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Background: Management of the extensive soft tissue injuries remains a significant challenge in orthopedic and plastic reconstructive surgery. Since the thumb is responsible for 40% of the functions of the hand, saving and reconstructing a mangled thumb is essential for the patient's future.

Case Presentation: This case report describes the management of a severe occupational thumb injury in a 25-year-old white Persian male who sustained an occupational injury to his left thumb, resulting in extensive burn, crush injury to the distal and proximal phalanx, and severe soft tissue damage to the first metacarpal, thenar, and palmar areas.

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Biofilms are complex adhesive structures that establish chronic infection and allow robust protection from external stressors such as antibiotics. Cellulose as one of the compositions of bacteria biofilm which protect bacteria from stress, host immune responses and resistance to antibiotics. Bacterial stress responses are regulated via guanosine pentaphosphate and tetraphosphate (p)ppGpp.

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Following a period of disuse owing to the emergence of multidrug-resistant Gram-negative bacteria, colistin has regained global attention as an antibiotic of last resort. The resurgence in its utilization has led to a concurrent increase in acquired resistance, presenting a significant challenge in clinical treatment. Predominantly, resistance mechanisms involve alterations in the lipid A component of the lipopolysaccharide (LPS) structure.

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Vibrio anguillarum is a pathogen responsible for vibriosis in aquaculture animals. The formation of bacterial biofilm contributes to infections and increases resistance to antibiotics. Tryptophanase and its substrate tryptophan have been recognized as signal molecules regulating bacterial biofilm formation.

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