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To contrive an effective method of repairing the scar in bilateral faciocervical region.Between April 2009 and February 2012, 9 patients with large scars on face and neck due to burn and scald were treated. There were 5 cases with face scars and 4 cervical scars. Their average age was 33 years (range: 23-48 years). The disease duration was 6 months to 20 years (mean: 6.5 years). The scar area was 12 cm × 7 cm to 22 cm × 26 cm. The soft tissue expanders (600-800 ml in volume) were implanted in delto-pectoral zone in one-stage operation. In two-stage operation, after the resection of cervical scars, the defects were repaired with delto-pectoral perforator flaps. In 5 facial scar cases, skin flap pedicle division was performed at Week 3. After the resection of scars, all wounds were repaired by expansion flap. The donor sites were sutured directly. The area of removed scar and the status of flap blood supply were observed. And the texture of flaps and patient satisfaction score were followed up for 6-30 months.Mild congestion of flap occurred postoperatively 1 case. The other flaps survived successfully. The flaps of 2 cases appeared bulky after transposition and flap repair was performed at Month 6. The appearance, texture, and color of flaps were similar to those at the donor sites. And there was an excellent match of flaps and recipient place.The patient satisfaction score was 7.6 ± 2.3. All achieved satisfactory functional and aesthetic outcomes.The method has many advantages and its clinical application is both safe and effective.

To evaluate the clinical efficacy of intralesional excision and immediate postoperative adjuvant radiotherapy in the treatment of keloids.Eighty-one patients with a combined total of 86 keloids were treated with 6 MeV electron beam radiotherapy after surgical intralesional excision of keloids. All received a total dose of 15 - 20 Gy for 5 consecutive days beginning the day of surgery. The time interval between keloid excision and the delivery of first fraction of radiotherapy was6 h. The post-operative follow-up period was 12 - 31 months.Forty-three cases yielded excellent outcomes and there were 18 fair cases. The overall effective rate was 85.9%. There were 10 recurrent cases. Only adverse effects such as delayed wound-healing and telangiectasias (11.3%) were found. Neither severe complications nor secondary malignancies occurred.Intralesional excision of keloid and postoperative electron radiotherapy are well-tolerated and efficacious in the prevention of keloid recurrence.

To investigate the effect of thin split-thickness skin, inter-mediate thickness skin and full-thickness skin autograft on the differentiation of fibroblasts into myofibroblasts in rats after deep partial thickness burn.A total of 40 SD rats were divided randomly into two groups (Group AGroup B, n = 20 each). In Group A, tissue samples were collected at Day 2 after skin-grafting while Day 7 in Group B. In each group, every rat was scalded to cause deep partial thickness wound with an area of 10% of total body surface. The wounds received eschar shaving instantly coupled with skin-autograft, covering with thin split-thickness skin, inter-mediate thickness skin and full-thickness skin respectively. Meanwhile the control wound on the same rat was scalded only. Then the expression of α-SMA was detected by immunohistochemistry in each wound. And the numbers of myofibroblasts (α-SMA positive cells) and fibroblasts (negative cells) were counted to calculate the conversion ratio of myofibroblasts.In Group A, the conversion ratios of myofibroblasts of control, thin split-thickness skin autograft, inter-mediate thickness skin and full-thickness skin groups were (76.3 ± 3.3)%, (69.8 ± 1.6)%, (57.5 ± 1.6)% and (44.7 ± 1.7)% respectively. In Group B, the ratios were (72.9 ± 6.1)%, (63.6 ± 4.7)%, (50.2 ± 1.6)% and (32.3 ± 1.2)% respectively. The ratio was higher in control group than that in any other one (P0.01). There was statistic difference between thin split-thickness skin, inter-mediate thickness skin and full-thickness skin autograft groups (P0.05).A direct association may exist between the conversion ratio of myofibroblasts and the application of skin-grafting in rats after deep partial thickness scalding. It is probably related with varying degrees of scar contracture in the long-term.