Management of early complications of the electrical injury and repair of the injured hands.

OBJECTIVE: To explore the management of early complications and repair of hand injuries in electrically injured patients. METHODS: Forty-five patients with electrical injuries admitted during 1995 and 2001 were analyzed retrospectively in terms of the incidences of early complications and the deformity of the injured hands repaired using different approaches. RESULTS: In the order of incidence, the complications arising in the early stages after electrical injuries included electric shock, hypovolemic shock, cardiac dysfunction, hemorrhage of the digestive tract, pulmonary infection, massive bleeding of the wound and renal dysfunction. The incidence of deformity of the hands was 79%. CONCLUSION: Proper management of early complications and repair of the injured hands are of great importance in cases of electrical surgery.

[The antagonistic effect of recombinant human decorin on TGF-beta1 stimulation of fibroblasts in collagen lattices].

OBJECTIVE: To mimic contact pattern between decorin and TGF-beta1, in vivo, and investigate the antagonistic effect of recombinant human decorin on TGF-beta1 stimulation of hypertrophic scar fibroblasts in collagen lattices. METHODS: Fibroblasts populated collagen lattices (FPCL) model was adopted in the study, and they were divided into control group, decorin group [2mg/L recombinant human decorin (rh-decorin) was administered to FPCL], TGF-beta1 group (5 microg/LTGF-beta1 was administered to the culture medium), and TGF-beta1 + decorin group (2mg/L rh-decorin was administered to FPCL, then culture medium containing 5 microg/L TGF-beta1 was added into FPCL). Changes in PAI-1 and alpha-SMA protein expression in scar fibroblasts in collagen lattices were detected with Western blotting at 12 post-administration hour (PAH), 24 PAH, 48 PAH, and 72 PAH, and expressions of PAI-1 and alpha-SMA mRNA were concomitantly examined by RT-PCR. RESULTS: The contraction of FPCL at each time-point in control group was obviously attenuated compared with that in decorin group, but it was significantly intensified compared with that in TGF-beta1 group. The expression of PAI-1 and alpha-SMA mRNA and protein in TGF-beta1 group (3482 +/- 211, 4320 +/- 272, 0.89 +/- 0.15, 0.56 +/- 0. 11) were markedly increased than those in control group (1764 +/- 147, 1699 +/- 146, 0.29 +/- 0.06, 0.21 +/- 0.06, P < 0.01), while no obvious difference of them was found between control and other two groups. CONCLUSION: Stimulation of scar fibroblasts by TGF-beta1, can be suppressed when rh-decorin is blended into collagen lattices, indicating that decorin is effective in neutralizing TGF-beta1 in vitro. The pathogenesis of hypertrophic scar might be related to up-regulation of TGF-beta1 with the lack of decorin after cutaneous injury.