中华烧伤与创面修复杂志

The practice of building a wound repair discipline system with Chinese characteristics in countryside area: insights from the "Three Souths" experience

Fu Xiaobing

2026, 42(1): 1-6. doi: 10.3760/cma.j.cn501225-20251119-00475

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The construction of a wound repair discipline system with Chinese characteristics is an ongoing process. The construction of this system at the grassroots level, particularly in country-level medical institutions and areas with relatively weak health resources, is the important part of the construction of a wound repair discipline system with Chinese characteristics. It plays an important role in improving the wound prevention and treatment levels, and meeting the medical needs of the people. This paper introduces the phased achievements in the construction of the wound repair discipline systems in the countryside areas of South Anhui, South Jiangxi, and Hainan (referred to as the "Three Souths"), providing a valuable reference for the construction of a wound repair discipline system in countryside areas in China.

Multidisciplinary expert consensus on tophus damage grading and surgical treatment (2025 edition)

2026, 42(1): 7-18. doi: 10.3760/cma.j.cn501225-20240721-00274

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Tophi, a severe complication of advanced gout, develop in approximately 12% to 53% of patients with gout. The treatment of bone and joint damages and chronic refractory wounds caused by tophi presents considerable clinical challenges. Currently, there is no unified standard for the optimal surgical timing, perioperative management, and treatment approaches for this condition. To address this, the Wound Repair Professional Committee of Chinese Medical Doctor Association convened a multidisciplinary panel of senior experts in wound repair, plastic surgery, orthopedics & joint surgery, rheumatology and immunology, radiology, and nursing and wound management. Based on the literature evidence combined with expert opinion, the panel employed nominal group and Delphi methods, and a grading standard (levels 1 to 4) defining the extent of tophi damage and the treatment principle were established for the first time to ensure homogeneity of surgical treatment; 14 recommendations on the diagnosis and treatment of tophi were proposed, providing practical guidance for the surgical treatment of tophi.

Repair and reconstruction of facial organ injuries: a perfect fit of structure and function

Song Baoqiang, Pei Jiaomiao

2026, 42(1): 19-25. doi: 10.3760/cma.j.cn501225-20251111-00468

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The repair of facial organ injuries is a complex field in plastic surgery that involves both functional recovery and morphological reconstruction. The therapeutic goal has evolved from traditional wound closure to the harmonious integration of form and function. To achieve this new objective, surgical plans need to combine various flap techniques, autologous and allogeneic tissue transplantation approaches, and incorporate emerging methods such as digital design and biomaterials. Although the repair outcomes of facial organ injuries have improved compared to the past, challenges remain, including insufficient nerve function reconstruction, limited scar management, donor site damage, and immune rejection in allogeneic transplantation. This article systematically reviews the mainstream repair methods and advancements in domestic and international research on key facial structures, including the nose, eyelids, lips, and ears, focusing on their defect characteristics and repair difficulties. It emphasizes how to achieve both three-dimensional structural reconstruction and dynamic functional restoration while maintaining aesthetic reconstruction. In the future, the integration of technologies such as tissue engineering, three-dimensional bioprinting, supermicrosurgery, and artificial intelligence will drive the development of facial organ injury repair and reconstruction towards precision, personalization, and minimally invasive approaches, ultimately achieving comprehensive rehabilitation of patients' physical, psychological, and social roles.

Reconstruction of superficial organs: a leap from structural restoration to functional rehabilitation

Zan Tao, Gao Yashan

2026, 42(1): 26-33. doi: 10.3760/cma.j.cn501225-20251110-00467

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The core objective of superficial organ reconstruction is to perfectly restore the organ's morphological structure and biological function. Currently, significant progress has been achieved in structural construction, blood supply assurance, and morphological and functional reconstruction of superficial organ reconstruction, primarily relying on approaches including surgical techniques, tissue engineering, and regenerative medicine. In the future, with the integration and application of cutting-edge technologies such as gene editing, artificial intelligence, three-dimensional printing, and brain-computer interfaces, superficial organ reconstruction is poised to enter a new historical stage characterized by high intelligence, precision, and comprehensive functional restoration. This article focuses on superficial organ reconstruction, systematically outlines its concept, challenges, and current development status, and proposes future perspectives for this field.

Refined surgical protocol and clinical efficacy of total expansion auricular reconstruction surgery

Hao Dongyue, Song Baoqiang, Dong Liwei, Cang Zhengqiang

2026, 42(1): 34-40. doi: 10.3760/cma.j.cn501225-20250929-00409

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Objective To summarize the refined surgical protocol and clinical efficacy of total expansion auricular reconstruction surgery. Methods This study was a retrospective study of case series. From July 2015 to June 2025, 1 136 patients (1 187 ears) with congenital microtia who met the inclusion criteria were admitted to the Department of Plastic Surgery of the First Affiliated Hospital of Air Force Medical University, including 781 males and 355 females, aged 8-40 years. All the patients underwent total expansion auricular reconstruction surgery, a procedure performed in 3 stages, with stage Ⅰ involving skin and soft tissue expander implantation, stage Ⅱ involving costal cartilage harvesting and expanded flap and residual ear management, cartilage framework fabrication and implantation, and stage Ⅲ involving residual ear revision and earlobe transposition. The postoperative complications after stages Ⅰ, Ⅱ, and Ⅲ were observed and recorded, and the total complication rate was calculated. At the last follow-up, patients' satisfaction with the surgical outcome was surveyed using a self-designed satisfaction scale, and the satisfaction rate was calculated. Results Postoperative hematoma occurred in 33 patients, including 17 cases after the stage Ⅰ surgery, 15 cases after the stage Ⅱ surgery, and 1 case after both the stage Ⅰ and Ⅱ surgeries. Cartilage framework infection occurred in 15 patients after the stage Ⅱ surgery, cartilage framework helix fracture occurred in 3 patients after the stage Ⅱ surgery, and cartilage framework deformation occurred in 12 patients after the stage Ⅱ surgery. The total complication rate of patients was 5.5% (63/1 136). At the last follow-up during 3 months to 4 years after the stage Ⅲ surgery, 957 patients were satisfied with the surgical outcome, 156 patients were basically satisfied, and 23 patients were dissatisfied, with satisfaction rate of 98.0% (1 113/1 136). Conclusions Total expansion auricular reconstruction surgery for congenital microtia provides sufficient expanded skin tissue, eliminating the need for skin grafting. The reconstructed auricle achieves an excellent shape with few complications, and patients are highly satisfied with the surgical outcome.

Clinical efficacy of two-stage ear reconstruction using autologous rib cartilage in the correction of congenital microtia

Xu Zhicheng, Zhang Qun, Xu Feng, Li Datao, Li Yiyuan, Chen Xia, Zhang Ruhong

2026, 42(1): 41-48. doi: 10.3760/cma.j.cn501225-20250902-00384

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Objective To explore the clinical efficacy of two-stage ear reconstruction using autologous rib cartilage in the correction of congenital microtia. Methods The study was a retrospective cohort study. From January 2000 to February 2025, 3 050 patients (1 992 males and 1 058 females, aged 6 to 52 years) with congenital microtia who met the inclusion criteria were admitted to the Department of Plastic and Reconstructive Surgery of Shanghai Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine. All of them were corrected by the two-stage ear reconstruction. The first stage operation involved harvesting of the 6^th to 8^th autologous rib cartilages (the 9^th autologous rib cartilage was harvested if necessary) for ear framework fabrication. Depending on the amount and location of residual ear tissue, the transverse, longitudinal, "V"-shaped, "U"-shaped, or "W"-shaped incisions were designed, and then fabricated frameworks were implanted, and the wounds were closed. The second stage operation was performed 3 to 6 months after operation. The reconstructed ear was first lifted, the reserved cartilage or titanium plate was used as supporting material to construct the cranio-auricular angle, and then the wound was closed with retroauricular fascial flap and split-thickness scalp skin graft. The wound at the donor site of the skin graft was packaged and fixed. After operation, the incidence of complications was recorded, and the occurrence rate was calculated. During the follow-up, the appearance of the reconstructed ear was observed, and the patients' satisfaction or reasons for dissatisfaction were counted. Results The complications, such as venous congestion, flap necrosis, and cartilage exposure, etc. occurred in the first stage operation, and the occurrence rate was 6.59% (201/3 050); partial skin graft necrosis, fascial flap necrosis, and cartilage exposure, etc. occurred in the second stage operation, and the occurrence rate was 9.18% (280/3 050). The complications were all controlled effectively after adopting treatment measures such as acupuncture and bloodletting combined with wet compress using gauze soaked in heparin solution, debridement and drainage, hyperbaric oxygen therapy, rational application of antibiotics, and repair with fascial flaps and skin grafts. During the follow-up of 6 months to 15 years after the second stage operation, the morphology of each sub-unit of the reconstructed ear appeared, the proportion was coordinated, and the structure was soft and natural. 89.02% (2 715/3 050) of the patients and their families were satisfied with the shape contour, position, and size of the reconstructed ear. The reasons for the dissatisfaction of the remaining patients were local structural defects of the reconstructed ear caused by postoperative complications, asymmetry in the position of the reconstructed ear due to factors such as hemifacial microsomia and ectopic auditory meatus. Conclusions Two-stage ear reconstruction using autologous rib cartilage in the correction of congenital microtia is a reliable surgical technique, characterized by a low incidence of postoperative complications, natural anatomical structure of the reconstructed ear, and high patient satisfaction.

Application of pectoralis major fascia in robotic nipple-sparing mastectomy with immediate breast reconstruction with gel implant

Chen Kuo, Lyu Pengwei

2026, 42(1): 49-56. doi: 10.3760/cma.j.cn501225-20250807-00351

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Objective To preliminarily evaluate the feasibility, safety, and early aesthetic outcomes of using the pectoralis major fascia in robotic nipple-sparing mastectomy with immediate breast reconstruction with gel implant (RNSMIBR). Methods This study was a retrospective cohort study. From November 2023 to April 2025, 34 female breast cancer patients who met the inclusion criteria were treated at the First Affiliated Hospital of Zhengzhou University. Seventeen patients, aged 43±7 years, who underwent posterior subpectoral pocket expansion using a titanium mesh patch in RNSMIBR surgery were included into titanium mesh patch group, and 17 patients, aged 46±7 years, who underwent posterior subpectoral pocket expansion using the pectoralis major fascia in RNSMIBR surgery were included into pectoralis major fascia group. Surgery-related complications during postoperative hospitalization and follow-up within 30 days after discharge were recorded and graded using the Clavien-Dindo classification. During the follow-up of approximately 3 months postoperatively, the BREAST-Q scale was used to score the patients' satisfaction with breast appearance, psychosocial well-being, and satisfaction with medical care. Results During postoperative hospitalization and follow-up within 30 days after discharge, three patients in titanium mesh patch group experienced grade Ⅰ complications. In pectoralis major fascia group, three patients experienced grade Ⅰ complications and three patients experienced grade Ⅲb complications. The grade Ⅲb complication in one patient was caused by radiotherapy. No complications occurred in other patients in the two groups. There was no statistically significant difference in the Clavien-Dindo classification of surgery-related complications between the two groups of patients (P>0.05). During the follow-up of approximately 3 months postoperatively, the BREAST-Q scale scores were 92±5 in titanium mesh patch group of patients and 79±28 in pectoralis major fascia group of patients, with no statistically significant difference between the two groups (P>0.05). Conclusions The pectoralis major fascia-assisted expansion technique may serve as an alternative option of expansion in RNSMIBR when titanium mesh patch is unavailable or cost-prohibitive. For patients requiring postoperative radiotherapy, titanium mesh patch or other materials that do not rely on vascular supply are still preferred to balance aesthetic outcomes and complication control.

Effects of ultrathin inguinal flap free transplantation in repairing hand and foot wounds

Zhang Weidong, Zhang Wei, Gong Xiang, Xu Junhui, Yang Fei, Luan Xiagang, Xie Weiguo

2026, 42(1): 57-65. doi: 10.3760/cma.j.cn501225-20241015-00390

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Objective To explore the effects of ultrathin inguinal flap free transplantation in repairing hand and foot wounds. Methods This study was a case series study. From January 2021 to March 2024, 18 patients (14 males and 4 females, aged 19 to 66 years) with skin and soft tissue defects of hands and feet accompanied by tendon and/or bone injuries and exposure were admitted to Tongren Hospital of Wuhan University ＆ Wuhan Third Hospital. A total of 21 wounds were involved, including 12 on hands and 9 on feet. The area of skin and soft tissue defects after debridement was 5.0 cm×2.5 cm to 16.0 cm×5.0 cm. Using the reverse dissection method, ultrathin inguinal flaps containing the subdermal vascular network were obtained with the pure skin perforator as the center. The size of flaps was 6.0 cm×3.0 cm to 17.0 cm×6.5 cm. Among them, 15 flaps were based on the superficial circumflex iliac artery as the vascular pedicle, 5 flaps were based on the common trunk of the superficial circumflex iliac artery and the superficial epigastric artery as the vascular pedicle, and 1 flap was based on the dual vessels of the superficial circumflex iliac artery and the superficial epigastric artery as the vascular pedicle. The flaps were transferred to the recipient wounds, and the arteries and veins of the vascular pedicles were end-to-end anastomosed with the recipient arteries and veins, and then the wounds were closed. The donor site wounds were sutured with tension reduction. During the operation, the thickness of flaps, the diameter of arterial anastomosis in vascular pedicle, the number of pure skin perforators carried, and the distance between adjacent pure skin perforators in multi-perforator flaps were measured and recorded. Postoperatively, the survival of the flaps, the occurrence of complications, as well as the healing of the donor site wounds were observed. During follow-up, the repair of the recipient areas was observed. At the last follow-up, the total active motion (TAM) was used to evaluate the function of the affected fingers, and the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS-AHS) was used to score the function of the affected feet. The Likert scale was used to evaluate the patients' satisfaction with the therapeutic effect. Results The thickness of flaps of patients was 0.2 to 0.5 cm, with an average of 0.4 cm; the diameter of arterial anastomosis in vascular pedicle was 0.5 to 1.2 mm, with an average of 0.7 mm; 7 flaps each carried one pure skin perforator, 6 flaps each carried two pure skin perforators, and 8 flaps each carried three pure skin perforators. The distance between adjacent pure skin perforators in multi-perforator flaps was 0.8 to 3.5 cm, with an average of 1.7 cm. Postoperatively, one flap showed small area of necrosis, which survived after debridement and suture; the remaining flaps survived smoothly. Three affected fingers had blood supply disorder at the distal end, and all survived after arterial recanalization. One donor site wound healed poorly due to high local tension and healed after debridement and suture, and the remaining donor site wounds healed smoothly. During the 6 to 35 months of follow-up, the flaps were soft and elastic. Two flaps were slightly swollen and underwent thinning treatment 3 to 5 months after surgery. At the last follow-up, the TAM of 10 affected fingers were excellent, and two were good, the AOFAS-AHS score of 9 affected feet was 99 to 100 points, and all 18 patients were very satisfied with the effects. Conclusions The ultrathin inguinal flap has the advantages of thin thickness, rich blood supply, and reliable harvesting method. Its application in repairing hand and foot wounds after burns and trauma can achieve ideal aesthetic and functional results, with a low rate of secondary revision, and it is worthy of clinical promotion and application.

Efficacy of free lateral arm tissue flap in repairing complex finger wounds

Yang Xi, Liu Wuhua, Duan Jiazhang, Fang Xiang, Xu Yongqing, Shi Yan, Zhang Xing, He Xiaoqing

2026, 42(1): 66-73. doi: 10.3760/cma.j.cn501225-20240927-00359

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Objective To explore the efficacy of free lateral arm tissue flap in repairing complex finger wounds. Methods This study was a retrospective case series study. From January 2020 to December 2023, 8 patients with complex finger wounds who met the inclusion criteria were admitted to the 920^th Hospital of Joint Logistic Support Force of PLA, including 5 males and three females, aged 24 to 56 years. There were 4 cases with multi-finger skin defects; there were 4 cases with single-finger skin combined with bone defects, three of whom were complicated with extensor tendon defects. The size of skin defects was 2.5 cm×2.0 cm to 8.0 cm×3.5 cm, and the size of bone defects was 1.5 cm×1.0 cm×1.0 cm to 2.0 cm×1.5 cm×1.0 cm. Five cases underwent emergency extended debridement and simultaneous transplantation of free lateral arm tissue flap for repair; the remaining three patients underwent extended debridement in stage Ⅰ and free lateral arm tissue flap transplantation for repair in stage Ⅱ. Four patients each underwent resection of lobulated flaps and chimeric osteocutaneous flaps, including 4 cases carrying the posterior arm cutaneous nerve and three cases having their extensor tendons being reconstructed with the triceps brachii aponeurosis. The size of skin flaps was 3.0 cm×2.5 cm to 9.0 cm×4.0 cm, and the size of bone flaps was consistent with the size of bone defects. The donor site wounds of skin flaps and bone flaps were closed with interrupted sutures. Postoperatively, the survival status of the tissue flaps was observed, and the pedicle division status of the lobulated flaps was recorded. At the final follow-up, the following parameters were assessed and documented: the appearance and texture of skin flaps, the sensory recovery of the affected finger transplanted with the posterior arm cutaneous nerve evaluated using the British Medical Research Council sensory function assessment criteria, the dorsiflexion of the affected finger transplanted with the triceps brachii aponeurosis, the survival of the bone flaps confirmed via X-ray examination, the scar formation at the donor sites of skin flaps, and the function of the affected fingers evaluated based on the trial standard for functional evaluation of the upper limb of the Hand Surgery Society of the Chinese Medical Association. Results Postoperatively, the tissue flaps survived well. The pedicles of the lobulated flaps were successfully divided under local anesthesia 4 weeks after surgery. The follow-up duration ranged from 10 to 24 months, with an average of 13.5 months. At the final follow-up, the color and texture of the skin flaps were good, the sensation of the affected fingers transplanted with posterior arm cutaneous nerve recovered to level S2 or S3, the affected fingers transplanted with triceps brachii aponeurosis all achieved limited improvement in dorsiflexion, X-ray examination showed that the bone flaps survived, linear scars formed at the donor sites of skin flaps after wound healing, and the function of the affected fingers was evaluated as excellent in 5 cases and good in three cases. Conclusions The lateral arm tissue is rich in perforators and has few anatomical variations, which can be prepared into lobulated flaps and chimeric osteocutaneous flaps for repairing complex finger wounds. The surgical operation is relatively simple, and the appearance and function of the donor and recipient sites are fairly good after surgery.

Efficacy of sequential lateral position management in patients with chronic wounds and pulmonary complications: a prospective RCT

Yin Xi, Chang Fei, Shao Lijia, Cao Jie, Sha Wei

2026, 42(1): 74-80. doi: 10.3760/cma.j.cn501225-20250222-00080

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Objective To investigate the efficacy of sequential lateral position management in patients with chronic wounds and pulmonary complications. Methods This study was a prospective randomized controlled trial (RCT). From January 2023 to December 2024, 48 patients with chronic wounds and pulmonary complications who met the inclusion criteria were admitted to the Department of Burns and Plastic (Reconstructive) Surgery of Zhangjiagang Hospital Affiliated to Soochow University. They were randomly divided into control group (n=24, 13 males and 11 females, aged (76±12) years) and experimental group (n=24, 12 males and 12 females, aged (76±12) years) using an envelope method, and underwent conventional position management and sequential lateral position management based on conventional position management protocol, respectively, with a period of 7 days. On the 1^st and 7^th day of body position management, blood gas analysis parameters (including partial pressure of arterial oxygen (PaO₂), arterial oxygen saturation (SaO₂), and partial pressure of arterial carbon dioxide (PaCO₂)) as well as safety indicators such as respiratory rate in both groups of patients were statistically analyzed. Additionally, from the 1^st to 7^th days of body position management, sputum volume grading (mild, moderate, and severe), along with the frequency of complications and adverse events (aspiration, arrhythmia, skin injury, endotracheal tube displacement, and unplanned extubation, etc.) were statistically analyzed. Results Compared with those in control group, the differences in PaO₂, SaO₂, and PaCO₂ between the 7^th day and the 1^st day of body position management of patients in experimental group were statistically significant (with F values of 15.50, 18.79, and 10.13, respectively, P<0.05). On the 7^th day of body position management, the PaO₂ of patients in experimental group was (102±24) mmHg (1 mmHg=0.133 kPa), which was higher than (79±16) mmHg in control group. Compared with that in control group, the respiratory rate difference between the 7^th day and the 1^st day of body position management of patients in experimental group was statistically significant (F=15.17, P<0.05). From the 1^st to 7^th days of body position management, there was no statistically significant difference in sputum volume grading between the two groups of patients (P>0.05). No related complications or adverse events such as aspiration, arrhythmia, skin injury, endotracheal tube displacement, and unplanned extubation occurred in the two groups of patients. Conclusions The RCT shows that for patients with chronic wounds and pulmonary complications, sequential lateral position management can improve pulmonary ventilation function, improve oxygenation, correct hypoxemia, reduce respiratory rate, promote pulmonary rehabilitation of patients, and is safe and reliable.

Clinical effects of using the ALTPF pedicled with the oblique branch of the lateral circumflex femoral artery in repairing skin and soft tissue defects in the extremities under the guidance of color Doppler ultrasound

Sun Fengkun, Wang Limin, Song Xinghua, Zhao Xudong

2026, 42(1): 81-90. doi: 10.3760/cma.j.cn501225-20240623-00247

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Objective To investigate the clinical effects of using the anterolateral thigh perforator flaps (ALTPF) pedicled with the oblique branch of the lateral circumflex femoral artery in repairing skin and soft tissue defects in the extremities under the guidance of color Doppler ultrasound. Methods This study was a retrospective cohort study. A total of 30 patients who were admitted to Dongying Traditional Chinese Medicine Hospital from March 2018 to November 2020 and met the inclusion criteria were included into control group. The patients underwent repair of skin and soft tissue defects in the extremities using the ALTPF pedicled with the oblique branch of the lateral circumflex femoral artery which was designed and harvested based on the surgeons' clinical experience. Another 30 patients who were admitted to the same hospital from December 2020 to May 2023 and met the inclusion criteria were included into ultrasound group. The patients underwent repair of skin and soft tissue defects in the extremities using the ALTPF pedicled with the oblique branch of the lateral circumflex femoral artery which was designed and harvested based on the results of preoperative color Doppler ultrasound. Among the patients, there were 49 males and 11 females, aged 19 to 60 years. After debridement, the wound areas ranged from 6.0 cm×3.0 cm to 13.0 cm×11.0 cm, and the harvested areas of ALTPF ranged from 7.0 cm×4.0 cm to 18.0 cm×8.0 cm. The donor site wounds were directly sutured. For patients in ultrasound group, the consistency in the classification of the oblique branches of the lateral circumflex femoral artery and the number of its perforating vessels determined by the preoperative color Doppler ultrasound examination and the intraoperative exploration results was analyzed; the diameters of the oblique branches of the lateral circumflex femoral artery at its origin, the diameters of the vessels at the perforation points of its perforating branches, as well as the length of the vascular pedicle detected by the preoperative color Doppler ultrasound examination and the intraoperative exploration were compared. For patients in the two groups, the blood supply status of the flaps on postoperative days 1, 3, 5, 7, and 14 was scored using a flap blood supply assessment scale; the duration of flap surgery, intraoperative blood loss volume, and length of hospital stay were recorded; the incidence of tension blisters and venous crisis in the flap recipient areas within one week after surgery and flap necrosis within two weeks after surgery were recorded, and the incidence of incision dehiscence in the flap donor areas within two weeks after surgery and abnormal scar hyperplasia, sensory abnormality, and decreased motor function within one year after surgery were recorded. One year after surgery, the satisfaction of patients in the two groups with the treatment outcomes was evaluated using a Likert 5-grade scale, and the satisfaction rate was calculated. Results For patients in ultrasound group, the preoperative color Doppler ultrasound examination revealed that the oblique branch of the lateral circumflex femoral artery was type 1 in 17 cases, type 2 in 5 cases, type 3 in 3 cases, type 4 in 3 cases, and type 5 in 2 cases, which was completely consistent with the intraoperative exploration findings (κ=1.00, P<0.05). The number of perforating vessels of the oblique branch of the lateral circumflex femoral artery detected by the preoperative examination showed a high degree of consistency with the intraoperative exploration results (κ=0.80, P<0.05). There were no statistically significant differences in the diameters of the oblique branches of the lateral circumflex femoral artery at its origin, the diameters of the vessels at the perforation points of its perforating branches, as well as the length of the vascular pedicle detected by the preoperative color Doppler ultrasound examination and the intraoperative exploration (with t values of 0.60, 0.85, and 0.78, respectively, P>0.05). On postoperative days 1, 3, 5, 7, and 14, the scores of flap blood supply status in ultrasound group of patients were significantly higher than those in control group (with t values of 8.64, 10.41, 10.84, 8.99, and 6.37, respectively, P<0.05). The duration of flap surgery and length of hospital stay in ultrasound group of patients were significantly shorter than those in control group (with t values of 5.34 and 3.73, respectively, P<0.05), and the intraoperative blood loss volume was significantly less than that in control group (t=18.37, P<0.05). The incidences of complications in the flap donor and recipient areas in ultrasound group of patients at different time points after surgery were significantly lower than those in control group (P<0.05). One year after surgery, the satisfaction rate of patients with the treatment outcomes in ultrasound group was significantly higher than that in control group (P<0.05). Conclusions The color Doppler ultrasound can be used to clarify the classification and distribution of the oblique branch of the lateral circumflex femoral artery preoperatively. Based on this, the ALTPF pedicled with the oblique branch of the lateral circumflex femoral artery was designed and harvested to repair the skin and soft tissue defects in the extremities. In comparison with empirical treatment, it can reduce intraoperative blood loss volume,significantly improve the postoperative flap blood supply, effectively shorten surgical duration and length of hospital stay, reduce the incidence of complications, and enhance patients' satisfaction with treatment outcomes.

Proteomics analysis of the effect and mechanism of ADSCs on full-thickness skin defects in diabetic rats

Gu Yuan, Chen Yuanzheng, Wang Shuyu, Song Hongye, Bai Nan

2026, 42(1): 91-100. doi: 10.3760/cma.j.cn501225-20240617-00236

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Objective To explore the effect and mechanism of adipose-derived mesenchymal stem cells (ADSCs) on full-thickness skin defects in diabetic rats using proteomics analysis. Methods This study was a self-control design experimental study. Four 8 to 10 weeks old male Sprague-Dawley rats were selected, and ADSCs were extracted from their epididymal adipose tissue and successfully identified. The third passage of ADSCs were used for the following experiments. Twenty-four 4 to 6 weeks old male Sprague-Dawley rats were selected and the type 2 diabetes model was successfully established. Among them, 16 diabetic rats weighing 350 to 400 g were chosen, and a full-thickness skin defect wound was created on each side of the spine on their backs at the same level. Using the random number table method, the two wounds of each rat were included in experimental group and control group (with 16 wounds in each group), and the cell suspensions containing ADSCs and phosphate buffered saline were injected at multiple points around and at the base of the wounds immediately after injury, respectively. The wound healing rates were calculated at day 7, 10, and 14 after injury in rats. At day 7 after injury in rats, wound tissue was collected and proteins were extracted. Four-dimensional data-independent acquisition label-free quantitative proteomics technology was used for quantitative proteomics analysis and bioinformatics analysis to screen differentially expressed proteins (DEPs) in the two groups of wound tissue. Then, key DEPs were screened through protein-protein interaction networks, gene ontology (GO) was used for functional annotation and enrichment analysis, and Kyoto encyclopedia of genes and genomes (KEGG) was used for pathway enrichment analysis to further screen target DEPs. The wound tissue of rats 7 days after injury was collected, and Western blotting was used to detect the protein expression of thymocyte differentiation antigen 1 (Thy-1) and G protein-coupled receptor 177/Wnt ligand secretion mediator (GPR177/Wls). Results At day 7, 10, and 14 after injury in rats, the wound healing rates in experimental group were (66±16)%, (83±8)%, and (93±4)%, respectively, which were significantly higher than (30±8)%, (62±6)%, and (77±8)% in control group (with t values of -4.41, -7.46, and -6.65, respectively, P<0.05). At day 7 after injury in rats, compared with those in control group, a total of 474 DEPs were screened from the wound tissue in experimental group (P<0.05). A total of 224 key DEPs were further screened out, among which 78 DEPs were significantly upregulated and 146 DEPs were significantly downregulated. GO functional annotation analysis showed that the most significantly upregulated and downregulated DEPs mainly affected protein expression under cellular processes and biological regulation conditions, and were related to cell anatomical entities and protein-containing complexes, as well as specific binding and catalytic activity between biomolecules. GO functional enrichment analysis showed that the most significantly upregulated DEPs were significantly enriched in Wnt-protein binding. KEGG pathway enrichment analysis showed that the significantly upregulated and downregulated DEPs were enriched in pathways such as starch and sucrose metabolism, nucleotide metabolism, p53 signaling pathway, and extracellular matrix -receptor interaction, and so on. A total of 4 target proteins were screened out, including Thy-1, GPR177/Wls, Fer/CIP4 homology domain only 2, and mitochondrial ribosomal protein L21, with the first two being significantly upregulated DEPs while the latter two being significantly downregulated DEPs. At day 7 after injury in rats, the protein expressions of GPR177/Wls and Thy-1 in the wound tissue in experimental group were 0.93±0.07 and 0.96±0.05, respectively, which were significantly higher than 0.39±0.07 and 0.36±0.12 in control group (with t values of 11.61 and 9.41, respectively, P<0.05). Conclusions Based on proteomics analysis, it was revealed that ADSCs from rats can promote the wound healing of full-thickness skin defects in diabetic rats by upregulating the protein expression of GPR177/Wls and Thy-1.

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2026, Volume 42, Issue 1

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Current Issue 2026, Volume 42, Issue 1

Guidelines and Consensus>>

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Current Issue
2026, Volume 42, Issue 1