Zhonghua shao shang yu chuang mian xiu fu za zhi最新文献

Objective: To summarize the refined surgical protocol and clinical efficacy of total expansion auricular reconstruction surgery. Methods: This study was a retrospective study of case series. From July 2015 to June 2025, 1 136 patients (1 187 ears) with congenital microtia who met the inclusion criteria were admitted to the Department of Plastic Surgery of the First Affiliated Hospital of Air Force Medical University, including 781 males and 355 females, aged 8-40 years. All the patients underwent total expansion auricular reconstruction surgery, a procedure performed in 3 stages, with stage Ⅰ involving skin and soft tissue expander implantation, stage Ⅱ involving costal cartilage harvesting and expanded flap and residual ear management, cartilage framework fabrication and implantation, and stage Ⅲ involving residual ear revision and earlobe transposition. The postoperative complications after stages Ⅰ, Ⅱ, and Ⅲ were observed and recorded, and the total complication rate was calculated. At the last follow-up, patients' satisfaction with the surgical outcome was surveyed using a self-designed satisfaction scale, and the satisfaction rate was calculated. Results: Postoperative hematoma occurred in 33 patients, including 17 cases after the stage Ⅰ surgery, 15 cases after the stage Ⅱ surgery, and 1 case after both the stage Ⅰ and Ⅱ surgeries. Cartilage framework infection occurred in 15 patients after the stage Ⅱ surgery, cartilage framework helix fracture occurred in 3 patients after the stage Ⅱ surgery, and cartilage framework deformation occurred in 12 patients after the stage Ⅱ surgery. The total complication rate of patients was 5.5% (63/1 136). At the last follow-up during 3 months to 4 years after the stage Ⅲ surgery, 957 patients were satisfied with the surgical outcome, 156 patients were basically satisfied, and 23 patients were dissatisfied, with satisfaction rate of 98.0% (1 113/1 136). Conclusions: Total expansion auricular reconstruction surgery for congenital microtia provides sufficient expanded skin tissue, eliminating the need for skin grafting. The reconstructed auricle achieves an excellent shape with few complications, and patients are highly satisfied with the surgical outcome.

Tophi, a severe complication of advanced gout, develop in approximately 12% to 53% of patients with gout. The treatment of bone and joint damages and chronic refractory wounds caused by tophi presents considerable clinical challenges. Currently, there is no unified standard for the optimal surgical timing, perioperative management, and treatment approaches for this condition. To address this, the Wound Repair Professional Committee of Chinese Medical Doctor Association convened a multidisciplinary panel of senior experts in wound repair, plastic surgery, orthopedics & joint surgery, rheumatology and immunology, radiology, and nursing and wound management. Based on the literature evidence combined with expert opinion, the panel employed nominal group and Delphi methods, and a grading standard (levels 1 to 4) defining the extent of tophi damage and the treatment principle were established for the first time to ensure homogeneity of surgical treatment; 14 recommendations on the diagnosis and treatment of tophi were proposed, providing practical guidance for the surgical treatment of tophi.

The core objective of superficial organ reconstruction is to perfectly restore the organ's morphological structure and biological function. Currently, significant progress has been achieved in structural construction, blood supply assurance, and morphological and functional reconstruction of superficial organ reconstruction, primarily relying on approaches including surgical techniques, tissue engineering, and regenerative medicine. In the future, with the integration and application of cutting-edge technologies such as gene editing, artificial intelligence, three-dimensional printing, and brain-computer interfaces, superficial organ reconstruction is poised to enter a new historical stage characterized by high intelligence, precision, and comprehensive functional restoration. This article focuses on superficial organ reconstruction, systematically outlines its concept, challenges, and current development status, and proposes future perspectives for this field.

The repair of facial organ injuries is a complex field in plastic surgery that involves both functional recovery and morphological reconstruction. The therapeutic goal has evolved from traditional wound closure to the harmonious integration of form and function. To achieve this new objective, surgical plans need to combine various flap techniques, autologous and allogeneic tissue transplantation approaches, and incorporate emerging methods such as digital design and biomaterials. Although the repair outcomes of facial organ injuries have improved compared to the past, challenges remain, including insufficient nerve function reconstruction, limited scar management, donor site damage, and immune rejection in allogeneic transplantation. This article systematically reviews the mainstream repair methods and advancements in domestic and international research on key facial structures, including the nose, eyelids, lips, and ears, focusing on their defect characteristics and repair difficulties. It emphasizes how to achieve both three-dimensional structural reconstruction and dynamic functional restoration while maintaining aesthetic reconstruction. In the future, the integration of technologies such as tissue engineering, three-dimensional bioprinting, supermicrosurgery, and artificial intelligence will drive the development of facial organ injury repair and reconstruction towards precision, personalization, and minimally invasive approaches, ultimately achieving comprehensive rehabilitation of patients' physical, psychological, and social roles.

The construction of a wound repair discipline system with Chinese characteristics is an ongoing process. The construction of this system at the grassroots level, particularly in country-level medical institutions and areas with relatively weak health resources, is the important part of the construction of a wound repair discipline system with Chinese characteristics. It plays an important role in improving the wound prevention and treatment levels, and meeting the medical needs of the people. This paper introduces the phased achievements in the construction of the wound repair discipline systems in the countryside areas of South Anhui, South Jiangxi, and Hainan (referred to as the "Three Souths"), providing a valuable reference for the construction of a wound repair discipline system in countryside areas in China.