Efficacy of hydrosurgical excision combined with skin grafting in the treatment of deep partial-thickness and full-thickness burns: A two-year retrospective study.

INTRODUCTION: Deep partial-thickness and full-thickness burn wounds often undergo tangential excision or escharectomy to expose healthy tissue, combined with skin grafting to promote wound healing. However, conventional tangential excision with the humby knife leads to inevitable damage to the dermis while excising burn tissue due to the lack of precision. Indeed, the preservation of dermal tissue is a key factor in determining wound healing and scar quality. The precision and tissue selectivity of the Versajet Hydrosurgical System has been established for excising burn tissue while preserving dermal tissue. In this study, we retrospectively compared the efficacy of "Hydrosurgical excision combined with skin grafting" and "Conventional tangential excision combined with skin grafting" in treating deep partial-thickness and full-thickness burn wounds to demonstrate that hydrosurgery improved the treatment of deep partial-thickness and full-thickness burns. METHODS: A total of 86 patients with deep partial-thickness and/or full-thickness burns with a total burn surface area (TBSA) ≤ 25% from July 2018 to July 2020 were included in this study and were divided into experimental (hydrosurgical excision combined with skin grafting, n = 43) and control (conventional tangential excision combined with skin grafting, n = 43) groups. Parameters were analyzed, including the intraoperative blood loss volume per unit area of grafted skin, surgery duration, wound healing time, skin graft survival, and the treatment costs per unit of burned area. Scar assessment was performed at 1 year with the modified Vancouver Scar Scale linked with TBSA (mVSS-TBSA). RESULT: No significant difference was found in male to female ratio, age, weight, TBSA, burn depth, skin grafting area (SKA), skin grafting methods, cases treated with carbon dioxide fractional laser or incidence of inhalation injury, and the incidence of hypovolemic shock between two groups(p > 0.05). Compared with the control group, patients treated with hydrosurgical excision combined with skin grafting experienced less intraoperative blood loss volume per unit area of grafted skin (p < 0.05). The mVSS-TBSA of patients that underwent hydrosurgical excision combined with skin grafting was significantly improved in comparison to the control group (p < 0.01). No significant difference was found in surgery duration, wound healing time, skin graft survival and treatment costs per unit of burned area between the two groups (p > 0.05). CONCLUSION: Hydrosurgical excision combined with skin grafting reduced intraoperative blood loss volume per unit area of grafted skin, improved scarring 1-year after injury, and did not increase the treatment costs per unit of burned area. This technique provides a novel alternative for managing deep partial-thickness and full-thickness burn wounds.

[Effect of compound Chinese sour taste herbs on advanced glycation end products content and gene expression of their receptors in aorta of rats with type 2 diabetes mellitus].

OBJECTIVE: To investigate the possible mechanism of compound Chinese sour taste herbs (CS) in preventing and ameliorating diabetic macroangiopathy by analyzing the effects of CS on the deposition of advanced glycation end products (AGEs) and gene expression of receptor for advanced glycation end products (RAGE) in the aorta tissue of rats with type 2 diabetes mellitus (T2DM). METHODS: Rat model of T2DM was established by peritoneal injection of streptozotocin (STZ) and high caloric diet feeding. Experimental SD rats were divided into the normal group, the model group, the aminoguanidine (AG) group, and the CS group. At the end of the 8th and 12th week, the fasting blood glucose (FBG) was measured by glucose oxidase method; content of AGEs and collagen in aorta detected by fluorescent method and gene expression of RAGE in aorta determined by Real-time PCR method. RESULTS: FBG, AGEs and collagen contents and RAGE expression in aorta of model rats were all higher than those in the normal control group (P <0.05), while all these indices were lower in the CS group than in the model group (P<0.05). CONCLUSION: CS could realize the goal for preventing and ameliorating diabetic macroangiopathy by way of suppressing the production of AGEs and down-regulating the gene expression of RAGE in aorta of T2DM rats.