摘要:

Removal of the coagulated protein of a burn using sutilains ointment (Travase) and scraping, followed by immediate resurfacing with thin split-thickness autograft, is an advantageous technique for managing the deep dermal burn of the hand. Optimal results are obtained when the enzyme is applied immediately and the hands are grafted within 24 hours. Acceptable results are obtained with a delay in grafting but not with delay in application of the enzyme. By aggressive and early debridement with the use of an enzymatic debriding agent allowing early autografting, the hypertrophic granulation and infective stages of the deep dermal wound are precluded, facilitating early mobilization and return to function, as well as allowing excellent cosmetic results

ISSN:0273-8481    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Wick catheters were used to obtain direct measurements of interstitial fluid pressure in concert with determinations of serum oncotic pressure in severely burned patients receiving either crystalloid or colloid plus crystalloid resuscitation. It appears that capillary permeability following thermal injury may be measured directly to determine the extent of the capillary leak and its temporal relationships. The theoretical benefit of a higher serum oncotic pressure with protein resuscitation is mitigated by changes in interstitial fluid pressure. Calculations of fluid for protein or nonprotein resuscitation must consider changes in interstitial fluid pressure. This study indicates that the wick catheter technique is a valuable new method for evaluating the effect of various fluid resuscitation regimens on interstitial fluid dynamics following burn injury.

ISSN:0273-8481    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Recent experimental and clinical evidence has suggested that circulating fibronectin plays an important role as a nonspecific opsonin in the phagocytosis of some bacteria. The effect of circulating fibronectin levels on leukocyte phagocytosis was determined in a serial study of 20 burn patients (mean TBSA 56%, range 32%-84%) and in 24 healthy donors. The metabolic activity of peripheral blood leukocytes, as reflected by oxygen consumption after stimulation with preopsonized zymosan, correlated with fibronectin levels (rocket immunoelectrophoresis) in healthy donors (r=0.77,P<0.05). The results showed a decrease of fibronectin level in burned patients' serum with parallel decreased leukocyte oxygen consumption (r=0.95,P<0.005 for the first three days postburn). Profound decrease of both values was observed, especially during the septic episodes. Decrease of leukocytes' oxygen consumption, when incubated in fibronectin-depleted serum (affinity chromatography), additionally suggests participation of fibronectin in the opsonization processes of some target particles

ISSN:0273-8481    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

The reticuloendothelial system (RES) is an integral component of the body's defense system and plays an important homeostatic role in the individual's response to stress. Agents that modify the RES may affect the host's ability to respond to stress, eg, RES stimulants will increase the resistance of the host to stress, whereas RES depressants may convert a nonlethal injury to a lethal event. RES depression resulting from trauma, shock, or sepsis may be indirectly responsible for the damage that occurs in other organ systems, eg, lung or kidneys, by forcing these organs to assume a major role in the clearance of blood-borne particulate debris. Based on extensive human and animal studies, it is apparent that the serum level of the circulating opsonic protein, plasma fibronectin, must be normal for the RES to function optimally. Consumption of this protein occurs prior to phagocytic cell exhaustion, and thus plasma fibronectin can be viewed as a weak link in the RES. Even a mild insult, such as elective surgery in a healthy person, can result in a transient depression of fibronectin, which may impair RES activityMany factors associated with a major thermal injury can depress fibronectin levels besides the burn itself: these include the general stress state, impaired caloric intake, operative procedures, and sepsis. Anecdotal clinical studies indicate that plasma fibronectin repletion may be associated with clinical improvement in burned, traumatized, and septic patients

ISSN:0273-8481    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Staphylococcus aureus was the most common organism colonizing the burn wound and causing burn wound infection. Pseudomonas aeruginosa caused wound infection almost as often and was the organism most frequently isolated from blood cultures. A delay of more than 24 hours between burn and initiation of definitive wound care increased the incidence of burn wound infection due to S. aureus and group A streptococci. In patients admitted within 24 hours of burn, the incidence of burn wound infection due to group A streptococci did not differ significantly between those who did or did not receive a prophylactic systemic antibioticSilver sulfadiazine cream was a more effective topical prophylactic antibacterial against P. aeruginosa but less effective than gentamicin used topically against S. aureus and enterococcus. As indicated by seven years of use, topical silver sulfadiazine remains effective prophylaxis against infection due to P. aeruginosa and other gram-negative organisms, although infection due to enterococcus has increased

ISSN:0273-8481    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

The advantages of caring for the patient with severe drug-induced toxic epidermal necrolysis in a burn unit are numerous. A case of toxic epidermal necrolysis arising from cephalosporin therapy in a patient with Waldenstrdm's macroglobulinemia is described. A review of the literature revealed no previous reports of this untoward effect of cephalosporin therapy.

ISSN:0273-8481    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

Data frequently used for a nutritional evaluation, eg, estimated calorie and protein needs, weight, triceps skinfold thickness, midarm-muscle circumference, serum albumin and transferrin levels, skin tests, total lymphocyte count, nitrogen balance, and creatinine height index determinations, are conceptualized herein. It is thought that many of these values lack appropriate validation in burn patients. With the accumulation of new data, many nutritional surveillance techniques will require modification and reinterpretation. Therefore, caution is essential when interpreting these data. In the meantime, currently available data are probably best construed by a team as an assemblage of findings that may classify a burn patient at risk of morbidity and mortality unless additional attention is given to meeting nutritional needs

ISSN:0273-8481    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

The public expects firefighters not only to extinguish fires in burning structures but also to search out and assist victims whose lives are in immediate danger. Because of this expectation, many fire departments require firefighters to be certified as emergency medical technicians. Fire victims may suffer from chemical and electrical burns as well as thermal injury. Associated life-threatening problems include inadequate ventilation, impaired circulation, and extensive bleeding. High levels of carbon monoxide and other toxic gases may also pose a danger to life. This article describes the firefighter's assessment of the burn victim and discusses the emergency diagnosis and treatment of conditions that threaten the lives of victims of structural fires

ISSN:0273-8481    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0273-8481    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0273-8481    

出版商:OVID    

年代:1983

数据来源: OVID