Acne Scars

BJU Int. 2009 Apr 4; Haber GP, Brethauer S, Crouzet S, Berger A, Gatmaitan P, Kamoi K, Gill IOBJECTIVES To determine the technical feasibility and reproducibility of pure natural orifice transluminal endoscopic surgery (NOTES) transvaginal nephrectomy using NOTES-specific instrumentation, with no transabdominal assistance. MATERIALS AND METHODS Five female farm pigs (mean weight 45 kg) had a right NOTES nephrectomy, using a single-channel gastroscope in the first three pigs and a dual-channel gastroscope in the remaining two. The peritoneal cavity was accessed through the posterior fornix of the vagina. Dissection was started at the lower pole of the kidney, and the ureter was retracted laterally and followed towards the hilum. An XL articulated 60 cm endo-GIA stapler (US Surgical, Norwalk, CO, USA), inserted transvaginally via a separate vaginal incision, was used for tissue retraction and renal hilar transection. The kidney was freed, entrapped in an impermeable sac, and extracted intact transvaginally. RESULTS All five procedures were successful with no addition of a transabdominal laparoscopic port or open conversion. The total operative duration decreased from 200 min in the first pig to 60 min in the last (mean 113 min); the mean blood loss was

Br J Surg. 2009 May 11; 96(6): 613-620Potter S, Thomson HJ, Greenwood RJ, Hopwood P, Winters ZEBACKGROUND:: Health-related quality of life (HRQL) is an important outcome following breast reconstruction. This study evaluated current methods of HRQL assessment in patients undergoing latissimus dorsi breast reconstruction, hypothesizing that early surgical morbidity would be reflected by poorer HRQL scores. METHODS:: Patients completed the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and breast module (QLQ-BR23), the Functional Assessment of Cancer Therapy (FACT) general measure, and breast module and arm subscale (FACT-B + 4), and the Body Image Scale and Hospital Anxiety and Depression Scale (HADS) 3 months after surgery. They also reported additional HRQL problems not included in the questionnaires. HRQL scores were compared between patients with and without early surgical morbidity. RESULTS:: Sixty women completed the questionnaires, of whom 25 (42 per cent) experienced complications. All EORTC and FACT subscale and HADS scores were similar in patients with or without morbidity. Women with complications were twice as likely to report feeling less feminine and dissatisfied with the appearance of their scar than those without problems. Thirty-two women (53 per cent) complained of problems not covered by the questionnaires, most commonly donor-site morbidity. CONCLUSION:: Existing HRQL instruments are not sufficiently sensitive to detect clinically relevant problems following breast reconstruction. Copyright (c) 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

J Cutan Med Surg. 2009 May-Jun; 13(3): 129-33Ju-Lin X, Shao-Hai Q, Tian-Zeng L, Chao-Quan L, Hou-Dong L, Ying-Bin X, Xu-Sheng L, Bin S, Hui-Zhen L, Yong HBACKGROUND:It has been demonstrated that hypertrophic scar fibroblasts (HSFs) overexpress collagen messenger ribonucleic acid (mRNA) and protein, especially alpha1 collagen. Antisense nucleic acids are effective in inhibiting harmful or uncontrolled gene expression, suggesting that antisense ribonucleic acid (RNA) can effectively downregulate the expression of alpha1 collagen gene and attenuate the scars.AIMS:This study was conducted to observe the effect of recombinant plasmid pREP9-COL1 on alpha1 collagen expression in HSFs and clarify the prospect of antisense RNA on scar treatment.METHODS:The alpha1 collagen gene fragment including the region of 5' UTR to exon (229 bp) was cloned in the eukaryotic expression plasmid pREP9 in the antisense orientation relative to the RSV-LTR promoter to reconstruct the pREP9- COL1 plasmid. Then it was transferred into HSFs through lipofectamine. The expression of alpha1 collagen was examined by immunostaining, reverse-transcriptase polymerase chain reaction, and Western blots.RESULTS:The recombinant plasmid pREP9-COL1 with a correct sequence was constructed successfully; pREP9-COL1 consistently inhibited human alpha1 collagen gene expression at both mRNA and protein levels.CONCLUSIONS:Antisense RNA was effective in downregulating alpha1 collagen expression of HSFs. Therefore, this approach offered a prospect of scar treatment by attenuation of alpha1 collagen production with antisense RNA.

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2009 Apr; 23(4): 448-50Tang Y, Zhou C, Li Y, Li Q, Li F, Zhao M, Yang ZOBJECTIVE: To investigate the surgical procedures and outcomes of repairing the wound in the posterior wall of vaginal orifice by labium minus flap transfer, when vagina tightening plastic surgery is performed on the patient with scar in the posterior wall of vaginal orifice and labium minus hypertrophy. METHODS: From May 2007 to May 2008, 10 patients suffering from postpartum vaginal relaxation combined with scar in the posterior wall of vaginal orifice and labium minus hypertrophy were treated. The patients aged 28-40 years old and the width of their labium minus was 3-5 cm. Six of them had coitus pain. Vaginal tightening surgery was performed, meanwhile the hypertrophic labium minus was prepared into the anterior-pedicle labium minus flap (4 cm x 1 cm - 5 cm x 1 cm) and the posterior-pedicle labium minus flap (3 cm x 2 cm - 4 cm x 3 cm), respectively. The posterior-pedicle labium minus flap was transferred inwards by 90 degrees to repair the wound caused by the resection of the scar, and the anterior-pedicle labium minus flap was sutured in situ to form the new labium minus. RESULTS: All the posterior-pedicle labium minus flaps survived, except for 3 cases in which the epidermis 1 cm around the distal end of posterior-pedicle labium minus flap was exfoliated and recovered 2 weeks after hip bath with potassium permanganate solution (1:5000). All the anterior-pedicle labium minus flaps survived, and all the incisions healed by first intention. Over the follow-up period of 2-8 months, all the patients were satisfied with their vulva configuration, good elasticity of vaginal orifice and no tenderness pain of vaginal orifice. The sensitivities to feeling, such as touch and pain, of the transferred labium minus flap were similar to the normal labium minus. Postoperatively, the coitus pain disappeared, 7 cases had much better sex life and 3 cases had no significant improvement in sex life. CONCLUSION: Transferring labium minus flap to vaginal orifice is an effective way to improve the coital pain resulted from the scar of vaginal orifice.