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Background: The septal extension graft (SEG) has become the preferred augmentation rhinoplasty technique in Asia for its superiority in correcting tip projection and rotation.Objectives: The author sought to build a rabbit model for SEG surgery and compared the postoperative stability of the tip support between the bilateral batten costal and conchal cartilage extension grafts at the nasal tip.Methods: Twenty rabbits underwent SEG surgery with either bilateral batten costal cartilage graft (Group A) or bilateral batten conchal cartilage graft (Group B). Serial photographs were obtained to evaluate the change of the nasal tip shape and graft shape. The observed indices include tip projection, tip angle, shape of extension graft, and histological features of the extension graft.Results: Twelve weeks after the operation, one costal extension graft in group A (1/10) and three conchal extension grafts in group B (3/10) were reabsorbed. The costal cartilage graft showed better exterior results than conchal cartilage graft in terms of tip projection and angle relapse rate (13.01% vs. 25.02% and 15.18% vs. 28.73%, p < 0.05). The costal cartilage graft maintains its structure more than the conchal cartilage graft. A greater degree of calcification and more fibrous capsules around the extension graft were found in Group A.Conclusions: A rhinoplasty rabbit model was established to compare costal and conchal autologous cartilages for SEG. Additionally, this model may serve as a training tool for rhinoplasty surgeons. The costal cartilage extension graft is more reliable in terms of stability and may be paid more attention. [ABSTRACT FROM AUTHOR]

Skin grafting is an important method of wound repair and reconstruction. Skin grafting can be classified using multiple classification criteria. We often perform full‐thickness skin grafting (FTSG) for small wound areas; however, the traditional FTSG technique frequently causes postoperative scar depression at the donor site, especially in the abdomen. This study aimed to determine whether preserving the subcutaneous fat when performing FTSG can improve donor site prognosis. We reviewed 25 patients who underwent autologous FTSG in the last 3 years. Among them, subcutaneous fat was preserved in 11 patients (experimental group), whereas it was not preserved in 14 patients (control group). Using a 3D camera and the Patient and Observer Scar Assessment Scale (POSAS), we evaluated the donor site postoperatively. According to POSAS, vascularization was significantly more severe in the experimental group. The Antera 3D camera revealed more severe scar depression at the donor site in the control group. The processing time for graft take, subcutaneous fat trimming and donor site closure was less in the experimental group than in the control group. Preserving subcutaneous fat at the donor site improved patient outcomes by reducing donor site depression after FTSG. [ABSTRACT FROM AUTHOR]

Although the incidence of scalp avulsion has decreased in recent years, it remains a major concern among plastic surgeons. We therefore aimed to introduce an improved free flap technique for repairing scalp avulsion with less tissue from the donor site. This method can achieve maximum primary closure of the donor site and improve its appearance and function as well as reduce the donor-site morbidity by ensuring that a smaller free flap can completely cover the scalp defect. Eight patients with scalp avulsion who had undergone staggered placement of the free flaps were evaluated. Data on the age, cause of scalp avulsion, scalp defect size, degree of avulsion, postoperative complications, and follow-up duration were analyzed. The postoperative evaluation criteria were donor-site sensation, latissimus dorsi muscle strength, upper extremity function, and quality of life. Patients' mean age was 38.7 years. The main cause of scalp avulsion was occupation-related accidents. The mean scalp defect size and postoperative follow-up duration were 26 cm × 20.4 cm and 41.5 months, respectively. One patient developed flap congestion postoperatively. The wounds at the recipient site healed well in all patients. There was no significant difference in the sensation between the surgical and nonsurgical sides. However, the latissimus dorsi muscle strength significantly differed between both sides. The mental component score, which was used to assess quality of life, did not significantly differ between the patients and healthy population, whereas the physical component score significantly differed between the two groups. None of the included patients had severe upper extremity functional limitation. Staggered placement of free flaps achieved maximum primary closure of the donor site and greater scalp avulsion defect coverage with less tissue excised from the donor site. Importantly, donor-site appearance improved and some donor-site functions were preserved postoperatively. [ABSTRACT FROM AUTHOR]

The pathogenesis of hypertrophic scar (HS) is still poorly understood. Macrophages, especially the polarisation of that to M1 or M2, play a pivotal role in control of the degree of scar formation. Profiling of macrophage phenotypes in human specimens during long‐term period of wound healing and HS formation may provide valuable clinical evidence for understanding the pathology of human scars. Human wound and HS specimens were collected, the macrophage phenotype was identified by immunofluorescence, and biomarkers and cytokines associated with M1 and M2 macrophages were detected by RT‐PCR. The correlation between the macrophage phenotype and HS characteristics was analysed by linear regression analyses. We found excessive and persistent infiltration by M1 macrophages around the blood vessels in the superficial layer of the dermis at early wound tissues, whereas M2 macrophages predominated in later wound tissues and the proliferative phase of HS and were scattered throughout the dermis. The density of M1 macrophages was positively correlated with mRNA expression levels of tumour necrosis factor‐alpha (TNF‐α) and IL‐6. The density of M2 macrophages was positively correlated with ARG1 and negatively correlated with the duration of HS. The sequential infiltration by M1 macrophage and M2 macrophages in human wound and HS tissues was confirmed. [ABSTRACT FROM AUTHOR]