Background: Decellularized porcine small intestinal submucosa (SIS), commercialized as an extracellular matrix rich in cell-inducing substrates and factors, has been clinically applied to treat intractable skin ulcers and has shown therapeutic effects. The SIS reportedly induces cell infiltration and integrates with the ulcer bed after 3–7 days of application. The attached SIS degenerates over time, and the remaining mass appears as slough, below which is granulation tissue that is essential for healing. This study aimed to determine whether the slough should be removed in clinical settings. Methods: Five patients with intractable skin ulcers were included in this case series. Seven days after applying a two-layer fenestrated-type SIS to the ulcer, the removed slough was histopathologically examined. Results: The collagen fibers of the SIS somewhat degenerated, and inflammatory cell infiltration was observed from the ulcer side to the surface side of the SIS. Neovascularization was similarly observed on the ulcer side. The degree of inflammatory cell infiltration decreased from the ulcer side to the surface side, whereas pus (ie, aggregates of neutrophils) was observed on the surface and ulcer edges. Additionally, the removed slough contained regenerative epithelium on the ulcer side of the remaining collagen fibers. Conclusions: After treating intractable skin ulcers using SIS, we recommend removal of the upper surface and ulcer edge of the degenerated SIS or slough to prevent infection and preservation of the lower side of the degenerated SIS to maintain the granulation tissue and regenerative epithelium.
And the personalized splints were made according to the maxillary molar area to ensure precise contact with the maxillary dentition during the operation; the adjustable design of the 2 ends of the annular lower arm ensures that the combination of the personalized splints and forceps can adapt to the arch width of the maxillary molar area of different patients. In our preliminary study, none of the 3 patients complained of hard palate discomfort, and we observed no damage to the hard palate mucosa postoperatively.Overall, the novel forceps we invented can accurately and steadily clamp the maxillary molar area on the premise of protecting the hard palate mucosa from loss of palatal vascularity and pressure necrosis, and then thoroughly mobilize the maxilla. Therefore, we suggest that the novel forceps can be mass-produced for clinical use.
There have been few reports of abdominal burns caused by molten metals and few reported cases of subcutaneously embedded metals 1) . We report a rare case of a side abdominal burn caused by melted aluminum, with some thesis considerations. Materials and methodsPatient: 70 years old, male Chief complaint: Burn on the lower left abdomen History: Left cervical lymph node swelling (excised at age 15)Family history: No special notes Current medical history: The patient was working at an aluminum refining plant when melted aluminum blew from a die casting press machine, fell on his lower left abdomen, and became lodged subcutaneously. After the incident, the patient washed the wound under running water and arrived at our hospital on foot while cooling the wound.Findings at the initial diagnosis: A depression of 3 cm in diameter in the lower left abdomen, embedding of a blackbrown mass, scattered small depressions in the surrounding skin, and second-degree burns were observed (Fig. 1a).Test results: General blood biochemical tests were performed and no abnormalities were observed.Abdominal radiography: A metal mass was revealed in the lower left abdomen (Fig. 1b).Abdominal CT examination: An area with a high absorption signal was observed in the lower left abdominal subcutaneous region-it penetrated the external and inner abdominal oblique muscles (Fig. 1c).After hospitalization: We identified a side abdominal thermal contusion caused by melting aluminum, which was associated with abdominal wall defects. We debrided the foreign body and the surrounding damaged tissue on the day of admission.
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