Throughout history, natural products have played a significant role in wound healing. Fibroblasts, acting as primary cellular mediators in skin wound healing, exhibit behavioral responses to natural compounds that can enhance the wound healing process. Identifying bioactive natural compounds and understanding their impact on fibroblast behavior offers crucial translational opportunities in the realm of wound healing. Modern scientific techniques have enabled a detailed understanding of how naturally derived compounds modulate wound healing by influencing fibroblast behavior. Specific compounds known for their wound healing properties have been identified. Engineered biomimetic compounds replicating the natural wound microenvironment are designed to facilitate normal healing. Advanced delivery methods operating at micro- and nano-scales have been developed to effectively deliver these novel compounds through the stratum corneum. This review provides a comprehensive summary of the efficacy of natural compounds in influencing fibroblast behavior for promoting wound regeneration and repair. Additionally, it explores biomimetic engineering, where researchers draw inspiration from nature to create materials and devices mimicking physiological cues crucial for effective wound healing. The review concludes by describing novel delivery mechanisms aimed at enhancing the bioavailability of natural compounds. Innovative future strategies involve exploring fibroblast-influencing pathways, responsive biomaterials, smart dressings with real-time monitoring, and applications of stem cells. However, translating these findings to clinical settings faces challenges such as the limited validation of biomaterials in large animal models and logistical obstacles in industrial production. The integration of ancient remedies with modern approaches holds promise for achieving effective and scar-free wound healing.

Artificial intelligence (AI) and machine learning (ML) involve the usage of complex algorithms to identify patterns, predict future outcomes, generate new data, and perform other tasks that typically require human intelligence. AI tools have been progressively adopted by multiple disciplines of surgery, enabling increasingly patient-specific care, as well as more precise surgical modeling and assessment. For instance, AI tools such as ChatGPT have been applied to enhance both patient educational materials and patient-surgeon communication. Additionally, AI tools have helped support pre- and postoperative assessment in a diverse set of procedures, including breast reconstructions, facial surgeries, hand surgeries, wound healing operations, and burn surgeries. Further, ML-supported 3D modeling has now been utilized for patient-specific surgical planning and may also be combined with 3D printing technologies to generate patient-customized, implantable constructs. Ultimately, the advent of AI and its intersection with surgical practice have demonstrated immense potential to transform patient care by making multiple facets of the surgical process more efficient, precise, and patient-specific.

Introduction: Radiation therapy is an effective and common cancer therapy, but it often results in the formation of radiation-induced fibrosis (RIF). RIF of the skin manifests as symptoms including erythema, ulceration, hypovascularity, and poor wound healing. Subdermal injection of decellularized adipose matrix (DAM) has been studied as a potential means of correcting volumetric deficiencies while imparting regenerative effects to the overlying skin in patients with cutaneous RIF. Methods: DAM was injected subdermally to the flank region of adult C57BL/6J mice and irradiation was then applied to this area. Irradiated mice were given 4 weeks after completion of the irradiation protocol to allow for development of chronic RIF. Magnetic resonance imaging studies were performed throughout the recovery interval to monitor volume retention of the product. Longitudinal laser Doppler studies were used to follow perfusion. After experimental completion, flank skin was harvested and underwent histological and biomechanical evaluation. Results: Histological staining with hematoxylin and eosin, Masson's trichrome, and picrosirius red stains demonstrated that irradiated skin architecture more closely resembled normal skin across measures of dermal thickness, collagen density, and collagen organization when DAM was injected prophylactically. Magnetic resonance imaging revealed that DAM volume retention decreased over time. Laser Doppler demonstrated improved perfusion of irradiated skin with prior DAM injection. Finally, biomechanical testing demonstrated that prophylactic DAM administration resulted in reduced skin stiffness compared to irradiated skin without DAM. Conclusions: This study reveals the therapeutic potential of prophylactic DAM treatment to prevent formation of RIF in skin. Our findings demonstrate that injected DAM volume is largely retained following irradiation and results in overlying skin retaining histologic and biomechanical characteristics of normal nonirradiated skin.

Post-traumatic wrist stiffness after intra-articular distal radius fractures rarely improves with hardware removal alone once arthrofibrosis is established. Arthroscopic arthrolysis allows minimally invasive release of intra-articular adhesions. Arthroscopic arthrolysis combined with hardware removal improves wrist motion and function compared with hardware removal alone. This single-center prospective study compared arthroscopic arthrolysis with hardware removal (combined) versus hardware removal alone (isolated) in patients with post-traumatic wrist stiffness after intra-articular distal radius fracture fixation. Outcomes were assessed preoperatively and at 1 year. The primary outcome of the study was the improvement in the flexion-extension arc. Secondary outcomes included changes in radial and ulnar deviation, pronation and supination and functional scores (QuickDASH). Forty patients were included (15 combined, 25 isolated). At 1 year, flexion-extension gain was significantly greater in the combined group (32.6° vs 6.4°; p < 0.001). QuickDASH improved significantly only in the combined group. No major complications occurred. Arthroscopic arthrolysis combined with hardware removal provides superior improvement in wrist motion and function compared with hardware removal alone and should be considered in patients with established post-traumatic wrist stiffness. III.