ISSN:0273-8481    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Progressive dermal ischemia resulting from a burn injury can be prevented by topical application of antithromboxane compounds. Using the Zawacki burn model, two experimental thromboxane synthetase inhibitors, UK 38485 and U63557A, were each mixed in a pharmaceutical cream base and compared with a known phospholipase inhibitor, methylprednisolone acetate, and two known thromboxane synthetase inhibitors, imidazole and an Aloe vera preparation. Control animals received no treatment. Comparative biopsies were examined by the peroxidase-antiperoxidase procedure for the presence or absence of thromboxane. UK 38485 and U63557A as topical therapeutic creams inhibited thromboxane production in the burn and were equal to or better than the two known antithromboxane inhibitors. Longitudinal studies showed that both UK 38485 and U63557A reversed progressive dermal ischemia and that healing occurred within three weeks postburn, comparable to burns treated with imidazole andA. vera.

ISSN:0273-8481    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Cryopreservation of human cadaveric skin for allografting is reviewed. Critical measurements that govern the freezing process are identified and discussed. To date, the optimal viability of frozen-thawed skin has been obtained with the combination of controlled cooling at 1-5 C per minute and thawing at 50-70 C per minute in the presence of glycerol or dimethylsulfoxide in a concentration of 10% or greater. Further work will be required to define protocols that will achieve optimal post-thaw viability in order to fully exploit the clinical potential of cryopreserved skins. The importance and control of various thermal and chemical values are discussed. There is a paucity of data on the basic physiochemical and permeability properties of skin both at subfreezing and suprafreezing temperatures. Such data are central to the rational design of optimal freezing protocols.

ISSN:0273-8481    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The time course of the level of plasma fibronectin (PFN) and its relationship to severity of injury, infection, and prognosis were studied in 27 burn patients with body surface area (BSA) burn greater than 20%. PFN was measured daily or every two days using a laser nephelometer. During the first four postburn days, a decrease in PFN was observed that was significant on days 2 and 3. On postburn day 2, a positive correlation was found between PFN decrease and extent of injury. The decrease was of high prognostic value. Between postburn days 4 and 16, PFN levels of infected patients were significantly lower than those of noninfected ones, but the onset of infection was not preceded by any significant decrease in PFN levels. This study offers arguments in favor of a close relationship between PFN deficiency and sepsis in burn patients, but it is impossible to assert that this deficiency plays a major role in the occurrence of infection.

ISSN:0273-8481    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Multiple isolates ofPseudomonas aeruginosafrom individual burn patients were tested for their antibiotic susceptibility-resistance patterns and serotype of their somatic antigen. P. aeruginosa strains with varying antibiograms and/or serotypes were found simultaneously in the same patient. Furthermore, several individual colonies of P. aeruginosa isolated from single-culture sites on patients were found to contain strains differing in antibiogram, serotype, or both. These results suggest that burn patients are co-colonized/co-infected with phenotypically diverse strains ofP. aeruginosa. These data may explain in part the failure of single-antibiotic therapy in many patients in whom it has been used to treat severeP. aeruginosainfections.

ISSN:0273-8481    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The medical records of 69 elderly burn patients admitted to a burn center between January 1978 and January 1984 were studied retrospectively. The mean burn size was 21% of the total body surface area and the mortality, 35%. Flames were the most frequent cause of burns, but no clearly definable action leading to the injury was identified. The accident location was the work place in 26% of patients, raising the question of adequate safety measures in such places. General public awareness safety programs have been thought to meet the needs of the elderly, but it appears that these programs must be further implemented to reach this target population, especially in view of the tremendously increased risk of morbidity and mortality associated with burns in the elderly.

ISSN:0273-8481    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Inhalation injury was produced in chronically instrumented sheep by insufflating them with smoke from burning cotton cloth. Study over a 72-hour period showed a marked increase in lung lymph flow and lung water as well as electron micrographic evidence of interstital edema in these animals. Lymph flow changes were associated with an elevation in the lymph-to-plasma protein concentration ratio, probably as a result of an increase in pulmonary microvascular permeability to protein. Light micrographic presence of neutrophil in the lung microvasculature and an elevation of the lysosomal enzyme beta-glucuronidase in the lymph are evidence that this permeability change was produced by products of these cells. Although the pulmonary capillary endothelial cell marker, converting enzyme, was elevated in the blood, in electron micrographs these cells appeared normal. Fluid changes correlate with a fall in total thoracic compliance. Smoke inhalation thus produces neutrophil-related pulmonary edema. The exact site of the injury remains unknown, but edema formation is responsible at least in part for the deterioration of respiration, as evidenced by the fall in compliance.

ISSN:0273-8481    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

Orthokinetics is a treatment method involving differential activation of skin exteroceptors aimed at restoring agonist-antagonist muscle balance and other remedial effects for a wide range of dyskinesias, as well as relief of pain without drugs. A male with 5% TBSA second-degree burns on hands and wrists was treated on postburn day 7 by application of orthokinetic orthoses to the right forearm. Active finger flexion improved for the metacarpophalangeal (MP), proximal interphalangeal (PIP), and distal interphalangeal (DIP) joints of the second to fifth fingers. Grip strength increased. Another male patient sustained 20% TBSA second-degree burns distal to the wrist on the dorsum of the hands. On postburn day 9, he had pain in the fifth finger (covered with regrown skin) on flexion. Treatment of the left hand with an orthokinetic orthosis resulted in immediate mitigation of pain. In both patients, an intensive time-series design A1-C1-C2-B1 (treatment phase Bl; positive control phases for placebo, Cl, and sham treatment, C2; and pretreatment baseline phase Al) was used. The outcomes in both cases supported cause-effect relationships of orthokinetics treatment and observed remediation of dyskinesia and pain.

ISSN:0273-8481    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

This case report deals with a growing problem since the widespread institution of topical antibacterial therapy: the emergence of mycotic fungi in burn wounds. A child with 60% deep partial- and full-thickness BSA burns from a gasoline fire (extinguished by wrapping in old carpet padding), received medical escharotomy and applications of Biobrane and antibacterial dressings. However, on postburn day 4 when black colonies began to appear, wound biopsies were done, revealing invasion ofAlternaria, a saprophytic fungus. Treatment with amphotericin B and then half-strength Dakin's solution and mafenide acetate, used in combination, finally eradicated the colonies in 72 hours. Although ubiquitous in soil and air,Alternariais a rare burn wound pathogen. Its appearance in this case underlines the necessity for continual observation of the progress of the burn wound and the importance of prompt investigation when the course is unusual.

ISSN:0273-8481    

出版商:OVID    

年代:1985

数据来源: OVID

摘要:

The effectiveness of a silicone gel sheet in increasing active range of motion (ROM) over burn wound contractures of the elbow and axilla was investigated. Gains in motion resulting from use of the gel sheet in conjunction with standard exercise and activity were measured and analyzed. These gains were also contrasted with gains in motion achieved over contralateral anatomical sites with the use of exercise alone. After 10 minutes of gel sheet application there was a mean ± SD gain of 11.6 ± 7.8 degrees of extension or abduction, whereas the contralateral control sites gained a mean ± SD of 1.0 ±2.7 degrees. It was concluded that use of the silicone gel sheet and exercise resulted in significantly greater gains in active ROM over burn wound contractures than did the use of exercise alone.

ISSN:0273-8481    

出版商:OVID    

年代:1985

数据来源: OVID