Objective The in vitro studies of indicators in burn patients with complicated infection have been little studied till now.So this study aims to investigate the change of proliferation of CD64 +neutrophils from the peripheral blood of burn patients in vitro. Methods CD64+neutrophils from peripheral blood of healthy people were isolated and purified, which was followed by stim-ulating its proliferation with inactivated Staphylococcus in vitro.We further analyzed the proliferation index with Modfit 2 analysis soft-ware.86 burn patients were divided into two groups, 44 cases with complicated infection assigned to experimental group, 42 uninfected assigned to controls.We further detect the counts of WBC and the percentage of CD64 +neutrophils, and then analyzed the specificity and sensitivity by using the receiver operating characteristic ( ROC) curves. Results This in vitro study, the average proliferation index of CD64 +cells in experimental wells was significantly higher than controls (6.48 ±0.11 vs 2.63 ±0.02), the difference was statistically significant (P<0.05);the percentage of CD64 +cells in the peripheral blood of patients in experimental group(64.25 ± 13.11%) was significantly higher than patients without infection(16.33 ±2.77%);The sensitivity and specificity of diagnostic meth-od of CD64 +cells for the burn infection were respectively 94.2%and 76.8%, which was superior to the traditional diagnostic meth-od of WBC ( 68.5%, 64.7%) according to ROC curves. Conclusion CD64 + cells in peripheral blood of burn patients complicated by infection increased more significantly and earlier when compared with the traditional diagnostic method, which may be used as a useful diagnostic indicator for burns complicated infection.

Objective:To investigate the clinical effect of using perforator flaps with the microsurgical technique in repairing secondary wounds after resecting superficial malignant tumors.Methods:A retrospective observational study was conducted in patients with superficial malignant tumors admitted to the Yulin NO.1 People’s Hospital from January 2018 to January 2021. After comprehensive examinations and multidisciplinary consultations, tumors were completely or palliatively resected based on results of the preoperative diagnosis and the intraoperative fast pathological test of cutting edge. Perforator flaps were used to repair the secondary wounds with microsurgical technique. The type of perforator flaps, including the lateral femoral circumflex artery perforator flap, the thoracodorsal artery perforator flap, the inferior epigastric artery perforator flap, the superficial iliac circumflex artery perforator flap, were decided by the intraoperative position, the defect size, the caliber and length of the blood vessel, etc. Postoperative conditions of the patients were observed.Results:Twenty-nine cases were included, with 19 males and ten females, aged from 28 to 69 years. Locations of the tumors included head and face (13 cases), upper extremity (four cases), lower extremity (six cases), and chest wall regions (six cases). The pathological type included 12 cases of squamous cell carcinoma, four of basal cell carcinoma, nine of sarcoma, and four of advanced breast cancer. The size of the wound after tumor resection ranged from 9.0 cm×7.5 cm to 22.0 cm×17.0 cm. There were 20 cases repaired with the lateral femoral circumflex artery perforator flap, four with the thoracodorsal artery perforator flap, four with the inferior epigastric artery perforator flap, and one with the superficial iliac circumflex artery perforator flap. The size of the flap ranged from 10.0 cm×9.0 cm to 24.0 cm×18.0 cm. One case had venous reflux obstruction and survived after exploringa bridging vein. One case suffered from the arterial crisis. Since this patient refused the exploration surgery, the skin-grafting was used to repair after flap necrosis. In addition, the other flaps survived successfully. Twenty-five patients achieved R0 resection. No recurrence was observed, and the appearance of the tumor was smooth after half a year to two years of follow-up. Four cases of advanced breast cancer were treated with palliative resection. The wounds were repaired and showed no recurrence. The quality of life was improved in the survival period. The donor site was closed directly in 13 cases, and thick skin grafting was used to cover the remaining 16 cases. No dysfunction was left.Conclusions:Using perforator flaps with microsurgical technique can repair the large and composite wound after extensive resection of malignant tumors. It is an essential guarantee for surgical treatment of body surface malignant tumors.

Objective:To investigate the clinical effect of using perforator flaps with the microsurgical technique in repairing secondary wounds after resecting superficial malignant tumors.Methods:A retrospective observational study was conducted in patients with superficial malignant tumors admitted to the Yulin NO.1 People’s Hospital from January 2018 to January 2021. After comprehensive examinations and multidisciplinary consultations, tumors were completely or palliatively resected based on results of the preoperative diagnosis and the intraoperative fast pathological test of cutting edge. Perforator flaps were used to repair the secondary wounds with microsurgical technique. The type of perforator flaps, including the lateral femoral circumflex artery perforator flap, the thoracodorsal artery perforator flap, the inferior epigastric artery perforator flap, the superficial iliac circumflex artery perforator flap, were decided by the intraoperative position, the defect size, the caliber and length of the blood vessel, etc. Postoperative conditions of the patients were observed.Results:Twenty-nine cases were included, with 19 males and ten females, aged from 28 to 69 years. Locations of the tumors included head and face (13 cases), upper extremity (four cases), lower extremity (six cases), and chest wall regions (six cases). The pathological type included 12 cases of squamous cell carcinoma, four of basal cell carcinoma, nine of sarcoma, and four of advanced breast cancer. The size of the wound after tumor resection ranged from 9.0 cm×7.5 cm to 22.0 cm×17.0 cm. There were 20 cases repaired with the lateral femoral circumflex artery perforator flap, four with the thoracodorsal artery perforator flap, four with the inferior epigastric artery perforator flap, and one with the superficial iliac circumflex artery perforator flap. The size of the flap ranged from 10.0 cm×9.0 cm to 24.0 cm×18.0 cm. One case had venous reflux obstruction and survived after exploringa bridging vein. One case suffered from the arterial crisis. Since this patient refused the exploration surgery, the skin-grafting was used to repair after flap necrosis. In addition, the other flaps survived successfully. Twenty-five patients achieved R0 resection. No recurrence was observed, and the appearance of the tumor was smooth after half a year to two years of follow-up. Four cases of advanced breast cancer were treated with palliative resection. The wounds were repaired and showed no recurrence. The quality of life was improved in the survival period. The donor site was closed directly in 13 cases, and thick skin grafting was used to cover the remaining 16 cases. No dysfunction was left.Conclusions:Using perforator flaps with microsurgical technique can repair the large and composite wound after extensive resection of malignant tumors. It is an essential guarantee for surgical treatment of body surface malignant tumors.

Objective:To investigate the clinical effects of free descending branch tissue flap of lateral circumflex femoral artery in repairing Wagner grade 3 or 4 diabetic foot wounds.Methods:A retrospective observational study was conducted. From October 2019 to January 2022, 12 patients (10 males and 2 females, aged 38-66 years, with an average of 52 years) with diabetic foot wounds who met the inclusion criteria were admitted to the First People's Hospital of Yulin, of whom 5 cases being Wagner grade 3 and 7 cases being Wagner grade 4. Wound debridement and vacuum sealing drainage were performed to control infection, and the wound area after debridement was between 13 cm×6 cm and 28 cm×11 cm. The wounds were repaired with free descending branch tissue flaps of lateral circumflex femoral artery. Among them, the wounds of 4 cases were repaired with single flap of musculocutaneous branch or intermuscular branch of descending branch tissue flap of lateral circumflex femoral artery, 1 case with lobulated flap, 1 case with bilateral tandem flap, and 6 cases with chimeric lateral femoral muscle flap. The area of resected tissue flap was 9 cm×7 cm to 21 cm×10 cm; end-to-end anastomosis was selected between vessels in the donor sites and the recipient sites, and pressurized treatment should be performed if necessary. The donor site wounds of 10 patients were treated with cosmetic tension-relieving suture, and the donor site wounds of 2 patients were repaired with split-thickness skin graft from head. After operation, the condition of wound repair was recorded. After wound healing, the level of 2-hour postprandial blood glucose of patients was measured. During follow-up, the wound healing of the recipient site and scar formation of the donor site were observed. Before and 6 months after operation, computer tomography angiography was used to detect and compare the blood perfusion of the affected limb. At the last follow-up, the walking ability of the patients was recorded.Results:The wounds of 9 patients healed well after operation; the flaps in the recipient site of 2 patients were infected on postoperative day 5 after surgery and were repaired by suturing in stage Ⅱ after open drainage and inflammation control; the distal end of the grafted tandem flap in 1 patient gradually developed purple necrosis on postoperative day 4 and was repaired with a skin graft after debridement. After wound healing, the 2-hour postprandial blood glucose value of all patients was controlled in the range of 8-12 mmol/L. During Follow-up of 6 months to 1 year, 3 patients had partial ulceration in the plantar compression area, which healed after decompression combined with dressing change or flap repair, while the other 9 patients had no ulceration in the recipient area; the appearance of the affected foot was plump after wound healing, the transplanted flaps had good blood supply and good fit with the surrounding tissue, and were wear-resistant, but insensitive. During follow-up, only linear scar remained in the donor area of direct suture in 10 cases, and the skin grafts in the donor area were completely survived in 2 cases. Compared with the patency of the main blood vessels of the ankle joint segment of the affected limb before operation, the vascular network of the flap transplantation area in the affected foot was formed 6 months after operation. At the last follow-up, 8 patients could walk independently, and 4 patients could walk with crutches.Conclusions:The free descending branch tissue flap of lateral circumflex femoral artery is effective in repairing Wagner grade 3 or 4 diabetic foot wounds, which can shorten the course of disease and improve local blood flow.