To observe the clinical effect of medical tissue adhesive in fixing large sheet autologous split-thickness skin grafts.

A retrospective study was conducted on the clinical data of 196 patients who underwent large sheet autologous split-thickness skin grafting，including acellular allodermal matrix composite split-thickness skin grafting for wound repair，and were hospitalized in the Department of Burns and Dermatologic Surgery， Xijing Hospital of Air Force Medical University， from February 2021 to June 2024. According to the different skin graft fixation methods， patients were divided into the observation group （n=104） and the control group （n=92）. In the observation group， skin grafts were fixed with medical tissue adhesive， the first dressing change was performed at 4-5 days postoperatively for simple split-thickness skin grafting， and 8-10 days postoperatively for acellular allodermal matrix composite split-thickness skin grafting. In the control group，skin grafts were fixed with skin suture needles for patients undergoing simple split-thickness skin grafting，and the skin grafts were fixed with interrupted silk sutures for patients undergoing acellular allodermal matrix composite split-thickness skin grafts， the first dressing change time after surgery was the same as that in the observation group. The occurrence of skin graft displacement， hematoma formation， infection， and the survival of skin graft were observed during the first dressing change.

The incidence of skin graft displacement in the observation group （4.8%） was lower than that in the control group （13.0%）， and the proportion of displaced skin graft area （3.63%±1.38%） was also lower than that in the control group （6.60%±2.08%）, the differences were statistically significant （P<0.05）. There was no statistically significant difference in skin graft survival rate between the observation group （99.24%±3.55%） and the control group （97.77%±6.08%） （t=2.046， P=0.151）. In the observation group， 5 cases of hematoma and 2 cases of skin graft infection with necrosis occurred， while in the control group， 4 cases of hematoma and 3 cases of skin graft infection with necrosis occurred. There was no statistically significant difference between the two groups （P>0.05）. Among the patients who developed complications，4 in the observation group and 5 in the control group healed after undergoing additional skin grafting； the remainder healed with dressing changes.

Compared with traditional fixation methods， medical tissue adhesive for securing large sheet autologous split-thickness skin grafts demonstrates more stable and effective fixation， reduces skin graft displacement， and avoids operational injuries and pain caused by removing fixatives. It is worthy of clinical promotion and application.

To explore the therapeutic effect of the surgical approach combining staged debridement， vacuum sealing drainage and acellular dermal matrix and other appropriate techniques on gluteal muscle and skin necrosis after transcatheter arterial embolization （TAE）.

From August 2020 to September 2023， 6 patients with gluteal muscle and skin necrosis after TAE for massive hemorrhage caused by pelvic fracture who met the inclusion criteria were admitted to the Department of Plastic and Burn Surgery， Northern Jiangsu People's Hospital， including 4 males and 2 females， aged 42 to 65 years. All patients were treated with a surgical method combining staged debridement， vacuum sealing drainage and acellular dermal matrix and other appropriate techniques. The changes of creatine kinase levels after TAE and the CT or MRI imaging characteristics of gluteal muscle and skin necrosis were observed. The number of wound treatment operations， wound healing time and wound healing status were recorded.

The creatine kinase levels showed an overall upward trend from 1 to 3 days after TAE， peaked at 3 to 7 days after surgery， and maintained a high level （>10 000 U/L） for 2 to 7 days. CT or MRI showed edema of gluteal soft tissues and gluteal muscles （gluteus maximus， gluteus medius and gluteus minimus）， with uneven density of some muscles. The number of wound treatment operations was （4.7±0.8） times， and the wound healing time was （42.5±5.4） days. All 6 patients achieved good wound healing after surgery， and no wound rupture or exudation was found during the 2-month follow-up.

The combination of staged debridement， vacuum sealing drainage， acellular dermal matrix and other appropriate techniques can effectively treat gluteal muscle and skin necrosis after TAE.

To explore the clinical efficacy of autologous vascularized fibula flap transplantation for the treatment of infectious femoral bone defects.

A retrospective analysis was conducted on the clinical data of 11 patients with infectious femoral bone defects treated in the Department of Orthopedic Trauma， Norinco General Hospital from January 2018 to January 2022. There were 8 males and 3 females， with an average age of （34.0±4.5） years and an average bone defect length of （9.5±1.7） cm. During surgery， after thorough debridement of the bone defect ends， the femur was fixed. An autologous vascularized fibula composite tissue flap was harvested for one-stage reconstruction. The vascular pedicle of the vascularized fibula was anastomosed to the recipient vessels via end-to-side technique after isolating and trimming the vascularized fibula. Among them， 5 cases were repaired with a single fibula graft， and 6 cases were repaired with a two-segment fibula graft， with an average transplanted fibula length of （14.5±3.2） cm. The vascularized fibula was fixed with plates or an external fixator. Postoperatively， routine anti-infection， anticoagulation， and antivasospasm treatments were administered （anti-infection treatment course lasted 4-6 weeks， and anticoagulation and antivasospasm treatments lasted for 2 weeks）. Infection control and vascularized fibula survival were closely observed. The healing status at the junction of the vascularized fibula and the recipient site was evaluated by follow-up radiological examinations during reconsultations. Patients were instructed to perform lower limb functional exercises， and the healing conditions of the affected limb and donor site， as well as limb function， were evaluated using the Enneking score， Baird-Jackson ankle function score， association for the study and application of the method of Ilizarov （ASAMI） criteria， and lower extremity functional scale （LEFS） score.

All 11 patients were followed up， with an average follow-up time of （24.5±12.8） months. All wounds healed primarily without infection recurrence， all vascularized fibula survived with no vascular crisis observed， and there was no significant functional impairment at the donor sites. All transplanted vascularized fibula achieved stable bony union， without bone resorption， osteosclerosis， or refracture. The average time to bony union was （5.5±1.2） months. At 12 months postoperatively， the average Enneking score of the affected limb was （24.0±3.3） points， the average Enneking score of the donor site was （27.2±1.1） points， and the average Baird-Jackson ankle function score of the donor site was （95.5±1.6） points. At the final follow-up， ASAMI criteria assessment of the affected limb showed excellent bone results in all 11 patients， with 7 cases of excellent functional results and 4 cases of good functional results. The average LEFS score of the affected limb was （75.5±2.2） points.

The application of vascularized fibula transplantation and vascular reconstruction helps improve local blood supply and control infection， can effectively repair large-scale infectious femoral bone defects， and improve the bone healing rate. It is an effective clinical treatment for this type of disease.

To investigate the clinical efficacy of free flap repair for distal tibial bone exposure and analyze the factors affecting flap survival and postoperative complications.

A retrospective analysis was conducted on 78 patients with distal tibial bone exposure treated at the Department of Burns and Plastic Surgery， Beijing Jishuitan Hospital， Capital Medical University， from May 2019 to May 2024. The flap survival rate， complication rate， and functional recovery were statistically analyzed. Risk factors were analyzed using chi-square test and multivariate logistic regression analysis.

The flap survival rate was 94.9% (74/78). Complications included vascular crisis in 6 cases （7.7%） （comprising 4 arterial and 3 venous crises， with 1 case involving both）， infection in 2 （2.6%）， hematoma in 3 （3.8%）， wound dehiscence in 1 （1.3%）， and donor site complications in 4 （5.1%）. The good-to-excellent rate according to the Enneking score was 85.9% (67/78). Chronic infected wounds were identified as an independent risk factor for vascular crisis （OR=3.45， 95%CI： 1.12-10.67， P=0.031） and for wound infection or sinus tract formation at follow-up （OR=5.20， 95%CI： 1.80-15.10， P=0.002）. Smoking and diabetes were not significantly associated with complications.

Chronic infected wounds are the main risk factor for postoperative complications. Preoperative strengthening of infection control can improve the surgical success rate.

To retrospectively investigate factors influencing wound healing in patients with deep partial-thickness burns on neck undergoing non-surgical treatment, and provide references for optimizing non-surgical treatment strategies.

A total of 122 patients with deep partial-thickness burns on neck who received non-surgical treatment at the Department of Burns and Plastic Surgery， the First Hospital of Hebei Medical University between December 2018 and June 2024 were included. General demographic and clinical data of the patients were collected， including gender， age， body mass index （BMI）， injury causes， neck burn area， total burn area， wound management approach （exposure， semi-exposure， or occlusive dressing） ， and presence of inhalation injury. Univariate analysis and multiple linear regression were performed to identify factors associated with wound healing time.

The wound healing time ranged from 11 to 36 days， with an average of （19.3±5.6） days. Univariate analysis showed that wound healing time differed significantly among patients with different causes of injury， wound management approach， total burn area， and presence or absence of inhalation injury（P<0.05）. Multiple linear regression analysis showed that patients with flame burns or hydrothermal scald had a longer wound healing time compared with those with electrical flash burns （β=0.368， P=0.006； β=0.276， P=0.047， respectively）. Patients treated with occlusive dressings had significantly shorter wound healing time than those managed without occlusive dressings （β=-0.208， P=0.030）. Additionally， patients complicated with inhalation injury exhibited a longer wound healing time than those without inhalation injury（β=0.278， P=0.014）.

Occlusive dressing therapy may offer advantages in reducing wound healing time compared to exposure or semi-exposure approaches for non-surgical management of deep partial-thickness burn on neck. Flame burns and hydrothermal scald and concomitant inhalation injury are associated with prolonged healing， underscoring the need for early targeted interventions in such patients to enhance recovery.

To optimize the management mode of the plantar donor sites in severe burn patients and evaluate its application effect.

A retrospective study was conducted on 42 severe burn patients treated with bilateral plantar skin grafts at the Department of Burns and Plastic Surgery，the 910th Hospital of Joint Service Support Unit of PLA from April 2021 to September 2024. The patients were divided into a control group （20 cases） and an observation group （22 cases）， with the control group receiving conventional management and the observation group undergoing optimized management. The protocol included： reoperative skin keratin layer softening and partial removal，intraoperative graft area definition，surgical instrument selection and techniques，postoperative use of suspended beds and wound dressings，and discharge rehabilitation guidance. Comparative analysis was conducted on the number of harvestable procedures from the plantar sites，final graft area，initial dressing pain scores，dressing frequency，healing time，6-month scar scores，and complication rates.

The observation group underwent a greater number of harvestable procedures and had a larger final graft area （P<0.05） compared to the control group. In addition，the observation group showed significantly lower initial dressing pain scores，dressing frequency，healing time，6-month scar scores，and complication rates （P<0.05）.

Optimizing the management of plantar donor sites can increase the number of harvestable procedures and the amount of skin graft obtained， reduce wound dressing pain and frequency， promote healing， mitigate scar hyperplasia， without affecting postoperative ambulation.

Based on the framework of timing theory， this study explores the caregiving experiences of caregivers for children with severe burns at different disease stages， providing a basis for constructing staged intervention plans and establishing a diversified support system.

A qualitative research method was employed， using purposive sampling combined with maximum differentiation sampling strategy to select 18 caregivers of children with severe burns who were treated at Department of Burns and Cutaneous Surgery， Burn Center of PLA， Xijing Hospital, Air Force Medical Univercity from January 2024 to December 2024 as study subjects. Guided by the timing theory， face-to-face semi-structured interviews were conducted at different stages， and data were collected and analyzed using content analysis to extract themes.

Three themes were identified based on burn staging， comprising 9 sub-themes. (1) Shock stage： self-blame/guilt and urgent treatment needs； (2) Treatment stage： shift in life priorities， anxiety due to lack of knowledge， heavy financial burden， demanding caregiving tasks， and desire for social assistance； (3) Rehabilitation stage： increased concerns about the child's future and the need for rehabilitation care.

Healthcare providers， family members， and social organizations should pay attention to the dynamic caregiving experiences and changing needs of caregivers for children with severe burns at different disease stages， providing comprehensive， meticulous physical and psychological care and professional guidance. While improving the treatment success rate of pediatric burn patients， it is essential to address the needs of their caregivers by establishing a comprehensive support system to alleviate psychological burdens. This approach will better facilitate the treatment and rehabilitation process for severe burn patients， ultimately enhancing their quality of life.

To evaluate the therapeutic effect and potential mechanism of action of embryonic stem cell-derived immunity and matrix regulatory cells （IMRC） on traumatic heterotopic ossification （THO）.

A THO model was established via Achilles tendon injury in SD rats， which were then randomly divided into a sham operation group， a control group， and an IMRC treatment group. The IMRC group received local injections of a suspension containing 1×10⁶ IMRCs twice weekly for 4 weeks post-operation. At 4， 8， and 12 weeks post-surgery， heterotopic bone volume and bone mineral density （BMD） were quantitatively analyzed using micro-computed tomography (Micro-CT). Tissue inflammation， fibrosis， and heterotopic bone formation were assessed via haematoxylin-eosin stain and Masson staining. The protein expression levels of α-smooth muscle actin （α-SMA） and osteocalcin （OCN） were detected by immunohistochemistry. Safety was evaluated by monitoring body weight and examining the pathology of major organs.

Compared to the control group， IMRC treatment significantly inhibited heterotopic bone formation. Micro-CT revealed that at 12 weeks post-operation， the heterotopic bone volume in the IMRC group [（16.67±0.90） mm³] was reduced by 79.5% compared to the control group [（81.42±2.72） mm³] （P<0.001）， and the BMD was also significantly lower [（223.78±16.65） mg/cm³ vs （595.14±30.31） mg/cm³， P<0.001]. Histological analysis showed significant reductions in inflammatory cell infiltration， collagen deposition， and fibrosis scores in the IMRC group （all P<0.01）， alongside markedly suppressed expression of α-SMA and OCN （all P<0.01）. All rats exhibited steady body weight gain， and no pathological changes were observed in the major organs， indicating a favorable safety profile for IMRC treatment.

Local injection of IMRC can safely and effectively inhibit the development and progression of THO through a multi-mechanism approach involving anti-inflammation， anti-fibrosis， and inhibition of osteogenesis， representing a novel cell therapy strategy with broad translational potential.

Malnutrition is a common comorbidity in patients with diabetic foot ulcers (DUF) that significantly impairs wound healing and adversely affects patient prognosis， thereby garnering increasing clinical attention. This review aims to summarize nutritional management strategies by analyzing the epidemiological characteristics of malnutrition and its impact on wound healing. It further delves into a systematic approach to nutritional assessment， the specific roles of various macro- and micronutrients， and current nutritional intervention methods. The synthesis of these elements is intended to provide an evidence-based reference for optimizing clinical care.

The issue of wound healing is a significant clinical concern that warrants immediate attention. For example， delayed re-epithelialization and hypopigmented scars are manifestations of impaired skin regeneration resulting from suboptimal healing processes. Furthermore， existing prognostic techniques for plastic surgery repair continue to be insufficient in fully addressing these challenges. Epidermal stem cells are situated in the basal layer and have the capacity for self-renewal and multipotent differentiation. Epidermal stem cells derived exosomes regulate and promote the multi-stage wound healing process by carrying abundant bioactive factors. Therefore， it is necessary to conduct a systematic review on the research progress of exosomes derived from epidermal stem cells in wound repair， with the aim of providing references for the development of new therapeutic strategies for acute and chronic wound repair.

The healing process of burn wounds is intricate and often complicated by challenging issues such as microbial colonization and delayed healing. Thus， there is a critical need to explore novel therapeutic strategies that can accelerate wound healing and modulate the local microenvironment. As such agents， probiotics are beneficial microorganisms that exert effects including inhibiting pathogenic bacteria， promoting tissue regeneration， and modulating immune responses， thereby facilitating wound healing. Growing evidence has demonstrated that probiotic formulations hold promising potential for burn wound management. This article explores changes in burn wound microbiota composition and the role of probiotics in wound healing， by reviewing existing clinical evidence to offer insights and directions for improving outcomes and quality of life in burn patients.

Macrophage dysfunction is a key factor in uncontrolled inflammation and tissue injury in sepsis-induced acute lung injury. Metabolic reprogramming serves as a critical bridge linking the septic microenvironment to macrophage dysfunction. During sepsis-induced acute lung injury， macrophages undergo significant reprogramming in glucose metabolism， lipid metabolism， amino acid metabolism， and mitochondrial function. These metabolic alterations drive hyperactivation of pro-inflammatory responses while suppressing anti-inflammatory and tissue-repair functions， ultimately exacerbating lung injury. Therapeutic strategies targeting metabolic reprogramming may be beneficial for anti-inflammatory and tissue-protection， but face challenges of macrophage heterogeneity， metabolic network complexity， and clinical translation barriers. Future research requires in-depth analysis of metabolic signatures across distinct macrophage subsets， development of precise interventions， and exploration of metabolic reprogramming as a prognostic biomarker. This approach may facilitate the emergence of targeted metabolic reprogramming as a novel pathway to improve outcomes in sepsis-induced acute lung injury.

Diabetic foot ulcer （DFU） is one of the most serious chronic complications of diabetes， characterized by high disability and recurrence rates， as well as treatment resistance. DFU can lead to infection， declined functional status， hospitalization， lower limb amputation， and even death. The pathogenesis of DFU is complex， involving the interaction of multiple factors such as chronic inflammation， vascular lesions， extracellular matrix metabolism disorder， and nerve damage. Recently， the regulatory role of RNA binding proteins （RBPs） in pathogenesis of DFU has attracted increasing research interest. RBPs mediate post-transcriptional regulation of key pathological processes， such as the expression of inflammatory factors， angiogenesis， collagen metabolism， and nerve repair. Therefore， this article aims to review the mechanisms and research advances of RBPs in DFU development and progression， with a focus on their potential as therapeutic targets， thereby providing new insights for precision medicine in DFU.