Zhonghua shao shang yu chuang mian xiu fu za zhi最新文献

{"title":"[Clinical diagnosis and treatment strategies for malignant complex wounds].","authors":"C D Xia, D D Lei","doi":"10.3760/cma.j.cn501225-20250406-00166","DOIUrl":"https://doi.org/10.3760/cma.j.cn501225-20250406-00166","url":null,"abstract":"<p><p>This article focused on the research of clinical diagnosis and treatment system for malignant complex wounds, systematically sorted out the key issues in this field, and explored in detail the characteristics and targeted intervention measures of malignant complex wounds in different parts of body. It summarized the current strategies, multidisciplinary team collaboration models, and technological progress in the diagnosis and treatment of such wounds. The current treatment of malignant complex wounds is challenging, and existing diagnostic and therapeutic strategies and technologies have achieved certain outcome in controlling symptoms and promoting healing but still face many problems. In the future, it is necessary to further strengthen basic research, optimize diagnosis and treatment plans, promote multidisciplinary team collaboration, and develop more effective treatment methods to improve the diagnosis and treatment of malignant complex wounds, improve patients' quality of life, and prolong their survival. This article will provide a comprehensive reference for clinicians and promote the improvement of the treatment level of malignant complex wounds.</p>","PeriodicalId":516861,"journal":{"name":"Zhonghua shao shang yu chuang mian xiu fu za zhi","volume":"41 5","pages":"426-431"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152576","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":"[Repair strategies and clinical outcomes for complex cervico-occipital wounds].","authors":"X G Luan, W Zhang, W D Zhang, L Chen, T F Ru, Y Sun, D Y Wang","doi":"10.3760/cma.j.cn501225-20241201-00471","DOIUrl":"https://doi.org/10.3760/cma.j.cn501225-20241201-00471","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the repair strategies and clinical outcomes for complex cervico-occipital wounds. &lt;b&gt;Methods:&lt;/b&gt; This study was a retrospective observational study. From March 2014 to December 2023, 31 patients with complex cervico-occipital wounds who met the inclusion criteria were admitted to the Department of Burns of Tongren Hospital of Wuhan University & Wuhan Third Hospital. There were 20 males and 11 females, aged 25-80 years, including 17 cases of radiation-induced ulcers, 8 cases of electrical burns, and 6 cases of necrotizing soft tissue infection. The wound sizes ranged from 8.0 cm×5.0 cm to 51.0 cm×21.0 cm on admission. All patients underwent multidisciplinary team collaborative diagnosis and treatment, systemic support therapy, followed by debridement and negative-pressure wound therapy on stage Ⅰ. After complete removal of necrotic tissue, the wound repair was performed on stage Ⅱ according to the wound feature. The free tissue flaps transplantation was performed in 22 cases, the pedicled tissue flaps transplantation was performed in 5 cases, and transplantation of local tissue flaps combined with split-thickness skin grafts from head was performed in 4 cases. The sizes of free tissue flaps ranged from 15.0 cm×8.0 cm to 45.0 cm×10.0 cm, the sizes of pedicled tissue flaps ranged from 11.0 cm×6.5 cm to 17.0 cm×8.0 cm, and te sizes of local tissue flaps ranged from 5.0 cm×3.5 cm to 7.0 cm×5.0 cm. All wounds in the donor sites of tissue flaps were closed directly. After the operation, functional rehabilitation training of cervico-occipital region and comprehensive scar treatment of the donor and recipient sites of tissue flaps were performed. The postoperative survival and appearance of tissue flaps, wound healing and recurrence of infection or ulcer in the donor and recipient sites of tissue flaps, and wound healing in the donor and recipient sites of skin grafts were observed. At the last follow-up, the scars in the donor and recipient sites of tissue flaps were evaluated by Vancouver scar scale (VSS), the pain, range of motion, muscle strength, and daily living ability of cervico-occipital region were evaluated by a self-made neck rehabilitation function assessment scale, and the satisfaction of patients with the therapeutic effect was surveyed by a literature-based method. &lt;b&gt;Results:&lt;/b&gt; After surgery, all tissue flaps survived completely and had a good appearance, the wounds in the tissue flap donor and recipient sites healed well with no infection or ulcer recurrence, and the wounds in the donor sites of skin grafts healed well. The follow-up period was 6-48 months after stage Ⅱ surgery. At the last follow-up, among the 27 patients, the VSS scores of scar in the donor sites of tissue flaps were 2 in 16 cases, 3 in 7 cases, 5 in 2 cases, and 7 in 2 cases, and the VSS scores of scar in the recipient sites of tissue flaps were 3 in 17 cases, 4 in 8 cases, and 5 in 2 cases; the VSS scores of scar were 5 in 2 ","PeriodicalId":516861,"journal":{"name":"Zhonghua shao shang yu chuang mian xiu fu za zhi","volume":"41 5","pages":"454-462"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153177","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":"[Expert consensus on systematic assessment and treatment of refractory wounds in the elderly (2025 edition)].","authors":"","doi":"10.3760/cma.j.cn501225-20241128-00466","DOIUrl":"https://doi.org/10.3760/cma.j.cn501225-20241128-00466","url":null,"abstract":"<p><p>Early prevention and standardized management of refractory wounds in the elderly are very important for improving prognosis, reducing disability rate, and improving the quality of life of patients. For the diagnosis and treatment of refractory wounds in the elderly, it is necessary to comprehensively consider the primary disease or comorbidity of patients and systematically evaluate the overall condition and the local characteristics of wounds of patients. The treatment principles include controlling or slowing down the development of the primary disease, nutritional support, infection control, improving circulation, sealing wounds, and paying attention to the water balance of wounds, at the same time selecting a reasonable treatment plan according to different types of wounds. The goal of treatment is to close the wound as much as possible if conditions permit, while in some cases, palliative management may be appropriate. In the future, the development of smart wear, big data, and artificial intelligence will play a significant role in promoting the assessment and treatment of refractory wounds in the elderly. The Burns and Trauma Branch of Chinese Geriatrics Society organized domestic experts engaged in wound repair and related fields to jointly formulate this consensus, aiming to establish a full-process standard covering prevention, assessment, treatment, and rehabilitation and to promote the standardization and intelligence of diagnosis and treatment of refractory wounds in the elderly, thus providing efficient and homogeneous solutions for clinical practice.</p>","PeriodicalId":516861,"journal":{"name":"Zhonghua shao shang yu chuang mian xiu fu za zhi","volume":"41 5","pages":"401-416"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153163","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 strategy for severe radiation-induced ulcers near major blood vessels].","authors":"T Y Cao, W L Du, D N Yu, Y Zhang, H H Jiang, Y G Hu, Y M Shen","doi":"10.3760/cma.j.cn501225-20240521-00191","DOIUrl":"https://doi.org/10.3760/cma.j.cn501225-20240521-00191","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the treatment strategy for severe radiation-induced ulcers near major blood vessels. &lt;b&gt;Methods:&lt;/b&gt; This study was a retrospective observational study. From January 2016 to December 2023, 23 patients with radiation-induced ulcers near major blood vessels who met the inclusion criteria were admitted to Beijing Jishuitan Hospital of Capital Medical University, including 18 females and 5 males, aged 39 to 77 years. Ulcers were distributed in the axilla in 11 cases, in the groin in 4 cases, in the neck in 5 cases, and in the subclavicular region in 3 cases. According to the distance between the ulcer base and the major blood vessels, the ulcers were classified. The ulcers with major blood vessels exposed at the ulcer base was classified as exposed-vessel type (2 cases), the distance between the ulcer base and the major blood vessel wall ≤1 cm was classified as near-vessel type (8 cases), and the distance between the ulcer base and the major blood vessel wall &gt;1 cm was classified as distant-vessel type (13 cases). After comprehensive preoperative evaluation and multidisciplinary team collaboration, the covered stents were implanted before surgery in patients with exposed-vessel type of ulcers and partial patients with near-vessel type of ulcers and high risk of vascular rupture, while preoperative vascular localization and careful operation were conducted during surgery to prevent vascular injury in other patients. After radical debridement, the wounds were repaired with flaps or myocutaneous flaps, the wound area after debridement was 6 cm×5 cm to 22 cm×12 cm, and the area of the flaps or myocutaneous flaps was 14 cm×9 cm to 27 cm×10 cm. The classification of ulcers in different regions, specific wound repair methods, and bacterial culture results of wound tissue specimens collected during the surgery were recorded. The survivals of flaps or myocutaneous flaps after surgery, the recurrence of infection or sinus, and wound healing were observed during follow-up after surgery. &lt;b&gt;Results:&lt;/b&gt; Among the 11 patients with axillary ulcers, 3 had near-vessel type of ulcers, 8 had distant-vessel type of ulcers; among the 3 patients with subclavicular ulcers, one had near-vessel type of ulcer and two had distant-vessel type of ulcers, which were repaired with rectus abdominis myocutaneous flaps or latissimus dorsi myocutaneous flaps. Among the 5 patients with neck ulcers, two had exposed-vessel type of ulcers, and 3 had near-vessel type of ulcers, which were repaired with pectoralis major myocutaneous flaps or transverse carotid artery perforator flaps. Among the 4 patients with groin ulcers, one had near-vessel type of ulcer, and 3 had distant-vessel type of ulcers, which were repaired with tensor fascia lata myocutaneous flaps, anterolateral thigh flaps, or contralateral rectus abdominis myocutaneous flaps. The bacteria detected in the wound tissue specimens collected during surgery were mainly &lt;i&gt;Staphylococcus aureu","PeriodicalId":516861,"journal":{"name":"Zhonghua shao shang yu chuang mian xiu fu za zhi","volume":"41 5","pages":"432-439"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153185","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":"[Efficacy of free perforator flap combined with great toe transplantation in repairing thumb damage combined with thermal crush injuries in the hand].","authors":"J J Chen, S Li, S P Zhou, H P Wang, X F Xing, P C Shi, L W Zheng, C N Chang, D Zhang, S M Li","doi":"10.3760/cma.j.cn501225-20250130-00046","DOIUrl":"https://doi.org/10.3760/cma.j.cn501225-20250130-00046","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To explore the efficacy of free perforator flap combined with great toe transplantation in repairing thumb damage combined with thermal crush injuries in the hand. &lt;b&gt;Methods:&lt;/b&gt; This study was a retrospective observational study. From May 2014 to March 2024, seven cases (5 males and 2 females, aged from 25 to 46 years) with thumb injuries combined with thermal crush injuries in hands were admitted to the 988&lt;sup&gt;th&lt;/sup&gt; Hospital of Joint Logistics Support Force of the PLA. After surgical debridement, the thumb defects were classified as grade Ⅱ in 2 cases, grade Ⅲ in 3 cases, and grade Ⅳ in 2 cases. The great toe transplantations were adopted to reconstruct the damaged thumb, and subsequent measurements indicated that the wound area of the affected hand ranged from 9.0 cm×4.0 cm to 18.0 cm×10.0 cm. Hand wounds were repaired in 5 cases by free anterolateral thigh perforator flap transplantations and in 2 cases by free deep inferior epigastric artery perforator flap transplantations. The harvested perforator flap area ranged from 9.5 cm×4.5 cm to 19.0 cm×11.0 cm. The arteries of the perforator flap and transplanted great toe were anastomosed to the radial artery of the affected hand, while the veins were anastomosed to the radial vein, cephalic vein, or other matching veins in the recipient area. Meanwhile, the cutaneous nerves carried by the perforator flap were anastomosed with the superficial branch of the radial nerve or the palmar cutaneous branch of the median nerve in the recipient region. The wounds in the flap donor sites were closured by suture or repaired by skin grafting. After the surgery, the survival status of the reconstructed thumb and the perforator flap were observed, as well as the healing conditions at the donor and recipient sites. During the postoperative follow-up, the bone healing condition of the reconstructed thumb was examined, and the appearance and function of the reconstructed thumb were observed. The appearance of the perforator flap was observed, the two-point discrimination distances and sensory recovery were detected. The function of the foot after the removal of the great toe was also observed. At the last follow-up, the functions of the reconstructed thumbs of patients were evaluated with reference to the trial standard for the evaluation of thumb and finger reconstruction function formulated by the Hand Surgery Society of the Chinese Medical Association. &lt;b&gt;Results:&lt;/b&gt; Both the reconstructed thumb and the perforator flaps survived after the operation. The sutured sites of the perforator flaps in 2 cases had delayed healing due to fat liquefaction and skin edge inflammation. The wounds of the recipient areas of the remaining cases healed well. All the wounds of the donor areas healed well. During the follow-up period of 8 to 18 months, the bone of the reconstructed thumb healed well, with its appearance being similar to that of the healthy side. The opposition and apposition functions","PeriodicalId":516861,"journal":{"name":"Zhonghua shao shang yu chuang mian xiu fu za zhi","volume":"41 5","pages":"463-470"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152990","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":"[Role and mechanism of Prussian blue nanoparticles in the apoptosis of mouse adipose-derived mesenchymal stem cells treated with hydrogen peroxide].","authors":"S Y Xu, Z Gong, Y J Han, J X Wang, L Yu, G Xu","doi":"10.3760/cma.j.cn501225-20240525-00197","DOIUrl":"https://doi.org/10.3760/cma.j.cn501225-20240525-00197","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To explore the role and mechanism of Prussian blue nanoparticle (PBNP) in the apoptosis of mouse adipose-derived stem cells (ADSCs) treated with hydrogen peroxide, providing a reference for chronic wound treatment. &lt;b&gt;Methods:&lt;/b&gt; This research was an experimental research. PBNP with a cubic micromorphology was synthesized via the hydrothermal method. ADSCs were isolated from 6 male 6-8 weeks old Institute of Cancer Research mice using enzymatic digestion. ADSCs were divided into control group with normal culture, hydrogen peroxide group treated with hydrogen peroxide at final molarity of 200 μmol/L, and low PBNP group and high PBNP group pretreated with PBNP at final mass concentration of 10 and 20 μg/mL respectively and then treated as that in hydrogen peroxide group. After 24 h of culture, the reactive oxygen species (ROS) level was detected by fluorescence probe method, the superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), catalase (CAT), malondialdehyde (MDA) levels, and lactate dehydrogenase (LDH) release rate were measured by colorimetric method, the cell survival rate was assessed by cell counting kit-8, and the protein expression levels of B-cell lymphoma-2 (Bcl-2), Bcl-2-associated X protein (Bax), cytochrome C (Cyt-C), cleaved cysteinyl aspartate specific protease-3 (caspase-3), cleaved caspase-9, phosphatidylinositide 3-kinase (PI3K), phospho-PI3K (p-PI3K), protein kinase B (Akt), and phospho-Akt (p-Akt) were detected by Western blotting, with ratios of p-PI3K/PI3K and p-Akt/Akt being calculated. Another batch of ADSCs were divided into control group, hydrogen peroxide group, high PBNP group, which were treated as before, and N-acetyl-L-cysteine (NAC) group, high PBNP+LY294002 group, and high PBNP+MK-2206 group pretreated with NAC at final molarity of 5 mmol/L, PBNP at final mass concentration of 20 μg/mL and LY294002 at final molarity of 10 μmol/L, and PBNP at final mass concentration of 20 μg/mL and MK-2206 at final molarity of 100 μmol/L, respectively, and then treated as that in hydrogen peroxide group. After 24 h of culture, the p-PI3K/PI3K and p-Akt/Akt ratios were detected and calculated, and protein expression levels of Bcl-2, Bax, Cyt-C, cleaved caspase-3, and cleaved caspase-9 were measured as before. There were 3 samples in all experiments. &lt;b&gt;Results:&lt;/b&gt; After 24 h of culture, the ROS level in cells in hydrogen peroxide group was 29.0±1.1, which was significantly higher than 2.6±1.1 in control group, 16.5±0.9 in low PBNP group, and 5.3±0.9 in high PBNP group (with &lt;i&gt;P&lt;/i&gt; values all &lt;0.05). Compared with those in hydrogen peroxide group, the levels of SOD, CAT, and GSH-Px, the cell survival rate, the Bcl-2 protein expression level, and the ratios of p-PI3K/PI3K and p-Akt/Akt were markedly increased in cells in control group, low PBNP group, and high PBNP group (&lt;i&gt;P&lt;/i&gt;&lt;0.05), the MDA level and LDH release rate in cells in control group and high PBNP group and the LDH release rate in ce","PeriodicalId":516861,"journal":{"name":"Zhonghua shao shang yu chuang mian xiu fu za zhi","volume":"41 5","pages":"481-490"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153182","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":"[Analysis of the relationship between acute stress disorder or posttraumatic stress disorder and total burn area in adult burn patients based on brain function detection results].","authors":"J J Ruan, H Zhao, L Zeng, L L Fu, M M Xi","doi":"10.3760/cma.j.cn501225-20240926-00354","DOIUrl":"https://doi.org/10.3760/cma.j.cn501225-20240926-00354","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To analyze the relationship between acute stress disorder (ASD) or posttraumatic stress disorder (PTSD) and total burn area in adult burn patients based on brain function detection results. &lt;b&gt;Methods:&lt;/b&gt; This study was a cross-sectional survey. From May to September in 2024, 121 adult burn patients admitted to the Department of Burns of Tongren Hospital of Wuhan University & Wuhan Third Hospital (hereinafter referred to as this hospital) who met the inclusion criteria were selected as respondents. A self-made general information questionnaire was used to investigate the following information of all patients, including the gender, age, total burn area, abbreviated burn severity index, post-injury investigation time, inhalation injury, intensive care unit (ICU) admission during the shock stage. The burn specific health scale-brief scale was used to investigate the quality of life of all patients. The ASD scale-5 (ASDS-5) was used to investigate the severity of ASD in 62 patients within 3 days to 1 month after injury, and the diagnosis of ASD was made by the psychiatrists of this hospital. The PTSD checklist-5 (PCL-5) was used to investigate the severity of PTSD in 59 patients more than 1 month after injury, and the diagnosis of PTSD was made as before. The functional near-infrared spectroscopy was employed to measure the oxy-hemoglobin integral values (hereinafter referred to as integral values) of Broca's area on both sides, the dorsolateral prefrontal cortex on both sides, and the frontopolar cortex on both sides for all patients. Based on the diagnosis results from psychiatrists, patients within 3 days to 1 month after injury were divided into ASD-positive group and ASD-negative group and the prevalence of ASD was calculated, while patients more than 1 month after injury were divided into PTSD-positive group and PTSD-negative group and the prevalence of PTSD was calculated. The general information, quality of life scores, ASDS-5 scores, PCL-5 scores, and the integral values of the above 6 brain regions of interest were respectively counted for each group of patients. Pearson correlation analysis was employed to evaluate the correlations between the age, total burn area, integral values of the 6 brain regions of interest and the ASDS-5 scores of patients who underwent ASDS-5 assessment, and the correlations between the age, total burn area, integral values of the 6 brain regions of interest and the PCL-5 scores of patients who underwent PCL-5 assessment were evaluated. Based on the results of univariate analysis and clinical significance, the independent influencing factors for the occurrence of ASD or PTSD in adult burn patients were screened out. &lt;b&gt;Results:&lt;/b&gt; Based on the ASD diagnosis results, among the 62 patients, 16 patients were included in ASD-positive group and 46 patients were included in ASD-negative group. The prevalence of ASD was 25.8%. There were no statistically significant differences in the general i","PeriodicalId":516861,"journal":{"name":"Zhonghua shao shang yu chuang mian xiu fu za zhi","volume":"41 5","pages":"471-480"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152325","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 systematic review and Bayesian network meta-analysis of the effectiveness of non-pharmacological interventions in treating chronic wound pain in patients].","authors":"C Y Fu, N Li, M J Li, H S Li, L Cheng, L H Wang","doi":"10.3760/cma.j.cn501225-20241213-00486","DOIUrl":"10.3760/cma.j.cn501225-20241213-00486","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the effectiveness of non-pharmacological interventions in treating chronic wound pain in patients. <b>Methods:</b> This study was a systematic review and Bayesian network meta-analysis. Randomized controlled trials on the effectiveness of non-pharmacological interventions in treating chronic wound pain in patients, published from the establishment of the database until June 30, 2024, were retrieved from databases including China National Knowledge Infrastructure, Chinese Biomedical Literature Database, PubMed, Embase, and other databases. The outcome indicator was pain score. Pairwise meta-analysis and Bayesian network meta-analysis were conducted using ADDIS version 1.16.8 and Stata version 17.0 statistical softwares. <b>Results:</b> A total of 30 studies were included, involving 1 929 patients, including 1 016 patients in experimental group who received non-pharmacological intervention measures such as low-level laser therapy (LLLT), frequency rhythmic electrical modulation system (FREMS), virtual reality technology (VRT), non-contact low-frequency ultrasound (NCLFU), extracorporeal shock wave therapy, topical oxygen therapy, cold atmosphere plasma (CAP), negative pressure wound therapy, intermittent pneumatic compression (IPC), and exercise, and 913 patients in control group who received standard wound care, placebo treatment, etc. Pairwise meta-analysis showed that compared with that of control group, patients in experimental group who received LLLT, FREMS, VRT, NCLFU, CAP, and IPC had significantly reduced chronic wound pain scores (with standardized mean differences of -0.45, -4.09, -1.04, -0.61, -1.87, and -0.64, respectively, 95% confidence intervals of -0.76 to -0.15, -5.94 to -2.24, -1.56 to -0.52, -0.88 to -0.33, -3.16 to -0.58, and -1.03 to -0.25, respectively). Bayesian network meta-analysis showed that compared with that of standard wound care, patients who received FREMS, CAP, NCLFU, and LLLT had significantly reduced chronic wound pain scores (with standardized mean differences of -3.13, -1.75, -1.22, and -1.11, respectively, 95% confidence intervals of -4.35 to -1.98, -3.23 to -0.26, -2.36 to -0.06, and -2.18 to -0.06, respectively). FREMS had the highest probability of ranking 14^th, at 75%; the probability of CAP ranking 12^th was the highest, at 21%; the probability of NCLFU ranking 10^th and 9^th was the highest, both at 13%; LLLT had the highest probability of ranking 8^th, at 14%. <b>Conclusions:</b> Non-pharmacological intervention measures such as LLLT, FREMS, NCLFU, and CAP can effectively relieve chronic wound pain in patients, among which, FREMS shows the best effect, followed sequentially by CAP, NCLFU, and LLLT.</p>","PeriodicalId":516861,"journal":{"name":"Zhonghua shao shang yu chuang mian xiu fu za zhi","volume":"41 5","pages":"491-500"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152220","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 application and Zunyi Classification of free anterolateral thigh chimeric flaps].","authors":"Y J Zhang, H Li, X K Wu, B H Wu, S E Xiao, Z R Wei, C L Deng","doi":"10.3760/cma.j.cn501225-20241108-00438","DOIUrl":"https://doi.org/10.3760/cma.j.cn501225-20241108-00438","url":null,"abstract":"<p><p><b>Objective:</b> To summarize the clinical application and Zunyi Classification of free anterolateral thigh chimeric flaps. <b>Methods:</b> This study was a retrospective observational study. From June 2021 to June 2024, 200 patients who underwent free anterolateral thigh chimeric flap transplantation and met the inclusion criteria were admitted to the Affiliated Hospital of Zunyi Medical University, including 106 males and 94 females, aged 3 to 77 years. The wound types included mechanical trauma wounds in 175 cases, chronic wounds in 18 cases, and other wounds (postoperative infection, burns, etc.) in 7 cases. The wounds were located distal to the ankle or wrist joints in 171 cases; between the knee and above the ankle or between the elbow and above the wrist in 24 cases; and between the sacrum and above the knee, or between the shoulder and above the elbow in 5 cases. The application of free anterolateral thigh chimeric flaps with different tissue components for repairing various defects was analyzed to sum up the classification of free anterolateral thigh chimeric flaps. <b>Results:</b> The Zunyi Classification of free anterolateral thigh chimeric flaps was successfully established, including 68 cases of type Ⅰ, 81 cases of type Ⅱ, 23 cases of type Ⅲ, and 28 cases of type Ⅳ. type Ⅰ chimeric flaps were composed of 1 type of tissue, such as bilobed, trilobed, or other lobed flaps, which were suitable for patients requiring repair of simple skin defects. Type Ⅱ chimeric flaps were composed of 2 types of tissue and were further classified into subtypes Ⅱa and Ⅱb based on the presence or absence of lobed skin. They were suitable for patients requiring repair of skin defects along with reconstructing the function of another tissue type. Type Ⅲ chimeric flaps were composed of 3 or more types of tissue and were further classified into subtypes Ⅲa and Ⅲb based on the presence or absence of lobed skin. They were suitable for patients requiring repair of skin defects along with reconstructing the function of 2 or more types of tissue. Type Ⅳ chimeric flaps required microsurgical construction via vascular anastomosis. These flaps could be flexibly designed with customized tissue combinations to meet specific wound reconstruction needs. They were indicated for patients with extensive skin defects, specialized tissue defects, or anatomical regions where reconstruction cannot be achieved by a single anterolateral thigh donor site, necessitating harvest of additional donor tissues. <b>Conclusions:</b> The Zunyi Classification of free anterolateral thigh chimeric flaps based on tissue sources of chimeric flaps emphasizes the functional requirements of recipient sites, which helps guide the repair of various complex wounds and facilitates clinical promotion.</p>","PeriodicalId":516861,"journal":{"name":"Zhonghua shao shang yu chuang mian xiu fu za zhi","volume":"41 5","pages":"447-453"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152572","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 efficacy of composite transplantation of fascia lata-anterolateral thigh flap in repairing complex defects after radical tumor resection in maxillofacial region].","authors":"F Han, W F Zhang, L Tong, J L Jiao, Y Chen, Y Zhang, H Guan","doi":"10.3760/cma.j.cn501225-20240801-00290","DOIUrl":"https://doi.org/10.3760/cma.j.cn501225-20240801-00290","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the clinical efficacy of composite transplantation of fascia lata-anterolateral thigh flap for repairing complex defects after radical tumor resection in maxillofacial region. &lt;b&gt;Methods:&lt;/b&gt; This study was a retrospective observational study. From January 2023 to January 2024, 12 patients (7 males and 5 females, aged 42 to 60 years) meeting the inclusion criteria with complex defects after radical tumor resection in maxillofacial region were treated at the Department of Burns and Cutaneous Surgery of the First Affiliated Hospital of Air Force Medical University. After radical tumor resection, the sizes were 6.0 cm×4.0 cm to 11.0 cm×10.0 cm for skin and soft tissue defects and 4.0 cm×3.0 cm to 11.0 cm×5.0 cm for buccal mucosa-zygomatic arch defects. The anterolateral thigh flap with area ranging from 7.0 cm×5.0 cm to 12.0 cm×11.0 cm was first designed and harvested, followed by the underlying fascia lata (ranging from 4.0 cm×3.0 cm to 11.0 cm×5.0 cm). Then, the fascia lata was used first to reconstruct the oral lining, and the anterolateral thigh flap was subsequently employed to repair the residual skin and soft tissue defects. Postoperatively, the survival of the patient's flap was observed, the epithelialization time of the fascia lata used as lining was recorded, and wound healing at the donor and recipient sites was monitored, along with whether complications such as vascular crisis, oral fistula, or infection were present at the recipient site. During follow-up, the epithelialization of the fascia lata as a lining was observed, the mouth opening degree of the patient was measured, the occlusal function was evaluated, and the facial appearance and scar condition in donor site were observed. &lt;b&gt;Results:&lt;/b&gt; Postoperatively, all flaps of patients survived successfully, with the fascia lata used as a lining achieving complete epithelialization within 8-10 days. Only one patient with maxillary sinus squamous cell carcinoma experienced delayed wound healing at the flap margin, which was resolved after dressing changes; the recipient site wounds in the remaining patients healed well. All the donor site healed well. No vascular crisis, oral fistula, infection, or other complications occurred at the recipient sites. During 3 months of follow-up, the oral mucosa had covered the surface of the fascia lata; the vertical mouth opening was 3 transverse fingers in 9 cases, 2.5 transverse fingers in 1 case, 2 transverse fingers in 1 case, and 1.5 transverse fingers in 1 case, the horizontal mouth opening was 3-5 cm; chewing and swallowing functions were normal. All patients exhibited facial symmetry with the surgical area being full, and only linear scars were left in the donor sites. &lt;b&gt;Conclusions:&lt;/b&gt; The composite transplantation of fascia lata-anterolateral thigh flap demonstrates excellent efficacy in repairing complex defects after radical tumor resection in maxillofacial area. Through staged reconstruction of ","PeriodicalId":516861,"journal":{"name":"Zhonghua shao shang yu chuang mian xiu fu za zhi","volume":"41 5","pages":"440-446"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152954","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}