Abstract:

Severe post-traumatic deformities are defined as severe superficial organs defect, deformity and dysfunction that result from burn, traffic injury, industrial injury or blast injury. This kind of disease has two general characteristics: high incidence and grave harmfulness. In the field of plastic and reconstructive surgery which is the main subject for the restoration of post-traumatic deformities, the weaknesses and limitation of main reconstructive techniques at present is obvious: current treatments aim for recovery of defect, far from the reconstruction of function and appearance. This project has created new more effective treatments by means of the combination of molecular biology, stem cells technology and digital medicine with conventional plastic and reconstructive surgery techniques. The main progress is as follows: (1) Flap prefabrication is a frontier technique for treatment of severe posttraumatic deformities. However, insufficient neovascularization and subsequent necrosis remain difficult problems in applications of the technique. It is found that “therapeutic vasculogenesis” with stem cell transplantation is superior to “therapeutic angiogenesis” with vascular endothelial growth factor (VEGF) administration in improving revascularization during flap prefabrication in our research. The therapeutic vasculogenesis effect of somatic stem cells can be enhanced by VEGF gene transfection, which means a reduced quantity of stem cells would be needed for treatment after VEGF gene transfection. The further founding is that application of hypoxia-mimetic could promote the directional migration and homing of transplanted stem cells. (2) Series methods and revolution of superficial tissue and organ reconstruction with flap prefabrication and tissue expansion. (3) The 3-d digital dynamic mechanics analysis of soft tissue is accomplished. And 3-d digital simulation software has been applied in the treatment of 2-3 types of typical craniofacial deformities successfully. (4) Some treatment methods are established or improved such as facial nerve reconstruction by masseter-facial nerve coaptation, transposition of pedicled sternocleidomastoid muscle for repair of facial paralysis, etc. By the development and application of these new techniques and methods mentioned above, the therapeutic effects were well improved.

Key words: post-traumatic deformities, stem cell transplantation, soft tissue expansion, craniofacial deformities, facial paralysis