The authors reported nine patients with burn scar contracture of head and face treated by operation. The varieties of operations ineiuded: (1) excision of the scar and primary closure of the wound; (2) excision of the scar and coverage of the wound with split or full thickness skin grafts; (3) excision of the scar and repaired by pedicled flap, and (4) skin expansion by expander, followed by excision the scar and transfer of the "more available skin flap" to the wound. According to certain characteristics of children, the choice of the time for operation, the indications of each methods, and some problems related to operation ahd been discussed.
Abstract Postburn deformities, including hypertrophic scars, scar contracture and defect or deformity of tissue or organ, are the commonest disorders in plastic surgery. It is also difficult to deal with. If the diformity involved multiple organs, oftentimes the teatmentis very difficult because the material for repair is limited and the donorsite usually could not provide adequate amount of skin for repair. Since 1978,2496 cases of various postburn deformities were admitted. In this article, theoptimal time to operate was discussed. The use of flap transfer and soft tissueexpander was described. Prolonged traction in the treatment of severe contracture of large joint was also described.
Objective To explore the effectiveness of hairpin shaped incision combined with cover-lifting flap in plastic surgery of huge fat pad on nape and back. Methods Between March 2019 and March 2023, 10 patients with huge fat pad on the nape and back were treated. There was 1 male and 9 females with an average age of 52 years (range, 39-57 years). All patients had soft tissue bulge on the nape and back. Preoperative MRI showed the subcutaneous fat thickening. The length of the longitudinal axis of the fat pad ranged from 10.0 to 25.0 cm (mean, 14.1 cm), the length of the transverse axis ranged from 6.0 to 15.0 cm (mean, 10.8 cm); the thickness of the fat pad ranged from 2.5 to 5.1 cm (mean, 3.9 cm). Under general anesthesia, the patient was placed in a prone position and a hairpin shaped incision was made. The flap was lifted to remove the fat pad according to the marked area. The dressing was changed every 2 days after operation. ResultsThe operation time was 35-110 minutes (mean, 72 minutes). The intraoperative blood loss was 35-80 mL (mean, 49.5 mL). The drainage tube was removed at 2-5 days after operation (mean, 3.4 days). All incisions healed by first intention without incision dehiscence, infection, subcutaneous bruising, hematoma, or other related complications. All patients were followed up 2-24 months (mean, 12 months). All patients had a good shape of the nape and back and no noticeable scar on the incision. According to the Vancouver Scar Scale evaluation criteria, the incision scar score was 3-5 (mean, 3.7) at 2 months after operation. Patients had good neck movement with no recurrence. ConclusionFor the huge fat pad on the nape and back, the plastic surgery using hairpin shaped incision and cover-lifting flap has the advantages of fully exposing the fat pad, concealed incision, simple operation, and natural shape of the nape and back after operation.
【摘要】 目的 探讨肥胖人群减肥后体重急剧下降导致腹壁松弛行腹壁整形手术的疗效。 方法 2003年4月-2009年10月，24例减肥后体重下降导致腹壁松弛患者中男3例，女21例，年龄28~44岁，平均36岁。其中1例合并甲状腺功能亢进，1例合并糖尿病病史；20例均通过运动、控制饮食等方式致体重下降，4例接受胃减容手术后体重下降。体重下降稳定后至腹壁整形手术时间间隔2~4年，平均2.5年；减肥前至腹壁整形手术前体重下降37~67 kg，平均下降45 kg。手术采用屈髋位，切除松弛皮肤组织，收紧腹壁及腰部松弛组织，耻骨上沿皮瓣远端去表皮后与耻骨上沿骨膜缝合固定。所有患者随访5个月~2年。 结果 23例术后2周皮瓣完全成活，切口愈合良好，无切口感染；1例术后出现耻骨上切口约2 cm表皮裂开，换药2周后切口愈合，术后腹壁平整、对称，无皮下血肿发生。随访期间切口疤痕隐蔽，阴阜无上移，腹壁平坦、对称。 结论 该腹壁整形手术方式效果良好，术后并发症少，值得推广。From April 2003 to October 2009, 24 obese patients, including three males and 21 females, developed abdominal chalastodermia caused by weight loss. Their age ranged from 28 to 44 years old with an average age of 36 years. Among them, one had hyperthyroidism and one had a medical history of diabetes. Twenty patients lost weight by exercise and diet, while the other four lost weight through stomach reduction surgery. Time span from weight loss to abdominal plastic surgery was two to four years, averaging at 2.5 years. During the time from before weight loss until the surgery, weight loss ranged from 37-67 kg, averaging at 45 kg. The surgery adopted the position of bending hip. The loose skin was removed; abdominal wall and loose waist tissues were tightened; and the far end of flap without skin along the upper edge of pubis was sutured with the periosteum. All patients were followed up for a time ranged from five months to two years. Results Flaps survived within two weeks after the surgery, incision healed perfectly, and no infection occurred to the incision for all the patients except in one case, there was a 2 cm of skin fissure in the upper incision which was cured after two weeks of dressing. After the surgery, the abdominal wall was flat and symmetrical without subcutaneous hematoma. During the follow-up, scars were well hidden, mons pubis was not shifted upward, and the abdominal wall was flat and symmetrical. Conclusion The abdominal wall plastic surgery has a good clinical outcome with few complications, which is worth being popularized.
【摘要】目的 探讨分段整形提缩注射术治疗脱肛痔的临床疗效。方法 175例重度环状痔, 沿肛缘弧形切除结缔组织外痔以整形肛门, 再于结扎痔核基底及其上端黏膜下层注射消痔灵注射液,并进行疗效观察。结果 术后肛周水肿(72 h)、疼痛(24及72 h)明显减少； 术后4周临床治愈145例,好转23例,总有效率为96.0%； 所有患者均随访3~6个月，未见复发。结论 选择分段整形提缩注射术既比较彻底地去除了痔核使之不易复发，又整形了肛门，保护其大小和功能, 该术式可成为治疗脱肛痔的较理想术式。
ObjectiveTo explore the clinical application of oncoplastic surgery in breast-conserving surgery after neoadjuvant chemotherapy.MethodsFrom May 2016 to May 2018, 32 breast cancer patients (cT2–3N0–3M0) who were scheduled for neoadjuvant chemotherapy (NAC) and agreed to accept breast-conserving surgery after NAC in the Henan Tumor Hospital were enrolled into the retrospective study. These patients were originally unable to perform traditional breast conserving surgery because of the size or location of the tumor. We observed the success rate, safety and cosmetic effects of breast-conserving therapy, which were applicated of tumor down-staging after neoadjuvant chemotherapy combined with oncoplastic surgery.ResultsIn this study, after neoadjuvant chemotherapy, 31 patients achieved CR or PR, and 1 patient had SD. All 32 patients underwent breast-conserving surgery successfully, 3 patients underwent breast-conserving combined with volume replacement, and 29 patients underwent breast-conserving combined with volume displacement. One patient was not satisfied with the cosmetic effects, the other patients were satisfied or basically satisfied with the cosmetic effects. The median follow-up was 18 months (5–24 months), and no local recurrence or distant metastasis was found in 32 patients.ConclusionsBy tumor down-staging after neoadjuvant chemotherapy combined with oncoplastic surgery, we can make some patients who are originally not suitable for breast conserving due to tumor size and tumor location succeed in breast-conserving therapy, and the safety and cosmetic effect are basically satisfied.
The booming three-dimensional laser scanning technology can efficiently and effectively get spatial three-dimensional coordinates of the detected object surface and reconstruct the image at high speed, high precision and large capacity of information. Non-radiation, non-contact and the ability of visualization make it increasingly popular in three-dimensional surface medical mapping. This paper reviews the applications and developments of three-dimensional laser scanning technology in medical field, especially in stomatology, plastic surgery and orthopedics. Furthermore, the paper also discusses the application prospects in the future as well as the biomedical engineering problems it would encounter with.
Objective To investigate effectiveness of the modified edge resection technique for composite labia minora and clitoral hood reduction with preserved microstructures. Methods A retrospective analysis was conducted on 36 female patients, who were diagnosed with composite hypertrophy of the labia minora and clitoral hood and admitted between September 2022 and December 2024. The patients’ ages ranged from 18 to 45 years (mean, 27.4 years). The primary surgical motivations included poor appearance alone (8 cases), functional impairment alone (14 cases), both poor appearance and functional impairment (12 cases), and psychological factors (2 cases). All patients were treated with the modified edge resection technique for composite labiaminora and clitoral hood reduction with preserved microstructures. The surgical technique emphasized precise adjustments to the clitoral-labial junction and optimization of the anterior labial structure to ensure a natural postoperative appearance and functional integrity. Postoperative follow-up assessed improvements in appearance and function of clitoral hood and labia minora, complications, and overall patient satisfaction. Results One patient exhibited suboptimal wound healing, while the remaining patients experienced no complications such as postoperative bleeding, hematoma, wound dehiscence, suture cutting, or labial edema and enlargement. Thirty patients were followed up with a duration of 1-6 months (mean, 2.4 months). In the early postoperative period, 2 patients perceived asymmetry of the bilateral labia minora; 1 underwent labial revision surgery, while the other achieved near-symmetry without intervention. At last follow-up, 25 patients experienced varying degrees of relief from preoperative functional impairments, while the remaining patients showed no improvement; 27 patients reported varying degrees of improvement in appearance, 2 reported no change, and 1 reported a worse appearance compared to preoperatively. Sixteen patients were very satisfied with the surgical results, 8 were satisfied, 5 were moderate satisfied, and 1 was dissatisfied, with a satisfaction rate of 80% (24/30). Conclusion The modified edge resection technique for composite labia minora and clitoral hood reduction with preserved microstructures which preserves and optimizes fine anatomical structures through precise adjustments at the clitoral-labial junction, achieves high patient satisfaction with both aesthetic and functional outcomes while minimizing postoperative complications.