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

{"title":"[Application effect of LLMs as decision-support tools in emergency burn treatment].","authors":"M T Yan, J T Wei, S Y Jiang, P Wu, X G Wang","doi":"10.3760/cma.j.cn501225-20260601-00223","DOIUrl":"10.3760/cma.j.cn501225-20260601-00223","url":null,"abstract":"<p><p><b>Objective:</b> To explore the application effect of large language models (LLMs) as decision-support tools in emergency burn treatment. <b>Methods:</b> This study was a cross-sectional study. A total of 100 burn patients meeting the inclusion criteria were admitted to the Department of Emergency Medicine of the Second Affiliated Hospital of Zhejiang University School of Medicine between September 2025 and April 2026, including 52 males and 48 females, aged 34.5 (25.0, 56.8) years. Based on patients' discharge summaries, the diagnoses and treatment plans reviewed and confirmed by an expert panel, consisting of two emergency medicine physicians with associate senior titles and one burn and wound-repair specialist with a senior title from the hospital, were taken as the gold standard. Based on the gold standard and in a blind manner, two burn and wound-repair physicians with more than 5 years of working experience in the hospital used the Likert scale to evaluate the diagnostic accuracy and rationality of treatment plans, which were generated during May 25-28, 2026 for the aforementioned 100 patients by 4 LLMs (ChatGPT-5.5, Doubao-2.0-Pro, Qwen-3.6-Max-Preview, and Gemini 3.5 Flash) as well as 10 emergency medicine department junior physicians (EDJPs). The percentage of diagnostic accuracy scores and treatment plan rationality scores for the 100 patients were compared among EDJPs and the four LLMs; the percentage of diagnostic accuracy scores across patients with varying burn severities were also compared among EDJPs and the four LLMs; the consistency of diagnostic accuracy scores and treatment plan rationality scores were compared between the two evaluators. <b>Results:</b> The percentages of diagnostic accuracy scores for the 100 patients by Doubao-2.0-Pro, Gemini 3.5 Flash, ChatGPT-5.5, and Qwen-3.6-Max-Preview were 100% (100%, 100%), 100% (100%, 100%), 100% (50%, 100%), and 100% (50%, 100%), respectively, which were all significantly higher than the 100% (50%, 100%) by EDJPs (<i>P</i><0.05). The treatment plan rationality scores for the 100 patients by Doubao-2.0-Pro, ChatGPT-5.5, and Gemini 3.5 Flash were 4.0 (4.0, 4.0), 4.0 (4.0, 4.0), and 4.0 (4.0, 4.0), respectively, which were all significantly higher than the 4.0 (3.0, 4.0) by EDJPs (<i>P</i><0.05). The treatment plan rationality scores for the 100 patients by Doubao-2.0-Pro and ChatGPT-5.5 were significantly higher than the 4.0 (3.0, 4.0) by Qwen-3.6-Max-Preview (<i>P</i><0.05). The percentages of diagnostic accuracy scores for patients with mild burns by Doubao-2.0-Pro, Gemini 3.5 Flash, and ChatGPT-5.5 were significantly higher than that by EDJPs (<i>P</i><0.05); the percentages of diagnostic accuracy scores for patients with moderate burns by Doubao-2.0-Pro, Qwen-3.6-Max-Preview, and Gemini 3.5 Flash were significantly higher than that by EDJPs (<i>P</i><0.05); the differences in percentages of diagnostic accuracy scores were not statistically significant among EDJPs and the f","PeriodicalId":516861,"journal":{"name":"Zhonghua shao shang yu chuang mian xiu fu za zhi","volume":"42 9","pages":"828-836"},"PeriodicalIF":0.0,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Surgical designs and clinical effects of pedicled transfer of extended lower trapezius musculocutaneous flap in repairing massive wounds in the shoulder and back].","authors":"M Wang, T J Xie, S S Li, Z X Chen, S Zhu, M Q Zang, Y B Liu","doi":"10.3760/cma.j.cn501225-20260414-00152","DOIUrl":"10.3760/cma.j.cn501225-20260414-00152","url":null,"abstract":"<p><p><b>Objective:</b> To explore the surgical designs and clinical effects of pedicled transfer of extended lower trapezius musculocutaneous flap (e-LTMF) in repairing massive wounds in the shoulder and back. <b>Methods:</b> This study was a retrospective case series study. From January 2009 to April 2023, 41 patients with massive wounds in the shoulder and back who met the inclusion criteria were admitted to Plastic Surgery Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College, including 26 males and 15 females, aged 4 to 83 years. The surgical design was selected according to the nature of the wound and surgical timing. The 15 patients repaired with the conventional e-LTMF were included in conventional group, the 15 patients repaired with the modified e-LTMF incorporating a distal segment of the latissimus dorsi muscle were included in modified group, and the 11 patients repaired with the pre-expanded e-LTMF were included in pre-expanded group. The wound areas ranged from 7 cm×5 cm to 21 cm×12 cm and the harvested musculocutaneous flap areas ranged from 7 cm×5 cm to 33 cm×10 cm in patients in conventional group. The wound areas ranged from 16 cm×8 cm to 28 cm×18 cm and the harvested musculocutaneous flap areas ranged from 25 cm×8 cm to 40 cm×12 cm in patients in modified group. The wound areas ranged from 12 cm×8 cm to 36 cm×12 cm and the harvested musculocutaneous flap areas ranged from 22 cm×8 cm to 35 cm×15 cm in patients in pre-expanded group. The musculocutaneous flaps were transferred to the recipient sites in a fashion of propeller rotation or as an island flap through a subcutaneous tunnel. The donor site wounds were repaired by direct suture, local flap transfer, or skin grafting. After surgery, the survival of musculocutaneous flaps was observed, the complete survival rate and the necrosis rate of musculocutaneous flaps were calculated, and the management and outcome of the necrotic musculocutaneous flaps were recorded. During follow-up, the appearance and texture of the musculocutaneous flaps, the recovery of the affected upper limb and the shoulder and back at recipient sites, the tumor recurrence in patients with tumors, and the wound healing at donor sites were observed. <b>Results:</b> After surgery, among the 41 patients, the musculocutaneous flaps survived completely in 38 patients, with a complete survival rate of musculocutaneous flaps of 92.7% (with a 95% <i>CI</i> of 80.6% to 97.5%). The necrosis of the musculocutaneous flaps occurred in 3 patients, with a necrosis rate of musculocutaneous flaps of 7.3% (with a 95% <i>CI</i> of 2.5% to 19.4%). Among them, total necrosis of the musculocutaneous flaps occurred in one patient in conventional group, whose wound healed after skin grafting. Distal necrosis of the musculocutaneous flap occurred in two patients in modified group, whose wounds both healed after dressing changes. During the follow-up of 1 to 48 months after surgery, the color and texture ","PeriodicalId":516861,"journal":{"name":"Zhonghua shao shang yu chuang mian xiu fu za zhi","volume":"42 8","pages":"749-758"},"PeriodicalIF":0.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical evaluation and repair strategies for complex inguinal wounds].","authors":"W L Du, Z X Liu, F Xiong, T Y Cao, H J Zhang, K X Che, Y M Shen","doi":"10.3760/cma.j.cn501225-20260505-00182","DOIUrl":"10.3760/cma.j.cn501225-20260505-00182","url":null,"abstract":"<p><p><b>Objective:</b> To explore the clinical evaluation and repair strategies for complex inguinal wounds. <b>Methods:</b> This study was a retrospective case series study. From September 2020 to October 2025, 15 patients with complex inguinal wounds who met the inclusion criteria were admitted to Beijing Jishuitan Hospital of Capital Medical University. There were 10 males and 5 females, aged 12 to 79 years. Preoperatively, the involvement of vital structures and infectious status in the inguinal region was precisely evaluated through medical history inquiry, physical examination, and multiple auxiliary examinations. After timely management of femoral artery lesions, precise debridement was carried out. The sizes of inguinal wounds after debridement ranged from 11.0 cm×4.0 cm to 20.0 cm×9.0 cm. According to the wound bed conditions after debridement, well-vascularized tissue flaps were selected to obliterate the wound cavity and achieve wound closure. The following data were recorded, including the involvement of femoral vessels by the wound, the exposure and retention or removal of prosthetic vascular grafts, management of the femoral artery in patients with radiotherapy, the type and size of the adopted tissue flaps, the methods of wound closure at the donor site, the preoperative bacterial culture results of wound exudate samples, and the results of intraoperative histopathological examination of wounds. The survival of tissue flaps and wound healing were observed two weeks postoperatively. During follow-up, the appearance of tissue flaps, recurrence of wounds, patency of femoral artery, swelling of the affected limb, scar formation of the donor sites, and occurrence of abdominal wall hernia at the donor site of rectus abdominis myocutaneous flap were observed. <b>Results:</b> All inguinal wounds involved femoral vessels. Exposure of the prosthetic vascular graft was observed in 4 patients, among which the prosthetic vascular graft was preserved in three patients and removed in one patient. Among patients with radiotherapy, two patients received preoperative covered stent implantation, one patient underwent intraoperative femoral artery resection and prosthetic vascular vessel grafting, and the femoral artery in the remaining patients was successfully preserved without rupture. Eleven cases of inguinal wounds were repaired with thoracoumbilical flaps combined with rectus abdominis myocutaneous flap, one case was repaired with tensor fasciae latae myocutaneous flap combined with sartorius muscle flap, one case was repaired with tensor fasciae latae myocutaneous flap combined with rectus femoris muscle flap, and two cases were repaired with pedicled anterolateral thigh flap chimerized with vastus lateralis muscle flap. The sizes of tissue flaps ranged from 13.0 cm×6.0 cm to 26.0 cm×14.0 cm. Only the donor site wound in one patient was covered with split-thickness skin graft, and the donor site wounds in the remaining 14 patients were closed ","PeriodicalId":516861,"journal":{"name":"Zhonghua shao shang yu chuang mian xiu fu za zhi","volume":"42 8","pages":"741-748"},"PeriodicalIF":0.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Effects of astragaloside Ⅰ on full-thickness skin defects in diabetic rats and its underlying mechanism].","authors":"Y Li, Y Y Zheng, Y H Wang, Z Y Zhang, J P Liu, Z H Luo","doi":"10.3760/cma.j.cn501225-20260116-00026","DOIUrl":"10.3760/cma.j.cn501225-20260116-00026","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the effects of astragaloside Ⅰ (AS-Ⅰ) on full-thickness skin defects in diabetic rats and its underlying mechanism. <b>Methods:</b> This study was an experimental study with grouped design and repeated measures design. Twenty-four male Sprague-Dawley rats aged 6-8 weeks were divided into control group (<i>n</i>=6) and modeling group (<i>n</i>=18) using a random number table method (the same grouping method was used throughout). After successful induction of diabetes mellitus, the modeling group was further divided into model group, low-dose AS-Ⅰ group, and high-dose AS-Ⅰ group, with 6 rats in each group. A full-thickness skin defect wound of 10 mm in diameter was created on the back of each rat. Wounds in control group and model group were treated with normal saline, while wounds in low-dose AS-Ⅰ group and high-dose AS-Ⅰ group were treated with 1.15 and 11.50 mmol/L AS-Ⅰ, respectively, for 3 consecutive days. Wound healing rates of rats were calculated at 3, 5, 7, 9, 13, and 15 days after injury. At 15 days after injury, Masson's trichrome staining was used to assess the deposition of collagen fibers in wound tissue; immunohistochemical staining was performed to detect Ki-67 positive expression in wound tissue, and the expression level was quantified. Network pharmacology analysis was applied to screen for potential core targets of AS-Ⅰ in treatment of diabetic wounds; molecular docking simulation was utilized to validate the binding affinity of AS-Ⅰ to the core targets, and molecular dynamics simulation was performed to verify the dynamic stability of the interaction between AS-Ⅰ and forkhead box O1 (FOXO1). At 15 days after injury, Western blotting was used to determine the protein expression levels of epidermal growth factor receptor (EGFR), cyclin-dependent kinase 2 (CDK2), growth factor receptor-bound protein 2 (GRB2), phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA), signal transducer and activator of transcription 3 (STAT3), and FOXO1 in wound tissue of rats in four groups. <b>Results:</b> Compared with those in control group, the wound healing rates of rats in model group at 3 and 15 days after injury were significantly decreased (<i>P</i><0.05); whereas the wound healing rates of rats in low-dose AS-Ⅰ group at 7 and 13 days after injury, and in high-dose AS-Ⅰ group at 5, 7, 9, 13, and 15 days after injury were significantly increased (<i>P</i><0.05). Compared with those in model group, the wound healing rates of rats in both low-dose AS-Ⅰ group and high-dose AS-Ⅰ group at 3, 9, 13, and 15 days after injury were significantly increased (<i>P</i><0.05). At 15 days after injury, collagen fibers in the wound tissue of rats in control group were arranged in an orderly and dense manner; whereas those in the wound tissue of model group were sparse and disorganized; the deposition of collagen fibers in the wound tissue of rats in low-dose AS-Ⅰ group was improved compared with ","PeriodicalId":516861,"journal":{"name":"Zhonghua shao shang yu chuang mian xiu fu za zhi","volume":"42 8","pages":"793-802"},"PeriodicalIF":0.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Expert consensus on the application of bone cement in the treatment of diabetic wounds (2026 edition)].","authors":"","doi":"10.3760/cma.j.cn501225-20260128-00052","DOIUrl":"10.3760/cma.j.cn501225-20260128-00052","url":null,"abstract":"<p><p>Diabetic wounds, including diabetic foot ulcers, represent one of the severe complications associated with diabetes mellitus, which progress rapidly, are difficult to treat, and frequently lead to amputation or even life-threatening consequences. The current treatment principles for closing the wounds are based on improving limb blood supply while combining the application of surgical techniques-such as negative-pressure drainage, wound dressing changes, and coverage with muscle flaps, skin flaps, autologous skin, or artificial skin substitutes. In recent years, numerous studies have reported on the therapeutic approach involving the initial management of diabetic wounds with bone cement, followed by skin or flap transplantation for definitive wound coverage. To further standardize the application of bone cement in the treatment of diabetic wounds, the Burns and Trauma Branch of Chinese Geriatrics Society jointly organized an expert panel to develop the <i>Expert consensus on the application of bone cement in the treatment of diabetic wounds (2026 edition)</i>. This consensus, which is based on evidence from literature search integrating the latest advances in clinical and basic research, aims to establish a standardized protocol for treating diabetic wounds with bone cement. It serves as a critical reference for clinicians to enhance the diagnostic and therapeutic outcomes of diabetic wounds.</p>","PeriodicalId":516861,"journal":{"name":"Zhonghua shao shang yu chuang mian xiu fu za zhi","volume":"42 8","pages":"703-716"},"PeriodicalIF":0.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Concepts and clinical practice of functional reconstruction of complex wounds].","authors":"Y M Shen, L Zhi, Y W Wang","doi":"10.3760/cma.j.cn501225-20260507-00185","DOIUrl":"10.3760/cma.j.cn501225-20260507-00185","url":null,"abstract":"<p><p>The repair of complex wounds has shifted from simple wound closure toward functional reconstruction. Nevertheless, a systematic exposition regarding their definition, the principles of functional reconstruction, and future directions is currently lacking. Based on a literature review and comprehensive analysis, this article proposes that the definition of complex wounds should incorporate four dimensions including abnormal healing timeline, involvement of anatomical structures, coexistence of multiple risk factors, and complex management requirements. Furthermore, the core concept of functional reconstruction for such wounds can be summarized into four-tiered principles: biological matching between donor and recipient sites, minimization of donor-site morbidity, restoration of aesthetic appearance and sensory function, and functional reconstruction of deep structures, including blood vessels, nerves, tendons, bones, and joints. This article systematically reviewed the developmental trajectory of complex wound reconstruction, from skin grafting as the cornerstone of wound repair, to microsurgery for functional reconstruction, and onward to the emergence of multidisciplinary regenerative strategies, highlighting the original contributions of Chinese investigators in this field. In the future, the deep integration of technologies such as regenerative medicine, intelligent navigation, super-microsurgery, and precision subtyping is expected to facilitate the transition of complex wound reconstruction from anatomical repair to functional regeneration.</p>","PeriodicalId":516861,"journal":{"name":"Zhonghua shao shang yu chuang mian xiu fu za zhi","volume":"42 8","pages":"733-740"},"PeriodicalIF":0.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Application effects of the hydrosurgical debridement system in eschar excision and debridement in <i>ex vivo</i> porcine skin burn wound models].","authors":"X L Pan, J Chen, C M Han, X G Wang","doi":"10.3760/cma.j.cn501225-20250327-00146","DOIUrl":"10.3760/cma.j.cn501225-20250327-00146","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the application effects of the hydrosurgical debridement system (hereinafter referred to as the hydrosurgery system) in eschar excision and debridement in <i>ex vivo</i> porcine skin burn wound models. <b>Methods:</b> This was a basic research study using grouped design. On November 21^st, 2024, 23 young surgeons (20 males and 3 females, aged 30-43 years) participated in the 2024 Zhejiang Provincial Burn Surgery Clinical Skills Competition in Ningbo city. Each surgeon used the hydrosurgery system and convetional instruments to perform eschar excision (using the hydrosurgery system and roller dermatome) and debridement (using the hydrosurgery system and conventional scalpel) on <i>ex vivo</i> porcine skin burn wound models featuring both early-stage eschar and late-stage liquefied eschar (both with an area of 12 cm×8 cm), respectively. The operative time (assessing speed) and amount of removed tissue (assessing precision) were recorded for both instruments in both procedures. <b>Results:</b> The operative time for eschar excision was not statistically different between the hydrosurgery system (122 (96, 145) s) and traditional instrument (125 (56, 233) s), <i>P</i>>0.05; however, the amount of removed tissue by the hydrosurgery system (2.88±0.27) g was significantly less than that (13.81±1.93) g by traditional instrument (<i>t</i>=-5.44, <i>P</i><0.05). The operative time for debridement by the hydrosurgery system ((121±9) s) was significantly shorter than that ((368±33) s) by traditional instrument (<i>t</i>=-7.00, <i>P</i><0.05); however, the amount of removed tissue by the hydrosurgery system ((30.85±1.98) g) was significantly greater than that ((21.48±1.45) g) by traditional instrument (<i>t</i>=4.00, <i>P</i><0.05). <b>Conclusions:</b> Compared with traditional instruments, the hydrosurgery system allows more precise removal of necrotic tissue and minimize damage to healthy tissue in early-stage eschar excision in <i>ex vivo</i> porcine skin burn wounds; however, while it significantly accelerates debridement during late-stage debridement of liquefied eschar, it may remove excessive normal tissue.</p>","PeriodicalId":516861,"journal":{"name":"Zhonghua shao shang yu chuang mian xiu fu za zhi","volume":"42 8","pages":"787-792"},"PeriodicalIF":0.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522918/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical efficacy of thinned free flaps in reconstructing the wounds following excision of malignant extremity tumors].","authors":"B Li, Y Yang, P C Li, F J Yang, D D Tong, Z X Wang, F Li, Y Wang","doi":"10.3760/cma.j.cn501225-20260426-00167","DOIUrl":"10.3760/cma.j.cn501225-20260426-00167","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the clinical efficacy of thinned free flaps in reconstructing the wounds following excision of malignant extremity tumors. <b>Methods:</b> This study was a retrospective case series study. From June 2023 to February 2026, 17 patients (11 males and 6 females, aged 38-91 years) with malignant extremity tumors who met the inclusion criteria were admitted to the Department of Hand Surgery of Beijing Jishuitan Hospital of Capital Medical University. Tumors were located in the upper extremity in 9 patients and in the lower extremity in 8 patients, including 6 patients of squamous cell carcinoma, 2 patients of dermato-fibrosarcoma protuberans, 2 patients of liposarcoma, 2 patients of synovial sarcoma, 2 patients of malignant peripheral nerve sheath tumor, 1 patient of epithelioid sarcoma, 1 patient of angiosarcoma, and 1 patient of cutaneous carcinoma. Wide excision of the tumor was performed, with soft tissue defect areas ranging from 4 cm×4 cm to 24 cm×12 cm. Thinned free flaps were used for wound reconstruction, including 7 anterolateral thigh flaps, 6 groin flaps, 2 medial sural artery perforator flaps, 1 inferior epigastric artery perforator flap, and 1 medial plantar flap. Flaps were harvested with areas ranging from 4 cm×4 cm to 24 cm×13 cm, with a thickness of 4-10 mm (with a mean of 5.8 mm). Donor site wounds were closed by direct suture, local relay flaps or skin grafting. Postoperative flap survival was recorded, as well as the occurrence of complications at the flap recipient site including infection, hematoma, and delayed wound healing, and the healing status and complications at the donor site. A comprehensive assessment of flap reconstructive outcomes was conducted at the final follow-up. Tumor prognosis of all patients was tracked and documented. <b>Results:</b> Postoperatively, the flaps in 16 patients survived uneventfully. One patient who underwent groin flap reconstruction for wound following resection of angiosarcoma on the dorsum of the hand developed epidermal necrosis at the distal portion of the flap on postoperative day 3, which healed after dressing changes. No infection, hematoma, or delayed wound healing occurred in any flap recipient site. Donor site wounds healed uneventfully in 15 patients but showed delayed healing in 2 patients. No major complications were observed in any donor site wound. At the last follow-up, the flap reconstructive outcomes were rated as excellent in 14 patients and good in 3 patients. The follow-up period ranged from 2 to 34 months. Local recurrence of tumors occurred in 3 patients. Metastasis of tumors developed in 2 patients. The remaining 12 patients showed no signs of local tumor recurrence or distant metastasis. <b>Conclusions:</b> Clinical use of thinned free flaps to reconstruct the wounds following excision of malignant extremity tumors yields excellent reconstructive outcomes, with few donor site complications.</p>","PeriodicalId":516861,"journal":{"name":"Zhonghua shao shang yu chuang mian xiu fu za zhi","volume":"42 8","pages":"759-766"},"PeriodicalIF":0.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148907941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Performance of phenylboronic acid-modified GelMA hydrogel loaded with copper-doped cerium oxide nanozyme and its effect on healing of infected burn wounds in mice].","authors":"Y J Shang, Y R Chen, Z Liang, X P Wang","doi":"10.3760/cma.j.cn501225-20260430-00178","DOIUrl":"10.3760/cma.j.cn501225-20260430-00178","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To explore the performance of phenylboronic acid-modified gelatin methacryloyl (GelMA) hydrogel loaded with copper-doped cerium oxide nanozyme (hereinafter referred to as composite hydrogel) and its effects on healing of infected burn wounds in mice. &lt;b&gt;Methods:&lt;/b&gt; This study was an experimental study including group design and repeated measures design. The phenylboronic acid-modified GelMA hydrogel (hereinafter referred to as simple hydrogel) with a three-dimensional loose porous network structure was prepared. The copper-doped cerium oxide nanozyme with a uniform spherical structure was prepared by a hydrothermal method. The copper-doped cerium oxide nanozyme with a final mass concentration of 100 μg/mL, which had no obvious effect on the viability of human umbilical vein endothelial cells and possessed high superoxide dismutase-like and catalase-like activities, was screened out and added into the simple hydrogel to prepare the composite hydrogel. After the composite hydrogels were soaked in phosphate buffer saline (PBS) or hydrogen peroxide solution for 24, 48, and 72 h, the release percentages of copper-doped cerium oxide nanozymes in the composite hydrogel were calculated, with a sample size of 3. Thirty 8-week-old male BALB/c mice were taken to establish a burn wound infection model by creating symmetrical burn wounds on both sides of the spine, and then dropping methicillin-resistant &lt;i&gt;Staphylococcus aureus&lt;/i&gt; (MRSA) bacterial suspension to the wounds. According to the random number table method (the same grouping method below), the mice were divided into control group, simple hydrogel group, and composite hydrogel group, with 10 mice in each group (20 wounds). No drug intervention was administered to the wounds of mice in control group, the simple hydrogel and composite hydrogel were dropped on the wounds of mice in simple hydrogel group and composite hydrogel group, respectively. At post injury day (PID) 3, 7, and 14, the residual wound area was measured and the percentage of residual wound area was calculated. At PID 3, the MRSA concentration in the wound was measured using the plate counting method. At PID 5, the wound blood perfusion volume was evaluated by a laser speckle blood flow imaging system. Another six 8-week-old male BALB/c mice were taken and divided into PBS group and composite hydrogel implantation group, with 3 mice in each group, and PBS was subcutaneously injected and composite hydrogels were subcutaneously implanted into the center of the mice's backs, respectively. At 14 d after treatment, abdominal whole blood of mice was collected, then the blood routine test indexes and blood biochemical test indexes were detected. &lt;b&gt;Results:&lt;/b&gt; After immersion in PBS or hydrogen peroxide solution for 24, 48, and 72 h, respectively, the overall differences in the release percentages of copper-doped cerium oxide nanozymes in the composite hydrogel were statistically significant (with &lt;i&gt;F&lt;/i&gt; values of","PeriodicalId":516861,"journal":{"name":"Zhonghua shao shang yu chuang mian xiu fu za zhi","volume":"42 8","pages":"777-786"},"PeriodicalIF":0.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Practice guideline for adult burn rehabilitation nursing (2026 edition)].","authors":"","doi":"10.3760/cma.j.cn501225-20260402-00138","DOIUrl":"10.3760/cma.j.cn501225-20260402-00138","url":null,"abstract":"<p><p>Burn patients are often accompanied by problems such as functional and psychological impairments, difficulties in social adaptation. Rehabilitation nursing plays an important role in functional recovery, complication prevention, and improvement of quality of life. To further assist nurses in implementing adult burn rehabilitation nursing in a scientific and standardized manner, the guideline writing group, based on evidence from evidence-based medicine and guided by the Delphi method, developed 16 recommendations addressing 11 clinical questions in adult burn rehabilitation nursing. These recommendations cover multidisciplinary teams, rehabilitation nursing assessment, positioning, edema management, scar care, orthosis care, activities of daily living, pain care, sleep management, psychological interventions, and follow-up care, providing an evidence-based foundation to support clinical practice.</p>","PeriodicalId":516861,"journal":{"name":"Zhonghua shao shang yu chuang mian xiu fu za zhi","volume":"42 8","pages":"717-732"},"PeriodicalIF":0.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148908284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}