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Objective: After injury, humans and other mammals heal by forming fibrotic scar tissue with diminished function, and this healing process involves the dynamic interplay between resident cells withi...

Despite important advances in the pre-clinical animal studies investigating the neuroinhibitory microenvironment at the injury site, traumatic injury to the spinal cord remains a major problem with no concrete response. Here, we examined whether (1) intranasal (IN) administration of miR133b/Ago2 can reach the injury site and achieve a therapeutic effect and (2) NEO100-based formulation of miR133b/Ago2 can improve effectiveness. 24 h after a cervical contusion, C57BL6 female mice received IN delivery of miR133b/Ago2 or miR133b/Ago2/NEO100 for 3 days, one dose per day. The pharmacokinetics of miR133b in the spinal cord lesion was determined by RT-qPCR. The role of IN delivery of miR133b on motor function was assessed by the grip strength meter (GSM) and hanging tasks. The activity of miR133b at the lesion site was established by immunostaining of fibronectin 1 (FN1), a miR133b target. We found that IN delivery of miR133b/Ago2 (1) reaches the lesion scar and co-administration of miR133b with NEO100 facilitated the cellular uptake; (2) enhanced the motor function and addition of NEO100 potentiated this effect and (3) targeted FN1 expression at the lesion scar. Our results suggest a high efficacy of IN delivery of miR133b/Ago2 to the injured spinal cord that translates to improved healing with NEO100 further potentiating this effect.

Background and objectives Both artesunate and fractional CO2 laser have been proved effective in the treatment of hypertrophic scars, yet little data are available for the efficacy of artesunate combined with fractional CO2 laser. In order to assess the pre-clinical significance and the underlying mechanism of this combined treatment profile, we attempted to observe the effectiveness of this therapy in rabbit models through determining the expression of BMP-7 and Fas. Materials and methods Twenty-Four New Zealand white rabbits with established hypertrophic scar samples were randomly divided into control group and three treatment groups. Artesunate (20 μl/cm2) was injected into the rat’s scar of artesunate and combination groups, while fractional CO2 laser (Combo mode, deep energy:10 mJ, super energy: 50 mJ) was applied to rats in fractional CO2 laser and combination groups at week 4 after model establishment. All rabbits underwent a total of 3 sessions of treatment once every 2 weeks. Histological and immunohistochemistry study, Western blot assay, cell viability, ELISA and RT-QPCR were performed at week 10 to observe the aspects of hypertrophic scar sample changes and expression of BMP-7 and Fas in the scar tissues. Results Compared with control group, hypertrophic scars and the collagen fibers were significantly inhibited after treatment, and higher inhibition was seen in the samples in combination group compared to that in artesunate and fractional CO2 laser groups (P Conclusions Artesunate combined with fractional CO2 laser is effective in hypertrophic scarring in this rabbit model. Our findings can serve as a potential alternative strategy to treatment of hypertrophic scar in clinical practice.

Keloids are disfiguring pathological scars that could cause pain and pruritus. The conventional treatments, such as bolus injection of drugs or surgery, are invasive and require a personal visit to clinic. Microneedle (MN) technology has great potential to offer a self-administered and minimally invasive treatment of keloids. However, drugs delivered using MNs suffer from limited penetration in keloid tissue. This study demonstrates enhanced drug penetration in human keloid scar tissue by combining MN and sonophoresis.

Purpose To determine the differences in the scar tissue formation during the healing of the repaired retracted cuff tear from that of the nonretracted tear. Methods Eighteen right rabbit shoulders received a 1-cm transverse cuff incision over the footprint to simulate “nonretracted cuff tears” before the transosseous repairs (group A). A 1-cm tendinous portion was excised from 18 left shoulders to create defects to simulate “retracted cuff tears” before repairing the defects (group B). At week 12 postrepair, 20 and 16 shoulders underwent histologic and biomechanical analyses, respectively. Eight shoulders were used as a control group for biomechanical analyses. Results All specimens showed good healing and continuity of the repaired tendons. At low magnification, fibrous tissue firmly held the tendon-to-bone junctions in group A; however, all specimens in group B showed medially retracted tendons with fibrous tissue continuity between the tendon stumps and footprints. At medium magnification, more irregular collagen fiber orientation was observed in group B. Polarized light microscopy showed fibrous tissue continuity with medially retracted tendons in group B. When we quantified collagen fiber orientation using ImageJ software, group B had inferior grayscale measurements when compared with group A (P = .001). At week 12, no statistical differences existed in mean loads-to-failure at the repair sites between the groups (P = .783). Conclusions In the nonretracted cuff tears, fibrous tissue bound the tendon-to-bone junction with healing. After the healing of the retracted cuff tears, continuity of nontendinous tissue was observed adjacent to the medially retracted tendon, which comprised more disorganized immature fibrous tissue than that in the nonretracted cuff tears. Clinical Relevance Unlike the healing of nonretracted rotator cuff tear, repairing of the “retracted” tendon end of cuff tear still resulted in retraction of the tendon back to its original position but being held down with fibrous tissue to the footprint.

The U.S. Transuranium and Uranium Registries whole-body tissue donor Case 0407 had an acute intake of ‘high-fired’ plutonium oxide resulting from a glove-box fire in a fabrication plant at a nuclear defence facility. The respiratory tract of this individual was dissected into five regions (larynx, bronchi, bronchioles, alveolar-interstitial, and thoracic lymph nodes) and analysed for plutonium content. The activities in certain compartments of the respiratory tract were found to be higher than expected from the default models described in publications of the International Commission on Radiological Protection. Because of the extremely slow rate of dissolution of the material inhaled, the presence of bound fraction is incapable of explaining the higher-than-expected retention. A plausible hypothesis—encapsulation of plutonium in scar tissues—is supported by the review of literature. Therefore, scar-tissue compartments corresponding to the larynx, bronchi, bronchioles and alveolar-interstitial regions were added to the existing human respiratory tract model structure. The transfer rates between these compartments were determined using Markov Chain Monte Carlo analysis of data on urinary excretion, lung counts and post-mortem measurements of the liver, skeleton and regional retention in the respiratory tract. Modelling of the data showed that approximately 30% of plutonium activity in the lung was sequestered in scar tissues. The dose consequence of such sequestration is qualitatively compared against that of chemical binding.

Introduction Vertical ridge augmentation (VRA) is one of the most challenging procedures. This is the first case report to show 2-5 mm VRA after two unsuccessful GBRs around previously placed dental implants, with the use of an exposed d-PTFE membrane. Case presentation A 79-year-old ASA II Caucasian male presented after two previous GBR procedures on the LLQ. The second attempt left the site with two exposed implants, scar tissue, no keratinized tissue and lack of vestibular depth. VRA was attempted with the use of cortical perforations, tenting screws, dense PTFE membrane and a 50:50 mixture of anorganic bovine bone matrix and mineralized allograft. The site was left to heal in a secondary intention, leaving the d-PTFE membrane exposed. The membrane was removed 4 weeks postoperatively. The healing abutments were placed, the tenting screws were removed, and the site was allowed to heal for more than seven months. Radiographically, VRA was achieved ranging from 2 to 5 mm. A vestibuloplasty was performed using a diode laser and subsequent flap dissection. Four months after the vestibuloplasty, the tissue surrounding the implants showed adequate keratinization, and an elongated vestibular depth. In addition, in both implants, the emergence profile buccal and lingual was more than 3 mm and the patient was referred to his prosthodontist for the fabrication of the final restorations. Conclusions VRA around dental implants was achieved with the use of a nonresorbable dense PTFE membrane, which was left exposed to heal in a secondary intention, tenting screws and a combination grafting technique to correct two previously failed GBRs.

Gastric ulcers are one of the most common stomach diseases that often accompanied by inflammation, congestion, edema, scar tissue formation, and pyloric obstruction. Fiberoptic endoscopy and X-ray analysis of the upper GI tract have become the diagnostic procedure of choice for patients. However, conventional diagnosis technology is either invasive or radioactive. Herein, a novel CD-MOF NIR-II fluorophore (GPs-CH1055) was developed. The relative fluorophore intensity was largely consistent at various media and pH buffers, and it can swell into gel particles in solvents and be completely expelled from the gastrointestinal tract without being assimilated. GPs-CH1055 has been further evaluated in vivo, and exhibited strong retention effect on the gastric ulcer sites, bright NIR-II signals with high spatial and temporal resolution. Therefore, GPs-CH1055 shows great promise for realizing real-time gastric ulcer imaging and diagnosis.

The respiratory tract tissues of four former nuclear workers with plutonium intakes were radiochemically analyzed post mortem by the United States Transuranium and Uranium Registries. Plutonium activities in the upper respiratory tract of these individuals were found to be higher than those predicted using the most recent biokinetic models described in publications of the International Commission on Radiological Protection. Modification of the model parameters, including the bound fraction, was not able to explain the data in one of the four individuals who had inhaled insoluble form of plutonium. Literature review points to the presence of—and a significant retention of—plutonium in the scar tissues of the lungs. Accordingly, an alternate model with scar-tissue compartments corresponding to larynx, bronchi, bronchioles, alveolar-interstitium and thoracic lymph nodes was proposed. The rates of transfer to the scar tissue compartments were determined using Markov Chain Monte Carlo analysis of data on urinary excretion, lung counts and post-mortem measurements of liver, skeleton and individual respiratory tract compartments, as available. The posterior models predicted that 20–100%—depending on the solubility of the material inhaled—of the activities retained in the respiratory tract were sequestered in the scar tissues.

The therapeutic interventions of human hypertrophic scars (HHS) remain puzzle largely due to the lack of accepted models. Current HHS models are limited by their inability to mimic native scar architecture and associated pathological microenvironments. Here, we create a 3D functional HHS model by preformed cellular aggregates (PCA) bioprinting, firstly developing bioink from scar decellularized extracellular matrix (ECM) and alginate-gelatin (Alg-Gel) hydrogel with suitable physical properties to mimic the microenvironmental factors, then pre-culturing patient-derived fibroblasts in this bioink to preform the topographic cellular aggregates for sequent printing. We confirm the cell aggregates preformed in bioink displayed well defined aligned structure and formed functional scar tissue self-organization after bioprinting, hence showing the potential of creating HHS models. Notably, these HHS models exhibit characteristics of early-stage HHS in gene and protein expression, which significantly activated signaling pathway related to inflammation and cell proliferation, and recapitulate in vivo tissue dynamics of scar forming. We also use the in vitro and in vivo models to define the clinically observed effects to treatment with concurrent anti-scarring drugs, and the data show that it can be used to evaluate the potential therapeutic target for drug testing. The ideal humanized scar models we present should prove useful for studying critical mechanisms underlying HHS and to rapidly test new drug targets and develop patient-specific optimal therapeutic strategies in the future., Graphical abstract Image 1, Highlights • PCA bioprinted model mimics the microenvironmental factors of hypertrophic scar. • PCA bioprinting promotes functional scar self-organization. • Hypertrophic scar model exhibit characteristics of early-stage HHS. • HHS model could be able to study the scar biology and drug screen.

Scars usually do not show strong contrast under standard skin examination relying on dermoscopes. They usually develop after skin injury when the body repairs the damaged tissue. In general, scars cause multiple types of distress such as movement restrictions, pain, itchiness and the psychological impact of the associated cosmetic disfigurement with no universally successful treatment option available at the moment. Scar treatment has significant economic impact as well. Mueller matrix polarimetry with integrated autofocus and automatic data registration can potentially improve scar assessment by the dermatologist and help to make the evaluation of the treatment outcome objective. Polarimetry can provide new physical parameters for an objective treatment evaluation. We show that Mueller matrix polarimetry can enable strong contrast for in vivo scar imaging. Additionally, our results indicate that the polarization stain images obtained form there could be a useful tool for dermatology. Furthermore, we demonstrate that polarimetry can be used to monitor wound healing, which may help prevent scarring altogether.

BACKGROUND The procedure of reinfibulation is the resuturing (usually after vaginal childbirth) of the incised scar tissue in women with previous female genital mutilation. Many authorities do not recommend the practice of reinfibulation. OBJECTIVE We sought to assess physicians' approach to the practice of reinfibulation. STUDY DESIGN A structured online, anonymous questionnaire was sent to 130 practicing obstetricians and gynecologists through Survey Monkey. RESULTS The questionnaire was completed by 98 respondents (75.4%).This survey showed that 76% of obstetricians (74 of 98) agree with a standard policy of not performing reinfibulation. However, 37% of those who refused to perform reinfibulation (27 of 74) would agree to undertake it if the woman insisted because she feared marital problems or divorce, and 73% of them (54 of 74) would offer treatment from an obstetrician with a different view. CONCLUSION The complex nature of reinfibulation is discussed and an alternative approach is suggested.

Among the available dressings for partial-thickness burn wound treatment, SUPRATHEL has shown good usability and effectiveness for wound healing and patient comfort and has been used in many burn centres in the last decade. Recently, bacterial nanocellulose (BNC) has become popular for the treatment of wounds, and many studies have demonstrated its efficacy. epicitehydro , consisting of BNC and 95% water, is a promising product and has recently been introduced in numerous burn centres. To date, no studies including direct comparisons to existing products like SUPRATHEL have been conducted. Therefore, we aimed to compare epicitehydro to SUPRATHEL in the treatment of partial-thickness burns. Twenty patients with partial-thickness burns affecting more than 0.5% of their total body surface area (TBSA) were enrolled in this prospective, unicentric, open, comparative, intra-individual clinical study. After debridement, the wounds were divided into two areas: one was treated with SUPRATHEL and the other with epicitehydro . Wound healing, infection, bleeding, exudation, dressing changes, and pain were documented. The quality of the scar tissue was assessed subjectively using the Patient and Observer Scar Scale. Wound healing in patients with a mean TBSA of 9.2% took 15 to 16 days for both treatments without dressing changes. All wounds showed minimal exudation, and patients reported decreased pain with the only significant difference between the two dressings on day 1. No infection or bleeding occurred in any of the wounds. Regarding scar evaluation, SUPRATHEL and epicitehydro did not differ significantly. Both wound dressings were easy to use, were highly flexible, created a safe healing environment, had similar effects on pain reduction, and showed good cosmetic and functional results without necessary dressing changes. Therefore, epicitehydro can be used as an alternative to SUPRATHEL for the treatment of partial-thickness burn wounds.

Background: Achilles tendon rupture diagnosis is frequently missed, leading to the development of a chronic rupture that requires surgical intervention to remove scar tissue and return the elongated Achilles tendon to appropriate functional length. The limited scar resection (LSR) intervention strategy may provide an advantage over other techniques, as it is less invasive and nondestructive to other tissues, although there is little evidence comparing outcomes between intervention strategies. Hypothesis: The LSR technique would be a viable treatment option for chronic Achilles tendon ruptures and would perform comparably with a more clinically accepted procedure, the gastrocnemius fascial turndown (GFT), in postintervention functional outcome measures and tendon mechanical and histological properties. Study Design: Controlled laboratory study. Methods: Chronic Achilles tendon ruptures were induced in the right hindlimb of Sprague-Dawley rats by Achilles tendon transection without repair, immobilization in dorsiflexion, and 5 weeks of cage activity. Animals were randomly divided between the intervention strategy groups (LSR and GFT), received 1 week of immobilization in plantarflexion, and were sacrificed at 3 or 6 weeks postintervention. In vivo functional outcome measures (gait kinetics, passive joint function, tendon vascular perfusion) were quantified during healing, and tendon mechanical and histological properties were assessed postsacrifice. Results: When compared with the GFT, the LSR technique elicited a faster return to baseline in gait kinetics, although there were few differences between groups or with healing time in other functional outcome measures (passive joint function and vascular perfusion). Quasi-static mechanical properties were improved with healing in both surgical intervention groups, although only the LSR group showed an improvement in fatigue properties between 3 and 6 weeks postintervention. Histological properties were similar between intervention strategies, except for decreased cellularity in the LSR group at 6 weeks postintervention. Conclusion: The LSR technique is a viable surgical intervention strategy for a chronic Achilles tendon rupture in a rodent model, and it performs similarly, if not better, when directly compared with a more clinically accepted surgery, the GFT. Clinical Relevance: This study supports the increased clinical use of the LSR technique for treating chronic Achilles tendon rupture cases.

It is well known that collagen tissue, especially the collagen structure, plays an important role in wound healing. However, most research on collagen has been qualitative and morphological, based on sections, and cannot be used for real-time monitoring and clinical prediction. There are no standardized methods of quantitative analysis based on the whole skin sample in three dimensions (3-D). In order to explore a 3-D quantitative analysis, we developed a method that was derived from that of material science and physics, combined with our previous technique, X-ray scattering (SAXS). We hypothesized that the dermis might be analysed by fractal dimensions. To test this hypothesis, we performed the analysis in different pathological conditions, such as scar tissue, different time points after wounding, skin in different degrees of burns and skin in diabetes. The results showed that fractal dimension analysis could detect differences in different locations of the scar tissue, at different time points after wounding, and at a different extent of the severity of skin in diabetes. The research demonstrated that fractal dimension analysis can describe the 3-D structure of the collagen tissue of the skin, which will be beneficial for studying wound healing and finding new clinical treatments.

The paper presents evidence of the effectiveness and safety of using the acoustic method for predicting scar formation in patients with purulent inflammatory diseases of the face and neck. An acoustic medical diagnostic device was used to develop a prognostic criterion for assessing scar formation in these patients, and factors influencing the scarring process have been determined. Results of this study demonstrated that it is possible to determine the type of scarring at the early stage of wound healing in patients with purulent inflammatory diseases in the face and neck area using an acoustic medical diagnostic device that allows the assessment of the scarring type, prescribing adequate treatment, and taking preventive measures against pathological scarring of tissues.

Both silicone gel and quercetin are effective in scar treatment but have different action mechanisms. Quercetin is mainly applied in the gel form and can lead to poor adhesion of silicone gel sheet; therefore, they cannot be combined in clinical use. In this study, a silicone gel sheet that releases quercetin in a sustained manner for 48 hours was successfully developed. Four round scars (Ø: 1 cm) were made in the ears of New Zealand albino rabbits (n = 10). After scar healing, the rabbits were divided into four groups: blank control group with no treatment, silicone gel sheet group with dressing change every 2 days, quercetin group with dressing change three times daily, and combination treatment group with dressing change every 2 days. Scar assessment was performed 3 months later. Transepidermal water loss showed no difference between the combination treatment group and the silicone gel sheet group, but was lower than that in the quercetin group and the blank control group. Immunohistochemistry of CD 31 and proliferating cell nuclear antigen showed the following results: combination treatment group < silicone gel sheet group = quercetin group < blank control group. Polymerase chain reaction results showed that the expression of type-I and type-III collagen in the combination treatment group and the quercetin group was significantly lower than that in the other two groups. Thus, quercetin-modified silicone gel sheet combines the advantages of the two treatments and is more effective at inhibiting cell proliferation in scar tissue than either of the two treatments alone.

Keloids are unorganized proliferation of fibrous tissue, usually arising from a site of injury, due to an aberrant healing process. Clinically, it presents as an ugly scar tissue on the skin and shows genetic predilection. They cause esthetic, physical, and psychological disturbances in the affected individuals. Such patients require special precautions during the normal surgical procedures. Keloid treatment is prone to a high degree of resistance and recurrence. In this article, one such a case is reported along with a review of the literature discussing the nature of the lesion, treatment options, and the recommended precautions.

BACKGROUND Ventricular scars due to myocardial infarction provide a substrate for ventricular arrhythmias, and cardiac magnetic resonance (CMR) is the golden standard for the quantification of scar tissue magnitude. CMR has still limitations with patients with ICD despite ICD's becoming MR-compatible. We investigated the association between calibrated integrated backscatter (cIBS) and arrhythmia frequency in patients with ICD. METHODS Thirty-two ischemic dilated cardiomyopathy (ICM) patients with VVI-ICD (mean age 66.56 ± 9.05, 28 male, and four female) were divided into three groups according to their arrhythmia frequency (ventricular arrhythmia-[VA -], VA + [VA +], and arrhythmia storm [AS]). Then with transthoracic echocardiography (TTE), all patients' cIBS values were calculated and these values were compared with the patients' arrhythmia frequency. RESULTS cIBS values of patients with VA + and AS were significantly higher in the apical-septal (0.66 ± 0.11 vs. 0.50 ± 0.16, p = .008) and apical-lateral (0.62 ± 0.19 vs. 0.46 ± 0.18, p = .041) segments compared to those of patients with VA -. The cIBS values of apical-septal (0.50 ± 0.16 vs. 0.65 ± 0.08 vs. 0.66 ± 0.13 respectively, p = .032) and apical-anterior (0.53 ± 0.22 vs. 0.48 ± 0.17 vs. 0.79 ± 0.23 respectively, p = .03) segments were significantly different between the groups. Furthermore, in the post hoc analysis, the difference was significantly higher in VA + than VA - in the apical-septal segment and higher in AS than VA + in apical-anterior segments. CONCLUSION Our findings suggest an association between the cIBS values and arrhythmia frequency in the study group.

Background: Acne is the most common skin disorder, especially in adolescents and youths. Inflammation due to acne may leave scar tissue. The scar severity may correlate with gender and skin type. Objective: This study aims to investigate the correlation between gender, skin type, and acne scar severity in youth. Methods: This is a cross-sectional study with 132 (81 female) medical college students aged from 18 to 23 participated in the study. Skin type was assessed using a Baumann Skin Type questionnaire. Acne scar severity was evaluated using the Qualitative Global Scarring Grading. Skin examination was conducted through the image from the face photograph. Lambda test was used to confirm the correlation between gender, skin type, and acne scar severity. Multiple logistic regression was applied to determine the odd risk of gender and skin type to moderate-severe acne scar. Significance was set at p

Myocardial infarction (MI) can lead to scar tissue formation and even heart failure. Cardiac patches are a promising technology to strengthen scar tissue post-MI. In this work, we introduce a novel periodic architected material (PAM) for potential use as cardiac patches to prevent aneurysm. The PAM is formed by a set of triangular architectures that rotate as stretching is applied. Using a combination of analytical, computational, and experimental methods, we analyze the mechanical aspects and design of the rotating triangles PAM. We demonstrate that this new material can produce localized deformation in the heart tissue and improve the force generation in the infarcted tissue. Furthermore, we show that the mechanical behavior of the rotating triangles PAM can be easily tuned, facilitating the match between the mechanical behavior of the myocardium and the cardiac patch.

In patients with burn injury, due to the inevitable preservation of a cosmetic defectafter injury, although in the presence of positive functional results of treatment, rehabilitation is ofparamount importance. Physical rehabilitation of burn patients is consistently carried out duringall periods of burn disease. Preventive rehabilitation (the first stage) is carried out in the acuteperiod of trauma in the process of restoring the lost skin. At the second stage (early conservativerehabilitation), when, after closure of wounds, there is an intensive formation of scar tissue,conservative measures are aimed at limiting, softening scars and preventing deformities andcontractures.

The aim of the study was to observe the effect of allogeneic acellular dermal matrix (ADM) combined with autologous razor‐thin graft on the appearance and function of hands in patients with extremely large area burns combined with deep hand burns. Sixty‐four patients with severe burn combined with deep burn of the hand in our hospital from August 2015 to August 2019 were selected as the study subjects. All patients were randomly divided into the study group (32 cases, given allogeneic ADM combined with autologous razor‐thin graft) and the control group (32 cases, given autologous scar tissue combined with autologous razor‐thin graft). Hand appearance, wound healing, wound contraction, hand function, and quality of life were compared between the two groups at 3 and 6 months after treatment. The vascular distribution, skin thickness, and flexibility scores of the two groups 6 months post operation were lower than those of the 3 months post operation (P

To date, treatment of atrophic acne scars remains a therapeutic challenge for dermatologists, yet there is no standard option on the most effective treatment. Microneedling (MN) is a minimally invasive technology that involves repetitive skin puncture using sterile microneedles to disrupt dermal collagen that connects the scar tissue. Recent studies have demonstrated the potency of MN, such as dermaroller and fractionated microneedle radiofrequency, in the treatment of atrophic scars. The objective of this review is to evaluate systematically the current literature on MN for atrophic acne scars. A systematic search of literature was performed from PubMed, Medline, Cochrane Central, and Google Scholar databases for articles published during the last 20 years. Only randomised controlled trials (RCTs) with full‐text version of the manuscript available were included in our study. Nine RCTs were included in this review. All treatment modalities demonstrated consistent results that MN was efficacious in treating atrophic acne scars as a monotherapy or in combination with other treatments. Moreover, no serious adverse effects were reported in all studies after MN treatment. MN is a well‐tolerated and effective therapeutic modality in treating atrophic acne scars. Further research is required to validate the efficacy of MN with a larger sample size and lengthy follow‐up.

Objective Caesarean rates have increased rapidly for various reasons recently. One of the important reasons among these is medicolegal problems. Our aim with this study was to preoperatively predict abdominal adhesion density by combining the scar tissue morphology formed in the post-caesarean Pfannenstiel incision line and the skin color scoring of the patients. Material and methods Patients who had undergone one caesarean section previously, completed their terms (37−39 weeks) and were under 35 years old were included in the study. Skin color scoring of the patients was performed using the Fitzpatrick skin color scale. Intra-abdominal adhesion scoring of the participant patients was performed using Nair’s adhesion scoring system. Results The change in abdominal adhesion scores was evaluated based on the Fitzpatrick color scale. Adhesion scores per the Nair intra-abdominal adhesion scoring system were found to be 0.04±0.209 in the FP1 group, 0.35±0.662 in the FP2 group, 1.58±0.923 in the FP3 group, and 2.33±0.577 in the FP4 group (p Conclusion The aim of this study was to increase the prediction rates by adding the skin color scoring to the scar tissue characteristics, which have been used in previous studies. The results of this study indicate that the combination of these two parameters may be more effective in predicting intra-abdominal adhesions. Nevertheless, there is a need for studies with a much higher number of patients and multiple parameters to be able to predict intra-abdominal adhesion density preoperatively with greater accuracy.

Although many invasive and noninvasive approaches exist, management of keloids and hypertrophic scars remains challenging. By better understanding patient expectations regarding scar treatments, dermatologists can provide higher quality and more satisfying care. Survey patients age 18 to 80 years with a history of hypertrophic, keloid, or disfiguring scars. Overall, 187 participants completed the 25-question survey. Expectations and willingness were measured on a 1-5 Likert scale. Results were analyzed overall and by patient demographics. Older respondents more often expected scar reduction, while younger patients expected scar removal. Compared with Caucasians, Asian respondents were more symptomatic, more likely to have seen a physician, and more willing to undergo invasive therapies. Respondent willingness for treatment and their perceived efficacy significantly differed across gender, age, and race. This study explores a gap in the literature of what role patient expectations play in electing specific treatments. Although patient expectations are complex and context dependent, gaining more understanding of what therapies patients are willing to attempt, and their expectations from those therapies could help guide counseling with the goal setting realistic expectations to improve patient compliance and satisfaction.

In this study, ultrasound measurement was used to reveal objective differences between male and female patients in arm burn scar thickness. An experienced physician trained by radiologists used an ultrasound machine and a digital height and weight scale to measure normal skin and scar thicknesses and patients’ body mass indices (BMIs). On the day of testing, the pressure garments (PGs) on the patients’ arms were removed. Bonferroni 95% confidence intervals for scar thicknesses measured in female and male patients were 0.135 to 0.212 cm and 0.045 to 0.113 cm, respectively; the individual confidence level was 97.5%. For both groups, a P value of

Following myocardial infarction, tissue undergoes pathophysiological changes involving inflammation and scar tissue formation. However, little is known about the pathophysiology and prognostic significance of any corresponding changes in remote myocardium. The aim of this study was to investigate the potential application of a combined constant infusion of 18F-FDG and Gd-DTPA to quantitate inflammation and extracellular volume (ECV) from 3 to 40 days after myocardial infarction. Eight canine subjects were imaged at multiple time points following induction of an MI with a 60-minute concurrent constant infusion of Gd-DTPA and 18F-FDG using a hybrid PET/MRI scanner. There was a significant increase in ECV in remote myocardium on day 14 post-MI (P = .034) and day 21 (P = .021) compared to the baseline. ECV was significantly elevated in the infarcted myocardium compared to remote myocardium at all time points post-MI (days 3, 7, 14, 21, and 40) (P < .001) while glucose uptake was also increased within the infarct on days 3, 7, 14, and 21 but not 40. The significant increase in ECV in remote tissue may be due to an ongoing inflammatory process in the early weeks post-infarct.

A wound is a break in the continuity of the skin. The body’s response to injury and the restoration of the same is healing. Wound healing is a biological process that is initiated by trauma and often terminated by scar formation. In this research, guava leaf extract was used as antiseptic and its efficacy was tested to commercially available products. The result revealed that all mice which received guava leaf extract formed scar earlier as compared to povidone iodine and PNSS. Since maturation phase which also refers to remodeling phase is responsible for the new epithelium and final scar tissue formation, and as the development of these completes the complex process of wound healing, the researchers suggest that the use of guava leaf extract in comparison with povidone iodine and PNSS when it comes to wound healing is the most affordable in treatment and promoting normal and more rapid wound healing.

Introduction: Children aged 0–6 years with Chiari malformation (CM) often present with atypical symptoms and require revision surgery more often than older children. We studied characteristics and outcomes of CM patients in this age-group who underwent one or more revision surgeries to assess how often revision surgery is necessary and successful in this age-group. Methods: We retrospectively reviewed patients who were diagnosed with CM 1 or CM 1.5 and surgically treated with posterior fossa decompression (PFD) with or without duraplasty before their 7th birthday. Basic demographics, preoperative presentation, operative details, and postoperative outcomes were analyzed. Results: Forty patients (mean age 3.2 ± 1.7 years, 35% female) were reviewed. The most common presenting symptoms were headache, dysphagia, and respiratory problems. Eight patients required one or more revision surgeries 11.6 ± 7.6 months on average after their initial surgery. Comparing the revision and no revision groups, dysautonomia was significantly more common prior to initial surgery in the children requiring revision (37.5 vs. 3.1%, p = 0.02). The revision group also trended toward more dysphagia (75.0 vs. 46.9%, p = 0.24) and respiratory problems (75.0 vs. 40.6%, p = 0.12). The most frequent reasons for reoperation were symptom recurrence (6/8), residual posterior fossa compression (3/8), significant scar tissue formation (2/8), ventral brainstem compression (1/8), and suspected craniocervical instability (1/8). Of the 8 children undergoing reoperation, surgery achieved symptom resolution or improvement in 5, while 3 had unchanged symptoms. Two patients underwent a third surgery, after which 1 showed improvement and the other did not. This last patient showed short-term improvement after a fourth surgery but had symptom recurrence 12 months later. Discussion/Conclusion: Oropharyngeal and respiratory problems are particularly common in children aged 0–6 years with CM. Presentation with dysautonomia or other signs of brainstem compression will often predict an additional surgery will be needed after an initial PFD. Symptom recurrence is the most frequent reason for reoperation, and revision surgeries lead to improved clinical outcomes in the majority but not all of these young patients. Surgery in very young children is successful, but reoperation should be integrated into an up-front discussion algorithm particularly in children with severe symptoms.

Post-infarct-related ventricular tachycardia (VT) occurs due to reentry over surviving fibres within ventricular scar tissue. The mapping and ablation of patients in VT remains a challenge when VT is poorly tolerated and in cases in which VT is non-sustained or not inducible. Conventional substrate mapping techniques are limited by the ambiguity of substrate characterisation methods and the variety of mapping tools, which may record signals differently based on their bipolar spacing and electrode size. Real world data suggest that outcomes from VT ablation remain poor in terms of freedom from recurrent therapy using conventional techniques. Functional substrate mapping techniques, such as single extrastimulus protocol mapping, identify regions of unmasked delayed potentials, which, by nature of their dynamic and functional components, may play a critical role in sustaining VT. These methods may improve substrate mapping of VT, potentially making ablation safer and more reproducible, and thereby improving the outcomes. Further large-scale studies are needed.

The evaluation of the morphology and organization of collagen fibers is critical in understanding wound healing and tissue remodeling after a thermal injury of the skin. However, histological analysis conducted by pathologists is often labor-intensive and limited to qualitative evaluations and scoring within a narrow field of view. In this study, we propose a convolutional neural network (CNN) model to classify Masson’s trichrome (MT)-stained histology images of burn-induced scar tissue and to characterize the microstructures of normal tissue and scar tissue in a quantitative manner. The scar tissue is created on in vivo rodent models and prepared for MT-stained histology slides after wound healing. A CNN model is developed, trained, and tested with various sizes of the histology images for classification and characterization. The proposed model classifies both normal tissue (i.e., without burn, as the control) and scar tissue at various scales with over 97% accuracy. The features acquired from the proposed CNN model visually characterizes the density and directional variance of the collagen fibers distributed in the dermal layers from whole histology images. The proposed deep learning technique can provide an objective and reliable method to rapidly assess and quantify wound repair and remodeling.

The tissue reaction of pig skin to implantation of decellularized and recellularized dermal matrices on a formed wound defect was evaluated by histological methods on days 2, 5, 8, 16, and 20 after surgery. Differences in tissue response to different matrices were identified. In experimental wounds coated with decellularized dermal matrices, we observed the formation of a scar tissue, which required autodermoplasty on day 12 of the experiment. In wounds coated with recellularized dermal matrices, all layers of the skin completely recovered by day 20 after surgery with the formation of full dermal and epidermal layers. Our findings suggest that reparative morphological changes in the wound depend on the presence of fibroblasts in the implanted dermal matrix.

Lips are highly exposed to various factors such as ultraviolet radiation (UV), food, tobacco. That may result in substantial morbidity. The lesions range from simple infections, reactive lesions to malignancies. The aim of this study is to determine the prevalence of different lip lesions among patients visiting a dental hospital. The study was done in a hospital setting. The study was a retrospective cross-sectional study. Data from 86000 patients visiting Saveetha Dental College from June 2019 to March 2020 were reviewed and the samples included patients presented with lip lesion. The data was collected, tabulated and analyzed using SPSS software. From the study, we observed that a total of 69 patients had lip lesions. Herpes labialis was the most prevalent lip lesion (76.8%). The prevalence of other lip lesions like mucocele (7.2%), angular cheilitis (5.8%), squamous cell carcinoma (2.9%), scar tissue granulomatous lesion (1.4%), hemangioendothelioma (1.4%) was very less. The lip lesions were more prevalent in males (55%). From this study, we can conclude that herpes labialis was the most prevalent lip lesion and it is more prevalent in males especially in older age(>50 years). The lip lesions range from developmental to malignancies. This study was done to gain adequate knowledge about the etiology, clinical features, diagnosis and prevalence of lip lesions.

Most patients with neurogenic thoracic outlet syndrome (NTOS) have a history of trauma. Scar tissue formation within the scalene muscle and around the nerves after injury cause arm and hand symptoms. We report that supraclavicular scalenotomy followed by external neurolysis without rib resection is very effective as the surgical treatment.Consecutive case series. Our aim was to evaluate the outcomes of patients who underwent supraclavicular scalenotomy followed by external neurolysis without rib resection for post-traumatic NTOS. Neurogenic thoracic outlet syndrome (NTOS) comprises over 95% of all TOS patients, and most patients with NTOS have a history of trauma before the onset of their symptoms. Patients treated with supraclavicular scalenotomy and neurolysis without rib resection from September 2014 to December 2019 were retrospectively reviewed by using the medical records and operative notes. Patient's characteristics, clinical symptoms before treatment, operative findings, and short- and long-term outcomes were assessed. To assess clinical outcomes at 2 months after surgery (short-term outcomes) and 12 months later (long-term outcomes), we used a 4-grade categorization (Excellent, Good, Fair, and Poor) of patients’ subjective evaluations after surgery on the basis of modified Odom's criteria. Excellent and Good were defined as a successful outcome. Ninety-six supraclavicular scalenotomies without rib resection were performed on patients with post-traumatic NTOS. The most common intraoperative observation was the fibrous bands within the anterior scalene muscle in 86 cases (89.6%). The short-term outcome with patients’ subjective evaluation in 96 operations at 2 months after surgery showed a 96.9% success rate (Excellent + Good). In 85 cases followed for more than 12 months after surgery, the success rate based on patients’ subjective evaluation at the last clinic follow-up appointment as a long-term outcome was 74.1%. In post-traumatic NTOS, it has been reported the arm and hand symptoms are due to pressure on the brachial plexus, which can stem from the swollen muscle following injuries and later from tightness of the scarred muscle. Considering this mechanism and our results, we concluded that supraclavicular scalenotomy and external neurolysis without rib resection made sense, as they were very effective and adequate to improve symptoms of NTOS. Level of Evidence: 5.

Purpose : to compare the effectiveness of corneal ulcer treatment by antibiotic therapy and local ultraviolet crosslinking in a clinical and morphological experimental study using the new Crosscor device. Material and methods . The study was performed on 15 rabbits (30 eyes) with a model of corneal ulceration caused by Staphylococcus aureus. Rabbits were divided into 3 groups of 5 specimens each (10 eyes). Group 1 received local ultraviolet A range (UVA) crosslinking (CL) of the cornea using the Crosscor device (3 procedures lasting 5, 6 and 6 minutes each were given with intervals of three days). In group 2, CL was combined with antibacterial treatment (AB): instillations of tobramycin 0.3 % and ofloxacin ointment 3 mg / g were given 4 times a day for 14 days. In the control group, only AB treatment was given. The dynamics of inflammation, the intensity of turbidity and the size of the corneal ulcer were evaluated using biomicroscopy, fluorescein test, photoregistration of the anterior part of the eye, and according to a point system. Morphological changes in the cornea were determined using light microscopy (Leica with a DFC 420C digital camera). Results . In group 1 (CL) complete healing of the ulcer defect was noted on the 9th day of observation; in group 2 (CL + AB), the diameter of the corneal ulcer was reduced to 1.6 ± 0.5 mm, in the control group (AB) it was reduced to 1.9 ± 0.3 mm (p < 0.05). The total score of inflammatory changes on day 9 in the 1st group was 0.8 ± 1.3, in the 2nd group, 3.6 ± 0.8, and in the control group, 3.7 ± 0.4 (p < 0.05). On day 9, in all cases of the 1st group, a slight clouding of the cornea was formed (0–-1 point); in the 2nd group and in the control group in 90 % of cases a rough clouding of the cornea with vascularization was formed (3 points). Morphological examination of the eyes showed that only in the 1st group avascular scars with an ordered arrangement of fibrous tissue fibrils were formed. Conclusion . The data obtained indicate a significantly higher efficiency of corneal ulcer treatment by local UVA crosslinking using Crosscor as compared with antibiotic therapy.

After ischemic injury in adolescence, the human heart has only limited capacity to regenerate. The loss of cardiomyocytes is typically replaced by fibrotic scar tissue. The resulting scars reduce myocardial contractility and function. To date, the gold standard for end-stage heart disease remains a heart transplant, which is not a realistic option due to donor heart shortage. The regenerative potential of reprogrammed stem cells has the potential for a long-expected breakthrough in development of efficient therapeutic interventions.

The understanding of Ilizarov’s biological principles is guiding clinical treatment. Ilizarov’s First Principle of Biology, Distraction Histogenesis, is a fundamental guidance for bone lengthening. The “Harbin Phenomenon” is an extension of “Transformation Histogenesis”, which was discovered by bone transport for bone defects treatment. It describes the transformation and regeneration capacities of scar tissues under slow and rhythmic distraction, and this transformation satisfies the morphological and functional requirements. This principle is a supplement to the first principle, and could be Ilizarov’s Second Principle of Biology. Together they form the basis to guide clinical bone transport treatment.

Tendons are specialized matrix-rich connective tissues that transmit forces from muscle to bone and are essential for movement. As tissues that frequently transfer large mechanical loads, tendons are commonly injured in patients of all ages. Following injury, mammalian tendons heal poorly through a slow process that forms disorganized fibrotic scar tissue with inferior biomechanical function. Current treatments are limited and patients can be left with a weaker tendon that is likely to re-rupture and an increased chance of developing degenerative conditions. More effective, alternative treatments are needed. However, our current understanding of tendon biology remains limited. Here, we emphasize why expanding our knowledge of tendon development, healing, and regeneration is imperative for advancing tendon regenerative medicine. We provide a comprehensive review of the current mechanisms governing tendon development and healing and further highlight recent work in regenerative tendon models including the neonatal mouse and zebrafish. Importantly, we discuss how present and future discoveries can be applied to both augment current treatments and design novel strategies to treat tendon injuries. This article is protected by copyright. All rights reserved.

Patients with congenital heart disease (CHD) are prone to develop atrial and ventricular arrhythmias. Multiple factors throughout life contribute to arrhythmogenicity substrate such as (i) (longstanding) volume and/or pressure overload, (ii) scar tissue, (iii) ageing-related structural remodelling, (iv) cardiovascular risk factors and (v) tachycardia-induced remodelling. At present, it is unknown whether, and to what extent, paediatric patients with CHD have atrial or ventricular conduction disorders early in life and whether there is a correlation between duration of volume/pressure overload and extensiveness of conduction disorders. To investigate this, we initiated high-resolution intraoperative epicardial mapping in paediatric patients with CHD undergoing primary open-heart surgery.

Bone possesses a remarkable repair capacity to regenerate completely without scar tissue formation. This unique characteristic, expressed during bone development, maintenance and injury (fracture) healing, is performed by the reparative cells including skeletal stem cells (SSCs) and their descendants. However, the identity and functional roles of SSCs remain controversial due to technological difficulties and the heterogeneity and plasticity of SSCs. Moreover, for many years, there has been a biased view that bone marrow is the main cell source for bone repair. Together, these limitations have greatly hampered our understanding of these important cell populations and their potential applications in the treatment of fractures and skeletal diseases. Here, we reanalyse and summarize current understanding of the reparative cells in bone regeneration and repair and outline recent progress in this area, with a particular emphasis on the temporal and spatial process of fracture healing, the sources of reparative cells, an updated definition of SSCs, and markers of skeletal stem/progenitor cells contributing to the repair of craniofacial and long bones, as well as the debate between SSCs and pericytes. Finally, we also discuss the existing problems, emerging novel technologies and future research directions in this field.

Reconstruction of auricular deformities and facial scars after burns is a challenging undertaking for surgeons. Excessive scar tissue, a poor blood supply and the paucity of available skin are all substantial difficulties that should be considered before the operation. Expanded neck flaps provide comparatively larger and thinner flaps for the simultaneous treatment of auricular deformities and facial scars in burn patients. In this article, the authors introduced the use of an expanded neck flap as coverage tissue for ear reconstruction and face resurfacing in 2 burn patients. The operation consisted of 3 stages. In the first stage, the expander was implanted subcutaneously under the skin of the neck to create adequate skin and soft tissue. In the second stage, the expander was removed, and the expanded flap was transferred to cover defects on the auricle and face. The third operation to repair the reconstructed ear and thick flap could be performed according the willingness of the patients and surgeons. Esthetically satisfactory results were achieved in both of the patients. The flaps survived completely, and the skin color, texture, and flexibility were well matched to those of the peripheral tissue. Six months postoperatively, the flaps did not shrink, and subsequent contractures did not recur. Both of the patients experienced high satisfaction, and no adverse effects were detected.

Ischaemic heart disease is among the most frequent causes of death. Early detection of myocardial pathologies can increase the benefit of therapy and reduce the number of lethal cases. Presence of myocardial scar is an indicator for developing ischaemic heart disease and can be detected with high diagnostic precision by magnetic resonance imaging. However, magnetic resonance imaging scanners are expensive and of limited availability. It is known that presence of myocardial scar has an impact on the well-established, reasonably low cost, and almost ubiquitously available electrocardiogram. However, this impact is non-specific and often hard to detect by a physician. We present an artificial intelligence based approach — namely a deep learning model — for the prediction of myocardial scar based on an electrocardiogram and additional clinical parameters. The model was trained and evaluated by applying 6-fold cross-validation to a dataset of 12-lead electrocardiogram time series together with clinical parameters. The proposed model for predicting the presence of scar tissue achieved an area under the curve score, sensitivity, specificity, and accuracy of 0.89, 70.0, 84.3, and 78.0%, respectively. This promisingly high diagnostic precision of our electrocardiogram-based deep learning models for myocardial scar detection may support a novel, comprehensible screening method.

In the current research, two porous Co(II)-containing metal–organic frameworks (MOFs) whose chemical formulae can be teamed as [Co2(bptc)(H2O)2]·5DMA (1, H4bptc = biphenyl-3,3′,5,5′-tetracarboxylic acid) and [Co2(Hatta)2·(H2O)3]·3DMA (2, H4atta = 2′-amino-[1,1′:4′,1″-terphenyl]-3,3″,5,5″- tetracarboxylic acid) have been solvothermally synthesized by using two similar tetracarboxylic ligands and structurally characterized. The complex 2 with amino-functionalized pores could be used as recoverable heterogeneous catalytic agent for Knoevenagel condensation without solvents. The inhibitory activity of compounds on the scar tissue hyperplasia was evaluated and the related mechanism was discussed as well. First of all, the proliferation of the human hypertrophic scar fibroblasts was measured after indicated treatment was measured by CCK-8 assay. Next, the real time RT-PCR was applied to determine the activation power of the VEGF signaling pathway after using compounds.

Objective The objectives were to quantify collagen content in nonlactating uninfected and Staphylococcus aureus–infected mammary glands and determine the relative abundance of collagen in different gland regions. Materials and Methods Mammary tissues that were previously collected from a mastitis-challenge trial were examined. Mammary tissues were collected along a vertical midline through each gland and included parenchymal tissues that were proximal to the gland cistern (cisternal parenchyma) and tissues near the abdominal wall (deep parenchyma) from each saline-infused (n = 18) and Staph. aureus–infused (n = 18) gland. Collagen was detected via picro-sirus red staining and visualized using polarized light for image acquisition and subsequent analysis. Results and Discussion Most interlobular collagen was associated with larger ducts and stromal tissues. Some collagen was intralobular and was mostly associated with these larger ducts but was also present in epithelial basement membranes. Staphylococcus aureus–infused glands contained more tissue area occupied by collagen than saline-infused glands (19.78 vs. 17.26 ± 1.19%). Additionally, parenchyma near the gland cistern contained more collagen than deep parenchyma (19.95 vs. 17.09 ± 1.19%). Results indicate that mastitis elicits the deposition of collagen in affected glands and that collagen abundance is affected by gland region. Implications and Applications Nonlactating mammary glands affected by Staph. aureus mastitis may have a greater amount of collagen, believed to be resulting scar tissue. We speculate that it may have long-term, and possibly irreversible, effects on glandular structure and, consequently, lifetime productivity.

Objective: The aim of this systematic review with meta-analysis was to describe the status on the effects of physical scar treatments on pain, pigmentation, pliability, pruritus, scar thickening, and surface area. Design: Systematic review and meta-analysis. Subjects: Adults with any kind of scar tissue. Interventions: Physical scar management versus control or no scar management. Outcome measures: Pain, pigmentation, pliability, pruritus, surface area, scar thickness. Results: The overall results revealed that physical scar management is beneficial compared with the control treatment regarding the management of pain (p = 0.012), pruritus (p

Purpose: to conduct a clinical and morphological study of the role of corticosteroids in the healing of the ulcerative defect on an experimental model of the bacterial corneal ulcer. Material and methods . The developed model of the bacterial corneal ulcer was used. Rabbits with bacterial corneal ulcer were divided into 4 groups of 10 animals (10 eyes) each. Group 1 received local antibacterial treatment. Groups 2 and 3 additionally received injections of 0.2–0.3 ml of Dexamethasone 0.1 % solution once per day (parabulbarly or under the skin of the back, respectively). Group 4 received no treatment but was checked clinically after ulcer modeling. Structural changes in eye tissues were assessed by histopathological examination using an examination on a Leica microscope system with a magnification of 100 to 600. Results. Addition of corticosteroids in the early period of bacteria ulcer treatment contributes to an inhibition of the inflammatory process, reduces the action of collagenolysis processes and the size of the ulcer defect, and suppresses angiogenesis, which leads to an improvement in scar tissue quality. Conclusion. Topical parabulbar injections of corticosteroids adding to the treatment topically in the form of parabulbar injections of corticosteroids contributes to changes in the emerging fibrous tissue which fills the ulcerous defect: a thin scar is formed, which is optically useful.

To compare the clinical and radiologic outcomes and arthroscopic findings of proximal tibial osteotomy (PTO) alone versus PTO combined with medial meniscal posterior root repair (MMPRR).Between October 2010 and September 2016, patients who underwent PTO and second-look arthroscopy at a minimum of 24 months postoperatively were reviewed. Patients were divided into group I (isolated PTO), group P (PTO with MMPRR using the pull-out technique), and group F (PTO and MMPRR using the side-to-side repair method). The subjective knee scores were assessed. Radiologic evaluation was based on the Kellgren-Lawrence grade. Healing of medial meniscal posterior root tears (good/loose/scar tissue/failed) and cartilage regeneration (excellent/good/poor) were assessed by arthroscopic examination.Mean clinical follow-up duration of group I (n = 22), P (n = 25), and F (n = 24) was 28.5 ± 5.7, 27.9 ± 6.2, and 26.3 ± 5.3 months, respectively. At final follow-up, Lysholm score, International Knee Documentation Committee subjective score, and Tegner activity scale significantly improved in all groups (P.001), and subjective scores did not differ among the groups. The Kellgren-Lawrence grade progression showed no significant differences among 3 groups (P = .461). Good healing of medial meniscal posterior root tears was found in 24% and 12.5% of patients in groups P and F, respectively, and 0 in group I; there were significant differences between groups I and P (P.001) and groups I and F (P.001). Excellent cartilage regeneration in the medial femoral condyle and medial tibial plateau was found in 13.6% and 9.1% in group I, 24% and 12% in group P, and 16.7% and 8.3% in group F, respectively, without significant differences.Concurrent MMPRR during PTO appears to improve the arthroscopic appearance (healing of MMRPTs and cartilage regeneration) during second-look arthroscopy. However, concurrent MMPRR does not significantly improve clinical and radiologic outcomes at short-term follow-up.Level III, retrospective comparative study.