目录

The Experimental Morphological Study on Microcirculatory Vascular Tree of Skin (6)

(Abstract)

Bat Shuting Sun Yunfeng Li Ji

(Chinese Medical University)

Under optical microscope and scanning electron microscope, the characteristics of the three I I dimensional architecture and the sPacial distributive regularity of the microcirculatory vessels of the scrotum skin flap were studied in detail by observation , of the tissue slices of the flaps which were intravascUlarly injected with Indian ink.

The morphological characteristics of the 5 grades of the vascular networks of the external spermatic fascia, the dartos, the reticular layer of the dermis, the subpapillary layers and the papillary layers were also studied.

The morphological features of vascular networks of the accessory cutaneous structure such as the sweat glands, sebaceous glands, hair follicles and the corpuscula lamellosa were also observed.

The special regularity of the vascular architecture of the scrotum skin flap was illustrated.

The purpose of this paper is to offer the basic research data for the application of the scrotum skin flap and for furnishing the new evidences to the theory of the microcirculatory vascular tree of skin.

Control of the Growth of Fiborblast

(Abstract)

Xi Sichuan

(Cardiovascular Institute and Fuwai Hosplital, Chinese Academy of Medical Sciences)

Reports about the structure of fibroblast and the control of the growth of fibroblast can be easily found in various scientific magazines. Now, more and more molecular bioloqy techniques have been applied to the research of signal transduction among cells. This review comes from the latest reports about the fibroblast.

Dynamic Observation and Clinical Analysis of Blood

Viscosity of Burn Patients

(Abstract)

Zhang Xiangqing Chang Jian Zhao Changshan

Wang Qingli Xi Yonghuai Don Nuting

(No. 139 Hospital PLA, North Shandong Burn Centre)

Dynamic observa.tion of 8 indices regarding blood viscosity of 41 patients were made. The results revealed that the larger the burn area, the more significant the change in blood viscosity. At the early stage of burn, blood viscosity and hematocrit increased significantly, electrophoresis time of erythrocyte markedly prolonged, while erythrocyte sedimentation rate and K value of blood sedimentation equation decreased. After that, blood viscosity turned to normal in about 7 days after burn, electrophoresis time of erythrocyte turned to normal in 14 days after burn, hematocrit lowered down continuously and erythrocyte sedimentation rate and K value of blood sedimentation equation increased continuously.

The author6 suggested that the main causes of the increase in blood viscosity of burn patients include plasma effusion, blood concentration, microcirculation disturbance and decrease in the velocity of blood flow. Drastic increase in hematocrit and decrease in blood sedimentation rate, at the early stage, indicate the seventy of the disease and are the signs of danger, while at the later stage, continuous decrease in hematocrit and increase in blood sedimentation rate indicate hemolysis and anemia of the patients. The authors concluded that acute burn at the early stage is not an indication of whole blood trans fusion. Large dose fluid infusion, as an anti-shock measure should include mainly crystalloid fluid. Colloidals should be used with careful consideration after weighing the pros and cons.

Clinical Significance of Changes in Urine PH Value

After Serious Burn

(Abstract)

(Dept. of Burns and Plastic Surgery,The First Hospital of Mudanjiang, Heilongjiang Province)

This paper analyzes the relationships between changes in urine pH value after burn and total input fluid volume, sodium bicarbonate input volume and repercussive time of tissue swelling, injury condition and resuscitation time of 20 cases of serious burn. The results suggested that after serious burn and through fluid resuscitation, early stage aciduria changed into continuous alkaline urine accompanied with increase in urine volume. This is a reliable clinical index to determine the recovery of edematous fluid. It has important significance in the judgement of the recovery stage of edematous fluid to avoid disturbance of internal environment and to prevent septicemia in the early stage.

Clinical Research on Medium Molecular Weight Dextran for Blood Volume Expansion in Treating Burn Shock --Rational Dosage of Medium Molecular Weight Dextran

(Abstract)

Wang Dechang, et al.

(Dept. of Burn Plastic Surgery, Sbandong Provincial Hospital)

Medium molecular weight dextran has been widely used for blood volume expansion in treating burn shock, but its dosage is not yet standardized. The authors, according to their clinical experience in the application of dextran for more than 10 years, Suggested a rational dosage. Using this dose, blood volume expansion for anti -- shock purpose can be achieved add the edematous fluid of the patient can be recovered.

The authors treated 142 cases of exceptionally severe burns and analyzed the clinical data of 83 cases and concluded that for adults, the rational dose of medium molecular weight dextran is no mote than l, 500 ml in 48 hours, and for children, no more than 100 ml for each year of age. Colloidal supply should be performed at early stage. The ratio of colloidal supply of the first 24 hours to the second 24 hours should be 2: 1.

Clinical Analysis of 100 Cases of Burn Treated with MEBT

(Abstract)

Fang Tlyi Song Jinliang

(Langshan County Hospital, Shandong Province)

From May 1989 to December 1991, we treated 238 cases of burn using MEBT. The results were very satisfactory. For comparison, 200 patients were divided into 2 groups, 100 in each. Patients in one group were treated with MEBT and those in the other group treated with conventional dry therapy. The difference of the results between the two groups was yely significant, which included the rate of wound infection (P<0.01), the rate of skin grafting (P < 0. 01), the rate of application of analgesics (P < 0. 01), the rate of healing of scar tissue (P<0.01),the rate of trans fusion (P<0. 01) and th.6 rate of using antibiotics (P<0. 01), etc. MEBT gave much better results than the conventional therapy.

The Mechanism of Healing Promoting Action of MEBO on Residual Burn Wounds

(Abstract)

Chang Jian Zhang Xlangqing

(North Shandong Burn Centre, No. 139 HosDltal, PLA)

18 patients were burned to form 58 burn wounds. Among which 38 wounds were treated with MEBO and at the same, 20 burn wounds were bleated with conventional therapy as an auto--control, All the 38 wounds treated with MEBO healed with an average healing time of 8.6+3. 2 days. As compared with the result of conventional therapy, MEBO raised the healing rate by 35% and shortened the healing time . by 6 days. The authors suggested that the mechanism of the healing promoting action of MEBO is that it forms a spontaneous circulation of fluid on the wound surface and creates an adequate drainage. The condition of the wound surface is improved, so that, bacterial infection is prevented, microcirculation is improved and wound tissue immunity is enhanced. As a result, it provides an environment fsvorable to the regeneration of the surviving epithelial cells at the wound edge and woUnd surface and promotes the repair of wound tissue.

MEBO for Treating Cornea Burn of Both Eyes

(Abstract)

Liu Jingwen Yu Chunren Wang Mei

(Hospital of Burns, Wounds and Ulcers , Petrochemical Bureau, Jiamusi City, Heilongjiang Province)

It is a traditional idea that the Znd and the 3rd layers of the cornea can not regenerate after injured and the connective tissue will proliferate to form permanent scar such as coeneal nebula and leukoma, etc. Serious cornea burn often results in coagulation necrosis. After exfoliation of the necrotic tissue, ulcer or perforation will occur. Finally, scar -- pterygium, leukoma adhaerens or staphyloma will happen. The patients may lose their eyesight or have their eyeball atropnied.

The authors used MEBO and MEBT for treating 2 cases of cornea burn caused by electric spark. The results were marvelous. Both patients had their eyesight recovered and their cornea clearly discernible. The authors made a comparioson between the efficacy of conventional therapy and MEBO and discussed the mechanism of the therapeutic action of MEBO.

An Approach to the Recovery of the Function of Burned Hands

(Abstract)

Zhao Ruiqing Jia Shenbin

(The 2nd People's Hospital, Taiyuan City)

The authors treated 136 burn hands involving 216 fingers using MEBT. The patients were advised topractise diirgation exercise at the early stage under the direction of the doctor. If the patients were poor in activities, they were treated in conjunction with massage, immersion bath and grip exercise to prevent disablement of hand joints. The authors suggested that 2 weeks after injury is the critical moment for starting the exercise for the preservation of the function of intercarpal, carpometacarpal metacarpophalangeal and interphalangeal joints. The method of practising the exercise is described in detail. The curative rate was 80% and total effectivi rate 98. 5%. A discussion was made on the attentiol points in the treatment.

Moist Exposed Burn Therapy for Treating Burn Children

(A Report of 20 Cases)

(Abstract)

Huang Deyan Hua Yunliang Hong Xiaoyu

(Chinese Traditional Medicine Hospital, Wuxi City, Jlangsu Province)

Burn children are more difficult to cure because of their anatomical and physiological characteristics. This paper introduces the experience and therapeutic result in treating burn children with moist exposed therapy. The authors point out the difficulties in treating third degree burns. Using MEBO and mois. exposed therapy in burn children, the results Were very satisfsctory. At the same time, the authors also stress the importance of general syst.6mic treatment.

Experience in Treating Pediatric Burn Complicated by Acute Appendicitis

(Abstract)

Zhu Xiaoyuan

(Hospital of Integrated Chinese and Western Medicine, Nancbang City, Jiangxi Province)

6 children below 3 years of age, were burned to a medium and small area and complicated by acute appendicitis. Analysis of the clinical data revealed that the complication was due to improper management of the wounds. Pyocyanic infection and septicemia were the direct causes of appendicitis. A discussion was made on the manifestation of the complication, surgical treatment, control of pyocyanic infection and burn wound management after operation. The author concluded that early application of MEBT is the main measure to prevent bacterial infection and appendicitis.

The Treatment of Bromine Burn Associated with Acute intoxication

(Abstract)

Sun Dongxing Liu Zaixiang

(Dept. of Burns, The Third Hospital of Xuzhou City)

Bromine, which belings to the halogen group,causes burn when it contacts the skin. Published reports on bromine burn associated with acute intoxication are few. In this article, we analyze the treatment of 4 cases of bromine burn, in which 2 cases were associated with acute intoxication and try to state the clinical characteristics of bromine burn and related lesions of the body when associated with acute intoxication. The authors used MEBO to treat bromine burn and made a research on the treatment when bromine burn is associated with acute intoxication.

A Comparison of Burn Patient Body Temperature in the

Course of Treatment Using MEBT and Bandaging Method

(Abstract)

Jia Kaide

(Dept. of Surgery, The First People's Hospital, Datong . City, Shanxi Province)

40 cases of burn were treated either with MEBT or bandaging method. Their body temperature was carefully observed and recorded. The results proved that MEBT is superior to bandaging method in this respect.

Plastic Surgical Treatment of Radiation Ulcer

A Report of 5 Cases

(Abstract)

Deng Fumin

(Dept. of Burn Plastic Surgery, Affiliated Hospital of Qingdao Medical College)

5 cases of radiation ulcer caused by radiotherapy were treated using transposition of skin flaps. All the flaps survived at primary repair after removing the scar and ulcer.

The author made a discussion on the mechanism of the formation of the ulcer, its clinical characteristics and the attention points of its treatment.

Experience with MEBO in Treating Skin Defects

(Abstract)

Sun Backal Qiu Shouyi

(Dept. of Surgery, People's Hospital, Wudi County, . Shandong Provinve)

According to the theory of MEBT, the authors used MEBO for treating 68 cases of skin and soft tissue defects, caused by trauma. The results were very satisfactory. Patients with small area skin defect healed in 10 to 20 days. Patients with large area and deep defect and complicated by infection healed in 15 to 21 days. The average healing time was 14 days. None of them had dysfunctions due to scar formation.

The authors made a discussion on the theory of the application of MEBT for treating traumatic skin and soft tissue defects.

The Efficacy of MEBO for Treating 572 Cases if Hand and Foot Chaps

(Abstract)

Han Quanfu Xu Shu

(Hospital for Staff and Workers, Jingmen Organic Chemical Factory .and institute of Plastic Surgery, Jingmen City)

572 cases of hand and foot chaps were treated with MEBO. The results were very satisfactory, with a healing rate of 40.2%, markedly effective rate 75% and total effective rate 94.7%.

The authors concluded that MEBO has blood citculation prompting, stasis removing, analgesic, anti -- inflammatory, microcirculation improving and vasculodilating effects. It promotes the regenerationof the epithelial tissue.

Nursing Experience with MEBO in Treating Burns Nursing Experience with MEBO in Treating Burns

(Abstract)

Don Nuting Sun Yanhong

(No. 139 Hospital. FLA)

MEBT is a new technique. Nursing experience for MEBT is lacking. This paper summarizes the nursing experience with MEBO in treating 98 cases of burn. The experience fits in with the practice. It includes the nursing for patients lying on beds with turnover device and for those lying on beds without turnover device and the method for bandaging of the wounds. The authors suggested that as the technique for burn treatment is developing, the nursing work in MEBO treatment is facing new challenges. It is the responsibility of the nursing workers to make effort to raise the level of nursing work and to perfect the technique of MEBO treatment.

Nursing Experience with MEBT in Treating Perineum and Buttock Burns of Children

(Abstract)

Meng Chongllan Li Fengchun

(The 4th Dept.of Surgery, No. 322 Hospital, PLA)

89 cases of podiatric peineum and buttock burns were treated with MEBT. This paper summarizes the nursing experience in the treatment. In addition to careful routine nursing work, the authors suggested special attention points in the nursing work of special burn areas such as perineum, etc. These suggestions are very practical and have great clinical significance. The authors also suggested the pharmacological effect of MEBO andconcluded that MEBT is ideal for treating podiatric burns.

Early Division of Distal Pedicle Animal Experiment and Clinical Observation

(Abstract)

Jing Xingwei

(Dept. of Burns, The Second Hospital of Shaoxing, Zhejiang Province)

Distal pedicle flap has its advantages for repairing functional site, local deep tissue damage, because of its simplicity in technique, good flexibility and wearability and cheapness in cost. It is suitable to be used in grass--root medical units. It was generally recognized that pedicle division should be done about 3 weeks after operation and should spend a few days to exercise blocking of blood circulation in the pedicle before it is divided. This is at complex, time consuming and painful procedure. The author made an experiment on rabbits, using 17 pieces of pedicle flaps and the pedicles were divided on the 5th, 6th, 7th, 8th, 9th, 10th and llth day after operation respectively. Through flap temperature determination, tissue sections and chromoscopic examination, it was proved that it is feasible to divide the pedicle on the 6th day after operation. Although the skin structure and healing process differ very greatly between man and rabbit, the result of the experiment is still of value as a reference for clinicians.

The author also performed clinical practice using 28 pieces of pedicle flaps in 47 repairing sites. The flaps were exposed to infrared radiation. Vasculodilator was usedand the operation procedure was improved. The average time for pedicle division f was shortened to be 8 days after operation. The pedicle division was carried out in two groups. The first group had 13 flaps. Blood supply to the pedicles was cut down and observations were made to ensure everything of the flaps was normal before the pedicles were divided. The other group had 15 flaps. The pedicles were divided directly without blocking blood' circulation. Both groups gave the same results. All the 28 flaps survived.

The Human Scar: The Dialectics of the Structure and Function Category

(Abstract)

Tang Shaoming

(Research Dept. of Plastic Surgery, Zhanjlang Medical College)

This is a study of the dialectics of the structure and function category in the human scar. The injury and antiinjury contradiction movement of the body exists in the individual, organ, tissue, cell and molecule levels. On the one hand, the human scar is a necessary and essential product of wound healing. It helps to recover the continuity and protection function of the skin. On the other hand, patients with scar have functional obstacle, appearance effects and psychological pressure. Besides contradiction 1 movement, the author also describes clinical types and attention points of prevention and treatment of the; scars.

The Characteristics of Blood Supply in Cervico --Shoulder--Humeral SVN Flap.

(Abstract)

Chen Bohua Si Tupu Xu Dachuan Zhong Shizhen

(Dept. of Plastic Surgery, Zhujiang Hospital, The First Military Medical University, Guangzhou)

Subdermal vascular network skin flap (SVN flap) . has widely been applied to repair the skin defects on burns and plastics in recent years. Clinical results demonstrated, the greatest length to breadth ratio of "supra -- thin flap" can reach 7: 1. The flap can be designed as irregular shape according to the requirement of the recipient site. The time of pedicle division can be advanced to one week from three weeks in the traditional flap. After healing, the flap's contour is beautiful without sulkyness. It is very suitable for repariing the skin defects of face, neck and extremities on burns and wounds and gets a high; aesthetic Value. Having micro,dissected in 10 fresh 1 cadavers perfused Latex well in artery, We found the blood supply of cervico--shoulder --burneral SVN flap; not only came from the pedicle by means of subdermal vascular network layer anastomosed heavy, but also from the early revascularization between the subdermal vascular network plane and the recipient site, so SVN flap owned two vascular systems without ischemic time. Because of great blood flow, its viability was high.