To assess the clinical efficacy of antibiotic bone cement combined with vacuum sealing drainage in the treatment of diabetic foot ulcers, and to provide basis of evidence-based medicine.

A computerized literature search in CNKI, Wanfang, Vipshop, China Biomedical Literature, Pubmed, The Cochrane Library, and Web of Science, Embase, Clinical Trials databases was performed, screened clinical randomized controlled trials of antibiotic bone cement combined with vacuum sealing drainage for the treatment of diabetic foot. The retrieval time was from the time of database establishment to March 2023. Meta-analysis of the included studies was performed using RevMan 5.4 software.

A total of 12 studies with 789 patients were included, including 399 cases in the trial group and 390 cases in the control group. Due to the specificity of the treatment modality, it was difficult to implement the blinded method, so there was some bias. Meta-analysis results showed that compared to patients using vacuum sealing drainage alone for treatment, the time of wound healing was shorter (MD= -8.97, 95%CI: -11.64--6.29, P<0.001), the efficiency was better (RR=1.25, 95%CI: 1.14-1.37, P<0.001), the length of hospital stay was less (MD=-7.94, 95%CI: -11.21--4.66, P<0.001), the number of surgical procedures decreased (MD=-1.90, 95%CI: -2.97--0.82, P<0.001), the time of bacterial negative conversion was shorter (MD=-5.00, 95%CI: -5.26--4.73, P<0.001) in patients using antibiotic bone cement combined with vacuum sealing drainage.

The combination of antibiotic bone cement and vacuum sealing drainage for the treatment of diabetic foot has significant advantages over the use of vacuum sealing drainage alone, but due to the low quality of some of the included literature, the results may vary, and therefore a large amount of high-quality literature is needed to verify the above conclusions.

To evaluate the effect of pig-monkey skin transplantation using GGTA1/β4GalNT2 double gene knockout inbred Wuzhishan miniature pig.

Donor pig split skins were taken from double gene knockout inbred Wuzhishan miniature pigs and wild type Wuzhishan inbred miniature pigs. The recipients were rhesus monkeys. According to different skin graft donors, they were divided into experimental group and control group, 4 in each group. Four full-thickness skin excision wounds were made on the back of each rhesus monkey, and double-knocked-gene pig skin and wild-type pig skin were transplanted respectively. The color and texture of the grafted skin were observed at different time points after the operation, the vitality of the skin was evaluated, and specimens were taken for pathological examination. Serum were collected at different time points to detect the contents of IL-2, IL-4, IL-12, IFN-γ and IFN-γ/IL-4.

The average survival time of double-knock-out pigskin was (13.9±3.1)days, which was longer than that of wild-type pigskin (11.0±2.0)d (t=-3.0901, P=0.0043). In the early postoperative period, both groups of skins survived well. On the 7th day after the operation, the double-knockout pig skin grafts were still ruddy, and some wild-type pig skins showed rejection manifestations such as big or small blisters, or cyanosis. On the 10th day after the operation, the texture of the double gene knockout skin grafts were softer than that of the wild type pig skin. The cyanosis of the wild type pig skin still exists. On the 12th day after the operation, some double gene knockout skin grafts were still intact and soft, however, intact and ruddy skin grafts could not be found in wild-type pigskin grafts. On the 14th day after the operation, 9 and 14 grafts of double-knock-out pigskin and wild-type pigskin were completely peeled off, respectively. The shedding rate of double-knock-out pigskin was lower than that of wild pig skin group (Pearson chi²=3.8647, P=0.049). Among the 7 double-knockout pig grafts still presented in the wound, two grafts were still ruddy, warm, and soft, and the two grafts turned to crust and lost viablity on the 21st day after surgery. Pathological observation showed that there was no significant difference in the early stage after the two types of skin transplantation. On the 7th day after the operation, the number of epidermal cells decreased and dermal collagen tissue were edema in the epidermis of two types of pig skin. Small vacuoles appeared in the epidermis of wild-type pig skin. A part of double-knocked pig skin and wild-type pig skin were closely connected to the wound bed to form an " engraft". On the 10th day after operation, the number of epidermal cells in the two types of pig skin continued to decrease compared with before, and vacuoles were seen in the epidermis. Among them, the vacuoles in the epidermis of the double-knock gene pigskin were similar to iof the wild-type pig skin increased significantly compared with the previous ones. Both grafts and the wound bed were still tightly connected. On the 14th day after the operation, the overall structure of some double-knocked pig skins remained basically intact, but the vacuoles in the epidermis were significantly enlarged, so that most of the epidermis and dermis were separated, and the dermis was still connected to the wound bed. After the wild-type pig skin fell off, the wound bed was exposed, the granulation tissue proliferated and a large number of inflammatory cells infiltrated. There was no regular change in the levels of serum IL-2, IL-4, IL-12, IFN-γ and IFN-γ/IL-4 between the two groups.

The immune rejection of GGTA1/β4GalNT2 double gene knockout inbred line Wuzhishan miniature pig skin is reduced and its survival time is prolonged. It has the prospect of clinical application to treat burn wounds.

To compare the efficacy of meshed skin grafting and ReCell epidermal cell transplantation in the treatment of deep partial-thickness burns.

A tatal of 40 patients with deep partial-thickness burns who were admitted to the Department of Burns at Beijing Jishuitan Hospital, Capital Medical University from January 2019 to January 2022 and met the inclusion criteria were randomly divided into a study group and a control group. The study group received treatment with ReCell epidermal cell transplantation, while the control group received treatment with meshed skin grafting (1∶2). Postoperative wound observation and evaluation were performed at regular intervals and photographs were taken. The healing time, donor site area, operation time, postoperative pain, and postoperative scar formation were compared between the two groups. Data were analyzed using t test and χ² or Fisher test.

This study included 20 patients in the ReCell epidermal cell transplantation group and 20 patients in the meshed skin graft group. There was no statistically significant difference between the two groups in baseline characteristics such as age, gender, and burn area.The healing time was (15.3±2.3)d in the study group and (18.5±3.5)d in the control group, and there was a significant difference between the two groups (P<0.05). For the same repaired 100 cm² wound, the donor site area was (1.8±0.2)cm² in the study group and (48.3±2.9) cm² in the control group. The average operation time was (45.3±6.3)min in the study group and (50.4±9.9)min in the control group, and there was no significant difference between the two groups. Postoperative pain: on postoperative day 1, 3, and 7, the pain index of the study group was significantly lower than that of the control group (P<0.05). Postoperative scar formation: in the follow-up at 3, 6, 9, and 12 months after surgery, the scar score of the study group was significantly lower than that of the control group (P<0.05), especially at 9 and 12 months after surgery.

ReCell epidermal cell transplantation has a shorter healing time, smaller donor site area, less postoperative pain and scar formation compared to meshed skin grafting in the treatment of deep partial-thickness burns, and there is no significant difference in operation time. ReCell epidermal cell transplantation is an effective treatment for deep partial-thickness burns, which can improve the therapeutic effect.

To preliminarily investigate the effect of human umbilical cord mesenchymal stem cell exosomes on the migration of heat-damaged human skin fibroblasts.

Umbilical cord mesenchymal stem cells (hucMSCs) were isolated and morphologically identified surface markers by flow cytometry. Human umbilical cord mesenchymal stem cell exosomes (hucMSC-Exos) were obtained and identified by PEG precipitation combined with differential centrifugation. Human dermal fibroblasts were isolated and cultured, and a model of fibroblast thermal injury was established. Heat-damaged fibroblasts were divided into three groups, different doses of hucMSC-Exos solution (0 μg, 50 μg, 100 μg) were added, and cell scratches and Transwell experiments were performed sequentially to observe the effect of hucMSC-Exos on the migration of heat-damaged fibroblasts.

After 24 h, the scratch healing rates of heat-damaged fibroblasts in 50 μg and 100 μg hucMSC-Exos groups were 42.86%±6.54% and 55.42%±8.53%, respectively, which were higher than that in 0μg hucMSC-Exos group (23.21%±8.25%) with statistically differences (t=-7.111、-9.268, P<0.05). After 24 h, the migration numbers of heat-damaged fibroblasts in 50 μg and 100 μg hucMSC-Exos groups were 31.47±4.31 and 39.53±3.11, respectively, which were more than that in 0 μg hucMSC-Exos group (19.20±2.91), the differences were statistically significant (t=-10.213、-28.710, P<0.05).

Human umbilical cord mesenchymal stem cell exosomes can promote the migration of heat-damaged human skin fibroblasts.

To explore the clinical effect of modified pedicled thoracic umbilical flap in the repair of deep wound of wrist back.

From May 2017 to February 2021, 36 patients with deep wounds of wrist back admitted to the Department of Burn and Plastic Surgery, 910 Hospital of PLA Joint Logistics Support Force were divided into study group and control group, with 18 cases in each group. After debridement, the study group was treated with modified pedicled thoracic umbilical flap. From the 6th day after the operation, the silk thread was ligated in segments to block the blood flow of the pedicle. The blocking time was gradually extended, when the blocking time reached 30 minutes and there was no significant change in the blood supply of the flap, flap peduncle was performed. While the control group was treated with abdominal random pedicle flap. Three weeks after the operation, the skin flap was cut off. The flap survival rate, flap infection rate, pedicle division time, wound healing time and wrist function assessment were compared between the two groups. Data were processed with t test, chi-square test and Fisher exact probability test.

The flap survival rate of the study group was 100%, which was significantly higher than that of the control group (72.2%), and the flap infection rate was 5.6%, which was lower than that of the control group (38.9%), the differences were statistically significant (P<0.05). The pedicle division time and wound healing time were (13.4±3.4), (20.2±2.2)d in the study group, which were significantly shorter than those in the control group [(20.6±2.8), (30.2±4.3)d], the differences were statistically significant(t=-6.880, -8.836; P<0.05). Twelve months after wounding healing, the wrist function in the study group (excellent in 16 cases and good in 2 cases) was significantly better than that in the control group (excellent in 9 cases and good in 9 cases), the difference was statistically significant (P<0.05).

The modified pedicled thoracic umbilical flap has higher survival rate, shorter wound healing time, lower infection rate, and better recovery of wrist appearance and function in repairing deep wound of wrist.

To study the biocompatibility of alginate oligosaccharides with different degree of lysis and effect on wound healing.

Depending on the difference of molecular weight, the alginate oligosaccharides with different degree of lysis were separated by dialysis method. The molecular weight was <1000, 1000-5000, 5000-10000 and >10000 respectively, and the non-cleaved alginate was used as control. Observed the film formation ability of alginate oligosaccharides with different molecular weight, detected the bacteria resistance and moisture retention after film formation ability, and detected the cytotoxicity, sensitization and intradermal stimulation according to the requirements of GB/T 16886 to verify the biocompatibility. A full-thickness wound defect model with a diameter of 3 cm was prepared on the back of SD rats. Alginate oligosaccharide solution with different degrees of lysis was used for dressing change, which was divided into experimental group 1-4, alginate solution as the positive control group, and physiological saline as the negative control group. The dressing was changed daily. The wound healing rate was calculated on the 7th and 14th days.The wound tissue was taken for HE staining to observe the tissue changes, and sirius red picric acid staining was used to observe the collagen secretion.

When the molecular weight was less than 1000, no film formation was observed, and there was no obvious bacteria resistance and moisture retention. With the increase of molecular weight, the film formation ability, bacteria resistance and moisture retention were enhanced. At the concentration of 0.02%, the alginate oligosaccharides with different molecular weight and non-cleaved alginate had no obvious cytotoxicity and sensitization, but when the molecular weight was less than 1 000, it had slight intradermal stimulation. On the 7th and 14th day after modeling, except for experimental group 2, the wound healing rate of each group in the experimental group and the positive control group was significantly higher than that of the negative control group(F=0.018, 0.097, 0.016, 0.055; t=3.737, 3.853, 3.861, 3.525; P<0.05; F=0.562, 0.111, 1.162, 0.206; t=3.484, -1.557, -0.319, 3.851; P<0.05). HE and sirius red picric acid staining showed that when the molecular weight was above 5 000, the granulation tissue proliferation and collagen content increased significantly.

The algal oligosaccharides with low degree of lysis has the ability of film formation, bacteria inhibition and moisture retention, and can provide a moist environment suitable for wound healing.

To investigate the clinical effect of flap combined with vacuum sealing drainage, lavage and drainage in the treatment of plate exposure after internal fixation of tibial fracture.

From January 2012 to June 2022, 12 patients with tibial fracture and postoperative plate exposure were treated with surgical debridement combined with vacuum sealing drainage, continuous lavage and drainage in Department of Cosmetic Burn and Plastic Surgery, the People′s Hospital of Leshan and in Department of Burn Plastic Surgery, Sichuan Provincial Corps Hospital of Armed Police, and appropriate type of flap repairment (muscle, myocutaneous or axial pattern skin flap) in accordance with wound condition. Regular postoperative follow-up were conducted, along with regular X-ray review. Removed the internal fixation after clinical fracture healing.

All 12 patients had viable flaps (muscle, myocutaneous and axial pattern skin flap), closed wounds and controlled infection condition. All patients were followed up for 4-18 months. The plates were retained during the whole treatment duration until the fracture healed with full functional recovery.

In patients with exposed plates after internal fixation of tibial fractures, the combination treatment method of flap with vacuum sealing drainage, continuous lavage and drainage has advantages in retaining the internal fixation during the fracture healing, leading to wound repairment and full functional recovery at the same time.