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A successful case of crossover replantation of the left foot to the stump of the right leg was described. The lower extremities were amputated at different levels. On the left side, there was a complete amputation in the distal part of the lower leg with comminuted fracture of the distal tibia. On the right side, there was a complete amputation in the hindfoot with comminuted fracture of both the talus and calcaneus. Since anatomical replantation was impossible, we performed crossover replantation of the left foot to the right lower leg. At the latest follow-up examination, forty-six months after the accident, the patient walked independently with a prosthesis on the stump of the left leg. Crossover replantation should be considered in bilateral amputations for the salvage of at least one extremity.

Diabetic wound complications are financially costly and difficult to heal in worldwide. Whereas the therapies of diabetic wound, such as wound dressing, endocrine therapy or flap-transplantations, were not satisfied. Based on our previous study of exosome secreted by adipose-derived stem cell (ADSC-exo), we loaded ADSC-exo into the matrix metalloproteinase degradable polyethylene glycol (MMP-PEG) smart hydrogel. Physical and chemical properties of ADSC-exo@MMP-PEG smart hydrogel were tested by scanning electron microscope (SEM), Fourier transform infrared spectroscopy (FTIR), weight loss examination, etc. As the hydrogel degraded in response to MMP, ADSC-exo was released and subsequently enhanced cell function via Akt signaling. Moreover, treatment with ADSC-exo@MMP-PEG smart hydrogel significantly relieved the H

Background aims Tissue engineering technology is a promising therapeutic strategy in peripheral nerve injury. Schwann cells (SCs) are deemed to be a vital component of cell-based nerve regeneration therapies. Many methods for producing SC-like cells derived from adipose-derived stromal cells (ADSCs) have been explored, but their phenotypic and functional characteristics remain unsatisfactory. Methods We investigated whether human ADSCs can be induced to differentiate into mature and stable SC-like cells with the addition of insulin, progestero``ne and glucocorticoids. The phenotypic and functional characteristics of new differentiated ADSCs (modified SC-like cells) were evaluated by real-time quantitative polymerase chain reaction, enzyme-linked immunosorbent assay and immunocytochemistry in vitro. Cells loaded into collagen sponge biomaterials were implanted around transected sciatic nerves with a 10-mm gap in vivo. The axon regrowth and functional recovery of the regenerated nerves were assessed by immunohistochemistry and Walking footprint analysis. Results After differentiation induction, the modified SC-like cells showed significantly up-regulated levels of S100B and P0 and enhanced proliferative and migratory capacities. In addition, the modified SC-like cells showed increased secretion of neurotrophic factors, and their functional characteristics were maintained for more than 3 weeks after removing the induction reagents. The modified SC-like cells exhibited significantly enhanced axon regrowth, myelination and functional recovery after sciatic nerve injury. Conclusions Overall, the results suggest that this modified induction method can induce human ADSCs to differentiate into cells with the molecular and functional properties of mature SCs and increase the promotion of peripheral nerve regeneration.

Foot degloving injuries are frequently encountered by reconstructive surgeons as there are more and more vehicles on the road. The separation between the deep facia and the superficial skin often damage the blood supply of the cutaneous tissue, resulting skin defect and digit necrosis. In order to manage these challenging situations, reconstructive surgeons have explored various types of techniques. Our team have managed to cure one such patient through bilateral anterolateral thigh flaps, in which the two flaps cover the dorsal and plantar side respectively. The flaps survived uneventfully and second stage operation of defatting was consequently arranged. The patient obtained protective sensation and felt satisfied with the cosmetic outcome. With the development of microsurgery, bilateral anterolateral thigh flaps could be effectively adopted to manage foot degloving injuries.