Clinical Features and Expression Patterns for Burn Patients Developed Marjolin Ulcer.

Marjolin's ulcer is a type of skin cancer that generated from chronic nonhealing trauma. For years, its pathogenesis mechanisms remain unclear. Regarding this situation, the authors retrospectively analyze the patients admitted to their department from 2005 to 2019 to present several representative cases and examine the expression patterns of survivin and its role in this process. Among these patients, the latent period ranges from 2 to 25 years, with 8.43 years in average. There is no notable relationship between the latent period and age (P = .643 > .05). Therefore, Marjolijn's ulcer arises from extremities and joints more often compared with other parts (P < .05). The expression ratio of survivin in Marjolin's ulcer is significantly higher than that in skin ulcer (P < 0.05). And the expression ratio of survivin in patients diagnosed with Marjolin's ulcer is also correlated with lymphatic metastasis (P < .05). Frequent follow-ups and prompt diagnosis and management are necessary as the prognosis is poor for patients with metastasis. Survivin may be a potential target for future development of target therapy in order to maximize the efficacy and improve the quality of life for patients suffering from Marjolin's ulcer.

[Effect of vacuum sealing drainage on expressions of transforming growth factor ß 1 and its receptor in diabetic foot wound].

Objective: To investigate the changes of transforming growth factor ß 1 (TGF- ß 1) and type Ⅱ of TGF-ß-receptor (TßRⅡ) expressions in wound tissue after the treatment of diabetic foot with vaccum sealing drainage (VSD), and to analyze the mechanism of accelerating wound healing. Methods: Between May 2012 and May 2016, 80 patients with diabetic foot were randomly divided into 2 groups, 40 cases in each group. After the same basic treatment, the wounds of VSD group and control group were treated with VSD and external dressing, respectively. There was no significant difference in gender, age, disease duration, body mass, foot ulcer area, and Wagner grade between 2 groups ( P>0.05). The time of foundation preparation and hospitalization stay of 2 groups were recorded. The wound tissue was collected before treatment and at 7 days after treatment, and the positive indexes of TGF-ß 1 and TßRⅡexpressions were measured by immunohistochemical staining. Results: Before skin grafting, the patients in VSD group were treated with VSD for 1 to 3 times (mean, 2 times), and the patients in control group were treated with dressing change for 1 to 6 times (mean, 4 times). The time of foundation preparation and hospitalization stay in VSD group were significantly shorter than those in control group ( t=-13.546, P=0.036; t=-12.831, P=0.041). The skin grafts of both groups survived smoothly and the wound healed well. Before treatment, immunohistochemical staining results showed that the positive indexes of TGF-ß 1 and TßRⅡ expressions in VSD group were 5.3±2.4 and 14.0±2.6, while those in control group were 4.4±2.3 and 14.7±3.1, respectively. There was no significant difference between 2 groups ( t=1.137, P=0.263; t=1.231, P=0.409). At 7 days after treatment, the positive indexes of TGF-ß 1 and TßRⅡ expressions in VSD group were 34.3±2.9 and 41.7±3.7, respectively, and those in control group were 5.8±2.0 and 18.1±2.5. There were significant differences between 2 groups ( t=-35.615, P=0.003; t=23.725, P=0.002). Conclusion: VSD can increase the expressions of TGF-ß 1 and TßRⅡ in diabetic ulcer tissue, promote granulation tissue growth, and accelerate wound healing.

A Case Report of a Complete Penile and Scrotum Skin Degloving Injury.

Male genital injuries are rare and only few of them are total penoscrotal degloving injuries. Though this kind of injury is not life-threatening, it could be psychologically devastating to patients if not treated appropriately. This report presents a case of total male genitalia degloving injury treated by sliding flap and skin graft, assisted by Vacuum Sealing Drainage. Via this therapeutic approach, the injured area was completely healed. Three months after surgery, there were still no scars that affected normal function of male genitalia.This approach, which has never been reported before, yields a satisfactory result for both aesthetic appearance and sexual functions.