Search

Secondary intention healing offers an alternative when surgical options are infeasible. This study analyzed the effect of micronized acellular dermal matrices (mADMs; CGderm Matrix®, CG Bio, Seoul, Republic of Korea) on secondary intention healing in patients with complex soft-tissue defects and assessed mADMs' efficacy in promoting secondary healing and improving clinical outcomes in these challenging cases. This retrospective study included 26 patients treated with sheet-type reprocessed mADMs between August 2022 and December 2022 at Soonchunhyang University Cheonan Hospital. Patients with full-thickness skin defects classified as complex wounds were included. Data on demographics, wound characteristics, and treatment outcomes were collected and analyzed. Wound area was measured using ImageJ software, and statistical analyses were conducted using SPSS. The application of mADMs resulted in a median wound area reduction of 81.35%, demonstrating its significant efficacy in wound healing. Most patients presented with compromised vascular supply, significant tissue loss, or infections that precluded conventional surgical interventions. No significant correlations were observed between patient variables and wound-healing outcomes, indicating the complex nature of wound healing. mADMs effectively promote secondary intention healing by providing a supportive extracellular matrix scaffold that enhances epithelialization and angiogenesis. Their rapid absorption, ease of handling, and ability to improve wound tensile strength make them particularly suitable for complex wounds. [ABSTRACT FROM AUTHOR]

This study examined the feasibility of non‐invasive infrared thermography to monitor skin graft viability. Sixty‐three patients with skin defects attending a single institution from May 2022 to August 2023 were included. Patients underwent full‐thickness or split‐thickness skin grafts based on clinical indication. Infrared thermal images were obtained on postoperative days 0, 2, 4, 6 and 8. The temperature difference between the skin graft and surrounding normal skin was assessed using image analysis software. All 33 patients with full‐thickness skin grafts showed successful healing. Among the 30 patients with split‐thickness skin grafts, 7 experienced failure. The groups with successful full‐thickness and split‐thickness skin grafts exhibited a gradual increase in graft temperature, peaking on postoperative day 6 and decreasing on postoperative day 8. Temporal temperature changes were significant in each patient group (p < 0.001), and the differences in temperature change patterns between the two groups with successful grafts and the group with graft failure were also significant (p < 0.001). On postoperative day 6, the temperature difference was highest in the full‐thickness skin graft group (0.197 ± 0.335°C), followed by the successful split‐thickness skin graft group (0.426 ± 0.428°C), and the split‐thickness skin graft group with graft failure (−2.100 ± 0.361°C). In conclusion, infrared thermal imaging can provide a non‐invasive real‐time assessment of graft status and predict graft success or failure. [ABSTRACT FROM AUTHOR]

Flap surgery is a common method used to cover defects following tumor ablation, trauma, or infection. However, insufficient vascularity in the transferred flap can lead to flap necrosis and failure. Proper postoperative monitoring is essential to prevent these complications. Recently, research has explored the use of infrared thermal imaging in plastic surgery, leading to its clinical application. This study comprises two separate parts: an in vivo experimental study and a clinical study. In this study, 28 rats underwent reverse McFarlane flap surgery, and their flaps were analyzed using a FLIR thermal imaging camera seven days post-surgery. Additionally, thermal images of flaps were taken on postoperative days 0, 1, 2, 3, and 7 in 22 patients. This study focused on temperature differences between normal skin and the perforator compared to the average flap temperature. Results showed that the temperature difference was higher in the necrosis group and increased over time in cases of total necrosis. A lower perforator temperature compared to the flap's average indicated vascular compromise, potentially leading to flap failure. The FLIR camera, being contact-free and convenient, shows promise for understanding and inferring the clinical progression of flaps in postoperative monitoring. [ABSTRACT FROM AUTHOR]

Background: During blow-out fracture surgery, restoration of the orbital volume and rigid implant fixation are essential. The migration of an implant is a concern of most surgeons. The purpose of this study was to introduce a simple idea of molding and fixing an orbital implant. Methods: In the tongue-in-groove method, an incision of about 2 mm was made on the edge of the implant and it was bent to form a slot. A hole was made in the center of the implant for fitting a bone hook, and the implant was firmly fit into the remaining intact bone. Before and after surgery, computed tomography (CT) was used to evaluate changes in the orbital volume and the location of the implant. Statistically significant restoration of the orbital volume was confirmed on postoperative CT. Results: Compared with the unaffected orbital volume, the affected orbital volume was increased from 87.06 ± 7.92% before surgery to 96.14 ± 6.11% after surgery (p < 0.001). There was one case of implant migration during follow-up. However, the degree of movement was not severe, and there were no events during the follow-up period. Conclusions: The tongue-in-groove technique offers advantages, such as easy fixation of the implant, with minimal trauma to the surrounding tissues. In addition, the method offers advantages, such as being easy to learn, requiring little time for trimming the implant, and being relatively low cost. Therefore, it can be one of the options for implant fixation. [ABSTRACT FROM AUTHOR]

Protonic ceramic fuel cells (PCFCs) are promising eco‐energy electrochemical energy conversion systems that can efficiently operate in intermediate (500–700 °C) to low (500 °C) temperature ranges. In this review the most recent advances in materials research for the ceramic components of PCFCs (i.e., electrolyte, cathode, and anode) and their interface engineering are introduced. Recent approaches to improve the protonic of conductivity, and activity and stability of electrolyte and electrode materials are first presented. In addition, new attempts to stabilize/activate electrode/electrolyte interfaces and electrode surfaces are also discussed. Details of the theoretical background behind the electron and ion transfer processes at electrodes are also discussed. Finally, the challenges and perspectives of PCFC development are suggested from the point of view of materials engineering. [ABSTRACT FROM AUTHOR]

Treating a diabetic foot ulcer (DFU) extending to the tendon or bone can be a challenge for physicians. Recent studies have shown positive results of micronized acellular dermal matrix (ADM) treatment for treating DFU. However, studies on such ADM with a long‐term follow‐up are rare. Thus, the objective of this study was to retrospectively analyse patients treated with micronized ADM with a long‐term follow‐up to assess the effectiveness of the treatment and determine the recurrence rate. The rate of success of complete healing was 62.96% and the time of complete healing was 86.96 days in this study. The recurrence rate of DFUs was 41.17% in the overall group. However, it was only 23.52% in the micronized ADM group. The average duration of recurrence was 720.50 ± 505.12 days. The recurrence rate was 50% in weight bearing areas such as the plantar and heel. It was 12.5% in toes and non‐weight bearing areas. In conclusion, micronized ADM can be used to effectively treat DFUs that have invaded ligaments or bones. A close follow‐up of weight bearing area wounds will allow us to identify and treat recurrence early. [ABSTRACT FROM AUTHOR]

Diabetes mellitus (DM) causes various complications over time, one such complication is diabetic foot ulcers (DFU), which are challenging to treat and can lead to amputation. Additionally, a system for accurate prediction of amputation has yet to be developed. In total, 131 patients were included in the study after retrospectively collecting data from 2016 to 2020 about DFU. The collected data were used for comparison of the accuracy between five existing classification systems and the newly revised DIRECT coding system, and investigation of risk factors for lower extremity amputation (LEA). The existing five classification systems and DIRECT system can effectively predict LEA. The DIRECT3 system has three elements, C‐reactive protein (CRP), ulcer history (UH), and hypertension (HTN) in addition to those of the DIRECT system. It had a high predictive value and accuracy similar to that of Wagner and University of Texas (UT) on depth among the five classification systems. Among the statistically significant risk factors, duration of DM and HTN, haemoglobin (Hb), CRP, and UH showed an association with LEA. The DIRECT coding system is effective for predicting LEA and explaining appropriate treatment methods for DFU, and is widely applicable because of its user accessibility and convenience. [ABSTRACT FROM AUTHOR]

The development of a biodegradable vascular scaffold (BVS) for the treatment of cardiovascular diseases (CVDs) still requires some improvement. Among them, re-endothelialization and anti-inflammation are clinically important to restore vascular function. In this study, we proposed a coating system to deliver hydrophilic bioactive agents to BVS using nanoemulsion and drop-casting methods. The poly(L-lactide) (PLLA) scaffold containing magnesium hydroxide (MH) was coated on the surface with bioactive molecules such as polydeoxyribonucleotide (PDRN), L-arginine (Arg, R), and mesenchymal stem cell-derived extracellular vesicles (EVs). PDRN upregulates the expression of VEGF as one of the A2A receptor agonists; and Arg, synthesized into nitric oxide by intracellular eNOS, induces endothelialization. In particular, EVs, which are composed of a lipid bilayer and transfer bioactive materials such as protein and nucleic acid, regulate homeostasis in blood vessels. Such a bioactive agent coating system and its PLLA composite suggest a new platform for the treatment of cardiovascular dysfunction. [ABSTRACT FROM AUTHOR]

We consider a hub and spoke location problem (HSLP) with multiple scenarios. The HSLP consists of four sub-problems: hub location, spoke location, spoke allocation, and customer allocation. Under multiple scenarios, [...]

Poly(L–lactic acid) (PLLA), as a biodegradable polymer, has attracted attention for use as a biomaterial. In order to apply PLLA as a cardiovascular stent, stronger mechanical properties and anti–inflammatory effects against acidic by–products are required. In this study, PLLA/PDLA stereocomplex microparticles (SC) were developed and surface–modified magnesium hydroxide (MH) nanoparticles with oligolactide were combined with these PLLA composites. The SC improved the mechanical properties of the PLLA composites through the formation of stereocomplex structures. The surface–modified MH nanoparticles showed enhanced mechanical properties due to the stereocomplex structures formed by PLLA chains and inhibited inflammatory responses by pH neutralization as a result of MH. Additionally, the MH nanoparticles containing PLLA composites had antibacterial effects and increased the viability of human vascular endothelial cells. This technology is expected to have great potential in the development of PLLA composite materials for the production of various medical devices, such as cardiovascular stents. [ABSTRACT FROM AUTHOR]

Tendinopathy is a term used to describe tendon disorders that are marked by pain and a loss of function. Recent studies demonstrated that inflammation plays an important role throughout the broad spectrum of tendinopathy. Conventional treatments such as steroid injections, analgesics, and physical modalities simply give pain relief and do not alter the disease progression without the tendon regeneration effect. Tenocytes are responsible for maintaining the tendon matrix and understanding how they function is essential to studying new treatments for tendinopathy. Our previous study showed the protective effects of vitamin D (Vit D) on damaged tenocytes. Besides its well-known effects on bone metabolism, the non-classical action of Vit D is the pleiotropic effects on modulating immune function. In the present study, we developed a Vit D delivery system with hyaluronic acid (HA), which is one of the major components of the extracellular matrix that has anti-inflammation and wound-healing properties. A novel Vit D delivery system with cross-linked HA hydrogel (Gel) and Tween 80 (T80), Vit D@Gel/T80, could be a new regeneration technique for the treatment of tendinopathy. Vit D@Gel/T80 reduced TNF-α induced damage to human tenocytes in vitro. In an animal study, the Vit D@Gel/T80 injected group demonstrated tendon restoration features. As a result, this Vit D@Gel/T80 system might be a local injection material in the treatment for tendinopathy. [ABSTRACT FROM AUTHOR]

The oxygen reduction reaction, which proceeds at the cathode of a fuel cell, is primarily important as its rate determines the overall performance of a device. However, designing a single-phase material that meets multiple standards (e.g., high activity, stability, and thermomechanical characteristics) at once to become an ideal cathode still remains a great challenge. In this regard, the use of multi-phase catalysts, especially those with complex nanoscale domains, may serve as a rational strategy. Here, we present Ba0.5Sr0.5Co0.6Fe0.2Zr0.1Y0.1O3−δ (BSCFZY) as a superior biphasic nano-composite cathode, which self-assembles into two discrete cubic perovskites: Co-rich (Ba0.5Sr0.5Co0.7Fe0.2Zr0.07Y0.03O3−δ) and Zr-rich (Ba0.6Sr0.4Co0.3Fe0.2Zr0.4Y0.1O3−δ) phases. The former promotes the electrocatalytic activity while the latter supports the microstructural robustness; thus, the synergic ensemble of Co- and Zr-rich perovskite domains yields an area specific resistance of only ∼0.013 Ω cm2 at 650 °C, which is far superior to that anticipated from the component phases in isolation. The cooperative interaction found in multi-phase catalysts prepared via a simple one-pot synthesis is not only attractive for SOFCs but also for other kinds of energy conversion and storage devices, such as protonic ceramic electrochemical cells, electrolysers, and membrane chemical reformers. [ABSTRACT FROM AUTHOR]