To evaluate the clinical outcomes of paraumbilical perforator flaps with inferior epigastric vessels for the repair of radiation-induced ulcers on the thigh or inguinal regions.

From June 2016 to May 2024，11 patients with radiation-induced thigh or inguinal regions ulcers who met the inclusion criteria were admitted to the Department of Burn and Plastic Surgery of Beijing Jishuitan Hospital，Capital Medical University. There were 5 males and 6 females，aged 40 to 73 years. The wounds were located in the inguinal region in 3 cases and in the middle-upper thigh in 8 cases. After debridement，the wound area ranged from 9 cm×6 cm to 23 cm×10 cm. Paraumbilical perforator flaps with inferior epigastric vessels were used to repair the wounds，with flap area ranging from 15 cm×8 cm to 28 cm×14 cm. The donor sites were all closed by direct approximation after flap transfer. Postoperative flap survival，wound healing，and donor site complications were observed. Preoperative and intraoperative bacterial culture results of wound tissue specimens and pathological results of ulcer tissue specimens were recorded.

Bacterial cultures of wound tissue were negative in 1 case and positive in 10 cases. Among the positive cases，5 had monomicrobial infection and 5 had polymicrobial infection （≥2 bacterial species）. During postoperative follow-up of 6 to 24 months，7 flaps survived completely with primary wound healing； 2 flaps developed distal marginal necrosis and healed after revision surgery； 2 flaps survived completely but with persistent sinus tracts，which healed after dressing changes or surgical debridement. All donor sites healed primarily，with no complications such as abdominal wall hernia observed.

The paraumbilical perforator flap with inferior epigastric vessels is characterized by reliable blood supply，adequate tissue volume，and long vascular pedicle. It is an effective technique for the repair of radiation-induced ulcers on the thigh or inguinal regions.

To explore the clinical effect of the pendulum-shaped latissimus dorsi myocutaneous flap harvested with endoscopic assistance for repairing breast defects after surgery in breast cancer patients.

From June 2021 to February 2024，9 patients with breast defects after surgery who met the inclusion criteria were admitted to the Department of Burns and Cutaneous Surgery of the First Affiliated Hospital of Air Force Medical University. All patients were female，aged 13 to 51 years. The breast cancer had not recurred. Among them，4 cases had skin defects after breast implant placement，5 cases had breast defects after breast cancer resection. The area of breast skin soft tissue defect ranged from 7.0 cm × 4.0 cm to 11.0 cm × 7.5 cm. All patients underwent debridement and then received repair with a pendulum-shaped latissimus dorsi myocutaneous flap harvested with endoscopic assistance，and the donor area wounds were sutured in one stage. Postoperative anti-inflammatory，anticoagulation，and prevention of vascular spasm treatments were performed，and bed rest was required. Postoperatively，the blood supply of the flap was closely observed. The drainage tube was removed on postoperative day 3, and the sutures were removed 12-14 days after the operation. Observed the wound healing，breast shape，and whether the tumor recurred during follow-up.

The flaps of all 9 patients survived well after the operation. The postoperative follow-up period was 6 to 12 months. During the follow-up period，no cases of breast cancer recurrence were observed. For the 4 patients with exposed implants，the wounds had completely healed，and no implants re-exposure occurred. Among the 5 patients with breast defects，the wounds healed well，but there were certain differences in shape between the reconstructed and the contralateral breast in 3 cases. The incisions in the donor area healed well，and only 1 case had obvious scar hyperplasia，which was significantly improved after laser treatment. The linear scars formed by the transverse incision in the donor area could be covered by clothing，and the impact on appearance was slight.

The pendulum-shaped latissimus dorsi myocutaneous flap harvested with endoscopic assistance for repairing breast defects after surgery in breast cancer patients offers several advantages，including simple intraoperative operation，favorable aesthetic outcomes at the donor area，facilitation of implant retention，and prevention of implant re-exposure. It is a safe and effective surgical technique.

To evaluate the clinical efficacy of three-dimensional reconstruction with finger web artery perforator triangular flaps for web space scars in children.

From January 2022 to June 2025，34 pediatric web space scar patients who met the inclusion criteria were admitted to the Department of Burn Plastic Surgery and Wound Repair of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine，including 19 males and 15 females，with a mean age of （9.2±2.8） years and a scar duration ranging from 1 to 4 years. The patients underwent three-dimensional reconstruction with finger web artery perforator triangular flaps. The harvested flap areas ranged from 0.5 cm×0.5 cm to 1.5 cm×1.3 cm. Postoperative flap survival and complications were recorded. The appearance，colour and texture of flaps were assessed during follow-up. The Withey score and Vancouver scar scale （VSS） were adopted to evaluate hand appearance and scar hyperplasia at the last follow-up.

The flaps of all 34 patients survived without necrosis，haematoma or other complications. The follow-up period were 6-18 months. The flaps presented similar colour and texture to the surrounding native tissue； the depth，width and slope of reconstructed finger webs approximated normal anatomical morphology，with no obvious scar hyperplasia and intact metacarpophalangeal joint mobility. At the last follow-up，the mean Withey score was 0.57 and the mean VSS score was 2.21 across all patients.

Three-dimensional reconstruction using finger web artery perforator triangular flaps is a simple and effective method for correcting web space scars in children.

To develop a non-contact precision monitoring system based on machine learning and computer vision technology，enabling continuous and objective assessment of flap perfusion status and early warning of vascular crisis.

From March 2024 to April 2025，84 patients who underwent free flap transplantation in the Department of Hand Surgery at Beijing Jishuitan Hospital，Capital Medical University were enrolled. Videos of the flap transplanted areas were recorded during the first 72 hours postoperatively. A dataset comprising 580 videos was constructed and randomly divided into training set and test set at a ratio of 8∶2. The Mask R-CNN model was employed for automatic flap segmentation and tracking. Eight features，including color，texture，and photoplethysmographic signals，were extracted，and a risk warning model was established based on ensemble learning algorithms. The system's performance was compared with conventional manual monitoring for validation.

The system demonstrated high segmentation accuracy on the test set, the average precision reached 1.000 at an intersection over union of 0.75，and the classification model achieved an accuracy of 0.851±0.085. For the two patients who developed vascular crisis in the test set，the model provided earlier warnings than conventional manual monitoring in all cases.

The artificial intelligence–based monitoring system constructed in this study enables non-invasive，continuous，and precise assessment of flap perfusion，enhances warning timeliness and clinical practicality，and holds potential for reducing the risk of flap necrosis and improving the quality of postoperative management.

This study evaluates the clinical efficacy of dual bone tunnel reconstruction for treating volar plate avulsion injuries in proximal interphalangeal （PIP） joints of the finger.

A retrospective analysis was conducted on 7 patients with the proximal interphalangeal joint volar plate avulsion injuries，who were treated at the Department of Hand Surgery，Suzhou Ruihua Orthopaedic Hospital between June 2021 and January 2024. The cohort included 5 males and 2 females，aged 22–63 （46.0±15.7） years. Injury distribution： 1 left hand，6 right hands； 1 index finger，2 middle fingers，1 ring finger，and 3 little fingers. Mechanisms of injury comprised falls （n=2），machinery entanglement （n=3），vehicular accidents （n=1），and crush injuries （n=1）. All cases of avulsion injuries involved dorsal dislocation of the proximal interphalangeal joints，including 3 cases with Type Ⅱ avulsion fractures of the middle phalanx base and 4 non-fracture cases. Emergency surgical intervention via volar approach was performed： fragmented bone was debrided with cortical preservation，followed by anatomic reattachment of the avulsed volar plate using dual bone tunnels with nonabsorbable sutures.

Primary wound healing was achieved in all cases. Mean follow-up duration was 6 months （range： 4–10 months）. At final assessment，active PIP joint flexion ranged from 70 ° to 100 ° with stable joints and absence of pain during motion. According to the upper limb function assessment of the Chinese Medical Association Hand Surgery Society，outcomes were graded as excellent in 3 cases and good in 4 cases.

Dual bone tunnel reconstruction provides a technically feasible and clinically effective solution for PIP joint volar plate avulsion injuries，demonstrating satisfactory functional restoration.

To investigate the clinical efficacy and safety of antibiotic bone cement in the treatment of diabetic foot osteomyelitis.

A retrospective analysis was conducted on the clinical data of 41 patients with diabetic foot osteomyelitis who met the inclusion criteria and were admitted to the Department of Wound Repair Surgery, Zhongshan Yuantian Orthopedic Hospital, from October 2023 to October 2024. All patients underwent one-stage thorough debridement with implantation of antibiotic bone cement into the wound cavity, followed by two-stage removal of the bone cement and definitive wound repair using skin grafting, flap transfer, or direct softtissue closure. Among them, there were 29 males and 12 females, with a mean age of (60.98±8.82) years; 22 cases involved the left foot and 19 cases involved the right foot. The length of hospital stay, postoperative recurrence, and complications were analyzed, with a follow-up period of 6 months postoperatively.

Postoperative infection was effectively controlled in all patients, and the wounds healed satisfactorily. No recurrence was observed during the follow-up period. The duration of the first hospitalization was (3.73±1.05) days, the duration of the second hospitalization for reconstructive surgery was (9.32±1.01) days, and the total hospitalization duration was (13.05±1.34) days. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score at 6 months postoperatively was (60.02±9.05) points.

The treatment strategy of one-stage debridement combined with antibiotic bone cement implantation followed by two-stage definitive wound reconstructive surgery can effectively control infection and promote wound healing in diabetic foot osteomyelitis.

To construct a hierarchical training program for burn unit nurses based on competency，and provide a basis for the training of burn unit nurses.

From August to September 2024，a competency-based hierarchical training program for burn unit nurses was preliminarily developed through literature review and semi-structured interviews. From October to December 2024，15 nursing experts from 11 tertiary Grade A hospitals with independent burn or trauma departments were selected，and the Delphi method was employed for two rounds of expert consultation to determine the training content for nurses at each competency level. From January to March 2025，nurses from the Department of Burn Plastic Surgery and Wound Repair of Ruijin Hospital，Shanghai Jiao Tong University School of Medicine，were selected as the study subjects，and the nurses' theoretical and operational assessment scores and the doctors' satisfaction scores before and after the implementation of the training program were compared.

The expert positive coefficients for both rounds of consultation were 100%，and the expert authority coefficients were 0.863 and 0.860，respectively. The overall Kendall's coefficients of concordance were 0.131（χ²=430.900，P<0.001） and 0.130 （χ²=408.011，P<0.001）, and the coefficients of variation were 0.089 to 0.167 and 0.037 to 0.122，respectively. At last，the training program was established including five first-level indicators，15，16，23，16 second-level indicators and 38，41，64，31 third-level indicators for N0 to N3 nurses. After the training，both the nurse's assessment scores and the doctors' satisfaction scores were better than those before the training（P<0.05）.

The hierarchical training program for burn unit nurses based on competency has strong scientificity，which can reflect the comprehensive clinical ability of burn unit nurses，and improve the professional quality of the burn unit nurses and the satisfaction of doctors. It has certain significance for promoting the stable development of the burn nursing team.

To evaluate the clinical effect of bundled airway care in patients with inhalation injury undergoing tracheostomy.

A total of 216 patients with inhalation injury who met the inclusion criteria and underwent tracheostomy were enrolled from the Department of Burns and Cutaneous Surgery, Xijing Hospital, Air Force Medical University, between February 2021 and December 2024. According to the tracheostomy care protocol, they were divided into a bundled airway care group (observation group, n=106) and a routine airway care group (control group, n=110). Outcome measures included duration of tracheostomy tube retention, incidence of accidental extubation and tube blockage, incidence of ventilator-associated pneumonia (VAP), and antibiotic use density.

The observation group had a significantly shorter duration of tracheostomy tube retention than the control group [10.00 (8.00, 11.25)d vs. 11.50 (8.00, 15.00)d, P<0.001]. The incidence of accidental extubation and tube blockage was lower in the observation group (0.94% vs. 8.18%, P<0.05), as was the incidence of VAP (17.92% vs. 35.45%, P<0.05). Antibiotic use density was also significantly lower in the observation group (30.71±10.13 vs. 34.90±18.20, P<0.05).

Bundled airway care effectively improves airway management outcomes in patients with inhalation injury and tracheostomy, reduces complications such as accidental extubation and tube blockage, and decreases antibiotic use density. This approach is beneficial to the recovery of patients and is worthy of clinical promotion.

To investigate the physicochemical properties of silk fibroin （SF）-modified sheep acellular dermal matrix （SADM），and the repair effect and mechanism of its composite system with human adipose-derived mesenchymal stem cell （hADSCs） membranes on full-thickness skin defect wounds in mice.

Microporous SADM was prepared by combining pancrease-ribozyme digestion with repeated freeze-thaw. SF-SADM was obtained by impregnation with 5.0% SF solution. Changes in SADM pore structure before and after modification were observed under scanning electron microscopy and porosity was measured. The degradation profiles of SADM before and after modification were evaluated via in vitro degradation experiments. The hADSCs were isolated and cultured from discarded adipose tissue obtained from plastic surgery. Following characterization，the hADSCs were subjected to sheet culture and subsequently co-cultured with SADM and SF-SADM to establish the SADM-hADSCs and SF-SADM-hADSCs composite system. MTS assay were used to compare cell proliferation activity before and after SF modification，fluorescence labeling was used to observe the adhesion of cell membranes to scaffolds，and laser confocal microscopy was used to observe cell migration ability on scaffolds. Thirty-six healthy Kunming mice were selected and approximately 1 cm diameter circular full-thickness skin defect model was established at the mid-dorsal area. The mice were divided into SADM，SADM-hADSCs，and SF-SADM-hADSCs groups，with 12 mice in each group. The wounds in each group were covered with the corresponding membrane. Wound healing，histological changes，and angiogenesis were observed at 3，7，and 14 days postoperatively，and one-way ANOVA and t-test were performed on the data.

After SF modification，SADM porosity was significantly improved （P<0.05）. SF delayed the enzymatic hydrolysis process to some extent，making the degradation more controllable. The cell proliferation activity of SF-SADM-hADSCs was significantly higher than that of SADM-hADSCs （P<0.05）. In vivo healing promoter experiments，the wound healing rate at 14 days after surgery in the SF-SADM-hADSCs group reached 96.3%±2.1%，significantly higher than 72.4%±4.2% in the SADM group and 85.7%±3.5% in the SADM-hADSCs group （P values all <0.05）, with essentially achieved re-epithelialization and good vascularization.

5.0% SF solution can optimize the physicochemical properties of SADM，making it more bioactive. The SF-SADM-hADSCs composite system can accelerate high-quality healing of full-thickness skin defect wounds in mice by promoting re-epithelialization and angiogenesis.

Bi-unicompartmental knee arthroplasty （Bi-UKA） is an effective surgical approach for select knee osteoarthritis （KOA） patients，significantly improving knee function and quality of life. However，Bi-UKA was once regarded as a middle-groud or supplementary option to total knee arthroplasty （TKA）. In recent years，the clinical value and application prospects of Bi-UKA have once again become a focus of research. Increasing evidence suggests that Bi-UKA，by balancing anatomical structure preservation with more natural postoperative kinematic recovery，may offer a novel strategy for the stepwise treatment of KOA. This paper aims to review recent advances concerning the fundamental concepts，current development，clinical outcomes，patient selection，and future trends of Bi-UKA，and discusses its role and challenges in the context of stepwise treatment for KOA，aiming to provide a reference for clinical application.

Traumatic liver injury （TLI） is one of the most common and life-threatening visceral injuries in blunt abdominal trauma. Early and accurate assessment of the extent and severity of liver injury is crucial for selecting appropriate treatment strategies and improving patient outcomes. Currently，computed tomography （CT） remains the most reliable imaging modality for evaluating liver injuries. However，CT interpretation is highly dependent on radiologists' expertise and is associated with challenges such as subjectivity，time-consuming image review，and an increased risk of missed diagnoses under heavy workloads. In recent years，deep learning has achieved remarkable progress in medical image analysis. This review explores a precision assessment framework for TLI based on injury detection，quantitative severity assessment，and identification of associated imaging findings. Furthermore，it discusses how diagnostic and therapeutic decision-making can be enhanced through imaging optimization and multimodal data integration. The challenges facing the clinical application of deep learning models，including the long-tail effect of medical data，the “black-box” nature of algorithms，and integration into clinical workflows，are also analyzed. Finally，future research directions，such as explainable artificial intelligence and edge computing，are proposed to promote the standardized application of artificial intelligence technologies in the diagnosis and management of TLI.

Diabetic foot ulcer （DFU） is one of the chronic complications with the highest disability rate among diabetic patients. Clinical treatment and nursing care are notably challenging，and traditional dressing change regimens are often inadequate for meeting the repair requirements of complex wounds. As a novel collaborative nursing model，negative pressure wound therapy （NPWT） combined with bioactive dressings can effectively improve the wound microenvironment and promote tissue regeneration through the dual effects of physical-mechanical intervention and bio-biochemical regulation，and has become a core approach in the clinical nursing of DFU. From the perspective of clinical nursing，this article systematically reviews the clinical application basis，standardized nursing operation procedures，complication prevention，and comfort care measures of this combined model，analyzes the difficulties in clinical nursing management and proposes targeted solutions，and also looks into its development trend towards intelligent nursing. This review aims to provide standardized and refined practical references for clinical nursing staff，so as to enhance the quality of DFU nursing and reduce the risk of amputation in patients.

Skeletal muscle injury repair is a complex biological process involving cell proliferation，differentiation，and tissue reconstruction，with diverse and interrelated regulatory mechanisms. The phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway as one of the core signaling pathway regulating cell proliferation，survival，and metabolism，plays an important role in skeletal muscle injury repair，and is particularly critical in the activation of muscle satellite cells and the differentiation of myoblasts. However，the specific molecular mechanisms of this pathway in skeletal muscle injury repair still need to be further elucidated. This article reviews the research progress of the PI3K/Akt signaling pathway in the repair of skeletal muscle injury aiming to provide a reference for future studies.