Engineered skeletal muscle tissues have been proposed as potential solutions for volumetric muscle losses, and biologic scaffolds have been obtained by decellularization of animal skeletal muscles. The aim of the present work was to analyse the characteristics of a biologic scaffold obtained by decellularization of human skeletal muscles (also through comparison with rats and rabbits) and to evaluate its integration capability in a rabbit model with an abdominal wall defect. Rat, rabbit and human muscle samples were alternatively decellularized with two protocols: n.1, involving sodium deoxycholate and DNase I; n.2, trypsin-EDTA and Triton X-NH4OH. Protocol 2 proved more effective, removing all cellular material and maintaining the three-dimensional networks of collagen and elastic fibers. Ultrastructural analyses with transmission and scanning electron microscopy confirmed the preservation of collagen, elastic fibres, glycosaminoglycans and proteoglycans. Implantation of human scaffolds in rabbits gave good results in terms of integration, although recellularization by muscle cells was not completely achieved. In conclusion, human skeletal muscles may be effectively decellularized to obtain scaffolds preserving the architecture of the extracellular matrix and showing mechanical properties suitable for implantation/integration. Further analyses will be necessary to verify the suitability of these scaffolds for in vitro recolonization by autologous cells before in vivo implantation.

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Highlights COVID-19 is an adjunctive risk factor for burn injured patients. Isolation of suspected cases and development of management procedures are essential preventive measures to reduce viral spread. We developed an admission protocol to our Burn Unit which proved itself effective in minimizing the contagion between patients and healthcare workers.

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At the end of January 2020, SARS-CoV-2 started escalating worldwide. COVID-19 can exert its effects on immunity, inflammation, and multi-organ system disease, common denominators with the burn injury. The pandemic required major efforts to Burn centres in order to preserve burn patients’ care and contribute to the health care response. In our Burn Unit we autonomously developed a protocol for patients acceptance and surveillance of the hospitalized ones and the personnel. We briefly describe our experience with six cases of burn patients infected by SARS-CoV-2 highlighting the overlap between medical treatment of burn patients and COVID-19 patients. To avoid viral spreading epidemiologic control is essential, especially preventive measures such as isolation of infected patients and identification of the source of infection. In our surgical practice, we increased the use of enzymatic debridement avoiding procedures with a high risk of viral particles spreading. Personnel protection and dedicated pathways have been planned, optimizing air circulation and disinfection. Vaccines represent the best hope for the global population to stop the viral spread, despite new variants outbreaks.

Full-thickness abdominal wall defects complicated with bowel exposure require a stable reconstruction that may be achieved with mesh repair, muscle rotational flaps, pedicled flaps, freeflaps or any combination of these techniques. We present a case report of a complex abdominal wound caused by a gunshot trauma in an elderly patient. His general health condition and local disruption of the left rectus, external, internal oblique and transverse abdominis muscles prevent local flaps or major surgical reconstruction procedures. The combined use in multiple stages of a homologous fascia lata graft, negative pressure therapy and acellular dermal substitute template followed by skin graft allowed stable wound healing. Level of Evidence: Level V, therapeutic stud