Objective: To systematically explore the effects of moderate-intensity static magnetic fields (SMF) on type 2 diabetic wound healing and preliminarily explore the possible mechanism, and hence to lay a foundation for ...Objective: To systematically explore the effects of moderate-intensity static magnetic fields (SMF) on type 2 diabetic wound healing and preliminarily explore the possible mechanism, and hence to lay a foundation for its scientific and extensive clinical application. Methods:Round-shape wound of soft tissues with 1-cm diameter was constructed on the dorsum of thirty-two 3-month-old male type 2 diabetic db/db mice and sixteen wild-type mice with the same gene background, followed by covered with transparent film wound dressing. The experiment was divided into the control group (control), db/db mice group (db/db), and db/db mice exposed to SMF group (db/db+SMF) with sixteen mice in each group. Four mice in each group were killed post 5, 12 and 19 days of the wound model establishment, respectively. The mice in the db/db+SMF group were subjected to systemic SMF exposure (4 mT peak intensity) with 2 h per day. The wound closure rate, overall wound healing period, tensile strength, and histopathological morphology in each group were determined and analyzed. The interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF) gene expression were also measured and analyzed. Results: SMF significantly increased the wound closure rate (P<0.05), decreased the overall healing period (P<0.05), increased the tensile strength of wound tissues (P<0.05), decreased the number of inflammatory cells, and inhibited the expression of inflammatory cytokines (IL-1β, TNF-αand IL-6) in db/db mice at 5, 12 and 19 days post-surgery (P<0.05), whereas SMF had no significant effect on the VEGF expression. Conclusion: Moderate-intensity systemic SMF exposure exhibits positive therapeutic effects on accelerating type 2 diabetic soft tissue wound repair, and the positive effects are closely related to its significant anti-inflammatory response.展开更多
Objective: To explore an early stage repair method for soft tissue defect of limbs of modern firearm wound, and to improve treating result. Methods: Defects of the hind limbs of dogs were repaired with skin, muscle an...Objective: To explore an early stage repair method for soft tissue defect of limbs of modern firearm wound, and to improve treating result. Methods: Defects of the hind limbs of dogs were repaired with skin, muscle and myocutaneous flaps. Results: Wounds healed within 2 weeks in the experimental group except one that healed in 3 weeks because of infection. Limb function was close to normal. The treatment result was better in the experimental group than the control. Conclusions: Skin, muscle and myocutaneous flaps can cover soft tissue defect at an early stage, prevent and reduce infection, promote the healing and recovery of combined injury, reduce the time of treatment and disability rate.展开更多
Background:Currently,various external tissue expansion devices are becoming widely used.Considering the scarcity of relevant application standards,this systematic review was performed to explore the effectiveness and ...Background:Currently,various external tissue expansion devices are becoming widely used.Considering the scarcity of relevant application standards,this systematic review was performed to explore the effectiveness and safety of external tissue expansion techniques for the reconstruction of soft tissue defects.Method:A systematic review and meta-analysis on the efficacy and safety of external tissue expansion technique was conducted.A comprehensive search was performed in the following electronic databases:PubMed/Medline,Embase,Cochrane Library(Wiley Online Library),andWeb of Science.Studies reporting patients with soft tissue defects under the treatment of external tissue expansion technique were included.Results:A total of 66 studies with 22 different types of external tissue expansion devices met the inclusion criteria.We performed a descriptive analysis of different kinds of devices.A single-arm meta-analysis was performed to evaluate the efficacy and safety of the external tissue expansion technique for different aetiologies.The pooled mean wound healing time among patients with defects after fasciotomy was 10.548 days[95%confidence interval(CI)=5.796-15.299].The pooled median wound healing times of patients with defects after excisional surgery,trauma,chronic ulcers and abdominal defects were 11.218 days(95%CI=6.183-16.253),11.561 days(95%CI=7.062-16.060),15.956 days(95%CI=11.916-19.996)and 12.853 days(95%CI=9.444-16.227),respectively.The pooled wound healing rates of patients with defects after fasciotomy,excisional surgery,trauma,chronic ulcers and abdominal defects were 93.8%(95%CI=87.1-98.2%),97.2%(95%CI=92.2-99.7%),97.0%(95%CI=91.2-99.8%),99.5%(95%CI=97.6-100%),and 96.8%(95%CI=79.2-100%),respectively.We performed a subgroup analysis in patients with diabetic ulcers and open abdominal wounds.The pooled median wound healing time of patients with diabetic ulcers was 11.730 days(95%CI=10.334-13.125).The pooled median wound healing time of patients with open abdomen defects was 48.810 days(95%CI=35.557-62.063)and the pooled successful healing rate was 68.8%(95%CI=45.9-88.1%).A total of 1686 patients were included,265(15.7%)of whom experienced complications.The most common complication was dehiscence(n=53,3.14%).Conclusions:Our systematic review is the first to demonstrate the efficacy and safety of external tissue expansion in the management of soft tissue defects.However,we must interpret the meta-analysis results with caution considering the limitations of this review.Large-scale randomized controlled trials and long-term follow-up studies are still needed to confirm the effectiveness and evaluate the quality of healing.展开更多
A 38-year-old man sustained a traffic accident injury to his right medial malleolus and leg. It was an open fracture of the right tibia and fibula accompanied by a large soft tissue defect of the right medial malleolu...A 38-year-old man sustained a traffic accident injury to his right medial malleolus and leg. It was an open fracture of the right tibia and fibula accompanied by a large soft tissue defect of the right medial malleolus sized 12 cmx4 cm. Doppler examination revealed that the tibialis posterior vessel was occluded due to thrombosis. The anterior tibial artery was patent. Three weeks after injury, the left anterolateral thigh muscle flap was harvested and transplanted to the right medial malleolus defect area for repair of the soft tissue defect, and an end-to-side anastomosis was performed between the posterior tibial vessel of the contralateral leg and the muscle flap＇s vascular pedicle.A split thickness free skin graft was used to cover the muscle flap and around the flap＇s vascular pedicle. The vascular pedicle was cut off after 28 days and the muscle flap survived completely. After 3-year follow-up postoperatively, the right tibia and fibula fractures were confirmed healing radiologically. The posterior tibial artery of contralateral leg was patent by clinical and Doppler examinations. This technique can be used to preserve the flow and patency of recipient arteries.展开更多
Long-standing wounds are at high risk for infection.Therefore,it is critical to achieve wound healing in a timely manner;however,some complex wounds remain recalcitrant and difficult to treat.Local muscle flaps are an...Long-standing wounds are at high risk for infection.Therefore,it is critical to achieve wound healing in a timely manner;however,some complex wounds remain recalcitrant and difficult to treat.Local muscle flaps are an underutilized technique with great utility in the reconstruction of complex foot wounds.Providing a healthy bleeding base that promotes wound healing,these muscle flaps can greatly benefit the patient and prevent amputation.In this present report,we demonstrate the use of the abductor hallucis muscle flap in the reconstruction of a complex wound following bunion surgery.展开更多
基金This study was supported by the General Project of National Natural Science Foundation of China (Grant 81471806)
文摘Objective: To systematically explore the effects of moderate-intensity static magnetic fields (SMF) on type 2 diabetic wound healing and preliminarily explore the possible mechanism, and hence to lay a foundation for its scientific and extensive clinical application. Methods:Round-shape wound of soft tissues with 1-cm diameter was constructed on the dorsum of thirty-two 3-month-old male type 2 diabetic db/db mice and sixteen wild-type mice with the same gene background, followed by covered with transparent film wound dressing. The experiment was divided into the control group (control), db/db mice group (db/db), and db/db mice exposed to SMF group (db/db+SMF) with sixteen mice in each group. Four mice in each group were killed post 5, 12 and 19 days of the wound model establishment, respectively. The mice in the db/db+SMF group were subjected to systemic SMF exposure (4 mT peak intensity) with 2 h per day. The wound closure rate, overall wound healing period, tensile strength, and histopathological morphology in each group were determined and analyzed. The interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF) gene expression were also measured and analyzed. Results: SMF significantly increased the wound closure rate (P<0.05), decreased the overall healing period (P<0.05), increased the tensile strength of wound tissues (P<0.05), decreased the number of inflammatory cells, and inhibited the expression of inflammatory cytokines (IL-1β, TNF-αand IL-6) in db/db mice at 5, 12 and 19 days post-surgery (P<0.05), whereas SMF had no significant effect on the VEGF expression. Conclusion: Moderate-intensity systemic SMF exposure exhibits positive therapeutic effects on accelerating type 2 diabetic soft tissue wound repair, and the positive effects are closely related to its significant anti-inflammatory response.
文摘Objective: To explore an early stage repair method for soft tissue defect of limbs of modern firearm wound, and to improve treating result. Methods: Defects of the hind limbs of dogs were repaired with skin, muscle and myocutaneous flaps. Results: Wounds healed within 2 weeks in the experimental group except one that healed in 3 weeks because of infection. Limb function was close to normal. The treatment result was better in the experimental group than the control. Conclusions: Skin, muscle and myocutaneous flaps can cover soft tissue defect at an early stage, prevent and reduce infection, promote the healing and recovery of combined injury, reduce the time of treatment and disability rate.
基金the National Natural Science Foundation of China(81930057,81772076,81971836)the CAMS Innovation Fund for Medical Sciences(2019-I2M-5-076)+1 种基金the Deep Blue Talent Project of Naval Medical University,the 234 Academic Climbing Programme of Changhai Hospitalthe Achievements Supportive Fund(2018-CGPZ-B03).
文摘Background:Currently,various external tissue expansion devices are becoming widely used.Considering the scarcity of relevant application standards,this systematic review was performed to explore the effectiveness and safety of external tissue expansion techniques for the reconstruction of soft tissue defects.Method:A systematic review and meta-analysis on the efficacy and safety of external tissue expansion technique was conducted.A comprehensive search was performed in the following electronic databases:PubMed/Medline,Embase,Cochrane Library(Wiley Online Library),andWeb of Science.Studies reporting patients with soft tissue defects under the treatment of external tissue expansion technique were included.Results:A total of 66 studies with 22 different types of external tissue expansion devices met the inclusion criteria.We performed a descriptive analysis of different kinds of devices.A single-arm meta-analysis was performed to evaluate the efficacy and safety of the external tissue expansion technique for different aetiologies.The pooled mean wound healing time among patients with defects after fasciotomy was 10.548 days[95%confidence interval(CI)=5.796-15.299].The pooled median wound healing times of patients with defects after excisional surgery,trauma,chronic ulcers and abdominal defects were 11.218 days(95%CI=6.183-16.253),11.561 days(95%CI=7.062-16.060),15.956 days(95%CI=11.916-19.996)and 12.853 days(95%CI=9.444-16.227),respectively.The pooled wound healing rates of patients with defects after fasciotomy,excisional surgery,trauma,chronic ulcers and abdominal defects were 93.8%(95%CI=87.1-98.2%),97.2%(95%CI=92.2-99.7%),97.0%(95%CI=91.2-99.8%),99.5%(95%CI=97.6-100%),and 96.8%(95%CI=79.2-100%),respectively.We performed a subgroup analysis in patients with diabetic ulcers and open abdominal wounds.The pooled median wound healing time of patients with diabetic ulcers was 11.730 days(95%CI=10.334-13.125).The pooled median wound healing time of patients with open abdomen defects was 48.810 days(95%CI=35.557-62.063)and the pooled successful healing rate was 68.8%(95%CI=45.9-88.1%).A total of 1686 patients were included,265(15.7%)of whom experienced complications.The most common complication was dehiscence(n=53,3.14%).Conclusions:Our systematic review is the first to demonstrate the efficacy and safety of external tissue expansion in the management of soft tissue defects.However,we must interpret the meta-analysis results with caution considering the limitations of this review.Large-scale randomized controlled trials and long-term follow-up studies are still needed to confirm the effectiveness and evaluate the quality of healing.
文摘A 38-year-old man sustained a traffic accident injury to his right medial malleolus and leg. It was an open fracture of the right tibia and fibula accompanied by a large soft tissue defect of the right medial malleolus sized 12 cmx4 cm. Doppler examination revealed that the tibialis posterior vessel was occluded due to thrombosis. The anterior tibial artery was patent. Three weeks after injury, the left anterolateral thigh muscle flap was harvested and transplanted to the right medial malleolus defect area for repair of the soft tissue defect, and an end-to-side anastomosis was performed between the posterior tibial vessel of the contralateral leg and the muscle flap＇s vascular pedicle.A split thickness free skin graft was used to cover the muscle flap and around the flap＇s vascular pedicle. The vascular pedicle was cut off after 28 days and the muscle flap survived completely. After 3-year follow-up postoperatively, the right tibia and fibula fractures were confirmed healing radiologically. The posterior tibial artery of contralateral leg was patent by clinical and Doppler examinations. This technique can be used to preserve the flow and patency of recipient arteries.
文摘Long-standing wounds are at high risk for infection.Therefore,it is critical to achieve wound healing in a timely manner;however,some complex wounds remain recalcitrant and difficult to treat.Local muscle flaps are an underutilized technique with great utility in the reconstruction of complex foot wounds.Providing a healthy bleeding base that promotes wound healing,these muscle flaps can greatly benefit the patient and prevent amputation.In this present report,we demonstrate the use of the abductor hallucis muscle flap in the reconstruction of a complex wound following bunion surgery.
