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

Objective: To explore the classification and repair effects of stage 4 pressure injury in ischial tuberosity in elderly patients. Methods: This study was a retrospective observational study. From January 2021 to December 2022, 45 elderly patients with stage 4 pressure injury in ischial tuberosity of type 4b, 4c, and 4d, who met the inclusion criteria and were admitted to the First Affiliated Hospital of Wannan Medical College, Bengbu Third People's Hospital Affiliated to Bengbu Medical University, and Lu'an Hospital Affiliated to Anhui Medical University (hereinafter referred to as the three hospitals) were selected as the control group, including 28 males and 17 females, aged 60 to 78 years. Fifty elderly patients with stage 4 pressure injury in ischial tuberosity of type 4b, 4c, and 4d, who met the inclusion criteria and were admitted to the three hospitals from January 2023 to December 2024 were selected as the observation group, including 31 males and 19 females, aged 60 to 80 years. The stage 4 pressure injury in ischial tuberosity of patients in observation group were classified on admission, and the targeted surgical methods were selected. For type 4b, the fascial flap was preferred for repair, including fascial flap with skin pedicle (12 cases) and kite flap (14 cases); for type 4c, myocutaneous flap repair was preferred (17 cases); for type 4d, island myocutaneous flap (4 cases) or a combination of muscle flap and flaps (3 cases) was preferred for repair. The surgical methods for repairing the pressure injury of patients in control group were selected based on the surgeon's clinical experience. The type 4b was repaired with fascial flap with skin pedicle in 18 cases and kite flap in 6 cases; the type 4c was repaired with fascial flap with skin pedicle in 6 cases, kite flap in 7 cases, and myocutaneous flap in 3 cases; the type 4d was repaired with kite flap in 2 cases and myocutaneous flap in 3 cases. The sizes of wounds in the two groups of patients were 5.5 cm×4.5 cm to 8.0 cm×7.0 cm after the wound bed was prepared, and the sizes of grafted tissue flaps were 5.0 cm×4.5 cm to 10.0 cm×8.0 cm. The wounds in the flap donor sites were directly sutured or repaired with a relay flap. The following data were recorded, including the wound healing rate after one-time surgical repair, wound healing time, length of hospital stay, hospitalization treatment cost, pressure ulcer scale for healing (PUSH) score at discharge, and recurrence rate of pressure injury during follow-up in two groups of patients. Results: The wound healing rate after one-time surgical repair of patients in observation group was 88.00% (44/50), which was significantly higher than 66.67% (30/45) in control group (with relative risk of 1.32, 95% confidence interval of 1.08 to 1.61, χ²=6.48, P<0.05). After adjusting the general information using multiple logistic regression analysis, the wound healing rate after one-time surgic

Objective: To investigate the effects and mechanism of tannic acid/magnesium nanocomplex (MgTA NC) on wound healing in rats with full-thickness scald. Methods: This study was an experimental study. The MgTA NC with good biocompatibility was synthesized using the hydrothermal method. Mouse RAW 264.7 cells were divided into endotoxins/lipopolysaccharides (LPS) alone group, low MgTA NC group, medium MgTA NC group, and high MgTA NC group, which were all treated with LPS at final mass concentration of 1 μg/mL, and then cultured respectively with MgTA NC at the final mass concentration of 0 (without), 2.5, 5.0, or 7.5 μg/mL for 24 hours. The protein expressions of M1 type macrophage marker inducible nitric oxide synthase (iNOS), M2 type macrophage marker CD163, as well as glycolysis metabolism-related proteins pyruvate kinase type M2 (PKM2) and hexokinase in cells were detected by Western blotting; the expression levels of succinate dehydrogenase and isocitrate dehydrogenase in cells were detected by enzyme-linked immunosorbent assay method. The sample size in cell experiment was 3. Twelve six-week-old male Sprague-Dawley rats were selected and subjected to full-thickness scald on their backs using a temperature-controlled electrothermal burn device. The rats were assigned to control group, simple hydrogel group, and composite hydrogel group according to the random number table method, with 4 rats in each group. The wounds were treated with phosphate buffered saline, methacrylated gelatin (GelMA) hydrogel, or GelMA hydrogel loaded with MgTA NC, respectively. The wound healing rates were calculated at post-injury day 3, 7, and 14 (with the sample size of 4), and the expression level of inflammatory factor tumor necrosis factor α (TNF-α) in the wound tissue at post-injury day 14 was detected by immunohistochemical staining. Results: After 24 hours of culture, the protein expressions of iNOS, the M1 type macrophage marker in RAW 264.7 cells decreased successively in LPS alone group, low MgTA NC group, medium MgTA NC group, and high MgTA NC group, while the protein expressions of CD163, the M2 type macrophage marker increased successively, and the protein expressions of PKM2 and hexokinase decreased successively. After 24 hours of culture, compared with those in LPS alone group, the expression levels of succinate dehydrogenase and isocitrate dehydrogenase in RAW 264.7 cells in low MgTA NC group were significantly increased (P<0.05); compared with those in low MgTA NC group, the expression levels of succinate dehydrogenase and isocitrate dehydrogenase in RAW 264.7 cells in medium MgTA NC group were significantly increased (P<0.05); compared with those in medium MgTA NC group, the expression levels of succinate dehydrogenase and isocitrate dehydrogenase in RAW 264.7 cells in high MgTA NC group were significantly increased (P<0.05). At post-injury day 3, there was no statistically significant difference in the w

Objective: To explore the effects and mechanism of electroacupuncture stimulation on the survival of multi-territory perforator flaps in rats. Methods: This study was an experimental study. Thirty male Sprague-Dawley rats aged 8-10 weeks were collected and divided into electroacupuncture stimulation group and control group according to the random number table method, with 15 rats in each group. Doppler blood flow detectors were used to explore the positions of the dorsal deep circumflex artery, posterior intercostal artery, and thoracodorsal artery in the two groups of rats, and a multi-territory perforator flap was designed and resected with the dorsal deep circumflex artery as the pedicle after ligation of the posterior intercostal artery and thoracodorsal artery, and the flap was replanted in situ. Before the operation, the skin in the area containing choke vessels at the junction between the angiosomes of the thoracodorsal artery and posterior intercostal artery (i.e. the choke zone Ⅱ) in the flaps of rats in electroacupuncture stimulation group was subjected to electroacupuncture stimulation for 1 hour per day for 7 consecutive days, while the flaps of rats in control group received no electroacupuncture stimulation. Seven days after the operation, the survival status of the flaps of all rats in the two groups was observed and the flap survival rate was calculated; the skin tissue from the choke zone Ⅱ was collected and stained with hematoxylin-eosin to observe the microvascular neogenesis and calculate the microvessel density (with sample number of 3). Immunohistochemical staining was performed to observe the expression and distribution of vascular endothelial growth factor (VEGF), and Western blotting was used to detect the protein expression of VEGF (with sample number of 3). Results: Seven days after the operation, the flaps of rats in control group were partially blackened and necrotic, while those in electroacupuncture stimulation group survived with almost no necrosis. The flap survival rate of rats in electroacupuncture stimulation group was (92.1±2.1)%, which was significantly higher than (85.2±1.2)% in control group (t=-10.95, P<0.05). Seven days after the operation, compared with those in control group, the number of new microvessels in the skin tissue in the choke zone Ⅱ of the flaps in rats of electroacupuncture stimulation group increased significantly. The microvessel density in the skin tissue in the choke zone Ⅱ of the flaps in rats of electroacupuncture stimulation group was (21.4±3.0) vessels/mm², which was significantly higher than (11.5±3.7) vessels/mm² in control group (t=-7.34, P<0.05). Seven days after the operation, compared with those in control group, the expression of VEGF in the vascular area of the skin tissue in the choke zone Ⅱ of the flaps in rats of electroacupuncture stimulation group was significantly increased, and the protein expression of VEG

Chronic wounds refer to wounds that fail to achieve complete structural repair within the expected time frame despite standardized systemic treatment, which are characterized by high incidence, complex mechanisms, prolonged clinical course, and difficulty in treatment. Topical growth factor drugs or biological agents, which regulate cell proliferation, migration, and differentiation, thereby effectively promoting the wound healing process, are widely used in the repair of various acute and chronic wounds. However, there is still some controversy over the application of topical growth factors in the clinical practice of treating various chronic wounds. Chinese Burn Association and Editorial Committee of Chinese Journal of Burns and Wounds jointly initiated and organized a multidisciplinary expert group. Based on current evidence-based medical evidence, clinical practice, and authoritative guidelines from other disciplines, this clinical expert consensus was developed for further standardization of the application of topical growth factors in the clinical treatment of chronic wounds.

After craniotomy, the surgical site is prone to develop refractory wounds, which seriously affects the patient's quality of life and significantly increases the medical cost. Clinical studies indicate that the pathogenic factors of such wounds are extremely diverse, their formation mechanism is complex, and their clinical treatment is extremely difficult. In this paper, iceberg analysis is applied to the diagnosis and treatment of refractory wounds after craniotomy. Based on domestic and international literature and clinical practice, combined with preoperative image examination results and intraoperative exploration findings, we provided an in-depth discussion on the causes of wound formation, comprehensively analyzed the pathogenic factors affecting wound healing, and shared the clinical diagnosis and treatment experience in this aspect. Based on the iceberg theory, we propose precise debridement measures and targeted effective repair strategies for this type of refractory wounds.

Wound healing is a complex biological process involving multiple stages, including hemostasis, inflammation, proliferation, and remodeling. Cold atmospheric plasma (CAP), as an efficient, non-invasive, and innovative therapy for wound care, has significant application prospects in this field. It has been demonstrated that CAP can promote wound cell proliferation and reduce microbial load on wounds through various mechanisms. Through a comprehensive analysis of recent domestic and international literature on the biological effects of CAP, this paper reviews how CAP promotes the repair of acute and chronic wounds from the perspectives of mechanism and clinical application and the research progress in the application methods of CAP in recent years.