Study Of Microvascular Structure In The Scar Of Lip After The Surgical Repair The Cleft Lip: Density Of Microvessels And The Pattern Of Angiogenesis

Subject: To study the density of microvessels and the pattern of angiogenesis between hypertrophic and normal scar of lip after the surgical repair the cleft lip, to explore the differences between the scar in lip and the scar in other parts of body, to provide references for early diagnosis of hypertrophic scars and the early prevention of the scar in postoperative of upper lip.Method: This study selected patients with unilateral complete cleft lip in the phase Ⅱreconstructive surgery in Qingdao Hiser medical group oral and maxillofacial surgery clinic from October 2012 to September 2014.We collected the scar of lip 31 cases in total.According to the clinical manifestations to classify the scar and with hematoxylin-eosin(HE) staining, we observed the result of the dyeing and on the basis of histologic expression after HE staining to correct and unified the clinical group. Hypertrophic scars(n=11)and normal scars(n=20)were collected, they were immunostained with anti-CD34 antibody. The structure of scar was observed and the photo was taken in 200 times, the area of each photo is 0.7704mm2.Microvessels were counted and microvessel density was calculated according to the CD34 expression with the function“threshold”of Image J software. Using Image J software, the length of the major and minor axes were measured, and the major: minor axes ratio was calculated. The pattern of angiogenesis was described and analyzed according to the above data. The data between two groups was statistical analyzed by SPSS 17.0 software.Result: By statistical analysis of the capillary density, the distribution of angiogenesis in hypertrophic scars is uneven, which is significantly increased and confluent locally. There is capillary plexus under the cuticle and there is little of capillary and no vascular endothelial cells in the collagen of dermal of normal scars. We clarified that there were more capillaries in hypertrophic scars than that in normal scars(p<0.01). In the pattern of angiogenesis, the large number of irregular lumen and vascular endothelial cells are observed in the hypertrophic scars, the branch of capillary is few and the lumen is uniform in the normal scars. The length of the major and the minor axes were measured, the major:minor axis ratio was calculated. The length of the major and minor axes of hypertrophic scars were longer than the normal scars(p<0.05).The major: minor axes ratio of hypertrophic scars were longer than the normal scars(p<0.01).Conclusion: There are significant increase in the density of microvessels and the variation in the pattern and morphology of angiogenesis in the hypertrophic scars. They are related to the formation and development of scar in postoperative of upper lip.