Wound treatment must be conducted after proper assessment of diabetic foot lesions. This implies appropriate foot care and the use of proper footwear from the perspectives of prophylaxis and walking. Diabetic foot wounds have some wound impairment factors including peripheral neuropathy (PN), peripheral arterial disease (PAD), and infection. These wounds constitute combinations of these lesions. An additional goal besides wound healing is gait salvage for patients.
Here, we want to propose the classification of diabetic foot ulcers as follows: Type I, PN; Type II, PN+PAD;
Type III, PN+infection; and Type IV, PN+PAD+infection.

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There are numerous methods to obtain and accelerate the formation of optimal scars at the end of the wound healing process. Stem cells are one of the therapeutic options in wound healing. ES cells and iPS cells are promising ; however, there are ethical problems in the associated clinical practice. Somatic stem cells have been studied and their clinical effectiveness has been investigated. Understanding the dynamism, expression pattern, proliferation and differentiation of stem cells will lead to clinically effective and optimal wound healing and treatment. Current research on the regeneration pattern of skin appendages is also discussed and a potential application is proposed.
In our clinical experience, adipose-derived stem cell therapy using a patient's own fat tissue can successfully treat intractable skin ulcers. There should be extensive investigations in this area.

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This paper presents an evidence-based review of previous papers on the treatment and prevention of keloids and hypertrophic scars (HSs). The methodological quality of clinical trials was evaluated, and the baseline characteristics of patients and the interventions that were applied and their outcomes were extracted. Important factors that promote keloid / HS development include mechanical forces acting on the wound, wound infection and foreign body reactions. For HSs, the treatment method that should be used depends on whether scar contractures, especially joint contractures, are present. Small / single keloids can be treated radically by surgery with adjuvant therapy, which includes radiation or corticosteroid injections, or by nonsurgical monotherapy, which includes corticosteroid injections, cryotherapy, laser and anti-tumor / immunosuppressive agents (e.g., 5-fluorouracil). Large / multiple keloids are difficult to treat radically and are currently only treatable by multimodal therapies that aim to relieve symptoms. After a sequence of treatments, long-term follow-up is recommended. Conservative therapies, which include gel sheeting, taping fixation, compression therapy, external / internal agents and make-up (camouflage) therapy, should be administered on a case-by-case basis.

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Subcutaneous hematoma is commonly caused by the trauma of surgery, and proper treatment is needed to avoid severe complications. To minimize invasion in the drainage procedure, we developed an original method called “ cylinder syringe suction ” and reported on the clinical usage of this technique. In this study, we undertook basic research to investigate in detail the mechanism by which this technique is effective.
House rabbits were used for this experiment. By injecting fresh venous blood into the subcutaneous layer of the scalp, we created hematoma. Hematoma evacuation was performed in 4 different ways, including needle aspiration, cylinder syringe suction with needle puncture, and opening a small wound (5 mm) with both of these methods. We compared the amounts of evacuated hematoma and the suction pressures created by these methods.
Needle aspiration showed high suction pressure; however, the amount of evacuated hematoma was small. Cylinder syringe suction with a small wound showed the highest suction pressure and the largest amount of evacuated hematoma; however, needle puncture is insufficient to perform cylinder syringe suction.
Cylinder syringe suction is effective by creating a high suction pressure and opening a small wound, of at least 5 mm, to enable viscous coagula to pass through the skin.

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Infection and exposure are the major complications of pacemaker (PM) and implantable cardioverter defibrillator (ICD) devices. We salvaged exposed or contaminative PM or ICD devices in 12 cases between April 2004 and March 2009. In all cases, the generator unit was extracted and the leads were preserved. Sixteen operations were performed in 12 cases. The surgical technique involved removal of the generator unit and shortening of the lead, and then the stump was buried into muscle or fixed to periosteum. Seven of the 12 patients were cured without recurrence of exposure or infection. In 3 patients, exposure or infection recurred. Two patients died of sepsis within 1 year. In the 3 cases with recurrence, an additional operation was performed and 2 patients were cured.
In cases where the leads were buried into muscle, the cure rate was 40%, whereas it was 83% when the leads were fixed to periosteum. Preserving the leads and fixing them to surrounding tissue is less invasive than lead extraction with cardiotomy. We conclude that it is better to fix the leads to periosteum than bury them into muscle.

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