Pub Date : 2023-09-20DOI: 10.3760/cma.j.cn501225-20230504-00153
X J Ma, C Dong
Before scar reconstruction, a plan must be carefully designed in accordance with certain design principles. The new technologies for scar reconstruction should be carried out actively and steadily in a standardized manner, with attentions to the follow-up and evaluation work after reconstruction. The vigorous development of artificial intelligence, the mature of three-dimensional bioprinting technology, and the in-depth breakthrough in basic research are likely to bring revolutionary progress to the field of scar reconstruction.
{"title":"[Thinking and prospect of scar reconstruction].","authors":"X J Ma, C Dong","doi":"10.3760/cma.j.cn501225-20230504-00153","DOIUrl":"10.3760/cma.j.cn501225-20230504-00153","url":null,"abstract":"<p><p>Before scar reconstruction, a plan must be carefully designed in accordance with certain design principles. The new technologies for scar reconstruction should be carried out actively and steadily in a standardized manner, with attentions to the follow-up and evaluation work after reconstruction. The vigorous development of artificial intelligence, the mature of three-dimensional bioprinting technology, and the in-depth breakthrough in basic research are likely to bring revolutionary progress to the field of scar reconstruction.</p>","PeriodicalId":24004,"journal":{"name":"Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns","volume":"39 9","pages":"801-805"},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41108198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-20DOI: 10.3760/cma.j.cn501225-20221022-00468
H Y Chen, G H Xin
The prognosis-related forecasting model for burn patients was first proposed in 1961, and the establishment of the models not only plays an important role in assessing the severity of burns and predicting fatality rate, but also has a positive implication for improving treatment strategies of patients. The early prognosis-related forecasting models for burn patients are mainly based on factors including patients' age and burn area, and as the research goes on, the prognostic forecasting models are constantly updated and improved. There are new insights provided by an increasing number of scholars. This article summarizes the brief history of development of prognosis-related forecasting models for burn patients, the progress of some prognosis-related forecasting models for burn patients at home and abroad, and the related risk factors, with the aim of providing some references for the selection of appropriate forecasting models in clinic.
{"title":"[Research advances on prognosis-related forecasting models for burn patients].","authors":"H Y Chen, G H Xin","doi":"10.3760/cma.j.cn501225-20221022-00468","DOIUrl":"10.3760/cma.j.cn501225-20221022-00468","url":null,"abstract":"<p><p>The prognosis-related forecasting model for burn patients was first proposed in 1961, and the establishment of the models not only plays an important role in assessing the severity of burns and predicting fatality rate, but also has a positive implication for improving treatment strategies of patients. The early prognosis-related forecasting models for burn patients are mainly based on factors including patients' age and burn area, and as the research goes on, the prognostic forecasting models are constantly updated and improved. There are new insights provided by an increasing number of scholars. This article summarizes the brief history of development of prognosis-related forecasting models for burn patients, the progress of some prognosis-related forecasting models for burn patients at home and abroad, and the related risk factors, with the aim of providing some references for the selection of appropriate forecasting models in clinic.</p>","PeriodicalId":24004,"journal":{"name":"Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns","volume":"39 9","pages":"891-895"},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41121500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-20DOI: 10.3760/cma.j.cn501225-20220726-00310
C P Yang, L F Tang, Z J Liu, S Z Liu, L Yang, J N Cheng, T Zhang, F W Sun, Y T Huang, Q F Gao, J H Ju
Objective: To investigate clinical effects of anterolateral thigh flap with blood supply source of medial femoral perforator in repairing the wounds on extremities. Methods: A retrospective observational study was conducted. From October 2018 to June 2021, Suzhou Ruihua Orthopedic Hospital admitted 12 patients (11 males and 1 female, aged 24-64 years) who met the inclusion criteria, and did not have the lateral circumflex femoral artery during anterolateral thigh flap resection, or changed to medial femoral perforator as a source of blood supply due to small perforator to repair the wound with flap transplantation. The wounds were on the upper limbs in 7 cases and on the lower limbs in 5 cases. The wound area after debridement was 8.0 cm×5.0 cm-24.0 cm×6.5 cm, and the applied flap area was 9 cm×6 cm-25 cm×7 cm. During transplantation, the perforating branch or source artery of the flap was anastomosed end to end with the vascular pedicle of the recipient area. Subcutaneous beauty suture was performed on all the donor wounds. After operation, the survival of the flap and vascular crisis were observed; and the wound healing at the donor site was observed. During follow-up, the texture of the flap and complications at the donor site were observed. At the last follow-up, the effect of flap repair was evaluated by using the modified self-made comprehensive efficacy rating table. Results: After operation, all the flaps of patients survived without vascular crisis; the wounds in the donor site healed smoothly. During follow-up of 6 to 26 months, the flaps had good texture; only linear scars remained in the donor area without scar contracture, pain or other discomfort. At the last follow-up, the total score of flap repair effect of 12 patients was 75-95, with an average of 87, of which 5 cases were rated as excellent, 6 cases as good, and 1 case as fair, and the proportion of excellent and good patients was 11/12. Conclusions: The application of anterolateral thigh flap with blood supply from the medial femoral perforator to repair wounds on extremities is an alternative method for the vascular variations such as no descending branch, oblique branch, or small perforator of the lateral circumflex femoral artery during the resection of the anterolateral thigh flap. This operation has the advantages of simple operation, small trauma, and others, which effectively ensures the smooth operation.
{"title":"[Clinical effects of anterolateral thigh flap with blood supply source of medial femoral perforator in repairing the wounds on extremities].","authors":"C P Yang, L F Tang, Z J Liu, S Z Liu, L Yang, J N Cheng, T Zhang, F W Sun, Y T Huang, Q F Gao, J H Ju","doi":"10.3760/cma.j.cn501225-20220726-00310","DOIUrl":"10.3760/cma.j.cn501225-20220726-00310","url":null,"abstract":"<p><p><b>Objective:</b> To investigate clinical effects of anterolateral thigh flap with blood supply source of medial femoral perforator in repairing the wounds on extremities. <b>Methods:</b> A retrospective observational study was conducted. From October 2018 to June 2021, Suzhou Ruihua Orthopedic Hospital admitted 12 patients (11 males and 1 female, aged 24-64 years) who met the inclusion criteria, and did not have the lateral circumflex femoral artery during anterolateral thigh flap resection, or changed to medial femoral perforator as a source of blood supply due to small perforator to repair the wound with flap transplantation. The wounds were on the upper limbs in 7 cases and on the lower limbs in 5 cases. The wound area after debridement was 8.0 cm×5.0 cm-24.0 cm×6.5 cm, and the applied flap area was 9 cm×6 cm-25 cm×7 cm. During transplantation, the perforating branch or source artery of the flap was anastomosed end to end with the vascular pedicle of the recipient area. Subcutaneous beauty suture was performed on all the donor wounds. After operation, the survival of the flap and vascular crisis were observed; and the wound healing at the donor site was observed. During follow-up, the texture of the flap and complications at the donor site were observed. At the last follow-up, the effect of flap repair was evaluated by using the modified self-made comprehensive efficacy rating table. <b>Results:</b> After operation, all the flaps of patients survived without vascular crisis; the wounds in the donor site healed smoothly. During follow-up of 6 to 26 months, the flaps had good texture; only linear scars remained in the donor area without scar contracture, pain or other discomfort. At the last follow-up, the total score of flap repair effect of 12 patients was 75-95, with an average of 87, of which 5 cases were rated as excellent, 6 cases as good, and 1 case as fair, and the proportion of excellent and good patients was 11/12. <b>Conclusions:</b> The application of anterolateral thigh flap with blood supply from the medial femoral perforator to repair wounds on extremities is an alternative method for the vascular variations such as no descending branch, oblique branch, or small perforator of the lateral circumflex femoral artery during the resection of the anterolateral thigh flap. This operation has the advantages of simple operation, small trauma, and others, which effectively ensures the smooth operation.</p>","PeriodicalId":24004,"journal":{"name":"Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns","volume":"39 9","pages":"842-848"},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41108497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-20DOI: 10.3760/cma.j.cn501225-20220522-00198
M J Li, H L Chen, Y Y Ju, L J Zeng, N Li
<p><p><b>Objective:</b> To investigate the status of knowledge, attitude, and behavior of enteral nutrition implemented by nurses in burn intensive care unit (BICU) and analyze its influencing factors. <b>Methods:</b> A multi-center cross-sectional survey research method was used. On May 8<sup>th</sup>, 2022, 107 BICU nurses who met the inclusion criteria were selected from the burn departments of the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Guangdong Provincial People's Hospital, the First Affiliated Hospital of Guangxi Medical University, the Affiliated Hospital of Qinghai University, the Second Affiliated Hospital of Air Force Medical University, the Affiliated Hospital of Nantong University, Guiyang Steel Factory Staff Hospital, and the Second Affiliated Hospital of Kunming Medical University. The self-made nurses' enteral nutrition nursing knowledge-attitude-behavior questionnaire for severely burned patients was used to investigate the nurses' gender, age, working years, professional title, position, highest educational background, and whether they received systematic training in knowledge of enteral nutrition, the scores of each factor, and the total scores of knowledge, attitude, and behavior dimensions of enteral nutrition in nurses. The nurses were classified according to the general data, and the total scores of their knowledge, attitude, and behavior of enteral nutrition were calculated. Data were statistically analyzed with independent sample <i>t</i> test, one-way analysis of variance, Mann-Whitney <i>U</i> test, and Kruskal-Wallis <i>H</i> test. According to the results of univariate analysis and combined with clinical experience and significance, the generalized linear model analysis was carried out to screen the independent influencing factors of the total scores of knowledge, attitude, and behavior of enteral nutrition in BICU nurses. <b>Results:</b> A total of 107 nurses were surveyed, and 107 valid questionnaires were collected, with an effective recovery rate of 100%. In the BICU nurses' enteral nutrition knowledge-attitude-behavior questionnaire, the total scores of knowledge, attitude, and behavior were 44±13, 87±15, and 70±19, respectively. Most of the BICU nurses in this survey were female, aged 22-48 (31±6) years, and the number of nurses worked for 1-5, 6-10, and ≥11 years was evenly distributed. The majority of the professional titles of nurses were nurses, positions were responsible nurses, and the highest educational background was undergraduate. Forty-four nurses received systematic training in knowledge of enteral nutrition. There were statistically significant differences in the total scores of knowledge of enteral nutrition among BICU nurses with different ages, working years, professional titles, positions, highest educational background, and whether they received systematic training in knowledge of enteral nutrition (with <i>H</i> values of 27.36, 15.27, and
{"title":"[A cross-sectional survey and influencing factors analysis of knowledge, attitude, and behavior of enteral nutrition implemented by nurses in burn intensive care unit].","authors":"M J Li, H L Chen, Y Y Ju, L J Zeng, N Li","doi":"10.3760/cma.j.cn501225-20220522-00198","DOIUrl":"10.3760/cma.j.cn501225-20220522-00198","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the status of knowledge, attitude, and behavior of enteral nutrition implemented by nurses in burn intensive care unit (BICU) and analyze its influencing factors. <b>Methods:</b> A multi-center cross-sectional survey research method was used. On May 8<sup>th</sup>, 2022, 107 BICU nurses who met the inclusion criteria were selected from the burn departments of the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Guangdong Provincial People's Hospital, the First Affiliated Hospital of Guangxi Medical University, the Affiliated Hospital of Qinghai University, the Second Affiliated Hospital of Air Force Medical University, the Affiliated Hospital of Nantong University, Guiyang Steel Factory Staff Hospital, and the Second Affiliated Hospital of Kunming Medical University. The self-made nurses' enteral nutrition nursing knowledge-attitude-behavior questionnaire for severely burned patients was used to investigate the nurses' gender, age, working years, professional title, position, highest educational background, and whether they received systematic training in knowledge of enteral nutrition, the scores of each factor, and the total scores of knowledge, attitude, and behavior dimensions of enteral nutrition in nurses. The nurses were classified according to the general data, and the total scores of their knowledge, attitude, and behavior of enteral nutrition were calculated. Data were statistically analyzed with independent sample <i>t</i> test, one-way analysis of variance, Mann-Whitney <i>U</i> test, and Kruskal-Wallis <i>H</i> test. According to the results of univariate analysis and combined with clinical experience and significance, the generalized linear model analysis was carried out to screen the independent influencing factors of the total scores of knowledge, attitude, and behavior of enteral nutrition in BICU nurses. <b>Results:</b> A total of 107 nurses were surveyed, and 107 valid questionnaires were collected, with an effective recovery rate of 100%. In the BICU nurses' enteral nutrition knowledge-attitude-behavior questionnaire, the total scores of knowledge, attitude, and behavior were 44±13, 87±15, and 70±19, respectively. Most of the BICU nurses in this survey were female, aged 22-48 (31±6) years, and the number of nurses worked for 1-5, 6-10, and ≥11 years was evenly distributed. The majority of the professional titles of nurses were nurses, positions were responsible nurses, and the highest educational background was undergraduate. Forty-four nurses received systematic training in knowledge of enteral nutrition. There were statistically significant differences in the total scores of knowledge of enteral nutrition among BICU nurses with different ages, working years, professional titles, positions, highest educational background, and whether they received systematic training in knowledge of enteral nutrition (with <i>H</i> values of 27.36, 15.27, and ","PeriodicalId":24004,"journal":{"name":"Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns","volume":"39 9","pages":"874-881"},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41111937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-20DOI: 10.3760/cma.j.cn501225-20220907-00396
H N Guan, X Ma, Y K Liu, Y W Niu, B M Sun, J J Tang, S L Lu
Objective: To explore the clinical effects of pedicled omental flap transplantation in repairing secondary rejection wounds after brain pacemaker implantation. Methods: A retrospective observational study was conducted. From January to August 2021, 5 patients with secondary rejection wounds after brain pacemaker implantation who met the inclusion criteria were admitted to the Wound Repair Center of Ruijin Hospital of Shanghai Jiao Tong University School of Medicine, including 3 males and 2 females, aged 56-69 years, with the wound developed at the pulse generator implantation site in the chest in 2 cases, at the connection site of the wire and electrode behind the ear in 2 cases, and at both the chest and the back of the ear in 1 case. All the wounds were repaired by pedicled omental flap transplantation. The wound area after debridement was 2-15 cm2. After operation, the wound healing and related complications (pain, infection, incisional hernia, omental flap necrosis, etc.) were observed. During follow-up, the recurrence of the wound was observed. Results: The wounds of all 5 patients healed within 2 weeks after operation, without related complications. During follow up of 12-18 months, 1 patient got a recurrence of rejection wound behind the left ear 4 months after surgery and eventually had the brain pacemaker removed; the other 4 patients had no recurrence of wounds. Conclusions: Pedicled omental flap transplantation can repair the secondary rejection wounds after brain pacemaker implantation safely and effectively, with few postoperative complications.
{"title":"[Clinical effects of pedicled omental flap transplantation in repairing secondary rejection wounds after brain pacemaker implantation].","authors":"H N Guan, X Ma, Y K Liu, Y W Niu, B M Sun, J J Tang, S L Lu","doi":"10.3760/cma.j.cn501225-20220907-00396","DOIUrl":"10.3760/cma.j.cn501225-20220907-00396","url":null,"abstract":"<p><p><b>Objective:</b> To explore the clinical effects of pedicled omental flap transplantation in repairing secondary rejection wounds after brain pacemaker implantation. <b>Methods:</b> A retrospective observational study was conducted. From January to August 2021, 5 patients with secondary rejection wounds after brain pacemaker implantation who met the inclusion criteria were admitted to the Wound Repair Center of Ruijin Hospital of Shanghai Jiao Tong University School of Medicine, including 3 males and 2 females, aged 56-69 years, with the wound developed at the pulse generator implantation site in the chest in 2 cases, at the connection site of the wire and electrode behind the ear in 2 cases, and at both the chest and the back of the ear in 1 case. All the wounds were repaired by pedicled omental flap transplantation. The wound area after debridement was 2-15 cm<sup>2</sup>. After operation, the wound healing and related complications (pain, infection, incisional hernia, omental flap necrosis, etc.) were observed. During follow-up, the recurrence of the wound was observed. <b>Results:</b> The wounds of all 5 patients healed within 2 weeks after operation, without related complications. During follow up of 12-18 months, 1 patient got a recurrence of rejection wound behind the left ear 4 months after surgery and eventually had the brain pacemaker removed; the other 4 patients had no recurrence of wounds. <b>Conclusions:</b> Pedicled omental flap transplantation can repair the secondary rejection wounds after brain pacemaker implantation safely and effectively, with few postoperative complications.</p>","PeriodicalId":24004,"journal":{"name":"Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns","volume":"39 9","pages":"882-885"},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41129225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-20DOI: 10.3760/cma.j.cn501225-20221017-00455
Y B Tao, K Q Shi, J Xiao
Many injury-causing factors, including burns and surgery, etc., can lead to the destruction of structure and function of skin. Suitable wound dressing or implant is the material basis to promote wound healing and regeneration. Biomaterials with micro-nano structure can affect cell behavior, promote orderly growth of cell in accordance with the structure. Their application in wound healing can promote angiogenesis, regulate immune response, and reduce scar area. In recent years, the application of biomaterials with ordered micro-nano structure in tissue engineering has attracted extensive attention. This paper introduces the structure and preparation methods of several biomaterials with ordered micro-nano structure, and focuses on how the surface microstructure of biomaterials affects the process of wound healing and its molecular mechanism, in order to find and develop medical biomaterials that are closer to the skin tissue structure for clinical wound treatment.
{"title":"[Research progress of biomaterials with ordered micro-nano structure in wound repair].","authors":"Y B Tao, K Q Shi, J Xiao","doi":"10.3760/cma.j.cn501225-20221017-00455","DOIUrl":"10.3760/cma.j.cn501225-20221017-00455","url":null,"abstract":"<p><p>Many injury-causing factors, including burns and surgery, etc., can lead to the destruction of structure and function of skin. Suitable wound dressing or implant is the material basis to promote wound healing and regeneration. Biomaterials with micro-nano structure can affect cell behavior, promote orderly growth of cell in accordance with the structure. Their application in wound healing can promote angiogenesis, regulate immune response, and reduce scar area. In recent years, the application of biomaterials with ordered micro-nano structure in tissue engineering has attracted extensive attention. This paper introduces the structure and preparation methods of several biomaterials with ordered micro-nano structure, and focuses on how the surface microstructure of biomaterials affects the process of wound healing and its molecular mechanism, in order to find and develop medical biomaterials that are closer to the skin tissue structure for clinical wound treatment.</p>","PeriodicalId":24004,"journal":{"name":"Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns","volume":"39 9","pages":"896-900"},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630437/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41111679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-20DOI: 10.3760/cma.j.cn501225-20230706-00248
W Zhang, W D Zhang, L Chen, X G Luan, F Yang, Z Li, F Liu, D Y Wang
<p><p><b>Objective:</b> To investigate the clinical effects of expanded flaps in reconstructing scar contracture deformities in the face and neck after extensive burns. <b>Methods:</b> A retrospective observational study was conducted. From May 2016 to September 2022, 17 patients with scar contracture deformities in the face and neck after extensive burns were admitted to Tongren Hospital of Wuhan University & Wuhan Third Hospital, including 13 males and 4 females, aged 23 to 55 years, with 3 patients having degree Ⅱ cervical contracture, 14 patients having degree Ⅲ cervical contracture, and 12 patients having facial scar contracture deformity. In the first stage, 34 rectangular skin and soft tissue expanders (hereinafter referred to as expanders) with rated capacity of 100-600 mL were inserted into the face, chest, shoulder, and abdomen, and then the normal saline was injected for expansion. In the second stage, the scar tissue was removed and the contracture was released to correct the deformity. Two expanded facial flaps were transplanted in local fashion, 17 expanded flaps were transplanted in pedicled fashion, and 15 expanded flaps were freely transplanted to repair the secondary wounds after release, with artery pressurization was performed in 7 flaps. Indocyanine green fluorescence imaging was used to evaluate the arterial blood perfusion and venous return of the flaps during transplantation. The incision area of 32 flaps except 2 facial flaps was 10 cm×8 cm-36 cm×16 cm. The wounds of 31 flap donor sites were closed by direct suture, and the wound of 1 flap donor site was repaired by autologous split-thickness scalp transplantation. The skin condition of inserted place, expansion time, and total amount of normal saline injection of expanders, complications of skin and soft tissue expansion surgery, and survival of flap after the second stage surgery were observed and recorded. The long-term face and neck reconstruction effect and recovery of flap donor area were followed up. At the last follow-up, the 5-level Likert scale was used to evaluate the efficacy satisfaction of patients. <b>Results:</b> Of the 34 expander inserted places in 17 patients, 22 places were superficial scar skin after deep partial-thickness burns, 8 places were superficial scar skin after multiple skin donations, and 4 places were normal skin. After 4 to 15 months of expansion, the total normal saline injection volume was 238 to 2 000 mL, with no complications occurred. After the second stage surgery, the distal part of 2 pedicled flaps was partially necrotic, and the necrotic wounds were healed after flap dressing and free transplantation of contralateral expanded triangular flaps, respectively; the other flaps survived completely. During 6 to 18 months of follow-up, except for 2 expanded paraumbilical flaps and 1 expanded groin flap, which were bloated and improved by flap thinning, the appearance and texture of the other flaps were good, and all the flap donor sites
{"title":"[Clinical effects of expanded flaps in reconstructing scar contracture deformities in the face and neck after extensive burns].","authors":"W Zhang, W D Zhang, L Chen, X G Luan, F Yang, Z Li, F Liu, D Y Wang","doi":"10.3760/cma.j.cn501225-20230706-00248","DOIUrl":"10.3760/cma.j.cn501225-20230706-00248","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the clinical effects of expanded flaps in reconstructing scar contracture deformities in the face and neck after extensive burns. <b>Methods:</b> A retrospective observational study was conducted. From May 2016 to September 2022, 17 patients with scar contracture deformities in the face and neck after extensive burns were admitted to Tongren Hospital of Wuhan University & Wuhan Third Hospital, including 13 males and 4 females, aged 23 to 55 years, with 3 patients having degree Ⅱ cervical contracture, 14 patients having degree Ⅲ cervical contracture, and 12 patients having facial scar contracture deformity. In the first stage, 34 rectangular skin and soft tissue expanders (hereinafter referred to as expanders) with rated capacity of 100-600 mL were inserted into the face, chest, shoulder, and abdomen, and then the normal saline was injected for expansion. In the second stage, the scar tissue was removed and the contracture was released to correct the deformity. Two expanded facial flaps were transplanted in local fashion, 17 expanded flaps were transplanted in pedicled fashion, and 15 expanded flaps were freely transplanted to repair the secondary wounds after release, with artery pressurization was performed in 7 flaps. Indocyanine green fluorescence imaging was used to evaluate the arterial blood perfusion and venous return of the flaps during transplantation. The incision area of 32 flaps except 2 facial flaps was 10 cm×8 cm-36 cm×16 cm. The wounds of 31 flap donor sites were closed by direct suture, and the wound of 1 flap donor site was repaired by autologous split-thickness scalp transplantation. The skin condition of inserted place, expansion time, and total amount of normal saline injection of expanders, complications of skin and soft tissue expansion surgery, and survival of flap after the second stage surgery were observed and recorded. The long-term face and neck reconstruction effect and recovery of flap donor area were followed up. At the last follow-up, the 5-level Likert scale was used to evaluate the efficacy satisfaction of patients. <b>Results:</b> Of the 34 expander inserted places in 17 patients, 22 places were superficial scar skin after deep partial-thickness burns, 8 places were superficial scar skin after multiple skin donations, and 4 places were normal skin. After 4 to 15 months of expansion, the total normal saline injection volume was 238 to 2 000 mL, with no complications occurred. After the second stage surgery, the distal part of 2 pedicled flaps was partially necrotic, and the necrotic wounds were healed after flap dressing and free transplantation of contralateral expanded triangular flaps, respectively; the other flaps survived completely. During 6 to 18 months of follow-up, except for 2 expanded paraumbilical flaps and 1 expanded groin flap, which were bloated and improved by flap thinning, the appearance and texture of the other flaps were good, and all the flap donor sites","PeriodicalId":24004,"journal":{"name":"Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns","volume":"39 9","pages":"826-834"},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41115996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-20DOI: 10.3760/cma.j.cn501225-20230420-00134
J M Wu, H Yang, Q Li, T F Luo, P Yang, W C Huang
<p><p><b>Objective:</b> To investigate the clinical efficacy of local injection of platelet-rich plasma (PRP) combined with double-layer artificial dermis in treating wounds with exposed tendon on extremity. <b>Methods:</b> A retrospective observational study was conducted. From December 2017 to October 2022, 16 patients were admitted to Department of Orthopaedic Trauma of the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, and 32 patients were admitted to Department of Burns and Plastic Surgery of Guiyang Steel Factory Staff Hospital. All the patients had wounds with exposed tendon on extremity caused by various reasons and met the inclusion criteria. There were 39 males and 9 females, aged 26 to 58 years. The patients were divided into PRP alone group, artificial dermis alone group, and PRP+artificial dermis group, with 16 patients in each group. The wounds were treated with autologous PRP, double-layer artificial dermis, or thei combination of autologous PRP and double-layer artificial dermis, followed by autologous split-thickness scalp grafting after good growth of granulation tissue. On the 7<sup>th</sup> day after the secondary surgery, the autograft survival was observed, and the survival rate was calculated. The wound healing time and length of hospital stay of patients were recorded. At 3 and 6 months after wound healing, the Vancouver scar scale (VSS) was used to score the pigmentation, height, vascularity, and pliability of scars, and the total score was calculated. Adverse reactions during the entire treatment process were recorded. Data were statistically analyzed with chi-square test, Fisher's exact probability test, one-way analysis of variance, least significant difference test, Kruskal-Wallis <i>H</i> test, Nemenyi test, and Bonferroni correction. <b>Results:</b> On the 7<sup>th</sup> day after the secondary surgery, there was no statistically significant difference in the autograft survival rate of patients among PRP alone group, artificial dermis alone group, and PRP+artificial dermis group (<i>P</i>>0.05). The wound healing time and length of hospital stay of patients in PRP+artificial dermis group were (20.1±3.0) and (24±4) d, respectively, which were significantly shorter than (24.4±5.5) and (30±8) d in PRP alone group (<i>P</i><0.05) and (24.8±4.9) and (32±8) d in artificial dermis alone group (<i>P</i><0.05). At 3 and 6 months after wound healing, the pliability scores of patients in PRP+artificial dermis group were significantly lower than those in PRP alone group (with <i>Z</i> values of 12.91 and 15.69, respectively, <i>P</i><0.05) and artificial dermis alone group (with <i>Z</i> values of 12.50 and 12.91, respectively, <i>P</i><0.05). There were no statistically significant differences in pigmentation, vascularity, height scores, and total score of scar of patients among the three groups (<i>P</i>>0.05). In artificial dermis alone group, one patient experienced partial liquefaction an
{"title":"[Clinical efficacy of local injection of platelet-rich plasma combined with double-layer artificial dermis in treating wounds with exposed tendon on extremity].","authors":"J M Wu, H Yang, Q Li, T F Luo, P Yang, W C Huang","doi":"10.3760/cma.j.cn501225-20230420-00134","DOIUrl":"10.3760/cma.j.cn501225-20230420-00134","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the clinical efficacy of local injection of platelet-rich plasma (PRP) combined with double-layer artificial dermis in treating wounds with exposed tendon on extremity. <b>Methods:</b> A retrospective observational study was conducted. From December 2017 to October 2022, 16 patients were admitted to Department of Orthopaedic Trauma of the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, and 32 patients were admitted to Department of Burns and Plastic Surgery of Guiyang Steel Factory Staff Hospital. All the patients had wounds with exposed tendon on extremity caused by various reasons and met the inclusion criteria. There were 39 males and 9 females, aged 26 to 58 years. The patients were divided into PRP alone group, artificial dermis alone group, and PRP+artificial dermis group, with 16 patients in each group. The wounds were treated with autologous PRP, double-layer artificial dermis, or thei combination of autologous PRP and double-layer artificial dermis, followed by autologous split-thickness scalp grafting after good growth of granulation tissue. On the 7<sup>th</sup> day after the secondary surgery, the autograft survival was observed, and the survival rate was calculated. The wound healing time and length of hospital stay of patients were recorded. At 3 and 6 months after wound healing, the Vancouver scar scale (VSS) was used to score the pigmentation, height, vascularity, and pliability of scars, and the total score was calculated. Adverse reactions during the entire treatment process were recorded. Data were statistically analyzed with chi-square test, Fisher's exact probability test, one-way analysis of variance, least significant difference test, Kruskal-Wallis <i>H</i> test, Nemenyi test, and Bonferroni correction. <b>Results:</b> On the 7<sup>th</sup> day after the secondary surgery, there was no statistically significant difference in the autograft survival rate of patients among PRP alone group, artificial dermis alone group, and PRP+artificial dermis group (<i>P</i>>0.05). The wound healing time and length of hospital stay of patients in PRP+artificial dermis group were (20.1±3.0) and (24±4) d, respectively, which were significantly shorter than (24.4±5.5) and (30±8) d in PRP alone group (<i>P</i><0.05) and (24.8±4.9) and (32±8) d in artificial dermis alone group (<i>P</i><0.05). At 3 and 6 months after wound healing, the pliability scores of patients in PRP+artificial dermis group were significantly lower than those in PRP alone group (with <i>Z</i> values of 12.91 and 15.69, respectively, <i>P</i><0.05) and artificial dermis alone group (with <i>Z</i> values of 12.50 and 12.91, respectively, <i>P</i><0.05). There were no statistically significant differences in pigmentation, vascularity, height scores, and total score of scar of patients among the three groups (<i>P</i>>0.05). In artificial dermis alone group, one patient experienced partial liquefaction an","PeriodicalId":24004,"journal":{"name":"Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns","volume":"39 9","pages":"849-856"},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41111808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-20DOI: 10.3760/cma.j.cn501225-20230602-00198
Y H Su, W Z Xia, X Huang, R Q Xu, Y M Yimin, T Zan
As a first-line classical drug, glucocorticoids are used in most combination treatment regimens of keloid. However, there are issues such as poor treatment efficacy and recurrence of keloid after keloid was treated with glucocorticoids, which seriously affect the therapeutic effect. In recent years, many studies have explored the factors influencing the efficacy of glucocorticoids in treating keloid and the action mechanism of glucocorticoids from different perspectives. Based on this, this paper reviews the mechanism and the factors influencing the efficacy of glucocorticoids in treating keloid, and explores ways to improve the treatment efficacy of glucocorticoids, aiming to provide thoughts for improving glucocorticoid-related diagnostic and therapeutic strategies.
{"title":"[Research advances in the treatment of keloid with glucocorticoids].","authors":"Y H Su, W Z Xia, X Huang, R Q Xu, Y M Yimin, T Zan","doi":"10.3760/cma.j.cn501225-20230602-00198","DOIUrl":"10.3760/cma.j.cn501225-20230602-00198","url":null,"abstract":"<p><p>As a first-line classical drug, glucocorticoids are used in most combination treatment regimens of keloid. However, there are issues such as poor treatment efficacy and recurrence of keloid after keloid was treated with glucocorticoids, which seriously affect the therapeutic effect. In recent years, many studies have explored the factors influencing the efficacy of glucocorticoids in treating keloid and the action mechanism of glucocorticoids from different perspectives. Based on this, this paper reviews the mechanism and the factors influencing the efficacy of glucocorticoids in treating keloid, and explores ways to improve the treatment efficacy of glucocorticoids, aiming to provide thoughts for improving glucocorticoid-related diagnostic and therapeutic strategies.</p>","PeriodicalId":24004,"journal":{"name":"Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns","volume":"39 9","pages":"886-890"},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630446/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41100756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-09-20DOI: 10.3760/cma.j.cn501225-20230225-00059
Z G Wang, J M Pei, C H Liu, J Zhang, B Q Song
<p><p><b>Objective:</b> To investigate the clinical effects of free transplanted pre-expanded scapular flap in reconstructing scar contracture deformity of neck. <b>Methods:</b> A retrospective observational study was conducted. From February 2010 to August 2020, 17 cervical scar deformity patients (9 males and 8 females, aged 8-42 years) who met the inclusion criteria were admitted to the First Affiliated Hospital of Air Force Medical University. The patients underwent skin and soft tissue expander (hereinafter referred to as expander) implantation in scapular region in stage Ⅰ procedures, and the free transplanted pre-expanded flaps were used to resurface the wounds followed by neck scar resection in the stage Ⅱ procedures. The wound size after neck scar release was 12.0 cm×6.0 cm-30.0 cm×24.0 cm, and the size of the flap ranged from 13.0 cm×7.5 cm to 31.5 cm×25.0 cm. The wounds in donor site of 15 patients were sutured directly, and the wounds in donor site of 2 patients were covered with full-thickness skin graft from abdominal area. The survival of flaps was observed after the operation of stage Ⅱ. Six months after stage Ⅱ surgery, Z plasty was performed to treat the incision scar contracture in 2 patients. For the 5 patients of overweight or bloating appearance in the 1/3 proximal flap underwent debulking procedures in 6-9 months after stage Ⅱsurgery. Before the stage Ⅰ surgery and six months after the last procedure (stage Ⅱ or stage Ⅲ), mental cervical angle (MCA) and cervical mandibular angle (CMA) were measured and the improvement of neck scar was evaluated by the angle values. The cervical motor function, skin color and texture in recipient areas, and scar in the donor sites assessed by Vancouver scar scale (VSS) were observed during follow-up. Data were statistically analyzed with paired sample <i>t</i> test. <b>Results:</b> After stage Ⅱ surgery, 15 patients' flaps survived well; venous crisis occurred in 2 flaps within 24 h after operation, and the flaps survived well after emergency exploration and thrombus removal+vascular re-anastomosis. Compared with the angle values of MCA of (126±12)° and CMA of (148±13)° of patients before the stage Ⅰ surgery, the angle values of MCA of (107±12)° and CMA of (123±11)° of patients in six months after the last procedure were significantly decreased (with <i>t</i> values of 10.68 and 6.54, respectively, <i>P</i><0.05). After 2 years of follow-up, the patient's neck dorsiflexion, lateral bending, or other motor functions were not restricted; the color and texture of the flap in recipient site were close to those of the normal neck skin; the patient cases with VSS scores of scarring of 3, 4, 5, 6, and 7 were 1, 3, 7, 5, and 1 case, respectively. <b>Conclusions:</b> The free transplantation of the pre-expanded scapular flaps can provide sufficient tissue for wound coverage after the release of cervical scar contracture deformity; the expanded skin tissue is featured by thin soft tissue and good plia
{"title":"[Clinical effects of free transplanted pre-expanded scapular flap in reconstructing scar contracture deformity of neck].","authors":"Z G Wang, J M Pei, C H Liu, J Zhang, B Q Song","doi":"10.3760/cma.j.cn501225-20230225-00059","DOIUrl":"10.3760/cma.j.cn501225-20230225-00059","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the clinical effects of free transplanted pre-expanded scapular flap in reconstructing scar contracture deformity of neck. <b>Methods:</b> A retrospective observational study was conducted. From February 2010 to August 2020, 17 cervical scar deformity patients (9 males and 8 females, aged 8-42 years) who met the inclusion criteria were admitted to the First Affiliated Hospital of Air Force Medical University. The patients underwent skin and soft tissue expander (hereinafter referred to as expander) implantation in scapular region in stage Ⅰ procedures, and the free transplanted pre-expanded flaps were used to resurface the wounds followed by neck scar resection in the stage Ⅱ procedures. The wound size after neck scar release was 12.0 cm×6.0 cm-30.0 cm×24.0 cm, and the size of the flap ranged from 13.0 cm×7.5 cm to 31.5 cm×25.0 cm. The wounds in donor site of 15 patients were sutured directly, and the wounds in donor site of 2 patients were covered with full-thickness skin graft from abdominal area. The survival of flaps was observed after the operation of stage Ⅱ. Six months after stage Ⅱ surgery, Z plasty was performed to treat the incision scar contracture in 2 patients. For the 5 patients of overweight or bloating appearance in the 1/3 proximal flap underwent debulking procedures in 6-9 months after stage Ⅱsurgery. Before the stage Ⅰ surgery and six months after the last procedure (stage Ⅱ or stage Ⅲ), mental cervical angle (MCA) and cervical mandibular angle (CMA) were measured and the improvement of neck scar was evaluated by the angle values. The cervical motor function, skin color and texture in recipient areas, and scar in the donor sites assessed by Vancouver scar scale (VSS) were observed during follow-up. Data were statistically analyzed with paired sample <i>t</i> test. <b>Results:</b> After stage Ⅱ surgery, 15 patients' flaps survived well; venous crisis occurred in 2 flaps within 24 h after operation, and the flaps survived well after emergency exploration and thrombus removal+vascular re-anastomosis. Compared with the angle values of MCA of (126±12)° and CMA of (148±13)° of patients before the stage Ⅰ surgery, the angle values of MCA of (107±12)° and CMA of (123±11)° of patients in six months after the last procedure were significantly decreased (with <i>t</i> values of 10.68 and 6.54, respectively, <i>P</i><0.05). After 2 years of follow-up, the patient's neck dorsiflexion, lateral bending, or other motor functions were not restricted; the color and texture of the flap in recipient site were close to those of the normal neck skin; the patient cases with VSS scores of scarring of 3, 4, 5, 6, and 7 were 1, 3, 7, 5, and 1 case, respectively. <b>Conclusions:</b> The free transplantation of the pre-expanded scapular flaps can provide sufficient tissue for wound coverage after the release of cervical scar contracture deformity; the expanded skin tissue is featured by thin soft tissue and good plia","PeriodicalId":24004,"journal":{"name":"Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns","volume":"39 9","pages":"813-819"},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11630154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41094813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号