Objective:To explore the clinical application effect of autologous fat granule transplantation in facial depression plastic surgery.Methods:A total of 98 patients with facial depression admitted to the plastic surgery...Objective:To explore the clinical application effect of autologous fat granule transplantation in facial depression plastic surgery.Methods:A total of 98 patients with facial depression admitted to the plastic surgery department of our hospital from January 2021 to December 2023 were selected and divided into observation group(49 cases)and control group(49 cases)according to the random number table method.The observation group was treated with autologous fat granule transplantation,while the control group was treated with hyaluronic acid filling.The total effective rate of treatment,incidence of postoperative complications,improvement indicators of facial morphology(depth of depression,symmetry),and effect maintenance rate after 6 months of follow-up were compared between the two groups.Results:The total effective rate of treatment in the observation group was 93.88%(46/49),which was significantly higher than that in the control group(79.59%,39/49)(P<0.05).The incidence of postoperative complications in the observation group was 6.12%(3/49),which was lower than that in the control group(20.41%,10/49)(P<0.05).One month after surgery,the depth of depression(1.23±0.31 mm)and symmetry(1.02±0.15 points)in the observation group were better than those in the control group(P<0.05).After 6 months of follow-up,the effect maintenance rate in the observation group was 89.80%(44/49),which was significantly higher than that in the control group(67.35%,33/49)(P<0.05).Conclusion:Autologous fat granule transplantation for the treatment of facial depression can significantly improve facial morphology,enhance treatment effect and patient satisfaction,reduce the incidence of complications,and maintain a more durable effect.It is a clinically preferred facial depression plastic surgery solution.展开更多
The treatment of a 40-year-old woman with a giant fibroadenoma in her left breast is presented. The fibroadenoma measured 14 × 5 × 3 cm and weighed 170 g. We demonstrate that the surgical strategy and the re...The treatment of a 40-year-old woman with a giant fibroadenoma in her left breast is presented. The fibroadenoma measured 14 × 5 × 3 cm and weighed 170 g. We demonstrate that the surgical strategy and the reconstructive techniques in oncoplastic breast cancer surgery successfully can be applied to the treatment of these rare benign tumours improving the cosmetic and functional outcome.展开更多
BACKGROUND Endometrial cancer(EC)is a common gynecological malignancy,but metastasis to the abdominal wall is extremely rare.Therefore,an appropriate treatment approach for large metastatic lesions with infection rema...BACKGROUND Endometrial cancer(EC)is a common gynecological malignancy,but metastasis to the abdominal wall is extremely rare.Therefore,an appropriate treatment approach for large metastatic lesions with infection remains a great challenge.CASE SUMMARY We report the case of a 65-year-old woman who developed abdominal metastasis of endometrioid adenocarcinoma,as defined by International Obstetrics and Gynecology stage II,in which the lesion was complicated by infection.A right hemicolectomy was performed for colon metastasis in relation to her initial gynecological cancer 3 years ago.When admitted to our department,a complete resection of the giant abdominal wall lesion was performed,and a Bard composite mesh was used to reconstruct the abdominal wall.A local flap was used to close the resultant large defect in the external covering of the abdomen.The patient underwent chemotherapy following cytoreductive surgery.Pathology revealed metastasis of EC,and molecular subtyping showed copy number high of TP53 mutation,implying a poor prognosis.CONCLUSION When EC patients develop giant abdominal wall metastasis,a plastic surgeon should be included before contemplating resection of tumors.展开更多
An increasing number of researchers have demonstrated that poloxamer 188(P188)can be used as a pharmaceutical excipient for clinical applications.Its membrane-sealing effects and inherent biological activities make it...An increasing number of researchers have demonstrated that poloxamer 188(P188)can be used as a pharmaceutical excipient for clinical applications.Its membrane-sealing effects and inherent biological activities make it an extremely promising agent for plastic surgery.In this review,we summarize the positive roles of P188 in autologous fat grafting,wound healing,and cartilage transplantation.These roles include improving the survival rate of fat grafts and chondrocytes,stimulating the metabolic activity of adipocytes,promoting wound healing,and contributing to cartilage formation.Although further research is still needed,it is clear that P188 has great potential and application value in the field of plastic surgery.展开更多
Autologous fat grafting is an increasingly popular technique in plastic surgery for volume augmentation and rejuvenation.However,the unpredictability of long-term volume retention limits its clinical application.Vario...Autologous fat grafting is an increasingly popular technique in plastic surgery for volume augmentation and rejuvenation.However,the unpredictability of long-term volume retention limits its clinical application.Various animal studies have documented the positive effects of adipose tissue-derived stem cells(ADSCs)on the acceleration of lipofilling.However,the results have been inconsistent,and there is an insufficient number of high-quality clinical studies to formulate evidence-based recommendations for ADSC-enriched fat grafts.Moreover,related technical standards,such as the final count of harvested ADSCs and the enrichment ratio,have not yet been established.This systematic review included all clinical trials on ADSC-enriched fat grafts in plastic surgery from PubMed in the past 10 years,as well as all registered clinical trials on ClinicalTrials.Gov.To examine the current landscape of ADSCs harvest,we summarize the current applications of ADSCs in the field of plastic surgery and discuss the current barriers to universal clinical use.展开更多
Objective: to analyze the application and clinical significance of early burn plastic surgery. Methods: Methods: 156 cases of burn and plastic surgery patients in my hospital who received early plastic surgery after 1...Objective: to analyze the application and clinical significance of early burn plastic surgery. Methods: Methods: 156 cases of burn and plastic surgery patients in my hospital who received early plastic surgery after 10 days were compared. The cases of two groups of patients who received early plastic surgery after 10 days were compared, and 102 cases of two groups of patients who received early plastic surgery after 10 days were compared. Results: The excellent and good rates of the short-term therapeutic effects in the experimental group after the operation reached 93.99% respectively;However, in the control group, the excellent and good rate of the recent treatment after the recent treatment reached 79.29% respectively, and the comparative difference between the two was statistically significant (P<0.05). During the long-term follow-up of the patients, no case in the experimental group may have significant scar and scar hyperplasia in the operation area, so it is required to complete the secondary operation, which is equivalent to the control group. Only 19 hands may have significant scar and scar, and need to undergo the secondary operation again. The occurrence rate has reached 13.57%. The difference between the two groups has certain data and statistical significance (P<0.05). Conclusion: For patients with severe hand burn and inflammation, early reconstructive surgery should be adopted. In principle, the necessary surgical treatment should be completed. Effective surgical treatment or ideal recovery of body function should be given accordingly, which can be popularized and applied in clinical practice.展开更多
Objective: to analyze the clinical effect of orthopedic surgery combined with 90Si-90Y radionuclide in the treatment of keloid. Methods: 76 keloid patients admitted from June 2018 to June 2019 were randomly divided in...Objective: to analyze the clinical effect of orthopedic surgery combined with 90Si-90Y radionuclide in the treatment of keloid. Methods: 76 keloid patients admitted from June 2018 to June 2019 were randomly divided into control group and observation group, with 38 patients in each group. The control group was treated with resection suture combined with 90Si-90Y radionuclide. Patients in the observation group underwent plastic surgery in addition to those in the control group, and scar scale scores related to treatment outcomes were statistically compared between the two groups. The scores of observation group were significantly lower than control group. The overall clinical effective rate was significantly higher than that of the control group, both of which had statistical significance (P < 0.05). Conclusion: the application of orthopedic surgery and 90Si-90Y radionuclide in keloid patients can effectively improve the clinical efficacy and has obvious application value.展开更多
Objective: to study the factors influencing the effect of plastic surgery and its preventive measures. Methods: during the period from January 2020 to January 2021, 200 cases of patients receiving plastic surgery in o...Objective: to study the factors influencing the effect of plastic surgery and its preventive measures. Methods: during the period from January 2020 to January 2021, 200 cases of patients receiving plastic surgery in our hospital were taken as the main objects of analysis. Retrospective analysis was conducted to find out the factors influencing the therapeutic effect of plastic surgery through the relevant data of surgery, and relevant preventive measures were put forward. Results: according to the analysis of satisfaction questionnaire, the probability of dissatisfaction among 200 patients was 28.57%. The main factors included high preoperative expectation of surgical effect, defects in preoperative design, improper intraoperative and post-operative operation, which led to some complications, and inappropriate material, model and specification of prosthesis during operation. After communication with the patients, the patients were given secondary repair surgery or follow-up treatment, and the results were basically satisfactory. Conclusion: through the analysis of the factors affecting the effect of plastic surgery, find out the relevant factors, through the relevant preventive measures, strengthen the professional skills of medical workers, and improve the correct cognitive awareness of patients and other measures, so that the operation effect is more significant.展开更多
BACKGROUND Post-operative massive hemorrhage is a critical concern in oral cancer surgery,associated with severe complications and heightened morbidity and mortality rates.CASE SUMMARY A 46-year-old male with advanced...BACKGROUND Post-operative massive hemorrhage is a critical concern in oral cancer surgery,associated with severe complications and heightened morbidity and mortality rates.CASE SUMMARY A 46-year-old male with advanced poorly differentiated squamous cell carcinoma(ypT4aN3bN0M0)of the oral floor underwent extensive surgery,including total glossectomy,partial mandibulectomy,and free flap reconstruction.Postoperatively,he developed life-threatening hemorrhage on day 3 due to wound dehiscence.Rapid nursing interventions-prompt suture removal,pressure hemostasis,and multidisciplinary collaboration-controlled bleeding.Postoperative care emphasized hemodynamic monitoring,infection prevention,and rehabilitation.Despite comorbidities(hypertension,diabetes,prior stroke),the patient achieved functional recovery:Oral flap epithelialization,restored swallowing(water swallow test:Grade 1),70% tongue mobility,and 80% preoperative chewing efficiency at 6-month follow-up.This case underscores the critical role of structured nursing protocols in managing postoperative hemorrhage and optimizing outcomes in high-risk oral cancer surgery.CONCLUSION This case report highlights the pivotal role of structured nursing interventions in managing life-threatening postoperative hemorrhage following complex oral cancer surgery.By integrating meticulous preoperative risk stratification,intraoperative hemostatic collaboration,and vigilant postoperative monitoring(e.g.,timely suture management,pressure hemostasis,blood product administration),the interdisciplinary team achieved rapid hemorrhage control.Comprehensive psychological care and rehabilitation protocols further facilitated functional recovery,enabling the patient to regain swallowing,speech,and mobility despite advanced disease and comorbidities.The findings underscore that standardized nursing workflows,balancing procedural rigor with holistic patient support,are essential for mitigating complications and enhancing outcomes in high-risk head and neck surgical populations.展开更多
Objective： Keloids are exuberant cutaneous scars that form due to abnormal growth of fibrous tissue fol- lowing an injury. The primary aim of this study was to assess the efficacy and mechanism of hyperbaric oxygen t...Objective： Keloids are exuberant cutaneous scars that form due to abnormal growth of fibrous tissue fol- lowing an injury. The primary aim of this study was to assess the efficacy and mechanism of hyperbaric oxygen therapy （HBOT） to reduce the keloid recurrence rate after surgical excision and radiotherapy. Methods： （1） A total of 240 patients were randomly divided into two groups. Patients in the HBOT group （O group） received HBOT after surgical excision and radiotherapy. Patients in the other group were treated with only surgical excision and radiotherapy （K group）. （2） Scar tissue from recurrent patients was collected after a second operation. Hematoxylin and eosin （H＆E） staining was used to observe keloid morphology. Certain inflammatory factors （interleukin-6 （IL-6）, hypoxia-inducible factor-1α （HIF-1α）, tumor necrosis factor-α （TNF-α）, nuclear factor KB （NF-κB）, and vascular endothelial growth factor （VEGF）） were measured using immunohistochemical staining. Results： （1） The recurrence rate of the O group （5.97%） was significantly lower than that of the K group （14.15%）, P〈0.05. Moreover, patients in the O group reported greater satisfaction than those in the K group （P〈0.05）. （2） Compared with the recurrent scar tissue of the K group, the expression levels of the inflammatory factors were lower in the recurrent scar tissue of the O group. Conclusions： Adjunctive HBOT effectively reduces the keloid recurrence rate after surgical excision and radiotherapy by improving the oxygen level of the tissue and alleviating the inflammatory process.展开更多
This study examined the effects of a combined surgery of sleeve gastrectomy （SG） and modified jejunoileal bypass （JIB） on the body weight, food intake, and the plasma levels of active glucagon-like peptide-1 （GL...This study examined the effects of a combined surgery of sleeve gastrectomy （SG） and modified jejunoileal bypass （JIB） on the body weight, food intake, and the plasma levels of active glucagon-like peptide-1 （GLP-1） and total ghrelin of rats. Rats were divided into 3 groups in terms of different surgical protocol： SG-JIB （n=12）, SG （n=12）, JIB （n=12） and sham surgery groups （n-10）. In SG-JIB group, rats was subjected to sleeve gastrectomy and end to side anastomosis of part of the jejunum （25 cm from the ligament of Treitz） to the ileum 25 cm proximal to the cecum. The body weight and food intake were evaluated during 10 consecutive weeks postoperatively. The levels of active GLP-1 and total ghrelin in the plasma of the rats were measured by ELISA assay. The results showed that the SG-JIB treated rats relative to SG- or JIB-treated ones produced a sustained reduction in food intake and weight gain. The level of active GLP-1 was elevated and total ghrelin level decreased in SG-JIB-treated rats as compared with SG- or JIB-treated ones. It was concluded that SG-JIB could efficiently reduce the body weight and food intake, alter obesity-related hormone levels of the rats, indicating that SG-JIB may be potentially used for the treatment of obesity.展开更多
The application of autologous fat grafting in reconstructive surgery is commonly used to improve functional form.This review aims to provide an overview of the scientific evidence on the biology of adipose tissue,the ...The application of autologous fat grafting in reconstructive surgery is commonly used to improve functional form.This review aims to provide an overview of the scientific evidence on the biology of adipose tissue,the role of adipose-derived stem cells,and the indications of adipose tissue grafting in peripheral nerve surgery.Adipose tissue is easily accessible through the lower abdomen and inner thighs.Non-vascularized adipose tissue grafting does not support oxidative and ischemic stress,resulting in variable survival of adipocytes within the first 24 hours.Enrichment of adipose tissue with a stromal vascular fraction is purported to increase the number of adipose-derived stem cells and is postulated to augment the long-term stability of adipose tissue grafts.Basic science nerve research suggests an increase in nerve regeneration and nerve revascularization,and a decrease in nerve fibrosis after the addition of adipose-derived stem cells or adipose tissue.In clinical studies,the use of autologous lipofilling is mostly applied to secondary carpal tunnel release revisions with promising results.Since the use of adipose-derived stem cells in peripheral nerve reconstruction is relatively new,more studies are needed to explore safety and long-term effects on peripheral nerve regeneration.The Food and Drug Administration stipulates that adipose-derived stem cell transplantation should be minimally manipulated,enzyme-free,and used in the same surgical procedure,e.g.adipose tissue grafts that contain native adipose-derived stem cells or stromal vascular fraction.Future research may be shifted towards the use of tissue-engineered adipose tissue to create a supportive microenvironment for autologous graft survival.Shelf-ready alternatives could be enhanced with adipose-derived stem cells or growth factors and eliminate the need for adipose tissue harvest.展开更多
This review comprehensively explores the versatile potential of mesenchymal stem cells(MSCs)with a specific focus on adipose-derived MSCs.Ophthalmic and oculoplastic surgery,encompassing diverse procedures for ocular ...This review comprehensively explores the versatile potential of mesenchymal stem cells(MSCs)with a specific focus on adipose-derived MSCs.Ophthalmic and oculoplastic surgery,encompassing diverse procedures for ocular and periocular enhancement,demands advanced solutions for tissue restoration,functional and aesthetic refinement,and aging.Investigating immunomodulatory,regenerative,and healing capacities of MSCs,this review underscores the potential use of adipose-derived MSCs as a cost-effective alternative from bench to bedside,addressing common unmet needs in the field of reconstructive and regenerative surgery.展开更多
The aging of the periocular region has always aroused great interest.A fresh,young,and attractive sight determined an ever-greater attention to surgical and non-surgical techniques to obtain this result.In particular,...The aging of the periocular region has always aroused great interest.A fresh,young,and attractive sight determined an ever-greater attention to surgical and non-surgical techniques to obtain this result.In particular,the change in the concept of a young look,considered then“full”,led to the increasing use of surgical(fat grafting)or medical(hyaluronic acid)filling techniques.Eyelid rejuvenation became increasingly popular in the field of cosmetic treatments,with a focus on achieving a youthful and refreshed appearance.Among the various techniques available,the choice between using fat grafting or fillers presented a clinical dilemma.In particular,what surgery considered of fundamental importance was a long-lasting result over time.On the other hand,aesthetic medicine considered it fundamental not to have to resort to invasive treatments.But what was the reality?Was there one path better than the other,and above all,was there a better path for patients?The minireview aims to explore the physiopathology,diagnosis,treatment options,prognosis,and future studies regarding this dilemma.We analyzed the literature produced in the last 20 years comparing the two techniques.Current literature reveals advancements in biomaterials,stem cell research and tissue engineering held promise for further enhancing the field of eyelid rejuvenation.The choice between fat grafting and fillers in eyelid cosmetic treatments presented a clinical dilemma.Understanding physiopathology,accurately diagnosing eyelid aging,exploring treatment options,assessing prognosis,and conducting future studies were essential for providing optimal care to patients seeking eyelid rejuvenation.展开更多
Oral cancer is usually treated combining surgery, radiation therapy and chemotherapy, following effective therapeutic protocols. Severe maxillary and mandibular bone atrophy resulting after therapies are usually treat...Oral cancer is usually treated combining surgery, radiation therapy and chemotherapy, following effective therapeutic protocols. Severe maxillary and mandibular bone atrophy resulting after therapies are usually treated with autologous bone grafting procedures even though these techniques often present a significant risk of postoperative complications and disadvantages. We describe the case of a 59-year-old woman presenting severe bone defect after being treated with surgery and radiotherapy for recurrent oral verrucous squamous cell carcinoma. We performed bone regeneration using Platelet-Derived Growth Factors (PDGF) in combination with autologous bone chips. Our procedure of bone regeneration allowed the placement of dental implants and the achievement of a good aesthetic and functional result. Regenerative surgery may enable the regeneration of substantial bone defects. Moreover, PDGF application decreases the risk of implant failure in irradiated patients.展开更多
BACKGROUND In rhinoplasty,calcification around silicone implants is frequently observed in the tip dorsum(TD)area.Additionally,based on a review of various literature,it is presumed that calcification in silicone impl...BACKGROUND In rhinoplasty,calcification around silicone implants is frequently observed in the tip dorsum(TD)area.Additionally,based on a review of various literature,it is presumed that calcification in silicone implants occurs due to both inflammatory chemical reactions and physical friction against the tissue.The calcification of nasal silicone implants not only results in the functional loss of the implants,but also leads to material deformation.However,there is a lack of research on calcification of nasal silicone implants in the current literature.AIM To elucidate various clinical characteristics of calcification around nasal silicone implants,using histological and radiological analysis.METHODS This study analyzed data from 16 patients of calcified nasal implants,who underwent revision rhinoplasty for various reasons after undergoing augmentation rhinoplasty with silicone implants.The collected data included information on implant duration,implant types,location of calcification,presence of inflammatory reactions,and computed tomography(CT)scans.RESULTS The most common location of calcification,as visually analyzed,was in the TD area,accounting for 56%.Additionally,the analysis of CT scans revealed a trend of increasing Hounsfield Unit values for calcification with the duration of implantation,although this trend was not statistically significant(P=0.139).CONCLUSION Our study shows that reducing the frequency of calcification may be achievable by using softer silicone implants and by minimizing the damage to perioperative tissues.展开更多
Objective:The effects of combined dexmedetomidine hydrochloride and propofol in minimally invasive axillary odor surgery with tumescent anesthesia.Methods:A total of 46 patients underwent minimally invasive axillary o...Objective:The effects of combined dexmedetomidine hydrochloride and propofol in minimally invasive axillary odor surgery with tumescent anesthesia.Methods:A total of 46 patients underwent minimally invasive axillary odor surgery by tumescent anesthesia received in the hospital from May 2017 to January 2019 were divided into observation group(23 cases)and control group(23 cases)according to the random number table method.The control group used propofol,and the observation group underwent minimally invasive axillary odor combined with dexmedetomidine hydrochloride by tumescent anesthesia.The changes of arterial blood pressure(MAP),heart rate(HR)and postoperative complications before and after anesthesia were compared and analyzed between the two groups.Results:After anesthesia,MAP and HR in both groups were lower than before anesthesia,and the observation group was lower than the control group,the difference was statistically significant(P<0.05).Compared with the control group,the postoperative complications were less in the observation group,but the difference was not statistically significant(P>0.05).Conclusion:Compared with the use of propofol,the effect of dexmedetomidine hydrochloride combined with minimally invasive axillary odor surgery by tumescent anesthesia is more obvious,and the postoperative recovery is faster with fewer complications.展开更多
BACKGROUND Trans-anal endoscopic microsurgery(TEM)enables a good visualization of the surgical field and is considered the method of choice for excision of adenomas and early T1 rectal cancer.The rectum and retro-rect...BACKGROUND Trans-anal endoscopic microsurgery(TEM)enables a good visualization of the surgical field and is considered the method of choice for excision of adenomas and early T1 rectal cancer.The rectum and retro-rectal space might be the origin of uncommon neoplasms,benign and aggressive,certain require radical trans-abdominal surgery,while others can be treated by a less aggressive approach.In this study we report outcomes in patients undergoing TEM for rare and non-adenomatous rectal and retro-rectal lesions over a period of 11 years.METHODS Between January 2008 to December 2019 a retrospective analysis was completed for all patients who underwent TEM for non-adenomatous rectal lesion or retro-rectal mass in our institution.Patients were discharged once diet was well tolerated and no complications were identified.They were evaluated at 3 wk post operatively,then at 3-mo intervals for the first 2 years and every 6 mo depending on the nature of the final pathology.Clinical examination and rectoscopy were performed during each of the follow-up visits.RESULTS Out of 198 patients who underwent TEM during the study period,18 had non-adenomatous rectal or retro-rectal lesions.Mean age was 47 years.The mean size of the lesions was 2.9 mm,with a mean distance from the anal margin of 7.9 cm.Mean surgical time was 97.8 min.There were no intra-operative neither late post-operative complications.Mean length of stay was 2.5 d.Mean patient follow-up duration was 42 mo.CONCLUSION TEM allows for reduced morbidity given its minimally invasive nature.Surgeons should be familiar with the technique but careful patient selection should be considered.It can be used safely for uncommon rectal and selected retro-rectal lesions without compromising outcomes.We believe that it should be reasonably considered as one of the surgical methods when treating rare lesions.展开更多
Apart from listening to the cry of a healthy newborn,it is the declaration by the attending paediatrician in the labour room that the child is normal which brings utmost joy to parents.The global incidence of children...Apart from listening to the cry of a healthy newborn,it is the declaration by the attending paediatrician in the labour room that the child is normal which brings utmost joy to parents.The global incidence of children born with congenital anomalies has been reported to be 3%-6%with more than 90%of these occurring in low-and middle-income group countries.The exact percentages/total numbers of children requiring surgical treatment cannot be estimated for several reasons.These children are operated under several surgical disciplines,viz,paediatric-,plastic reconstructive,neuro-,cardiothoracic-,orthopaedic surgery etc.These conditions may be life-threatening,e.g.,trachea-oesophageal fistula,critical pulmonary stenosis,etc.and require immediate surgical intervention.Some,e.g.,hydrocephalus,may need intervention as soon as the patient is fit for surgery.Some,e.g.,patent ductus arteriosus need‘wait and watch’policy up to a certain age in the hope of spontaneous recovery.Another extremely important category is that of patients where the operative intervention is done based on their age.Almost all the congenital anomalies coming under care of a plastic surgeon are operated as elective surgery(many as multiple stages of correction)at appropriate ages.There are advantages and disadvantages of intervention at different ages.In this article,we present a review of optimal timings,along with reasoning,for surgery of many of the common congenital anomalies which are treated by plastic surgeons.Obstetricians,paediatricians and general practitioners/family physicians,who most often are the first ones to come across such children,must know to guide the parents appropriately and convincingly impress upon the them as to why their child should not be operated immediately and also the consequences of too soon or too late.展开更多
The use of tendon transfer to restore functions of extremities was initially recognised in the 19th century, and its advancement was further amplified by the polio epidemic towards the turn of that century. Tendon tra...The use of tendon transfer to restore functions of extremities was initially recognised in the 19th century, and its advancement was further amplified by the polio epidemic towards the turn of that century. Tendon transfer surgery extended to the use for traumatic reconstructive surgery during World War I, with key surgical pioneers, including Mayer, Sterling Bunnell, Guy Pulvertaft and Joseph Boyes. In 1921, Robert Jones first described the transfer of pronator teres (PT) to the wrist extensors for irreparable radial nerve paralysis in infantile hemiplegia. Although, a detailed description of its indication and surgical outcomes were not published until 1959 and 1970 by Stelling and Meyer, and Keats, respectively. Pronator teres is often the tendon of choice for reconstructing wrist extensors, and used in a multiple of pathologies, including radial nerve palsy, cerebral palsy, and tetraplegia. Reconstruction of finger extensors are less straightforward and options include flexor carpi radialis (FCR), flexor carpi ulnaris (FCU), and flexor digitorum superficialis (FDS). Our article describes the techniques and outcomes of 25 patients that undergone pronator teres transfer. A good understanding of the pronator teres anatomical location and potential variations, aids efficient harvesting and limits unnecessary tissue dissection. Pronator teres tendon harvest is best performed through a systematic and anatomic approach.展开更多
文摘Objective:To explore the clinical application effect of autologous fat granule transplantation in facial depression plastic surgery.Methods:A total of 98 patients with facial depression admitted to the plastic surgery department of our hospital from January 2021 to December 2023 were selected and divided into observation group(49 cases)and control group(49 cases)according to the random number table method.The observation group was treated with autologous fat granule transplantation,while the control group was treated with hyaluronic acid filling.The total effective rate of treatment,incidence of postoperative complications,improvement indicators of facial morphology(depth of depression,symmetry),and effect maintenance rate after 6 months of follow-up were compared between the two groups.Results:The total effective rate of treatment in the observation group was 93.88%(46/49),which was significantly higher than that in the control group(79.59%,39/49)(P<0.05).The incidence of postoperative complications in the observation group was 6.12%(3/49),which was lower than that in the control group(20.41%,10/49)(P<0.05).One month after surgery,the depth of depression(1.23±0.31 mm)and symmetry(1.02±0.15 points)in the observation group were better than those in the control group(P<0.05).After 6 months of follow-up,the effect maintenance rate in the observation group was 89.80%(44/49),which was significantly higher than that in the control group(67.35%,33/49)(P<0.05).Conclusion:Autologous fat granule transplantation for the treatment of facial depression can significantly improve facial morphology,enhance treatment effect and patient satisfaction,reduce the incidence of complications,and maintain a more durable effect.It is a clinically preferred facial depression plastic surgery solution.
文摘The treatment of a 40-year-old woman with a giant fibroadenoma in her left breast is presented. The fibroadenoma measured 14 × 5 × 3 cm and weighed 170 g. We demonstrate that the surgical strategy and the reconstructive techniques in oncoplastic breast cancer surgery successfully can be applied to the treatment of these rare benign tumours improving the cosmetic and functional outcome.
基金the National Key Technology R&D Program of China,No.2019YFC1005200,and No.2019YFC1005201the Natural Science Foundation of Beijing,No.7202213+1 种基金the National Natural Science Foundation of ChinaNo. 82072861, 81672571, and 81874108.
文摘BACKGROUND Endometrial cancer(EC)is a common gynecological malignancy,but metastasis to the abdominal wall is extremely rare.Therefore,an appropriate treatment approach for large metastatic lesions with infection remains a great challenge.CASE SUMMARY We report the case of a 65-year-old woman who developed abdominal metastasis of endometrioid adenocarcinoma,as defined by International Obstetrics and Gynecology stage II,in which the lesion was complicated by infection.A right hemicolectomy was performed for colon metastasis in relation to her initial gynecological cancer 3 years ago.When admitted to our department,a complete resection of the giant abdominal wall lesion was performed,and a Bard composite mesh was used to reconstruct the abdominal wall.A local flap was used to close the resultant large defect in the external covering of the abdomen.The patient underwent chemotherapy following cytoreductive surgery.Pathology revealed metastasis of EC,and molecular subtyping showed copy number high of TP53 mutation,implying a poor prognosis.CONCLUSION When EC patients develop giant abdominal wall metastasis,a plastic surgeon should be included before contemplating resection of tumors.
基金The study was supported by the Scientific Research Staring Foundation for the Returned Overseas Chinese Scholars of the Peking University Third Hospital(grant no.BYSYLXHG2019001).
文摘An increasing number of researchers have demonstrated that poloxamer 188(P188)can be used as a pharmaceutical excipient for clinical applications.Its membrane-sealing effects and inherent biological activities make it an extremely promising agent for plastic surgery.In this review,we summarize the positive roles of P188 in autologous fat grafting,wound healing,and cartilage transplantation.These roles include improving the survival rate of fat grafts and chondrocytes,stimulating the metabolic activity of adipocytes,promoting wound healing,and contributing to cartilage formation.Although further research is still needed,it is clear that P188 has great potential and application value in the field of plastic surgery.
文摘Autologous fat grafting is an increasingly popular technique in plastic surgery for volume augmentation and rejuvenation.However,the unpredictability of long-term volume retention limits its clinical application.Various animal studies have documented the positive effects of adipose tissue-derived stem cells(ADSCs)on the acceleration of lipofilling.However,the results have been inconsistent,and there is an insufficient number of high-quality clinical studies to formulate evidence-based recommendations for ADSC-enriched fat grafts.Moreover,related technical standards,such as the final count of harvested ADSCs and the enrichment ratio,have not yet been established.This systematic review included all clinical trials on ADSC-enriched fat grafts in plastic surgery from PubMed in the past 10 years,as well as all registered clinical trials on ClinicalTrials.Gov.To examine the current landscape of ADSCs harvest,we summarize the current applications of ADSCs in the field of plastic surgery and discuss the current barriers to universal clinical use.
文摘Objective: to analyze the application and clinical significance of early burn plastic surgery. Methods: Methods: 156 cases of burn and plastic surgery patients in my hospital who received early plastic surgery after 10 days were compared. The cases of two groups of patients who received early plastic surgery after 10 days were compared, and 102 cases of two groups of patients who received early plastic surgery after 10 days were compared. Results: The excellent and good rates of the short-term therapeutic effects in the experimental group after the operation reached 93.99% respectively;However, in the control group, the excellent and good rate of the recent treatment after the recent treatment reached 79.29% respectively, and the comparative difference between the two was statistically significant (P<0.05). During the long-term follow-up of the patients, no case in the experimental group may have significant scar and scar hyperplasia in the operation area, so it is required to complete the secondary operation, which is equivalent to the control group. Only 19 hands may have significant scar and scar, and need to undergo the secondary operation again. The occurrence rate has reached 13.57%. The difference between the two groups has certain data and statistical significance (P<0.05). Conclusion: For patients with severe hand burn and inflammation, early reconstructive surgery should be adopted. In principle, the necessary surgical treatment should be completed. Effective surgical treatment or ideal recovery of body function should be given accordingly, which can be popularized and applied in clinical practice.
文摘Objective: to analyze the clinical effect of orthopedic surgery combined with 90Si-90Y radionuclide in the treatment of keloid. Methods: 76 keloid patients admitted from June 2018 to June 2019 were randomly divided into control group and observation group, with 38 patients in each group. The control group was treated with resection suture combined with 90Si-90Y radionuclide. Patients in the observation group underwent plastic surgery in addition to those in the control group, and scar scale scores related to treatment outcomes were statistically compared between the two groups. The scores of observation group were significantly lower than control group. The overall clinical effective rate was significantly higher than that of the control group, both of which had statistical significance (P < 0.05). Conclusion: the application of orthopedic surgery and 90Si-90Y radionuclide in keloid patients can effectively improve the clinical efficacy and has obvious application value.
文摘Objective: to study the factors influencing the effect of plastic surgery and its preventive measures. Methods: during the period from January 2020 to January 2021, 200 cases of patients receiving plastic surgery in our hospital were taken as the main objects of analysis. Retrospective analysis was conducted to find out the factors influencing the therapeutic effect of plastic surgery through the relevant data of surgery, and relevant preventive measures were put forward. Results: according to the analysis of satisfaction questionnaire, the probability of dissatisfaction among 200 patients was 28.57%. The main factors included high preoperative expectation of surgical effect, defects in preoperative design, improper intraoperative and post-operative operation, which led to some complications, and inappropriate material, model and specification of prosthesis during operation. After communication with the patients, the patients were given secondary repair surgery or follow-up treatment, and the results were basically satisfactory. Conclusion: through the analysis of the factors affecting the effect of plastic surgery, find out the relevant factors, through the relevant preventive measures, strengthen the professional skills of medical workers, and improve the correct cognitive awareness of patients and other measures, so that the operation effect is more significant.
基金Supported by the First Batch of 2024 Social Welfare and Basic Research Projects in Zhongshan City(General Projects in the Field of Healthcare),No.2024B1100Guangdong Provincial Administration of Traditional Chinese Medicine,No.20241357.
文摘BACKGROUND Post-operative massive hemorrhage is a critical concern in oral cancer surgery,associated with severe complications and heightened morbidity and mortality rates.CASE SUMMARY A 46-year-old male with advanced poorly differentiated squamous cell carcinoma(ypT4aN3bN0M0)of the oral floor underwent extensive surgery,including total glossectomy,partial mandibulectomy,and free flap reconstruction.Postoperatively,he developed life-threatening hemorrhage on day 3 due to wound dehiscence.Rapid nursing interventions-prompt suture removal,pressure hemostasis,and multidisciplinary collaboration-controlled bleeding.Postoperative care emphasized hemodynamic monitoring,infection prevention,and rehabilitation.Despite comorbidities(hypertension,diabetes,prior stroke),the patient achieved functional recovery:Oral flap epithelialization,restored swallowing(water swallow test:Grade 1),70% tongue mobility,and 80% preoperative chewing efficiency at 6-month follow-up.This case underscores the critical role of structured nursing protocols in managing postoperative hemorrhage and optimizing outcomes in high-risk oral cancer surgery.CONCLUSION This case report highlights the pivotal role of structured nursing interventions in managing life-threatening postoperative hemorrhage following complex oral cancer surgery.By integrating meticulous preoperative risk stratification,intraoperative hemostatic collaboration,and vigilant postoperative monitoring(e.g.,timely suture management,pressure hemostasis,blood product administration),the interdisciplinary team achieved rapid hemorrhage control.Comprehensive psychological care and rehabilitation protocols further facilitated functional recovery,enabling the patient to regain swallowing,speech,and mobility despite advanced disease and comorbidities.The findings underscore that standardized nursing workflows,balancing procedural rigor with holistic patient support,are essential for mitigating complications and enhancing outcomes in high-risk head and neck surgical populations.
基金Project supported by the National Natural Science Foundation of China(No.81471885)the Beijing Natural Science Foundation(No.7172172),China
文摘Objective： Keloids are exuberant cutaneous scars that form due to abnormal growth of fibrous tissue fol- lowing an injury. The primary aim of this study was to assess the efficacy and mechanism of hyperbaric oxygen therapy （HBOT） to reduce the keloid recurrence rate after surgical excision and radiotherapy. Methods： （1） A total of 240 patients were randomly divided into two groups. Patients in the HBOT group （O group） received HBOT after surgical excision and radiotherapy. Patients in the other group were treated with only surgical excision and radiotherapy （K group）. （2） Scar tissue from recurrent patients was collected after a second operation. Hematoxylin and eosin （H＆E） staining was used to observe keloid morphology. Certain inflammatory factors （interleukin-6 （IL-6）, hypoxia-inducible factor-1α （HIF-1α）, tumor necrosis factor-α （TNF-α）, nuclear factor KB （NF-κB）, and vascular endothelial growth factor （VEGF）） were measured using immunohistochemical staining. Results： （1） The recurrence rate of the O group （5.97%） was significantly lower than that of the K group （14.15%）, P〈0.05. Moreover, patients in the O group reported greater satisfaction than those in the K group （P〈0.05）. （2） Compared with the recurrent scar tissue of the K group, the expression levels of the inflammatory factors were lower in the recurrent scar tissue of the O group. Conclusions： Adjunctive HBOT effectively reduces the keloid recurrence rate after surgical excision and radiotherapy by improving the oxygen level of the tissue and alleviating the inflammatory process.
基金supported by a grant from Wuhan Municipal Science and Technology Key Project(201060938360-07)
文摘This study examined the effects of a combined surgery of sleeve gastrectomy （SG） and modified jejunoileal bypass （JIB） on the body weight, food intake, and the plasma levels of active glucagon-like peptide-1 （GLP-1） and total ghrelin of rats. Rats were divided into 3 groups in terms of different surgical protocol： SG-JIB （n=12）, SG （n=12）, JIB （n=12） and sham surgery groups （n-10）. In SG-JIB group, rats was subjected to sleeve gastrectomy and end to side anastomosis of part of the jejunum （25 cm from the ligament of Treitz） to the ileum 25 cm proximal to the cecum. The body weight and food intake were evaluated during 10 consecutive weeks postoperatively. The levels of active GLP-1 and total ghrelin in the plasma of the rats were measured by ELISA assay. The results showed that the SG-JIB treated rats relative to SG- or JIB-treated ones produced a sustained reduction in food intake and weight gain. The level of active GLP-1 was elevated and total ghrelin level decreased in SG-JIB-treated rats as compared with SG- or JIB-treated ones. It was concluded that SG-JIB could efficiently reduce the body weight and food intake, alter obesity-related hormone levels of the rats, indicating that SG-JIB may be potentially used for the treatment of obesity.
文摘The application of autologous fat grafting in reconstructive surgery is commonly used to improve functional form.This review aims to provide an overview of the scientific evidence on the biology of adipose tissue,the role of adipose-derived stem cells,and the indications of adipose tissue grafting in peripheral nerve surgery.Adipose tissue is easily accessible through the lower abdomen and inner thighs.Non-vascularized adipose tissue grafting does not support oxidative and ischemic stress,resulting in variable survival of adipocytes within the first 24 hours.Enrichment of adipose tissue with a stromal vascular fraction is purported to increase the number of adipose-derived stem cells and is postulated to augment the long-term stability of adipose tissue grafts.Basic science nerve research suggests an increase in nerve regeneration and nerve revascularization,and a decrease in nerve fibrosis after the addition of adipose-derived stem cells or adipose tissue.In clinical studies,the use of autologous lipofilling is mostly applied to secondary carpal tunnel release revisions with promising results.Since the use of adipose-derived stem cells in peripheral nerve reconstruction is relatively new,more studies are needed to explore safety and long-term effects on peripheral nerve regeneration.The Food and Drug Administration stipulates that adipose-derived stem cell transplantation should be minimally manipulated,enzyme-free,and used in the same surgical procedure,e.g.adipose tissue grafts that contain native adipose-derived stem cells or stromal vascular fraction.Future research may be shifted towards the use of tissue-engineered adipose tissue to create a supportive microenvironment for autologous graft survival.Shelf-ready alternatives could be enhanced with adipose-derived stem cells or growth factors and eliminate the need for adipose tissue harvest.
文摘This review comprehensively explores the versatile potential of mesenchymal stem cells(MSCs)with a specific focus on adipose-derived MSCs.Ophthalmic and oculoplastic surgery,encompassing diverse procedures for ocular and periocular enhancement,demands advanced solutions for tissue restoration,functional and aesthetic refinement,and aging.Investigating immunomodulatory,regenerative,and healing capacities of MSCs,this review underscores the potential use of adipose-derived MSCs as a cost-effective alternative from bench to bedside,addressing common unmet needs in the field of reconstructive and regenerative surgery.
文摘The aging of the periocular region has always aroused great interest.A fresh,young,and attractive sight determined an ever-greater attention to surgical and non-surgical techniques to obtain this result.In particular,the change in the concept of a young look,considered then“full”,led to the increasing use of surgical(fat grafting)or medical(hyaluronic acid)filling techniques.Eyelid rejuvenation became increasingly popular in the field of cosmetic treatments,with a focus on achieving a youthful and refreshed appearance.Among the various techniques available,the choice between using fat grafting or fillers presented a clinical dilemma.In particular,what surgery considered of fundamental importance was a long-lasting result over time.On the other hand,aesthetic medicine considered it fundamental not to have to resort to invasive treatments.But what was the reality?Was there one path better than the other,and above all,was there a better path for patients?The minireview aims to explore the physiopathology,diagnosis,treatment options,prognosis,and future studies regarding this dilemma.We analyzed the literature produced in the last 20 years comparing the two techniques.Current literature reveals advancements in biomaterials,stem cell research and tissue engineering held promise for further enhancing the field of eyelid rejuvenation.The choice between fat grafting and fillers in eyelid cosmetic treatments presented a clinical dilemma.Understanding physiopathology,accurately diagnosing eyelid aging,exploring treatment options,assessing prognosis,and conducting future studies were essential for providing optimal care to patients seeking eyelid rejuvenation.
文摘Oral cancer is usually treated combining surgery, radiation therapy and chemotherapy, following effective therapeutic protocols. Severe maxillary and mandibular bone atrophy resulting after therapies are usually treated with autologous bone grafting procedures even though these techniques often present a significant risk of postoperative complications and disadvantages. We describe the case of a 59-year-old woman presenting severe bone defect after being treated with surgery and radiotherapy for recurrent oral verrucous squamous cell carcinoma. We performed bone regeneration using Platelet-Derived Growth Factors (PDGF) in combination with autologous bone chips. Our procedure of bone regeneration allowed the placement of dental implants and the achievement of a good aesthetic and functional result. Regenerative surgery may enable the regeneration of substantial bone defects. Moreover, PDGF application decreases the risk of implant failure in irradiated patients.
基金Supported by The Soonchunhyang University Research Fund,No.2024-0022.
文摘BACKGROUND In rhinoplasty,calcification around silicone implants is frequently observed in the tip dorsum(TD)area.Additionally,based on a review of various literature,it is presumed that calcification in silicone implants occurs due to both inflammatory chemical reactions and physical friction against the tissue.The calcification of nasal silicone implants not only results in the functional loss of the implants,but also leads to material deformation.However,there is a lack of research on calcification of nasal silicone implants in the current literature.AIM To elucidate various clinical characteristics of calcification around nasal silicone implants,using histological and radiological analysis.METHODS This study analyzed data from 16 patients of calcified nasal implants,who underwent revision rhinoplasty for various reasons after undergoing augmentation rhinoplasty with silicone implants.The collected data included information on implant duration,implant types,location of calcification,presence of inflammatory reactions,and computed tomography(CT)scans.RESULTS The most common location of calcification,as visually analyzed,was in the TD area,accounting for 56%.Additionally,the analysis of CT scans revealed a trend of increasing Hounsfield Unit values for calcification with the duration of implantation,although this trend was not statistically significant(P=0.139).CONCLUSION Our study shows that reducing the frequency of calcification may be achievable by using softer silicone implants and by minimizing the damage to perioperative tissues.
文摘Objective:The effects of combined dexmedetomidine hydrochloride and propofol in minimally invasive axillary odor surgery with tumescent anesthesia.Methods:A total of 46 patients underwent minimally invasive axillary odor surgery by tumescent anesthesia received in the hospital from May 2017 to January 2019 were divided into observation group(23 cases)and control group(23 cases)according to the random number table method.The control group used propofol,and the observation group underwent minimally invasive axillary odor combined with dexmedetomidine hydrochloride by tumescent anesthesia.The changes of arterial blood pressure(MAP),heart rate(HR)and postoperative complications before and after anesthesia were compared and analyzed between the two groups.Results:After anesthesia,MAP and HR in both groups were lower than before anesthesia,and the observation group was lower than the control group,the difference was statistically significant(P<0.05).Compared with the control group,the postoperative complications were less in the observation group,but the difference was not statistically significant(P>0.05).Conclusion:Compared with the use of propofol,the effect of dexmedetomidine hydrochloride combined with minimally invasive axillary odor surgery by tumescent anesthesia is more obvious,and the postoperative recovery is faster with fewer complications.
文摘BACKGROUND Trans-anal endoscopic microsurgery(TEM)enables a good visualization of the surgical field and is considered the method of choice for excision of adenomas and early T1 rectal cancer.The rectum and retro-rectal space might be the origin of uncommon neoplasms,benign and aggressive,certain require radical trans-abdominal surgery,while others can be treated by a less aggressive approach.In this study we report outcomes in patients undergoing TEM for rare and non-adenomatous rectal and retro-rectal lesions over a period of 11 years.METHODS Between January 2008 to December 2019 a retrospective analysis was completed for all patients who underwent TEM for non-adenomatous rectal lesion or retro-rectal mass in our institution.Patients were discharged once diet was well tolerated and no complications were identified.They were evaluated at 3 wk post operatively,then at 3-mo intervals for the first 2 years and every 6 mo depending on the nature of the final pathology.Clinical examination and rectoscopy were performed during each of the follow-up visits.RESULTS Out of 198 patients who underwent TEM during the study period,18 had non-adenomatous rectal or retro-rectal lesions.Mean age was 47 years.The mean size of the lesions was 2.9 mm,with a mean distance from the anal margin of 7.9 cm.Mean surgical time was 97.8 min.There were no intra-operative neither late post-operative complications.Mean length of stay was 2.5 d.Mean patient follow-up duration was 42 mo.CONCLUSION TEM allows for reduced morbidity given its minimally invasive nature.Surgeons should be familiar with the technique but careful patient selection should be considered.It can be used safely for uncommon rectal and selected retro-rectal lesions without compromising outcomes.We believe that it should be reasonably considered as one of the surgical methods when treating rare lesions.
文摘Apart from listening to the cry of a healthy newborn,it is the declaration by the attending paediatrician in the labour room that the child is normal which brings utmost joy to parents.The global incidence of children born with congenital anomalies has been reported to be 3%-6%with more than 90%of these occurring in low-and middle-income group countries.The exact percentages/total numbers of children requiring surgical treatment cannot be estimated for several reasons.These children are operated under several surgical disciplines,viz,paediatric-,plastic reconstructive,neuro-,cardiothoracic-,orthopaedic surgery etc.These conditions may be life-threatening,e.g.,trachea-oesophageal fistula,critical pulmonary stenosis,etc.and require immediate surgical intervention.Some,e.g.,hydrocephalus,may need intervention as soon as the patient is fit for surgery.Some,e.g.,patent ductus arteriosus need‘wait and watch’policy up to a certain age in the hope of spontaneous recovery.Another extremely important category is that of patients where the operative intervention is done based on their age.Almost all the congenital anomalies coming under care of a plastic surgeon are operated as elective surgery(many as multiple stages of correction)at appropriate ages.There are advantages and disadvantages of intervention at different ages.In this article,we present a review of optimal timings,along with reasoning,for surgery of many of the common congenital anomalies which are treated by plastic surgeons.Obstetricians,paediatricians and general practitioners/family physicians,who most often are the first ones to come across such children,must know to guide the parents appropriately and convincingly impress upon the them as to why their child should not be operated immediately and also the consequences of too soon or too late.
文摘The use of tendon transfer to restore functions of extremities was initially recognised in the 19th century, and its advancement was further amplified by the polio epidemic towards the turn of that century. Tendon transfer surgery extended to the use for traumatic reconstructive surgery during World War I, with key surgical pioneers, including Mayer, Sterling Bunnell, Guy Pulvertaft and Joseph Boyes. In 1921, Robert Jones first described the transfer of pronator teres (PT) to the wrist extensors for irreparable radial nerve paralysis in infantile hemiplegia. Although, a detailed description of its indication and surgical outcomes were not published until 1959 and 1970 by Stelling and Meyer, and Keats, respectively. Pronator teres is often the tendon of choice for reconstructing wrist extensors, and used in a multiple of pathologies, including radial nerve palsy, cerebral palsy, and tetraplegia. Reconstruction of finger extensors are less straightforward and options include flexor carpi radialis (FCR), flexor carpi ulnaris (FCU), and flexor digitorum superficialis (FDS). Our article describes the techniques and outcomes of 25 patients that undergone pronator teres transfer. A good understanding of the pronator teres anatomical location and potential variations, aids efficient harvesting and limits unnecessary tissue dissection. Pronator teres tendon harvest is best performed through a systematic and anatomic approach.
