BACKGROUND:Living microecological hydrogels are a hot topic in the field of wound dressing and have received widespread attention.OBJECTIVE:To summarize the basic features and advantages of living microecological hydrogels,review the progress in the application of hydrogels loaded with different living organisms in skin wound repair in recent years.METHODS:The articles published from database inception to 2024 were retrieved from Web of Science,PubMed,CNKI,and WanFang databases with"cell,probiotics,phage,chlorella,algae,living microecological,hydrogel,skin,wound healing,wound repair"as search terms in English and Chinese.The articles for inclusion were screened according to the inclusion and exclusion criteria.Finally,108 articles were included for review.RESULTS AND CONCLUSION:The living microecological hydrogels have good biocompatibility,and the hydrogel can provide a suitable living environment for the loaded organisms,and play a barrier role between the living organisms and the wound to avoid potential threats.Compared with traditional wound dressings,the effect of living microecological hydrogels is sustainable and renewable.Biological regulation can keep the microenvironment at the wound site relatively stable,which can provide suitable conditions for wound healing for a long time and reduce the additional trauma caused by frequent dressing changes.Compared with the direct use of living organisms to promote wound healing,living microecological hydrogels can improve the survival rate of organisms and ensure their biological regulation.Living microecological hydrogels promote wound healing mainly by regulating the"inflammation"and"proliferation"stages in the wound healing process.The existing living microecological hydrogels mainly load organisms such as cells,probiotics,algae,and phages,which give hydrogels with different biological properties,so that they can promote wound healing by releasing substances required for wound healing or improving the wound environment,and have great application potential.To further expand the actual clinical application of living microecological hydrogels,it is necessary to further control the biosafety risks of active organisms in hydrogels in the future,avoid potential biological threats,and research the hydrogel matrix that can better adapt to the complex changes of human skin wounds and can support living organisms.

BACKGROUND:Living microecological hydrogels are a hot topic in the field of wound dressing and have received widespread attention.OBJECTIVE:To summarize the basic features and advantages of living microecological hydrogels,review the progress in the application of hydrogels loaded with different living organisms in skin wound repair in recent years.METHODS:The articles published from database inception to 2024 were retrieved from Web of Science,PubMed,CNKI,and WanFang databases with"cell,probiotics,phage,chlorella,algae,living microecological,hydrogel,skin,wound healing,wound repair"as search terms in English and Chinese.The articles for inclusion were screened according to the inclusion and exclusion criteria.Finally,108 articles were included for review.RESULTS AND CONCLUSION:The living microecological hydrogels have good biocompatibility,and the hydrogel can provide a suitable living environment for the loaded organisms,and play a barrier role between the living organisms and the wound to avoid potential threats.Compared with traditional wound dressings,the effect of living microecological hydrogels is sustainable and renewable.Biological regulation can keep the microenvironment at the wound site relatively stable,which can provide suitable conditions for wound healing for a long time and reduce the additional trauma caused by frequent dressing changes.Compared with the direct use of living organisms to promote wound healing,living microecological hydrogels can improve the survival rate of organisms and ensure their biological regulation.Living microecological hydrogels promote wound healing mainly by regulating the"inflammation"and"proliferation"stages in the wound healing process.The existing living microecological hydrogels mainly load organisms such as cells,probiotics,algae,and phages,which give hydrogels with different biological properties,so that they can promote wound healing by releasing substances required for wound healing or improving the wound environment,and have great application potential.To further expand the actual clinical application of living microecological hydrogels,it is necessary to further control the biosafety risks of active organisms in hydrogels in the future,avoid potential biological threats,and research the hydrogel matrix that can better adapt to the complex changes of human skin wounds and can support living organisms.

Objective To investigate the clinical efficacy of buttress plating for patients with posterior pilon fracture.Methods From April 2012 to January 2015,12 patients with posterior pilon fracture of the distal tibia were treated in our hospital.They were 7 men and 5 women,30 to 56 years of age (average,41.2 years).According to the CT classification by Haraguchi et al.,5 cases belonged to type I,3 to type Ⅱ and 4 to type Ⅲ.All the patients underwent open reduction and internal fixation with buttress plate via either a posterolateral approach or a dual posterolateral-posteromedial approach.All the patients were available for follow-up.The clinical outcomes were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the visual analogue scale (VAS).The radiological evaluation was performed using the osteoarthritis-score (OA-score).Results The patients obtained an average follow-up of 21.2 months (range,from 12 to 30 months).Bone fractures united after an average of 15 weeks (range,from 13 to 19 weeks).The time for full weight walking averaged 16 weeks,ranging from 15 to 23 weeks.The ankle plantar flexion ranged from 36° to 42° (average,40.4°);the ankle dorsal extension ranged from 38° to 44° (average,42.6°).At the final follow-ups,the AOFAS scores ranged from 82 to 97 (average,88.2);the OA-score ranged from 0.6 to 0.8 (average,0.71);the VAS scores during rest,active motion and weight-bearing walking ranged from 0.5 to 0.8 (average,0.66),from 0.6 to 0.9 (average,0.82) and from 1.2 to 1.8 (average,1.41),respectively.No fracture malunion,implant loosening,pain or stiffness of the affected ankle was observed at the final follow-ups.Conclusion Buttress plating for posterior pilon fractures can lead to satisfactory clinical outcomes,because it ensures rigid fixation which in turn enables earlier postoperative mobilization.