Tao Zan

• Ph D, MD
• Medical Doctor at Shanghai Jiao Tong University

Keloids are a typical skin fibroproliferative disease that can cause severe aesthetic and functional concerns. Pain and pruritus are the most common clinical symptoms of keloids, but the mechanisms underlying these symptoms remain unclear. The peripheral nervous system plays a pivotal role in the transmission of superficial sensation signals. Mount...

Glioblastoma (GBM) is the most aggressive subtype of primary brain tumors, which marginally respond to standard chemotherapy due to the blood‐brain barrier (BBB) and the low tumor specificity of the therapeutics. Herein, a double‐layered microneedle (MN) patch is rationally engineered by integrating acid and light dual‐activatable PROteolysis TArge...

Epigenetic modifications serve as crucial molecular switches for pathological fibrosis; howbeit the role of m¹A in this condition remains enigmatic. Herein, it is found that ALKBH3 exerts a pro‐fibrotic effect in pathological skin fibrosis by reshaping N6‐methyladenosine (m⁶A) RNA modification pattern. First, ALKBH3 exhibited specific upregulation...

Hyperglycemia and bacterial colonization in diabetic wounds aberrantly activate Nod-like receptor protein 3 (NLRP3) in macrophages, resulting in extensive inflammatory infiltration and impaired wound healing. Targeted suppression of the NLRP3 inflammasome shows promise in reducing macrophage inflammatory disruptions. However, challenges such as dru...

The growing discussion on "interdisciplinary integration" brings attention to the "interprofessional education" (IPE) in the field of plastic surgery. IPE not only improves the precision and effectiveness of plastic and reconstructive surgery but also plays an important role in personalized treatment. Whereas, the implementation of IPE in plastic a...

Background Elevated extracellular matrix (ECM) accumulation is a major contributing factor to the pathogenesis of fibrotic diseases. Recent studies have indicated that N6‐methyladenosine (m⁶A) RNA modification plays a pivotal role in modulating RNA stability and contribute to the initiation of various pathological conditions. Howbeit, the precise m...

Importance Total face restoration remains a challenge in modern reconstructive surgery. After 17 years of experiments and preliminary clinical studies, a new concept of face prefabrication was developed for face restoration with autologous tissue. Objective To evaluate the long-term results of face restoration with autologous tissue and report a f...

Efferocytosis, by phagocytosing and processing apoptotic cells in injured skin, directly influences the immune microenvironment. However, the comprehensive widespread inflammation and disrupted efferocytosis in injured skin cannot be effectively halted. Herein, “Grid Efferocytosis” strategy within injury site is proposed, which segments the inflamm...

Background Traumatic injuries to the lower extremities are frequently accompanied by extensive soft tissue loss, combined with vascular damage or exposure of bony tissues, making it difficult to reconstruct; consequently, patients are commonly at risk of amputation. Due to its superior anatomical and biochemical properties, the omental flap has bee...

Effectively eliminating apoptotic cells is precisely controlled by a variety of signaling molecules and a phagocytic effect known as efferocytosis. Abnormalities in efferocytosis may bring about the development of chronic conditions, including angiocardiopathy, chronic inflammatory diseases and autoimmune diseases. During wound healing, failure of...

The global increase of cutaneous wounds imposes huge health and financial burdens on patients and society. Despite improved wound healing outcomes, conventional wound dressings are far from ideal, owing to the complex healing process. Smart wound dressings, which are sensitive to or interact with changes in wound condition or environment, have been...

Background: Impaired wound re-epithelialization contributes to cutaneous barrier reconstruction dysfunction. Recently, N6-methyladenosine (m6A) RNA modification has been shown to participate in the determination of RNA fate, and its aberration triggers the pathogenesis of numerous diseases. Howbeit, the function of m6A in wound re-epithelializatio...

Background: As effective measures to visualize flap vasculature and perfusion were unavailable, flap fenestration and facial organ fabrication could not be performed safely, preventing the transition from 2-D coverage to the restoration of the 3-D structure of facial organs. This study aims to evaluate the efficacy of indocyanine green angiography...

The midface is an important area in aesthetics and function and a complex area to manage after burn injuries, trauma, and tumor resection. Traditional treatment to reconstruct midface defects involving the nose, lips and cheeks requires multiple sequential flap surgeries but results in a patch-like appearance, which remains a major challenge for he...

Total facial deformities always lead to psychological and functional consequences, making plastic and reconstructive surgery a great challenge. The skin of the anterior chest area is matched in thickness, texture, and color to the head and face. The purpose of this article was to discuss and evaluate reconstructive surgeons’ experiences with obtain...

Melanoma, a malignant mass lesion that originates in melanocytes and has a high rate of malignancy, metastasis, and mortality, is defined by these characteristics. Malignant melanoma is a kind of highly malignant tumor that produces melanin and has a high mortality rate. Its incidence accounts for 1%–3% of all malignant tumors and shows an obvious...

Dermal fibrosis is characterized by excessive deposition of extracellular matrix in the dermis and affects millions of people worldwide and causes limited movement, disfigurement and psychological distress in patients. Fibroblast dysfunction of plays a central role in the pathogenesis of dermal fibrosis and is controlled by distinct factors. Recent...

Chronic non-healing wounds, a prevalent complication of diabetes, are associated with increased mortality in diabetic patients. Excessive accumulation of M1 macrophages in diabetic wounds promotes inflammation and results in dysregulated tissue repair. Adipose tissue macrophages (ATMs) derived from healthy lean donors have the ability to improve gl...

Continuing problems with fewer training opportunities and a greater awareness of patient safety have led to a constant search for an alternative technique to bridge the existing theory-practice gap in plastic surgery training and education. The current COVID-19 epidemic has aggravated the situation, making it urgent to implement breakthrough techno...

Modern medicine tends to provide comprehensive medical services based on disease or pathological features. As a result, the overlap between plastic surgery and other surgical departments greatly deepened. What was exclusively done by plastic surgeons are nowadays frequently practiced by other surgeons as well. Thus, generating confusion as to wheth...

Chronic non-healing wounds, an important complication of diabetes, are associated with increased mortality in patients afflicted with this disease. Excessive accumulation of M1 macrophages in diabetic wounds promotes inflammation and results in dysregulated tissue repair. Adipose tissue macrophages (ATMs) derived from healthy lean donors have the a...

Background Keloid is a dermal fibroproliferative disease with various etiologies and unclear pathogenesis. Recent studies have revealed that circular RNAs (circRNAs) exerted regulatory functions through a competing endogenous RNA (ceRNA) pathway in keloid progression. However, the expression profiles of circRNAs in keloid dermal tissues (KDTs) rema...

Head and neck squamous carcinoma (HNSC) is the most prevalent malignancy of the head and neck regions. Long noncoding RNAs (lncRNAs) are vital in tumorigenesis regulation. However, the role of lncRNAs in HNSC requires further exploration. Herein, through bioinformatic assays using The Cancer Genome Atlas (TCGA) datasets, rapid amplification of cDNA...

Aged skin wounds heal poorly, resulting in medical, economic, and social burdens posed by nonhealing wounds. Age-related defects in repair are associated with reduced myofibroblasts and dysfunctional extracellular matrix (ECM) deposition. Bidirectional cell-cell communication involving exosome-borne cargo such as micro RNAs (miRs) has emerged as a...

With advances in anatomical knowledge and technology, increased interest has been directed towards reconstruction with enhanced aesthetic and functional outcomes. A myriad of thinned perforator flap harvest approaches have been developed for this purpose; however, concerns about jeopardizing their vascularity remain. To ensure optimum reconstructiv...

Background Hypertrophic scar (HTS) is a fibrotic disorder of skins and may have repercussions on the appearance as well as functions of patients. Recent studies related have shown that competitive endogenous RNA (ceRNA) networks centering around miRNAs may play an influential role in HTS formation. This study aimed to construct and validate a three...

Background: Challenging large soft tissue defects are typically treated with microvascular free tissue transfer; however, success has been noted with pre-expanded perforator flaps. Objective: To report outcomes and complications from pre-expanded perforator flaps. Methods: A retrospective chart review of patients undergoing tissue reconstruction wi...

Background Use of internal filling ports in tissue expander–based reconstructions are advantageous because of easier self-care, lower infection rates, and fewer instances of capsule formation. The appearance of periprosthetic fluid accumulation after internal-port tissue expander implantation is a common complication that warrants treatment. In thi...

Background: Extensive cervicofacial reconstruction is challenging for plastic surgeons. Because of the location of the adjacent scalp flap nourished by the superficial temporal artery (STA), it can be a candidate for cervicofacial reconstruction. Objectives: This article aims to report a combined treatment of an expanded island STA flap and an 8...

Fibroblasts (Fbs) are critical to hypertrophic scar (HTS) formation and were recently demonstrated to be highly heterogeneous. However, Fb heterogeneity in HTSs has not been fully elucidated. Here, we observed an increased fraction of CD39+ Fbs in HTS after screening four Fb subtypes (CD26+, CD36+, FAP+, and CD39+). CD39+ Fbs, enriched in the upper...

Background Hypertrophic scar (HTS) is a fibroproliferative skin disorder characterized by excessive cell proliferation, migration, and extracellular matrix (ECM) deposition. The CUB and Sushi multiple domains 1 (CSMD1) has previously been identified as the key regulatory gene of hypertrophic scar by a large sample GWAS study. However, further resea...

Fibroblasts are the chief effector cells in fibrotic diseases and have been discovered to be highly heterogeneous. Recently, fibroblast heterogeneity in human skin has been studied extensively and several surface markers for dermal fibroblast subtypes have been identified, holding promise for future antifibrotic therapies. However, it has yet to be...

Background: Vascular supercharge and flap prefabrication are two surgical maneuvers to improve flap blood supply. Although these techniques have been studied intensively, few studies have focused on the differences between supercharge and prefabricated flaps regarding their flap survival areas, vasculatures, and hemodynamics. Methods: In this st...

Background Manitoba-oculo-tricho-anal (MOTA) syndrome is a rare syndrome with only 27 cases reported worldwide so far, but none was reported in the population of Eastern Asia. Such extremely low prevalence might be contributed by misdiagnosis due to its similarities in ocular manifestations with facial cleft. In our study, we discovered the first c...

Background: Because neurofibromatosis type I (NF1) is a cancer predisposition disease, it is important to distinguish between benign and malignant lesions, especially in the craniofacial area. Purpose: The purpose of this study is to improve effectiveness in the diagnostic performance in discriminating malignant from benign craniofacial lesions bas...

Importance: The strategic option between vascular supercharge and flap prefabrication in the fabrication of multipedicle flaps for difficult head and neck reconstruction has not been reported. Objectives: To summarize our 13-year experience in the design of multipedicle pre-expanded perforator flaps for extensive head and neck defect reconstruction...

Re-epithelialization is a fundamental process in wound healing that involves various cytokines and cells during cutaneous barrier reconstruction. Ubiquitin-specific peptidase 15 (USP15), an important member of the deubiquitinating enzymes (DUBs), removes ubiquitin chains from target proteins and maintains protein stability. However, the dynamic rol...

Objective To investigate the utility of pre-expanded muscle-sparing latissimus dorsi flaps in the reconstruction of deformities secondary to severe scar contractures on the anterior chest. Methods The function of the latissimus dorsi was preserved with blood supply from the main or lateral branch of the thoracodorsal artery. The entire treatment p...

Pathological scars might cause a distorted appearance and restricted mobility, and the study of scar pathophysiology has been hindered by the absence of a reliable model. In this study, we introduce a model with a modified device to induce controlled tension on a wound healing by secondary intention to overcome the shortcomings of the model generat...

Background The novel Coronavirus Disease 2019 (COVID-19) has rapidly become a health threat worldwide and has been declared global pandemic by the World Health Organization. Possible transmission routes, including respiratory droplets, close contact, and aerosol propagation, have put plastic and reconstructive healthcare professionals at high risk,...

Numerous studies have shown that macrophages can orchestrate the microenvironment from the early stage of wound healing to the later stages of scar formation. However, few reviews have highlighted the significance of macrophages during the formation of abnormal scars. The purpose of this review was to outline the polarization of macrophages from ea...

Hypertrophic scar (HTS) is a common pathologic dermal fibroproliferative disease after skin injury. Transforming growth factor β (TGF-β) plays a central role in HTS formation and development. Thrombospondin-1 (TSP-1) activates latent TGF-β by binding to latency-associated peptide-β on TGF-β structure. So far, LSKL peptide was shown to selectively a...

Objectives: The aim was to evaluate overall quality of life (QOL) and investigate impact factors in Chinese neurofibromatosis type 1 (NF1) patients, particularly in those with craniofacial plexiform neurofibromas (pNFs). Methods: The Impact of NF1 on quality of life (INF1-QOL) Questionnaire were completed from a department of plastic and reconst...

Background: Microsurgical replantation has become the most favorable treatment option for scalp avulsion. However, the accurate prediction of postoperative replant viability remains challenging. Case presentation: In this article, we showed that (indocyanine green angiography, ICGA) can provide a much more precise prediction of replant necrosis...

The immune system plays an essential role in the development of tumors, which has been demonstrated in multiple types of cancers. Consistent with this, immunotherapies with targets that disrupt these mechanisms and turn the immune system against developing cancers have been proven effective. In neurofibromatosis type 1 (NF1), an autosomal dominant...

Background: Postoperative hypertrophic scarring of the medial canthal area is a common phenomenon and deterrent for patients considering epicanthoplasty. Botulinum toxin type A has been reported for hypertrophic scar and keloid treatment. However, there is a lack of high-level evidence regarding the effects of botulinum toxin type A in the medial c...

Rational: Ehlers-Danlos syndrome (EDS) is a heritable connective tissue disorder. Currently, the genotype-phenotype correlations of classical EDS (cEDS) are still controversial. Hence, this study reported a case of cEDS with both clinical manifestations and COL5A2 gene mutation. Patient concerns: A 30-year-old female presented to the plastic-sur...

Background: Most of the techniques used to investigate choke vessels are indirect. The aim of the present study is to assess the effectiveness of percutaneous endoscopy in direct real-time visualization of choke vessels in rat perforator flap models. Methods: A classic perforator flap on the rat dorsum was designed (n = 12). An additional incisi...

A 6-year-old boy presented with several tumoral lesions on sun-exposed skin. These lesions developed from local freckles beginning at 6 months of age and gradually spread with protruding growth. Over the past 2 years, tumors started to form and develop rapidly, becoming ulcerative and bleeding. The patient was intellectually standard and denied blu...

A woman in her 40s presented for evaluation of a disfiguring facial mass on the left side of her face; the mass had started as a 1-cm subcutaneous nodule on her left upper eyelid at birth and gradually grew to more than 94 cm in length (Figure, A and B). She felt mild discomfort with mastication and denied dysphonia, dysphagia, blurred vision, and...

Background Various techniques have been developed for postburn neck reconstruction, but a treatment algorithm is needed. Methods We retrospectively reviewed all patients treated for postburn neck contracture at our institution between February 2008 and December 2015. Necks were divided into one anterior subunit and two lateral subunits marked by th...

Background: For extensive postburn neck deformities, the preexpanded flaps in the upper back region were used and gained a uniform skin appearance and esthetic contours. Free-style perforator-based free-tissue transfer that represents the most recent advance in reconstructive surgery may provide more versatility of these flaps. Methods: We retro...

Tissue expansion-related severe complication exists, and the poor blood supply is one of the causes. After decades of negative correlation between capsule pressure and blood flow was verified, the widely recognized expansion capsule pressure is still absent. A prospective randomized controlled trial was performed to explore the optimal expanding ca...

Background Ultrathin melanoma was previously demonstrated to have higher risk for melanoma-specific mortality using SEER database. However, these guideline-changing conclusions has been recently challenged by miscoding of thickness. This present study was performed to assess the prognosis of thin and ultrathin melanoma using only surgically-treated...

Background Inadequate neovascularization is a major risk factor that can lead to subsequent necrosis of prefabricated flaps. Recent evidence indicates that transient receptor potential cation channel, subfamily V, member 4 (TRPV4) activates growth and remodeling of collateral arteries in ischemia tissues by responding to elevated fluid shear stress...

Background One set of perforators can supply its own perforasome as well as the adjacent perforasome. The process of tissue expansion can mimic the effect of surgical delay to include more perforasomes into the perforator flap. By combining the perforasome theory with the technique of tissue expansion, large and various expanded perforator flaps ca...

Background: In perforator flap transplantation, dissection of the perforator is an important but difficult procedure because of the high variability in vascular anatomy. Preoperative imaging techniques could provide substantial information about vascular anatomy; however, it cannot provide direct guidance for surgeons during the operation. In this...

Background: Mechanical stretch, in term of skin expansion, can induce effective but limited in vivo skin regeneration for complex skin defect reconstruction. We propose a strategy to obtain regenerated skin by combining autologous stem cell transplantation with mechanical stretch. Methods: This randomized, blinded placebo-controlled trial enroll...

In this article, we present the pre-expanded, prefabricated supercharged cervicothoracic monoblock perforator flap for total or subtotal facial resurfacing. This technique can be a reliable reconstruction option for extensive facial skin defect with undamaged muscles and deep structures, which could provide excellent aesthetic and functional outcom...

Background The epicanthal fold is a distinct characteristic of the Asian upper eyelid, which may impair the beauty of the eyes and the outcome of double eyelid blepharoplasty. Although many surgical procedures have been reported, their main drawbacks include a conspicuous scar in the medial canthal area and an unnatural palpebral contour. We devise...

Background: The face is one of the most important regions of the human body and contains complicated and delicate features that define the identity of a person. Treatment for extensive facial deformities requires resurfacing of the extensive skin defects and restoring the missing features. To date, it remains a major challenge to the reconstructiv...

Nerve regeneration conditioned fluid is secreted by nerve stumps inside a nerve regeneration chamber. A better understanding of the proteinogram of nerve regeneration conditioned fluid can provide evidence for studying the role of the microenvironment in peripheral nerve regeneration. In this study, we used cylindrical silicone tubes as the nerve r...

Desferrioxamine (DFO), an iron chelator, mimicked hypoxia by inhibiting HIF-1α degradation and upregulated angiogenic factors. In this experiment, we elucidated the effect of DFO on CD34 positive cells migration and neovascularization. CD34(+) cells were cultured in media with DFO or inhibitor and subjected to in vitro tubule formation and the expr...

Objective: The thoracic branch of supraclavicular artery (TBSA) flap has been widely used to reconstruct face and neck defects. However, the branches of the supraclavicular artery (SCA) exhibit considerable anatomical variations. The aim of this study was to evaluate and compare the role of contrast-enhanced ultrasound (CEUS) with 3-dimensional (3...

OBJECTIVE: To study the treatment results of the pre-expanded flaps for scar contracture on face, neck, and joints by comparing with the skin grafts.

To investigate the effectiveness of microbubble-enhanced ultrasound (MEUS) for detecting perforators preoperatively in supraclavicular flap surgery. From May 2009 to October 2013, there were 20 patients (26 flaps were involved) who planned to undergo supraclavicular artery based flap surgeries to recover the large-area defects in head and neck. The...

It is still highly challenging to restore the esthetic neck contour for postburn deformities. In many patients with burns, the back skin remains intact, which is a useful donor site for extensive contracture release. As the main technique, the refinement of the pre-expanded superficial cervical artery (SCA) flaps may improve its application in dive...

Endothelial progenitor cells (EPCs) play a significant role in physiological and pathological hypoxia resistance and neovascularization processes. The ability to mobilize EPCs from bone marrow usually indicates a prognostic endpoint of several vascular diseases. Thus, it is of great value to study possible approaches for activating functional EPCs....

Prefabricated flaps are an ideal alternative to repair massive and complex tissue defects. Nevertheless, the risk of necrosis due to unpredictable blood supplies is a major obstacle to the application of prefabricated flaps. The survival of a prefabricated flap depends on the neovascularization between the vascular carrier and the donor tissue. Her...

Background: In the reconstruction of facial burn scars, large, thin, color-matching flaps are desirable due to aesthetic and functional demands. There have been many reports using prefabricated flaps to resurface facial skin lesions. However, an algorithm to select the most suitable treatment option for the individual patient is lacking. Methods:...

Background: Prefabricated flap is an important technique to reconstruct massive face and neck skin defects. But its vascularization remains unpredictable and often leads to abnormal blood supply of the harvested flap, even necrosis. Flap supercharging and turbo supercharging techniques are effectively used to improve flap blood supply. However, fe...

Total face skin and soft-tissue defects remain one of the biggest challenges in reconstructive surgery. Reconstruction of the entire face with uniform coverage and delicate features is difficult to achieve. To avoid the patchwork result seen in multiple flaps and skin grafts, 1 monoblock flap that has similar color, texture, and thickness might be...

Postburn soft-tissue defects or scars can cause disfigurement and functional impairment and constitute a major therapeutic challenge. In the past 30 years, developments in reconstructive techniques have improved the treatment outcomes. However, these techniques are selected mainly according to the surgeon's preference. There is no classification fo...

The dynamic vibration absorber (DVA) is generally used to suppress the machining vibration in boring processes. The DVA consists of an additional massspringdamper sub-system, and needs accurately tuning of its natural frequency and damping ratio to match the main structure for vibration control. For obtaining the optimal performance of the DVA, the...

The perforator flap is one of the most useful techniques in reconstructive surgery. The operative procedure for these flaps will be greatly simplified if accurate localization of the course of the perforator can be preoperatively confirmed. However, small vessels with diameters less than 0.5 mm cannot be readily traced with conventional imaging tec...

Although expanded flaps have been shown to survive longer than unexpanded flaps, flap necrosis still occurs, particularly when a deep back cut has been made. Overcautious design can avoid necrosis but leads to inefficient usage of the expanded flap. In this study, we tested a surgical delay method to prevent partial necrosis and maximize the use of...

Background: For large defects or deformities of the face and neck, the anterior chest area appears to be an excellent donor site that provides well-matched skin colour and texture. Many flap techniques based on the anterior chest area have been reported; however, there are few reports that focus on a treatment strategy for these different flap tec...

Background: Massive scars of face and neck cause severe esthetic and functional problems in patients. To achieve better outcomes, in this study, we demonstrate the use of the expanded lateral thoracic pedicle flap, which provides a large and thin flap that matches the face and neck area in color and texture with minimal donor site morbidities. Me...

Umbilical cord blood-derived CD133+ cells exhibit the ability to differentiate into endothelial cells and induce new blood vessel growth. Hypoxia-inducible factor-1 (HIF-1), a regulator of hypoxia or the hypoxia-mimetic agent response, actives the SDF-1/CXCR4 signaling pathway and thus plays an important role in angiogenesis in-vivo. In this study...