normal saline in an identical manner. On day 2, superoxide dismutase (SOD) and malondialdehyde (MDA) levels, and production of the cytokines tumor necrosis factor-α and interleukin (IL)-6 were evaluated. On day 7, tissue slices were stained with hematoxylin and eosin. The expression of vascular endothelial growth factor (VEGF), IL-6, and IL-1β were immunohistochemically evaluated. Microcirculatory flow was measured using laser Doppler flowmetry. Flap angiography, using the lead oxide-gelatin injection technique, was performed with the aid of a soft X-ray machine. Results: The AS group exhibited greater mean flap survival area, improved microcirculatory flow, and higher expression levels of SOD and VEGF compared with the control group. However, MDA levels and the inflammatory response were significantly reduced. Conclusions: AS exhibits promise as a therapeutic option due to its effects on the viability and function of random skin flaps in rats.     

脂肪基质血管成分移植促进随意皮瓣成活的实验研究

目的探讨脂肪基质血管成分(Stromal vascular fraction,SVF)移植是否可以促进随意皮瓣成活,及其作用的相关机制。方法分离4周龄Wistar大鼠脂肪中的SVF及骨髓中的单个核细胞(BM-MNCs),RT-PCR检测VEGF和bFGF在两种细胞中的表达。根据移植细胞的不同,将24只Wistar大鼠分成3组,分别为对照组、BM-MNCs组和SVF组。在大鼠背部设计一个10 cm×3 cm大小的矩形皮瓣,分别将含有5×107个SVF及BM-MNCs的混悬液各1 mL均匀注射至皮下组织层,对照组单纯注射1 mL PBS。2 d后,皮瓣掀开原位缝合,术后7 d统计皮瓣的成活率。取各组皮瓣相同部位的组织,实时定量PCR检测组织中VEGF和bFGF基因的表达。结果 SVF和BM-MNCs细胞中VEGF和bFGF的表达无明显差别(P>0.05)。皮瓣原位缝合后7 d,SVF组和BM-MNCs组皮瓣的成活率分别为(72.2±2.0)%和(76.4±3.1)%,均明显高于对照组的(56.8±4.6)%(P<0.05)。实时定量PCR检测发现SVF组和BM-MNCs组皮瓣组织中VEGF和bFGF基因的表达明显升高。结论 SVF移植入皮瓣后可以通过旁分泌生长因子如VEGF和bFGF等增加皮瓣的成活面积。     

腹股沟皮瓣修复术治疗手及前臂皮肤烧伤瘢痕的临床效果

目的 探讨腹股沟皮瓣修复术治疗手及前臂皮肤烧伤瘢痕的临床效果。方法 选取2020年 1月-2021年12月邯郸邯钢医院烧伤整形科收治的100例手及前臂皮肤烧伤瘢痕患者为研究对象,按照随机 数字表法分为观察组和对照组,各50例。对照组给予股外侧皮瓣修复术治疗,观察组给予腹股沟皮瓣修复 术治疗,比较两组皮瓣断蒂时间、皮瓣存活情况、皮瓣感染情况、临床疗效、创面周围炎症情况及烧伤组 织恢复情况。结果 观察组皮瓣存活率、皮瓣断蒂时间、皮瓣感染率均优于对照组（P＜0.05）;观察组治 疗总有效率为96.00%,高于对照组的80.00%（P＜0.05）;观察组治疗后2、3、4、5周创面周围炎症评分均 高于对照组（P＜0.05）;两组治疗后肢体功能恢复评分、皮肤修复评分均高于治疗前,且观察组高于对照 组（P＜0.05）。结论 腹股沟皮瓣修复术治疗手及前臂皮肤烧伤瘢痕的临床效果确切,可有效提高皮瓣存 活率,控制创面周围炎症反应,降低皮瓣感染发生几率,从而改善肢体功能及皮肤情况,有利于促进患者 快速恢复。     

股前外侧游离皮瓣修复在足部皮肤软组织缺损治疗中的临床效果

探究股前外侧游离皮瓣修复在足部皮肤软组织缺损治疗中的临床效果。方法 选取2021年1月-2023年5月遵义市播州区人民医院收治的40例足部皮肤软组织缺损患者,依据手术方法不同将其分为对照组和观察组,各20例。对照组行传统带蒂皮瓣修复,观察组行股前外侧游离皮瓣修复,比较两组临床指标、皮瓣成活率、足部功能恢复情况。结果 观察组术中出血量少于对照组,手术时间、住院时间短于对照组,外形满意度高于对照组（P ＜0.05）;观察组皮瓣成活率高于对照组（P ＜0.05）;观察组AOFAS各维度评分高于对照组（P ＜0.05）。结论 在足部皮肤软组织缺损治疗中,实施股前外侧游离皮瓣修复效果确切,可有效减少术中出血量,缩短手术时间和住院时间,提高外形满意度和皮瓣成活率,促进足部功能恢复。     

Effect of Aspirin and Heparin on Random Skin Flap Survival in Rats

BACKGROUND Aspirin and heparin are commonly given to patients undergoing microvascular procedures to increase flap survival and patency, yet there is scant information concerning the effect these flaps have on nonmicrovascular flaps.
OBJECTIVE The objective was to obtain baseline values concerning the effect of aspirin and heparin on the viability of standardized flap tissues.
METHODS AND MATERIALS One hundred rats were divided into five groups receiving high-dose aspirin, low-dose aspirin, high-dose aspirin in combination with heparin, and heparin alone and the final group were controls. The viability of the tissue was measured at 1 week by fluorescein florescence.
RESULTS There was significant improvement in flap survival in the high-dose aspirin and high-dose aspirin combination groups.
CONCLUSIONS It appears that high-dose aspirin increases survival of ischemic flap tissue irrespective of the presence of microvascular anastomosis and may be of clinical benefit in all flap surgery.     

Restoration of the Gluteal fold by a Deepithelialized Skin Flap: Preliminary Observations

Background The gluteal fold represents an important aspect of the gluteal region. Destruction of this anatomic landmark as a consequence of trauma or tissue harvest can result in an aesthetically disturbing disfigurement. A technique for reconstruction of the gluteal fold and preliminary results are presented.Methods The newly formed gluteal fold is created by fixation of a deepithelialized skin flap to the periosteum of the tuber ischiadicum.Results The operative procedure is quick and easy to apply. The method is used mainly for patients with a distorted gluteal fold after tissue harvest for breast reconstruction. However, it also can be used after trauma such as that associated with burn injuries. In all patients, reconstruction of the gluteal fold yielded aesthetically pleasing and reliable results with high patient satisfaction.Conclusions The authors present a simple and effective technique for reconstruction of the gluteal fold by a deepithelialized skin flap. The technique is applicable for patients who have lost their natural gluteal sulcus, with a resultant altered buttock shape, after trauma or other causes.     

腓动脉穿支皮瓣修复足踝皮肤软组织缺损的临床效果

目的 探讨腓动脉穿支皮瓣修复足踝皮肤软组织缺损的临床效果。方法 选取2019年1月-2022年 12月本院收治的30例足踝皮肤软组织缺损患者为研究对象,均应用腓动脉穿支皮瓣进行修复,观察术后 皮瓣成活情况,比较患者治疗前后的足踝功能及生活质量。结果 30例患者皮瓣成活率为96.67%;治疗后 皮肤外观、疼痛程度、皮肤感觉及功能评分均高于治疗前,差异有统计学意义（P＜0.05）;治疗后躯体 功能、角色功能、社会功能、睡眠质量、情绪状态均高于治疗前,差异有统计学意义（P＜0.05）。结论 腓动脉穿支皮瓣修复足踝皮肤软组织缺损的临床效果良好,术后皮瓣成活率较高,可有效改善患者的足 踝功能及生活质量。     

以应激系统理论为指导的护理干预在皮瓣移植修复手指皮肤缺损患者中的应用效果

目的 观察手指皮肤缺损患者接受皮瓣移植治疗期间应用以应激系统理论为指导的护理干预效 果。方法 选取我院2020年1月-2022年12月收治的68例手指皮肤缺损患者为研究对象,采用随机数字表法 分为对照组和观察组,各34例。对照组予以常规护理,观察组在常规护理基础上实施应激系统理论为指导 的护理干预,比较两组心理状态、应激反应、皮瓣成活情况、并发症发生情况以及护理满意度。结果 观察组 护理后SAS及SDS评分低于对照组（P＜0.05）;观察组护理后ADH及GC水平均低于对照组（P＜0.05）;观察 组皮瓣成活率为97.06%,高于对照组的82.35%（P＜0.05）;观察组并发症发生率低于对照组（P ＜0.05）; 观察组护理满意度高于对照组（P ＜0.05）。结论 手指皮肤缺损患者在皮瓣移植围术期期间经应激系统 理论指导的护理干预可缓解围术期负面情绪及应激反应,减少术后并发症发生几率,促进提高皮瓣成活情 况,临床效果确切。     

改良菱形皮瓣修复发际部头皮缺损

目的 评价应用改良菱形皮瓣修复发际部位头皮缺损的效果.方法 自2000年1月以来,我们应用改良菱形皮瓣修复发际部位头皮缺损15例.结果 术后15例皮瓣均完全成活,切口Ⅰ期愈合,转移后的皮瓣毛发的毛流、毛向与周围毛发基本一致,效果满意.结论 改良菱形皮瓣可应用于修复发际部位头皮缺损,适用于发际部位面积不大但又不能直接缝合的创面修复.     

外痔皮瓣内移位治疗混合痔临床观察

为了探索痛苦小、恢复快的治疗混合痔的方法,将166例混合痔患者分为两组,治疗组120例采用外痔皮瓣内移位的方法治疗;对照组46例采用分段结扎术治疗。结果治疗组手术时间（5．0±3．7）min,微痛,全部门诊治疗,无需禁食禁便,臀沟恢复深度（4．1±3．6）cm,治愈时间（6．0±3．2）d,治愈率100％;对照组治愈时间（9．5±1．8）d,两组差异有统计学意义（P〈0．05）。结果表明,外痔皮瓣内移位治疗混合痔具有操作简单、痛苦小、疗程短、治愈率高、无复发的特点。     

The Effects of Tadalafil on Axial-Pattern Skin Flap Survival in Rats

BACKGROUND Pharmacologic augmentation to mimic the delay phenomenon that increases skin flap survival has been studied extensively. Tadalafil is a phosphodiesterase V inhibitor that is used for treatment of erectile dysfunction by enhancing vascular smooth muscle relaxation.
OBJECTIVE The aim of this study was to investigate the effects of local injection of tadalafil in enhancing axial-pattern skin flap survival in rats.
MATERIALS AND METHODS Twenty Sprague-Dawley rats were used and a McFarlane-type caudally based axial-pattern skin flap was designed on the dorsum of the rat (2 × 9 cm). Rats were divided into two groups: the treatment group and the control group. Tadalafil 10 mg/kg/day was injected to the distal flap area of the treatment group for 3 days, and normal saline was injected for the control group. On Postoperative Day 7, necrotic flap area was measured and compared, and angiograms of the skin flaps were obtained in the two groups.
RESULTS In the treatment group, the mean necrotic area was 21.9±6.4%, and in the control group, 37.7±5.9%. There was a statistically significant increase of skin flap survival in the treatment group ( p =.001). Angiography also showed vasodilation of the choke vessels between adjacent angiosomes to form true anastomosis in the treatment group.
CONCLUSION The results demonstrate that the use of local injection of tadalafil to failing skin flaps increases the survival of axial-pattern flaps in rats.     

Strong Immunohistochemical Expression of Vascular Endothelial Growth Factor Predicts Overall Survival in Head and Neck Squamous Cell Carcinoma

Background Head and neck squamous cell carcinoma (HNSCC) has high morbidity and mortality, and its relationship with tumor angiogenesis as measured by mircovessel density (MVD) or vascular endothelial growth factor (VEGF) expression has shown mixed results, with some, but not others, reporting correlation with outcome. Methods A retrospective study of 186 patients with HNSCC was performed. Patients were evaluated for MVD and VEGF and to correlate the levels with clinical parameters, including age at diagnosis, sex, site of tumor, stage, survival (disease free and overall), pathological tumor grade, and the presence of lymph node metastases. Results The 186 cancers included the following sites: oral tongue (n = 69), palate (n = 9), maxillary sinus (n = 8), floor of mouth (n = 13), oropharynx (n = 27), hypopharynx (n = 26) and larynx (n = 34). Over three-quarters of patients had advanced tumor (stage III/IV) and 58.6% had lymph node metastases. MVD and VEGF were assessed in 166 and 164 cases, respectively, but these were not correlated with site and grade. The 3-year overall and disease-free survival rates were 55.4% and 53.2%, respectively. Both univariate and multivariate survival analysis showed that advanced T stage, nodal metastasis, and strong VEGF intensity were independent adverse predictors for overall and disease-free survival. In stage IV disease, strong VEGF immunoreactivity was found to be the single adverse factor affecting the overall survival and a contributory factor for disease-free survival. Conclusions VEGF immunoreactivity is a strong predictor of adverse outcome, particularly in locoregionally advanced disease.     

红外热成像技术在皮瓣移植围术期检测中的应用

目的 探讨红外热成像装置在皮瓣移植围术期监测的应用价值及使用技巧。方法 采用便携式红外热像仪FLIRONE pro,在16例皮瓣移植患者术前、术中和术后对皮瓣及周围部位进行拍摄,并使用FLIRTools软件对拍摄的热像图进行分析和局部温度测量;同时,采用彩色多普勒超声对穿支血管进行定位,比较两种检测方法的检测结果。结果皮瓣移植术前的红外热像图可准确定位血管位置,血管走行区域皮肤温度高于周围,在热像图上呈现“亮点”或“亮线”,其结果与彩色多普勒超声所示一致。术中热像图可通过测定皮瓣各区域温度,辅助判断蒂部血管是否通畅,以及皮瓣远端血运情况。术后的热像图可用于监测皮瓣血供,通过比较皮瓣与周围正常皮肤温度,以及皮瓣温度变化,观察皮瓣微循环,有助于早期发现皮瓣血运障碍,从而及时采取干预措施。结论 红外热成像技术是一种无创、经济、简便、直观、准确的辅助检测手段,对于皮瓣移植术前血管定位及术中、术后血运监测具有较高应用价值。     

局部皮瓣修复肿物切除术后头面部皮肤软组织缺损中的应用研究

为探究局部皮瓣在修复肿物切除术后头面部皮肤软组织缺损中的应用效果,本研究选取2021年 7月1日-2022年11月1日在我院收治的因头面部病损行局部皮瓣修复肿物切除术后皮肤软组织缺损的患者 50例作为研究对象,于术后随访6个月,观察手术切口长度、皮瓣血运情况、患者对修复的满意度。平均 随访（14.46±2.38）个月后,结果显示手术切口长度（4.29±1.11）cm,平均拆线时间（5.28±0.28）d;皮 瓣血运有98.00%情况为良好,仅有1例为尖端缺血。满意度调查显示,27例表示非常满意（54.00%）,12例 表示比较满意（24.00%）,7例表示可以接受（14.00%）,4例失访。由此可得,局部皮瓣在修复肿物切除 术后头面部皮肤软组织缺损中具有理想的修复效果。