Negative Pressure Wound Therapy for Patients With Complicated Mucocutaneous Separation Following Ileal Conduit Urinary Diversion: A Case Series.

BACKGROUND: Mucocutaneous separation (MCS) is one of the early stomal complications of ileal conduit diversion after radical cystectomy. It can result in abdominal infection and sepsis, prolonging patient recovery. Negative pressure wound therapy (NPWT) has been widely used for abdominal wounds after orthopedic and burn surgery. This case series describes its use in complicated MCS and ostomy retraction after ileal conduit diversion. CASES: We describe a case series of 3 patients with moderate to severe MCS with and without infection after robot-assisted radical cystectomy with ileal conduit diversion. Our patients were treated with NPWT to avoid infection and create a satisfactory environment for healing MCS. After 2 to 4 weeks of NPWT, all 3 patients had normal micturition function with no additional peristomal wounds or complications. CONCLUSION: Negative pressure wound therapy may be used in the management of complicated MCS after ileal conduit diversion.

Category of upper eyelid morphology and the preferred double eyelid shape in Asians according to questionnaire survey.

BACKGROUND: The morphological classification of the upper eyelid in Asian people is complex and diverse and usually not consistent with what we know well. AIMS: To improve the classification of upper eyelid morphology and investigate the preferred double eyelid shape by Asian people. METHODS: An investigation of 640 patients' preferences for double eyelid shape was conducted, and the pre- and post-operative effects were assessed. The shapes of the natural eyelids of 247 people (485 eyes) who provided real photographs of the eyelids were counted. The chi-square test was used to analyze the differences. RESULTS: There were 10 eyelid shapes: single eyelid, parallel-shaped double eyelid, fan-shaped double eyelid, parallel fan-shaped double eyelid, opened fan-shaped double eyelid, crescent-shaped double eyelid, hidden-shaped double eyelid, horizontal-shaped double eyelid, triangle-shaped double eyelid, and multiple-fold eyelid. The difference in the shape of the natural eyelid between males and females was statistically significant (p < 0.05). The most popular eyelid shapes were single eyelid (24.9%), open fan-shaped double eyelid (21.0%), fan-shaped double eyelid (16.3%), and hidden-shaped double eyelid (12.6%). Men and women preferred a parallel fan-shaped double eyelid (18.0%), a parallel-shaped double eyelids (17.0%), and an open fan-shaped double eyelids (18.1%). CONCLUSIONS: The most popular upper eyelid shapes were single eyelid, open fan-shaped double eyelid, and fan-shaped double eyelid. The parallel fan-shaped, parallel-shaped, and open fan-shaped double eyelid were favored by men and women.

Wnt7a promotes wound healing by regulation of angiogenesis and inflammation: Issues on diabetes and obesity.

BACKGROUND: Diabetic skin heals wounds poorly. Though obesity is the common risk factor of diabetes mellitus, few studies have investigated its effects on wound healing. OBJECTIVES: This study aimed to evaluate the morphology and possible mechanism of human umbilical vein endothelial cells (HUVEC-C) in response to different levels of glucose and palmitic acid, and explore the role of Wnt7a in wound healing. METHODS: The functional changes of HUVEC-C and mRNA expression of Wnt signaling were determined by analyzing cell viability, migration, tube formation and rt-PCR in gradients of glucose and palmitic acid. Recombinant Wnt7a protein was injected around wounds made on streptozotocin (STZ) -induced diabetic rats with (HF) or without (DM) high-fat diet. Angiogenesis and inflammatory statement were mainly analyzed by immunohistochemistry, ELISA, cytometry and Western blotting. RESULTS: The expression of Wnt7a significantly decreased in high Glc/PA cultured cells or DM and HF wounded rats. Impaired wound healing was also observed in DM and HF groups. The healing rate significantly accelerated after localized injection with Wnt7a at d10. Moreover, the expression of CD31, eNOS phosphorylation and NO were increased; the reduction of local neutrophils influx, ICAM-1 and IL-6/8 expression levels were obvious especially in diabetic with obesity rats at d10 after Wnt7a treatment. CONCLUSION: This study indicates the potential role of Wnt7a, which is beneficial for regeneration of damaged vessels, moderation of inflammatory statement in diabetic wound healing with or without obesity, thus demonstrating its possible utility as a topical administration to promote healing rate.

The application of autologous platelet­rich plasma gel in cartilage regeneration.

Cartilage defect caused by disease or trauma remains a challenge for surgeons, owning to the limited healing capacity of cartilage tissues. Cartilage tissue engineering provides a novel approach to address this issue, and appears promising for patients with cartilage defects. The cell scaffold, as one of the three key elements of tissue engineering, plays an important role in cartilage tissue engineering. Platelet­rich plasma (PRP), which is a fraction of the plasma containing multiple growth factors, has become a major research focus in the context of its use as a bioactive scaffold for tissue engineering. Therefore, we investigated the value of using PRP scaffolds combined with chondrocytes in cartilage tissue engineering. In this study, we examined the levels of growth factors in PRP, and the effects of PRP on cell proliferation and matrix synthesis in rabbit chondrocytes cultured in PRP. Short-term in vitro culture followed by long­term in vivo implantation was performed to evaluate the chondrogenesis of neocartilage in vivo. The results show that PRP may provide a suitable environment for the proliferation and maturation of chondrocytes, and can be used as a promising bioactive scaffold for cartilage regeneration.

[Aesthetic effect of wound repair with flaps].

OBJECTIVE: To investigate the aesthetic effect of wound repair with flaps. METHODS: One thousand nine hundred and ninety-six patients with 2082 wounds hospitalized from January 2004 to December 2011. These wounds included 503 deep burn wounds, 268 pressure sores, 392 soft tissue defects caused by trauma, 479 soft tissue defects due to resection of skin cancer and mole removal, 314 soft tissue defects caused by scar excision, and 126 other wounds. Wound area ranged from 1.5 cm x 1.0 cm to 30.0 cm x 22.0 cm. Sliding flaps, expanded flaps, pedicle flaps, and free flaps were used to repair the wounds in accordance with the principle and timing of wound repair with flaps. RESULTS: Five flaps showed venous congestion within 48 hours post-operation, 2 flaps of them improved after local massage. One flap survived after local heparin wet packing and venous bloodletting. One flap survived after emergency surgical embolectomy and bridging with saphenous vein graft. One flap showed partial necrosis and healed after skin grafting. The other flaps survived well. One thousand three hundred and twenty-one patients were followed up for 3 months to 2 years, and flaps of them were satisfactory in shape, color, and elasticity, similar to that of normal skin. Some patients underwent scar revision later with good results. CONCLUSIONS: Application of suitable flaps in wound repair will result in quick wound healing, good function recovery, and satisfactory aesthetic effect.