Compound Huangbai liquid coating agent is a preparation that combines multiple traditional Chinese medicinal herbs and has shown significant efficacy in burn treatment. In recent years, the application of this coating agent in burn treatment has received widespread attention, and it plays a role in promoting wound healing, preventing infection, and reducing patient pain. This article reviews the research progress of compound Huangbai liquid coating agent in burn treatment, explores its mechanism of promoting wound healing, evaluates its current advantages and limitations in burn treatment, and provides scientific basis and theoretical support for its better use in burn treatment.
【摘要】 目的 探討中成藥參附注射液對大鼠深Ⅱ度燒傷創面愈合的影響。 方法 選用16只Sprague-Dawley（SD）大鼠，隨機分為實驗組、對照組，每組各8只，建立20%體表面積深Ⅱ度燙傷模型。燙傷后即刻及此后每天，實驗組大鼠以參附注射液20 mL/kg腹腔注射給藥，1次/d，連續給藥5 d；對照組給予注射等劑量的生理鹽水。分別于致傷后的7、14 d取創面組織塊，光學顯微鏡觀察成纖維細胞及膠原纖維生長情況，電子顯微鏡觀察致傷后14 d成纖維細胞細胞器情況，分別計算燒傷后第7、14天兩組的創面愈合率，并觀察比較兩組創面愈合的時間。 結果 所有選入實驗的SD大鼠均存活至實驗結束。實驗組、對照組術后第7天創面愈合率分別為（36.34±2.55）%及（33.13±2.62）%，兩組差異有統計學意義（t=2.486，P=0.027）；實驗組、對照組術后第14天創面愈合率分別為（75.71±2.29）%及（72.36±2.85）%，兩組差異有統計學意義（t=2.590，P=0.022）；實驗組、對照組創面愈合時間分別為（20.88±1.36）、（22.94±2.16） d，兩組差異有統計學意義（t=-2.286，P=0.0395）。傷后7、14 d創面組織塊切片光學顯微鏡觀察發現，實驗組肉芽組織及膠原纖維較多，排列更有序，表皮基底細胞增殖活躍，炎癥反應較輕；傷后14 d時電子顯微鏡觀察發現，實驗組成纖維細胞的細胞器更豐富，分泌膠原更多，實驗組創面愈合情況優于對照組。 結論 腹腔注射參附注射液可以促進燒傷創面的愈合，其可能的機制為清除氧自由基，抗脂質過氧化。【Abstract】 Objective To explore the effect of Shenfu injection on promoting healing of deep partial-thickness burn wound in rats. Methods Sixteen Sprague-Dawley (SD) rats were randomly selected, and deep partial-thickness burn with 20% of the body surface was inflicted. The rats were randomly divided into experimental group and control group with eight in each group. Rats in the experimental group were treated with abdominal injection of Shenfu injection at a dose of 20 mL/(kg?d) for five days continually, and rats in the control group were treated with the same dose of 0.9% saline solution. The growth of granulation tissue and collagen fibers were evaluated under light microscope at the seventh and the fourteenth day. The growth of fibroblast was observed under transmission electron microscope at the fourteenth day. The cure rate of both groups of rats at the seventh and fourteenth day was calculated. Then we compared their healing time and the cure rate of the traumatic wound respectively. Results All rats had survived until wound healing. The cure rate at the seventh day for the experimental group and the control group was (36.34±2.55)% and (33.13±2.62)%, and their difference was statistical (t=2.486, P=0.027); At the fourteenth day, the cure rate was respectively (75.71±2.29)% and (72.36±2.85)% with a significant difference between each other (t=2.590, P=0.022). The healing time of the experimental group (20.88±1.36) was significantly shorter than that of the control group (22.9±2.16) (t=-2.286, P=0.040). At the seventh and fourteenth day, light microscope observation showed that the growth of granulation tissue and collagen fibers for rats in the experimental group were much more than that in the control group, the basale cell proliferation was more active, and inflammation was slighter. Through transmission electron microscope, we observed more fibroblast and collagen in the experimental group, which showed a better cure than the control group. Conclusion Shenfu injection can significantly promote wound healing of deep partial-thickness burn. It may possibly get this effect through anti-oxidation.
【Abstract】 Objective To summarize the recent progress in related research on transforming growth factor β1 （TGF-β1）/Smad3 signal transduction pathway and post-traumatic scar formation. Methods Recent related literature at home and abroad on TGF-β1/Smad3 signal transduction pathway and post-traumatic scar formation was reviewed and summarized. Results TGF-β1 is an important influence factor of fibrotic diseases, and it plays biological effects by TGF-β1/Smad3 signal transduction pathway. The pathway is regulated by many factors and has crosstalk with other signal pathways at cellular and molecular levels. The pathway is involved in the early post-traumatic inflammatory response, wound healing, and late pathological scar formation. Intervening the transduction pathway at the molecular level can influence the process of fibrosis and extracellular matrix deposition. Conclusion TGF-β1/Smad3 signal transduction pathway is an important way to affect post-traumatic scar formation and extracellular matrix deposition. The further study on the pathway will provide a theoretical basis for promotion of wound healing, as well as prevention and treatment of pathological scar formation.
Objective To explore the clinical application effects of cervical advancement flaps in repairing mandibular scars. Methods A retrospective analysis was performed on the clinical data of patients with mandibular scars admitted to the Department of Plastic and Burn Surgery of West China Hospital of Sichuan University between January 2018 and July 2020. The lateral X-ray images of the patients were analyzed before and 2 weeks after surgery, and the differences in the mento-cervical angles and the cervico-mental angles before and after surgery were compared. Results A total of 21 patients were included, including 7 males and 14 females. At admission, all patients had a mandibular scar area of (3-7) cm × (3-6) cm, and underwent primary repair with cervical advancement flaps. All patients had good postoperative skin flaps survival, primary wound healing, and obvious mento-cervical angle and cervico-mental angle. The preoperative mento-cervical angle was (110.24±9.47)°, and at 2 weeks post surgery, the mento-cervical angle was (98.39±4.95)°, with a statistically significant difference (P<0.05). The preoperative cervico-mental angle was (134.15±6.00)°, and at 2 weeks post surgery, the cervico-mental angle was (126.44±3.60)°, with a statistically significant difference (P<0.05). Conclusion The neck advancement flap is an effective surgical method for treating simple mandibular scar, which is simple and can improve the appearance of the jaw and neck.
【摘要】 目的 探討肥胖人群減肥后體重急劇下降導致腹壁松弛行腹壁整形手術的療效。 方法 2003年4月-2009年10月，24例減肥后體重下降導致腹壁松弛患者中男3例，女21例，年齡28~44歲，平均36歲。其中1例合并甲狀腺功能亢進，1例合并糖尿病病史；20例均通過運動、控制飲食等方式致體重下降，4例接受胃減容手術后體重下降。體重下降穩定后至腹壁整形手術時間間隔2~4年，平均2.5年；減肥前至腹壁整形手術前體重下降37~67 kg，平均下降45 kg。手術采用屈髖位，切除松弛皮膚組織，收緊腹壁及腰部松弛組織，恥骨上沿皮瓣遠端去表皮后與恥骨上沿骨膜縫合固定。所有患者隨訪5個月~2年。 結果 23例術后2周皮瓣完全成活，切口愈合良好，無切口感染；1例術后出現恥骨上切口約2 cm表皮裂開，換藥2周后切口愈合，術后腹壁平整、對稱，無皮下血腫發生。隨訪期間切口疤痕隱蔽，陰阜無上移，腹壁平坦、對稱。 結論 該腹壁整形手術方式效果良好，術后并發癥少，值得推廣。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.
OBJECTIVE To study the influence and mechanism of gamma-IFN on fibroblasts in hypertrophic scars(HTS). METHODS The cultured fibroblastic cells were isolated from the hypertrophic scars of 10 patients. The fibroblasts were divided into two groups, one group was treated with gamma-IFN (100 U/ml, 5 days) and the other without gamma-IFN as control. The proliferative activity in both groups was investigated and compared by blood cytometer, the proportion of myofibroblast (MFB) and the ratio of apoptosis were examined and analysed between two groups by flow cytometry using alpha-smooth muscle actin (alpha-SMA) as marker. RESULTS The proliferative activity was downregulated with gamma-IFN. In gamma-IFN treated group, the differentiation of MFB were reduced and the decreasing ratio was 3.2% at the 2nd day and up to 10.5% at the 8th day, then it reduced gradually. The apoptosic ratio is 17.7% in gamma-IFN treated group, and is 10.9% in control group. The difference was statistically significant. CONCLUSION gamma-IFN could downregulate the proliferation of fibroblasts, decrease the differentiation of MFB and induce the apoptosis. It has beneficial effect in the treatment of hypertrophic scars(HTS).
Based on skin elasticity and mobility, V-Y advancement flaps are designed to repair wounds. Traditional V-Y flaps have been limited due to short advancing distance. With the development of perforator flaps and the application of microsurgical techniques, V-Y advancement flaps are gradually transiting from traditional random flaps to axial flaps containing well-known vessels or perforator arteries. The advancing distance of V-Y advancement flaps is significantly increased, and the design forms are gradually flexible and diversified. V-Y advancement flaps are widely used in clinical practice and can be used to repair wounds in almost all parts of the body. This article reviews the clinical application progress of V-Y advancement flaps to further promote its clinical application.
Poland syndrome is a congenital anomaly characterized by unilateral underdeveloped or absent chest wall, accompanied by varying degrees of ipsilateral limb defects. In clinical practice, Poland syndrome is prone to misdiagnosis and missed diagnosis, which delays treatment timing and affects treatment effectiveness, as the current etiology is not yet clear and there is no unified and standardized clinical classification and treatment plan. This article summarizes and elaborates on the etiology, clinical manifestations, classification, diagnosis, and treatment of Poland syndrome by reviewing relevant literature on the diagnosis and treatment of Poland syndrome both domestically and internationally in recent years, in order to enhance understanding of Poland syndrome, provide reference for standardized clinical diagnosis and treatment, and improve the efficiency of diagnosis and treatment.
【摘要】 目的 觀察綜合治療體表血管瘤及脈管畸形的臨床療效。 方法 2008年1月-2010年9月，收治體表血管瘤和脈管畸形患者共205例。手術治療156例，其中單純手術治療103例，合并介入治療9例，硬化劑治療44例；非手術治療49例，其中介入治療1例，硬化劑治療38例，介入合并硬化劑治療10例。術后隨訪6個月～3年。 結果 15例手術治療患者于術后6個月～2年復發，其中單純手術治療患者10例（復發率9.71%），合并介入治療患者2例（復發率22.22%），合并硬化劑治療患者3例（復發率6.82%），均再次手術治療后痊愈。9例非手術治療患者于治療后3個月～2年復發，其中8例硬化劑治療患者，1例介入合并硬化劑治療患者，均經手術治療后痊愈。余患者未見復發。 結論 以手術治療為主的綜合治療，是體表血管瘤和脈管畸形治療的良好方法。【Abstract】 Objective To observe the clinical therapeutic efficacy of comprehensive treatment on body surface hemangioma and vascular malformations. Methods Between January 2008 and September 2010, 205 pateints with surface hemangioma and vascular malformation were treated. A total of 156 patients received surgical treatment, in whom 103 received surgery alone, 9 underwent combined interventional treatment, and 44 received combined sclerotherapy. There were 49 patients underwent non-surgical treatment, including intervention in 1, sclerotherapy in 38 involving 10 had combined sclerotherapy. The patients were followed up for 6 months to 3 years. Results A total of 15 patients who had received surgical treatment recurred 6 months to 2 years after the treatment, including 10 who had been treated with surgery alone (with the recurrence rate of 9.71%), 2 combined with interventional treatment (with the recurrence rate of 22.22%), and 3 combined with sclerotherapy (with the recurrence rate of 6.82%). They were all cured after reoperation. Nine cases of non-surgical treatment recurred 3 months to 2 years after the treatment, including 8 who had received sclerotherapy, and 1 combined with interventional treatment and sclerotherapy. Patients were all cured after surgery. The other patients had no recurrence. Conclusion Applying mainly on surgical treatment, the combined therapy is a good way for body surface hemangioma and vascular malformations.
Objective To explore better approach of resecting tumoraround the anterior skull base and reconstructing the anterior skull base.Methods In November 2004, a 49-years-old male patient with intracranial recrudescent adenoid cystic carcinoma in the anterior cranial fossa was treated using modified transcranial approach. Neurosurgeon and rhinolaryngologist cooperated to excise the tumour completely, and to reconstruct anterior skull base using the pedicle periosteum temproal musculofascial flap(15 cm×10 cm) andthe pedicle flap of aponeurosis of occipitofron talis muscle and muscular fasciae（10 cm×6 cm）.Results After operation, the wound healed by first intention. Complication, such as infection and cerebrospinal rhinorrhea, did not occur. The patient was discharged 10 days after operation, and was followed up for 8 months, no local recurrence were investigated and no scar formed over the face.Conclusion The modified transcranial approachis a relatively novel exposure that enables the skilled cranial base surgeon tosafely resect many malignant lesions previously and to reconstruct the defect of anterior skull base together.