OBJECTIVE: To investigate the effect of nerve growth factor(NGF) on the burn wound healing and to study the mechanism of burn wound healing. METHODS: Six domestic pigs weighting around 20 kg were used as experimental animals. Twenty-four burn wound, each 2.5 cm in diameter, were induced on every pigs by scalding. Three different concentrations of NGF, 1 microgram/ml, 2.5 micrograms/ml, 5 micrograms/ml were topically applied after thermal injury, and saline solution used as control group. Biopsy specimens were taken at 3, 5 and 9 days following treatment and immunohistochemistry method was used to detect the epidermal growth factor(EGF), EGF receptor (EGF-R), NGF, NGF receptor (NGF-R), NGF, NGF-R, CD68 and CD3. RESULTS: The expression of EGF, EGF-R, NGF, NGF-R CD68 and CD3 were observed in the experimental group, especially at 5 and 9 days, no expression of those six items in the control group. CONCLUSION: NGF can not only act directly on burn wound, but also modulate other growth factors on the burn wound to accelerate the healing of burn wound.
OBJECTIVE: To investigate the clinical effect of vacuum sealing in treatment of traumatic soft tissue defect. METHODS: From 1998. 8 to 2001. 2, 49 patients with 55 traumatic soft tissue defects were treated by vacuum sealing after debridement. Among them, there were 39 males and 10 females with mean age 38. 4 years. The wound area varied from 10 cm x 10 cm to 30 cm x 30 cm. In the experimental group, the wound surfaces or cavities were filled with polyvinyl alcohol foams with embedded drainage tubes connected with vacuum bottle (negative pressure of 50-60 kPa). Wound closure was performed with secondary suturing, or skin transplantation, or local flap grafting after 5-7 days. Besides, 126 patients were managed by traditional dressing as the control group. RESULTS: Out of 51 traumatic soft tissue defects (45 patients), the wound closure was performed with a free flap in 4, with local flap in 8, with skin grafting in 27, with secondary suturing in 6, and with vacuum sealing directly in the other 6 defects. Forty-five patients recovered and no complications (systemic and located) occurred. There were significant differences in time of secondary suturing, times of dressing, wound shrink and total therapeutic cost between two groups (P lt; 0.01). CONCLUSION: Vacuum sealing can protect the wound against contamination, evacuate the wound exudates completely, stimulate the growth of granulation tissue, and facilitate the wound healing; so vacuum sealing is a simple and effective method in treatment of traumatic soft tissue defect.
Objective To investigate the influence of lipopolysaccharide(LPS) on the proliferation and collagen synthesis of normal human skin fibroblasts so as to elucidate its relation with skin wound healing. Methods Fibroblasts wereisolated and cultured in vitro, and then exposed to different doses of LPS(0.005, 0.010, 0.050, 0.100, 0.500, and 1.000 μg/ml) from E.coli055∶B5 respectively. Then the absorbance (A) value of fibroblasts was determined with the colorirneteric thiazolylblue (MTT) assay, and the cell number was counted under inverted phase contrast microscope from the 1st day to the 9th day after LPS administration, and collagen synthesis of fibroblasts in culture medium was measured with the method of pepsin digestion after incorporation of 3Hproline into stable, single-layered, confluent fibroblasts at 7 days after LPS administration. Results Compared with control group, A value increased with the increasing concentration of LPS (0.005 μg/ml 0.500 μg/ml) and LPS of 0.100 μg/mlgroup had the best effect. The difference was remarkable from the 5th day to the 9th day(P＜0.05). A value decreased when challenged with the LPS of 1.000 μg/ml and the difference was remarkable from the 3rd day to the 9th day(P＜0.05). Cell number increased with theadministration of LPS of different concentrations (0.005 μg/ml 0.500 μg/ml) and LPS of 0.100 μg/mlgroup had the best effect. The difference was remarkable from the 1st day to the 6th day(P＜0.05). Cell number decreased remarkably when challenged with LPS of 1.000 μg/ml and the difference was remarkable from the 2nd day to the 9th day(P＜0.05). Collagen synthesis increased when challenged with LPS of different concentrations (0.005 μg/ml 0.500 μg/ml) and the 0.100 μg/ml group had the best effect. However, when the dose of LPS reached 1.000 μg/ml, it inhibited collagensynthesis. Conclusion LPS could promote the proliferation andcollagen synthesis of fibroblasts within a certain range of low doses, but over-high dose ofLPS might inhibit the proliferation and collagen synthesis of fibroblasts, suggesting that LPS of certain concentrations might contribute to wound healing, while excessive LPS has negative effect on wound healing.
OBJECTIVE: To investigate the efficiency of recombinant human epidermal growth factor (rhEGF) on burn wound healing and to explore the effective density of the ointments. METHODS: A total of 120 cases of burn in superficial II degree and profound II degree were randomly divided into 2 groups. In the first group of 15 cases of superficial II degree, the wounds were treated by rhEGF ointments of different density, 0.5 microgram/g, 10 micrograms/g and 50 micrograms/g, to screen out the effective density. And in the other 105 cases of the second group, optimal density of the ointments based on the result of the first group were employed to treat the burn wound in superficial II degree and profound II degree, with the self-corresponding wounds of the same degree as control, to study the efficiency of rhEGF on wound healing, according to the wound healing time, and adverse reaction of the ointment. RESULTS: In the first group, the average healing time of superficial II wound treated by ointments of 10 micrograms/g and 50 micrograms/g significantly shortened when compared with that treated by ointments of 0.5 microgram/g(P lt; 0.01), but there was no obvious difference between the cases treated by ointments of 10 micrograms/g and 50 micrograms/g. In the second group, the healing time of superficial II wound treated by ointments of 10 micrograms/g was (8.39 +/- 2.25) days, (9.52 +/- 2.56) days in the control (P lt; 0.01); and healing time of profound II burn treated by ointments of 10 micrograms/g was (16.80 +/- 2.99) days, (18.27 +/- 3.17) days in the control (P lt; 0.01). And healing rates of burn wound at different periods were higher than those of the control. CONCLUSION: The above results indicate that rhEGF ointments can enhance burn wound healing significantly, and the ointment of 10 micrograms/g is a good choice for clinical application.
In order to preserve the major vessels of the extremities in the repair and reconstruction of wounds of the extremities, the distally based fascial pedicled island flap was applied clinically. Its axis and rotatary point were designed along orientation of the major arteries, and the blood supply was from the abundant vascular networks in the deep fascia. Twenty-two cases with exposure of tendon and bone including 10 upper limbs and 12 lower limbs were treated. The flap area of forearm ranged from 7 cm x 8 cm to 12 cm x 9 cm and the ratio of the length to width of the pedicle was 1: 1-2. The flap area of the calf ranged from 10 cm x 6 cm to 16.5 cm x 12 cm and the ratio of the length to width of the pedicle was 2:1. The rotatary angle was 130 degrees-170 degrees. After operation, 18 flaps were survived completely, 2 cases had partial necrosis on the margin, 2 failures received cross-leg flap in the second operation. The patients were followed up with an average of 13.5 months (ranged from 3 months to 2 years). The conclusions were as follows: 1. the blood supply of this type of flap was reliable and the major arteries of the extremities needed not to be sacrificed; 2. the preparation of the flap was easy and the survival rate was satisfactory; 3. the shortcomings of this flap were unsightly incision scar and the limited size of flap and; 4. during the operation, the compression of the pedicle must be avoided.
OBJECTIVE: To seek a simple, safe and effective method for the instant repair of soft-tissue defects after excision of superficial tumor, chronic ulcer and scar constructure as well as injury. METHODS: From August 1993 to October 1997, according to the location and size of the lesion, adjacent single or double reverse tongue-shaped skin flaps were designed to repair the defects of head, face, limb and shoulder in 31 cases, and the donor sites were closed directly. RESULTS: The wounds were healed by first intention and the skin flaps were all survived postoperatively. CONCLUSION: It suggests that the tongue-shaped flap have the following characteristics: abundant blood supply, high survival rate, wide application, less trauma, and adjacent tissue can be fully used. It is a simple, safe and effective method for the instant repair of soft-tissue defects.
Objective To evaluate the effectiveness of the dermal pedicled nasolabial flap with subdermal vascular network for repairing nasolabial skin defects. Methods Between July 2008 and July 2011, 43 cases of nasolabial defects wererepaired with dermal pedicled nasolabial flap with subdermal vascular network. There were 22 males and 21 females with a median age of 36 years (range, 6-68 years). All defects were caused by excision of lesions, including pigmented nevus in 23 cases, scar in 16 cases, and inflammatory granuloma in 4 cases. The disease duration was 3 months to 35 years. Lesions were located at the tip of the nose in 11 cases, at the alae of the nose in 10 cases, at the alae and tip of the nose in 10 cases, at the alar groove of the nose in 8 cases, and at upper l ip in 4 cases. The defect size ranged from 0.7 cm × 0.5 cm to 1.2 cm × 1.0 cm. The flap size ranged from 1.0 cm × 0.7 cm to 1.5 cm × 1.2 cm. Results All flaps survived and incisions at donors and wound healed by first intention. After operation, 34 patients were followed up 6-12 months (mean, 10 months). The texture and color of the flap were similar to adjacent skin. No obvious scar was observed at donor sites. Conclusion The dermal pedicled nasolabial flap with subdermal vascular network has the advantages of flexible flap transplantation, small damage to donor site, and low incidence of bloated subcutaneous tunnel.
OBJECTIVE: To study the therapeutic effect of Suyuping in which liposome is the main constituent on II degree burn wound. METHODS: From October 1998 to October 1999, 42 cases with II degree burn wound were adopted in this study. Among them, there were 30 males and 12 females, the average wound area was (23.4 +/- 9.7)%. The wounds on the left side of body were managed with sulfadiazine argentum(SD-Ag) while that on the right side with Suyuping. Healing and other situation about the burn wounds were observed and recorded at times. RESULTS: Forty-two patients completely healed when discharged from hospital. The average wound area managed with Suyuping was (11.2 +/- 7.3)% and the area with SD-Ag was (9.4 +/- 5.8)%. The mean healing time of Suyuping group was(18.4 +/- 4.7) days while that of SD-Ag was (23.5 +/- 7.9) days, there was significant difference(P lt; 0.05). Suyuping group presented few wound pain, allergy, bleeding and the side effect was less. CONCLUSION: Suyuping can accelerate wound healing and attenuate wound pain, allergy and bleeding, it is a potential and specific topical agent for treating II degree burn wound.
【Abstract】 Objective To search for a feasibil ity of repairing full-thickness cutaneous deficiency with tissueengineered skin substitute composited by human epidermal stem cells and fibroblasts in fibrin frame. Methods Epidermal stem cells and fibroblasts were harvested from human epidermis and dermis by trypsin digestion. Cells were cultured and subcultured in non-serum medium. Epidermal stem cells (5×104/mL) and dermal fibroblasts (1×104/mL) in 0.5 mL medium were coagulated in 0.5 mL fibrin frame to construct tissue engineered skin substitute. The tissue engineered skin substitute was grafted onto full-thickness cutaneous deficiency of nude mice. Forty-five male mice, 4-5 week old, weighted 20 g on average, were randomly divided into 5 groups. Oil yarn (group C), fibrin frame membrane without cell inoculation (group F), composite skin substitute with epidermal stem cells (group S) and composite skin substitute with fibroblasts (group Fb) were used as controls, while tissue engineered skin substitute (group T) was experimental group. The wounds were observed 1, 3, 6, 8 weeks after surgery. Samples were harvested 3, 6, 8 weeks after surgery, and were examined by means of histology、immunohistochemistryand scanning electron microscopy (SEM). Results Four weeks after cell culture, there were some round cells in the culture capsule of epidemic cells, and some fusiform cells in the culture capsule of fibroblast. Six days after cells were cultured in the BrdU culture medium, there were some BrdU positive cells appeared. There were some CK19 positive cells and Nestin positive cells appeared in the chaff of group T before transplanting. The new formed skin of group T grew faster and had less scar than other groups. Six weeks after surgery, the average thickness of new formed skin was (0.460 ± 0.049) mm in group C, (0.480 ± 0.055) mm in group F, (0.540 ± 0.043) mm in group S, (0.510 ± 0.032) mm in group Fb, (0.660 ± 0.047) mm in group T. The thickness of new formed skin in group T was thicker than other groups (P lt; 0.05). By histology and SEM observation, 3, 6, 8weeks after surgery, the new formed cuticular layer, fibroblast and blood vessels in the group T were more than those in theother groups. The al ignment of blood vessels and collagen fibers in group T were much regular than those in the other groups. Three weeks after surgery, the new formed skin of group T had a continuous color zone of positive collagen Ⅳ staining, while no continuous color zone was found in the other groups. Six weeks after surgery, CK14 positive cells appeared in the new formed skin of group T, while no positive cell was found in the other groups. Conclusion Tissue engineered skin substitute which is composited with epidermal stem cells and fibroblasts in fibrin frame has potential prospects in appl ication of repairing fullthickness cutaneous deficiency with advantage of faster wound heal ing.
Abstract In order to understand the expression change of epidermal growth factor (EGF) gene and its distribution in tissue duringwound healing, 12 Winstar rats were divided into 4 groups. In each side of the back of every rat, 4 wounds of 1.5cm×1.5cm in size were made. After 4,8,12,16 days, one group of rats was sacrificed and tissues from wound were collected. By DIG-labelled probe hybridization in situ technique, EGF gene mRNA was detected. It was shown that EGF gene expression was evident during the whole stage of woundhealing, and the peak was in 8th day. It suggested that the promotion of EGF gene expression may lead to wound healing earlier.