Concentrated growth factor intradermal injection assisted super-thin flap expansion for repairing skin defects: A randomized, single blinded, split-site study.

BACKGROUND: The super-thin skin flap formed by skin and soft tissue expansion has large area and good ductility, so it can be used to repair skin defects. However, because the flap is thin, the blood flow in the dermis of the super-thin expanded flap is weakened, and flap rupture and necrosis after secondary flap transfer may occur. OBJECTIVE: To compare the skin thickness difference between the expanded ultrathin flaps injected with concentrated growth factor (CGF) and the blank group or saline group. METHODS: From June 2021 to December 2023, 10 patients (44 sites) with large-area scars or skin tumors were treated, and a single center half randomized controlled trial was conducted. The test site of expander implantation was divided into three groups: intradermal injection of CGF group, normal saline group and blank group. The same amount of expansion was performed every 1-2 weeks, and CGF or normal saline was injected into the dermis every 4 weeks, a total of three times. After 2-3 months of expansion, color Doppler ultrasound was used to measure the skin thickness of each group. RESULTS: Compared with the blank group, the skin thickness of CGF group was 1.75 ± 0.08 mm, and that of BLA blank group was 1.42 ± 0.07 mm, with statistically significant difference (p < 0.0001); In the other group, compared with the saline group, the skin thickness of the CGF group was 1.54 ± 0.08 mm, and the average skin thickness of the saline group was 1.40 ± 0.08 mm, with significant difference between the two groups (p = 0.0067). CONCLUSION: CGF intradermal injection can increase the skin thickness of super-thin skin flap in the process of soft tissue expansion, which is a safe and effective auxiliary method of skin expansion.

Comparative efficacy and safety of tranexamic acid for melasma by different administration methods: A systematic review and network meta-analysis.

BACKGROUND: Tranexamic acid (TA) is a new and promising drug for the treatment of melasma. OBJECTIVES: This network meta-analysis aims to compare the efficacy and safety of various ways of administration of TA on melasma. METHODS: We collected researches from PubMed, EMBASE, Cochrane Library and Web of Science. Melasma area severity index (MASI) is used to evaluate the severity of melasma. After treatment with different TA administration methods, a difference in MASI is named ΔMASI. We evaluate the curative effect by comparing the ΔMASI of different TA administration methods at a certain time point. RESULTS: At the Weeks 4, 8, and 12 and the last follow-up, the ΔMASI of oral TA combined with routine topical agents (oTA + RTA) was higher than that of intradermal TA (iTA), topical TA (tTA) as well as microneedling TA (MNsTA), with statistical significance. At the 8th week, the ΔMASI of oTA was higher than that of iTA, with statistical significance. Compared with placebo, oTA showed statistically significant differences at Week 4, while tTA, iTA, and MNsTA showed statistically significant differences starting from Week 8. CONCLUSIONS: Among various ways of administration of TA, oTA + RTA has the best effect on melasma. In the short term, the curative effect of oTA is better than that of iTA, and the onset time of oTA is faster than that of tTA, iTA and MNsTA. In the long run, the curative effect of TA alone has nothing to do with the mode of administration.

Potential Resistance to Antineoplastic Aminated Fullerenes Mediated by M2-Like Monocyte-Derived Exosomes.

Exosomes are small extracellular vesicles critical for intercellular signaling via their delivery of cargoes, including proteins, DNA, RNA, lipids, and metabolites. Exosomes play essential roles in remodeling the tumor microenvironment (TME) for tumor growth, metastasis, and drug resistance. Aminated fullerenes (e.g., C70-ethylenediamine [EDA]) exhibit antineoplastic effects by targeting multiple functional proteins. Nanosized C70-EDA with positive surface charges tends to be taken up by monocytes in the bloodstream and monocyte-derived macrophages in the TME. Herein, the alterations of monocytes and monocyte-derived exosomes by C70-EDA have been investigated. C70-EDA reprogramed THP-1 monocyte to an M2-like state and substantially increased the protein content in exosomes secreted by M2-like monocytes. Notably, C70-EDA-induced M2-like monocytes released exosomes that triggered the proliferation of recipient tumor cells, which may alleviate the antineoplastic efficacy of C70-EDA. As revealed by proteomic profiling of exosomes, this outcome is probably a result of Rho GTPase/p21-activated kinase (PAK) pathway activation in recipient tumor cells induced by upregulated exosomal proteins. This work indicates a promising strategy in which aminated fullerenes can be combined with PAK inhibitors for cancer therapy.

Diketopyrrolopyrrole-Based Conjugated Polymer Entailing Triethylene Glycols as Side Chains with High Thin-Film Charge Mobility without Post-Treatments.

Side chain engineering of conjugated donor-acceptor polymers is a new way to manipulate their optoelectronic properties. Two new diketopyrrolopyrrole (DPP)-terthiophene-based conjugated polymers PDPP3T-1 and PDPP3T-2, with both hydrophilic triethylene glycol (TEG) and hydrophobic alkyl chains, are reported. It is demonstrated that the incorporation of TEG chains has a significant effect on the interchain packing and thin-film morphology with noticeable effect on charge transport. Polymer chains of PDPP3T-1 in which TEG chains are uniformly distributed can self-assemble spontaneously into a more ordered thin film. As a result, the thin film of PDPP3T-1 exhibits high saturated hole mobility up to 2.6 cm2 V-1 s-1 without any post-treatment. This is superior to those of PDPP3T with just alkyl chains and PDPP3T-2. Moreover, the respective field effect transistors made of PDPP3T-1 can be utilized for sensing ethanol vapor with high sensitivity (down to 100 ppb) and good selectivity.

An Overview of Pre-expanded Perforator Flaps: Part 1, Current Concepts.

Pre-expanded perforator flaps, a combination of tissue expansion with perforator flaps, are emerging as another landmark of plastic surgery. This flap inherits the characteristics of both perforator flaps and expanded flaps, making it a highly versatile option in reconstructive surgery. However, the definition of the pre-expanded perforator flap and the impact of pre-expansion on the superficial angio-architecture remain controversial. In this article, the authors review current concepts including the mechanism of expansion and the resultant changes in the angio-architecture. The authors also review the previous studies and classifications of pre-expanded perforator flaps.

Pre-expanded Super-Thin Skin Perforator Flaps.

Patients with severe postburn scar contractures underwent reconstruction of skin defects after scar excision with pre-expanded super-thin skin perforator flaps supplied primarily by perforators via the "bridging effect" from the branches of the adjacent arteries as 2-stage procedures. Pre-expansion is an innovative technique and may improve the anastomoses between subdermal vascular plexuses and extend the supplying area of these vessels to the flap. Such a flap becomes super thin, but with a prefabricated blood supply it can be used for reconstruction of skin defects of the face, neck, or other body part with improved functional and cosmetic outcomes.

Pre-expanded and Prefabricated Abdominal Superthin Skin Perforator Flap for Total Hand Resurfacing.

Reconstruction of the postburn hand remains a challenge for surgeons. For cosmetic and functional requirements, the desired flap should be thin enough to ensure the flexibility of the hand. Conventional perforator flaps serve as a viable option when reconstructing the postburn hand to regain functionality. However, limitations include the discrepancy in tissue thickness and the difficulty with donor site closure. Thus, a preexpanded superthin skin perforator flap is an ideal choice for postburn hand reconstruction, with the trade-off being a longer treatment course (3-4 months), but with results that satisfy both patients and their surgeons.

Thieno[3,4-c]Pyrrole-4,6-Dione and Dithiophene-Based Conjugated Polymer for Organic Field Effect Transistors: High Mobility Induced by Synergic Effect of H-Bond and Vinyl Linkage.

Here, a conjugated polymer VTTPD based on thieno[3,4-c]pyrrole-4,6-dione (TPD) and dithiophene with vinyl as linker is synthesized and characterized. Electrochemical and optical studies indicate the LUMO and HOMO energies of the polymer are -3.70 and -5.39 eV. Theoretical calculation with density functional theory suggests that H-bonds are formed between the TPD carbonyl (O) and its neighboring vinyl (H) which benefit the planarity and π-conjugation of the polymer backbone. Bottom contact bottom gate organic field effect transistor devices based on VTTPD are fabricated and examined in air. After annealing at 160 °C, the devices exhibit excellent performance of µh = 0.4 cm(2) V(-1) s(-1) , Ion/off = 10(6) , Vth within -10 V to -5 V. Thin film morphologies before and after the annealing process are also investigated with XRD and AFM.

The Clinical Application of Preexpanded and Prefabricated Super-Thin Skin Perforator Flap for Reconstruction of Post-Burn Neck Contracture.

OBJECTIVE: Based on our previous animal study, we applied the "bridging effect" to the neighboring axial flap through preexpansion and prefabrication of a skin perforator flap as a new method to reconstruct a large skin defect after release of severe neck burn scar contracture. METHODS: Twelve patients suffering from severe post-burn cervical contractures underwent reconstruction of large skin defects after surgical release of severe scar contractures with preexpanded and prefabricated super-thin skin perforator flaps supplied primarily by a number of perforators via the "bridging effect" from the branches of the adjacent arteries as 2-stage procedures. During the first-stage operation, 2 tissue expanders were placed accordingly, and this was followed by a subsequent second-stage procedure where an expanded super-thin skin perforator flap was transposed to reconstruct a large neck skin defect. Follow-up was between 6 months and 3 years in this series. RESULTS: All super-thin skin perforator flaps survived in this series with primary healing except one with a distal flap necrosis that was treated with a subsequent skin graft. All patients have had a good contour with improved range of motion in the neck. CONCLUSIONS: The preexpansion and prefabrication of a super-thin skin perforator flap can possibly improve the anastomoses between neighboring subdermal vascular plexuses and extend the supplying area of these vessels to the flap. This method may provide a favorable super-thin skin flap that can be used for reconstruction of large neck defects after release of post-burn cervical scar contracture as demonstrated in this case series.

The Value of Multidetector Row Computed Tomography Angiography for Preoperative Planning of Freestyle Pedicled Perforator Flaps.

BACKGROUND: Because the course and territory of perforators are different in each region, careful preoperative planning to identify the proper perforators can be critical to ensure a successful dissection of a freestyle pedicled perforator flap. In this study, our first experience for preoperative perforator mapping of a freestyle pedicled perforator flap using multidetector row computed tomography (MD-CT) angiography is presented. METHODS: Twelve patients were planned to undergo various soft-tissue reconstructions with freestyle pedicled perforator flaps. They were evaluated with preoperative MD-CT angiography. The OsiriX for mac software was used to process the data obtained from MD-CT angiography. The available images from MD-CT angiography were analyzed to determine where the proper perforators were located for preoperative planning of a freestyle pedicled perforator flap. Through the MD-CT angiography, the optimal perforators were mapped and a reliable flap design could be made so that the flap was elevated more safely and perfectly to cover an adjacent soft-tissue defect. RESULTS: In all 12 patients, each flap was elevated successfully based on the perforators mapped preoperatively with MD-CT angiography. A total of 27 perforators (1-3 perforators per flap) were identified by MD-CT angiography in 12 patients and later confirmed during the flap dissection (sensitivity, 100%). CONCLUSIONS: The MD-CT angiography can be a new but very effective imaging modality for preoperative planning of a freestyle pedicled perforator flap surgery. It allows surgeons to accurately select the most appropriate perforators with the shortest intramuscular or suprafascial course preoperatively leading to safer and easier flap dissection.

Thiepin-fused heteroacenes: simple synthesis, unusual structure, and semiconductors with less anisotropic behavior.

The simple one-pot syntheses of sulfur-rich thiepin-fused heteroacences with an alkylidene-fluorene framework, THA1 and THA6 (thiepin-fused heteroacene 1 or 6, in which the thiepin is conjugated at both ortho positions with SCH3 or SC6 H13 , respectively), is reported. Based on electrochemical studies and theoretical calculations, their LUMO energies are relatively low (-3.26 eV), and their HOMO and HOMO-1 orbitals are nearly degenerate. The thiepin ring contributes mainly to HOMO-1 and LUMO orbitals, however, HOMO orbitals dominantly reside on thienoacence rings. Within the crystal of THA1, the molecules adopt a herringbone arrangement and multiple intermolecular interactions lead to the formation of a 2D network. Interestingly, THA6 shows totally different intermolecular arrangements. Organic field-effect transistor (OFET) devices show both compounds exhibiting p-type semiconducting behavior. Thin films or microcrystals of THA1 possess relatively high hole mobility. Moreover, the mobilities of the microcrystal of THA1 along three directions are in the same order, thus the hole-carrier transporting within the hexagonal-plane of microcrystal of THA1 exhibits less anisotropic behavior. In comparison, both thin films and microrods of THA6 show low hole mobilities. This agrees well with the intermolecular arrangements and interactions within crystal of THA6. Further theoretical calculations reveal that significant intermolecular electronic coupling among HOMO-1 orbitals and sulfur atoms play an important role in intermolecular electronic coupling for THA1.

Simple bipolar molecules constructed from biphenyl moieties as host materials for deep-blue phosphorescent organic light-emitting diodes.

Simple is good! Based on biphenyl molecules, two bipolar host materials with high triplet energies have been rationally designed, synthesized, and fully characterized. Deep blue phosphorescent organic light-emitting diodes, which employ the new hosts and an iridium(III) complex as triplet emitter, show a maximum current efficiency of 40 cd A(-1), a maximum power efficiency of 36 lm W(-1), and a maximum external quantum efficiency of 19.5 %.