Background: The optimal therapy for deep burn wounds is based on the early debridement of necrotic tissue followed by wound coverage to avoid a systemic inflammatory response and optimize scar-free healing. The outcomes are affected by available resources and underlying patient factors, which represent challenges in burn care and suboptimal outcomes. In this study, we aimed to determine optimal burn-wound management using enzymatic debridement (NexoBrid™, MediWound Germany GmbH, Rüsselsheim, Germany) and intact fish skin (Kerecis^® Omega3 Wound, Isafjordur, Iceland). Methods: In this retrospective case series, 12 patients with superficial or deep dermal burn wounds were treated with enzymatic debridement followed by fish skin, Suprathel^® (PolyMedics Innovations GmbH, Denkendorf, Germany), or a split-thickness skin graft (STSG). Patients’ outcomes regarding healing and scar quality were collected objectively and subjectively for 12 months after the burn injury. Results: Wounds treated with fish skin demonstrated accelerated wound healing, a significantly higher water-storage capacity, and better pain relief. Furthermore, improved functional and cosmetic outcomes, such as elasticity, skin thickness, and pigmentation, were demonstrated. The pain and itch expressed as POSAS scores (Patient and Observer Scar Assessment Scale) for fish skin decreased compared to those for wounds managed with an STSG or Suprathel. Importantly, fish skin-treated wounds had significantly improved sebum production and skin elasticity than those treated with Suprathel but showed no significant superiority compared to STSG-treated wounds. Conclusions: Enzymatic debridement in combination with intact fish skin grafts resulted in the faster healing of burn wounds and better functional and aesthetic outcomes than split-thickness skin grafts and Suprathel treatment.

Background: Sarculator and Memorial Sloan Kettering Cancer Center (MSKCC) nomograms are freely available risk prediction scores for surgically treated patients with primary sarcomas. Due to the rarity of angiosarcomas, these scores have only been tested on small cohorts of angiosarcoma patients. In neither the original patient cohort upon which the Sarculator is based nor in subsequent studies was a distinction made between primary and secondary angiosarcomas, as the app is intended to be applied to primary sarcomas. Therefore, the objective of our investigation was to assess whether the Sarculator reveals a difference in prognosis and whether such differentiation aligns with actual clinical data. Patients and Methods: Thirty-one patients with primary or secondary soft tissue angiosarcoma, treated at our Sarcoma Center from 2001 to 2023, were included in the study. Actual survival rates were compared with nomogram-derived data for predicted 5-year survival (Sarculator), as well as 4-, 8- and 12-year sarcoma-specific death probabilities (MSKCC). Harrell’s c-index was utilized to assess predictive validity. Results: In total, 31 patients were analyzed. The actual overall 5-year survival was 22.57% with a predicted 5-year survival rate of 25.97%, and the concordance index was 0.726 for the entire cohort. The concordance index results from MSKCC for angiosarcoma patients were below 0.7 indicating limited predictive accuracy in this cohort, particularly when compared to Sarculator. Summary: Nomogram-based predictive models are valuable tools in clinical practice for rapidly assessing prognosis. They can streamline the decision-making process for adjuvant treatments and improve patient counselling especially in the treatment of rare and complicated tumor entities such as angiosarcomas.

Background and Objectives: Excessive social media use is repeatedly linked to negative body image outcomes, yet its association with muscle dysmorphia, especially in athletic youth, remains underexplored. We investigated how social media exposure, comparison behavior, and platform engagement relate to muscle dysmorphia symptomatology in young German athletes. Materials and Methods: An anonymous, web-based cross-sectional survey was conducted (July–October 2024) of 540 individuals (45% female; mean age = 24.6 ± 5.3 years; 79% ≥ 3 h sport/week) recruited via Instagram. The questionnaire comprised demographics, sport type, detailed social media usage metrics, and the validated German Muscle Dysmorphic Disorder Inventory (MDDI-1, 15 items). Correlations (Spearman’s ρ, Kendall’s τ) were calculated; multivariate importance was probed with classification-and-regression trees and CatBoost gradient boosting, interpreted via SHAP values. Results: Median daily social media time was 76 min (IQR 55–110). Participants who spent ≥ 60 min per day on social media showed higher MDDI scores (mean 38 ± 7 vs. 35 ± 6; p = 0.010). The strongest bivariate link emerged between perceived social media-induced body dissatisfaction and felt pressure to attain a specific body composition (Spearman ρ = 0.748, Kendall τ = 0.672, p < 0.001). A CatBoost gradient-boosting model out-performed linear regression in predicting elevated MDDI. The three most influential features (via SHAP values) were daily social media time, frequency of comparison with fitness influencers, and frequency of “likes”-seeking behavior. Conclusions: Intensive social media exposure substantially heightens muscle dysmorphia risk in young German athletes. Machine-learning interpretation corroborates time on social media and influencer comparisons as primary drivers. Interventions should combine social media literacy training with sport-specific psychoeducation to mitigate maladaptive comparison cycles and prevent downstream eating disorder pathology. Longitudinal research is warranted to clarify causal pathways and to test targeted digital media interventions.

Firework-related injuries remain a serious public health issue in Germany, especially during New Year’s Eve. While many injuries are minor, the misuse of illegal or homemade fireworks can cause severe trauma resembling military combat injuries and can heavily burden emergency services. Notably, injury rates declined during the COVID-19 firework bans, underscoring the impact of preventive measures. We report two cases of young males with severe injuries from illicit fireworks. The first is a case of a 16-year-old that detonated an illegal Polish firework ball bomb, sustaining 9% total body surface area (TBSA) burns (second- to third-degree), hand fractures, compartment syndrome of the hand, and soft-tissue trauma. He underwent multiple surgeries, including fasciotomy, osteosynthesis, and skin grafting. The other case presented is a 19-year-old man who was injured by a homemade device made of bundled firecrackers, suffering deep facial and bilateral hand burns. He required prolonged ventilation, surgical debridement, and treatment with Kerecis^® fish skin and Epicite^® dressings. Both required intensive ICU care, interdisciplinary management, and lengthy rehabilitation. Total hospital costs amounted to €58,459.52 and €94,230.23, respectively, as calculated according to the standardized German DRG. These cases illustrate the devastating impact of illegal fireworks. The devastating consequences of explosive trauma are often difficult to treat and may lead to long-term functional and psychological impairments. Prevention through public education, stricter regulations, and preparedness is essential. Pandemic-era injury reductions support sustained policy efforts.

Septic arthritis of the wrist is a rare but severe condition requiring urgent diagnosis and treatment to prevent joint destruction and functional impairment. The objective of this study was to investigate prognostic parameters and the long-term functional outcomes. This retrospective and prospective cohort study included 44 patients treated for septic arthritis of the wrist between 2008 and 2024. All patients underwent surgical wrist arthrotomy due to concomitant soft tissue involvement, with a median follow-up of 29 months. Clinical outcomes were assessed through total active range of motion (TROM), grip strength, and patient-reported hand function using the DASH questionnaire. Data analysis examined correlations between comorbidities, surgical interventions and long-term outcomes. Staphylococcus aureus was identified in 61.4% of cases, thus being the most common pathogen. Type 2 diabetes mellitus was identified as a risk factor for requiring a higher number of surgeries to control the infection. Patients requiring more invasive procedures showed worse long-term outcomes, with lower grip strength, a limited active range of motion (TROM) and higher DASH scores. Mortality was associated with higher inflammatory markers and older age at the onset of disease. A total of 36.4% of patients were unable to return to work after treatment, while those who successfully returned to work experienced a median recovery period of seven months. The timely initiation of appropriate surgical therapy is essential in the treatment of septic arthritis of the wrist in order to reduce joint damage and associated loss of hand function, particularly in patients with comorbidities such as diabetes mellitus. Studies should focus on comparing different treatment options and developing more targeted rehabilitation strategies to improve functional outcomes.

Background/Objectives: Pediatric sarcomas are a biologically diverse group of mesenchymal tumors associated with morbidity due to recurrence, despite aggressive multimodal treatment. Reliable predictors of early recurrence remain limited. This exploratory study aimed to identify clinical features associated with first tumor recurrence using a machine learning approach tailored to low-event settings. Methods: We conducted a retrospective, single-center cohort study of 23 pediatric patients with histologically confirmed sarcoma. Forty-six baseline variables were extracted per patient, including clinical, histological, and comorbidity data. Tumor recurrence was the primary binary endpoint. A LASSO-regularized logistic regression model was developed using leave-one-out cross-validation (LOOCV) to identify the most informative predictors. Dimensionality reduction (PCA) and SHAP-value analyses were used to visualize patient clustering and interpret variable contributions. Results: The model identified a four-variable risk signature comprising histological grade, primary tumor width, arterial hypertension, and extremity localization. Each additional tumor grade or centimeter of width approximately doubled the odds of recurrence (OR 2.18 and 2.04, respectively). Hypertension and limb location were associated with a 1.7 and 1.9 odds ratio of recurrence, respectively. The model achieved a balanced accuracy of 0.61 ± 0.08 and AUROC of 0.47 ± 0.12, reflecting limited discriminative power. PCA mapping revealed distinct outlier patterns correlating with high-risk profiles. Conclusions: Even in a small cohort, classical prognostic markers, such as tumor grade and size, retained predictive relevance, while hypertension emerged as a novel, potentially modifiable cofactor or indicator for recurrence. Although model performance was modest, the findings are hypothesis-generating and warrant validation in larger prospective datasets.