Background. Hot-crush injuries to the hands can be devastating, and early debridement and coverage with skin autograft remains the golden standard of wound treatment. However, this type of treatment is not feasible or unlikely to succeed due to limited donor sites and wound characteristics of hot-crush injuries on hands. Thus, the composite grafting of acellular dermal matrix (ADM) and split-thickness skin graft (STSG) as a novel alternative method has been attempted. In this series, the results are presented to demonstrate the feasibility and effectiveness of the use of one-stage procedure for early reconstruction in hand hot-crush injuries. Methods. All consecutive patients with hand hot-crush injuries, who underwent one-stage procedure of ADM and ultrathin STSG for soft tissue coverage at our institution from December 2018 to November 2019, were retrospectively analyzed. Wound dressings were opened on 7 days after operation to examine graft survival and complications. Patients were followed up for at least 9 months to evaluate their hand profiles. Results. Samples of 14 patients with a total of 23 wounds were involved in the study. Thirteen of the 23 third–fourth-degree wounds had varying degrees of tendon exposure. On 7 days postoperation, the composite grafts survived in 12 patients with minimal focal graft losses and liquefaction and necrosis in 2 patients, which achieved successful healing following new coverage of ultrathin STSG. All the wounds healed with hospital stays ranging from 9 days to 32 days (median: 24.5 days). At the final follow-up (from 9 months to 20 months), all patients achieved excellent or good total active motion grade and good scar quality (Vancouver scar scale scored 1–3) with no revision surgery. Conclusions. One-stage composite grafting of ADM and ultrathin STSG is a reliable alternative for early reconstruction in hand hot-crush injuries, which delivers good functional outcomes and a good cosmetic appearance.

Objective. This study was designed to understand the local changes of burn injuries in recent 10 years, so as to provide reliable reference data and viewpoints for prevention and vigilance of local burn injuries. Methods. In this study, 184 patients with a burn injury admitted to our hospital from 2012 to 2021 were enrolled and analyzed retrospectively. According to their information in the electronic database, the number of patients with burn injuries and the location of each disaster each year were analyzed, and the age, sex, hospital stay and hospitalization expense of each patient were collected. With 5 years as the boundary, the patients were divided into a 2012–2016 group and a 2017–2021 group and the differences of the two groups in the abovementioned aspects were compared. Results. During 2012–2021, the incidence rate of burn injuries in men was higher than that in women and workplaces had a higher burn injury rate than residents’ homes. Compared with the period of 2012–2016, the number of fires or explosions and the number of patients with a burn injury during 2017–2028 both increased, but there was no significant change in disaster location, male-female ratio, age, average hospital stay, and average hospitalization expense. Conclusion. In the face of the increasing prevalence of burn injuries, we should strengthen fire-fighting knowledge-related education and fire prevention management and actively explore post-burn injury treatment strategies and potential treatment targets to promote the development of burn injury management and treatment strategies.

Background This latest systematic review and meta-analysis aim to examine the effects of probiotic and synbiotic supplementation in critically ill patients. Methods Relevant articles were retrieved from PubMed, Embase, the Cochrane Database, and the Web of Science. The primary output measure was the incident of vendor associated pneumonia, and the secondary outputs were diarra, Clostridium diffusion infection (CDI), incident of sepsis, incident of hospital acquired pneumonia, incident of any infection, duration of mechanical exploitation, in hospital morality, length of hospital stay, ICU morality rate, And length of ICU stay. Data were pooled and expressed as relative risk (RR) and standardized mean difference (SMD) with a 95% confidence interval (CI). Results Third three studies were included in this systematic review and meta-analysis, with 4065 patients who received probiotics or synbiotics (treatment group) and 3821 patients who received standard care or placebo (control group). The pooled data from all included studies demonstrated that the treatment group has significantly reduced incidence of vessel associated pneumonia (VAP) (RR = 0.80; 95% CI: 0.67–0.96; p = 0.021, I2 = 52.5%) and sepsis (RR = 0.97; 95% CI: 0.66–1.42; p = 0.032, I2 = 54.4%), As well as significantly increased duration of mechanical exploitation (SMD=-0.47; 95% CI: -0.74–0.20, p = 0.012, I2 = 63.4%), length of hospital stay (SMD=-0.33; 95% CI: -0.57–0.08, p = 0.000, I2 = 74.2%), ICU mobility (RR = 0.95; 95% CI: 0.71–1.27; p = 0.004, I2 = 62.8%), And length of ICU stay [SMD=-0.29; 95% CI: -0.58-0.01; p = 0.000, I2 = 82.3%)] than the control group There were no significant differences in diarra, CDI, incidence of hospital acquired pneumonia, and in hospital morality between the two groups. Conclusion Our meta-analysis showed that probiotic and synbiotic supplements are beneficial for critically ill patients as they significantly reduce the incidence of vendor associated pneumonia and sepsis, as well as the duration of mechanical exploitation, length of hospital stay, length of ICU stay, and ICU morality How, this intervention has minimal impact on diarra, CDI, incidence of hospital acquired pneumonia, and in hospital morality in critically ill patients.

No abstract