[Research advances on application of miniature free skin grafting technique]

Analysis of the Effect of Wound-Edge Microgranular Skin Grafting in the Treatment of Various Small Wounds

Objective

To explore the clinical effect of wound edge microgranular skin grafting in the treatment of various small wounds.

Methods

From September 2018 to September 2021, Yueqing people's Hospital of Wenzhou City, Zhejiang Province collected and recorded the data of 12 patients with chronic wounds and third degree burns. The method of skin grafting with particles at the edge of the wound was used to graft skin on the wound. Scar evaluation scale was used to evaluate the wound. The patients were followed up for 12 months. The preoperative and postoperative data, scar index and patient satisfaction after healing were recorded and statistically analyzed.

Results

All patients in this group were followed up for 3-12 months, and the results showed that SCAR Scale score decreased gradually over time, with patient satisfaction ranging from 80% to 96%. The patient gradually healed, scar hyperplasia gradually improved, functional activities gradually returned to normal, clinical effect is satisfactory.

Conclusion

Microparticle skin grafting at the edge of wound avoids skin grafting at different skin donor sites. It has the characteristics of simple anesthesia, small trauma and convenient operation. This method can be considered when treating patients with chronic wounds and burns who need skin grafting.

Effects of Extracorporeal Shock Wave Combined with Vivaphototherapy on Blood Perfusion, Inflammatory Response, and Prognosis in Burn Patients

Objective

To investigate the effect of extracorporeal shock wave treatment (ESWT) combined with water-filtered infrared-A (wIRA) therapy on pain, blood perfusion, and inflammatory response in burn patients.

Methods

A total of 120 burn patients treated in our hospital from May 2019 to June 2021 were selected and randomly divided into observation group (n = 60) and control group (n = 60). The control group was treated with wIRA, and the observation group was treated with ESWT combined with wIRA. The hospitalization conditions of the two groups were observed; the visual analogue scale (VAS) was used to evaluate the pain on the 1st, 7th, and 14th days of treatment in the two groups; the blood perfusion was compared between the two groups; the levels of cerebral neuropeptide (NPY), 5-serotonin (5-HT), prostaglandin E2 (PGE2), C-reactive protein (CRP), interleukin-10 (IL-10), tumor necrosis factor-α (TNF-α), serum intercellular adhesion molecule-1 (sICAM-1), soluble-triggering receptor expressed myeloidcells-1 (sTREM-1), and soluble hemoglobin scavenger receptor (sCD163) were measured. Modified Vancouver Scar Scale (mVSS) was used to evaluate the wound scar at 3 and 6 months after the end of treatment.

Results

The wound healing rate in the observation group was significantly higher than that in the control group, and the wound healing time and hospitalization time were significantly shorter than that in the control group (P < 0.05). On the 7th and 14th days of treatment, the VAS scores of the observation group were significantly lower than those of the control group (P < 0.05). On 1st, 7th, and 14th days of treatment, the blood perfusion volume in the observation group was significantly higher than that in the control group (P < 0.05). The scar scores in the observation group at 3 months and 6 months after treatment were significantly lower than those in the control group (P < 0.05). After treatment, the levels of NPY, 5-HT, PGE2, CRP, IL-10, TNF-α, sICAM-1, sTREM-1, and sCD163 in the observation group were improved more than those in the control group, and the differences were statistically significant (P < 0.05).

Conclusion

ESWT combined with wIRA therapy can effectively improve the hospitalization situation of burn patients, relieve pain, improve blood perfusion, reduce scar hyperplasia, reduce inflammation, and have a good therapeutic effect.