Abstract:Negative pressure wound therapy with instillation (NPWTi) has the dual function of negative pressure sealing drainage and irrigation, which overcomes the disadvantages of NPWT, such as tube obstruction, inability to apply topical medicine, and poor anti-infection ability. NPWTi has been researched exten sively and widely used in various types of wounds, and certain effects have been achieved. A series of parameters for NPWTi have not been unified at present, including the flushing fluid option, flushing mode, and treatment period. This paper reviews the research progress of these parameters for NPWTi and their application in the treatment of orthopaedic wounds.

KEYWORDS:instillation, negative pressure wound therapy, orthopaedic wounds, treatment parameters

      Objective. To compare the clinical effffects of modifified above-knee and conventional surgery with the stripping of the greatsaphenous vein of varicose veins of the lower extremities. Methods. Clinical data of patients with a varicose vein of the lower extremity from May 2016 to May 2018 were collected. A retrospective study was conducted on the patients receiving modifified above-knee and conventional surgery with the great saphenous vein stripping. The baseline characteristics and long-term follow-up data were compared between the groups. Results. There were no signifificant difffferences in baseline characteristics between the two groups (P > 0:05). The surgeries were successfully performed by the same group of surgeons under local anesthesia and neuraxial anesthesia. The hospital stay, operation time, intraoperative blood loss, total length, and number of incisions in the above-knee group were comparable to those in the conventional surgery group (P > 0:05). The incidence of saphenous nerve injury and subcutaneous hematoma in the above-knee group was lower than that in the conventional surgery group (P < 0:05). There were no signifificant difffferences in recurrent varicose vein incidences (P > 0:05). After surgery, the venous clinical severity score (VCSS) and chronic venous insuffiffifficiency questionnaire (CIVIQ-14) scores of both groups were higher than those before operation (P < 0:05). There was no signifificant difffference in VCSS score or CIVIQ-14 scores between the two groups postoperation (P > 0:05). At 24 months after surgery, the above-knee group (71.8%) and conventional surgery group (73.2%) resulted in changes of at least two CEAP-C clinical classes lower than baseline, respectively. Conclusion. The modifified above-knee technique can ensure clinical outcomes, reduce intraoperative blood loss and complication incidences, and shorten the operative time. This gives evidence that the modifified above-knee technique is worthy of clinical application.

      Wound healing is one of the most complex physiological regulation mechanisms of the human body. Stem cell technology has had a signifificant impact on regenerative medicine. Adipose stem cells (ASCs) have many advantages, including their ease of harvesting and high yield, rich content of cell components and cytokines, and strong practicability. They have rapidly become a favored tool in regenerative medicine. Here, we summarize the mechanism and clinical therapeutic potential of ASCs in wound repair.

Keywords: adipose stem cells, wound healing, regenerative medicine, skin regeneration, inflflammation

Abstract：Sub-epidermal moisture is an established biophysical marker of pressure ulcer formation based on biocapacitance changes in affected soft tissues, which has been shown to facilitate early detection of these injuries. Artificial intelligence shows great promise in wound prevention and care, including in automated analyses of quantitative measures of tissue health such as sub-epidermal moisture readings acquired over time for effective, patient-specific, and anatomical-site-specific pressure ulcer prophylaxis.Here, we developed a novel machine learning algorithm for early detection of heel deep tissue injuries, which was trained using a database comprising six consecutive daily sub-epidermal moisture measurements recorded from 173 patients in acute and post-acute care settings. This algorithm was able to achieve strong predictive power in forecasting heel deep tissue injury events the next day, with sensitivity and specificity of 77% and 80%, respectively, revealing the clinical potential of artificial intelligence-powered technology for hospital-acquired pressure ulcer prevention. The current work forms the scientific basis for clinical implementation of machine learning algorithms that provide effective, early, and anatomy-specific preventive interventions to minimise the occurrence of hospital-acquired pressure ulcers based on routine tissue health status measurements.

KEYWORDS：artificial intelligence, predictive bioengineering modelling, pressure ulcer/injury prophylaxis, preventive interventions, SEM scanner