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Objective: To summarize the research progress of surgical technique and immunosuppressive regimen of abdominal wall vascularized composite allograft transplantation in animals and clinical practice., Methods: The literature on abdominal wall transplantation at home and abroad in recent years was extensively reviewed and analyzed., Results: This review includes animal and clinical studies. In animal studies, partial or total full-thickness abdominal wall transplantation models have been successfully established by researchers. Also, the use of thoracolumbar nerves has been described as an important method for functional reconstruction and prevention of long-term muscle atrophy in allogeneic abdominal wall transplantation. In clinical studies, researchers have utilized four revascularization techniques to perform abdominal wall transplantation, which has a high survival rate and a low incidence of complications., Conclusion: Abdominal wall allotransplantation is a critical reconstructive option for the difficulty closure of complex abdominal wall defects. Realizing the recanalization of the nerve in transplanted abdominal wall to the recipient is very important for the functional recovery of the allograft. The developments of similar research are beneficial for the progress of abdominal wall allotransplantation.

Hypertrophic scar is a common skin fibrosis disease. Currently, surgical resection, drug injection and radiotherapy were often used for treating it; however, limitations or adverse reactions still exist in these treatment. With the deepening understanding of immune response and related cytokines in the process of hypertrophic scar formation, the immunotherapy for hypertrophic scar is also gradually improved. Interleukin 10 (IL-10) is an important member of the leukocyte family, which has different expression in different cells and exerts an immunosuppressive effect mainly through regulating the activity of immune cells infiltrated in hypertrophic scar. However, in some cases, IL-10 also exhibits an immunostimulatory effect. Therefore, its role in the formation of hypertrophic scar is critical for developing and improving the immunotherapy for hypertrophic scar.

Objective: To investigate the feasibility of one-stage thinning of latissimus dorsi muscle, rectus abdominis muscle and gracilis flap in reconstruction of the hand and foot defects., Methods: From June 2009 to April 2015,24 free muscle flaps were thinned during transfer operation by removing their superficial muscle layers on the basis of their vessel pedicles running in the deep surface of flaps. The surface of the muscle flaps were covered by split-thickness skin grafts. There were 16 latissimus dorsi muscle flaps,4 gracilis flaps and 4 rectus abdominis muscle flaps. Flap size ranged from 6 cm × 4 cm to 20 cm × 12 cm. Thinned muscle flaps were used to resurface 7 hand defects and 17 foot defects., Results: All muscle flaps survived the thinning procedures without any circulation problems except for one case which suffered total flap necrosis due to venous thrombosis. Skins grafts on muscle flaps also took well. One patient experienced partial skin loss. Two patients underwent secondary debridement and thinning procedure for infection and bulkiness. During the 0.3-20 months follow-up, the contour of thinned muscle flaps matched well with the recipient areas. Reconstructed feet are able to wear regular shoes., Conclusions: Intraoperative immediate thinning of free muscle flaps can be safely accomplished during the primary reconstruction procedure. This procedure prevents the limitations of muscle flap bulkiness and may provide an alternative for surface coverage.

Objective: To investigate the angiogenesis in hypertropic scar tissue of rabbit ears at different periods and to explore a new method to prevent hyperplastic scar., Methods: Nineteen Japanese white rabbits (weigthing 2.0-2.5 kg) were made animal models of hypertropic scar of ear. At 10th, 30th, 60th and 90 days, after epithelization, the microvessel and microcirculation in hyperplastic scar of 8 rabbits were studied by microcirculation microscope and laser Doppler flowmetry. The other 11 rabbits' right or left ears were randomly chosen into experimental group and control group. At 10 days after epithelization, 40 microL of adenovirus extracellular protein with metalloprotease and thrombospondin 1 domains (Ad-METH1) was injected into tissue of scar along the perimeter of the scar in experimental group. The same volume of empty adenovirus was injected in control group. After 30 days of injection, the gross appearance of 10 rabbits' ears scar was recorded, the number of microvessel in scar was counted and HE stainning of scar tissue was performed in experimental and control groups. One additional rabbit was used to evaluate the mRNA and protein expression of METH1 by RT-PCR and Western blot after 3 days of injection., Results: The average number of microvessel at 10, 30, 60 and 90 days after epithelization was 42.37 +/- 3.89, 49.46 +/- 4.13, 33.12 +/- 4.34 and 13.24 +/- 2.31, respectively; the average value of microcirculatory perfusion at 10, 30, 60 and 90 days after epithetlization was (37.75 +/- 2.11), (59.87 +/- 6.46), (44.53 +/- 6.14) and (29.21 +/- 1.84) PU; the density of microvessels and perfusion of microcirculation in scar tissues during proliferative stage (from 10 to 60 days after epithelization) were markedly higher than that during mature period (90 days after epithelization, P < 0.05). At 10 to 30 days after epithelization, the histoligical features of scar showed early stage of proliferation and proliferative stage appearance; at 60 days after epithelization, it is still in proliferative stage, while some of scars were in mature phase; at 90 days after epithelization, the histoligical features of scar were mature period appearance. At 3 days after Ad-METH1 injection, METH1 gene was successfully expressed at both mRNA and protein levels in experimental group, but not in control group. At 30 days after injection, the gross appearance observation showed that scars in experimental group were flat and soft with the color close to normal, but scars in control group were obvious and hard. The number of microvessel of scar tissue was 12.38 +/- 2.56 in experimental group and 48.12 +/- 6.46 in control group, showing statistically significant difference between two groups (P < 0.01). In experimental group, HE staining shows that the density of microvessel and the number of fibroblasts were greatly decreased and collagen fibers arranged regularly. In control group, plenty of fibroblasts and abundant microvessels were observed. Thick and tight collagen fibers were seen in the outer layer of dermis with a irregular arrangement., Conclusion: The anti-angiogenesis by Ad-METH1 may have a promising application in the prevention of human hyperthropic scar.