【Abstract】 Objective To explore the effect of early scrotal dermatoplasty on spermatogenic functional rehabilitation of testis in juvenile pigs with third degree burn wound of the scrotum. Methods Thirty healthy male Guizhou miniature pigs (weighing 10-15 kg, 2-month-old) were divided into 3 groups: control group (group A, n=10), natural healing group (group B, n=10), and dermatoplasty group (group C, n=10). In group A, the pig was not given any treatment; after third degree burn model of the scrotum was prepared, wounds were not treated in group B and the burn skin was excised and whole hypogastric pachydermia was used for dermatoplasty in group C. At 3 months and 1 year after model preparation, bilateral testis were collected from 5 pigs, respectively. HE staining was performed to observe the effects of different repair method on the morphology of spermatogenic cells and immunohistochemical staining was used to detect Survivin protein expression. Results All pigs survived to the end of the experiment and the wound healed successfully. Histological observation showed that spermatogenic cells had normal shape at all stages and mature sperms were seen in lumens in group A; the thickness of seminiferous epithelium was thinner, having one layer or two layers of spermatogenic cells in group B; the spermatogenic cells in group C were slightly more than that in group B with some spermatids; and in groups B and C, the spermatogenic cells at 1 year were more than that at 3 months. Immunohistochemistry staining showed that the Survivin protein expression in groups B and C was less than in group A, and group B was less than group C, showing significant differences at 3 months and 1 year (P lt; 0.05), but no significant difference between 3 months and 1 year in the same group (P gt; 0.05). Conclusion Dermatoplasty has inhibitory effect on spermatogenic functional rehabilitation of testis. Dermatoplasty can decrease spermatogenic cells and reduce Survivin protein expression, but some spermatids still survive in seminiferous tubule.
ObjectiveTo develop a standardized venous thromboembolism (VTE) prevention program for burn patients and verify its safety and effectiveness by comparing with traditional thrombus prophylaxis.MethodsAll burn patients admitted and met selection criteria betweem April 2017 and September 2018 were included. Patients between January 2018 and September 2018 were included as the interventional group to implement standardized VTE prevention programs, while patients between April 2017 and December 2017 were included as the control group and traditional active and passive exercises were used to prevent VTE. There was no significant difference in the age, gender, ethnic group, marriage, education, occupation, type and site of the injury, burn area, operation time, and hospital stay between the two groups (P>0.05), which was comparable. The incidence of VTE, number of cases of tissue or organ hemorrhage, survival rate of skin grafting, and time of wound healing were compared.ResultsThe incidence of VTE was obviously lower in the interventional group (1.56%, 1/64) than in the control group (10.17%, 6/59) (χ2=?2.05, P=0.04). No bleeding occurred in any tissue or organ in the two groups. The survival rate of skin grafting and the time of wound healing were 89.06% (57/64) and (11.78±3.08) days respectively in the interventional group and 91.53% (54/59) and (11.66±2.30) days respectively in the control group; and the differences between the two groups were not statistically significant (χ2=0.21, P=0.65; t=?0.22, P=0.83).ConclusionThe standardized VTE prevention program can effectively prevent the occurrence of VTE, and its safety is relatively high.
OBJECTIVE: To evaluate the therapeutic effect of amniotic membrane transplantation(AMT) for ocular burn. METHODS: Twenty patients with ocular burn(28 eyes) were treated with amniotic membrane transplantation. Of them, there were 6 cases of severe alkali burn(10 eyes), 8 cases of severe acid burn(10 eyes), and 6 cases of thermal burn(8 eyes). RESULTS: In 28 eyes, ocular inflammation was controlled after 3-7 days of surgery; no continued dissolution, perforation and iris atrophy were found. There were corneal transparency in 16 eyes, keratoleukoma in 4 eyes, and total corneal opacity in 8 eyes. All eyeballs were saved and had stable ocular surface. There was no allograft immune rejection and secondary infection. CONCLUSION: Amnitic membrane transplantation can relieve the inflammatory reaction, reduce the growth of blood vessel and restrain the proliferation of fibrous tissue. It is an effect surgical method for ocular burn in reconstruction of ocular surface and salvage of eyeball.
Objective To investigate the effectiveness of autogenous platelet-rich plasma (PRP) gel with acellular xenogeneic dermal matrix in the treatment of deep II degree burns. Methods From January 2007 to December 2009, 30 cases of deep II degree burns were treated. There were 19 males and 11 females with an average age of 42.5 years (range, 32-57 years).The burn area was 10% to 48% of total body surface area. The time from burn to hospitalization was 30 minutes to 8 hours. All patients were treated with tangential excision surgery, one side of the wounds were covered with autogenous PRP gel and acellular xenogeneic dermal matrix (PRP group), the other side of the wounds were covered with acellular xenogeneic dermal matrix only (control group). The heal ing rate, heal ing time, infection condition, and scar formation were observed. Results At 7 days after operation, the infection rate in PRP group (6.7%, 2/30) was significantly lower than that in control group (16.7%, 5/30, P lt; 0.05). The healing times were (18 ± 4) days and (22 ± 4) days respectively in PRP group and control group, showing significant difference (P lt; 0.05). The healing rates at 14 days and 21 days were 75% ± 7% and 88% ± 5% in PRP group, were 62% ± 15% and 73% ± 7% in control group, showing significant difference (P lt; 0.05). RPR group was superior to control group in elasticity, color, appearance, softness, scar formation, and heal ing qual ity. Conclusion Autogenous PRP gel with acellular xenogeneic dermal matrix can accelerate the wound healing of deep II degree burns as well as alleviate the scar proliferation.
Objective To explore the feasibility and effectiveness of sideburn reconstruction using the expanded island scalp flap based on the parietal branch of the superficial temporal vessel. Methods Between February 2012 and April 2015, 7 patients underwent sideburn reconstruction. There were 3 males and 4 females with an average age of 15 years (range, 4-44 years). The etiologies included burn injury in 3 cases, trauma in 1 case, radiation therapy in 1 case, and congenital melanocytic nevus in 2 cases. The size of the sideburn defects ranged from 5.0 cm×3.5 cm to 16.0 cm×10.0 cm. At the first-stage, according to the sideburn defect, a tissue expander of the appropriate size was inserted beneath the superficial temporal fascia which containing the parietal branch of the superficial temporal vessel. Postoperatively, regular saline injection was commenced. After 3-6 months of the first-stage surgery, the expander was adequately inflated. While the second-stage surgery was performed, the lesion was excised and the tissue expander removed. The expanded island scalp flap based on the parietal branch of the superficial temporal vessel was harvested and advanced towards the defect of the sideburn according to the contralateral normal one, and the size of flap ranged from 8 cm×3 cm to 17 cm×11 cm. The donor site was closed primarily. Results All flaps survived and the wound and donor sites were healed primarily without any complication. All patients were followed up 1-36 months (mean, 9.8 months). The profile, hair density, and hair direction of the new sideburn were similar to the contralateral sideburn. In 1 patient, the reconstructed sideburn was a little larger than the contralateral normal one. After laser hair removal, the patient was satisfied with the appearance. Conclusion The expanded island scalp flap based on the parietal branch of the superficial temporal vessel provides an effective option for the sideburn reconstruction, which presents with the similar appearance to the contralateral one.
ObjectiveTo study whether emotional management can alleviate the occupational burnout of the health care providers. MethodsFrom May 1st 2015 to February 29th 2016, we sampled the medical workers of a class-3 grade-A hospital randomly, and performed the emotional management through self-emotion management and professionals-conducted emotion-management. The discrepancies before and after intervention were studied using Maslach Burnout Inventory General Survey (MBI-GS). ResultsIn total, 100 medical workers were enrolled in our study, of which there were 27 males and 73 females. There were 11 doctors and 89 nurses. The average age was (34.5±5.6) years. According to the MBI-GS survey, there were 69 medical workers suffering from occupational burnout. There were significant statistical differences before and after intervention in the MBI-GS scores in four aspects including emotion exhaustion, work status, sense of achievement and the total scores (P＜0.05). ConclusionThe medical workers can alleviate the occupational burnout under the self-management or professionals-conducted management of emotion.
To compare the effectiveness of dressing by a combination of traditional Chinese medicine (TCM)-Western medicine (WM) after TCM bath and by the silver sulfadiazine cream (SD-Ag) in treating residual deep burn wound. Methods A total of 128 cases of residual deep burn wound between July 2003 and December 2009 were randomly divided into the TCM-WM treatment group (70 cases) and the WM control group (58 cases). In the treatment group, there were 45 males and 25 females with an average age of 38.6 years (range, 18-60 years), including 34 cases of flame burns, 28 cases of molten steel burns, and 8 cases of chemical burns with an average burn area of 57.6% total body surface area (TBSA) and an average residual wound of 7.4% TBSA. In the control group, there were 50 males and 8 females with an average of 37.9 years (range, 20-59 years), including 26 cases of flame burns, 12 cases of hot water burns, 16 cases of molten steel burns, and 4 cases of chemical burns with an average burn area of 56.5% TBSA and an average residual wound of 6.9%TBSA. There was no significant difference in general data between 2 groups (P gt; 0.05), so the cl inical data of 2 groups had comparabil ity. In the treatment group, the patients had a bath with TCM, and then the wounds were treated with dressing change of combined TCM-WM. In the control group, the wounds were treated with SD-Ag after cleaning the wounds with chlorhexidine solution. The pain, wound heal ing time, and the rate of scar formation were observed in 2 groups after treatment. Results According to wound pain classification after medication, the results were excellent in 23 cases, good in 30 cases, fair in 17 cases in the treatment group; were excellent in 17 cases, good in 20 cases, fair in 13 cases, poor in 5 cases, and fairly poor in 3 cases in the control group. The wound heal ing time of the treatment group (13.45 ± 4.74) days was significantly shorter than that of the control group [(23.87 ± 14.45) days, P lt; 0.05)]. After 2 weeks of treatment, scar occurred in 15 patients (21.4%) of the treatment group and 35 patients (60.3%) of the control group, showing significant difference (P lt; 0.05). Conclusion Based on TCM bath, a combination of TCM-WM for the residual burn wounds is obviously superior to SD-Ag. It has the advantages of rapid heal ing, l ight pain, no obvious scar, and short hospital ization time.
OBJECTIVE: With the recognization of the mechanism of wound healing, some topical agents are created and applied in trauma to improve the healing rate of wounds. The main purpose of this study is to investigate the effect of some topical agents on the healing rate of deep second-degree burn wounds. METHODS: One thousand five hundred and sixty-three patients with deep second-degree burn wounds(total burn surface area lt; or = 10%) were involved in this study from January 1982 to December 1999. According to the application time of different treating measures including supplement of Zn, application of growth factors and collagenase, the patients were divided into 3 groups, wound healing rates were compared. RESULTS: Before 1991, none of special topical agents were used, and the healing time of deep second-degree burn wounds was(23.8 +/- 3.5) days. From 1991 to 1996, with the topical application of SD-Ag-Zn, which can provide Zn for cells taking part in wound healing, the healing time of deep second-degree burn wounds was (20.6 +/- 3.2) days, earlier than no special topical agents (P lt; 0.05). From 1997 to 1999, growth factors such as basic fibroblast growth factor(bFGF) and epithelial growth factor (EGF) and collagenases were applied in wound treatment combining with SD-Ag-Zn, wound healing time was (16.2 +/- 2.8) days, earlier than no special topical agents (P lt; 0.01) and simple SD-Ag-Zn application (P lt; 0.05). CONCLUSION: It indicates that the improvement of topical agents can accelerate wound healing speed.
ObjectiveTo investigate the effectiveness of Ilizarov technique in treatment of the clubfoot after burns.MethodsBetween March 2012 and February 2017, 12 patients (17 feet) with clubfoot after burns were treated with Ilizarov technique. There were 10 males (14 feet) and 2 females (3 feets) with an average age of 38 years (range, 18-52 years). There were 3 cases of left foot, 4 cases of right foot, and 5 cases of both feet. According to the Qin’s classification of clubfoot deformity, there were 5 feet of degreeⅠ, 9 feet of degreeⅡ, and 3 feet of degree Ⅲ.ResultsAll clubfeet were completely corrected without local skin necrosis, needle tract infection, or acroanesthesia. All patients could walk with a heavy load. Pationts were followed up from 4 months to 3 years (mean, 10 months). At last follow-up, according to the International Clubfoot Study Group (ICFSG) score, the effectiveness was rated as excellent in 7 feet, good in 7 feet, and fair in 3 feet, with the excellent and good rate of 82.4%.ConclusionUsing Ilizarov technique can gradually correct the clubfoot deformity with the advantages of minimal invasion, safeness, and simpleness.
ObjectiveTo prepare adipose-derived stem cells (ADSCs) and chitosan chloride (CSCl) gel complex to study the biocompatibility and the feasibility of repairing the wounds of deep partial thickness scald in rats. MethodsADSCs were prepared by enzymogen digestion and differential adherence method from the subcutaneous adipose tissue of SPF grade 6-week-old male Sprague Dawley (SD) rats. Temperature sensitive CSCl gel was prepared by mixing CSCl, β glycerol phosphate, and hydroxyethyl cellulose in 8∶2∶2.5 ratio. The proliferation of ADSCs was measured by cell counting kit 8 (CCK-8) assay and the survival of ADSCs was detected by the Live/Dead flurescent staining in vitro. A deep partial thickness burn animal model was made on the back of 72 SPF grade 6-week-old male SD rats by boiled water contact method and randomly divided into 3 groups (n=24). Group A was blank control group, group B was CSCl hydrogel group, group C was ADSCs/CSCl gel group. The wound closure rate at 3, 7, 14, 21 days was observed after operation. The number of inflammatory cells at 7 days and epidermal thickness at 21 days were observed by HE staining after operation. The angiogenesis at 7 days was evaluated by immunohistochemistry staining with CD31 expression. ResultsCSCl had a temperature sensitivity, at 4℃, the temperature-responsive hydrogel was liquid and became solid at 37℃. The CCK-8 assay and Live/Dead flurescent staining confirmed that ADSCs could grow and proliferate in the ADSCs/CSCl hydrogel complex. General observation showed the wound closure ratio in group C was superior to groups A and B after operation (P<0.05). HE staining showed that at 7 days after operation, the wound healing of the three groups entered fibrous proliferation stage. Collagen deposition and inflammatory cell infiltration were observed in the dermis of each group. The proportion of inflammatory cells in group C was significantly lower than that in groups A and B, and in group B than in group A (P<0.01). At 21 days after operation, the fibrous connective tissues of neoepithelium and dermis in groups B and C were arranged neatly, and fibroblasts and neocapillaries could be seen. In group A, neoepidermis could also be seen, but the fibrous connective tissues in dermis were arranged disorderly and sporadic capillaries could be seen. The thickness of neonatal epidermis in group C was significantly larger than that in groups A and B, and in group B than in group A (P<0.01). CD31 immunohistochemistry staining showed that the neovascularization could be seen in all groups. The number of neovascularization in group C was significantly higher than that in groups A and B, and in group B than in group A (P<0.05). ConclusionThe ADSCs/CSCl hydrogel complex has a good biocompatibility and possessed positive effects on promoting the deep partial thickness scald wound repairing in rats.