Background:Rats are often used to prepare skin defect models.However,the skin defect sizes of the models prepared by researchers are different,and the lack of consensus on the critical-size defect makes it difficult t...Background:Rats are often used to prepare skin defect models.However,the skin defect sizes of the models prepared by researchers are different,and the lack of consensus on the critical-size defect makes it difficult to compare their research results.Methods:The time for wound closure was evaluated and recorded through gross observation.The regression equation between the healing time and the diameter of skin defect was established,which can be used to predict the healing time for a certain skin defect size in rats.Histochemical and immunohistochemical staining was used to observe the regeneration and reconstruction of skin appendages,and the functional skin repair was quantitatively scored.Results:The critical-size defect of rats was determined based on the maximum capacity of structural skin repair,and the functional skin repair was quantitatively scored based on the regeneration and reconstruction of skin appendages.The allowable range of critical-size skin defect of SD rats lies between 45 and 50 mm in diameter.The concept of structural repair and the category of functional repair of injured skin are put forward.The regression equation between the structural skin healing time and defect diameters is established.Conclusion:The allowable range of skin critical-size defect of SD rats lies between 45 and 50 mm in diameter.The regression equation between the structural skin healing time and defect diameters can be used to predict the healing time for a certain skin defect size in rats.展开更多
Objective:To investigate the effect of a subcutaneous pedicle Limberg flap for the reconstruction of medium-sized skin defects in the face following skin tumor or scar excision. Methods: From August 2002 to June 2004,...Objective:To investigate the effect of a subcutaneous pedicle Limberg flap for the reconstruction of medium-sized skin defects in the face following skin tumor or scar excision. Methods: From August 2002 to June 2004,the subcutaneous pedicle Limberg flap was designed to repair facial skin defects in 17 patients(19 flaps),and the size of the lesions ranged from 2.0 cm×1.9 cm to 5.0 cm×4.5 cm.The operation was performed under general anesthesia in 2 children,and under local anesthesia in the remaining 15 patients. Results: All flaps survived with primary healing postoperatively.With a follow-up from 1 to 22 months,neither short-term nor long-term postoperative complications such as flap necrosis,hematoma,infection,visible dog-ear and trap door deformity were found,and functionally and cosmetically satisfactory outcomes were achieved. Conclusion: This subcutaneous pedicle Limberg flap provides a competitive repair alternative for the treatment of medium-sized skin defects in the face.展开更多
Objective: to analyze the clinical application effect of negative pressure sealing drainage (VSD) in skin defect complicated with infection wound. Methods: from June 2019 to June 2020, 39 cases of skin defect complica...Objective: to analyze the clinical application effect of negative pressure sealing drainage (VSD) in skin defect complicated with infection wound. Methods: from June 2019 to June 2020, 39 cases of skin defect complicated with wound infection in our hospital were listed as the reference group, and 39 cases of the same type treated from June 2020 to June 2021 were listed as the analysis group. With reference to the traditional treatment method in group A, VSD was used in the analysis group after debridement, and the clinical treatment related indexes and the effective rate of wound treatment were compared between the two groups. Results: the use time of antibiotics in the treatment of patients in the comparative analysis group was significantly shorter than that in the reference group, and the wound area of patients in the treatment analysis group was significantly larger than that in the reference group, all of which were statistically verified (P<0.05). After treatment, the total effective rate of two groups of patients was counted. The total effective rate of the analysis group was significantly higher, being 100.00%(39/39), and that of the reference group was 79.49%(31/39). It was verified that P<0.05. Conclusion: compared with the traditional treatment methods, VSD has more advantages in treating skin defects complicated with infected wounds, which can reduce the use of antibiotics by patients and help to reduce the wound area. Its total effective rate is obviously higher, and it is easy to operate, so it can be popularized.展开更多
Objective To introduce an effective reconstruction method for the finger injured with vessel and skin defect. Methods Free skin flap with skin vein was transplanted on the site of tissue defect, connecting by anastomo...Objective To introduce an effective reconstruction method for the finger injured with vessel and skin defect. Methods Free skin flap with skin vein was transplanted on the site of tissue defect, connecting by anastomosis the vein with artery or vein of the finger. Results Seven cases were treated with this method,among which 5 cases have sikin defect on the palm aspect of fingers, the rest have skin defect on the dorsal aspect skin of finger. All fingers survived with good shape and function. Conclusion This is a simple and effective method of finger reconstruction for the patients with defect of vessels and skin. 6 refs.展开更多
To report a method of repair facial skin defects with a skin flap of SMAS pedicle.Methods According to the size of defect of skin,design a skin flap with SMAS pedicle for repair of defect.Results The method has been s...To report a method of repair facial skin defects with a skin flap of SMAS pedicle.Methods According to the size of defect of skin,design a skin flap with SMAS pedicle for repair of defect.Results The method has been successfully applied for skin defects of eyelid and lip in 14 cases with satisfied results.The area of the largest flap was 5 cm×3 cm.Conclusion Repairing facial defects such as eyelid skin defect or lip skin defect with skin flap of SMAS pedicle is a very good method.The flap has a good blood supporting and satisfactory color and flexibility.5 refs,6 figs.展开更多
In young patients, even small circular facial defects after the excision of benign skin tumors present a reconstructive challenge. The usefulness of a V-Y advancement flap for reconstructing such defects is well docum...In young patients, even small circular facial defects after the excision of benign skin tumors present a reconstructive challenge. The usefulness of a V-Y advancement flap for reconstructing such defects is well documented. We refined this technique as a mini V-Y advancement flap consisting of two subcutaneous pedicles that vascularize the skin island via subdermal plexus lateral bridges. This technique was used for 21 middle-aged or younger patients with a small benign skin lesion. None of them experienced any postoperative complications. Aesthetically excellent results were found in all patients. This small advancement flap could be attempted as an alternative to fusiform excision of small skin lesions, particularly in younger patients.展开更多
The issue of skin defects is a major concern of almost every trauma surgeon after surgery. Despite numerous conventional methods and introduction of the reconstruction ladder, managing skin defects is still a challeng...The issue of skin defects is a major concern of almost every trauma surgeon after surgery. Despite numerous conventional methods and introduction of the reconstruction ladder, managing skin defects is still a challenge for the trauma surgeons. In recent years, parallel to the advances in the more conventional methods of skin repair, regenerative medicine has offered new and novel treatments. This article aims to explore these contemporary regenerative solutions as well as to review the conventional methods of treating skin defects.展开更多
Background:Split-thickness skin grafting is the current gold standard for the treatment of traumatic skin loss.However,for patients with extensive burns,split-thickness skin grafting is limited by donor skin availabil...Background:Split-thickness skin grafting is the current gold standard for the treatment of traumatic skin loss.However,for patients with extensive burns,split-thickness skin grafting is limited by donor skin availability.Grafting split-thickness skin minced into micrografts increases the expansion ratio but may reduce wound repair quality.Dermal substitutes such as Pelnac can enhance the healing of full-thickness skin wounds,but their application currently requires two surgeries.The present study investigated whether it is possible to repair full-thickness skin defects and improve wound healing quality in a single surgery using Pelnac as an overlay of minced split-thickness skin grafts in a rat model.Methods:A full-thickness skin defect model was established using male Sprague-Dawley rats of 10 weeks old.The animals were randomly divided into control and experimental groups in which Vaseline gauze and Pelnac,respectively,were overlaid on minced split-thickness skin grafts to repair the defects.Wound healing rate and quality were compared between the two groups.For better illustration of the quality of wound healing,some results were compared with those obtained for normal skin of rats.Results:We found that using Pelnac as an overlay for minced split-thickness skin grafts accelerated wound closure and stimulated cell proliferation and tissue angiogenesis.In addition,this approach enhanced collagen synthesis and increased the formation of basement membrane and dermis as well as the expression of growth factors related to wound healing while reducing scar formation.Conclusions:Using minced split-thickness skin grafts overlaid with Pelnac enables the reconstruction of fullthickness skin defects in a single step and can increase the healing rate while improving the quality of wound healing.展开更多
The healing of large skin defects remains a significant challenge in clinical settings.The lack of epidermal sources,such as autologous skin grafting,limits full-thickness skin defect repair and leads to excessive sca...The healing of large skin defects remains a significant challenge in clinical settings.The lack of epidermal sources,such as autologous skin grafting,limits full-thickness skin defect repair and leads to excessive scar formation.Skin organoids have the potential to generate a complete skin layer,supporting in-situ skin regeneration in the defect area.In this study,skin organoid spheres,created with human keratinocytes,fibroblasts,and endothelial cells,showed a specific structure with a stromal core surrounded by surface keratinocytes.We selected an appropriate bioink and innovatively combined an extrusion-based bioprinting technique with dual-photo source cross-linking technology to ensure the overall mechanical properties of the 3D bioprinted skin organoid.Moreover,the 3D bioprinted skin organoid was customized to match the size and shape of the wound site,facilitating convenient implantation.When applied to full-thickness skin defects in immunodeficient mice,the 3D bioprinted human-derived skin organoid significantly accelerated wound healing through in-situ regeneration,epithelialization,vascularization,and inhibition of excessive inflammation.The combination of skin organoid and 3D bioprinting technology can overcome the limitations of current skin substitutes,offering a novel treatment strategy to address large-area skin defects.展开更多
Background and objectives Skin defects are one of the primary problems that occur in post-harvest grading and processing of loquats.Skin defects lead to the loquat being easily destroyed during transportation and stor...Background and objectives Skin defects are one of the primary problems that occur in post-harvest grading and processing of loquats.Skin defects lead to the loquat being easily destroyed during transportation and storage,which causes the risk of other loquats being infected,affecting the selling price.Materials and Methods In this paper,a method combining band radio image with an improved three-phase level set segmentation algorithm(ITPLSSM)is proposed to achieve high accuracy,rapid,and non-destructive detection of skin defects of loquats.Principal component analysis(PCA)was used to find the characteristic wavelength and PC images to distinguish four types of skin defects.The best band ratio image based on characteristic wavelength was determined.Results The band ratio image(Q782/944)based on PC2 image is the best segmented image.Based on pseudo-color image enhancement,morphological processing,and local clustering criteria,the band ratio image(Q782/944)has better contrast between defective and normal areas in loquat.Finally,the ITPLSSM was used to segment the processing band ratio image(Q782/944),with an accuracy of 95.28%.Conclusions The proposed ITPLSSM method is effective in distinguishing four types of skin defects.Meanwhile,it also effectively segments images with intensity inhomogeneities.展开更多
BACKGROUND Although skin avulsions to male external genitalia are rare, they can be both physically and psychologically traumatic. Thus, the necessity for judicious management poses significant challenges to surgeons ...BACKGROUND Although skin avulsions to male external genitalia are rare, they can be both physically and psychologically traumatic. Thus, the necessity for judicious management poses significant challenges to surgeons in order to avoid potential permanent disabilities. We report a case of massive penoscrotal skin avulsion and a composite graft was creatively applied to cover the defect which achieved good results. We believe that this case is of great reference value for fellow surgeons.CASE SUMMARY A 52-year-old male presented with massive traumatic avulsion of the penile and scrotal skin following mishandling of an electric drill. The avulsed skin was missing. The patient was diagnosed with massive skin avulsion of external genitalia. Following initial complete debridement of devitalized or infected tissues, Pelnac dermal substitute was secured to the defect with the assistance of negative-pressure wound closure. In the final step, the silicone layer of Pelnac was removed and a split-thickness skin graft was applied. The defect had healed at the two-month follow-up. The patient now has normal erections and satisfactory sexual function.CONCLUSION Our experience with this wound repair demonstrated that the combination of a dermal regeneration template and a split-thickness skin graft with vacuumassisted closure is a safe, well-tolerated and efficient solution for the reconstruction of massive penoscrotal skin defects.展开更多
The use of skin flaps in reconstructive surgery is the first-line surgical treatment for the reconstruction of skin defects and is essentially considered the starting point of plastic surgery. Despite their excellent ...The use of skin flaps in reconstructive surgery is the first-line surgical treatment for the reconstruction of skin defects and is essentially considered the starting point of plastic surgery. Despite their excellent usability, their application includes general surgical risks or possible complications, the primary and most common is necrosis of the flap. To improve flap survival, researchers have used different methods, including the use of adiposederived stem cells, with significant positive results. In our research we will report the use of adipose-derived stem cells in pedicle skin flap survival based on current literature on various experimental models in animals.展开更多
基金National Key Research and Development Program of China,Grant/Award Number:2023YFC2410403。
文摘Background:Rats are often used to prepare skin defect models.However,the skin defect sizes of the models prepared by researchers are different,and the lack of consensus on the critical-size defect makes it difficult to compare their research results.Methods:The time for wound closure was evaluated and recorded through gross observation.The regression equation between the healing time and the diameter of skin defect was established,which can be used to predict the healing time for a certain skin defect size in rats.Histochemical and immunohistochemical staining was used to observe the regeneration and reconstruction of skin appendages,and the functional skin repair was quantitatively scored.Results:The critical-size defect of rats was determined based on the maximum capacity of structural skin repair,and the functional skin repair was quantitatively scored based on the regeneration and reconstruction of skin appendages.The allowable range of critical-size skin defect of SD rats lies between 45 and 50 mm in diameter.The concept of structural repair and the category of functional repair of injured skin are put forward.The regression equation between the structural skin healing time and defect diameters is established.Conclusion:The allowable range of skin critical-size defect of SD rats lies between 45 and 50 mm in diameter.The regression equation between the structural skin healing time and defect diameters can be used to predict the healing time for a certain skin defect size in rats.
文摘Objective:To investigate the effect of a subcutaneous pedicle Limberg flap for the reconstruction of medium-sized skin defects in the face following skin tumor or scar excision. Methods: From August 2002 to June 2004,the subcutaneous pedicle Limberg flap was designed to repair facial skin defects in 17 patients(19 flaps),and the size of the lesions ranged from 2.0 cm×1.9 cm to 5.0 cm×4.5 cm.The operation was performed under general anesthesia in 2 children,and under local anesthesia in the remaining 15 patients. Results: All flaps survived with primary healing postoperatively.With a follow-up from 1 to 22 months,neither short-term nor long-term postoperative complications such as flap necrosis,hematoma,infection,visible dog-ear and trap door deformity were found,and functionally and cosmetically satisfactory outcomes were achieved. Conclusion: This subcutaneous pedicle Limberg flap provides a competitive repair alternative for the treatment of medium-sized skin defects in the face.
文摘Objective: to analyze the clinical application effect of negative pressure sealing drainage (VSD) in skin defect complicated with infection wound. Methods: from June 2019 to June 2020, 39 cases of skin defect complicated with wound infection in our hospital were listed as the reference group, and 39 cases of the same type treated from June 2020 to June 2021 were listed as the analysis group. With reference to the traditional treatment method in group A, VSD was used in the analysis group after debridement, and the clinical treatment related indexes and the effective rate of wound treatment were compared between the two groups. Results: the use time of antibiotics in the treatment of patients in the comparative analysis group was significantly shorter than that in the reference group, and the wound area of patients in the treatment analysis group was significantly larger than that in the reference group, all of which were statistically verified (P<0.05). After treatment, the total effective rate of two groups of patients was counted. The total effective rate of the analysis group was significantly higher, being 100.00%(39/39), and that of the reference group was 79.49%(31/39). It was verified that P<0.05. Conclusion: compared with the traditional treatment methods, VSD has more advantages in treating skin defects complicated with infected wounds, which can reduce the use of antibiotics by patients and help to reduce the wound area. Its total effective rate is obviously higher, and it is easy to operate, so it can be popularized.
文摘Objective To introduce an effective reconstruction method for the finger injured with vessel and skin defect. Methods Free skin flap with skin vein was transplanted on the site of tissue defect, connecting by anastomosis the vein with artery or vein of the finger. Results Seven cases were treated with this method,among which 5 cases have sikin defect on the palm aspect of fingers, the rest have skin defect on the dorsal aspect skin of finger. All fingers survived with good shape and function. Conclusion This is a simple and effective method of finger reconstruction for the patients with defect of vessels and skin. 6 refs.
文摘To report a method of repair facial skin defects with a skin flap of SMAS pedicle.Methods According to the size of defect of skin,design a skin flap with SMAS pedicle for repair of defect.Results The method has been successfully applied for skin defects of eyelid and lip in 14 cases with satisfied results.The area of the largest flap was 5 cm×3 cm.Conclusion Repairing facial defects such as eyelid skin defect or lip skin defect with skin flap of SMAS pedicle is a very good method.The flap has a good blood supporting and satisfactory color and flexibility.5 refs,6 figs.
文摘In young patients, even small circular facial defects after the excision of benign skin tumors present a reconstructive challenge. The usefulness of a V-Y advancement flap for reconstructing such defects is well documented. We refined this technique as a mini V-Y advancement flap consisting of two subcutaneous pedicles that vascularize the skin island via subdermal plexus lateral bridges. This technique was used for 21 middle-aged or younger patients with a small benign skin lesion. None of them experienced any postoperative complications. Aesthetically excellent results were found in all patients. This small advancement flap could be attempted as an alternative to fusiform excision of small skin lesions, particularly in younger patients.
文摘The issue of skin defects is a major concern of almost every trauma surgeon after surgery. Despite numerous conventional methods and introduction of the reconstruction ladder, managing skin defects is still a challenge for the trauma surgeons. In recent years, parallel to the advances in the more conventional methods of skin repair, regenerative medicine has offered new and novel treatments. This article aims to explore these contemporary regenerative solutions as well as to review the conventional methods of treating skin defects.
文摘Background:Split-thickness skin grafting is the current gold standard for the treatment of traumatic skin loss.However,for patients with extensive burns,split-thickness skin grafting is limited by donor skin availability.Grafting split-thickness skin minced into micrografts increases the expansion ratio but may reduce wound repair quality.Dermal substitutes such as Pelnac can enhance the healing of full-thickness skin wounds,but their application currently requires two surgeries.The present study investigated whether it is possible to repair full-thickness skin defects and improve wound healing quality in a single surgery using Pelnac as an overlay of minced split-thickness skin grafts in a rat model.Methods:A full-thickness skin defect model was established using male Sprague-Dawley rats of 10 weeks old.The animals were randomly divided into control and experimental groups in which Vaseline gauze and Pelnac,respectively,were overlaid on minced split-thickness skin grafts to repair the defects.Wound healing rate and quality were compared between the two groups.For better illustration of the quality of wound healing,some results were compared with those obtained for normal skin of rats.Results:We found that using Pelnac as an overlay for minced split-thickness skin grafts accelerated wound closure and stimulated cell proliferation and tissue angiogenesis.In addition,this approach enhanced collagen synthesis and increased the formation of basement membrane and dermis as well as the expression of growth factors related to wound healing while reducing scar formation.Conclusions:Using minced split-thickness skin grafts overlaid with Pelnac enables the reconstruction of fullthickness skin defects in a single step and can increase the healing rate while improving the quality of wound healing.
基金Science Foundation of China(NO.92249303,NO.82230071,No.82172098,No.82371603)Jiangsu Province Natural Science and Technological Project(No.BK20231218)+4 种基金Experimental Animal Research Field Project Shanghai Science and Technology Commission(No.23141900600)Research Physician Innovation and Transformation Ability Training Project from Shanghai Health Commission(No.SHDC2023CRT013)Basic Medical Innovation Project of Changhai Hospital(No.20237Y38)Deep Blue Talent Project of Naval Medical University(Jin Cui)Shanghai Oriental Talent Program(Xiao Chen,Yuanyuan Liu).
文摘The healing of large skin defects remains a significant challenge in clinical settings.The lack of epidermal sources,such as autologous skin grafting,limits full-thickness skin defect repair and leads to excessive scar formation.Skin organoids have the potential to generate a complete skin layer,supporting in-situ skin regeneration in the defect area.In this study,skin organoid spheres,created with human keratinocytes,fibroblasts,and endothelial cells,showed a specific structure with a stromal core surrounded by surface keratinocytes.We selected an appropriate bioink and innovatively combined an extrusion-based bioprinting technique with dual-photo source cross-linking technology to ensure the overall mechanical properties of the 3D bioprinted skin organoid.Moreover,the 3D bioprinted skin organoid was customized to match the size and shape of the wound site,facilitating convenient implantation.When applied to full-thickness skin defects in immunodeficient mice,the 3D bioprinted human-derived skin organoid significantly accelerated wound healing through in-situ regeneration,epithelialization,vascularization,and inhibition of excessive inflammation.The combination of skin organoid and 3D bioprinting technology can overcome the limitations of current skin substitutes,offering a novel treatment strategy to address large-area skin defects.
基金the financial support provided by the National Natural Science Foundation of China(No.12103019)National Science and Technology Award Backup Project Cultivation Plan(No.20192AEI91007),China。
文摘Background and objectives Skin defects are one of the primary problems that occur in post-harvest grading and processing of loquats.Skin defects lead to the loquat being easily destroyed during transportation and storage,which causes the risk of other loquats being infected,affecting the selling price.Materials and Methods In this paper,a method combining band radio image with an improved three-phase level set segmentation algorithm(ITPLSSM)is proposed to achieve high accuracy,rapid,and non-destructive detection of skin defects of loquats.Principal component analysis(PCA)was used to find the characteristic wavelength and PC images to distinguish four types of skin defects.The best band ratio image based on characteristic wavelength was determined.Results The band ratio image(Q782/944)based on PC2 image is the best segmented image.Based on pseudo-color image enhancement,morphological processing,and local clustering criteria,the band ratio image(Q782/944)has better contrast between defective and normal areas in loquat.Finally,the ITPLSSM was used to segment the processing band ratio image(Q782/944),with an accuracy of 95.28%.Conclusions The proposed ITPLSSM method is effective in distinguishing four types of skin defects.Meanwhile,it also effectively segments images with intensity inhomogeneities.
基金Supported by National Natural Science Foundation of China,No.81702135Zhejiang Traditional Chinese Medicine Research Program,No.2016ZA124 and No.2017ZB057+1 种基金Zhejiang Medicine and Hygiene Research Program,No.2016KYB101 and No.2015KYA100Zhejiang Medical Association Clinical Scientific Research Program,No.2013ZYC-A19 and No.2015ZYC-A12
文摘BACKGROUND Although skin avulsions to male external genitalia are rare, they can be both physically and psychologically traumatic. Thus, the necessity for judicious management poses significant challenges to surgeons in order to avoid potential permanent disabilities. We report a case of massive penoscrotal skin avulsion and a composite graft was creatively applied to cover the defect which achieved good results. We believe that this case is of great reference value for fellow surgeons.CASE SUMMARY A 52-year-old male presented with massive traumatic avulsion of the penile and scrotal skin following mishandling of an electric drill. The avulsed skin was missing. The patient was diagnosed with massive skin avulsion of external genitalia. Following initial complete debridement of devitalized or infected tissues, Pelnac dermal substitute was secured to the defect with the assistance of negative-pressure wound closure. In the final step, the silicone layer of Pelnac was removed and a split-thickness skin graft was applied. The defect had healed at the two-month follow-up. The patient now has normal erections and satisfactory sexual function.CONCLUSION Our experience with this wound repair demonstrated that the combination of a dermal regeneration template and a split-thickness skin graft with vacuumassisted closure is a safe, well-tolerated and efficient solution for the reconstruction of massive penoscrotal skin defects.
文摘The use of skin flaps in reconstructive surgery is the first-line surgical treatment for the reconstruction of skin defects and is essentially considered the starting point of plastic surgery. Despite their excellent usability, their application includes general surgical risks or possible complications, the primary and most common is necrosis of the flap. To improve flap survival, researchers have used different methods, including the use of adiposederived stem cells, with significant positive results. In our research we will report the use of adipose-derived stem cells in pedicle skin flap survival based on current literature on various experimental models in animals.
