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

Objective: To preliminarily evaluate the feasibility, safety, and early aesthetic outcomes of using the pectoralis major fascia in robotic nipple-sparing mastectomy with immediate breast reconstruction with gel implant (RNSMIBR). Methods: This study was a retrospective cohort study. From November 2023 to April 2025, 34 female breast cancer patients who met the inclusion criteria were treated at the First Affiliated Hospital of Zhengzhou University. Seventeen patients, aged 43±7 years, who underwent posterior subpectoral pocket expansion using a titanium mesh patch in RNSMIBR surgery were included into titanium mesh patch group, and 17 patients, aged 46±7 years, who underwent posterior subpectoral pocket expansion using the pectoralis major fascia in RNSMIBR surgery were included into pectoralis major fascia group. Surgery-related complications during postoperative hospitalization and follow-up within 30 days after discharge were recorded and graded using the Clavien-Dindo classification. During the follow-up of approximately 3 months postoperatively, the BREAST-Q scale was used to score the patients' satisfaction with breast appearance, psychosocial well-being, and satisfaction with medical care. Results: During postoperative hospitalization and follow-up within 30 days after discharge, three patients in titanium mesh patch group experienced grade Ⅰ complications. In pectoralis major fascia group, three patients experienced grade Ⅰ complications and three patients experienced grade Ⅲb complications. The grade Ⅲb complication in one patient was caused by radiotherapy. No complications occurred in other patients in the two groups. There was no statistically significant difference in the Clavien-Dindo classification of surgery-related complications between the two groups of patients (P>0.05). During the follow-up of approximately 3 months postoperatively, the BREAST-Q scale scores were 92±5 in titanium mesh patch group of patients and 79±28 in pectoralis major fascia group of patients, with no statistically significant difference between the two groups (P>0.05). Conclusions: The pectoralis major fascia-assisted expansion technique may serve as an alternative option of expansion in RNSMIBR when titanium mesh patch is unavailable or cost-prohibitive. For patients requiring postoperative radiotherapy, titanium mesh patch or other materials that do not rely on vascular supply are still preferred to balance aesthetic outcomes and complication control.

Children constitute a key population for scar prevention and treatment, attributed to the unique features of their skin's physiological structure and psychosomatic growth. Current approaches for preventing and treating pediatric scars are formulated with reference to relevant consensuses and guidelines for adult, failing to fully consider the specific characteristics of pediatric scars and their special needs of growth and development. As a result, some strategies for prevention and treatment remain controversial. To address this limitation, the Chinese Burn Association brought together domestic and international experts in the field of scar prevention and treatment from relevant disciplines. Guided by evidence-based medicine, referring domestic and international literature, and combining the clinical experience of specialist physicians, the Clinical practice guideline for pediatric scar prevention and treatment (2025 edition) was finally developed after consultations on clinical issues and then multiple rounds of expert meetings for discussions. This guideline outlines 20 recom-mendations addressing 10 key issues in pediatric scar prevention and treatment, and discusses the controversial issues in this field, aiming to provide scientific guidance for the entire process of prevention, treatment, and rehabilitation of scars in children aged 1-14 years.

Diabetic foot is one of the common and serious complications among the patients with diabetes mellitus. The major causes of amputation and/or death in the patients are foot deformities, ulcers, ischemia, and possible concurrent infections. To further standardize diabetic foot prevention and treatment in China, improve its diagnostic and therapeutic consistency, and promote the development of a specialized tiered care system, Chinese Burn Association, Yangtze River Delta Integrated Diabetic Foot Alliance, and Editorial Committee of Chinese Journal of Burns and Wounds organized a multidisciplinary expert team. The team determined clinical issues related to the diagnosis, treatment, and prevention of diabetic foot and evaluated the quality grades of relevant evidence using the grading of recommendations assessment, development, and evaluation system, and eventually developed the Practical guideline on the prevention and management of diabetic foot in China. There were 46 recommendations formed in the guideline, covering comprehensive medical assessment, internal medical treatments such as control of blood glucose, blood pressure, and blood lipid, antithrombotic and anti-infection therapy, perioperative risk assessment and management, surgical treatments such as debridement, vascular reconstruction, and tissue repair surgeries, as well as foot disease prevention, multidisciplinary team cooperation, and the construction of a tiered care system, aiming to provide guidance for the clinical practice of diabetic foot in China.

Patients with burns and trauma often have complex conditions that require multidisciplinary diagnosis and treatment as a single discipline is insufficient to meet the needs of modern medical goals. Multidisciplinary team (MDT) collaborative diagnosis and treatment, as an important model for solving this problem, faces challenges such as the lack of initiation mechanisms, loose process management, and absence of value-based incentives in practical clinical applications. From a management perspective, this article analyzes the essential differences between MDT collaborative diagnosis and treatment for burn and trauma patients and traditional consultations, and explores the core issues from the technical level to management innovation, including leveraging on the advance technologies of burn discipline, relying on the strong disciplines of medical institutions, integrating disciplines centered on patients, optimizing processes with management as a link, and driving long-term operation with performance-based incentives. The aim is to provide strategic references for the effective implementation of MDT collaborative diagnosis and treatment for burn and trauma patients.

Burn medicine, as the only clinical discipline named based on etiology, is an interdisciplinary subject that integrates burn trauma emergency, wound repair, functional reconstruction, and comprehensive rehabilitation. The history of burn medicine development is an evolutionary history of the continuous integration and permeation of multi-disciplinary technologies and the continuous improvement of theoretical systems. In recent years, with the improvement of public protection awareness and changes in the disease spectrum, the burn discipline is undergoing a profound transformation from single-specialty treatment to the multidisciplinary team (MDT) collaborative diagnosis and treatment model. Its scope has gradually expanded to a more integrated burns and wound repair surgery. This article starts from the changes in the disease spectrum of the discipline, systematically analyzes the necessity, current status, and main practice models of multidisciplinary integration in the diagnosis and treatment of burns and wound repair surgery. It explores the opportunities and challenges that cutting-edge technologies such as artificial intelligence and regenerative medicine pose to the innovative development of the discipline in promoting the MDT collaboration, and puts forward the future direction for the development of MDT collaborative diagnosis and treatment in burns and wound repair surgery, hoping to provide a reference for the discipline construction.