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Research progress on thumb defect reconstruction WEI Chuanzhi, WU Junqing, WU Zhaosen Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (6): 614-.   Abstract （426）      PDF（pc） （1098KB）（389）       Knowledge map    Save The thumb accounts for approximately 50% of the hand’s functionality. Thumb defects caused by various congenital malformations， trauma， tumors and so on， significantly reduce the quality of life of patients and seriously affect their physical and mental health. Currently， there are numerous methods for thumb reconstruction， including both traditional classic surgical procedures and innovative ones after improvement. With the continuous development of microsurgery and tissue engineering technologies， as well as the increasing popularity of artificial intelligence， new concepts such as combined transplantation and artificial intelligence-assisted design offer more precise， personalized， and flexible surgical options for patients with thumb defects. This article provides a comprehensive overview of various surgical methods for thumb defect reconstruction to offer some references for clinical doctors. Related Articles | Metrics | Comments（0）

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In vitro evaluation of injectable dermal fillers for plastic surgery based on 3D skin models：Opportunities and challenges of animal experiments as alternatives XU Wenna, HAN Qianqian, SHI Jianfeng, et al Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (6): 593-.   Abstract （350）      PDF（pc） （1155KB）（492）       Knowledge map    Save With the rapid development of the medical aesthetics industry， the application of injectable fillers for plastic surgery has become increasingly widespread， and the evaluation of their safety and effectiveness has become the core focus of regulatory and research and development. Conventional biological assessments remain predominantly reliant on animal testing. However， substantial anatomical and physiological disparities between animal and human skin compromise translational accuracy. In response， three-dimensional （3D） skin models-offering enhanced physiological relevance， experimental reproducibility， and ethical acceptability-have emerged as promising in vitro alternatives. This review provides a comprehensive overview of the fabrication strategies， tissue architecture， and current progress of 3D skin models in the context of injectable filler evaluation. Emphasis is placed on their potential to assess biocompatibility and functional performance， as well as a comparative analysis of the inherent limitations of animal models. Moreover， key challenges associated with 3D skin models are critically examined， including structural incompleteness， restricted cellular heterogeneity， evaluation compatibility， and administration methodologies. Looking ahead， the integration of tissue engineering， bioprinting， and microfluidic technologies is anticipated to drive the standardization and in telligent evolution of these models ultimately advancing the scientific robustness and translational utility of in vitro testing systems for aesthetic biomaterials. Related Articles | Metrics | Comments（0）

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The effect of Zhangpi ointment on the microecology of chronic venous leg ulcers by 16S ribosomal RNA high-throughput sequencing LI Yan, HU Yueyu, YAO Danhua, et al Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (6): 586-.   Abstract （348）      PDF（pc） （2036KB）（298）       Knowledge map    Save Objective To investigate the clinical efficacy of Zhangpi ointment in the treatment of chronic venous leg ulcers （CVLU） and its impact on the microecology of the wound surface by using 16S ribosomal RNA （16S rRNA） high-throughput sequencing. Methods A total of 35 patients with CVLU were divided into a Zhangpi ointment group （treatment group，18 cases） and a control group （17 cases） based on the treatment method. The treatment group was treated with Zhangpi ointment， while the control group received conventional treatment. The treatment course was 4 weeks. The clinical efficacy， wound granulation tissue growth， and changes in the microbial flora were observed. Additionally， the differences in dominant bacterial genera and the correlation with clinical symptoms were analyzed. Results At 28 days post-treatment， the total effective rate of the treatment group was 88.9% （16/18）， and that of the control group was 70.6% （12/17）. The coverage of granulation tissue in the treatment group was significantly higher than that in the control group （P<0.05）. High-throughput sequencing of the 16S rRNA of the wound microbiota showed that compared with before treatment and the control group， the Alpha diversity index in the treatment group decreased significantly after treatment （P<0.05）， and the abundance of the Proteobacteria phylum and Pseudomonas genus decreased significantly （P<0.05）. LEfSe analysis indicated that the  differences in bacterial genera before and after treatment mainly included Pseudomonas and diminuta（P<0.05）. Correlation analysis revealed that the abundance of Pseudomonas was positively correlated with the clinical PUSH score （r=0.467，P< 0.01）， but negatively correlated with the coverage of granulation tissue （r=-0.545，P<0.01）. Conclusion Zhangpi ointment can ameliorate the clinical symptoms of patients with CVLU and promote the growth of granulation tissue on the wound surface. It may exert its effect by regulating the wound surface microbiota and has a significant inhibitory effect on Pseudomonas of the Proteobacteria phylum. Related Articles | Metrics | Comments（0）

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Integration of popular science into the design and practice of medical curriculum with ideological and political education LI Jinggui, CHEN Qinhao, HU Yue, et al Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (6): 619-.   Abstract （311）      PDF（pc） （1376KB）（359）       Knowledge map    Save In response to the new and high requirements for ideological and political education in China，our teaching and research team has been exploring ways to integrate the curriculum of Oral and Maxillofacial Surgery with science popularization education that incorporates ideological and political elements. Teachers analyze cases in detail through “case decomposition”， “discussion of issues”， and “summary of content”， classify and arrange teaching and popular science contents， guide students’ ideological exchanges， and consolidate and materialize teaching content， thereby achieving better teaching effect and cultivating medical students’ skills and abilities in doctor-patient communication. This practice of integrating popular science and ideological and political education can improve students’ learning effectiveness and expand the humanistic quality of the curriculum. Related Articles | Metrics | Comments（0）

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Experimental research of long bone defect repair using biomimetic  scaffold constructed via DLP 3D printing loaded with ADSC extracellular vesicles#br# JIANG Wenbin, REN Jinzhen, ZHANG Yifan, et al Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (6): 561-.   Abstract （257）      PDF（pc） （11037KB）（100）       Knowledge map    Save Objective To investigate the reparative effect of 3D printed biomimetic bone scaffolds loaded with adipose stem cell-derived extracellular vesicles （ADSC-EVs） on long bone defects. Methods High-precision biomimetic bone scaffolds were fabricated using digital light processing （DLP）3D printing with polycaprolactone triacrylate （PCLTA）. ADSCEVs were drop-loaded onto the scaffold surface. Scanning electron microscopy was used to observe the morphology of the vesicles on the scaffold. Cell compatibility and osteogenic ability of the scaffold were evaluated using immunofluorescence staining with phalloidin and Alizarin Red. Critical bone defects （15 mm） were created in the bilateral radius of New Zealand  white rabbits. Rabbits were randomly assigned to 3 groups： blank control group without scaffold implantation， control group with pure material scaffold implantation， and experimental group with scaffold loaded with ADSC-EVs. Samples were harvested at 12 weeks post-implantation for evaluation of osteogenesis and angiogenesis using X-ray， immunohistochemical staining， and histological analysis. Results Phalloidin staining showed uniform cell growth on the scaffold surface with normal cell morphology. Alizarin Red staining revealed that the vesicle-loaded scaffold had stronger osteoinductive ability （P< 0.05）. Scanning electron microscopy demonstrated uniform distribution of vesicles on the scaffold surface and within the scaffold. X-ray images indicated that the experimental group had faster new bone formation and higher bone mass than the control group （P<0.05） and blank control group （P<0.01）， which was further confirmed by histological analysis with  Hematoxylin-Eosin staining. Immunohistochemical staining of tissue sections showed that the expression of the endothelial cell-specific marker CD31 was higher in the experimental group than in the control group （P<0.05） and blank control group （P<0.01）. Conclusion PCLTA biomimetic bone scaffolds loaded with ADSC-EVs exhibit excellent osteogenic and angiogenic abilities， effectively promoting the repair of long bone defects. Related Articles | Metrics | Comments（0）

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The narrative care experience in patients with facial burn scars: A qualitative study CHEN Heyan, ZHUANG Leilan, WANG Yuyan Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (6): 534-.   Abstract （230）      PDF（pc） （1055KB）（143）       Knowledge map    Save Objective To explore the real experience of facial burn scar patients after receiving narrative care， and to provide reference for the clinical development of targeted psychological intervention programs. Methods Using phenomenological research methods，8 patients with facial burn scar who had received narrative care from November 2018 to December 2022 were selected for semi-structured interview， and Colaizzi 7-step analysis was used for data analysis. Results The experience of patients with facial burn scars after receiving narrative care could be summarized into three themes： Improving negative emotions， improving treatment compliance and treatment effect， and delivering positive energy. At the same time， it was concluded that the lack of clinical narrative care for such patients was its low popularity and insufficient standardization. Conclusion Narrative nursing is effective for patients with facial burn scar. After receiving clinical narrative nursing， patients with facial burn and scar can reduce their negative emotions， improve their treatment compliance， further improve their quality of life， and increase their confidence in work and life. Related Articles | Metrics | Comments（0）

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A retrospective study on NSAIDs-related pain management following endoscopically-assisted dual-plane breast implant augmentation AN Juan, LU Tingyu, ZHENG Danning, et al Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (6): 529-.   Abstract （209）      PDF（pc） （1278KB）（191）       Knowledge map    Save Objective To evaluate the efficacy of Ketorolac Tromethamine injection versus Parecoxib sodium injection in postoperative analgesia following transaxillary approach dual-plane prosthetic breast augmentation surgery. Methods A retrospective analysis was conducted on 91 patients with micromastia who underwent transaxillary approach dualplane implant breast augmentation surgery between December 2021 and September 2024. Patients were divided into two groups based on postoperative NSAIDs selection： the Ketorolac Tromethamine group （n=57） and the Parecoxib Sodium group （n= 34）. Postoperative pain VAS scores on days 1 and 2 were compared， and the incidence of adverse reactions such as nausea and vomiting was recorded. Results On postoperative day 1， the mean VAS score in the Ketorolac Tromethamine group was significantly higher than that in the Parecoxib Sodium group （6.40±2.17 vs. 4.44±2.60，P<0.05）. On postoperative day 2， no significant difference was observed between the groups （3.60±2.43 vs. 4.44±2.60，P>0.05）. The incidence of nausea on the first day post-operation was 7.7% （7/91）， the incidence of vomiting was 3.3% （3/91）， and there were no other adverse reactions. The incidence of nausea on the second day post-operation was 2.2% （2/91）， and there were no other adverse reactions. Conclusion Compared with Parecoxib Sodium， Ketorolac Tromethamine demonstrates superior analgesic efficacy in the early postoperative period for patients undergoing transaxillary approach dual-plane prosthetic breast augmentation. Related Articles | Metrics | Comments（0）

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Research progress on prevention and management of postoperative complications following abdominoplasty TU Shilin, DENG Chengliang, XIAO Shun’e Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (6): 607-.   Abstract （207）      PDF（pc） （1160KB）（235）       Knowledge map    Save Abdominoplasty continuously optimizes abdominal wall function and aesthetic outcomes through innovative and combined surgical approaches. This article systematically reviews the evolution of abdominoplasty techniques， with a focus on analyzing the causes of common complications such as seroma， venous thromboembolism （VTE）， and incisional scars， alongside their preventive and management strategies. Research indicates that combining traditional techniques with modified strategies like liposuction and minimally invasive procedures can significantly reduce complication risks. However， future optimization of surgical safety and aesthetic results still necessitates technological innovation and evidence-based research， ultimately promoting the standardized development of the discipline. Related Articles | Metrics | Comments（0）

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Application of internal mammary artery perforator flap in anterior chest wall reconstruction WU Zishan, ZOU Mingli, YANG Yijie, et al Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (6): 571-.   Abstract （197）      PDF（pc） （6142KB）（229）       Knowledge map    Save Objective To explore the clinical application of internal mammary artery perforator （IMAP） propeller flap in the repairing of anterior chest wall wounds. Methods A retrospective analysis was conducted on 16 cases who underwent the internal mammary artery perforator （IMAP） flap surgery for chest wall defect reconstruction in our department between January 2021 and September 2024. Etiologies included tumor resection （4 cases）， keloid excision （9 cases）， and ulceration （3 cases）. All patients underwent preoperative handheld Doppler ultrasound along with either digital subtraction angiography （DSA） or computed tomography angiography （CTA） to identify the locations of IMA perforators and determine the dominant perforator， thereby guiding perforator selection and flap design. For cases with anticipated large defects where the donor site could not be closed directly， primary tissue expansion was performed at the donor site. IMAP propeller flaps were utilized in all cases， with all donor sites successfully closed directly by layered suture. Patients with keloids received routine postoperative radiotherapy and additional anti-scarring therapy. Results In this series， the IMAP1 flap was utilized in 2 cases， the IMAP2 flap in 12 cases， and the IMAP3 flap in 2 cases. Of these，3 patients underwent tissue expander implantation， with flap transfer completed in a second-stage procedure. All flaps survived completely， and the donor site incisions healed well. Patients were followed up for 6 months to 2 years， with no bserved recurrence of tumors or keloids. Conclusion IMAP flap is a promising option for reconstructing chest wall defects. Preoperative Doppler ultrasound， DSA， and CTA provide valuable guidance for identifying IMA perforator locations， selecting the dominant perforator， and planning individualized flap design. Related Articles | Metrics | Comments（0）

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Preliminary study on NTF3 modRNA in the treatment of myocardial infarction by promoting angiogenesis and inhibiting cell apoptosis TANG Xin, LU Tingting, WANG Huijing, et al Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (6): 543-.   Abstract （190）      PDF（pc） （9930KB）（114）       Knowledge map    Save Objective To evaluate the cardioprotective effects and underlying mechanisms of neurotrophin-3 modified messenger RNA （NTF3 modRNA） following myocardial infarction （MI）， and to provide experimental and theoretical evidence for modRNA-based cardiac regeneration therapy. Methods In vitro， NTF3 modRNA was transfected into H9C2  cardiomyocytes. The transfection efficiency and NTF3 protein expression were examined by ELISA analysis， while flow cytometry was used to assess the anti-apoptotic effects. In vivo， a rat model of myocardial infarction was established， and NTF3 modRNA was injected intramyocardially into the infarct border zone. Cardiac function was evaluated by echocardiography after treatment， and cardiac electrophysiological recordings were used to evaluate the restoration of electrical conduction. Myocardial fibrosis and apoptosis were examined using Masson’s trichrome staining and TUNEL assay， respectively. Immunofluorescence for angiogenic markers （CD31 and α-SMA） was performed to assess neovascularization. Results NTF3 modRNA achieved efficient transfection and significantly increased NTF3 protein expression in H9C2 cells， leading to a marked reduction in apoptosis. In the rat MI model， intramyocardial delivery of NTF3 modRNA significantly improved left ventricular ejection fraction （LVEF） and fractional shortening （FS）， reduced myocardial fibrosis and decreased the number of TUNEL-positive cardiomyocytes. Electrical conduction recovery was markedly enhanced compared with the control group. Moreover， the expression of angiogenic markers was notably elevated. These findings suggest that NTF3 modRNA promotes myocardial repair and functional recovery by enhancing angiogenesis and cardiomyocyte survival. Conclusion NTF3 modRNA effectively mitigates post-infarction cardiac dysfunction by promoting angiogenesis， inhibiting cardiomyocyte apoptosis， and improving electrical conduction， thereby exerting significant cardioprotective and regenerative effects. This study provides new experimental insights and a potential therapeutic strategy for modRNA-based cardiac repair. Related Articles | Metrics | Comments（0）

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Application progress of silicone gel combined with photoelectric technology in the prevention and treatment of hypertrophic scars ZHANG Zheng, ZHANG Yixin Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (6): 599-.   Abstract （172）      PDF（pc） （1999KB）（212）       Knowledge map    Save Pathological scars represent an aberrant fibrotic repair outcome following deep dermal injuries. Among them， the incidence of hypertrophic scars is relatively high， commonly seen after burns， surgical operations and cesarean sections. These scars significantly impair patients' quality of life due to associated pruritus， pain， and functional impairment. Silicone gel has emerged as a preferred therapeutic option for hypertrophic scars and keloids， owing to its well-established safety， efficacy， and ease of use. Recent studies have demonstrated that combining silicone gel with photoelectric technologies synergistically enhances therapeutic outcomes. This review consolidates evidence-based data to evaluate the efficacy and safety of silicone gel monotherapy and its combination with photoelectric therapies across diverse clinical populations， including medical aesthetics， burn rehabilitation， surgical procedures， cesarean section scars， and pediatric scar management. Furthermore， it discusses key clinical considerations and practical recommendations to advance personalized scar management strategies. Related Articles | Metrics | Comments（0）

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Clinical practice and exploration of intercostal perforator flap for immediate nipple reconstruction in patients with prosthetic breast reconstruction LIU Dan, CHEN Ying, XIE Fengfeng, et al Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (6): 575-.   Abstract （163）      PDF（pc） （9549KB）（419）       Knowledge map    Save Objective To introduce a special technique for immediate nipple reconstruction， namely intercostal perforator flap nipple reconstruction. Methods Three typical cases were presented. Among them， two patients underwent stage I breast cancer prosthesis reconstruction. Pathology indicated that there were residual cancer cells in the nipples， and thus nipple reconstruction was carried out. Another patient had undergone right breast cancer reconstruction surgery （prosthesis implantation） for many years， and a new Paget's disease emerged in the right nipple， requiring another surgical treatment. Immediate nipple reconstruction was performed using intercostal artery perforating branch （ICAP） flaps in all cases. Specific procedures： The incision of the inframammary fold was selected， ICAP flap with sufficient width and length was separated， and the blood supply was detected by indocyanine green. According to the scope of fluorescence display， the ischemic part was removed. The C-V nipple reconstruction technique was used to rebuild a nipple with intercostal perforator. The periareolar incision was shrunken by purse-string suture. The reconstructed nipple was put to the shrunken peri-areolar incision， and the lower thoracic advancement flap facilitated the creation of the neo-inframammary fold at last. Results According to the evaluation of breast surface beautiful score （BSBs） and Breast-Q， all patients were satisfied with the results. After half a year follow-up， the reconstructed nipples survived well. Conclusion The ICAP fl ap is a good technique for immediate nipple reconstruction. The advantage of this technology lies in the fact that this flap has reliable blood supply， suitable volume， and covert scar. Appropriate patient selection， reasonable surgical design and meticulous intraoperative and postoperative care are the key points of this technique. Related Articles | Metrics | Comments（0）

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Study on in vivo cartilage regeneration using decalcified bone matrix-gelatin composite scaffold combined with bmsc-chondrocyte co-culture technology SONG Juntao, CI Zheng, GUO Xueqiang, et al Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (6): 555-.   Abstract （163）      PDF（pc） （5693KB）（236）       Knowledge map    Save Objective To explore the feasibility of achieving stable in vivo cartilage regeneration using demineralized bone matrix-gelatin （DBM-GT） composite scaffolds combined with BMSC-chondrocyte co-culture technology. Methods  DBM-GT composite scaffolds were prepared via gelatin freeze-drying cross-linking technology， and bone marrow mesenchymal stem cells （BMSCs） were seeded to determine cell loading efficiency. Live/dead staining of scaffold-loaded cells was performed to evaluate the role of chondrocytes in regulating BMSC proliferation. Subsequently， a mixture of BMSCs and chondrocytes at a 1∶4 ratio was seeded onto the composite scaffold as the experimental group， while chondrocytes alone were seeded as the control group. After 5 days of in vitro culture， both groups were implanted subcutaneously into nude mice. Post-harvest histological examination was conducted to assess differences in cartilage regeneration between the experimental and control groups. Results The DBM-GT scaffold exhibited superior porous structure compared to the DBM scaffold. Live/ dead staining and DNA quantitative analysis demonstrated that chondrocytes effectively promoted BMSC proliferation. No significant difference in cartilage regeneration was observed between the experimental group （BMSC-chondrocyte co-culture） and the control group （chondrocyte-only） in vivo. Conclusion The DBM-GT gelatin scaffold can be successfully  Related Articles | Metrics | Comments（0）

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Construction of rehabilitation nursing management program for patients with DIEP breast reconstruction after breast cancer surgery MENG Liujing, YANG Jiafei, BIAN Weiwei, et al Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (6): 523-.   Abstract （161）      PDF（pc） （1114KB）（237）       Knowledge map    Save Objective To construct a rehabilitation nursing management program suitable for patients with DIEP breast reconstruction after breast cancer surgery. Methods Based on the retrieval， analysis of domestic and foreign literature， guidelines， expert consensus and interviews， the preliminary content of the rehabilitation nursing management program for patients with DIEP breast reconstruction after breast cancer surgery was formulated. Subsequently， through two rounds of Delphi method， the rehabilitation nursing management program suitable for patients with DIEP breast reconstruction after breast cancer surgery was finally established. Results The effective recovery rates of the two rounds of Delphi expert correspondence inquiries were 100% and 92.86% respectively， and the coefficient of expert authority was 0.85. Finally， the rehabilitation nursing management plan included 7 time stages and corresponding physical assessment indicators，18 rehabilitation goals and corresponding rehabilitation nursing management measures. Conclusion A rehabilitation nursing management program suitable for patients with DIEP breast reconstruction after breast cancer surgery was initially established. After clinical verification， it will be applied to the clinical rehabilitation practice of patients with DIEP breast reconstruction after breast cancer surgery. Related Articles | Metrics | Comments（0）

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The effect of non-surgical treatment combined with health education on the mental health of patients with facial keloids DU Lin, ZHANG Zhen, ZHU Qi, et al Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (6): 538-.   Abstract （127）      PDF（pc） （1072KB）（77）       Knowledge map    Save Objective To evaluate the psychological outcomes associated with non-surgical treatment combined with health education in patients with facial keloids. Methods A prospective longitudinal cohort study was conducted with 61 consecutively enrolled patients undergoing multimodal non-surgical therapy， including procedural modalities （laser therapy， intralesional corticosteroid injections， radiation therapy and patient education） between January 2023 and April 2024. A triphasic assessment protocol was implemented， featuring semi-structured interviews via Generalized Anxiety Disorder-7 （GAD-7）， Patient Health Questionnaire-9（PHQ-9）， Modified Vancouver Scar Scale （MVSS）， Social Impact Scale （SIS）， General Self-Efficacy Scale （GSES） and Health Literacy Inventory at baseline， mid-treatment （week 4）， and one-month post-treatment，to assess the degree of anxiety and depression， scar status， social influence， self-efficacy and health knowledge acquisition. Results During the treatment process， the patient experienced a psychological transformation from low self-esteem and anxiety to gradually regaining confidence and facing life positively. Scores of GAD-7， PHQ-9， MVSS and SIS were significantly lower after treatment （P<0.05）. The score of GSES and rates of health knowledge acquisition were significantly higher than those before treatment （P<0.05）. Conclusion The non-surgical treatment combined with health education exerts a progressive effect of “appearance improvement-cognitive reconstruction-social adaptation”， which not only optimizes facial appearance but also improves psychological status， providing a theoretical basis for clinical formulation  of targeted psychological intervention strategies. Related Articles | Metrics | Comments（0）

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Effects of otoscopic resection of external auditory canal osteoradionecrosis with free flap repair on patients' clinical symptoms and quality of life DENG Huarui, DAI Ruli, LIN Guangming, et al Journal of Tissue Engineering and Reconstructive Surgery    2025, 21 (6): 581-.   Abstract （97）      PDF（pc） （1073KB）（47）       Knowledge map    Save Objective To explore the effect of otoscopic resection of external auditory canal osteoradionecrosis with free flap repair on patients' clinical symptoms and quality of life. Methods Sixty patients diagnosed with radiation-induced osteonecrosis of the external auditory canal from December 2021 to December 2023 were selected. The patients' previous medical history， otoendoscopy and pathological examination all supported the clinical diagnosis of radiation-induced osteonecrosis of the external auditory canal after radiotherapy for nasopharyngeal carcinoma. Moreover， CT examination indicated that the lesion was limited to the external auditory canal， and soft tissue shadows could be seen in the ear canal. In cases where free dead bone forms in the ear canal， there is a skin defect in the necrotic bone area. All the included patients underwent otoscopic resection of external auditory canal osteoradionecrosis with free flap repair， and the effects of the surgical treatment on the clinical symptoms and quality of life of the patients were observed. Results All 60 patients included in the study successfully completed the surgery. Postoperative follow-up ranged from 3 to 9 months. The clinical cure rate was 86.67% （52/60）. Specifically， patients with clinical stage I had a cure rate of 93.33% （42/45）， while those with clinical stage Ⅱ had a cure rate of 66.67% （10/15）. Comparison of clinical efficacy between different clinical stages revealed a statistically significant difference （P=0.019）. The main clinical symptoms such as recurrent pus， ear pain， restricted mouth opening， and hearing loss were significantly improved after otoscopic resection of external auditory canal osteoradionecrosis  and free flap repair （P<0.05）. The improvement of postoperative clinical symptoms in patients with clinical stage Ⅰ was better than that in patients with clinical stage Ⅱ， but the difference was not statistically significant （P>0.05）. The patients’ quality of life showed a significant improvement trend after otoscopic resection of external auditory canal osteoradionecrosis with free flap repair （P<0.05）， and no significant difference was seen between the patients with clinical staging type Ⅰ and type Ⅱ（P>0.05）. Conclusion Clinical efficacy of otoscopic radiolucent excision of necrotic bone in the external auditory canal with free flap repair can alleviate patients' clinical symptoms and improve their quality of life. Related Articles | Metrics | Comments（0）

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Advances in the application of collagenase-based enzymatic debridement for chronic wound managemen TAO Kai Journal of Tissue Engineering and Reconstructive Surgery    2026, 22 (3): 241-.   Abstract （0）      PDF（pc） （1045KB）（122）       Knowledge map    Save Chronic wounds have emerged as a global public health concern， characterized by prolonged disease course， poor prognosis， and significant patient healthcare burden. Debridement， as a critical step in wound bed preparation， directly determines therapeutic outcomes. Enzymatic debridement refers to the selective application of enzymatic agents to necrotic tissue for targeted debridement. Among these， collagenase-based preparations are the most widely used and evidencesupported enzymatic debridement agents in clinical practice. They selectively degrade necrotic collagen without damaging healthy tissue， while also exerting multiple effects such as anti-inflammatory action， modulation of the wound microenvironment， promotion of granulation tissue formation， and enhancement of epithelialization. This article systematically reviews the historical development of enzymatic debridement， summarizes the mechanisms of collagenasebased preparations， and evaluates their clinical applications in burn wounds， diabetic foot ulcers， pressure ulcers， and vascular occlusive wounds. Furthermore， it provides insights based on the latest guidelines and research advancements to support standardized clinical practice. Related Articles | Metrics | Comments（0）

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Tibial transverse transport combined with collagenase therapy for refractory diabetic foot ulcers LIU Ning, SONG Yang, CUI Xintao, et al Journal of Tissue Engineering and Reconstructive Surgery    2026, 22 (3): 245-.   Abstract （0）      PDF（pc） （3433KB）（113）       Knowledge map    Save Objective To explore the clinical efficacy of tibial transverse transport （TTT） combined with collagenase in the treatment of refractory diabetic foot ulcers. Methods  A retrospective analysis was conducted on 40 patients with refractory diabetic foot ulcers who met the inclusion criteria and were admitted between September 2021 and September 2023. The 40 patients were divided into two groups： the collagenase group（ 22 patients） received treatment with TTT combined with collagenase ointment， while the non-collagenase group （18 patients） received TTT treatment alone. The clinical efficacy， follow-up results and auxiliary examination findings were compared between the two groups. Results The hospitalization time， antibiotic usage time， wound dressing frequency， and the reduction rate of wound area upon discharge in the collagenase group were all better than those in the non-collagenase group（ P<0.05）. During the follow-up period， the wound healing time in the collagenase group was shorter than that in the non-collagenase group （P<0.05）. One week after surgery and one month after surgery， the WBC， CRP， and ESR in the collagenase group were all better than those in the noncollagenase group（ P<0.05）. Conclusion The combination of TTT technology and collagenase for the treatment of refractory diabetic foot ulcers can improve distal limb blood supply while ensuring thorough debridement， thereby shortening treatment duration and reducing recurrence rates. Related Articles | Metrics | Comments（0）

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Clinical application and efficacy analysis of facial artery perforator myomucosal flap in the repair of soft tissue defects of the anterior buccal mucosa and oral commissure YI Liang, SONG Dajiang, ZHOU Bo, et al Journal of Tissue Engineering and Reconstructive Surgery    2026, 22 (3): 252-.   Abstract （0）      PDF（pc） （2952KB）（83）       Knowledge map    Save Objective To investigate the optimization of clinical application techniques， anatomical advantages and longterm functional efficacy of the facial artery perforator myomucosal flap （FAPMF） in the repair of soft tissue defects in the anterior buccal mucosa and oral commissure regions， with a focus on analyzing its unique value in complex recurrent cases and scenarios requiring oral commissure reconstruction. Methods A retrospective analysis was conducted on the clinical data of 10 patients with soft tissue defects of the anterior buccal mucosa and oral commissure who underwent FAPMF repair from January 2025 to December 2025. Among them， 7 were male and 3 were female， aged 38 to 68 years with a mean age of 51.4 years. The etiologies included 8 cases of resection for recurrent oral squamous cell carcinoma after surgery and 2 cases of oral commissure laceration caused by trauma， 5 cases had a history of radiotherapy. The defect size ranged from 2.0 cm×2.0 cm to 3.0 cm×3.0 cm. Preoperative dual localization of perforator vessels by computed tomography angiography （CTA） and highfrequency ultrasound was routinely performed. The surgical strategy focused on technical optimization： the“ bilobed flap plasty for oral commissure reconstruction” was implemented for oral commissure defects； For patients with poor tissue bed conditions after radiotherapy， the“ perforator augmentation” technique were adopted. Postoperative follow-up was conducted to observe flap survival rate， complications， mouth opening degree and aesthetic satisfaction （Visual analogue scale， VAS score）. Results All 10 surgeries were successfully completed without conversion to free flap repair. The FAPMF harvest time was 30 to 55 minutes with a mean of 41.2 minutes； The total surgical time was 95 to 165 minutes with a mean of 128.4 minutes. The intraoperative blood loss was 40 to 120 mL with a mean of 72.5 mL. All flaps survived postoperatively， and transient venous congestion occurred in 1 case， which was relieved after partial suture removal and local management. All donor sites were directly closed by primary suture and achieved primary healing. At 6 months postoperatively， the mouth opening degree was（ 36.45±1.54） mm， and the mean VAS score of patients for mucosal color matching and oral commissure morphology satisfaction was 9.0 points. Conclusion FAPMF is an ideal choice for repairing small and medium-sized defects of the anterior buccal mucosa and oral commissure due to its texture highly matching with oral mucosa， reliable perforator blood supply and flexible rotation arc. Through the optimal application of preoperative precise localization， intraoperative perforator augmentation and oral commissure plasty techniques， the repair risk of post-radiotherapy patients can be significantly reduced， and dual reconstruction of function and aesthetics can be achieved. It is especially suitable for complex cases with poor recipient vessel conditions or the need to preserve major facial blood vessels. Related Articles | Metrics | Comments（0）

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Clinical efficacy of type Ⅱb free anterolateral thigh chimeric flap for reconstruction of complex wounds LIU Zhiyuan, LI Hai, WU Xiangkui, et al Journal of Tissue Engineering and Reconstructive Surgery    2026, 22 (3): 256-.   Abstract （0）      PDF（pc） （2378KB）（105）       Knowledge map    Save Objective To evaluate the clinical efficacy of the Zunyi type Ⅱb free anterolateral thigh chimeric flap in repairing complex wounds. Methods  A retrospective cohort study was conducted， including 22 patients with complex wounds admitted between June 2021 and June 2024. All patients underwent repair and reconstruction using the Zunyi type Ⅱ b free anterolateral thigh chimeric flap. The flap was designed based on a single vascular pedicle with multiple perforator branches in a lobulated pattern and was customized according to the shape and number of wounds. The chimeric flap could combine skin with one or more tissue types， including fascia lata， muscle， and sensory nerve. The primary outcome measures included flap survival rate， complication rate， donor site morbidity， and long-term functional outcomes. Results Among the 22 patients， 7 underwent repair with flap+fascia lata， 8 with flap+muscle， and 7 with flap+sensory nerve. The overall flap survival rate was high. Only one patient developed vascular crisis on the night after surgery， and the flap survived after emergency exploration， resulting in an actual survival rate of 100% （22/22）. No donor site complications occurred in any patient. During a follow-up period of 6 to 24 months （median 11.5 months）， no adverse events such as ulcer recurrence， wound infection， or lobulated flap necrosis were observed. All patients achieved satisfactory outcomes in wound repair and functional reconstruction. Conclusion  The Zunyi type Ⅱ b free anterolateral thigh chimeric flap provides a reliable and flexible surgical option for complex wound repair. By integrating multiple tissue types into a single vascular pedicle and enabling lobulated design to simultaneously cover multiple or irregular wounds， this technique achieves effective tissue coverage， functional reconstruction， and long-term durability. These findings support the further clinical application of the Zunyi classification in repair and reconstruction strategies for complex wounds. Related Articles | Metrics | Comments（0）