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To date, there are no studies reported in the literature on the possible use of bovine collagen, oxidized regenerated cellulose, or synthetic hyaluronic acid medications in the oral cavity. The aim of this paper is to report the use of bovine collagen, oxidized regenerated cellulose, and synthetic hyaluronic acid medications to improve wound healing in the oral cavity by stimulating granulomatous tissue. From 2007 to 2011, 80 patients (median age 67 years) suffering from oral mucosal lesions participated in this double-blind study. The patients were divided into two groups, each consisting of 40 patients. One group received conventional medications, while the other group of patients were treated with the advanced medications. Advanced medications allowed re-epithelialization of the wound margin in 2-20 days, whereas patients receiving conventional medication showed a median healing duration of 45 days. The results of this study demonstrate that treating oral mucosal wounds with advanced medication has an advantage with regard to wound healing time, allowing patients to have a rapid, functional, and esthetic recovery.

Radiotherapy, a prevalent and effective treatment for various malignancies, often causes collateral damage to normal skin and soft tissues in the irradiated area. To address this, we developed a novel approach combining SVFG-modified adipose-derived high-activity matrix cell clusters (HAMCC) with concentrated growth factors (CGF) to enhance regeneration and repair of radiation-induced skin and soft tissue injuries. Our study included cellular assays, wound healing evaluations, and histological analyses. In the inflammatory wound healing environment, this treatment reduced ROS and 8-oxo-dG expression while increasing four antioxidant-related proteins (Nrf2, HO-1, NQO1, AKR1C1), thereby suppressing oxidative stress and improving wound healing efficiency. Additionally, the HAMCC and CGF combination promoted collagen expression and rearrangement and accelerated angiogenesis. This innovative treatment presents a promising strategy for regenerating and repairing radiation-induced skin and soft tissue damage.

Hyperbaric oxygen treatment (HBO) promotes rapid recovery from soft tissue injuries. However, the healing mechanism is unclear. Here we assessed the effects of HBO on contused calf muscles in a rat skeletal muscle injury model. An experimental HBO chamber was developed and rats were treated with 100% oxygen, 2.5 atmospheres absolute for 2 h/day after injury. HBO reduced early lower limb volume and muscle wet weight in contused muscles, and promoted muscle isometric strength 7 days after injury. HBO suppressed the elevation of circulating macrophages in the acute phase and then accelerated macrophage invasion into the contused muscle. This environment also increased the number of proliferating and differentiating satellite cells and the amount of regenerated muscle fibers. In the early phase after injury, HBO stimulated the IL-6/STAT3 pathway in contused muscles. Our results demonstrate that HBO has a dual role in decreasing inflammation and accelerating myogenesis in muscle contusion injuries.

Purpose The purpose of this study was to determine the incidence of the “lateral femoral notch sign” in acute anterior cruciate ligament (ACL) tears and its correlation with lateral meniscal tears. Methods Lateral plain radiographs and sagittal magnetic resonance images (each performed within 1 month following injury) of 500 patients with acute and arthroscopically confirmed ACL tears were retrospectively evaluated for depth, length and position of the “lateral femoral notch sign”. The accompanying bone bruise was measured, as well. The correlation of the lateral femoral notch sign with high-risk and low-risk pivoting activities as well as with a lateral meniscus tear was evaluated. Results A total of 26.4 % of the patients had a lateral femoral notch sign deeper than 2.0 mm with a mean depth of 2.8 ± 0.8 mm SD. All lateral femoral notches were situated near or slightly posterior to Blumensaat’s line. ACL injuries sustained during high-risk pivoting sports were more prone to a lateral femoral notch sign than ACL injuries in low-risk pivoting sports ( r  = 0.107 vs r  = −0.107). Of all patients with a lateral femoral notch sign, 40.2 % also had lateral meniscus tears. The correlation between the presence of the lateral femoral notch sign and lateral meniscus tears was statistically significant ( p  = 0.004). Conclusion In more than one-quarter of patients, plain radiographs may help to establish the diagnosis of an ACL tear. Further, a lateral femoral notch sign greater than 2.0 mm also correlates with lateral meniscus tears. Hence, the lateral femoral notch sign is a useful diagnostic tool in daily clinical practice. Level of evidence IV.

PurposeTo determine the utility of cervical spine MRI in blunt trauma evaluation for instability after a negative non-contrast cervical spine CT.MethodsA review of medical records identified all adult patients with blunt trauma who underwent CT cervical spine followed by MRI within 48 h over a 33-month period. Utility of subsequent MRI was assessed in terms of findings and impact on outcome.ResultsA total of 1,271 patients with blunt cervical spine trauma underwent both cervical spine CT and MRI within 48 h; 1,080 patients were included in the study analysis. Sixty-six percent of patients with a CT cervical spine study had a negative study. Of these, the subsequent cervical spine MRI had positive findings in 20.9%; 92.6% had stable ligamentous or osseous injuries, 6.0% had unstable injuries and 1.3% had potentially unstable injuries. For unstable injury, the NPV for CT was 98.5%. In all 712 patients undergoing both CT and MRI, only 1.5% had unstable injuries, and only 0.42% had significant change in management.ConclusionsMRI for blunt trauma evaluation remains not infrequent at our institution. MRI may have utility only in certain patients with persistent abnormal neurological examination.Key Points• MRI has limited utility after negative cervical CT in blunt trauma.• MRI is frequently positive for non-specific soft-tissue injury.• Unstable injury missed on CT is infrequent.

Soft tissue injury (STI) is a prevalent condition that requires effective therapeutic approaches. The focus of this investigation was to elucidate the molecular mechanisms linked to the IGFBP3 protein in adipose-derived stem cells (ADSCs) for STI repair, utilizing single-cell multiomics technology and a 3D bioprinting model. Establishment of a mouse-based STI model facilitated the comparison of cellular compositions and communication variances between wounded and normal tissues through single-cell RNA sequencing (scRNA-seq). High-throughput transcriptomics and bioinformatics analysis pinpointed IGFBP3 as a key target in ADSCs related to STI repair. In vitro experiments assessed IGFBP3's effects on ADSCs' epithelial cell differentiation, proliferation, and migration using various assays and lentivirus transfection to manipulate IGFBP3 expression. A 3D bioprinting technique was used to create an ADSCs-IGFBP3 peptide self-assembling hydrogel scaffold, characterized by Fourier-transform infrared spectroscopy, X-ray diffraction, SEM, and TEM. The scaffold's efficacy was validated in an animal model. Results showed nine cell subtypes in both normal and injured tissues, with increased ADSCs in STI tissues exhibiting enhanced connectivity and interactions. RNA-seq analysis confirmed IGFBP3 as crucial for ADSCs and STI. In vitro and 3D bioprinting experiments, along with animal model validation, confirmed IGFBP3's role in STI repair. Upregulation of IGFBP3 in ADSCs promoted epithelial cell differentiation by enhancing ITGB1 expression, activating the ERK pathway to boost cell proliferation and migration. This study highlights IGFBP3's significant role in ADSCs for STI repair, providing potential molecular targets for developing new treatments. The findings offer valuable insights into IGFBP3's mechanisms, aiding in advancing STI therapeutic strategies. Graphical Abstract 1. IGFBP3 enhances ADSC function in STI repair by activating ITGB1 and ERK pathways. 2. High IGFBP3 expression promotes ADSC differentiation into epithelial cells, improving tissue regeneration. 3. Single-cell multiomics and 3D bioprinting validate IGFBP3’s role in advancing STI treatment. 4. Findings present IGFBP3 as a promising molecular target for clinical STI therapy. Highlights This research presents the initial discovery of the crucial role of IGFBP3 protein in ADSCs in the repair of STIs. Through single-cell multiomics technology and a 3D bioprinting model, this study found that high expression of IGFBP3 in ADSCs can promote epithelial cell differentiation. Bioinformatic analysis indicates that in STI, there is a closer interaction and enhanced mutual influence between ADSCs and other cells. Experimental validation in vitro and in animal models provides additional evidence supporting the crucial function of IGFBP3 in STI recovery. The research introduces original molecular targets and an intellectual underpinning to tackle STI, with significant potential for clinical applications.

A 36-year-old man presented with a large mass on his back after he slipped on the stairs and slid down on his back. Magnetic resonance imaging showed a large, encapsulated, subcutaneous, suprafascial lesion consistent with a Morel–Lavallée lesion.

Using Sprague-Dawley rats (350–450 g; n = 61) and the recently updated Walker-Mason rat scald burn model, we demonstrated that Pseudomonas aeruginosa readily formed biofilms within full-thickness burn wounds. Following the burn, wounds were surface-inoculated with P. aeruginosa in phosphate-buffered saline (PBS), while sterile PBS was used for controls. On post-burn days 1, 3, 7, and 11, animals were euthanized and samples collected for quantitative bacteriology, bacterial gene expression, complete blood cell counts, histology, and myeloperoxidase activity. Robust biofilm infections developed in the full-thickness burn wounds inoculated with 1 × 10 4 CFU of P. aeruginosa . Both histology and scanning electron microscopy showed the pathogen throughout the histologic cross-sections of burned skin. Quantigene analysis revealed significant upregulation of alginate and pellicle biofilm matrix genes of P. aeruginosa within the burn eschar. Additionally, expression of P. aeruginosa proteases and siderophores increased significantly in the burn wound environment. Interestingly, the host’s neutrophil response to the pathogen was not elevated in either the eschar or circulating blood when compared to the control burn. This new full-thickness burn biofilm infection model will be used to test new anti-biofilm therapies that may be deployed with soldiers in combat for immediate use at the site of burn injury on the battlefield.

Despite decades of research, the goal of achieving scarless wound healing remains elusive. One of the approaches, treatment with polymeric microcarriers, was shown to promote tissue regeneration in various models of wound healing. The effects of such an approach are attributed to transferred cells with polymeric microparticles functioning merely as inert scaffolds. We aimed to establish a bioactive biopolymer carrier that would promote would healing and inhibit scar formation in the murine model of deep skin wounds. Here we characterize two candidate types of microparticles based on fibroin/gelatin or spidroin and show that both types increase re-epithelialization rate and inhibit scar formation during skin wound healing. Interestingly, the effects of these microparticles on inflammatory gene expression and cytokine production by macrophages, fibroblasts, and keratinocytes are distinct. Both types of microparticles, as well as their soluble derivatives, fibroin and spidroin, significantly reduced the expression of profibrotic factors and in mouse embryonic fibroblasts. However, only fibroin/gelatin microparticles induced transient inflammatory gene expression and cytokine production leading to an influx of inflammatory Ly6C+ myeloid cells to the injection site. The ability of microparticle carriers of equal proregenerative potential to induce inflammatory response may allow their subsequent adaptation to treatment of wounds with different bioburden and fibrotic content.

Background The biological mechanisms involved in non-contact musculoskeletal soft tissue injuries (NCMSTI) are poorly understood. Genetic risk factors may be associated with susceptibility to injuries, and may exert marked influence on recovery times. Methods Data on type and degree of injury and recovery time were collected in 73 male professional soccer players (43 White, 11 Black Africans and 19 Hispanics) who suffered total of 242 injuries (203 muscle, 24 ligament, and 15 tendon injuries). One single nucleotide polymorphism (SNPs) in the following genes were analyzed: Elastin (ELN); Titin (TTN); SRY-related HMG-box (SOX15); Insulin-like growth factor 2 (IGF2); Chemokine, CC motif, ligand 2 (CCL2); Collagen type 1 alpha 1(COL1A1); Collagen type 5 alpha 1 (COL5A1), and Tenascin C (TNC). Results There was evidence of a statistically significant association between the degree of injury and the IGF2 genotype (P = 0.034). In addition, there was evidence of a statistically significant association between the degree of muscle injury and CCL2 (P = 0.026) Finally, there was evidence of a statistically significant association between ELN and degree of injury (p = 0.009) and recovery time (P = 0.043). There was no evidence of a statistically significant association between any of the genes studied and degree of injury or recovery time for tendon injuries. Conclusion SNPs in the IGF2, CCL2, and ELN genes may be associated to the degree and recovery time of NCMSTI.