Aim To investigate the growth-inhibition and the mechanism of apoptosis induced by sophoridine(SRI) on SW620 cells.Method MTT assay was used to detect the half-inhibition concentration(IC50),and fluorescence microscopy,electron microscopy,DNA fragmentation analysis,flow cytometry(FCM) were used to demonstrate the presence of apoptosis.Results SRI inhibited the growth of SW620 cells significantly in a dose-and time-dependent manner,and morphological characteristics of apoptosis were observed with condensation of nucleus,bubble of cytoplasm,fragment of nucleus.A DNA ladder pattern of internucleosomalfragmentation was observed.Compared with that of control group,the percentage of the G0/G1 phase and the Sphase cells increased after treated by SRI.SW620 cells were induced to undergo apoptosis and underwent G0/G1 arrest with exposure to SRI shown by FCM.Conclusions Sophoridine could induce the inhibition of cell growth by means of apoptosis in a dose-and time-dependent manner,and the blocking of G0/G1 phase of cells was involved in the mechanism of apoptosis.

Objective To examine neuroinflammation,oxidative damage and neuron loss in the contralateral parie-tal lobecortex of TBI model mice, and to investigate effects of berberine chloride on such secondary damage.Methods TBI model was established by a weight-drop hitting device and mice in berberine group were administered intragastrically with berberine chloride (50mg/kg.day) for 21 days.Immunofluorescence staining was used to assess activity of microglia and astrocyte.Immunohistochemistry was used to assess DNA oxidative damage, neuron loss and expression of COX-2 and iN-OS.Results Activation of microglia and astrocyte, expressions of COX-2 and iNOS and DNA oxidative damage were ob-viously increased by TBI,(19.82 ±1.88)and(16.96 ±1.69)、(13.79 ±4.32)and(8.67 ±0.96)、(27.86 ±5.38) and (16.00 ±7.59)、(31.92 ±6.57)and(24.79 ±2.78)respectively (P<0.01 or P<0.05).Activation of microglia and ex-pressions of COX-2 and iNOS were significantly suppressed by berberine ,(15.49 ±1.88)and(19.82 ±1.88)、(16.83 ± 7.89)and(27.86 ±5.38)、(26.25 ±2.41)and(31.92 ±6.57) respectively(P<0.01 or P<0.05).There was no differ-ence in neuron loss among three groups, (49.05 ±4.38),(48.56 ±3.56)and (47.75 ±4.14) respectively (P>0.05). Conclusions TBI can cause neuroinflammation and oxidative damage but not neuron loss in the contralateral parietal lobe cortex.Berberine chloride can significantly suppress neuroinflammtion in the contralateral parietal lobe cortex after TBI.

ObjectiveTo understand the death status of major chronic diseases among the registered residents in Xuhui District， Shanghai from 2007 to 2021， and to analyze the probability and trend of premature death， so as to provide an evidence for the policy-making of disease control and prevention. MethodsBased on the data from the death registration system of the registered residents in Xuhui District， Shanghai from 2007 to 2021， the mortality rate of major chronic diseases， life expectancy without cause of death， potential years of life lost （PYLL）， average years of life lost （AYLL）， and premature death rate were calculated. Joinpoint 4.8 software was used to calculate the annual percentage change （APC） of premature death rate and its trend. ResultsIn 2021， the mortality rate and standardized mortality rate of four major chronic diseases， namely cardiovascular and cerebrovascular diseases， malignant tumors， diabetes mellitus and chronic lower respiratory diseases among the registered residents in Xuhui District， Shanghai was 767.75/100 000 and 234.69/100 000， respectively， accounting for 85.63% of the total causes of death among the residents in Xuhui District， Shanghai. The PYLL， AYLL and PYLL rate were 10 710.00 person-years， 1.49 years per person， and 11.43‰， respectively. Life expectancy increased by 14.91 years after removing the four major chronic diseases. From 2007 to 2021， the premature death rate of chronic diseases among the registered residents in Xuhui District decreased from 9.38% to 7.91% （APC=-1.09%，P<0.05）. Malignant tumors had the highest rate in premature death， and the premature death rate was higher in males than that in females， with a slower rate of decline than in females. Cardiovascular and cerebrovascular diseases， malignant tumors and chronic lower respiratory diseases showed a significant decreasing trend in premature death rate （APC=-1.30%， -1.20%， -5.42%， P<0.05）， while diabetes mellitus showed a significant increasing trend in premature death rate （APC=3.20%， P<0.05）. There was a significant increasing trend in the rate of premature death from diabetes mellitus in males （APC=5.15%， P<0.05） and a decreasing trend in the rate of premature death from diabetes mellitus in females （APC=-0.76%， P<0.05）. ConclusionCardiovascular and cerebrovascular diseases， malignant tumors， diabetes mellitus and chronic lower respiratory diseases are the main causes of death among the registered residents in Xuhui District. The probability of premature death of the residents in Xuhui District from major chronic diseases is at a low level， indicating that the prevention and control of chronic diseases in Xuhui District has achieved some success， but it is still difficult to realize the goals of the Outline of the "Healthy China 2030" Plan. Therefore， it is necessary to comprehensively carry out the control of risk factors such as tobacco use， harmful alcohol consumption， salt intake， hypertension， hyperglycemia and obesity， especially to strengthen the control of risk factors for male residents， as well as early diagnosis and treatment of malignant tumors， cardiovascular and cerebral vascular diseases and diabetes mellitus， and to implement the disease management mechanism to reduce premature death.

OBJECTIVETo investigate the effects of lung protective ventilation strategy combined with lung recruitment maneuver on ARDS complicating patients with severe burn.

METHODSClinical data of 15 severely burned patients with ARDS admitted to our burn ICU from September 2011 to September 2013 and conforming to the study criteria were analyzed. Right after the diagnosis of acute lung injury/ARDS, patients received mechanical ventilation with lung protective ventilation strategy. When the oxygenation index (OI) was below or equal to 200 mmHg (1 mmHg = 0. 133 kPa), lung recruitment maneuver was performed combining incremental positive end-expiratory pressure. When OI was above 200 mmHg, lung recruitment maneuver was stopped and ventilation with lung protective ventilation strategy was continued. When OI was above 300 mmHg, mechanical ventilation was stopped. Before combining lung recruitment maneuver, 24 h after combining lung recruitment maneuver, and at the end of combining lung recruitment maneuver, variables of blood gas analysis (pH, PaO2, and PaCO2) were obtained by blood gas analyzer, and the OI values were calculated; hemodynamic parameters including heart rate, mean arterial pressure (MAP), central venous pressure (CVP) of all patients and the cardiac output (CO), extravascular lung water index (EVLWI) of 4 patients who received pulse contour cardiac output (PiCCO) monitoring were monitored. Treatment measures and outcome of patients were recorded. Data were processed with analysis of variance of repeated measurement of a single group and LSD test.

RESULTS(1) Before combining lung recruitment maneuver, 24 h after combining lung recruitment maneuver, and at the end of combining lung recruitment maneuver, the levels of PaO2 and OI of patients were respectively (77 ± 8), (113 ± 5), (142 ± 6) mmHg, and (128 ± 12), (188 ± 8), (237 ± 10) mmHg. As a whole, levels of PaO2 and OI changed significantly at different time points (with F values respectively 860. 96 and 842. 09, P values below 0. 01); levels of pH and PaCO2 showed no obvious changes (with F values respectively 0.35 and 3.13, P values above 0.05). (2) Levels of heart rate, MAP, CVP of all patients and CO of 4 patients who received PiCCO monitoring showed no significant changes at different time points (with F values from 0. 13 to 4. 26, P values above 0.05). Before combining lung recruitment maneuver, 24 h after combining lung recruitment maneuver, and at the end of combining lung recruitment maneuver, the EVLWI values of 4 patients who received PiCCO monitoring were respectively (13.5 ± 1.3), (10.2 ± 1.0), (7.0 ± 0.8) mL/kg ( F =117.00, P <0.01). (3) The patients received mechanical ventilation at 2 to 72 h after burn, lasting for 14-32 (21 ± 13) d. At post injury day 3-14 (7 ± 5) d, lung recruitment maneuver was applied for 2-5 (3.0 ± 2.0) d. All 15 patients recovered without other complications.

CONCLUSIONSLung protective ventilation strategy combining lung recruitment maneuver can significantly improve the oxygenation in patients with severe burn complicated with ARDS and may therefore improve the prognosis.

Acute Lung Injury ; physiopathology ; therapy ; Blood Gas Analysis ; Burns ; complications ; Extravascular Lung Water ; Hemodynamics ; Humans ; Positive-Pressure Respiration ; Respiration, Artificial ; methods ; Respiratory Distress Syndrome, Adult ; complications ; physiopathology ; therapy ; Treatment Outcome

Objective:To systematically evaluate the clinical efficacy and safety of autologous platelet-rich concentrate in facial fat transplantation.Methods:By combining subject headings with free words, the randomized controlled trials of platelet-rich concentrate combined with autologous fat grafting (AFG) on improving facial morphology were searched in domestic and foreign databases (PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Database, VIP Database) published in Chinese and English from database establishment to April 2023. According to inclusion and exclusion criteria, NoteExpress was used to screen relevant literatures, quality evaluation and data extraction were carried out for the final included literatures, and statistical analysis of the data was carried out using Review Manager 5.4 and Stata 15.0. For the count data, the risk ratio ( RR) was used as the statistical effect index, and the Mantel-Haenszel(M-H) hierarchical analysis method was used to calculate the combined results. For the measurement data, mean difference ( MD) was used as the statistical effect indicator, and the combined results were calculated by the inverse-variance(I-V) method. The heterogeneity among the studies was comprehensively tested by Q test combined with I2 statistic. If there was high heterogeneity among the studies, the random effect model was used for statistical analysis. Otherwise, the fixed effect model was used for statistical. Results:A total of 1 238 literatures were retrieved, and 19 randomized controlled trials involving 1 168 patients were eventually included after screening. The papers were all published within the last 10 years, mainly by Chinese authors. In the experimental group, the intervention measures of four studies were platelet-rich fibrin combined with AFG, two studies were concentrated growth factor combined with AFG, and the other thirteen studies were platelet-rich plasma combined with AFG. The results showed that: compared with fat transplantation alone, the addition of platelet-rich concentrate could improve the long-term fat retention rate ( MD=18.20%, 95% CI 14.03%-22.37%, P<0.001) and increase the operative response rate ( RR=1.22, 95% CI 1.15-1.29, P<0.001), shorten the postoperative recovery time ( MD=-4.18 d, 95% CI -7.01 d to -1.34 d, P=0.004), and reduce the incidence of secondary surgery ( RR=0.24, 95% CI 0.15-0.40, P<0.001), furthermore, patient satisfaction was improved ( RR=1.25, 95% CI 1.17-1.33, P<0.001). In addition, the incidence of complications during treatment was reduced ( RR=0.35, 95% CI 0.24-0.51, P<0.001). Conclusion:The efficacy and safety of platelet-rich concentrate assisted fat transplantation on face are worthy of recognition, and more large-scale and multi-center studies are needed for further clinical promotion.

Objective:To systematically evaluate the clinical efficacy and safety of autologous platelet-rich concentrate in facial fat transplantation.Methods:By combining subject headings with free words, the randomized controlled trials of platelet-rich concentrate combined with autologous fat grafting (AFG) on improving facial morphology were searched in domestic and foreign databases (PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang Database, VIP Database) published in Chinese and English from database establishment to April 2023. According to inclusion and exclusion criteria, NoteExpress was used to screen relevant literatures, quality evaluation and data extraction were carried out for the final included literatures, and statistical analysis of the data was carried out using Review Manager 5.4 and Stata 15.0. For the count data, the risk ratio ( RR) was used as the statistical effect index, and the Mantel-Haenszel(M-H) hierarchical analysis method was used to calculate the combined results. For the measurement data, mean difference ( MD) was used as the statistical effect indicator, and the combined results were calculated by the inverse-variance(I-V) method. The heterogeneity among the studies was comprehensively tested by Q test combined with I2 statistic. If there was high heterogeneity among the studies, the random effect model was used for statistical analysis. Otherwise, the fixed effect model was used for statistical. Results:A total of 1 238 literatures were retrieved, and 19 randomized controlled trials involving 1 168 patients were eventually included after screening. The papers were all published within the last 10 years, mainly by Chinese authors. In the experimental group, the intervention measures of four studies were platelet-rich fibrin combined with AFG, two studies were concentrated growth factor combined with AFG, and the other thirteen studies were platelet-rich plasma combined with AFG. The results showed that: compared with fat transplantation alone, the addition of platelet-rich concentrate could improve the long-term fat retention rate ( MD=18.20%, 95% CI 14.03%-22.37%, P<0.001) and increase the operative response rate ( RR=1.22, 95% CI 1.15-1.29, P<0.001), shorten the postoperative recovery time ( MD=-4.18 d, 95% CI -7.01 d to -1.34 d, P=0.004), and reduce the incidence of secondary surgery ( RR=0.24, 95% CI 0.15-0.40, P<0.001), furthermore, patient satisfaction was improved ( RR=1.25, 95% CI 1.17-1.33, P<0.001). In addition, the incidence of complications during treatment was reduced ( RR=0.35, 95% CI 0.24-0.51, P<0.001). Conclusion:The efficacy and safety of platelet-rich concentrate assisted fat transplantation on face are worthy of recognition, and more large-scale and multi-center studies are needed for further clinical promotion.

Objective:To explore the effect of adjusting elective operation response time and corresponding comprehensive reform measures on the operating effect of Operating Room.Methods:From July to December 2019, the response time of elective surgery at Peking University Third Hospital was adjusted, a multi-departmental collaboration system was established, and the Operating Room management system and reward and punishment mechanism were optimized. The corresponding Operating Room medical indexes in 2018 and 2019 were reviewed and analyzed. Changes of Operating Room workload, overtime work of nursing staff in operating room, supplementary time and relaxation allowance and other indicators were compared before and after the reform.Results:Compared with January to June 2018, the number of surgeries from January to June 2019 increased ( t=-7.249, P<0.001) , and the number of overtime hours worked by nursing staff in the Operating Room increased ( t=-5.364, P=0.003) . There was no statistically significant difference in the number of relaxation allowance hours ( t=0.433, P=0.683) . After the implementation of the reform, compared with July to December 2018, the number of surgeries increased from July to December 2019 ( t=-7.112, P<0.001) , and the difference in overtime hours was not statistically significant ( t=0.433, P=0.683) , the number of relaxation allowance hours increased ( t=-8.412, P<0.001) . Conclusions:The adjustment of the response time for elective surgery and implementation of multi-department cooperation and support can optimize the Operating Room management system and reward and punishment mechanism, improve the operating efficiency while maintaining the operating room operation safety and ensure the rest time of the Operating Room nurses.

Objective:To explore the clinical effect of a pedicled gracilis musculocutaneous flap on reconstruction of chronic sinus wounds in inguinal region.Methods:From September 2015 to June 2023, 10 patients with chronic inguinal sinus wounds were treated in Medical Centre of Burn Plastic and Wound Repair, the First Affiliated Hospital of Nanchang University. The patients were 6 males and 4 females, aged 15-72 years old with an average age of 45 years old. Causes of injury: 4 patients were of non-healed wound after inguinal lymph node dissection for external genital or penile cancer, 2 of chronic radiation ulcers formed in the inguinal area after radiotherapy, 2 of femoral artery angiography site non-healing after lower limb artery balloon angioplasty, 1 of wound non-healing after resection of inguinal protuberant skin fibrosarcoma, and 1 of non-healing ulceration after repeated scratching due to inguinal pruritus. The wounds were all chronic in the groin region, all with a course over 30 days and sinus formation. Soft tissue defects on the surface of wounds ranged from 2.0 cm × 3.0 cm to 5.0 cm × 7.0 cm, and the depth of the sinus was from 2.0 cm to 5.0 cm. After debridement, ipsilateral gracilis musculocutaneous flaps were taken for defect reconstruction. Size of the flaps was 3.5 cm × 4.0 cm - 8.0 cm × 9.0 cm, the length of the gracilis musculocutaneous composite flaps was 16.0 - 24.0 cm, and the volume of the flap was 96.0 - 180.0 cm 3. The gracilis tissue of the flap was filled into the sinus tract and the wound was covered by the cutaneous tissue of the flap. Donor sites of the flap were pulled together and directly sutured. After surgery, hip movements were avoided and appropriately raised the affected limb, observed the survival of gracilis musculocutaneous flap as well as the healing of donor site. Scheduled postoperative follow-ups were conducted through the visits of outpatient clinic and interviews via WeChat or Internet hospital. Results:All the flaps survived. One flap had bleeding at the edge of flap within 24 hours after surgery and resulted in suture dehiscence. After bedside haemostasis, debridement and re-suture, it was healed. All donor sites achieved primary healing. All of the 10 patients were included in the postoperative follow-up for 6-21 months, with an average of 13 months. The flaps were in good colour and appearance, and the patients were satisfactory with the appearance. Scars were seen in the donor sites, but there was no obvious functional impairment. During the follow-up, no flap rupture occurred.Conclusion:The pedicled gracilis musculocutaneous flap is used to reconstruction of chronic inguinal sinus wounds, which can fully fill the sinus tract and simultaneously reconstruct the soft tissue defect of wound. This surgery is simple, practical and with good clinical efficacy.

Objective:To study the changes of early (i.e., within post injury day (PID) 14) coagulation function in patients with severe burns.Methods:A retrospective case series study was conducted. From December 2018 to December 2019, 50 severe burn patients who met the inclusion criteria were admitted to Guangzhou Red Cross Hospital of Jinan University. According to the severity of burns, the patients were divided into severe burn group (17 cases, including 12 males and 5 females) and extremely severe burn group (33 cases, including 26 males and 7 females). The platelet count (PLT), and conventional coagulation indexe and thromboelastogram index levels of patients were collected at admission, post injury hour (PIH) 48 and 72, and on PID 7 and 14. The conventional coagulation indexes included prothrombin time (PT), thrombin time (TT), activated partial prothrombin time (APTT), and fibrinogen (FIB) and D-dimer levels. The thromboelastogram indexes included coagulation angle (i.e., α angle), coagulation composite index (CI), MA value, R value, and K value (reflecting maximum amplitude, coagulation reaction time, and blood agglutination time, respectively). Data were statistically analyzed with independent sample t-test, Wilcoxon rank sum test, and chi-square test. Verification of the mixed effect model was performed on each index data of patients in the two groups, while the repeated measures analysis of variance was performed on PLT. Pearson correlation analysis or Spearman correlation analysis were performed to analyze the correlation between the thromboelastogram index data (except CI) and the PLT and conventional coagulation index data, respectively. Results:At admission, PIH 48 and 72, and on PID 7 and 14, PLT of patients in severe burn group were (203±91), (148±70), (123±63), (203±62), (402±140)×10 9/L, respectively, PLT of patients in extremely severe burn group were (235±116), (145±71), (109±52), (235±106), (455±138)×10 9/L, respectively. In overall comparison, only the difference of the main effect of time factor was statistically significant ( F=92.55, P<0.05). In severe burn group, statistically significant differences were only identified in comparison of patients' PLT between PID 7 and the adjacent two time points (at PIH 72 and on PID 14, with both P values <0.05). The differences in PLT of patients between all the adjacent time points in extremely severe burn group were statistically significant ( P<0.05). In the overall comparison of PT, TT, and FIB level of patients in the two groups at each time point, only the difference of main effect of time factor was statistically significant (with F values of 6.04, 8.45, and 32.90, respectively, all P values <0.05), and APTT and FIB level of patients in extremely severe burn group within PID 14 were higher than those in severe burn group. There were statistically significant differences in MA value, α angle, K value, and CI of patients in the two groups at each time point (with F values of 18.82, 11.38, 9.11, and 9.42, respectively, all P values <0.05). MA value was moderately correlated with PLT ( r=0.69, P<0.05), weakly correlated with TT and FIB level (with r values of -0.29 and 0.30 respectively, P<0.05), and very weakly correlated with D-dimer level ( r=-0.15, P<0.05); α angle was moderately correlated with PLT ( r=0.58, P<0.05), and weakly correlated with FIB level and TT (with r values of 0.26 and -0.29, respectively, P<0.05); R value was weakly correlated with APTT and FIB level (with r values of 0.24 and 0.31, respectively, P<0.05), and very weakly correlated with PT and TT (with r values of 0.16 and 0.14, respectively, P<0.05); K value was moderately correlated with PLT ( r=-0.59, P<0.05), and weakly correlated with FIB and TT (with r values of -0.29 and 0.32, respectively, P<0.05), and very weakly correlated with D-dimer level ( r=-0.15, P<0.05). Conclusions:Severe burn patients are already characterized with coagulation function changes in early stage, including insufficiency of coagulation function, enhanced platelet aggregation ability and enhanced FIB function. There is a certain correlation between conventional coagulation indexes and thromboelastogram indexes, but they cannot replace each other.

OBJECTIVETo investigate the effects of unified surgical scheme for wounds on the outcome of patients with extensive deep partial-thickness to full-thickness (briefly referred to as deep) burn.

METHODSOne hundred and thirty-seven patients with extensive deep burn hospitalized from July 2007 to November 2012 underwent unified surgery according to area of deep wound (unified scheme group, US). Among them, 57 patients with deep wound area less than 51% TBSA received escharectomy or tangential excision by stages followed by autologous mesh skin grafting; 52 patients with deep wound area from 51% to 80% TBSA underwent escharectomy or tangential excision by stages followed by autologous mesh skin grafting and/or small skin grafting, or escharectomy or tangential excision followed by large sheet of allogeneic skin covering plus autologous mesh skin grafting and/or small skin grafting after the removal of allogeneic skin; 28 patients with deep wound area larger than 80% TBSA received escharectomy or tangential excision by stages followed by autologous microskin grafting plus coverage of large sheet of allogeneic skin, or escharectomy or tangential excision followed by small autologous skin grafting and/or intermingled grafting with small autologous and/or allogeneic skin. Another 120 patients with extensive deep burn hospitalized from January 2002 to June 2007 who did not receive unified surgical scheme were included as control group (C). Except for the surgical methods in group US, in 53 patients with deep wound area less than 51% TBSA in group C escharectomy or tangential excision was performed followed by autologous small skin grafting; in 40 patients with deep wound area from 51% to 80% TBSA in group C escharectomy or tangential excision was performed followed by autologous microskin grafting plus large sheet of allogeneic skin covering, or escharectomy or tangential excision followed by large sheet of allogeneic skin embedded with stamp-like autologous skin; in 27 patients with deep wound area larger than 80% TBSA in group C escharectomy or tangential excision was performed followed by covering with large sheet of allogeneic skin embedded with stamp-like autologous skin without intermingled grafting with small autologous and allogeneic skin in group US. In group US, escharectomy of full-thickness wound in extremities was performed with the use of tourniquet in every patient; saline containing adrenaline was subcutaneously injected when performing escharectomy or tangential excision over the trunk and skin excision; normal skin and healed superficial-thickness wound were used as donor sites for several times of skin excision. The baseline condition of patients and their treatment in the aspects of fluid resuscitation, nutrition support, anti-inflammation, and organ function support were similar between the two groups. The mortality and incidence of complications of all patients and wound healing time and times of surgery of healed patients were compared between the two groups. Data were processed with independent sample t test, Mann-Whitney U test, and Fisher's exact test.

RESULTS(1) Both the mortality and the incidence of complications of patients with deep wound area less than 51% TBSA in group US were 0, which were close to those of group C (with P values above 0.05). The number of times of surgery of healed patients with deep wound area less than 51% TBSA in group US was 2.4 ± 0.9, which was obviously fewer than that of group C (3.5 ± 1.8, U=-5.085, P<0.001), but with wound healing time close to that of group C (U=-1.480, P>0.05). (2) Both the mortality and the incidence of complications of patients with deep wound area from 51% to 80% TBSA in group US were 0, which were significantly lower than those of group C [both as 20.0% (8/40), with P values below 0.01]. The number of times of surgery and wound healing time of healed patients with deep wound area from 51% to 80% TBSA in group US were respectively 3.0 ± 1.0 and (43 ± 13) d, which were obviously fewer or shorter than those in group C [4.2 ± 2.3 and (61 ± 34) d, with U values respectively -2.491 and -2.186, P values below 0.05]. (3) Both the mortality and the incidence of complications of patients with deep wound area larger than 80% TBSA in group US were 25.0% (7/28), which were close to those of group C [both as 25.9% (7/27), with P values above 0.05]. The number of times of surgery and wound healing time of healed patients with deep wound area larger than 80% TBSA in group US were close to those of group C (with U values respectively -0.276 and -0.369, P values above 0.05).

CONCLUSIONSUnified surgical scheme can indirectly decrease the mortality and the incidence of complications of burn patients with deep wound area from 51% to 80% TBSA; it can reduce times of surgery of healed patients of this type and shorten their wound healing time.

Burns ; surgery ; Debridement ; methods ; Extremities ; Humans ; Severity of Illness Index ; Skin ; pathology ; Skin Transplantation ; Transplantation, Autologous ; Treatment Outcome ; Wound Healing