3D-printed piezocatalytic hydrogels for effective antibacterial treatment of infected wounds.

Bacterial-infected wound repair has become a significant public health concern. This study developed a novel 3D-printed piezocatalytic SF-MA/PEGDA/Ag@BT (SPAB) hydrogels were fabricated by using digital light processing. These hydrogels exhibited high consistency, mechanical properties and good biocompatibility. Besides, the SPAB hydrogels exhibited excellent piezocatalytic performance and thus could induce piezoelectric polarization under ultrasound to generate reactive oxygen species (ROS). The SPAB hydrogels possessed an antibacterial rate of 99.23% and 99.96% for Escherichia coli and Staphylococcus aureus, respectively, under 5 min of ultrasonic stimulation (US) in vitro. The US-triggered piezocatalytic performance could increase antibacterial activity and improve the healing process of the infected wound. Therefore, the 3D printed piezocatalytic SPAB hydrogels could be unutilized as wound dressing in the field of bacterial-infected wound repair.

A pH responsive tannic acid/quaternized carboxymethyl chitosan/oxidized sodium alginate hydrogels for accelerated diabetic wound healing and real-time monitoring.

Treatment of diabetic wounds is a major clinical issue. Diabetic wound dressings have higher requirements for anti-oxidant, antibacterial and wound monitoring properties compared to conventional wound dressings. In this study, a novel tannic acid (TA)/quaternized carboxymethyl chitosan (QCMCS)/oxidized sodium alginate (OSA)@carbon quantum dots (CQD) (TA/QCMCS/OSA@CQD) hydrogels for promoting diabetic wound healing and real-time monitoring have been developed. The TA/QCMCS/OSA@CQD hydrogels exhibited excellent self-healing, antibacterial and antioxidant properties. Besides, these hydrogels possessed good biocompatibility and effective hemostasis in a mouse liver injury model and significantly facilitated the healing process in a diabetic wound model. In addition, these hydrogels can reliable and timely measure the diabetic wound pH information by collecting image signals of hydrogels to monitor the healing status. Therefore, the pH responsive TA/QCMCS/OSA@CQD hydrogels could be utilized as wound dressing for promoting diabetic wound healing and real-time monitoring.

Predicting the Risk of Postoperative Complications of Schwannoma Surgery: Development and Assessment of a New Predictive Nomogram.

BACKGROUND: The aim of this study was to develop and internally validate a risk nomogram for postoperative complications of schwannoma surgery. METHODS: From 2016 to 2020, we reviewed 83 patients who underwent schwannoma resection with a total number of 85 schwannomas. A predictive model was developed based on the dataset of this group. During model construction, univariate and multivariate logistic regression analysis were used to determine the independent predictors of postoperative complications. Assessment of the discriminative function, calibrating proficiency, and clinical usefulness of the predicting model was performed using C-index, calibration plot, receiver operating characteristic (ROC) curve, and decision curve analysis. Internal validation was assessed using bootstrapping validation. RESULTS: Predictors contained in the prediction nomogram included age, tumor location, symptoms, and surgical approach. The model displayed satisfying abilities of discrimination and calibration, with a C-index of 0.901 (95% confidence [CI]: 0.837-0.965). A high C-index value of 0.853 was achieved in the interval verification. Decision curve analysis showed that the nomogram was clinically useful when intervention was decided at the complication possibility threshold of 2%. CONCLUSION: This new risk nomogram for postoperative complications of schwannoma surgery has taken age, tumor location, symptoms, and surgical approach into account. It has reasonable predictive accuracy and can be conveniently used. It shall help patients understand the risk of postoperative complications before surgery, and offer guidance to surgeons in deciding on the surgical approach.

Foot and ankle reconstruction using the lateral supramalleolar flap versus the anterolateral thigh flap in the elderly: A comparative study.

The purpose of this study was to compare the reconstructive outcomes of soft-tissue defects around the foot and ankle with anterolateral thigh (ALT) flap or lateral supramalleolar (LSM) flap and attempt to provide an optimal strategy for elderly patients. A retrospective review of all continuous patients with foot and ankle reconstruction using different flaps from October of 2010 and October of 2020 was performed. Based on the flap types, the patients were divided into two groups: ALT flap group (n = 50) and LSM flap group (n = 46). Outcomes were assessed according to the flap survival rate, early complications, general complications, late complications, cosmetic appearance, functional outcomes and Vancouver Scar Scale (VSS). We found that there was no difference in average age, gender, aetiology, size of the defect, debridement times between the two groups; however, a significant difference in operation time, hospitalisation time and cost were noted between them. What's more, the early flap complications between them were not significantly different. The LSM flap group showed less general complications, less flap bulky and lower cosmetic appearance. Moreover, the functional evaluation and VSS seem similar (P > .05). Thus, The ALT flap and LSM flap are both flaps available for foot and ankle reconstruction in elderly patients. However, the LSM flap offers short operation time, short hospitalisation time, and less cost with a lower frequency of postoperative complications. Thus, we advocate the LSM flap for the reconstruction of moderate-size defects of the foot and ankle region in elderly patients.

[MIPPO and ORIF for the treatment of elderly proximal humerus fractures of type Neer II:a case control study].

OBJECTIVE: To compare the clinical efficacy of minimally invasive percutaneous plate osteosynthesis(MIPPO)and open reduction and internal fixation (ORIF) in treating senile NEER IIproximal humerus fractures. METHODS: From March 2014 to March 2016, 46 elderly patients with Neer II proximal humerus fractures were retrospectively reviewed. Among them, 20 patients in MIPPO group included 9 males and 11 females with an average age of (70.4±4.4) years old; while 26 patients in ORIF group included 11 males and 15 females with an average age of (70.9±4.0) years old. The length of hospital stay, times of fluoroscopy, beginning time of function rehabilitation, healing time of fracture, Constant Murley score of the shoulder joint at 3, 6, 12 months after operation and complications were observed and compared. RESULTS: All patients were followed up for 12 to 24 months with an average of 16.8±3.7. The healing time of fracture, beginning time of function rehabilitation in MIPPO group were(13.0±0.8) weeks, (3.0±0.9) days respectively and shorter than those in ORIF group which were (13.8±1.4) weeks and(6.8±1.3) days. The times of fluoroscopy in MIPPO group was 19.2±3.7 and more than that in ORIF group which was 12.1±3.4. At 3 and 6 months after operation, Constant Murley score in MIPPO group were 81.3±3.9, 86.6±5.4 and more than that in ORIF group which were 69.5±6.6, 80.5±6.7. There were no differences between two groups in the length of hospital stay, Constant Murley score at 12 months after operation and grading at the final follow-up. There was one fracture redisplacement in each group. And 1 case of axillary nerve injury in MIPPO group, 2 cases of delayed union in ORIF group. No incision infection, screw loosening or plate break was found. CONCLUSIONS: MIPPO and ORIF are both effective in treating Neer II proximal humeral fractures. MIPPO technique has the advantages of faster recovery, earlier rehabilitative exercise and better shoulder function. The disadvantages are more exposure to radiationd and the possibility of axillary nerve injure.