Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns最新文献

{"title":"[Research advances in the treatment of keloid with glucocorticoids].","authors":"Y H Su, W Z Xia, X Huang, R Q Xu, Y M Yimin, T Zan","doi":"10.3760/cma.j.cn501225-20230602-00198","DOIUrl":"10.3760/cma.j.cn501225-20230602-00198","url":null,"abstract":"<p><p>As a first-line classical drug, glucocorticoids are used in most combination treatment regimens of keloid. However, there are issues such as poor treatment efficacy and recurrence of keloid after keloid was treated with glucocorticoids, which seriously affect the therapeutic effect. In recent years, many studies have explored the factors influencing the efficacy of glucocorticoids in treating keloid and the action mechanism of glucocorticoids from different perspectives. Based on this, this paper reviews the mechanism and the factors influencing the efficacy of glucocorticoids in treating keloid, and explores ways to improve the treatment efficacy of glucocorticoids, aiming to provide thoughts for improving glucocorticoid-related diagnostic and therapeutic strategies.</p>","PeriodicalId":24004,"journal":{"name":"Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41100756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical effects of expanded frontal flap and flip scar flap in repairing partial nasal defect].","authors":"F F Chu, Y K Tang, J K Ding, Y Zhang, W Liu, X J Ma","doi":"10.3760/cma.j.cn501225-20230517-00173","DOIUrl":"10.3760/cma.j.cn501225-20230517-00173","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the clinical effects of expanded frontal flap and flip scar flap in repairing partial nasal defect. <b>Methods:</b> A retrospective observational study was conducted. From January 2012 to January 2022, 26 patients with partial nasal defects who met the inclusion criteria were admitted to the First Affiliated Hospital of Air Force Medical University, including 19 males and 7 females, aged 5 to 61 years. The surgery was performed in 4 stages. In the first stage, a rectangular skin and soft tissue expander (hereinafter referred to as expander) with suitable rated capacity was planted in frontal region and expanded by injecting water regularly. In the second stage, flip scar flap was grafted to reconstruct nasal inner lining, whose area was about 10% larger than the area of defect. The expanded frontal flap with pedicle was transferred to repair the nasal defect, whose pedicle was supraorbital vessel or supratrochlear vessel on the contralateral side of the defect, and the area of expanded flap was 20% larger than the nasal defect area after resection and flipping of scar flap. The donor site of expanded flap was sutured directly. After 3 weeks of flap transferring, the flap was delayed in the third stage. After 1 week of delaying operation, the pedicle of flap was cut off in the fourth stage. The number, rated capacity, injection volume, and expansion time of embedded expanders were recorded. The occurrences of complications including infection, hematoma, ulceration of expanded flap after the first stage operation, and blood supply disorder or necrosis of flap after operation in the second and fourth stages were observed. All the patients were followed up for 1 year at least, and the color of flap, scar of frontal donor site, symmetry of bilateral eyebrows, and the nasal appearance and ventilated function of external nasal tract were observed. <b>Results:</b> A total of 26 expanders were embedded in 26 patients. The rated capacity of expanders ranged from 100 to 300 mL. The injection volume was 1.0 to 1.5 times of the rated capacity of expanders. The expansion time ranged from 2.5 to 4.0 months, with an average time of 3 months. There were no complications occurred after each operation. The follow-up showed that the color of flap was similar to the normal nasal skin, the scar of frontal region was not obvious, the bilateral eyebrows were basically symmetrical, the nose had excellent appearance, ventilation function of external nasal tract was not affected, while some of the patients had downward rotation or unapparent tip-defining point of nose. <b>Conclusions:</b> Using the flip scar flap to reconstruct the nasal inner lining and pre-expanded frontal flap to reconstruct the nasal skin, without free cartilage transplantation to repair the partial nasal defects can achieve satisfied nasal appearance post operation, without abnormal external nasal ventilation function.</p>","PeriodicalId":24004,"journal":{"name":"Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41101285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Influence of family with sequence similarity 134, member B-mediated reticulophagy on lipopolysaccharide-induced apoptosis of mouse dendritic cells].","authors":"Y Duan, R Q Yao, L Y Zheng, N Dong, Y Wu, Y M Yao, X G Dai","doi":"10.3760/cma.j.cn501225-20230227-00063","DOIUrl":"10.3760/cma.j.cn501225-20230227-00063","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the influence of family with sequence similarity 134, member B (FAM134B)-mediated reticulophagy on lipopolysaccharide (LPS)-induced apoptosis of mouse dendritic cells (DCs), so as to provide a basis for improving the immune suppression of sepsis caused by wound infection and other factors. <b>Methods:</b> The experimental research methods were used. The DC line DC2.4 of the 3^rd to 10^th passage in the logarithmic growth stage was collected for experiments. DCs were divided into LPS stimulation 0 h (no stimulation) group, LPS stimulation 6 h group, LPS stimulation 12 h group, LPS stimulation 24 h group, and LPS stimulation 72 h group, which were cultured with 1 μg/mL LPS (the same concentration below) for the corresponding time. The protein expressions of FAM134B, microtubule-associated protein 1 light chain 3B (LC3B), and transporter protein SEC61B were determined by Western blotting, and the ratio of LC3B-Ⅱ/LC3B-Ⅰ was calculated (<i>n</i>=3). DCs were divided into phosphate buffer solution (PBS) group and LPS group for corresponding treatment. After 24 hours of culture, the expression of FAM134B and its co-localization with lysosomal probes and LC3B were detected using immunofluorescence method, while the number of autolysosomes in cells were observed through transmission electron microscope. DCs were divided into the FAM134B-knockdown group that were transfected with lentivirus containing small interfering RNA (siRNA) sequence of <i>FAM134B</i> gene and the empty vector group with empty lentivirus transfected. At post transfection hour 72, the fluorescence expression of cells was observed under the inverted fluorescence phase contrast microscope, meanwhile, the normally cultured DCs were set as blank control group, and the same observation was performed at the corresponding time point. DCs were divided into PBS alone group and LPS alone group, DCs successfully transfected with lentivirus containing siRNA sequence of <i>FAM134B</i> gene were divided into FAM134B-knockdown+PBS group and FAM134B-knockdown+LPS group, and DCs successfully transfected with empty lentivirus were divided into empty vector+PBS group and empty vector+LPS group. These cells were stimulated correspondingly and cultured for 24 hours. The protein expression of FAM134B was detected using Western blotting (<i>n</i>=3); the apoptotic rate of cells was determined by flow cytometry (<i>n</i>=3); the situation of apoptosis was observed by Hoechst staining, and the apoptotic rate was calculated (<i>n</i>=5); the protein expressions of cleaved cysteine aspartic acid specific protease-3 (caspase-3), B cell lymphoma 2 (Bcl-2), and Bcl-2-associated X protein (Bax) were detected using Western blotting, and the ratio of Bax/Bcl-2 was calculated (<i>n</i>=5). Data were statistically analyzed with one-way analysis of variance (ANOVA), least significant difference test, and ANOVA for factorial design. <b>Results:</b> Compared with ","PeriodicalId":24004,"journal":{"name":"Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41111946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Best evidence summary of prevention strategies for pressure injury in adult hospitalized burn patients].","authors":"L Q Han, M Y Shen, X Y Tang, P X Wan, L D Lao, T He","doi":"10.3760/cma.j.cn501225-20230328-00101","DOIUrl":"10.3760/cma.j.cn501225-20230328-00101","url":null,"abstract":"<p><p><b>Objective:</b> To summarize the best evidence of prevention strategies for pressure injury in adult hospitalized burn patients. <b>Methods:</b> A bibliometric approach was used. Systematic searches were carried out to retrieve the published evidence of prevention strategies for pressure injury in adult hospitalized burn patients in the official websites of relevant academic organizations such as International Society for Burn injury, American Burn Association, and Japanese Dermatology Association, National Pressure Injury Advisory Panel, European Pressure Injury Advisory Panel, Pan Pacific Pressure Injury Alliance International Guidelines Website, foreign language databases such as UpToDate, BMJ Best Practice, MedSci, Joanna Briggs Institute Evidence-Based Practice Database, Cochrane Library, Web of Science, Embase, and PubMed, and Chinese databases such as China Biology Medicine disc, China National Knowledge Infrastructure, Wanfang Database, and China Clinical Guidelines Library. The literature types include clinical decision-making, evidence summary, guidelines, systematic review, and expert consensus. The search time was till February 21^st, 2023. Two researchers independently screened the literature and evaluated the quality, and other researchers extracted and graded the evidence according to the topic. <b>Results:</b> A total of 10 papers were included, including 6 evidence summaries, 3 guidelines, and 1 expert consensus, all with high literature quality. After extracting evidence and classifying, 27 pieces of best evidences were summarized from three aspects, including prevention training and supervision, risk assessment, and prevention measures of pressure injury. <b>Conclusions:</b> A total of 27 pieces of best evidences of prevention strategies for pressure injury in adult hospitalized burn patients were summarized from 3 aspects. Medical workers can follow the best evidence and give personalized prevention strategies according to the specific condition of adult hospitalized burn patients to reduce the incidence of pressure injury.</p>","PeriodicalId":24004,"journal":{"name":"Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41100755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Curative effects of medial plantar free flap in reconstructing electric burn wound and scar contracture in the palm].","authors":"F Han, X K Yang, T He, L X Wang, N Zhang, J T Han","doi":"10.3760/cma.j.cn501225-20230601-00197","DOIUrl":"10.3760/cma.j.cn501225-20230601-00197","url":null,"abstract":"<p><p><b>Objective:</b> To explore the curative effects of medial plantar free flap in reconstructing electric burn wound and scar contracture in the palm. <b>Methods:</b> A retrospective observational study was conducted. From January 2020 to January 2023, 6 patients with electric burn wounds or scar contracture in the palm who met the inclusion criteria were admitted to the First Affiliated Hospital of Air Force Medical University, including 5 males and 1 female, aged 35 to 55 years. The wound area was 5.0 cm×3.0 cm-8.0 cm×7.0 cm after the debridement of electric burn wounds or resection of scar in the palm. The medial plantar free flap anastomosed with cutaneous nerve was used for wound reconstruction, with flap area of 5.5 cm×3.5 cm-8.5 cm×7.5 cm. The wound in the donor site was repaired with transplantation of abdominal full-thickness skin graft. After surgery, the survival of flaps and skin grafts were observed, the shape and texture of flap and the recovery of donor site of flap were observed, and the holding function of the affected hand was assessed. At the last follow-up, the two-point discrimination distance of flap was measured, the sensory recovery of flap was evaluated with the trial standard for the evaluation of the functions of the upper limbs of the Hand Surgery Society of the Chinese Medical Association, and the function recovery of flap was evaluated by post-surgery flap function evaluation scale. <b>Results:</b> After surgery, 5 flaps survived well, while the distal part of 1 flap was partially necrotic, which was repaired by medium-thickness skin graft from lateral thigh after debridement. All the skin grafts at the donor sites survived well. During follow-up of 3 to 24 months, the flap was not bloated, the texture and color were good, the match with the surrounding tissue was high, with no obvious scar contracture occurred at the donor site. The affected hand had good holding function. At the last follow-up, the two-point discrimination distance of flap was 6-8 mm, the flap sensation recovery was as follows: 5 flaps recovered to grade S3⁺, 1 flap recovered to grade S3, and the functional evaluation of flaps was excellent in 5 cases and good in 1 case. The patients basically returned to normal life and work. <b>Conclusions:</b> The medial plantar free flap with cutaneous nerve anastomosis has many advantages, such as high matching degree of appearance, good sensory recovery, and holding function of the affected hand. It is an ideal choice for the reconstruction of the electric burn wound and scar contracture in the palm.</p>","PeriodicalId":24004,"journal":{"name":"Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41111745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Mechanism and prevention and treatment strategy of progressive injury in high-voltage electric burns].","authors":"Q F Zhang, J W Hao","doi":"10.3760/cma.j.cn501225-20230331-00107","DOIUrl":"10.3760/cma.j.cn501225-20230331-00107","url":null,"abstract":"<p><p>High-voltage electric burn is one of burns that can cause severe damages to tissue and organs. Clinically, progressive injury in high-voltage electric burns is a key pathological change that affects the level of amputation and the success rate of treatment. At present, the exact definition and mechanism of progressive injury in high-voltage electric burns have not been elucidated, and the clinical treatment is mainly symptomatic treatment. Relevant research data on the mechanism and treatment of progressive injury in high-voltage electric burns are lacking. This paper analyzes and summarizes the mechanism, diagnosis, treatment, and common outcome of progressive injury in high-voltage electric burns, and provides a reference for the mechanism research, clinical diagnosis and treatment of progressive injury in high-voltage electric burns.</p>","PeriodicalId":24004,"journal":{"name":"Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41178161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effects of tibial second toe free flap bridged with blood flow and nerve in the treatment of severe flexion contracture of the proximal interphalangeal joint].","authors":"K Wang, G Z Jin, Z C Teng, C W Ge, Z J Liu, J H Ju, S Dong, Q Wang, Y D Li","doi":"10.3760/cma.j.cn501225-20220707-00286","DOIUrl":"10.3760/cma.j.cn501225-20220707-00286","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the effects of tibial second toe free flap bridged with blood flow and nerve in the treatment of severe flexion contracture of the proximal interphalangeal joint. <b>Methods:</b> A retrospective observational study was conducted. From March 2013 to October 2019, 9 patients with severe flexion contracture (type Ⅲ) of the proximal interphalangeal joint after trauma operation, conforming to the inclusion criteria, were hospitalized in Suzhou Ruihua Orthopaedic Hospital, including 5 males and 4 females, aged from 17 to 62 years. After the contracture tissue affecting the extension of the proximal interphalangeal joint was cut off, and the scar tissue was resected, the size of the volar wound near the proximal interphalangeal joint in extended position was 2.0 cm×1.0 cm-2.5 cm×1.5 cm, with the length of proper digital artery and nerve defect being 1.0-1.5 cm. A free flap of the same size as the wound was cut from the tibial side of the second toe and transplanted to repair the wound, and the defective proper digital artery and nerve was repaired by bridging with the tibial proper plantar digital artery and nerve of about 1.5 cm in length. The full-thickness skin graft was taken from the proximal tibial side of the lower leg to repair the wound at flap donor site. The wound at skin graft donor site was sutured directly. The survival of flap and skin graft was observed after operation. The patients were followed up, and at the last follow-up, the recovery of the affected finger and the second toe, including the donor and recipient areas were observed, the two-point discrimination distances of the flap repaired site and the pulp of the affected finger were observed and measured at the same time, the blood flow patency of bridged vessel of the affected finger was examined by Allen test, and the function of the proximal interphalangeal joint of the affected finger was evaluated according to Chinese Medical Association's standard for the range of motion of proximal interphalangeal joint. <b>Results:</b> The flaps and skin grafts survived smoothly after operation. The follow-up after operation lasted for 5 to 22 months, with a mean of 10 months. At the last follow-up, the flap repaired site had good shape, good color and texture, with the two-point discrimination distance being 9-12 mm, and the two-point discrimination distance of the pulp of the affected finger was 6-10 mm; the Allen test results of the affected fingers were all negative (i.e., the bridged vessels had good blood flow patency), with no recurrence of flexion contracture, and the function of the proximal interphalangeal joint was evaluated as excellent; the skin graft area of the second toe was not ruptured but was a little pigmented, and the flexion and extension activities of toe were good. <b>Conclusions:</b> The tibial second toe free flap bridged with blood flow and nerve has reliable therapeutic effect in the treatment of severe flexion contracture ","PeriodicalId":24004,"journal":{"name":"Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41100754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A case with giant ulcer caused by skin diffuse large B-cell lymphoma in the axilla].","authors":"F Liu, W Zhang, W G Xie, L Chen, Z Li","doi":"10.3760/cma.j.cn501225-20220331-00116","DOIUrl":"10.3760/cma.j.cn501225-20220331-00116","url":null,"abstract":"<p><p>In May 16^th, 2019, a male patient (aged 51 years) with a rare giant ulcer caused by skin diffuse large B-cell lymphoma in the axilla was admitted to Tongren Hospital of Wuhan University & Wuhan Third Hospital, and the ulcer wound was confirmed by biopsy and immunohistochemical analysis after extensive excision. Ultimately, a good prognosis was obtained by transplantation of flap and skin graft in combination with radiotherapy and chemotherapy.</p>","PeriodicalId":24004,"journal":{"name":"Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41110362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research advances on post-burn cognitive disorders and its mechanism].","authors":"Y Luo, G P Liang","doi":"10.3760/cma.j.cn501225-20221117-00492","DOIUrl":"10.3760/cma.j.cn501225-20221117-00492","url":null,"abstract":"<p><p>Cognitive disorders after burns is an important problem that cannot be ignored in the diagnosis and treatment of burn patients. Its mechanism may be related to the activation of inflammatory response, destruction of the blood-brain barrier, hypothalamic-pituitary-adrenal axis imbalance, nerve cell changes, etc. Mechanism-specific prevention and treatment will be the best choice to reduce post-burn cognitive disorders in the future. This review introduces the research advances in epidemiology, risk factors, possible pathogenesis, diagnosis, treatment, and prevention of cognitive disorders in burn patients, in order to provide a reference for timely and accurate assessment, treatment, and prevention of cognitive disorders in burn patients.</p>","PeriodicalId":24004,"journal":{"name":"Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41129224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Treatment methods of upper limbs with destructive electric burns and its clinical efficacy].","authors":"W Zhang, L Chen, F Yang, W D Zhang, F Liu, W G Xie","doi":"10.3760/cma.j.cn501225-20230530-00188","DOIUrl":"10.3760/cma.j.cn501225-20230530-00188","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the treatment methods of upper limbs with destructive electric burns and its clinical efficacy. <b>Methods:</b> A retrospective observational study was conducted. From July 2014 to December 2020, 20 male patients with destructive electric burns in upper limbs who met the inclusion criteria were admitted to Tongren Hospital of Wuhan University & Wuhan Third Hospital, aged from 21 to 57 years, of whom 7 patients underwent emergency surgery, and a total of 20 affected limbs were treated with limb salvage. The necrotic bone was resected in 5 affected limbs, the residual hand and wrist at the distal end of left affected limb was replanted to the residual end of the right forearm in one patient in a cross heterotopic way, and short reduction and replantation after osteotomy were performed for two affected limbs with distal ulnar and radial necrosis. After thorough debridement, the area of wound proposed to be repaired by tissue flap was from 12 cm×7 cm to 58 cm×13 cm. According to the size and distribution of wound, the wounds of 2 affected limbs were repaired by transplantation of pedicled latissimus dorsi myocutaneous flap and free groin flap with vascular anastomosis. The wounds of the remaining 17 affected limbs were repaired with the transplantation of free latissimus dorsi myocutaneous flap, anterolateral thigh flaps, and paraumbilical perforator flap, with 10 affected limbs with larger wounds being jointly transplanted with the groin flap or the paraumbilical perforator flap on the other side. The total grafted tissue flap area was 20 cm×8 cm to 52 cm×20 cm. During tissue flap transplantation, according to the length of blood vessel defect in the affected limb, the distal artery of the affected limb was bridged with the distal part of flap vascular pedicle, undamaged vein on the affected side, superficial vein of abdominal wall, and great saphenous vein, etc., in 14 affected limbs, and the great saphenous vein was grafted in 3 of them with impeded distal return for recanalization of distal limb veins. The wound in the donor area was repaired by direct suture or grafting with split-thickness scalp. After the wound was basically healed, the functional rehabilitation training was started gradually, and the functional reconstruction and scar rectification surgery were started 3 months after tissue flap transplantation. The survival of tissue flaps/skin grafts, wound healing, limb salvage, and follow-up status after surgery were recorded. At the last follow-up, the function of the successfully salvaged limb was evaluated and scored by the disabilities of the arm, shoulder and hand (DASH) scoring scale. <b>Results:</b> After surgery, the grafted tissue flap in the affected limb and the skin grafts transplanted on the wound at flap donor site survived, and wounds at the recipient and donor sites healed well. Two affected limbs had distal necrosis within 10 days after tissue flap transplantation, and the middle and","PeriodicalId":24004,"journal":{"name":"Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41100699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}