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Yang J, Yu L, Meng F, Wen J, Xiao Y, Wan S, Yu F, Zhou Z. Role of microsurgical techniques combined with Ilizarov techniques in limb salvage and functional reconstruction of thermal‑crush injuries of the hand: A case report. Exp Ther Med 2024; 28:291. [PMID: 38827471 PMCID: PMC11140289 DOI: 10.3892/etm.2024.12580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 04/11/2024] [Indexed: 06/04/2024] Open
Abstract
The Ilizarov technology was proposed by Former Soviet orthopedic physician Ilizarov. It is a medical method to reconstruct missing tissues. Ilizarov technology combined with soft tissue stretching technology is of great significance in the treatment of common orthopedic problems like bone defects, finger absence, joint contracture and joint stiffness following thermal-crush injuries of the hand. In the present study a 25-year-old male patient sought for limb salvage treatment 1 month after sustaining thermal-crush injuries of the right hand and forearm. The patient had been treated by another hospital with multiple procedures of debridement, and recommended for forearm amputation. The patient was diagnosed with: i) Postoperative infection of thermal-crush injuries of the right hand and right forearm; ii) comminuted open fractures of the proximal and distal phalanges of the right thumb; iii) osteomyelitis; iv) palm skin defects with exposed tendons; and v) skin defects of the opisthenar and the forearm. After a series of treatments including debridement, removal of necrotic tissue, tissue transplantation, skin pedicle, bone lengthening, external shaping, tissue release, joint fusion, traction and rehabilitation exercises, the patient recovered some hand function. Overall, thermal-crush injuries of the hand are severe, complicated combined injuries composed of both heat burn and compression injury and their treatment is challenging. Overall, microsurgery combined with Ilizarov technology can effectively reconstruct the function of complex thermal-crush injuries of the hand.
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Affiliation(s)
- Jun Yang
- Department of Radiology, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China
| | - Longbiao Yu
- Department of Hand and Microsurgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China
| | - Fanbin Meng
- Department of Hand and Microsurgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China
| | - Jingjing Wen
- Department of Hand and Microsurgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China
| | - Yingfeng Xiao
- Department of Hand and Microsurgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China
| | - Shengxiang Wan
- Department of Hand and Microsurgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China
| | - Fei Yu
- Department of Bone and Joint Surgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China
- National and Local Joint Engineering Research Center of Orthopedic Biomaterials, Shenzhen, Guangdong 518036, P.R. China
- Shenzhen Key Laboratory of Orthopedic Diseases and Biomaterials Research, Shenzhen, Guangdong 518036, P.R. China
| | - Zhegang Zhou
- Department of Hand and Microsurgery, Peking University Shenzhen Hospital, Shenzhen, Guangdong 518036, P.R. China
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Kang D. Advancing Fingertip Regeneration: Outcomes from a New Conservative Treatment Protocol. J Clin Med 2024; 13:3646. [PMID: 38999212 PMCID: PMC11242295 DOI: 10.3390/jcm13133646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 06/19/2024] [Accepted: 06/19/2024] [Indexed: 07/14/2024] Open
Abstract
Background Fingertip injuries with volar pulp tissue defects present a significant challenge in management. This study aimed to evaluate the efficacy of a conservative treatment protocol using artificial dermis and semi-occlusive dressings for these injuries. Methods A single-center, prospective study was conducted on 31 patients with fingertip injuries involving volar pulp defects. The treatment protocol included wound debridement, application of artificial dermis (Pelnac®), and a semi-occlusive dressing (IV3000®). The outcomes were assessed using subjective questionnaires and objective measures, including fingerprint regeneration, sensory function, pain, and cosmetic appearance. Results The mean treatment duration was 45.29 days (SD = 17.53). Complications were minimal, with only one case (3.22%) directly attributable to the treatment. Fingerprint regeneration was considerable (mean score = 2.58, SD = 0.67). The sensory disturbances were minimal, with no significant differences across injury types. Post-treatment pain was low (mean = 0.45, SD = 0.67), and cosmetic satisfaction was high (mean = 4.09, SD = 0.94). The overall patient satisfaction was high (mean = 4.41, SD = 0.67), regardless of injury severity. Conclusions The conservative treatment protocol using artificial dermis and semi-occlusive dressings is a promising strategy for managing fingertip injuries with volar pulp defects. This approach minimizes surgical morbidity and achieves excellent functional and aesthetic outcomes.
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Affiliation(s)
- Daihun Kang
- Department of Plastic and Reconstructive Surgery, Ewha Womans University Seoul Hospital, Seoul 03760, Republic of Korea
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Larin II, Shatalova RO, Laktyushkin VS, Rybtsov SA, Lapshin EV, Shevyrev DV, Karabelsky AV, Moskalets AP, Klinov DV, Ivanov DA. Deep Learning for Cell Migration in Nonwoven Materials and Evaluating Gene Transfer Effects following AAV6-ND4 Transduction. Polymers (Basel) 2024; 16:1187. [PMID: 38732656 PMCID: PMC11085928 DOI: 10.3390/polym16091187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/15/2024] [Accepted: 04/16/2024] [Indexed: 05/13/2024] Open
Abstract
Studying cell settlement in the three-dimensional structure of synthetic biomaterials over time is of great interest in research and clinical translation for the development of artificial tissues and organs. Tracking cells as physical objects improves our understanding of the processes of migration, homing, and cell division during colonisation of the artificial environment. In this study, the 3D environment had a direct effect on the behaviour of biological objects. Recently, deep learning-based algorithms have shown significant benefits for cell segmentation tasks and, furthermore, for biomaterial design optimisation. We analysed the primary LHON fibroblasts in an artificial 3D environment after adeno-associated virus transduction. Application of these tools to model cell homing in biomaterials and to monitor cell morphology, migration and proliferation indirectly demonstrated restoration of the normal cell phenotype after gene manipulation by AAV transduction. Following the 3Rs principles of reducing the use of living organisms in research, modeling the formation of tissues and organs by reconstructing the behaviour of different cell types on artificial materials facilitates drug testing, the study of inherited and inflammatory diseases, and wound healing. These studies on the composition and algorithms for creating biomaterials to model the formation of cell layers were inspired by the principles of biomimicry.
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Affiliation(s)
- Ilya I. Larin
- Center for Translational Medicine, Sirius University of Science and Technology, Krasnodar Territory Sirius, 1 Olympic Ave., Sirius 354340, Russia
| | - Rimma O. Shatalova
- Center for Translational Medicine, Sirius University of Science and Technology, Krasnodar Territory Sirius, 1 Olympic Ave., Sirius 354340, Russia
| | - Victor S. Laktyushkin
- Resource Center for Cell Technology and Immunology, Sirius University of Science and Technology, Krasnodar Territory Sirius, 1 Olympic Ave., Sirius 354340, Russia
| | - Stanislav A. Rybtsov
- Resource Center for Cell Technology and Immunology, Sirius University of Science and Technology, Krasnodar Territory Sirius, 1 Olympic Ave., Sirius 354340, Russia
| | - Evgeniy V. Lapshin
- Center for Translational Medicine, Sirius University of Science and Technology, Krasnodar Territory Sirius, 1 Olympic Ave., Sirius 354340, Russia
| | - Daniil V. Shevyrev
- Resource Center for Cell Technology and Immunology, Sirius University of Science and Technology, Krasnodar Territory Sirius, 1 Olympic Ave., Sirius 354340, Russia
| | - Alexander V. Karabelsky
- Center for Translational Medicine, Sirius University of Science and Technology, Krasnodar Territory Sirius, 1 Olympic Ave., Sirius 354340, Russia
| | - Alexander P. Moskalets
- Federal Research and Clinical Center of Physical-Chemical Medicine, Federal Medical Biological Agency, Moscow 119435, Russia
| | - Dmitry V. Klinov
- Federal Research and Clinical Center of Physical-Chemical Medicine, Federal Medical Biological Agency, Moscow 119435, Russia
- Center for Genetics and Life Sciences, Sirius University of Science and Technology, Krasnodar Territory Sirius, 1 Olympic Ave., Sirius 354340, Russia
| | - Dimitry A. Ivanov
- Center for Genetics and Life Sciences, Sirius University of Science and Technology, Krasnodar Territory Sirius, 1 Olympic Ave., Sirius 354340, Russia
- Institut de Sciences des Matériaux de Mulhouse—IS2M, CNRS UMR 7361, F-68057 Mulhouse, France
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Liao Y, Zhang Z, Ouyang L, Mi B, Liu G. Engineered Extracellular Vesicles in Wound Healing: Design, Paradigms, and Clinical Application. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024; 20:e2307058. [PMID: 37806763 DOI: 10.1002/smll.202307058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/20/2023] [Indexed: 10/10/2023]
Abstract
The severe quality of life and economic burden imposed by non-healing skin wounds, infection risks, and treatment costs are affecting millions of patients worldwide. To mitigate these challenges, scientists are relentlessly seeking effective treatment measures. In recent years, extracellular vesicles (EVs) have emerged as a promising cell-free therapy strategy, attracting extensive attention from researchers. EVs mediate intercellular communication, possessing excellent biocompatibility and stability. These features make EVs a potential tool for treating a plethora of diseases, including those related to wound repair. However, there is a growing focus on the engineering of EVs to overcome inherent limitations such as low production, relatively fixed content, and targeting capabilities of natural EVs. This engineering could improve both the effectiveness and specificity of EVs in wound repair treatments. In light of this, the present review will introduce the latest progress in the design methods and experimental paradigms of engineered EVs applied in wound repair. Furthermore, it will comprehensively analyze the current clinical research status and prospects of engineered EVs within this field.
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Affiliation(s)
- Yuheng Liao
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China
| | - Zhenhe Zhang
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China
| | - Lizhi Ouyang
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China
| | - Bobin Mi
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China
| | - Guohui Liu
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, 430022, China
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