Staged Surgical Reconstruction With Skin Expansion of A Marjolin’s Ulcer With Better Recovery: a Case Report

Marjolin’s ulcers (MUs) are one of the most common tumors developed from non-healing wound with chronic inflammation or injury, specially burn scars, over many years. However, the therapy recommendations for MUs are not yet definitive. Here, we presented a case of 60-year-old man with a chronic non-healing infected wound related to MUs in the right knee. And, the wound made a better recovery after treatment with staged operation in combination with skin expansion.

Study on the Staged Operation of a Multi-Purpose Reservoir in Flood Season and Its Effect Evaluation

A reasonable analysis of flood season staging is significant to the management of floods and the alleviation of water shortage. For this paper, the case of the Chengbi River Reservoir in China was selected for study. Based on fractal theory, the flood season is divided into several sub-seasons by using four indexes (multi-year average daily rainfall, multi-year maximum rainfall, multi-year average daily runoff, and multi-year maximum daily runoff) in this study. Also the Benefit-Risk theory is applied to evaluate the effects of staged dispatching. The results show that the flood season of the Chengbi River basin should be divided into the pre-flood season (13 April–6 June), the main flood season (7 June–9 September) and the post-flood season (10 September–31 October). After adjusting the flood limit water level for sub-season and benefit assessment, the probability of exceedance after reservoir flood season operation increases by 0.13×10-5, the average annual expected risk is 0.2264 million RMB, and the average annual benefit increases by 0.88–1.62 million RMB. The benefits obtained far outweigh the risks, indicating the importance of staging the flood season.

Canonical Validation of a Modeling Strategy for Carbon Monoxide Emissions in Staged Operation of Gas Turbine Combustors

Canonical validation of a holistic modeling strategy for the prediction of CO emissions in staged operation of gas turbine combustors is subject of this study. Results from various validation cases are presented. Focus is on operating conditions that can be considered typical for modern, flexible gas turbines that meet the requirements of the upcoming new energy age. Reducing load in gas turbines is usually achieved by redistributing fuel referred to as fuel staging. Fuel-staged operation may lead to various mechanism like strong interaction of the flame with secondary air leading to quenching and elevated CO emissions and is - due to technical relevance - stressed in this work. In the recent past, our group published a new modeling strategy for the precise prediction of heat release distributions as well as CO emissions. An extension to the CO modeling strategy that is of high relevance for the introduced validation cases is addressed by this work. The first part of this study presents relevant aspects of the overall modelling strategy. Furthermore, a validation of the models is shown to demonstrate the ability of precisely predicting CO in two different multi-burner cases. Both validation cases feature a silo combustion chamber with 37 burners. The burner groups are switched off at partial load leading to intense interactions between hot and cold burners. Major improvement in comparison to CO predictions from the flamelet-based combustion model can be achieved as the modeling strategy is demonstrated to be capable of predicting global CO emissions accurately. Furthermore, the model’s precision in fuel staging scenarios are demonstrated and discussed.

Reconstruction for Defects of Total Nail Bed and Germinal Matrix Loss with Acellular Dermal Matrix Coverage and Subsequently Skin Graft

Background and Objectives: Nail bed and germinal matrix loss due to wide excision for fingertip tumors or malignancy are occasionally encountered complications. These defects also result from severely comminuted fingertip crush injuries. Large-area dorsal finger or toenail bed defects, which usually present with phalangeal bone exposure, remain challenging regardless of the usage of different reconstruction strategies. This study aimed to evaluate the clinical outcome of a staged operation with an acellular dermal matrix coverage and subsequent skin graft as reconstruction for defects of total nail bed, germinal matrix loss, and bone exposure. Materials and Methods: From April 2018 to October 2019, four patients with total nail bed, germinal matrix, and bone exposure loss after surgery were enrolled in our series. A staged operation of the acellular dermal matrix coverage with subsequent skin graft was performed on these patients. Skin graft take rate, oncological prognosis, and cosmetic outcome were evaluated. Patients were followed up for 5–13 months. An excellent skin graft take rate with a satisfying aesthetic result without local malignancy recurrence was noted. Minimal functional deficit and donor site morbidity were reported. Results: A staged operation with acellular dermal matrix coverage and subsequent skin graft proves to serve as a feasible strategy for patients who experience total nail bed, germinal matrix loss, and bone exposure after surgery. Conclusions: This reconstruction method provides a reliable repair result, satisfying aesthetic outcomes, as well as having minimal functional deficits and donor site morbidity.