Reconstructive surgery is fundamentally dedicated to restoring tissues and organs damaged by trauma, disease, or congenital anomalies, with the goal of re-establishing both physiological function and anatomical form. Facial reconstruction, as one of the most representative and technically demanding areas of the discipline, embodies the evolution of its concepts and technological progress. Using facial reconstruction as the point of departure, this article systematically delineates the scientific underpinnings and developmental frontiers of the field. Centered on four core elements—donor construction, vascular reconstruction, precision transplantation, and functional recovery, this article articulates the internal logic and technical considerations of both autologous and allogeneic reconstructive methods. Further, from the perspectives of regenerative donor fabrication, the digital and intelligent transformation of reconstructive surgery, breakthroughs in immune tolerance strategies, and the integration of engineering technologies to enhance functional outcomes, the article envisions potential paradigm shifts that may redefine the discipline. By leveraging facial reconstruction as a highly integrated lens, this work aims to elucidate the key drivers of innovation and chart the future directions of reconstructive surgery.
To observe the effect of percutaneous electrical stimulation on peripheral nerve regeneration, a model was created on the sciatic nerves of 56 rats from either sectioned and followed by direct anastomosis or clamping of the nerve. The indices, such as conducting velocity of nerve, maximal induced action potential of muscle, growth speed of nerve, rateof axon crossing anastomosis site, number of muscular fiber on transverse area and weight of muscle by autocontrol were compared. In this study, 36 rats were divided into two groups, 24 rats in Group 1 and 12 rats in Group 2. In Gourp 1, both sciatic nerves were sectioned and was anastomozed 4 weeks later. One side of the nerve was stimulated with percutaneous electric current, the other side was served as control. In Group 2, both sides of nerves were clamped and the electical stimulationwas carried out on one side. The parameters of the electric current were 2～5HZ, 0.4m/s, 24～48V. The electrophysiological and histomorphological features were observed 1 to 6 weeks after operation. The results showed that in the stimulatedside, the indices were all superior to that of the control side. This suggestedthat electrical stimulation could promote peripheral nerve regeneration.
OBJECTIVE: To explore the mechanism of tissue specificity of neurotropism in peripheral nerve regeneration, we investigated the biological characteristics of the nerve regeneration conditioned fluids(NRCF) on motoneuron of SD rats cultured in vitro. METHODS: Silicon chambers were sutured respectively to the distal stumps of motorial branch of femoral nerve and saphenous nerve to collect NRCF, namely MD-NRCF and SD-NRCF. The rats cortex motoneuron were divided into 4 groups and cocultured with MD-NRCF, SD-NRCF, b-FGF and serum-free medium respectively. The cultured cells were photoed under phase-contrast microscope, their longest neurites and cell-body areas were measured by cell image processing computer system. MTT automated colorimetric microassay was also adopted to quantify the activation of cultured motoneurons in each group. RESULTS: Cells of MD-NRCF group had longer neurites than those of the other three groups, and their activation was also superior to those of the other groups. CONCLUSION: The results suggest that MD-NRCF has more significantly neurite-promoting and neurobiological effects on motoneuron than SD-NRCF and b-FGF.
ObjectiveTo study the treatment results of the pre-expanded flaps for scar contracture on face, neck, and joints by comparing with the skin grafts. MethodsA total of 240 cases of scar contracture between July 2004 and June 2014 were included in the study by random sampling; skin grafts were used in 120 cases (skin graft group), and preexpanded flaps in 120 cases (pre-expanded flap group). There was no significant difference in age, sex, injury sites, and disease duration between 2 groups (P>0.05). Re-operation rate and A&F 0-6 quantization score were used to evaluate the treatment results. ResultsThe patients were followed up 12 to 75 months (mean, 23.47 months) in the skin graft group, and 12 to 61 months (mean, 19.62 months) in the pre-expanded flap group. The re-operation rate of the skin graft group was 72.5% (87/120), and was significantly higher than that of the pre-expanded flap group (19.2%, 23/120) (P=0.000). The re-operation rate of the neck contracture in teenagers was the highest. It was 93.9% in the skin graft group and 35.0% in the pre-expanded flap group. In the patients who did not undergo re-operations, A&F 0-6 quantization score of the skin graft group was 2.85±1.12, and was significantly lower than that of the pre-expanded flap group (5.22±0.74) (t=13.830, P=0.000). ConclusionPre-expanded flap for scar contracture on face, neck, and joints has lower re-operation rate and better aesthetic and functional restoration than skin graft. It should be regarded as the preferred method for teenagers.