RESUMO
Due to recalcitrant microangiopathy and chronic infection, traditional treatments do not easily produce satisfactory results for chronic diabetic ulcers. In recent years, due to the advantages of high biocompatibility and modifiability, an increasing number of hydrogel materials have been applied to the treatment of chronic wounds in diabetic patients. Research on composite hydrogels has received increasing attention since loading different components can greatly increase the ability of composite hydrogels to treat chronic diabetic wounds. This review summarizes and details a variety of newly loaded components currently used in hydrogel composites for the treatment of chronic diabetic ulcers, such as polymer/polysaccharides/organic chemicals, stem cells/exosomes/progenitor cells, chelating agents/metal ions, plant extracts, proteins (cytokines/peptides/enzymes) and nucleoside products, and medicines/drugs, to help researchers understand the characteristics of these components in the treatment of diabetic chronic wounds. This review also discusses a number of components that have not yet been applied but have the potential to be loaded into hydrogels, all of which play roles in the biomedical field and may become important loading components in the future. This review provides a "loading component shelf" for researchers of composite hydrogels and a theoretical basis for the future construction of "all-in-one" hydrogels.
RESUMO
BACKGROUND: To determine the characteristics of cross-pin protrusion in patients treated with the reverse Rigidfix femoral fixation device for femoral tunnel preparation through the anteromedial portal in Arthroscopic anterior cruciate ligament reconstruction (ACLR), analyse the reasons for this outcome, and identify safety hazards of this surgical technique for improvement. METHODS: A retrospective analysis of patients who underwent ACLR using this technology at our hospital in 2018 was conducted. Patients with and without cross-pin protrusion were included in the protrusion positive and negative groups, respectively. The sex, age and imaging characteristics of the patients with cross-pin protrusion were identified, and the reasons for cross-pin protrusion were analysed. RESULTS: There were 64 and 212 patients in the protrusion positive and negative groups, respectively. The proportion of cross-pin protrusion cases was 23.19% (64/276). There was a significant difference in the ratio of males to females (P < 0.001, χ2 = 185.184), the mediolateral femoral condyle diameter (protrusion positive group, 70.59 ± 2.51 mm; protrusion negative group, 82.65 ± 4.16 mm; P < 0.001, t = 28.424), and the anteroposterior diameter of the lateral femoral condyle (protrusion positive group, 58.34 ± 2.89 mm; protrusion negative group, 66.38 ± 3.53 mm; P < 0.001, t = 16.615). The cross-pins did not penetrate the lateral femoral condyle cortex in patients with a mediolateral femoral condyle diameter ≥ 76 mm, but the cross-pins definitely penetrated the cortex when the diameter was ≤ 70 mm. The cross-pins did not penetrate when the anteroposterior lateral femoral condyle diameter was ≥ 66 mm, but the cross-pins definitely penetrated it when the diameter was ≤ 59 mm. CONCLUSION: The patients with cross-pin protrusion after reverse Rigidfix femoral fixation treatment to prepare the femoral tunnel through the anteromedial portal in ACLR were mainly females with small femoral condyles. For patients with a mediolateral femoral condyle diameter ≥ 76 mm and an anteroposterior lateral femoral condyle diameter ≥ 66 mm, there is no risk of cross-pin protrusion, so this technique can be used with confidence. LEVELS OF EVIDENCE: III.