Healing Rate Research Articles

Heterogeneous mineralogical composition and fault behaviour: A systematic study in ternary fault rock compositions

The heterogeneous mineralogical compositions of fault gouges, formed during fault evolution, influence frictional properties and slip behaviour. While the influence of individual mineral phases on friction has been extensively studied, the impact of varying systematically mineral phases in gouge mixtures on macroscopic frictional behaviour remains unclear. Thus, we performed 34 frictional experiments on fault gouges composed of three representative mineral phases: muscovite (platy phyllosilicate), quartz (granular silicate) and calcite (granular carbonate), known for their markedly distinct frictional properties. Using a biaxial rock deformation apparatus (BRAVA), we performed tests on fault gouges with grain sizes <125 μm under normal stresses of 50–100 MPa, at room temperature and water-saturated conditions. Our data indicate that the mineralogical composition of fault gouges significantly affects frictional strength, healing, and stability with a non-trivial pattern. Increasing the muscovite content leads to a decrease in frictional strength, from 0.62 for pure calcite and 0.56 for pure quartz to 0.33 of pure muscovite, along with reduced frictional healing and a velocity-strengthening behaviour. This weakening is promoted by a transition from localized deformation along discrete shear planes in granular-rich fault gouges to distributed deformation within the entire gouge layer with increasing muscovite content. At fixed muscovite content, frictional properties depend on the dominant granular phase. Calcite-dominated mixtures exhibit more marked frictional weakening rather than quartz-dominated ones, suggesting a non-linear mixing law between friction coefficient and muscovite content. This different trend is likely due to favourable conditions for fluid-assisted pressure-solution of calcite and foliation development, unlike quartz. When only the granular phases are mixed, we observe complex behaviour with the indentation of quartz into calcite, resulting in higher values of healing rates than those of pure end-member mixtures.Our findings provide robust insights into microphysical processes strongly dependent on the complex mineralogical compositions usually observed along natural faults.

Dual-functional core–shell microneedle patches for oral ulcers treatment

Microneedle patches have been widely used in transdermal drug delivery due to their painless and enhanced drug delivery. Despite their established success, their application within the oral cavity, characterized by a dense distribution of nociceptor, remains largely unexplored. Here, we introduce a well-designed dual-functional core–shell microneedle patches to address oral ulcers. The outer shell of the microneedle tips is crafted from hyaluronic acid (HA) and loaded with lidocaine, while the inner core, composed of gelatin methyl methacrylate (GelMA) encapsulates dexamethasone. The HA shell rapidly dissolves upon application, facilitating the immediate release of lidocaine to induce anesthesia at the ulcer site, thereby alleviating the associated painful sensations. Simultaneously, GelMA imparts mechanical strength and ensured the sustained release of dexamethasone. In vivo experiments further demonstrated that the Dex@MN group exhibiting the most rapid healing rate also displayed the highest levels of collagen deposition and the lowest concentrations of inflammatory factors. This collective evidence underscores the considerable potential of dual-functional core–shell microneedle patches in the treatment of oral diseases.

Mycolactone causes destructive Sec61-dependent loss of the endothelial glycocalyx and vessel basement membrane: a new indirect mechanism driving tissue necrosis in Mycobacterium ulcerans infection.

The drivers of tissue necrosis in Mycobacterium ulcerans infection (Buruli ulcer disease) have historically been ascribed solely to the directly cytotoxic action of the diffusible exotoxin, mycolactone. However, its role in the clinically-evident vascular component of disease aetiology remains poorly explained. We have now dissected mycolactone's effects on primary vascular endothelial cells in vitro and in vivo. We show that mycolactone-induced changes in endothelial morphology, adhesion, migration, and permeability are dependent on its action at the Sec61 translocon. Unbiased quantitative proteomics identified a profound effect on proteoglycans, driven by rapid loss of type II transmembrane proteins of the Golgi, including enzymes required for glycosaminoglycan (GAG) synthesis, combined with a reduction in the core proteins themselves. Loss of the glycocalyx is likely to be of particular mechanistic importance, since knockdown of galactosyltransferase II (beta-1,3-galactotransferase 6; B3GALT6), the GAG linker-building enzyme, phenocopied the permeability and phenotypic changes induced by mycolactone. Additionally, mycolactone depleted many secreted basement membrane components and microvascular basement membranes were disrupted in vivo. Remarkably, exogenous addition of laminin-511 reduced endothelial cell rounding, restored cell attachment and reversed the defective migration caused by mycolactone. Hence supplementing mycolactone-depleted extracellular matrix may be a future therapeutic avenue, to improve wound healing rates.

High strength “breathable” glycosilicone/Aloe vera polysaccharide-based gel dressing for efficient wound repair

Medical wound dressings are effective in protecting wounds, maintaining moisture, creating an optimal healing environment and accelerating wound healing. However, their deficiencies in mechanical properties, adhesion and prevention of adhesion to the wound bed have been identified as limiting factors for their therapeutic efficacy in wound healing. To address these issues, we prepared glycosilicone gel dressings consisting of hydrophobic polysiloxanes and highly hydrophilic polysaccharides via ester exchange and silicone hydrogen addition reactions. Silicone gel dressings exhibit skin-like “respiratory” properties, with good permeability to O2 and CO2. Additionally, elongation and other important parameters are similar to those of the skin, which provides a foundation for the application of silicone gels in the field of wound dressings. The introduction of Aloe vera polysaccharide (AP) results in the glycosilicone gel exhibiting certain mechanical properties, including a tensile strength of 0.35 MPa and an adhesion force of 10 N/m. Furthermore, a mouse model of total skin defect demonstrated that the wound healing rate of the mice on the 12th day was 98 %, which effectively promotes wound healing. Consequently, the glycosilicone gel is anticipated to be an optimal wound dressing.

Prognostic factors of extracorporeal shockwave therapy in the treatment of nonunion in long bones: a retrospective study.

Nonunion of long bone fractures is a significant complication following surgical fixation, with an incidence ranging from 5% to 10%. Surgical intervention is the standard treatment for nonunions, but it may come with potential complications. Nonoperative approaches, such as Extracorporeal Shockwave Therapy (ESWT), have been advocated as alternatives. The retrospective study, conducted between January 2004 and January 2018, 91 patients who underwent ESWT for tibia or femur nonunions were included. Nonunion was defined based on radiographic criteria and clinical symptoms. The nonunion morphology was categorized as hypertrophic, oligotrophic, or atrophic. ESWT was administered using the OssaTron device in a single treatment session. Bony union was defined as the presence of bridging callus over fracture site with more than three-fourths of the circumference in both planes within the 12-month postoperative period. The study included 91 patients, with an overall union rate of 62.6%. Higher healing rate was observed in trophic nonunion(69.9%) than atrophic nonunion(33.3%). Multivariate analysis identified the number of surgeries, maximum fracture gap, and atrophic nonunion as independent factors influencing the risk of fracture nonunion after ESWT. ROC curves were generated for these factors, providing more than one surgical interventions, and fracture gap greater than 3.94mm as negative predictors of ESWT for long bone nonunions. The study's primary findings suggest that ESWT is effective in achieving bony union for nonunions in long bones(62.6%). Despite the overall positive results, the study highlights that atrophic nonunions, larger fracture gaps more than 3.94mm, and multiple surgeries are associated with poorer outcomes.

Healing of Humerus Non-union Fracture Using Recombinant Human Bone Morphogenetic Protein With Bone Graft Compared to Bone Graft Alone: A Systematic Review and Meta-Analysis.

Non-union fractures of the humerus present significant challenges in orthopedic surgery, often requiring advanced treatments to achieve successful bone healing. The study aimed to compare the use of recombinant human bone morphogenetic protein (rhBMP) with bone grafts versus bone grafts alone for treating humerus non-union fractures with regard to healing rate and complications. Six databases, PubMed, ScienceDirect, The Cochrane Library, Scopus, Web of Science, and Google Scholar, were searched for relevant literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and studies were selected according to the set eligibility criteria. Quality assessment was performed using the Mixed Methods Appraisal Tool for randomized controlled trials (RCTs) and non-RCTs. Review Manager (RevMan) version 5.4 (2020, The Cochrane Collaboration, London, United Kingdom) was utilized for meta-analysis at a significance level of 0.01. Eighteen research papers were included for qualitative and quantitative analysis. Due to the unavailability of RCTs, data from the two studies were combined. The pooled data from 16 studies for effectiveness regarding union achieved forrhBMP with bone graft versus bone graft alone was 0.65 (95%CI: 0.07-6.38, I2 =67%, p=0.02). For rhBMP-2 and rhBMP-7 with bone graft, the pooled data was 0.09 (95%CI: 0.00-3.63) with high heterogeneity (I2 =88%) and statistically significant differences (p<0.00001). In the sub-group analysis, the pooled data for infection rate was 1.18 (95%CI, 0.37-3.73) with 39% heterogeneity and a non-significant difference (p=0.10). AddingrhBMP to bone grafts may not significantly improve union rates compared to bone graft alone in humerus non-union fractures. However, the trend shows increased infection rates with rhBMP usage. Further high-quality RCTs are warranted to confirm these findings and elucidate the optimal management strategy for humerus non-union fractures.

Is chemodenervation with incobotulinumtoxinA an alternative to invasive chronic anal fissure treatments?

BackgroundBotulinum toxin type A is currently strongly recommended for the treatment of anal fissures (AFs). However, there is still no consensus on dosage or injection technique. This study provides further efficacy and safety evidence in a 2-year follow-up.MethodProspective, open-label, single-arm, single-center study carried out in adult patients with AFs non-responsive to previous treatments. Patients were treated with incobotulinumtoxinA (incoBoNT/A) injected in both laterals and posterior intersphincteric groove. Healing rate at 2 years was the primary endpoint. Secondary endpoints included internal anal sphincter pressures, incontinence, and safety.ResultsA total of 49 patients were treated with a mean incoBoNT/A dose of 40.5 U (spread across three locations). Healing rate at 2 years was 83.9% with a 24.5% of recurrence throughout the study. Only 7 patients (14.3%) reported adverse events (AEs) that were mild and temporary. Mean reduction in anal resting pressure was -9.1 mmHg at 3 months (p = 0.001). Mean reduction in voluntary squeeze pressure was -27.5 mmHg at 3 months (p < 0.001). Mean pain perception measured with a visual analog scale decreased by -6.5 points at 2 years (p < 0.001). There was an incontinence increase at 1 month of 1.3 points (p = 0.006), but baseline values were restored at 6 months.ConclusionWe present results that support the use of incoBoNT/A as a second line for AFs that do not respond to ointment therapy. IncoBoNT/A injection is a less invasive treatment that should be considered before surgery due to its efficacy and its safety which includes no permanent impairment.Trial registrationISRCTN90354265; Registered on 16th February 2024. Retrospectively registered.

Effectiveness of combined botulinum toxin and fissurectomy on chronic anal fissures - a systematic review.

Anal fissures are a debilitating benign condition, thought to be due to the hypertonicity of the internal anal sphincter resulting in localized ischaemia inhibiting healing. There are several surgical and non-surgical treatment options for chronic anal fissures. Clinical practice surveys report a trend toward sphincter-sparing options, reserving the more successful treatment of lateral sphincterotomy, with an incontinence rate up to 10%, for refractory fissures. A search of MEDLINE, Cochrane Database of Systematic Reviews and EMBASE for studies assessing sphincter-sparing treatment with botulinum toxin and fissurectomy was performed following PRISMA guidelines. Outcomes assessed included healing rate, persistence, recurrence, re-intervention and incontinence rates. Fifteen non-randomized studies assessed 978 patients managed with botulinum toxin and fissurectomy. The mean age was 40.8 years with a female predominance of 58.9%. Healing rate was reported on 14 of the 15 studies, with a healing rate of 81% (95% CI:0.67, 0.90). Persistence rate was reported as 15% (95% CI:0.07, 0.28) and a recurrence rate of 6% (95% CI: 0.01, 0.19). Re-intervention was required in 8% of patients with 55.1% requiring a repeat dose of botulinum toxin with or without fissurectomy. Incontinence appears to be transient with studies reporting a rate of 1% with median long-term follow up 23 months (range: 5-60 months). Combination fissurectomy and botulinum toxin is a safe and viable sphincter sparing treatment option, with moderate success rate and negligible complications. Randomized controlled trials are required to further strengthen the evidence for its use in chronic anal fissures.

A comparative study of the healing effects of sesame oil and TiO2 nanoparticles gel on second-degree burn

Burns, a severe form of soft tissue injury, can cause significant damage and, in extreme cases, be fatal. They also lead to considerable mental and emotional distress due to excessive scarring and skin contractures. Despite various treatment methods, burn care remains a challenging medical issue. In this study, titanium dioxide (TiO2) nanoparticles were synthesized and characterized using Field Emission Scanning Electron Microscopy (FE-SEM), revealing particle sizes ranging from 31.52 to 69.08 nanometers. The impact of biosynthetic nanomaterials and sesame seed oil on burn healing in laboratory rats was investigated. The study compared the effects of a 1% TiO2 solution and 20% sesame oil on burned skin with a control group of rats having natural skin. Fifteen rats were divided into three groups, each receiving daily treatment for 28 days. The results indicated that the TiO2 treatment significantly accelerated healing compared to the sesame seed oil group, which had a slower healing rate of 0.12 points per day. The TiO2 treatment demonstrated a marked improvement in healing speed and effectiveness.

Autologous platelet concentrates as adjuvant in the surgical management of medication-related osteonecrosis of the jaw.

Medication-related osteonecrosis of the jaw (MRONJ) is an infectious side effect associated with bisphosphonates and monoclonal antibodies (denosumab, immune modulators, and antiangiogenic medications). Adjunctive therapies for the surgical management of MRONJ include autologous platelet concentrates (APCs). These APCs serve as a source of various cells and growth factors that aid tissue healing and regeneration. This review evaluated the use of platelet-rich plasma (PRP), plasma-rich in growth factors (PRGF), and leukocyte- and platelet-rich fibrin (L-PRF) as adjuvant therapies for the surgical management of MRONJ by conducting analyses on the results of 58 articles. Compared to surgical treatment alone, the application of PRP and L-PRF after surgery appears to increase healing in the management of patients with MRONJ. No studies have reported unhealed lesions as a result of surgical treatment of MRONJ with PRGF application or compared it with surgical treatment alone. The overall results of this review have shown favorable healing rates of MRONJ lesions managed with the application of APCs after surgical treatment; however, significant methodological limitations may limit the scientific evidence supporting their use. Further randomized controlled trials with strict criteria are needed to establish the extent to which APCs can improve wound healing and quality of life in patients with MRONJ requiring surgical treatment.

Antibacterial cationic porous organic polymer coatings via an adsorption-contact-photodynamic inactivation strategy for treatment of drug-resistant bacteria

Although photodynamic therapy (PDT) has great potential for treating severely infected wounds, it is restricted by the short lifetime, limited diffusion distance of reactive oxygen species (ROS), and incomplete contact with bacteria. Herein, we report a novel nanosized ionic porous organic polymer (TPAPy-IPOP) based on the triphenylamine (TPA) moiety. Strong electron-deficient cationic groups were introduced into TPA to construct the donor–acceptor (D–A) system, in which the photoelectric effect of TPAPy-IPOP was greatly enhanced, and it was easily excited to produce ROS under irradiation with visible light. The introduction of cations not only facilitated bacterial adsorption by TPAPy-IPOP via electrostatic attraction, which was more conducive to killing bacteria by ROS, but also inactivated bacteria by the cations directly. The nanosized TPAPy-IPOP remained suspended in water for several months and could be sprayed onto various substrates to form a durable coating with excellent antibacterial properties. The in vivo results proved that the silk fibroin/polyvinyl alcohol non-woven fabric (SF/PVA) coated with TPAPy-IPOP could create and maintain a sterile microenvironment at a wound site. The rapid reduction in inflammation resulting from its bactericidal action accelerated the wound healing rate. Collectively, this design is expected to offer a generalizable approach for developing novel antibacterial therapeutic photosensitizers, especially for infected wound treatment.

The Wound-Healing Effect of a Novel Fibroblasts-Impregnated Hydroxyethylcellulose Gel in a Rat Full-Thickness Burn Model: A Preclinical Study.

Background/Objectives: The objective of this study was to assess the efficacy of a cell-containing wound dressing based on fibroblasts in hydroxyethylcellulose (HEC) gel for the local treatment of deep partial-thickness and/or full-thickness skin burns in an animal model. Methods: The rats (male Wistar, n = 100) were subjected to a full-thickness thermal burn (16 cm2). Radical necrectomy was performed one day after the burn. Three days later, the rats were randomly assigned to one of four groups: group 1 (no treatment), group 2 (chloramphenicol and methyluracil ointment, a routine clinical treatment), group 3 (a gel without cells, mock treatment), and group 4 (a dermal fibroblast-impregnated HEC gel). The treatment lasted for five days. The wound-healing process was evaluated by planimetric, cytologic, histologic, and immunohistochemical methods. Results: The differences in the rate of wound healing and the characteristics of wound cytology were identified. In the group 4, a regenerative type of cytogram was revealed, characterized by a significantly increased number of fibroblastic cells in comparison to samples from non-treated and mock-treated animals. Biopsy samples of burn wounds from animals in the group 4l demonstrated the presence of mature granulation tissue and a large number of microvessels. The repair process was stimulated, as evidenced by the increased thickness of newly formed granulation tissue and epidermis in the wound zone, elevated cellularity, and enhanced re-epithelialization activity. The number of Ki-67-positive proliferating cells was significantly higher in group 4 than in the control groups). A small number of non-proliferating donor fibroblasts was observed in the wound area 3 days after the end of treatment. Conclusions: The cell product is an effective agent for promoting wound healing during the regenerative phase. The experiments demonstrated that a gel populated by dermal fibroblasts can stimulate reparative regeneration processes in deep partial- and full-thickness burn wounds.

Analysis of computed tomography venography for the diagnosis and endovascular treatment of iliac venous compression syndrome with venous leg ulcers: a retrospective study

Iliac vein compression syndrome (IVCS) is a clinical condition defined as obstruction of the iliac vein caused by chronic compression imposed by various causes. Currently, the clinical role of computed tomography venography (CTV) in the diagnosis of IVCS is unclear. Accurately diagnosing IVCS using CTV may enhance the understanding of the pathological anatomy of iliac veins, which may lead to better treatment outcomes, especially for recalcitrant venous leg ulcers (VLU). We aimed to investigate diagnostic criteria, contributing clinical factors, and stenting for IVCS with VLU in this study. CTV, digital subtraction angiography (DSV), and Doppler ultrasound (DUS) data were obtained from the medical and imaging records of 62 patients. Additionally, contributing factors and stenting for IVCS were analysed. Patients (100%) had clinical, aetiological, anatomic, or pathological C6 disease. CTV reduced the procedure time and contrast medium dose and provided more information than DSV. Risk factors for IVCS with VLU included female sex (P = 0.036) and advanced age (P = 0.014). The rate of ulcer healing was lower in the IVCS group without stent implantation (P = 0.020). Significant improvements were noted in venous clinical severity scores (P < 0.001) and chronic venous insufficiency questionnaire-20 scores (P < 0.001) after stenting for IVCS with C6 ulcers. CTV provides a more accurate diagnosis than DUS and DSV and allows detection of possible causes of IVCS. Female sex and advanced age were potential contributing factors for IVCS. Satisfactory outcomes were observed with stenting in the treatment of IVCS with C6 ulcers.

Enhancing early-stage healing responses through the modified "Poncho" technique in customized titanium mesh-mediated bone regeneration: A soft tissue management approach-case series.

Soft tissue management is critical in bone augmentation surgery to prevent wound dehiscence. Several strategies for passive tissue primary closure have been explored. This article introduces a flap design known as the modified "Poncho" technique (MPT), integrated with customized titanium mesh-mediated bone regeneration, and investigates the healing quality during the initial stages of an incision. The cohort consisted of 5 patients undergoing customized bone regeneration procedures, concerned primarily with the successful integration and healing of the augmented bone site without complications such as wound dehiscence or infection. All patients were diagnosed with insufficient bone volume requiring augmentation to support future dental implants, necessitating the use of customized titanium mesh for guided bone regeneration. The MPT was detailed and applied during the customized bone regeneration procedures. Postoperative evaluations included recording complications and using Landry's healing index at intervals of 3, 7, 14, and 30 days post-surgery to assess the technique's performance in early wound closure. The study found that 95.7% of surgery sites experienced uneventful soft tissue healing within the observation period. Only 1 of 23 sites exhibited partial wound dehiscence at postsurgical days 14 and 30, accompanied by mild inflammation. The Landry's healing index increased from 3 ± 0.47 to a final value of 4.69 ± 1.06, indicating substantial improvement in healing over time. The MPT shows promise as an innovative approach for promoting passive and predictable primary wound closure beneath a digitally customized titanium mesh for bone regeneration, demonstrating a high rate of successful healing and minimal complications during the early postoperative phase.

Relationship between the healing rate of post-extraction sites and the quantity of platelets present in the blood: a retrospective observational study.

In daily surgical practice, the dentist deals with various types of oral surgery. At the first visit, the patient fills out a questionnaire about their state of health. If the questionnaire does not reveal any particular hematological problems, no special tests are usually required to determine the platelet count. The aim of this prospective study was to evaluate the healing process of patients and its correlation with platelet levels before surgery. A total of 50 patients were included in whom blood chemistry tests were performed with special attention to the platelet count and before their mandibular eights were extracted .The type of healing (EHI) and pain on the second day (VAS) were assessed using methods validated in the literature. After the EHI and VAS scores were noted in the medical records, envelopes containing the platelet scores of the previously requested blood samples, which were not read at the time of observation, were opened. An increase in EHI scores and a decrease in VAS scores was observed that were statistically significantly correlated with increasing platelet scores. These results suggest that the dentist should request chemistry tests on preoperative blood, especially if the patient is to undergo a particularly demanding oral surgical procedure, such as implants, guided bone regeneration or complex extractions.

Minimally Invasive vs Open First Ray Dorsiflexion Osteotomy: Radiographic Outcomes and Early Complications Report.

There is limited literature comparing open and minimally invasive surgical (MIS) techniques for first ray dorsiflexion osteotomy (DFO). This study is the first of its kind to report early healing and complication rates of patients undergoing MIS vs open first ray DFO. A retrospective cohort review of 28 patients who underwent a first ray DFO procedure at an academic medical center between 2015 and 2024 was conducted. Demographic factors and medical comorbidities were recorded. Radiologic parameters were measured along with healing. Postoperative healing and outcomes were identified through medical record review. Thirteen open and 15 MIS DFO procedures were performed. At follow-up, all osteotomies were healed with no wound or infection complications. There was no significant difference in hardware removal rates, 7.7% for open and 6.7% for MIS. The change in lateral Meary angle was 10.5 ± 3.9 and 9.7 ± 4.3 for the open and MIS groups, respectively (P = .61). The calculated dorsal closing wedge resection was 3.5 mm and 4.1 mm for open and MIS, respectively (P = .26). This study showed no significant differences in healing or complication rates in the short term between MIS and open surgery, with comparable magnitude of correction, suggesting similar ability for the MIS technique to correct first ray alignment. Further studies are needed to determine long-term outcomes.

High Rate of Return to Sport in Contact and Collision Athletes After Arthroscopic Latarjet With Cortical Button Fixation

Background: Contact and collision athletes face a higher risk of recurrent anterior shoulder instability after surgical stabilization. The Latarjet procedure is often preferred given the high incidence of bony lesions. However, this stabilizing procedure, performed either open or arthroscopically, is met with concerns regarding complications and revision surgery rates. Purpose: To evaluate the return to sport (RTS) and assess complication and instability recurrence rates in contact/collision athletes undergoing the arthroscopic Latarjet procedure using a guided technique with suture buttons for coracoid fixations. Study Design: Case series; Level of evidence, 4. Methods: A retrospective analysis was conducted on contact/collision athletes who underwent the arthroscopic Latarjet procedure for recurrent anterior shoulder instability between January 2011 and March 2018. All patients were operated on arthroscopically using glenoid and coracoid guides and suture button fixation of the transferred coracoid. RTS was defined as the patient being able to participate in his or her activity without any restriction postoperatively. Two independent observers assessed patients using postoperative computed tomography (CT) scans to evaluate coracoid positioning and healing. A multivariate analysis was performed to identify predictive factors associated with persistent apprehension. A group comparison was performed to assess RTS failure risk factors. Results: In 136 contact/collision athletes (mean age, 25 ± 7 years), 93% were satisfied, and 98% achieved shoulder stability at a mean follow-up of 60 months (range, 24-117 months). No suture button–related complications or neurovascular issues were reported. Overall, 82% (112/136) returned to contact/collision sports. The mean time to RTS was 5.3 ± 1.2 months (range, 3-7.3 months). In a CT study performed 2 weeks after surgery, 87% (118/136) of bone grafts were positioned below the equator and 93% (126/136) were flush to the glenoid surface. At the 6-month postoperative CT examination, complete bone block healing was achieved in 84% (114/136). On clinical examination at the latest follow-up, 36 patients (26%) reported some anterior apprehension on testing. On multivariate analysis, patients with severe humeral bone defects (medium to large Hill-Sachs lesions, Calandra grade 2 or 3) had a higher risk of postoperative persistent apprehension. On group comparison, a visual analog scale score >3 and persistent anterior apprehension were found to be associated with failure of RTS. Conclusion: The arthroscopic Latarjet procedure with suture button fixation allowed 82% of athletes with recurrent anterior shoulder instability to return to contact or collision sports. Patients with severe humeral bone defects have a higher risk of persistent anterior apprehension and decreased RTS. The arthroscopic-guided procedure with suture button fixation is safe; accurate, with a high rate of anatomic graft positioning and healing; and reliable, with a low recurrence rate.

The Untold Story: Early and Mid-Term Results of Subintimal Angioplasty in Superficial Femoral Artery Versus Popliteal Artery Chronic Total Occlusion.

This study aims to compare the immediate and mid-term outcomes of subintimal angioplasty (SIA) of chronic total occlusions (CTOs) of superficial femoral artery (SFA) versus popliteal artery (PA) and to identify possible predictors of loss of limb-based patency (LBP). This is a retrospective analysis of chronic lower-limb ischemia (CLI) patients (Rutherford classes 3-6) presenting with CTO of SFA or PA treated by SIA and selective stenting in the period 2018 to 2021. Immediate outcomes were compared between the SFA and PA groups, including technical success, perioperative complications, and 30-day major amputation and mortality rates. Mid-term outcomes for technically successful procedures included limb-based patency (LBP), wound healing rate, amputation-free survival (AFS), and major adverse limb events (MALEs). A total of 450 CLI patients underwent SIA of CTO at the SFA (n=260, 57.8%) and the PA (n=190, 42.2%). The indication for revascularization was chronic limb-threatening ischemia in 80.8% of SFA group and 84.2% of PA group. Technical success rate was higher in the PA group compared to the SFA group (96.3% vs 91.2%; p=0.03). The 30-day amputation rates were comparable between the SFA and PA groups (7.7% vs 6.8%, p=0.7, respectively). No perioperative mortality or systemic major complications occurred in the present study. Kaplan-Meier estimate of the 1-year rates were significantly better for SFA group regarding LBP (82% for SFA group vs 43% for PA group, p=0.006), AFS (88% vs 64%, p=0.02), and wound healing (79% vs 58%, p=0.027), respectively. The number of runoff vessels was the only factor associated with loss of LBP (hazard ratio [HR], 0.055; 95% confidence interval [CI]: 0.001-3.020, p=0.039). Subintimal angioplasty is an effective and safe endovascular treatment option of CTO at SFA and PA with satisfactory immediate outcomes. The mid-term outcomes, however, are better for SFA lesions in terms of improved LBP, AFS, and wound healing rates. Subintimal angioplasty is a valuable tool in the armamentarium of endovascular surgeons, as re-entry devices aren't always widely accessible. This study aims to assess the technical outcomes of peripheral vascular interventions for infrainguinal chronic total occlusions and identify possible predictors for successful subintimal angioplasty .Subintimal angioplasty is an effective treatment option for infrainguinal CTO with difference in result of immediate outcomes in popliteal lesions and SFA lesions.

Characterizing the Self‐Healing Asphalt Materials: A Neutron Imaging Study

Given the significant role of asphaltic pavement in surface transportation systems, even minor enhancements in asphalt materials hold the potential for cost savings and reduced environmental impacts. The healing properties of asphalt have drawn interest for sustainability, yet much remains unknown about the causes and influencing factors. To leverage self‐healing for extending pavement life, understanding the mechanisms and conditions that stimulate microcrack healing is essential. This study aims to investigate the dynamic progress of microcrack closure in asphalt mastics. The time‐series evolution of crack closure led by self‐healing is tracked by neutron computed tomography, with image processing facilitating volumetric analysis over a 7 h period. The study examines the healing process in mastic samples with three different sand filler contents (10, 20, and 30%). Results show that for all the investigated samples, the healing rate declines exponentially over time, with 100% recovery not achieved after 7 h at room temperature. Filler content‐influenced healing speed and 20% sand demonstrate the best performance. Meanwhile, the healing performance varies within the 10% and 30% groups, depending on initial crack size. Additionally, the study finds that initial crack size influences healing behavior in the samples.

Effects of different treatment measures on the efficacy of diabetic foot ulcers: a network meta-analysis.

Through a network meta-analysis, we compared different treatment measures for patients with diabetic foot ulcers (DFU), assessing their impact on the healing of DFU and ranking them accordingly. We searched the PubMed, the China National Knowledge Infrastructure (CNKI), Embase, the WanFang and the WeiPu database. The retrieval time was from database establishment to January 2024, and retrieval entailed subject and free words. Randomized controlled trials (RCTs) with different treatment measures for DFU were included. Data extraction and evaluation were based on the PRISMA guidelines. Meta-analyses using pairwise and network methods were employed to compare and rank the effectiveness of different treatments for DFU. Ultimately, we included 57 RCTs involving a total of 4,826 patients with DFU. When it comes to ulcer healing rates, compared to standard of care(SOC),platelet-rich plasma(PRP), hyperbaric oxygen therapy(HBOT), topical oxygen therapy(TOT), acellular dermal matrix(ADM), and stem cells(SCs) in both direct meta-analysis(DMA) and network meta-analysis(NMA) can effectively increase the complete healing rate. For Scs+PRP, a statistically significant improvement was only observed in the NMA. Moreover, when compared to the negative pressure wound therapy(NPWT) group, the PRP+NPWT group was more effective in promoting the complete healing of ulcers. In terms of promoting the reduction of ulcer area, no statistical differences were observed among various treatment measures. When it comes to ulcer healing time, both PRP and NPWT can effectively shorten the healing time compared to SOC. Furthermore, when compared to the NPWT group, the combined treatment of PRP and ultrasonic debridement(UD) with NPWT is more effective in reducing healing time. In terms of amputation rates and adverse reactions, the PRP group effectively reduced the amputation rate and adverse reactions for patients with DFU. Additionally, compared to the NPWT group, the combined treatment of PRP and UD with NPWT reduced the incidence of adverse reactions. However, no significant differences were observed among other treatment measures in terms of amputation rates and adverse reactions. The ranking results showed that the efficacy of PRP+NPWT and UD+NPWT in promoting ulcer healing, reducing ulcer area, shortening healing time, decreasing amputation rates and adverse reactions is superior to that of the alone PRP group, NPWT group, and UD group. Conversely, the SOC group demonstrates the least effective performance in all aspects. Due to the particularity of the wound of DFU, the standard of care is not effective, but the new treatment scheme has a remarkable effect in many aspects. And the treatment of DFU is not a single choice, combined with a variety of methods often achieve better efficacy, and will not bring more adverse reactions.