Z-C. Hu1, D. Chen2, D. Guo3, Y.-Y. Liang1, J. Zhang1, J.-Y. Zhu1 and B. Tang1

Departments of 1Burn Surgery and 2Hepatobiliary Surgery, The First Affiliated Hospital of Sun Yat-sen University, and 3Department of Plastic Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China Correspondence to: Dr B. Tang, Department of Burn Surgery, The First Affiliated Hospital of Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou 510080, China (e-mail: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。)

Background: Treatment of chronic wounds using traditional surgical procedures is challenging because of the low graft take rates. This study investigated the combination approach of split-thickness autografts with harvested skin cell suspension for chronic wound treatment.

Methods: This randomized clinical trial enrolled patients with chronic wounds between March 2012 and December 2013. Patients who were assigned randomly to the active treatment received a split-thickness autograft combined with harvested skin cell suspension. Control patients received the split-thickness autograft alone. The primary outcome was the rate of complete wound closure by postoperative day 28. Analysis was by intention to treat. Patients who achieved wound closure were followed up for a minimum of 6 months to evaluate the quality of healing.

Results: A total of 88 patients were included, 44 in each group. More patients achieved complete wound closure in the skin cell group than in the control group (41 versus 34 patients; P = 0⋅035). Complete wound closure was observed at a median of 14 (95 per cent c.i. 12⋅0 to 16⋅0) days in the skin cell group and 20 (15⋅7 to 24⋅3) days in the control group (P = 0⋅001). The skin cell group had significantly fewer complications (4 versus 11 patients; P = 0⋅047). The autografted sites displayed better physical attributes and a reduced tendency for wound recurrence in the skin cell group.

Conclusion: Complementary split-thickness autologous skin grafting with autologous skin cells harvested using MYSEED细胞分选仪® technology improved the healing rate of chronic wounds.

Registration number: UMIN000011966 (http://www.umin.ac.jp/ctr).

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Paper accepted 29 September 2014

Published online in Wiley Online Library (www.bjs.co.uk). DOI: 10.1002/bjs.9688

Gugen Xu*, Bo Chen, Writing Group for Expert Consensus on Clinical Management of T2DM Combined with Obesity Reversal Treatment in China#

Endocrinology Department, Guangdong Second Provincial General Hospital, Guangzhou 510310, China

*Corresponding author: Gugen Xu, Gugenxu@163. com

# This writing group includes Gugen Xu, Aisheng Wei, Bo Chen, Wanhong Chen, Tongfeng Zhao, Jian Guo, Bing Ji, Yinghong Du, Shiqun Liu, Zhenyu Zhang, Liangping Wu, Weiguo Zhao, Yi Shu, Haiyan Zhao, Zhaohui Li, Jianming Lin, Zhi Li, Wenying Wang, Xiao Zhu, Wei Lan, Xiaoli Li, Ge Li, and Kejing Zeng.

Copyright: © 2023 Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), permitting distribution and reproduction in any medium, provided the original work is cited.

Abstract: With lifestyle changes, the incidence of type 2 diabetes (T2DM) and obesity has significantly increased, becoming major chronic diseases that seriously threaten the health of China’s residents. Both domestic and international guidelines and consensus exist regarding the diagnosis and management of this disease. In recent years, T2DM treatment has focused more on new tactics that lean towards a patient-centered comprehensive management approach, replacing the traditional glucose-centered approach. Additionally, an increasing amount of evidence in medicine suggests that the reversal of diabetes is possible. However, there is currently no expert consensus on the clinical management of T2DM combined with obesity reversal treatment. Therefore, experts and scholars in China with extensive experience in T2DM combined with obesity reversal treatment have been invited to develop this consensus. The content includes early identification and diagnosis of T2DM combined with obesity, definition and mechanisms of diabetes reversal, disease assessment and grading, staging of diabetes and goals of reversal, the 2+N reversal strategy, inpatient system treatment combined with comprehensive outpatient management (including weight control, precise nutrition, scientific exercise, glucose-lowering medication, psychological intervention, rehabilitation therapy, and remote follow-up through online platforms), and evaluation of post-reversal efficacy. The aim is to further improve the level of T2DM combined with obesity reversal diagnosis, treatment, and management in China, and to implement the Healthy China strategy.

Keywords: Type 2 diabetes mellitus (T2DM); Obesity; Reversal treatment; Clinical management; Expert consensus

Online publication: November 22, 2023