Abstract:Objective To compare the long-term outcomes of three techniques for repairing wide cleft palate:Bardach method+Furlow method(B-F),Bardach method+Sommerlad method(B-S),and Bardach method alone.Methods A retrospective review of 457 consecutive wide-cleft patients January 2005 to December 2022 was conducted.Based on cleft width and soft-palate muscle develop-ment,patients were allocated to B-F(n=204),B-S(n=143)or Bardach method alone(n=1 10).Post-operative palatal fistula and velopha-ryngeal closure rate were compared among groups.Results Fistula rates were 5.4％(11/204)for B-F,4.9％(7/143)for B-S and 11.8％(13/110)for Bardach method alone.Velopharyngeal closure was achieved in 77.9％(159/204)(B-F),74.8％(110/143)(B-S)and 59.1％(65/110)(Bardach method).B-F and B-S did not differ significantly(P＞0.05),both outperformed Bardach method alone(P＜0.05).Conclusion B-F and B-S method,routinely supplemented with buccal fat pad grafting,yield favourable long-term results in wide cleft palate,reducing fistula risk and improving velopharyngeal closure.

Abstract:Objective To investigate the efficacy of chitosan quaternary ammonium salt bio-colloidal fluid in promoting the heal-ing of incisions after facial plastic surgery.Methods From July 2022 to July 2023,recruiting patients with postoperative wounds were randomly assigned to either an experimental or a control group.Employing a prospective double-blind randomized controlled study design,the control group underwent standardized closure of plastic surgery incisions with regular dressing changes.The experimental group re-ceived chitosan quaternary ammonium salt bio-colloidal spray on the day of surgery,postoperative days 1,4,and 7(suture removal day),with follow-up photography.A 6 months postoperative follow-up assessed incision healing using the visual analog scale(VAS)and evaluat-ed scarring using the modified vancouver scar scale(mVSS).Results Fifty patients with postoperative wounds from facial plastic surgery,25 in each group,were included.Throughout the follow-up,neither group exhibited significant adverse reactions such as allergies or infections.The experimental group demonstrated significantly lower mVSS total scores and scores for scar pigmentation and pliability compared to the control group.Additionally,patient satisfaction with incision healing in the experimental group was notably higher than in the control group.Conclusion In summary,chitosan quaternary ammonium salt bio-colloidal fluid effectively enhances incision healing in facial plastic surgery.It holds clinical application and promotional value by inhibiting scar proliferation.

Abstract:Cleft lip and palate is a common congenital malformation of the orofacial region,characterized by the clefting of lip and palatal soft and hard tissues,which significantly impacts patients both physically and psychologically.The treatment model primarily in-volves multidisciplinary collaboration with surgical reconstruction as the mainstay,while nursing care plays a crucial role throughout the entire process and is a key factor influencing therapeutic outcomes.This study systematically reviewed domestic and international literature,including guidelines,expert consensus statements,systematic reviews,evidence summaries,and original research related to nursing care for patients with cleft lip and palate.Integrating expert experience,we conducted two rounds of Delphi consultations.Based on this work,we propose recommendations for comprehensive nursing care throughout the entire disease course for patients with cleft lip and palate.These recommendations span three phases-pre-hospital,in-hospital,and post-hospital-and cover 16 key aspects,including infant feeding,nu-tritional management,preoperative nursing risk assessment,fluid intake and output management,airway management,postoperative nurs-ing considerations for different surgeries,dietary care,pain management,wound care,observation and management of postoperative com-plications,and psychological support.The study consolidates relevant consensus to provide specialized CLP healthcare professionals with standardized nursing protocols and operational guidelines.This aims to reduce variability and uncertainty in nursing practices,ensure uni-formity and scientific rigor in care quality,and ultimately enhance the overall therapeutic outcomes for CLP patients.

Abstract:Objective To investigate the clinical efficacy of electroacupuncture in alleviating early postoperative pain and swelling(within 72 hours)in patients with dentofacial deformities undergoing orthognathic surgery,and to provide a safe and effective ad-junctive treatment option for acute postoperative management.Methods This randomized controlled trial enrolled 76 patients with dento-facial deformities admitted to the Department of Orthodontics at the Affiliated Stomatological Hospital of Nanjing Medical University be-tween November 2023 and October 2024.Patients were randomly allocated into two groups at a 1:1 ratio(38 patients per group).The con-trol group received conventional analgesic medication and standardized postoperative care.In addition to this standard care,the elec-troacupuncture group received electroacupuncture intervention starting at 6 hours postoperatively.Acupuncture points included LI4(Hegu),ST36(Zusanli),ST6(Jiache),and SJ17(Yifeng).Stimulation was delivered using a sparse-dense wave(2/100 Hz)for 30 minutes once daily for 5 consecutive days.Outcome measures included pain intensity assessed using the visual analog scale(VAS)and swelling e-valuated by changes in the tragus-to-commissure(TC)and outer canthus-to-commissure(OC)distances,measured at 6,12,24,48,and 72 hours postoperatively.Results The electroacupuncture group demonstrated significantly lower VAS scores at all postoperative time points compared to the control group(all P＜0.05).At 72 hours,the pain score decreased to(1.5±0.5)in the electroacupuncture group,compared to(2.8±0.7)in the control group.Regarding swelling assessment,the swelling values(changes in TC and OC distances)in the electroacupuncture group were also significantly smaller than those in the control group at all measurement time points(all P＜0.05).The TC swelling value at 72 hours was(2.5±0.8)mm in the electroacupuncture group versus(4.6±1.2)mm in the control group.Only one mild adverse event(2.6％)was reported in the electroacupuncture group,indicating a favorable safety profile.Conclusion Electroacupuncture is a safe and effective modality for relieving pain and swelling during the acute phase following orthognathic surgery.Its therapeutic effect is superior to conventional analgesic medication alone,positioning it as a preferred adjunctive therapy for enhanced recovery after orthognath-ic surgery.

Abstract:Lip morphology aesthetics is an essential component of overall facial aesthetics and exhibits marked sexual dimorphism.Understanding gender-related differences in lip morphology is crucial for developing refined plastic surgery strategies.Using the keywords"Chinese population"and"lip morphology",a systematic search was conducted in CNKI,Wanfang,VIP,PubMed,and Science Direct databases.Studies were screened according to predefined inclusion and exclusion criteria,and 21 articles were ultimately included.Based on the internationally recognized nomenclature system,surface landmarks of the lips were summarized and the definitions of morphological parameters standardized.The parameters were innovatively categorized into four indicator groups-lip width,lip height,lip convexity,and lip three-dimensionality-for comparative analysis by gender.The results revealed notable differences between Chinese men and women in multiple morphological indicators,particularly in upper and lower white lip height,lip convexity,and lip three-dimensionality.These dif-ferences are closely associated with skeletal structure,soft tissue distribution,and cultural aesthetic preferences.This study is the first to integrate objective morphometric measurements with sociocultural aesthetic analysis,providing evidence-based guidance for the expression of lip sexual characteristics and gender-specific contouring in the Chinese population,and offering important clinical insights for advancing gender-oriented and individualized lip surgery strategies.

Abstract:Objective To evaluate the clinical efficacy of forehead pedicled flap in repairing lower eyelid defects after resection of malignant tumors.Methods From January 2023 to July 2024,nine patients with lower-eyelid cancer underwent reconstruction surgeries.According to the location of the defect,foreheas flaps were used for repair;for medial or inner canthal defects(4 case),the contralaterally based supatrochlear artery flap was adopted,for lateral or outer canthal defects(5 case),the ipsilaterally based superfical temporal artery island flap was selected.Results The 9 patients were followed up for 6 to 12 months.All 9 flaps survived without necrosis,ischemia,or congestion.No patient developed ectropion,lagophthalmos,or keratitis.Eight flaps matched the color and texture of the surrounding eyelid skin.Three flaps were slightly bulky and improved after secondary thinning.Conclusion Forehead pedicled flaps provide a safe,simple,and reliable way to repair lower-eyelid defects after tumor removal,achieving satisfactory functional and aesthetic results.

Abstract:Objective To explore the clinical efficacy of combined osteotomy and bone grinding in treating maxillofacial bone fi-brous dysplasia.Methods From September 2007 to September 2024,17 patients with maxillofacial fibrous dysplasia were treated with a combination of osteotomy and bone grinding.Results The postoperative follow-up was 6 months to 2 years.All 17 cases of maxillofacial bone fibrous dysplasia in this group did not have serious postoperative complications,and the results were satisfactory.Three cases re-pro-liferated 6 months to 2 years after surgery.Conclusion Because it can remove the lesion more accurately,the combined operation method of osteotomy and bone grinding can significantly remove the lesion while protecting the nerve function to the greatest extent and reducing complications.It is an effective technique for dysplasia of maxillofacial bone fibers.

Abstract:Objective To investigate the clinical application of the diamond-shaped flap in the interlabial groove,combined with edge excision for the treatment of labial hypertrophy,combined with lateral clitoral hood hypertrophy.Methods From October 2023 to December 2024,56 patients with labial hypertrophy and lateral clitoral hood hypertrophy were treated at the Department of Medical Aes-thetics,Maternal and Child Health Hospital of Hubei Province.All patients underwent the diamond-shaped flap in the interlabial groove to remove the hypertrophic clitoral hood,while marginal excision was used to reduce the hypertrophic labia minora.Results All patients had primary healing after the surgery,and were followed up for 3 to 6 months.There was no infection,necrosis,or post hematoma of the labia minora and clitoral prepuce.All patients were satisfied with the shape of the labia minora and clitoral prepuce.Conclusion For patients with labial hypertrophy combined with lateral clitoral hood hypertrophy,the diamond-shaped flap in the interlabial groove combined with edge excision offers effective simultaneous aesthetic correction.The method is simple,has few complications,and provides high satisfaction in both function and appearance post-surgery.

Abstract:With the development of the nation and the change in people's lifestyle,the number of pet dogs is increasing,leading to a rise in the incidence of dog bites year by year.Dog bites,as one of the common causes of injury in emergency departments,not only result in surgical trauma but also are accompanied by serious complications such as tetanus,rabies,and infections.The scars and disfigurement caused by poor prognosis after the injury can impose a significant psychological and social burden on the patients.Therefore,dog bites have become a serious public health issue.The key to the diagnosis and treatment of dog bite wounds lies in early intervention,with thorough debridement and disinfection of the wound,wound closure,and prevention of infection being most crucial.Currently,wound closure meth-ods can be mainly divided into primary closure and delayed closure.However,there is still controversy over the choice of wound closure method in clinical practice.Factors such as wound infection rate,scar formation,and aesthetic outcome after wound healing all influence the selection of the closure method.This review aims to explore the advantages and disadvantages of different closure methods for dog bite wounds,providing a reference and basis for the selection of clinical treatment methods.

Abstract:Objective To explore the appropriate drug concentration of 5-fluorouracil combined with triamcinolone acetonide in the treatment of non-ear small keloids with 24 MHz high-frequency ultrasound-assisted evaluation.Methods A prospective randomized controlled study was conducted on 60 patients with non-auricular small keloids who were admitted to the Medical Aesthetic Center of Chengdu Second People's Hospital from December 2022 to December 2023.According to the random number table method,20 cases were divided into low concentration group,medium concentration group and high concentration group,and different concentrations of 5-fluo-rouracil(0.5 mg/ml,2.3 mg/ml,5.0 mg/ml)combined with triamcinolone acetonide(10.0 mg/ml)were used for local injection.The scar vol-ume parameters and blood flow signals were collected by 24 MHz high-frequency ultrasound,and the blood flow signals in keloids were quantitatively evaluated according to the blood flow grading method,and the scar volume,blood flow grade,Vancouver scar scale(VSS)score,adverse reactions,and recurrence after one year of follow-up after the last treatment were compared between the three groups before treatment and 4 weeks after the last treatment.Results Compared with before treatment,4 weeks after the last treatment,the scar volume of the three groups decreased,the blood flow grade decreased,and the VSS score decreased,and the differences were statistically signifi-cant(P＜0.05).Compared with the low concentration group,the scar volume and VSS score of the patients in the medium concentration group and the high concentration group decreased respectively,and the blood flow grade of the high concentration group decreased statisti-cally significant(P＜0.05).Compared with the medium concentration group,the scar volume and VSS score of the patients in the high con-centration group decreased(P＜0.05).There was no significant difference in the incidence of adverse reactions between the three groups(P＞0.05).At one year of follow-up after the end of the last treatment,there was no significant difference in the recurrence rate of keloids between the three groups(P＞0.05).Conclusion 24 MHz high-frequency ultrasound,as an auxiliary evaluation tool,can quantify the vol-ume parameters of the scar,monitor the blood flow signal in the scar,and provide an objective basis for the treatment and evaluation of keloids,which is a promising evaluation method,and the high-concentration 5-fluorouracil combined with triamcinolone acetonide in the treatment of non-ear small keloids has better clinical effects,the scar volume and blood flow signal are significantly improved,there are no obvious adverse reactions,and the clinical efficacy is safe and reliable.

Abstract:Objective To investigate the application effect of artificial dermis and epidermal growth factor(EGF)in burn wound repair.Methods From January 2021 to December 2024,Burn and Plastic Surgery Department,Nanjing Drum Tower Hospital Group An-qing Petrochemical Hospital included 82 burn patients were selected and divided into group A(artificial dermis treatment)and group B(ar-tificial dermis combined with EGF treatment)according to treatment methods,41 cases in each group.The two groups of clinical data were compared.Results The hospitalization time,dressing change times,wound healing time and granulation growth time in group B were shorter(P＜0.05).Three weeks after operation,the visual analogue scale(VAS)score,the serum of interleukin-10(IL-10)and C-reactive protein(CRP)levels in both groups decreased,while those in group B were higher(P＜0.05).The total effective rate in group B(82.93％)was higher than that in group A(52.54％),P＜0.05.Six months after operation,the scores of Vancouver Scar Scale(VSS)in group B were lower(P＜0.05).There was no statistical difference in the total incidence of complications between the two groups(P＞0.05).Conclusion Artificial dermis combined with EGF has a good effect in burn wound repair,which can effectively reduce the level of inflammatory factors,promote wound healing and reduce scar formation.

Abstract:Objective To analyze the efficacy and safety of autologous skin transplantation combined with vacuum sealing drainage(VSD)and autologous platelet-rich plasma(PRP)gel in treating refractory diabetic foot ulcer.Methods The study subjects included 78 patients with refractory diabetic foot ulcer received by Department of Plastic Surgery,Tianmen First People's Hospital from June 2023 to November 2024.According to the random number table,they were assigned into the regular group(VSD+PRP gel)and the combined group(VSD+PRP gel+autologous skin transplantation).The wound healing,pain degree,safety,efficacy,diabetes foot ulcer healing scale(DMIST)score,and the changes in vascular growth factor and inflammatory factors were compared between before and after treatment.Results After treatment 1 month,the matrix metalloproteinase-9(MMP-9),tumor necrosis factor-α(TNF-α),procalcitonin(PCT),monocyte chemoattractant protein-1(MCP-1),numerical rating scale score(NRS)and DMIST score in both groups decreased(P＜0.05),and with the combined group being lower than the regular group(P＜0.05);the platelet-derived growth factor(PDGF)and basic fibroblast growth factor(bFGF)increased in both groups(P＜0.05),and with the combined group being higher than the regular group(P＜0.05).The combined group had shorter wound healing time than the regular group(P＜0.05).The combined group showed prominently higher efficacy(89.74％)than the regular group(69.23％)(P＜0.05),but there was no prominent difference in the incidence of untoward reactions(P＞0.05).Conclusion Autologous skin transplantation combined with VSD and PRP gel can accelerate the process of wound healing in patients with refractory diabetic foot ulcer,and it is effective and safe.

Abstract:Mayer-Rokitansky-Küster-Hauser(MRKH)syndrome and vaginal atresia are two important causes of primary amen-orrhea.MRKH syndrome is characterized by normal ovarian development,uterine and vaginal upper 2/3 hypoplasia,and the clinical mani-festation of congenital vaginal atresia is well-developed ovaries and uterus,but the vagina is completely atretic.Currently,there are many treatment options for these two diseases,but no unified treatment strategy has been formed.The purpose of this review is to summarize the pathogenesis,clinical manifestations and diagnosis of MRKH syndrome and congenital atresia,the influence on the mental health of pa-tients and the treatment plan,and discuss the surgical methods combined with the treatment experience of our department.

Abstract:Objective To explore the clinical effect of using the perforator muscle flap of the superficial peroneal artery to repair the wound of finger(toe)bone defect.Methods This study was a retrospective observational study.From April 2022 to July 2024,15 pa-tients with finger(toe)bone defect wounds who met the inclusion criteria were admitted to Suzhou Ruihua Orthopedic Hospital.There were a total of 15 wounds,including 9 finger wounds and 6 toe wounds;15 cases of bone defect wounds after injury,among which 8 cases were complicated with bone infection wounds.The wound area was 3.6 cm × 1.6 cm to 8.0 cm × 4.0 cm.The volume of the phalangeal defect ranges from 0.5 cm × 0.5 cm × 0.5 cm to 1.5 cm × 1.0 cm × 1.0 cm.The perforator muscle flap of the superficial peroneal artery was used to repair the wound,and the carried muscle was used to fill the bone defect cavity.The flap was harvested with an area of 5.0 cm × 2.0 cm to 12.0 cm × 4.5 cm,and the volume of the carried muscle was 1.5 cm × 1.0 cm × 0.5 cm to 5.0 cm × 2.0 cm × 1.0 cm.The donor sites of the flaps were all directly sutured.The survival of the flaps and the healing of the donor site wounds were observed after the operation.The oc-currence of infection was followed up.The clinical efficacy of the perforator muscle flap of the superficial peroneal artery was evaluated us-ing the flap comprehensive evaluation scale.Results All 15 perforator muscle flaps of the superficial peroneal artery survived smoothly;the donor sites healed in the first stage.During the follow-up period of 2 to 13 months,no recurrence of infection occurred in the bone de-fect wounds.The total score of the flap comprehensive evaluation scale was 100 points,and the scores of the 15 patients ranged from 71 to 93 points,with an average of 85 points.The comprehensive evaluation was excellent in 9 cases,good in 5 cases,and fair in 1 case,with an excellent and good rate of 93.3％.Conclusion The application of the perforator muscle flap of the superficial peroneal artery to repair the wound of finger(toe)bone defect can effectively fill the dead space and improve local blood circulation,reduce the recurrence of infection,cause less damage to the donor site,and achieve satisfactory therapeutic effects.

Abstract:Objective The recurrence rate of auricular keloid(EKD)after surgery is high,and radiotherapy is an effective means to reduce recurrence.However,the optimal timing of radiotherapy remains controversial.This study aimed to compare the effects of different postoperative radiotherapy timings(＜7 hours and 7～24 hours)on the recurrence rate and patient satisfaction of EKD.Methods A retro-spective cohort study design was adopted,including 193 patients with EKD who underwent surgery combined with radiotherapy at the First Affiliated Hospital of Xinjiang Medical University from June 2023 to July 2024.The radiotherapy dose was adjusted according to the thick-ness of the scar(17.5～20.0 Gray),and the patients were divided into the＜7 hours group(n=108)and the 7～24 hours group(n=85)based on the timing of radiotherapy.Results The total effective rates of the＜7 hours group and the 7～24 hours group were 92.59％and 89.41％respectively(P=0.884),and the satisfaction rates were 91.66％and 85.88％respectively(P=0.060),with no statistically significant differ-ences(P＞0.05).No severe radiotherapy-related adverse reactions were reported.Conclusion Radiotherapy within 24 hours after surgery can effectively inhibit the recurrence of EKD,and the therapeutic effects and satisfaction rates of radiotherapy within＜7 hours and 7～24 hours are comparable.Future studies need to expand the sample size and extend the follow-up period to verify the long term effects.

Abstract:Objective The effect of Astragalus injection on the growth of human hypertrophic scar fibroblasts(HSFB)was ex-plored.Methods From January to March 2024,sixteen patients who visited the Second Affiliated Hospital of Shenyang Medical College were selected.With the patients' consent,hypertrophic scar(HS)tissues removed during surgery were collected,and hypertrophic scar fi-broblasts(HSFB)were extracted from them for cell experiments.Eleven groups were observed(blank group,control group,Astragalus in-jection 5 mg/ml group,20 mg/ml group,40 mg/ml group,60 mg/ml group,80 mg/ml group,100 mg/ml group,120 mg/ml group,140 mg/ml group,160 mg/ml group),and they were cultured in vitro for 12,24,36,48 h respectively.The effect of different concentrations of Astra-galus injection on the growth ability of HSFB was observed by CCK8 assay,the inhibition rate was calculated,the IC50 curve was drawn,and the cytotoxicity and the relationship between the inhibition rate and the drug concentration and time were detected to select the appro-priate drug concentration for subsequent experiments.The effect of different concentrations of Astragalus injection on the migration ability of fibroblasts was observed by Transwell assay and scratch assay.The effect of different concentrations of Astragalus injection on the apop-tosis of HSFB was observed by Annexin Ⅴ-Propidium iodide(AV-PI)technology.The effect of different concentrations of Astragalus injec-tion on the expression of type Ⅰ collagen(CollagenⅠ),cell cycle protein(Cyclin D1)and apoptosis regulatory protein(Bel-2)in HSFB was detected by Western blot assay.Results The IC50 curve indicated that the inhibition rate of Astragalus injection on HSFB was time-and concentration-dependent,and it had a non-toxic inhibitory effect on cells.Five concentrations were selected for data analysis.The CCK8 assay results showed that after Astragalus injection intervened HSFB for 12,24,36,48 h,the 20 mg/ml,40 mg/ml,60 mg/ml and 80mg/ml drug concentration groups inhibited the proliferation of HSFB to varying degrees compared with the control group(P＜0.05).There was no significant difference in the OD value of HSFB between the 5 mg/ml group and the control group(P＞0.05);there was no significant differ-ence in the OD value of HSFB between the 80 mg/ml group and the 60 mg/ml group(P＞0.05).Subsequently,20 mg/ml,40 mg/ml and 60 mg/ml drug concentrations were used for experiments.The Transwell assay and scratch assay results showed that Astragalus injection inhibited the proliferation and migration of HSFB to varying degrees,and the inhibitory effect increased with the increase of Astragalus injection concen-tration(P＜0.05).The AV-PI assay results showed that Astragalus injection increased the apoptosis rate of HSFB to varying degrees(P＜0.05).The Western blot assay results showed that Astragalus injection down-regulated the expression of CollagenⅠ,Cyclin D1 and Bcl-2,and the down-regulation effect increased with the increase of Astragalus injection concentration(P＜0.05).Conclusion Astragalus injection can inhibit the proliferation and migration of HSFB and induce their apoptosis by down-regulating the expression of CollagenⅠ,Cyclin D1 and Bcl-2,and the effect is concentration-dependent.

Abstract:Objective To investigate the effects of the flow-through type anterolateral femoral perforators flap pedicled with the oblique branch of lateral circumflex femoral artery in repairing wound on the back of the hands caused by hot pressure injury.Methods From March 2021 to July 2024,Department of Hand Surgery,Suzhou Ruihua Orthopedic Hospital used the flow-through type anterolateral femoral perforators flap pedicled with the oblique branch of lateral circumflex femoral artery to repair wound on the back of the hands of 15 patients caused by hot pressure injury.There were 6 cases of left hand,8 cases of right hand,1 case of both hands,2 cases of back of hand,13 cases of back of hand and fingers.The wound area ranged from 5.0 cm × 4.0 cm to 18.0 cm × 9.0 cm,and the flap area ranged from 6.0 cm × 5.0 cm to 20.0 cm × 10.0 cm.The flap donor sites of all patients were sewn directly.All flaps are repaired 7 to 14 days after the injury.The survival of all flaps was observed postoperatively,and the appearance and feeling of the flaps and the functional recov-ery of the donor and recipient sites were followed up regularly.Results All 15 flaps in this study survived.Postoperative follow-up time ranged from 6 to 13 months,with an average of 8 months.All 15 patients underwent flap thinning 3 to 6 months after surgery,and 4 of them underwent syndactyly division surgery at the same time as flap thinning.At the last follow-up visit,all patients had good flaps,feeling re-stored to S1 to S2,linear scars remained at the donor site of the thigh,and the walking function of the lower limbs was normal.The efficacy of flap repair was evaluated according to the comprehensive flap evaluation scale.The results were rated as excellent in 11 cases,good in 4 cases.The hand function of the patients in this study was evaluated using the trial standard for partial upper limb function evaluation of the Branch of Hand Surgery of the Chinese Medical Association.The results were rated as excellent in 5 cases,good in 7 cases,and fair in 3 cases,with an excellent and excellent rate of 80％.Conclusion The flow-through type anterolateral femoral perforators flap pedicled with the oblique branch of the lateral circumflex femoral artery can reduce the damage to the donor site and avoid damage to the blood sup-ply to the recipient site.This surgical method can achieve satisfactory recovery of hand function and appearance,and is an ideal surgical method for repairing hot pressure injuries on the back of the hand.

Abstract:Objective To investigate the application of a modified negative pressure wound therapy(NPWT)technique that we could monitor the flap by a small window at negative pressure dressings.Methods From October 2021 to November 2023,46 patients who underwent flap reconstruction in the Department of Plastic Surgery of the First Affiliated Hospital of Naval Medical University.Among them,23 cases were in the control group and 23 cases were in the study group.In the control group,each flap was covered with convention-al dressing for flap monitoring.In the study group,the flap was covered with negative pressure dressing which contains a small window for monitoring the distal end of the flap.All patients were followed up for at least one year.The incidence of postoperative complications in both groups were statistically analyzed.Results Neither of patients presented flap necrosis after the operation.Compared with the control group,the occurrence of complications was less frequent in the study group.In terms of the self-rating anxiety scale(SAS),the postopera-tive anxiety score of the study group(35.48±12.02)score was significantly lower than that of the control group(52.17±11.83)score(P＜0.05).The degree of postoperative pain in the study group was significantly milder than that in the control group(P＜0.05).After a one year follow-up,by the Vancouver scar scale(VSS),the control group was higher than the study group,and the difference was statistically significant(P＜0.05).Conclusion The negative pressure placement observation window can more effectively monitor the vitality of the flap,reduce the occurrence of flap complications,and improve the physical and mental health of.

Abstract:The formation of scars,accompanied by continuous changes in normal tissue structure,is the result of wound healing and fibrotic disorders.When the skin is damaged,fibroblasts proliferate and secrete collagen fibers to promote wound healing.However,if this proliferation and secretion are out of control,it will lead to the formation of abnormal scars,manifested as disordered arrangement of collagen fibers and dermal fibrosis,and then cause excessive fiber hyperplasia.Transforming growth factor-β(TGF-β)is a multi-direc-tional differentiation,proliferation,migration and immune regulatory factor.It can transform the phenotype of normal fibroblasts and is in-volved in the Extracellular matrix at the same time.The secretion and differentiation of ECM and other physiological processes have exten-sive biological significance.This article mainly focuses on the two special isomers,TGF-β1 and TGF-β3,elaborating on their expression at different development stages of pathological scars,as well as the possible feedback regulatory mechanisms between the two isomers.It pro-vides a review to offer experimental basis and research ideas for the further clinical application of TGF-β factors in the treatment of patho-logical scars.

Abstract:Objective To explore the clinical efficacy of using retrograde medial plantar island flap to repair tissue defect wounds after resection of forefoot tumors.Methods A retrospective analysis was conducted on the clinical data of 11 patients with tissue defects following anterior plantar tumor resection,who were admitted to the Department of Burn and Plastic Surgery,Naval Medical Center of PLA from November 2021 to July 2024.Based on the anatomical feature that there is extensive anastomosis between the terminal branch of the medial plantar artery,the lateral plantar artery,the first dorsal metatarsal artery and its plantar deep branch,a retrograde medial plantar is-land flap was designed to repair the tissue defect wounds after resection of forefoot tumors,and the donor site was repaired by direct skin grafting.Dressing removal was performed 7 days postoperatively to assess the survival of skin grafts at the donor sites.After the flaps achieved complete healing,patients were guided to conduct gradual rehabilitation exercises.The color and texture of the flaps,as well as the appearance and function of the feet,were evaluated.Results All the transferred flaps in 11 patients survived,and the skin grafts at the donor sites survived well.During the 6 to 12 months of postoperative follow-up,the transferred flaps exhibited a satisfactory appearance without redundancy,and the motor function of the feet and toes was well preserved.Conclusion The application of retrograde medial plantar island flap yields favorable outcomes in repairing skin and soft tissue defect wounds after resection of forefoot tumors.