For many years infection has been the leading cause of implant failure and different approaches have been used to overcome the difficulties faced with infection management. Commonly, implant infection occurs due to biofilm formation, and a better understanding of this has led to the prevention of biofilm formation. The coating of implants with antibiotics and other antimicrobials has been done for the past decades and recently, noble metal nanoparticles have been used as an alternative to titanium alloys. This case series will describe three different patients for whom antibiofilm coated implants were used with a good clinical outcome.

Key words: ■ Bactiguard coating ■ Orthopaedic prosthetic infection ■ Noble metal nanoparticle coating

Dato Dr Badrul Akmal Hisham Md Yusoff, Consultant Orthopaedic & Sports Surgeon Department of Orthopaedics & Traumatology, Hospital Canselor Tuanku Muhriz,UKM Medical Centre, Kuala Lumpur Malaysia; Dr Mohamed Razzan Rameez, Medical Officer, Department of Orthopaedics & Traumatology, Hospital Canselor Tuanku Muhriz,UKM Medical Centre,Kuala Lumpur Malaysia; Dr Ahmad Farihan Mohd Don, Consultant Orthopaedic & Sports Surgeon Department of Orthopaedics & Traumatology, Hospital Canselor Tuanku Muhriz,UKM Medical Centre, Kuala Lumpur Malaysia; Dr Muhamad Karbela Reza Bin Ramlan, Specialist Orthopaedic & Sports Surgeon, Department of Orthopaedics & Traumatology Hospital Canselor Tuanku, Muhriz, UKM Medical Centre, Kuala Lumpur, Malaysia; Continued on page 28;

Dr Norlelawati Mohamad, Consultant in Sports Physician, Department of Orthopaedics & Traumatology, Hospital Canselor Tuanku Muhriz, UKM Medical Centre, Kuala Lumpur, Malaysia; Professor Harikrishna KR Nair, Head of the Wound Care Unit, Department of Internal Medicine, Hospital Kuala Lumpur Malaysia; Declaration of Interest: The authors no conflict of interest with regards to this work. The Bactiguard coated implant used was sourced from Vigilenz Medical Devices Sdn Bhd.

付小兵' '解放军总医院第四医学中心，北京100048
通信作者:付小兵，Email :fuxiaobing@ vip. sina. com,电话:010 - 66867396

[摘要]本文基于国家 卫生健康委刚刚发布的“关于加强体表慢性难愈合创面(溃疡)诊疗
管理工作的通知”精神以及同时发布的有关“医疗机构创面修复科基本标准”和“创面修复科临床
医师,护士基本技能要求”两个指导性文件,结合前期我们在探索建立创面修复学科体系的具体实
践，分几个方面就如何高质量高水平建设具有中国特色的创面修复科进行解读,并提出相关建议，
仅供读者参考。

[关键词]创面; 修复;国家 卫生健康委
D0I: 10.3760/cma. j. issn. 1001 - 8050. 2020. 03. 000
Application of constructing standardized and well - developed wound repair department in China Fu Xiaobing Fourth Medical Center, PLA General Hospital, Beijing 100048 , China Corresponding author: Fu Xiaobing, Email fuxiaoobing@ rip. sina. com, Tel :0086 66867396

[Abstract] Bused on the spirit of the regulations about diagnosis and treatment of chronic skin wounds and its standardization for doctors and muses just issued by National Health and Health Commission and our practices in this field, we offer our understanding and comments for these standardization. We emphasize that a well-developed wound repair department with Chinese characteristic in China will be build with the standardization. The aim will offer the high quality and excellent service for these patients.

[Key words] Wounds; Repair; National Health and Health Commission

DOI:10. 3760/cma. j. issn. 1001 - 8050.2020. 01.000

Background: A decrease in blood circulation in diabetic foot ulcers (DFU) leads to a reduction in the angiogenesis process, macrophages function, neutrophils, and growth factors, which in turn slow the healing process. However, electrical muscle stimulation (EMS) can be used to stimulate the muscle that leads to the lower limbs, increasing local blood circulation. Aim: This study was conducted to identify changes in the ABI and the wound development score following EMS in DFUs. Methods: We used sequential sampling of respondents who met the inclusion criteria. The control group received standard wound care, while the intervention group received standard wound care plus EMS therapy. EMS intervention was performed for 4 weeks for 30 minutes per day. Result: The intervention group that received standard wound care plus the EMS had better-wound healing than the group that only received standard wound care. Conclusion: EMS can increase nitric oxide, which causes vasodilation of the blood vessels and stimulates cell synthesis and migration to the wound area.

Key words: ■Diabetic foot ulcer  ■Electrical muscle stimulation (EMS)  ■Nitric Oxide  ■Veinoplus Arterial

Sukarni is a lecturer in the Department of Nursing Education, University of Tanjungpura, Pontianak, West Kalimantan, Indonesia; Hikmat Permana is an Internist of Hasan Sadikin Hospital Bandung, West Java; Chandra Isabella is a lecturer in the Department of Nursing Education, University of Padjadjaran, Bandung, West Java, Indonesia

JACQUI FLETCHER OBE Clinical Editor, Wounds UK