| The skin flap is a compound tissue mass with blood supply of its own, including skin and subcutaneous tissue or the deeper level of tissue. The skin flap transplantation is one of the most generally used reparative and reconstructive methods in the plastic surgery. Flap has many levels of tissue and very much tissue, when especially excessive subcutaneous adipose, the flap thickness is too big, so that the shape of some reconstructed organ may appear too bulky and swollen, and the operative result is affected and unsatisfied. So as the function. The abdominal skin flap is commonly used to reconstruct penis. Most of the patients have considerable fat tissue in the belly wall. The flap elevated is thick and the shape of reconstructed penis may seem to be unbearably big and swollen. Using the super thin skin flap technique may decrease flap thickness. It is only the middle-distant part of flap that can be removed a slice of subcutaneous fat. If the scope of flap cut down is too abroad, the flap vessel would be damaged, and the flap blood carries may be influenced, and the terminal of penis would become necrosis. Therefore, it has been become a new clinical lesson to look for a method of reducing the subcutaneous fat tissue and not hurting the vessel. The toxicity and side-effect of improved TNF-α , rh-TNFα - D3 a obviously decreases, and has been into the clinician practice phase. This dose of 2× 106IU/kg. m2 d is the result of the phase I clinical trial and is its tolerable safe dose for human.Tumor necrosis factor alpha (TNF-α) , an other name Cachectin, is a multifunctional cytokine, can not only cause tumor cell necrosis but also affect energy and fat metabolism, and play a important play in mediating the growth of the adipose. TNF-α can increase catabolic metabolism and inhibit anaerobic metabolism, promote liposis, induce delipitation of the mature fat cells, and induce apoptosis of adipocyte and preadipocyte.Through a series of experiment studies, we attempt to research for the change of weight loss and the subcutaneous adipose in the treated rat, and the pathological changes of subcutaneous adipose and vessel, and thechange of survival length of skin tube in the treated rat, and the possibility of TNF-α used to decrease the thickness of flap in clinical phalloplasty.We chose rats as our experimental model and carried experiments as follows: (1) Adult rats were injected intraperitoneally with rh-TNF-α 3a (2× 106IU/kg. m2. d) in the treated rats. In the control subjects we treat with physiological brine. We weighed the rats once every week, and the changes of the rat' s body weight were observed. (2) We excised example every week end in the special place, and measured the thickness of the example and observed the changes of thickness. (3) The macroscopic and histological changes of the subcutaneous adipose and vessel. (4)We designed skin flap of 6cm×2cm in the back of rat and sutured to make a skin tube to mimic the penis reconstruction by skin tube, and observed the length changes of the survival skin tubes.Results were gained as followed: (1) the weight loss of the treated rats decreased continuously in a dose- and time-dependent manner, so as the fat tissue. The subcutaneous adipose decreased markedly by the end of 6 weeks. (2) There were no thrombosis and vessel closing up in the subcutaneous blood vessel in treated rat. The subcutaneous blood vessel did not see to be harmed obviously. (3) The live length of the skin tube suffered a certain influence and were shorter than the control rats by about 20 percent.Our study confirms that TNF- α plays an important role in the energy and lipid metabolism. It can mediate and control growth of fat tissue, inhibit fat tissue excessive developing, and does not obviously harmful to subcutaneous vessel. The suvival length of skin tube in the TNF α-treated rats was 80% as much as that of the control subjects. TNF-α may be used to reduce reasonably subcutaneous fat tissue and not to damage subcutaneous vessel. Whether may apply TNF-α...
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