Objective:To investigate the feasibility and clinical outcomes of using the deep inferior epigastric perforator flap to repair stage Ⅳ pressure ulcers in elderly patients with the femoral trochanter.Methods:Retrospective analysis of clinical data of elderly patients with stage Ⅳ pressure ulcers of the femoral trochanter treated at the Medical Center of Burn Plastic and Wound Repair, the First Affiliated Hospital of Nanchang University from May 2018 to May 2023 using the deep inferior epigastric perforator flap.The deep inferior epigastric perforator flap was designed on the same side of the abdomen based on the preoperative detection of the paraumbilical perforating branch.The axis of the inferior epigastric artery was determined by the line connecting the femoral artery pulsation point at the inguinal ligament and the obvious paraumbilical perforating branch point. The axis of the skin flap was determined by the line connecting the obvious paraumbilical perforating branch point and the subscapular angle. Combined with the situation of the sinus after pressure ulcer debridement and the range of skin and soft tissue defects, the inferior epigastric artery perforating branch skin flap was cut and repaired. The pedicle of the inferior epigastric artery was freed to the required length according to the location of the pressure ulcer, and the wound was transferred and repaired through a subcutaneous tunnel. The donor area was directly pulled and sutured. The survival of the skin flap and the healing of the donor site wound after surgery were observed, and the recurrence of pressure ulcers, the appearance and texture of the skin flap, and the recovery of the donor site were followed up regularly.Results:A total of 11 patients were included, including 7 males and 4 females; age ranged from 66 to 83 years old, with an average of 72.1 years old. There were total of 11 pressure ulcers in the femoral trochanter, with an area of 5.0 cm × 3.0 cm-13.0 cm ×6.0 cm before debridement and an area of 8.0 cm × 5.0 cm-16.0 cm × 8.0 cm after debridement. The deep inferior epigastric perforator flap was used to repair the wound. The flap was cut with an area of 10.0 cm × 6.0 cm-18.0 cm × 9.0 cm, and the length of the blood vessels in the flap pedicle was 12-16 cm, with an average of 14 cm. After surgery, 9 of the 11 flaps survived completely. One skin flap developed purplish discoloration at the distal end 24 hours after surgery, which was relieved by removing the suture at the site with high tension at the wound edge. One skin flap also showed slight necrosis at the distal end. The flap was removed under local anesthesia at the bedside of the ward, and the surgical wound was directly sutured. After dressing change, it healed. The wounds in the donor area all healed well. Follow up for 3-15 months postoperatively, with an average of 11 months, showed no recurrence of pressure ulcers in all patients. The skin flap had a soft texture, and its color and appearance were similar to those of the surrounding skin. No abdominal wall hernia was observed in the inferior epigastric donor area.Conclusion:The deep inferior epigastric perforator flap has a long vascular pedicle, reliable blood supply, sufficient tissue volume for cutting, no recurrence of pressure ulcers after surgery, good appearance and texture of the affected area, and no secondary abdominal wall hernia in the donor site. It is an effective method for repairing stage Ⅳ pressure ulcers of the femoral trochanter in elderly patients.

Objective:To investigate the feasibility and clinical outcomes of using the deep inferior epigastric perforator flap to repair stage Ⅳ pressure ulcers in elderly patients with the femoral trochanter.Methods:Retrospective analysis of clinical data of elderly patients with stage Ⅳ pressure ulcers of the femoral trochanter treated at the Medical Center of Burn Plastic and Wound Repair, the First Affiliated Hospital of Nanchang University from May 2018 to May 2023 using the deep inferior epigastric perforator flap.The deep inferior epigastric perforator flap was designed on the same side of the abdomen based on the preoperative detection of the paraumbilical perforating branch.The axis of the inferior epigastric artery was determined by the line connecting the femoral artery pulsation point at the inguinal ligament and the obvious paraumbilical perforating branch point. The axis of the skin flap was determined by the line connecting the obvious paraumbilical perforating branch point and the subscapular angle. Combined with the situation of the sinus after pressure ulcer debridement and the range of skin and soft tissue defects, the inferior epigastric artery perforating branch skin flap was cut and repaired. The pedicle of the inferior epigastric artery was freed to the required length according to the location of the pressure ulcer, and the wound was transferred and repaired through a subcutaneous tunnel. The donor area was directly pulled and sutured. The survival of the skin flap and the healing of the donor site wound after surgery were observed, and the recurrence of pressure ulcers, the appearance and texture of the skin flap, and the recovery of the donor site were followed up regularly.Results:A total of 11 patients were included, including 7 males and 4 females; age ranged from 66 to 83 years old, with an average of 72.1 years old. There were total of 11 pressure ulcers in the femoral trochanter, with an area of 5.0 cm × 3.0 cm-13.0 cm ×6.0 cm before debridement and an area of 8.0 cm × 5.0 cm-16.0 cm × 8.0 cm after debridement. The deep inferior epigastric perforator flap was used to repair the wound. The flap was cut with an area of 10.0 cm × 6.0 cm-18.0 cm × 9.0 cm, and the length of the blood vessels in the flap pedicle was 12-16 cm, with an average of 14 cm. After surgery, 9 of the 11 flaps survived completely. One skin flap developed purplish discoloration at the distal end 24 hours after surgery, which was relieved by removing the suture at the site with high tension at the wound edge. One skin flap also showed slight necrosis at the distal end. The flap was removed under local anesthesia at the bedside of the ward, and the surgical wound was directly sutured. After dressing change, it healed. The wounds in the donor area all healed well. Follow up for 3-15 months postoperatively, with an average of 11 months, showed no recurrence of pressure ulcers in all patients. The skin flap had a soft texture, and its color and appearance were similar to those of the surrounding skin. No abdominal wall hernia was observed in the inferior epigastric donor area.Conclusion:The deep inferior epigastric perforator flap has a long vascular pedicle, reliable blood supply, sufficient tissue volume for cutting, no recurrence of pressure ulcers after surgery, good appearance and texture of the affected area, and no secondary abdominal wall hernia in the donor site. It is an effective method for repairing stage Ⅳ pressure ulcers of the femoral trochanter in elderly patients.

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 explore the feasibility and clinical efficacy of reconstruction of the soft tissue defect after keloidectomy and/or cicatricial ulcers excision caused by sternotomy with the 5th intercostal perforator flap of the internal thoracic artery.Methods:From September 2016 to August 2023, 10 patients with sternal keloids and/or sternal scar ulcers caused by sternotomy were treated in the Medical Centre of Burn Plastic Surgery and Wound Repair, the First Affiliated Hospital of Nanchang University. The soft tissue defect after resection reconstructed by the pedicled 5th intercostal perforator flap of the internal thoracic artery. The patients were 7 males and 3 females, aged 17-65 years, with an average age of 43 years. The history of sternal scar was 2-15 years, with an average of 5.5 years. And the sizes of sternal scars were 2.0 cm×6.5 cm-5.5 cm×10.0 cm. After admission, the patients firstly received surgery to remove sternal keloids and/or scar ulcers. The defects of soft tissue were found from 2.5 cm×7.0 cm to 6.0 cm×10.5 cm in size after surgery. Then one-stage reconstructive surgery were performed on all of the patients with a transposition of the pedicled 5th intercostal perforator flap of the internal thoracic artery. Flaps were harvested in surgery at 3.5 cm×7.5 cm-6.0 cm×11.0 cm in size. The donor sites of flaps were pulled and directly sutured. After the surgery, wound healing and flap survival were observed, through regular follow-ups at outpatient clinics, and via internet hospitals or WeChat reviews to monitor the colour and appearance of the flaps, recurrence of keloids and/or ulcers, the appearance of donor sites and the secondary dysfunction of surgery.Results:All incisions healed well after surgery, and all the pedicled 5th intercostal perforator flaps of the internal thoracic artery survived. All 10 patients were included in the postoperative follow-up for a period of 6-31 months, with an average of 15 months. During follow-up, the colour and appearance of the flaps were found good, and the patients were satisfied. There was no recurrence of keloid and/or scar ulcer in the reception sites. Two patients had linear scar hyperplasia at the incision sites over the period of follow-up, due to the failure of adherence to regular scar prevention and treatment after wound healing. Appearances of the donor sites were good without functional impairment.Conclusion:The pedicled 5th intercostal perforator flap of the internal thoracic artery has a better clinical effect in reconstruction of the soft tissue defect after keloidectomy and/or cicatriciad ulcers excision caused by sternotomy and without a postoperative recurrence of a keloid and/or scar ulcer, with a good colour and appearance in the affected area and in a good appearance without a secondary functional impairment at the donor site.

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.

Objective:To explore the feasibility and clinical efficacy of reconstruction of the soft tissue defect after keloidectomy and/or cicatricial ulcers excision caused by sternotomy with the 5th intercostal perforator flap of the internal thoracic artery.Methods:From September 2016 to August 2023, 10 patients with sternal keloids and/or sternal scar ulcers caused by sternotomy were treated in the Medical Centre of Burn Plastic Surgery and Wound Repair, the First Affiliated Hospital of Nanchang University. The soft tissue defect after resection reconstructed by the pedicled 5th intercostal perforator flap of the internal thoracic artery. The patients were 7 males and 3 females, aged 17-65 years, with an average age of 43 years. The history of sternal scar was 2-15 years, with an average of 5.5 years. And the sizes of sternal scars were 2.0 cm×6.5 cm-5.5 cm×10.0 cm. After admission, the patients firstly received surgery to remove sternal keloids and/or scar ulcers. The defects of soft tissue were found from 2.5 cm×7.0 cm to 6.0 cm×10.5 cm in size after surgery. Then one-stage reconstructive surgery were performed on all of the patients with a transposition of the pedicled 5th intercostal perforator flap of the internal thoracic artery. Flaps were harvested in surgery at 3.5 cm×7.5 cm-6.0 cm×11.0 cm in size. The donor sites of flaps were pulled and directly sutured. After the surgery, wound healing and flap survival were observed, through regular follow-ups at outpatient clinics, and via internet hospitals or WeChat reviews to monitor the colour and appearance of the flaps, recurrence of keloids and/or ulcers, the appearance of donor sites and the secondary dysfunction of surgery.Results:All incisions healed well after surgery, and all the pedicled 5th intercostal perforator flaps of the internal thoracic artery survived. All 10 patients were included in the postoperative follow-up for a period of 6-31 months, with an average of 15 months. During follow-up, the colour and appearance of the flaps were found good, and the patients were satisfied. There was no recurrence of keloid and/or scar ulcer in the reception sites. Two patients had linear scar hyperplasia at the incision sites over the period of follow-up, due to the failure of adherence to regular scar prevention and treatment after wound healing. Appearances of the donor sites were good without functional impairment.Conclusion:The pedicled 5th intercostal perforator flap of the internal thoracic artery has a better clinical effect in reconstruction of the soft tissue defect after keloidectomy and/or cicatriciad ulcers excision caused by sternotomy and without a postoperative recurrence of a keloid and/or scar ulcer, with a good colour and appearance in the affected area and in a good appearance without a secondary functional impairment at the donor site.

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.

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.