ISSN:0273-8481    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

An established model of inhalation injury in the dog is used to demonstrate that computed tomography (CT) of the lung detects abnormalities following smoke exposure when the standard chest x-ray and Xenon 133 ventilation scan do not. The parenchymal densities seen on CT after smoke inhalation could be reduced but not eliminated by manual hyperinflation of the airway, suggesting that the radiographic changes represent the atelectasis known to occur in this model. A brief review of the literature makes it clear that most diagnostic studies have been conducted in patients who are also burned, which introduces the uncontrolled variable of respiratory function and radiography of the chest. The importance of having a more sensitive and quantifiable diagnostic method to help to define the range in severity of inhalation injury is stressed. This pilot study suggests that CT may fulfill this function and provide some pathophysi-ologic insight as well.

ISSN:0273-8481    

出版商:OVID    

年代:1982

数据来源: OVID

ISSN:0273-8481    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Widely meshed skin grafts, 6:1 or greater, are frequently needed to cover large burn wounds. Such grafts often slip on the wound or are lost due to mechanical disruption of the thin mesh. To improve graft take, we explored the use of two synthetic materials, IP-758 and Biobrane, in protecting the early phases of healing of widely meshed grafts in rats. IP-758 is composed of a silicone rubber layer laminated to a nylon knitted fabric and is applied with the nylon layer facing the wound. Biobrane, a commercially available product similar in composition to IP-758, but containing numerous holes to allow fluid drainage, has protein products associated within the synthetic materials. Both materials protect the wide mesh if they are peeled off before the fifth postoperative day. If the prostheses are retained beyond the fifth day, they interfere with re-epithelialization.

ISSN:0273-8481    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Fifty burn patients were treated with a solution consisting of equal volumes of chloramine-T 0.5% and glycerin. This solution successfully cleansed and debrided old and grossly infected wounds after chemical or mechanical debride-ment removed thick eschar. It prepared deep partial-thickness and full-thickness burns for split-thickness skin grafts and obviated the need for porcine hetero-grafting. Partial-thickness and small full-thickness burns treated with this solution healed without use of grafts. It was also employed as a continuous irrigation for split-thickness skin grafts applied to granulation tissue heavily contaminated with virulent gram-negative organisms, and there was a higher percentage of graft take than was expected. Our experience with this solution suggests that it is excellent for wound cleansing, stimulation of granulation tissue, preparing wounds for split-thickness skin grafting, and maintaining heavily contaminated skin grafts. Chloramine-T 0.5% and glycerin dressings do not cause skin or granulation tissue injury, allergic manifestations, or metabolic or electrolyte derangements.

ISSN:0273-8481    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

Dobhoff tube jejunal feeding was evaluated in two groups of adult and pediatric patients. Group I received high-calorie, high-protein diets; group 2 received the same diet plus Dobhoff tube supplement. Comparison of the caloric intake showed that the adults in group 2 received 45.9% more kcal/kg/day and 67.2% more protein/kg/day than did those in group I. Children in group 2 received 117% more kcal/kg/day and 91.1% more protein/kg/day than did those in group 1. The Dobhoff tube is a safe, effective method to deliver supplemental nutrition to patients without the increased infection rates seen with intravenous hyperalimentation or the risk of aspiration seen with nasogastric tube feedings. The tube is comfortable for the patient, thereby facilitating continued oral intake.

ISSN:0273-8481    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

The purpose of this investigation is to develop a simple and clinically useful system for measuring severity of burn injury. A five-variable scale consisting of sex of patient, age, presence of inhalation injury, presence of full-thickness burn, and percent of total body surface area burned that predicted to death was derived from multivariate logistic regression. A simplified version of this scale demonstrated predictive power for classifying patients according to their risk. This simplified scale was subsequently validated to another sample of burn patients.

ISSN:0273-8481    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

To determine what relationship exists between burned patients' perception of pain and nurses 'perception of patients' pain, a study was conducted using the Stewart Pain-Color Scale (SP-CS) on 15 burned patients and eight nurses working with these patients. Each patient subject's pain perception was measured by the SP-CS three randomly selected times, immediately followed by the nurse's assessment of the patient and measurement of his/her perception of the patient's pain, also using the SP-CS.Data analyzed on the 45 paired scores demonstrated that there was a positive correlation between the nurses' perception of the burned patients'overall pain experience and the degree of pain supported by the burned patients, P = .01. However, when data were analyzed in reference to pain experienced by burned patients during specific treatment methods, eg, physical therapy, debridement, and hydrotherapy, there was no statistically significant demonstrable correlation. Neither were there any statistically significant relationships between length of time in nursing and perception of patients'pain, or length of time in burn nursing and perception of patients pain. Nurses, therefore, need a means of evaluating their methods of pain intervention.

ISSN:0273-8481    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

A program that provides a transitional stage from intensive care to rehabilitation can be used in any burn care facility. Although the rehabilitation approach at the University of Michigan/ Chelsea Hospital Burn Unit is enhanced by a near-ideal physical setting, we must emphasize that the philosophy and approach to rebahilitation are of course more important. It is most desirable that the burn patient not only have the opportunity to experience normal behaviors and social situations but that he/she participate actively in this normal behavior and encounter potentially problematic situations in a supportive environment prior to discharge.Although returning to a normal healthy life is, even in the best controlled environment, a painful and difficult process, it is fundamental that the burn specialist be aware that it is the process itself that determines the patient's chance for success. It would then seem a responsibility of all who are dedicated to resolving the burn problem to facilitate this rehabilitative process.

ISSN:0273-8481    

出版商:OVID    

年代:1982

数据来源: OVID

摘要:

The results of a clinical evaluation of a nonadhering interpositional surfacing material (N- TERFACE™) are reported. Forty-eight postburn patients undergoing reconstruction received 94 applications: 46 areas where skin grafting was performed, 46 sites where donor skin was harvested, and two areas where scar revisions were performed. The material was used directly on sheet skin grafts. Donor sites were treated with an application of a fine mesh gauze impregnated with a petroleum-based antimicrobial agent, followed by a layer of interpositional surfacing material, over which an absorbent and wrapping layer was then applied. Scar revision sites were treated by direct application of the interpositional surfacing material followed by absorbent and wrapping layers. In all applications, adherence by the absorbent layer was reduced when initial dressing changes were done several days later.This brief clinical evaluation suggests that this interpositional surfacing material facilitates dressing changes, but additional controlled testing must be done to further demonstrate its apparent efficacy.

ISSN:0273-8481    

出版商:OVID    

年代:1982

数据来源: OVID