Along with improvements in the embedding materials, continual innovation of the applied technique, and further understanding of therapeutic mechanism, the application scope of negative pressure wound therapy (NPWT) becomes broader, clinical experience in its use becomes more abundant. This issue of the journal highlights 5 papers to introduce the experience and knowledge regarding NPWT technique of the authors.
Humans ; Negative-Pressure Wound Therapy ; Wound Healing

Collagen, as the main structural protein in human body, plays an important role in the wound healing process. Due to their inherent hemostatic characteristics, good biocompatibility, low immunogenicity, as well as controllable biodegradability, collagen-based materials have attracted much attention. In this article, we mainly introduce the characteristics of collagen-based wound biomaterials and the application mechanism as scaffold and wound dressing. And the standard and unified experts' consensus formed on the clinical indications, recommended applications, contraindications, and matters needing attention. The consensus wound help clinicians and patients to recognize collagen-based wound biomaterials correctly and use them rationally.
Bandages ; Biocompatible Materials ; Collagen ; Consensus ; Humans ; Wound Healing

OBJECTIVETo dicuss the application and therapeutic effect of middle-forearm flap based on perforator of ulnar artery for electrical burn wound on the wrist.

METHODSFrom Oct. 2009 to Oct. 2012, 10 cases of electrical burn wounds on the wrist were treated. A line from radialis medial epicondyle of humerus to the interior radialis pisiform bone was connected as flap axis. At the midpoint of the line, Doppler flow imaging meter was used to detect the emerging point of perforator vessel. The flap was designed and harvested. The flap was transferred reversely, with superficial vein retaining which was anastomosed with vein at recipient sites in 3 cases. The wounds in the donor sites were closed directly in 2 cases, and with skin graft in 8 cases.

RESULTSAll the 10 flaps survived completely. 7 cases without vein anastomosis underwent obvious flap edema during 2-4 days postoperatively, which resovled 1 week later. Sub-flap tissue necrosis and infection happened in 2 cases, which healed after dressing and drainage. Patients were followed up for 3-36 months with satisfactory results.

CONCLUSIONSThe middle-forearm flap based on perforator of ulnar artery has a stable and reliable blood supply. It offers a new choice for the electric burn wound on the wrist, especially at the ulnar side.

Burns, Electric ; surgery ; Forearm ; Humans ; Reconstructive Surgical Procedures ; Skin Transplantation ; Surgical Flaps ; blood supply ; transplantation ; Ulnar Artery ; Wrist Injuries ; surgery

Under the guidance of the predecessors and the efforts of the whole staff, Department of Burns and Plastic Surgery of Wuxi Third People′s Hospital has grown into a well-known regional burn diagnosis and treatment center in China after about 30 years of development. Summarizing the experience, gain, and loss in the course of department growth, following and attaching importance to the discipline development law, consolidating the foundation, strengthening the skills, and being diligent in innovation are the most important. The future trend of discipline development is as follows: wound treatment is still fundamental, burn emergency treatment system should be further improved, interdisciplinary and multidisciplinary cooperation should be further strengthened, and basic scientific research should have the potential to transform to reality.

There are many pathogenic correlation factors of chronic refractory wound. Due to the complexity and particularity of the causes of wounds and lack of a standard diagnosis guide, it is hard to treat this kind of wound. Based on our recent scientific research data and the relative research at home and abroad in the present, we systematically analyze and summarize the causes and non-surgical treatment of chronic refractory wound in this article.

Objective:To explore the effects of fractional carbon dioxide laser combined with autologous fat injection in the treatment of hypertrophic scar after burn.Methods:From April 2018 to April 2019, 12 patients with hypertrophic scar after burn who met the inclusion criteria were admitted to the Department of Plastic Surgery and Burns of Xuzhou Renci Hospital, and were included in this prospective parallel controlled clinical study. There were 7 males and 5 females with an age of (32±11) years old and scar area of (412±295) cm 2. One scar was selected from each patient and divided into two equal area scars, and they were divided into combined treatment group and laser alone group with 12 scars in each group according to the ramdom number table.The scar in laser alone group was only treated with fractiona carbon dioxide laser, while the scar in combined treatment group was injected with autologous granular fat and then treated with fractional carbon dioxide laser. Scars in the two groups were treated once every 2 months, a total of 3 times. Before the first treatment and 6 months after the last treatment, the scars in the two groups were evaluated by modified Vancouver Scar Assessment Scale (mVSS), hematoxylin-eosin staining and color Doppler ultrasound. Six months after the last treatment, the curative effect of scars in the two groups was evaluated. The adverse reactions during the whole treatment were recorded. Data were statistically analyzed with independent sample t test, paired sample t test, and McNemar exact probability method test. Results:Six months after the last treatment, the mVSS score of scars in combined treatment group was (4.5±0.4) points, which was significantly lower than (7.8 ±0.6) points in laser alone group ( t=10.000, P<0.01). Six months after the last treatment, the mVSS scores of scars in combined treatment group and laser alone group were significantly lower than those before the first treatment [(13.5±0.7) and (13.8±0.6) points, t=8.805, 9.010, P<0.01]. The effective number of scar treatment in combined treatment group was significantly more than that in laser alone group ( P<0.05). There was no scar aggravation, infection, or other adverse reactions during the treatment of scars in both groups. Before the first treatment, the scars in both groups had large collagen, disordered arrangement, proliferation of capillaries, infiltration of some inflammatory cells, and disappearance of skin appendages. Six months after the last treatment, the scar collagen in both groups was sparse and orderly arranged, and the vascular density was reduced. The improvement of scars in combined treatment group was more obvious than that of laser alone group. Six months after the last treatment, the scar thickness in combined treatment group was significantly smaller than that in laser alone group ( t=2.657, P<0.05). Before the first treatment, the blood flow of scars in both groups was abundant; 6 months of the last treatment, the blood flow of scars in combined treatment group was significantly less than that in laser alone group. Conclusions:Fractional carbon dioxide laser combined with autologous fat injection in the treatment of hypertrophic scar after burn can significantly reduce the pain and itching symptoms of scar, and improve the thickness, texture, and congestion of scar. The combined treatment has synergistic effect and less adverse reactions, which provides a more effective treatment for patients with hypertrophic scar.

Objective To discuss on nursing of patients multiple- patient burn- blast combined injury, the cooperation of processes and quality control. Methods For 35 cases of burn- blast combined injury, emergency plan was initiated immediately, including staffing allocation, supplies allocation, nursing quality control and monitoring the inpatient areas, etc. Results 35 cases of burn- blast combined injury acquired immediate treatment of burn shock and nursing. Rescue rate of multiple- patient burn blast arrived 77.14%(27/35), with no case of nursing complication. Conclusions Timely allocation of nursing staff, rational quantity and structure, forceful organization and coordination, complete and timely supplies, correct quality control of emergence nursing and beneficial solutions are keys to ensure successive nursing of intensive patients of burn-blast combined injury, and also reflection of nursing quality guarantee.

The mental disorders, scar, and dysfunction will affect the work and study of patients with extensive burn, which can further affect the quality of life and the rate of return to society. Under the premise of saving life, the function of patients with extensive burn should be reserved as much as possible for a better living quality. In addition to the specialized treatment, body positioning, therapeutic exercise, orthosis application, and psychotherapy can be used in the early stage of burn rehabilitation. Early rehabilitation training is beneficial to the circulatory system, immune system, functional and psychological recovery of patients. It can also improve the quality of extensive burn treatment, and decrease deformities and the incidence of complications in the late stage.

On August 2nd, 2014, 35 patients with extremely severe burns involved in August 2nd Kunshan factory aluminum dust explosion accident, including 18 males and 17 females, aged from 21 to 50 years, were admitted to our unit. According to the patient′s condition, the rescue members divided the participants into groups according to their characteristics, and used the multi-disciplinary cooperative treatment and management mode of integrating critical care medicine, anesthesia, traditional Chinese medicine, rehabilitation, and nursing led by burn medicine. Totally 27 patients were successfully treated, with a success rate of 77.14%.

The treatment of mass burn patients is related to social stability, life saving, and disability reducing. It is also an important opportunity to accumulate, summarize, and improve clinical rescue and treatment experience. Aiming at August 2nd Kunshan factory aluminum dust explosion, this article reviews and summarizes experience and problems about rescue reserve, first-aid system, multidisciplinary cooperation, and integration of usual time and emergent time treatment, so as to propose corresponding strategies and provide reference for the treatment of mass burn patients and critically burned patients.