With the advances in resuscitation, infection control, and metabolic management, the treatment strategies for burn patients have improved remarkably in the last half century. As a result, more patients with deep burn wound survived, and how to optimize the burn wound care aiming at recovery of the normal appearance and physiologic function of patients has been investigated and discussed widely through both the whole treatment strategy making and the new techniques performing. In the present discussion, early tissue reconstruction as well as early wound covering and repair are emphasized by summarizing the improved aesthetic and functional effects obtained by applying the principles of plastic surgery in early burn wound repair, the use of composite skin grafting, the grafting with split-thickness autografts on the preserved denatured dermis or on the preserved healthy fat tissue, etc. Besides these, more attention should be given to the repair and reconstruction in specialized functional parts of the body, such as head and face, neck, hand, female breast, perineum, and joint areas, after a deep burn. The role of rehabilitation during and after the burn wound treatment process is elucidated by demonstrating its potential biophysical mechanism and preventing scar deformity. Adequate treatment of deep burn wound demands a number of important measures including the timing of surgery, adoption of essential techniques, suitable types of wound covering materials, motivated rehabilitation, and necessary psychological therapy. The optimal recovery of damaged part of body after burn should depend on the similarity of rebuild tissue structure to simulate the nature of the original tissue in the cellular, histological, anatomic characteristics, which is the aim of all burn wound care and the basis of the appearance and function repair or reconstruction.
Burns ; rehabilitation ; surgery ; Humans ; Reconstructive Surgical Procedures ; Wound Healing

"Survival first" has been the leading rule in burn surgery for a long time. However, the life quality of patients in future should also be emphasized on the strategic level during the early treatment of patients with massive burn. Aesthetics is also extremely important in wound repair, and it should form a clear conception in the mind of the attending surgeons. Therefore, the aesthetic effect of each surgical intervention should be elaborated with all enough attention. Moreover, we should constantly improve our techniques and skills to obtain presentable postoperative appearance. In addition, we should emphasize the application of new techniques and materials in wound repair, with which to improve aesthetic effect. In conclusion, we should pay more attention to promoting the aesthetic effect in the treatment of burns and traumatic wounds to maintain our superior status in burn treatment in the world.
Burns ; surgery ; Esthetics ; Humans ; Reconstructive Surgical Procedures ; methods ; Wound Healing

Drainage ; methods ; Humans ; Surgical Wound Infection ; surgery ; Vacuum

Drainage ; methods ; Humans ; Surgical Wound Infection ; surgery ; Vacuum

Sacrococcygeal pilonidal disease(SPD) is an acquired disease intimately related to the presence of hair in the gluteal groove. Although its pathogenesis is still controversial, numerous treatment options are available for SPD including gluteal groove and surrounding skin hair removal, sinusectomy, open healing by secondary intention, primary closure, and local excision with flap reconstruction. Lacking of standardized diagnosis and treatment processes of SPD in China, Chinese Medical Doctor Association Anorectal Branch and its Clinical Guidelines Committee jointly organized experts in this field to form expert consensus opinion on the basis of summarizing latest research progress in China and abroad, experts' clinical experience and principles of evidence-based medicine. The expert group formed opinion in 12 terms of SPD diagnosis, risk factors, non-surgical treatment, surgical treatment, minimally invasive treatment, and wound management, and developed the "Chinese expert consensus on the diagnosis and treatment of sacrococcygeal pilonidal disease (2023 edition)" after rounds of discussion and revision, to improve the diagnosis and treatment of SPD.
Humans ; Consensus ; Surgical Flaps ; Wound Healing ; China ; Pilonidal Sinus/surgery*

BACKGROUNDThe techniques of resection and repair of large lesions in the abdominal wall are very challenging in the area of gynecology. We explored the techniques of resection and plastic surgical repair of large abdominal wall lesions in gynecologic patients.

METHODSTwenty-six patients with large lesions in the abdominal wall underwent resection by the gynecologists and repair through abdominal plasty and V-Y plasty with or without fascia patch grafting by the gynecologists or plastic surgeons from March 2003 to October 2010.

RESULTSAll patients had a history of cesarean section. One patient had an infected sinus tract after cesarean section, one patient had an inflammatory nodule, and the others had lesions of endometriosis, including one cancer. The average largest lesion diameter was (4.79 ± 4.18) cm according to the ultrasonography results. The lesions of all patients were completely resected with pretty abdominal contour. A polypropylene biological mesh was added to the fascia in 20 patients. One patient underwent groin flap repair, and one underwent V-Y advanced skin flap repair on the left of the incision to relieve the suture tension.

CONCLUSIONSMulti-department cooperation involving the gynecology and plastic surgery departments, and even the general surgery department, is essential for patients with large lesions in the abdominal wall. This cooperative effort enabled surgeons to completely resect large lesions. Abdominal wall plastic surgical repair can ameliorate large wounds of the abdominal wall.

Abdominal Wall ; surgery ; Adult ; Endometriosis ; surgery ; Female ; Humans ; Reconstructive Surgical Procedures ; Surgical Flaps ; Surgical Wound Infection ; surgery

The healing process of burn wounds is strongly associated with the depth of wounds, and the depth of wounds is dependent to initial temperature and duration of contact with source of heat, infection, and secondary damage in the debridement process. On this basis, some experts present a concept of accurate debridement, which denotes removal of all necrotic tissue and at the same time protecting viable tissue for repair of raw wounds in order to maximally maintain patients' appearance and functions. A new technology of burn wound debridement--hydrosurgery system has been applied clinically. This paper summarizes the characteristics of hydrosurgery in the aspects of its technology, suitable wounds, bacterial load, amount of blood loss, and degree of pain produced during operation, and also the author's opinions regarding its efficacy to realize an accurate debridement for burn injury.
Burns ; pathology ; surgery ; Debridement ; methods ; Humans ; Necrosis ; Surgical Wound Infection ; Treatment Outcome ; Wound Healing

Acellular Dermis ; Female ; Humans ; Male ; Oropharyngeal Neoplasms ; surgery ; Reconstructive Surgical Procedures ; Surgical Flaps ; Wound Healing

The principles of open fracture management are to manage the overall injury and specifically prevent primary contamination becoming frank infection. The surgical management of these complex injuries includes debridement & lavage of the open wound with combined bony and soft tissue reconstruction. Good results depend on early high quality definitive surgery usually with early stable internal fixation and associated soft tissue repair. While all elements of the surgical principles are very important and depend on each other for overall success the most critical element appears to be achieving very early healthy soft tissue cover. As the injuries become more complex this involves progressively more complex soft tissue reconstruction and may even requiring urgent free tissue transfer requiring close co-operative care between orthopaedic and plastic surgeons. Data suggests that the best results are obtained when the whole surgical reconstruction is completed within 48-72 h.
Debridement ; Fractures, Open ; surgery ; Humans ; Reconstructive Surgical Procedures ; methods ; Surgical Wound Infection ; prevention & control ; Therapeutic Irrigation

OBJECTIVETo explore a new method to correct secondary lip whistle deformities and nasal base depression after bilateral complete cleft lip (BCCL) repair with lip subdermal soft tissue flap.

METHODSBilateral subdermal soft tissue "C" flaps and "lambda" flap were designed to repair secondary deformities of nasal base and reconstruct vermilion tubercle in patients after BCCL repair.

RESULTSGood results were achieved in all the patients with primary healing. No flap necrosis happened. The result was satisfactory.

CONCLUSIONSWith bilateral subdermal soft tissue "C" flaps and " lambda" flap, nasal base depression deformities and lip whistle deformities can be corrected. It is an ideal method for correction of deformities after BCCL repair.

Cleft Lip ; surgery ; Humans ; Lip ; surgery ; Nose ; Nose Deformities, Acquired ; surgery ; Reconstructive Surgical Procedures ; Surgical Flaps ; Treatment Outcome ; Wound Healing