Clinical application of platelet rich plasma to promote healing of open hand injury with skin defect.

Background: Skin defects caused by open hand trauma are difficult to treat clinically and severely affect the recovery of hand function. Autologous platelet-rich plasma (PRP) has been widely used in the treatment of refractory chronic wounds, but its use in hand trauma skin defects remains scarce. Methods: This study compared the outcomes of 27 patients treated with PRP to 31 patients undergoing skin flap transplantation for hand wounds. We assessed several parameters, including healing times, duration of surgery, postoperative pain (VAS score), intraoperative amputation length, finger function, sensation restoration, nail bed preservation, and hospitalization expenses. Results: PRP-treated patients showed a mean healing time of 21.59 ± 3.17 days. Surgical times were significantly shorter in the PRP group (22.04 ± 7.04 min) compared to the flap group (57.45 ± 8.15 min, P < 0.0001). PRP patients experienced longer postoperative healing times (20.15 ± 2.16 days) than those in the skin flap group (12.84 ± 1.08 days, P < 0.0001), but reported lower pain scores (1.3 ± 1.44 vs 2.55 ± 2.06, P = 0.0119). Range of Motion (ROM) at the proximal interphalangeal joint was better in the PRP group (96.26° ± 6.69) compared to the flap group (86.16° ± 15.24, P = 0.0028). Sensory outcomes favored the PRP group, with a two-point discrimination of 2.37 ± 1.34 mm versus 2.52 ± 1.27 mm in the flap group (P = 0.0274). Costs were lower in the PRP group ($2081.6 ± 258.14 vs $2680.18 ± 481.15, P < 0.0001). Conclusion: PRP treatment for skin defects from hand trauma is effective, offering advantages in terms of reduced surgical time, pain, and cost, with comparable or superior functional outcomes to flap transplantation. Despite longer healing times, PRP may represent a preferable option for open hand injuries, preserving more nail beds and resulting in better sensation and joint motion.

Reverse circumcision foreskin advancement flap for reconstructing penile shaft skin defects in adults with burn injuries in the perineal region.

AIM: Genital burns are rare injuries. Reconstruction of penile skin defects should consider cosmetic and functional outcomes. Skin grafts can develop scar contractures and carry hair follicles, causing unwanted results. These downsides remain unsolved issues. This work aimed to describe a new foreskin advancement flap method for completely reconstructing penile shaft skin defects in severely burned patients. MATERIALS AND METHODS: From 2021 to 2023, four patients with third-degree burns in the genital area were enrolled in this investigation. We describe a series of cases with deep burns to the penile shaft and surrounding area that needed debridement and reconstruction using a novel technique called "reverse circumcision," which consists of tangential excision of the penis and a foreskin advancement flap without longitudinal cuts with less morbidity, preservation of function, and a better aesthetic appearance. The patients had an average follow-up of nine months. RESULTS: The reverse circumcision technique was established for patients with severe burns in the genital area. The four patients were satisfied with the postoperative results and the aesthetic results of the procedure without reporting any complications. No scarring or contractures were observed on the glans or penile shaft after surgery. CONCLUSIONS: Compared with other flap methods, the use of a reverse circumcision foreskin advancement flap was more straightforward, feasible, and effective. In adults, the foreskin tissue completely covers the penile shaft skin defect. It is a viable reconstructive surgical technique that is easily reproducible and has excellent aesthetic and functional results. For this surgical technique, tissue transfers, bulky regional flaps, or skin grafts were not needed.

Comparison of Anatomically of Medial Plantar Flap versus Reverse Sural Fasciocutaneous Flap in the Treatment of Skin Defects After Cutaneous Squamous Cell Carcinoma Excision

SUMMARY: To compare the advantages and disadvantages of reverse sural fasciocutaneous flap (RSFF) versus medial plantar flap (MPF) in the treatment of skin defects after excision of squamous cell carcinoma (SCC) of the heel. The research participants were 80 SCC patients admitted to Lishui People's Hospital between January 2019 and April 2022, who were assigned to RSFF group (n=37) and MPF group (n=43) according to the flap type. After a one-year follow-up, the survival, flap necrosis and ulceration, as well as pain and tactile sensation recovery of both groups were counted. At the last follow-up, the clinical response was evaluated, and Short-Form 36 Item Health Survey (SF-36) and appearance satisfaction surveys were conducted. No patients died in either group, and one patient in each group developed flap necrosis. The MPF group had better sensory recovery and a lower incidence of flap ulceration (P0.05). The cosmetic satisfaction was higher in MPF group than in RSFF group (P<0.05). MPF contributes to beautiful appearance, better sensory recovery, and low risk of long-term ulceration, while RSFF is suitable for lesions with large defects or those located at the lateral heel.

El objetivo del estudio fue comparar las ventajas y desventajas del colgajo fasciocutáneo sural inverso (RSFF) versus el colgajo plantar medial (MPF) en el tratamiento de defectos de la piel después de la escisión de un carcinoma de células escamosas (CCE) del talón. Los participantes de la investigación fueron 80 pacientes con CCE ingresados en el Hospital Popular de Lishui entre enero de 2019 y abril de 2022, que fueron asignados al grupo RSFF (n=37) y al grupo MPF (n=43) según el tipo de colgajo. Después de un año de seguimiento, se observó la supervivencia, la necrosis y ulceración del colgajo, así como la recuperación del dolor y la sensación táctil de ambos grupos. En el último seguimiento, se evaluó la respuesta clínica y se realizaron encuestas de salud de formato corto de 36 ítems (SF-36) y encuestas de satisfacción. Ningún paciente falleció en ninguno de los grupos y un paciente de cada grupo desarrolló necrosis del colgajo. El grupo MPF tuvo una mejor recuperación sensorial y una menor incidencia de ulceración del colgajo (P 0,05). La satisfacción cosmética fue mayor en el grupo MPF que en el grupo RSFF (P<0,05). MPF contribuye a una mejor apariencia, mejor recuperación sensorial y un bajo riesgo de ulceración a largo plazo, mientras que RSFF es adecuado para lesiones con defectos grandes o localizados en la parte lateral del talón.

Enhancing cutaneous wound healing: A study on the beneficial effects of nano-gelatin scaffold in rat models.

The challenges in achieving optimal outcomes for wound healing have persisted for decades, prompting ongoing exploration of interventions and management strategies. This study focuses on assessing the potential benefits of implementing a nano-gelatin scaffold for wound healing. Using a rat skin defect model, full-thickness incisional wounds were created on each side of the thoracic-lumbar regions after anesthesia. The wounds were left un-sutured, with one side covered by a gelatin nano-fibrous membrane and the other left uncovered. Wound size changes were measured on days 1, 4, 7, and 14, and on day 14, rats were sacrificed for tissue sample excision, examined with hematoxylin and eosin, and Masson's trichrome stain. Statistical comparisons were performed. The gelatin nanofibers exhibited a smooth surface with a fiber diameter of 260 ± 40 nm and porous structures with proper interconnectivity. Throughout the 14-day experimental period, significant differences in the percentage of wound closure were observed between the groups. Histological scores were higher in the experiment group, indicating less inflammation but dense and well-aligned collagen fiber formation. A preliminary clinical trial on diabetic ulcers also demonstrated promising results. This study highlights the potential of the nano-collagen fibrous membrane to reduce inflammatory infiltration and enhance fibroblast differentiation into myofibroblasts during the early stages of cutaneous wound healing. The nano-fibrous collagen membrane emerges as a promising candidate for promoting wound healing, with considerable potential for future therapeutic applications.

Fetal and Placental Causes of Elevated Serum Alpha-Fetoprotein Levels in Pregnant Women.

The most common association related to alpha-fetoprotein (AFP) is fetal neural tube defect (NTD), and indeed, this is where the international career of this protein began. In times when ultrasonography was not yet technically advanced, the detection of high levels of AFP in maternal serum (MS-AFP) and amniotic fluid was the basis for suspecting neural tube defects. In cases where there was no confirmation of NTD, other causes were sought. It has been established that high titers of MS-AFP could originate in other defects or diseases, such as (1) increased proteinuria in severe fetal kidney diseases; (2) pathological overproduction in liver diseases; (3) penetration through the membranes of gastrointestinal organs exposed to amniotic fluid; (4) passage through the walls of skin vessels; and as a side effect of (5) hepatic hematopoiesis and increased transfer through the edematous placenta in fetal anemia. This article provides a review of the current literature on congenital defects and genetic diseases in the fetus where an elevated level of MS-AFP may serve as the initial diagnostic clue for their detection.

The Application of Modified Kite Flap: A Novel Technique for Reconstruction of Defects in Areas with High Tension.

Objective: It is challenging to reconstruct defects resulting from surgical procedures in areas with high tension. We present modified kite flaps that allowed us to reconstruct the defect with high mechanical tension. Methods: With the combination of advancement and rotation, the defect using bilateral modified kite flaps closes with significantly reduced tension. The double flap not only advances but also rotates the flap. This technique retained and exploited the limbs of the flaps, which were often removed with the traditional V-Y flaps. Results: Eleven patients have had their surgical defects repaired using this technique, and the results were satisfactory. A follow-up period of three months or longer was conducted. There were no perioperative complications, and major anatomic landmarks were reconstructed. All patients were satisfied with the functional recovery. Conclusion: The modified method enables a significantly shortened advancement distance of flaps, more flexible flap movement, and sacrifice of healthy tissue to be minimal, and significantly diminished tension for closure. Approximately half the width and length of traditional V-Y flaps were used in this flap donor. Preserving the flap limbs, which were often removed with the traditional V-Y flaps, was also applied to fill defects. Modified kite flaps are a suitable option for the repair of defects in areas with high tension.

Digital skin defect management: Hand and wrist volar flap solutions.

BACKGROUND: Selecting the optimal flap for managing digit skin defects is challenging, particularly for inexperienced surgeons, given the numerous reconstructive options and insufficient evidence supporting one flap type's superiority over another. This retrospective study introduces four efficacious hand flaps to address volar skin defects and transverse and oblique cuts, examines the optimal flap advancement distance, and discusses effective management. METHODS: Patients with digit skin defects who underwent flap surgery between 2009 and 2022 were included. Fifty-four patients treated with oblique triangular, volar VY advancement (unilateral and bilateral pedicled volar VY advancement flaps for fingers and thumbs, respectively), reverse homodigital island, and radial artery superficial palmar branch flaps were included. We evaluated the flap advancement distance, flap length, range of motion, complications, and Semmes-Weinstein monofilament test and Disabilities of the Arm, Shoulder, and Hand questionnaire results. RESULTS: The median flap advancement distances for triangular oblique (19 patients), unilateral (11 patients), and bilateral pedicled (5 patients) volar VY advancement flaps were 1.3, 1.8, and 2.0 cm, respectively. The flap lengths for the reverse digital island (8 patients) and radial artery superficial palmar branch (11 patients) flaps were 2.4 and 5.0 cm, respectively. Five, three, and one cases of proximal interphalangeal flexion contractures of ≥ -20° were observed in the VY advancement, reverse digital island, and radial artery superficial palmar branch flaps, respectively. One unilateral VY advancement flap case caused severe numbness and neuroma. All complication cases featured >15 and > 20 mm defect lengths on the fingers and thumb, respectively. CONCLUSIONS: To minimize sensory disruption and contractures, we recommend oblique triangular and unilateral pedicle volar VY advancement flaps for finger skin defects up to 12 mm and defects sized 12-15 mm, respectively. Advancement flaps are unsuitable for >15 and > 20-25 mm defects on the fingers and thumb, respectively.

Evaluation of The Composite Skin Patch Loaded with Bioactive Functional Factors Derived from Multicellular Spheres of EMSCs for Regeneration of Full-thickness Skin Defects in Rats.

BACKGROUND: Transplantation of stem cells/scaffold is an efficient approach for treating tissue injury including full-thickness skin defects. However, the application of stem cells is limited by preservation issues, ethical restriction, low viability, and immune rejection in vivo. The mesenchymal stem cell conditioned medium is abundant in bioactive functional factors, making it a viable alternative to living cells in regeneration medicine. METHODS: Nasal mucosa-derived ecto-mesenchymal stem cells (EMSCs) of rats were identified and grown in suspension sphere-forming 3D culture. The EMSCs-conditioned medium (EMSCs-CM) was collected, lyophilized, and analyzed for its bioactive components. Next, fibrinogen and chitosan were further mixed and cross-linked with the lyophilized powder to obtain functional skin patches. Their capacity to gradually release bioactive substances and biocompatibility with epidermal cells were assessed in vitro. Finally, a full-thickness skin defect model was established to evaluate the therapeutic efficacy of the skin patch. RESULTS: The EMSCs-CM contains abundant bioactive proteins including VEGF, KGF, EGF, bFGF, SHH, IL-10, and fibronectin. The bioactive functional composite skin patch containing EMSCs-CM lyophilized powder showed the network-like microstructure could continuously release the bioactive proteins, and possessed ideal biocompatibility with rat epidermal cells in vitro. Transplantation of the composite skin patch could expedite the healing of the full-thickness skin defect by promoting endogenous epidermal stem cell proliferation and skin appendage regeneration in rats. CONCLUSION: In summary, the bioactive functional composite skin patch containing EMSCs-CM lyophilized powder can effectively accelerate skin repair, which has promising application prospects in the treatment of skin defects.

Clinical applications of skin traction technique with adjustable tension in treatment of large area skin defects.

OBJECTIVE: To explore the clinical applications of the adjustable skin traction technique in the treatment of large area skin defects. RESEARCH DESIGN: A prospective study. BACKGROUND: The skin is the largest organ of the human body and skin tissue exposed to external environment which makes it vulnerable to damage. There are many reasons for skin defects such as trauma, infection, burns, scars, tumors resection, inflammation, pigmented nevus, etc. Skin traction is the application of pulling force to the trunk or extremities for immobilization, fracture reduction and deformity correction. This technique accurately controls skin expansion which is safe, convenient and accelerates wound healing. METHODS: A prospective study was conducted on 80 patients suffered from large area skin defects in the department of orthopedics, the first affiliated hospital of Zhengzhou University from September 2019 to January 2023. There were 40 patients in the experimental group who underwent skin traction. In contrast, 40 people in the control group underwent skin flaps or skin grafts without skin traction. The inclusion criteria include large area skin defects, normal peripheral skin & blood supply, normal vital organs, no severe coagulation dysfunction etc. Male & female with and without skin traction are 22 & 18 and 25 & 15 respectively. The skin traction device used was a hook and single rod type. The skin defect area was approximately 15 cm × 9-43 cm × 10 cm. RESULTS: Postoperatively, the experimental group with traction showed 2 cases of skin infection, 1 case of skin necrosis and 3 cases of inflammation recurrence. In contrast, the control group without traction showed 8 cases of skin infection, 6 cases of skin necrosis and 10 cases of inflammation recurrence. Skin infection (P = 0.04), skin necrosis (P = 0.02) and inflammatory response (P = 0.03) represented significant differences between two groups. There was also a significant difference in hospitalization costs (P = 0.001). CONCLUSION: Skin traction has huge clinical applications including a shorter hospital stay, faster wound healing, lower hospitalization cost, high satisfaction rate, and a fair skin appearance after surgery. It is an effective method of treating skin and musculoskeletal defects.

3D-Bioprinted Biomimetic Multilayer Implants Comprising Microfragmented Adipose Extracellular Matrix and Cells Improve Wound Healing in a Murine Model of Full-Thickness Skin Defects.

Repairing full-thickness skin defects is a major challenge in clinical practice. Three-dimensional (3D) bioprinting of living cells and biomaterials is a promising technique to resolve this challenge. However, the time-consuming preparation and limited sources of biomaterials are bottlenecks that must be addressed. Therefore, we developed a simple and fast method to directly process adipose tissue into a microfragmented adipose extracellular matrix (mFAECM) as the main component of bioink to fabricate 3D-bioprinted, biomimetic, multilayer implants. The mFAECM retained most of the collagen and sulfated glycosaminoglycans in the native tissue. In vitro, the mFAECM composite demonstrated biocompatibility, printability, and fidelity and could support cell adhesion. In a full-thickness skin defect model in nude mice, cells encapsulated in the implant survived and participated in wound repair after implantation. The basic structures of the implant were maintained throughout wound healing and gradually metabolized. The biomimetic multilayer implants fabricated via mFAECM composite bioinks and cells could accelerate wound healing by promoting the contraction of new tissue inside the wound, collagen secretion and remodeling, and neovascularization. This study provides an approach for improving the timeliness of fabricating 3D-bioprinted skin substitutes and may offer a useful tool for treating full-thickness skin defects.

Locoregional Flaps for the Reconstruction of Midface Skin Defects: A Collection of Key Surgical Techniques.

BACKGROUND: The reconstruction of midface skin defects represents a challenge for the head and neck surgeon due to the midface's significant role in defining important facial traits. Due to the high complexity of the midface region, there is no possibility to use one definitive flap for all purposes. For moderate defects, the most common reconstructive techniques are represented by regional flaps. These flaps can be defined as donor tissue with a pedunculated axial blood supply not necessarily adjacent to the defect. The aim of this study is to highlight the more common surgical techniques adopted for midface reconstruction, providing a focus on each technique with its description and indications. METHODS: A literature review was conducted using PubMed, an international database. The target of the research was to collect at least 10 different surgical techniques. RESULTS: Twelve different techniques were selected and cataloged. The flaps included were the bilobed flap, rhomboid flap, facial-artery-based flaps (nasolabial flap, island composite nasal flap, retroangular flap), cervicofacial flap, paramedian forehead flap, frontal hairline island flap, keystone flap, Karapandzic flap, Abbè flap, and Mustardè flap. CONCLUSIONS: The study of the facial subunits, the location and size of the defect, the choice of the appropriate flap, and respect for the vascular pedicles are the key elements for optimal outcomes.

Repair of fingertip defect with reverse digital artery island flap and repair of donor site with digital dorsal advancement flap.

Objective: The reverse digital artery island flap (RDAF) is widely used in repairing fingertip skin defects based on its good appearance and practicability. However, the donor area of the flap needs skin grafting, which can lead to complications. This retrospective study explored the clinical application of digital dorsal advance flap (DDAF) in repairing the donor site of the reverse digital artery island flap. Method: From June 2019 to February 2022, 17 patients with a soft tissue defect of the finger had been restored with the reverse digital artery island flap, and at the same time, the donor area was repaired with digital dorsal advance flap (DDAF). The sensitivity, the active range of motion (ROM) and patient satisfaction were assessed after the operation. Results: All flaps survived completely without skin grafting with only one linear scar. The sensory and motor functions of all patients recovered well. Assessment based on the Michigan Hand Outcomes Questionnaire (MHQ) showed satisfactory functional recovery for all patients. Conclusions: Reconstruction using RDAF combined with DDAF represents an effective alternative for repairing fingertip skin defects.

Modified gelatin hydrogel nonwoven fabrics (Genocel) as a skin substitute in murine skin defects.

Introduction: From previous research, an emerging material composed of gelatin hydrogel nonwoven fabric (Genocel) has shown potential as a skin substitute, by improving neovascularization promotion in the early phase of wound healing. However, Genocel was inferior in terms of granulation formation compared to Pelnac. To solve this problem, we modified the manufacturing process of Genocel to reduce its water content, extend the degradation time (Genocel-L), and evaluate its healing process as a skin substitute. Methods: Genocel with a low water content (Genocel-L) was prepared and the difference in water content compared to that of the conventional Genocel was confirmed. Degradation tests were performed using collagenase and compared among Genocel-L, Genocel, and Pelnac sheets. In the in vivo study, sheets of Genocel-L or Pelnac were applied to skin defects created on the backs of C57BL/6JJcl mice. On days 7, 14, and 21, the remaining wound area was evaluated and specimens were harvested for Hematoxylin and Eosin, Azan, anti-CD31, CD68, and CD163 staining to assess neoepithelialization, granulation tissue, capillary formation, and macrophage infiltration. Results: Genocel-L had a lower water content than the conventional Genocel and a slower degradation than Genocel and Pelnac. In the in vivo experiment, no significant differences were observed between Genocel-L and Pelnac in relation to the wound area, neoepithelium length, granulation formation, and the number of newly formed capillaries. The area of newly formed capillaries in the Pelnac group was significantly larger than that in the Genocel-L group on day 21 (p < 0.05). Regarding macrophage infiltration, significantly more M2 macrophages were induced in the Pelnac group on days 14 and 21, and the M2 ratio was larger in the Pelnac group (p < 0.05) during the entire process. Conclusions: Genocel-L has a lower water content and slower degradation rate than the conventional Genocel. Genocel-L had equivalent efficacy as a skin substitute to Pelnac, and can therefore be considered feasible for use as a skin substitute. However, a manufacturing method that can further modify Genocel-L is required to recover its early angiogenic potential.

Shengji solution accelerates the wound angiogenesis of full-thickness skin defect in rats via activation of TGF-ß1/Smad3-VEGF signaling pathway.

Shengji solution is made according to the classic prescription - Shengji prescription. Shengji solution is a external prescription of traditional Chinese medicine with the functions of nourishing blood, relieving pain, producing muscle and shrinking the wound. In the present study, we investigated the therapeutic effects of Shengji solution on dorsal full-thickness skin defects in rats. We also detected the activation of transforming growth factor beta1 (TGF-ß1)/SMAD3/vascular endothelial growth factor (VEGF) signaling pathways in the wound-healing process. The results showed that the wound was cleaned with normal saline followed by bandaging with cotton gauze according to the groups, respectively: (a) control group; (b) Kangfuxin group, the wound was moistened with Kangfuxin solution; (c) Shengji solution group, the wounds were moistened with Shengji solution; (d) Shengji solution+SB431542 inhibitor group, the wound was moistened with Shengji solution, and then SB431542 inhibitor (10 mg/kg) was injected intraperitoneally for 5 days. On the 14th day after operation, the wound-healing rate of Shengji solution group was more than 95% and also greater than that in the control group and Shengji solution+SB431542 inhibitor group. Besides, Shengji solution could inhibit the inflammation and capillary production by enhancing the epithelial regeneration, dermal repair and angiogenesis. Moreover, Shengji solution could also increase CD34 content, the expressions of TGF-ß1, VEGF proteins and the phosphorylation of SMAD3 in wound granulation tissue. In conclusion, Shengji solution can accelerate the dermal cutaneous wound healing in rats, stimulate angiogenesis and collagen synthesis by activating TGF-ß1/SMAD3/VEGF pathway.

A Case of Cochlear Implant Replacement Requiring Full-Thickness Skin Grafting.

Cochlear implants improve the quality of life of patients with bilateral severe sensorineural hearing loss. Normally, patients with cochlear implants can continue to use the devices for years without any complications. However, equipment failure or infection at the implant site could develop in some patients, and this might often necessitate implant replacement. Although cochlear implant replacement surgery itself is not a major risk in most cases, extensive tissue resection will be required in cases involving infection, and the insertion site of the temporal bone implant will need to be changed. We encountered a case of skin necrosis at the temporal bone implant site caused by constant external irritation from the temple of an eyeglass frame. The patient underwent cochlear implant replacement surgery involving full-thickness skin grafting from the abdomen. Thereafter, the patient's condition improved. Full-thickness skin grafting can be useful in cases of extensive skin defects encountered during cochlear implant replacement.

Versatility and aesthetic performance of the submental flap for reconstruction of skin defects in head and neck.

The submental flap (SMF) is a reliable option for head and neck reconstruction. It is a pedicle flap based on the submental artery and vein, divisions of the facial pedicle. The purpose of this Operative Technique is to describe the step-by-step setup of the submental flap for reconstruction of the preauricular region and to briefly examine its versatility and range of choices in skin and soft tissue defect reconstruction (see Supplemental video in the online version of the article). The harvesting of the SMF provides an aesthetically acceptable result for both the donor and reconstructed sites. The main advantages of the flap are its excellent color and texture match to the tissue in the cheek, and the possibility of restoring pilosity in male patients. In the opinion of the authors, the SMF is one of the best reconstructive alternatives for defects in the lower two-thirds of the face in elderly male patients.

Comparison of Two Surgical Techniques Based on the Semitendinosus Myocutaneous Flap in Cats.

The objective of this experimental study was to compare the semitendinosus (ST) to the split-semitendinosus (SST) myocutaneous flap in covering distal limb skin defects in cats. Twenty-eight purpose-bred laboratory DSH cats were used and allocated into two groups (ST-group (A); n = 14, SST-group (B); n = 14). ST flaps, based on the distal muscle pedicle, and SST flaps, after longitudinal division of the muscle based on both muscle pedicles, were tested over skin defects created on the medial distal tibia. Clinical assessment, planimetry, CT-angiography (CTA) and histological examination were compared between groups. Days to complete flap healing between ST and SST-flaps (30.36 ± 9.1, 32.29 ± 5.44, respectively) and final total flap areas (68.36% ± 27.18, 51.83% ± 22.48, respectively) revealed no significant differences. On CTAs, the caliber of the distal caudal femoral vein on day 10 was statistically significant higher (p < 0.001) for group A and a significantly higher caliber of the distal caudal femoral artery on day 30 for group B (p = 0.021). Histology revealed statistically higher degeneration at 6 months (p = 0.047) for group A, and statistically higher fibrosis at 12 months (p = 0.019) for group B. Both ST and SST flaps had similar healing times and provided coverage of skin tibial defects in cats.

Application of collagen-chondroitin sulfate scaffolds with different pore sizes combined with acidic fibroblast growth factor in repairing full thickness skin defects in nude mice.

Wound healing of skin defects is complex. For the treatment of large and deep wounds, it is a good alternative to accept artificial dermis grafting at the first stage surgery, and autologous split-thickness skin grafting 2-3 weeks later at the second stage surgery. In addition, the effectiveness of numerous cytokines such as fibroblast growth factor (FGF) on wounds healing has been widely researched. The traditional view is that direct external application orin vivoinjection of exogenous FGFs may not achieve the desired therapeutic effect as the effective concentration cannot be maintained for a long time. Therefore, some researchers have tried to integrate various cytokines into skin substitutes for combined application. However, we believe that considering the current situation, it is still difficult to achieve mass production of these types of artificial dermis. Here, we manufactured a collagen-chondroitin sulfate scaffold material by imitating the marketed artificial dermis materials. Then, we combined it with recombinant human acidic FGF in a single full dose during the first-stage artificial dermis transplantation, which is simple and completely feasible but always controversial in the current clinical work, to explore whether this combinatorial therapy could serve as an efficient way wound healing in the Balb/c-nu mice full-thickness skin defect model.

Use of a bilayer biodegradable synthetic dermal matrix for the management of defects arising from necrotising fasciitis.

The aim of this article is to provide a brief overview of necrotising fasciitis, including causative factors, incidence, diagnosis and clinical outcomes. Various surgical treatment options are outlined, including methods of soft tissue reconstruction after wide excision of infected and necrotic tissues. The role of dermal matrices, including a synthetic biodegradable temporising matrix made of polyurethane, are described in terms of wound bed preparation, surgical application and clinical outcomes.