ISSN:0273-8481    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0273-8481    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

It is unclear whether burn blister fluid is beneficial or deleterious to the healing of the underlying wound. We investigated the calcium binding protein calmodulin in human burn blister fluid and its role in the mitogenicity of this fluid in the culture of human keratinocytes, fibroblasts, and mouse 3T3 fibroblasts. Calmodulin levels in blister fluid were three times greater than in serum (p <0.005)Whereas epidermal growth factor and platelet-derived growth factor concentrations were significantly lower (p <0.001). Calmodulin in blister fluid was biochemically identified after affinity chromatography, Western blotting, and immunostaining with a monoclonal antibody. Inhibiting calmodulin with either an antagonist or antibody to calmodulin reduced the mitogenic activity of blister fluid in three cell types by 26% to 80%. These in vitro studies suggest that burn blister fluid may promote wound healing, and locally released calmodulin contributes to this effect. In appropriate cases it may be beneficial to leave burn blisters intact.

ISSN:0273-8481    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Rats, with the preoptic anterior hypothalamus implanted with two thermodes and a thermocouple reentry tube, had simultaneous direct and indirect calorimetry performed [during the ninth to eleventh postburn day interval] at ambient temperatures of 22° and 28° C. During calorimetry, blood was drawn at baseline and near the end of each period of displacement of the preoptic anterior hypothalamus temperature for catecholamine assay. Cooling the preoptic anterior hypothalamus resulted in a significant increase in heat production and plasma epinephrine and norepinephrine concentrations for both burn and control groups at 22° C and 28° C (P<0.05 for all comparisons). Heat production demonstrated consistent negative linear correlation with preoptic anterior hypothalamic temperature. Plasma epinephrine values correlated with preoptic anterior hypothalamic temperature for only the controls at 28° C ambient, whereas norepinephrine had significant linear correlation with heat production for all groups and significant negative linear correlation with preoptic anterior hypothalamic temperature. These data indicate norepinephrine may be more important than epinephrine in the maintenance of postburn hypermetabolism in this rat burn model while demonstrating that the hypermetabolism is appropriately responsive to perturbation of preoptic anterior hypothalamic temperature.

ISSN:0273-8481    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Hydrofluoric acid has unique properties that make it attractive for a variety of industrial and household uses. Exposure to dilute and concentrated solutions of hydrofluoric acid can lead to severe pain and tissue necrosis. Local treatment with topical calcium gluconate and subdermal injections of 0.5 ml 10% solution of calcium gluconate per cm2of affected tissue has been advocated but frequently fails to relieve the patient of pain. Intraarterial infusion of calcium gluconate has been advocated for these patients, but several reports have been made of massive soft-tissue loss associated with such therapy. The purpose of this study was to show what, if any, were the microscopic effects on the distal arterial tree of intraarterial infusion of calcium gluconate. By studying 1 µm-thick cuts of distal rat aortas after proximal infusion of concentrated (10%) and dilute (2%) calcium gluconate, we were able to show that the incidence of microperforations in the intima and media of the rat aorta increased with the concentration of calcium gluconate. We conclude that intraarterial infusions should be reserved for only the most severe cases of hydrofluoric acid burns unresponsive to local therapy.

ISSN:0273-8481    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The authors have carried out an experimental protocol on pigs, producing identical electrical burns to examine clinically and histologically the evolution of these burns with time. A clinical lesion in the form of a rosette was observed. It was composed of three zones: a central zone of carbonization, a pale ischemic intermediate zone, and an erythematous peripheral zone. Microscopic observation showed vascular thrombosis in the intermediate and peripheral zones in addition to necrosis of the central zone. These vascular lesions can be classified in three stages, I, II and III, according to the degree of vascular damage. The evolution of the lesions was stabilized at 72 hours after burn injury. These observations are important in determining the surgical treatment, particularly debridement, on postburn day 3, when the prognosis of the intermediate and peripheral zones must be taken into account.

ISSN:0273-8481    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

A retrospective analysis of 29 patients who sustained perioral electrical burns was undertaken. Children were divided into three groups: (group 1) no surgery and no splint (n=21), (group 2) nonsurgical management with splint appliance (n=8), and (group 3) commissuroplasty (n=9). Mean age was 3 years, and minimum follow-up was 1 year. Subjective evaluation of standard photographs was performed by six surgeons. Group 2 had a less noticeable scar and more normal lip parameters. Group 3 and group 1 had similar percent scar involvement and overall poor subjective scores. All evaluators felt diat commissuroplasty (group 3) improved patients' appearance compared with no surgery and no splint (group 1). Therefore the application of our easily constructed splint alone yielded the best cosmetic results.

ISSN:0273-8481    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Between July 1, 1984, and December 31, 1991, 27 consecutive patients required admission to the Grady Memorial Hospital Burn Unit for care of hot tar burns. This group represented 1.4% of all admissions to this burn unit. Injuries occurred at the workplace and occurred mostly during the summer. They most commonly involved the patient slipping while carrying a bucket of hot tar. Ninety-six percent were male. The mean age was 33.7 years. Mean burn size was 13.1% total body surface area. Burn topography centered on the upper extremities and hands. Forty-one percent required a surgical procedure for their burn. Mean hospitalization time for survivors was 16.6 days. The survival rate was 92.6%. Both of the patients who died had large burns and/or preexisting medical problems. Hot tar burns occur under predictable circumstances, appear to be preventable, and have accounted for only a small fraction of all admissions to this burn unit.

ISSN:0273-8481    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

We used a living bilayered cultured skin replacement to close full-thickness wound defects on the dorsum of athymic mice. The skin replacement is composed of human fibroblasts that condense a bovine collagen lattice; the lattice is then seeded with cultured human keratinocytes. The collagen lattice with fibroblasts serves as a dermal template, and die overlying human keratinocytes form the epidermal component of this composite skin replacement. Twenty-four animals were grafted, and groups of six were killed and biopsied at 6, 15, 30, and 60 days after graft placement. Twenty-four mice in the control group receiving grafts of fresh, split-thickness, human cadaver skin were biopsied at the same time points. “Take” of all grafts was excellent, with only one graft loss in the 48 mice (one Graftskin graft, at 15 days). Light microscopy revealed that vascular ingrowth into Graftskin occurred rapidly, and discrete dermal and epidermal layers were seen at all time points. Evidence of basement membrane formation was seen at 6 days after grafting by immunohistochemical staining for laminin and by electron microscopic visualization of lamina lucida and lamina densa zones at the dermal-epidermal junction. The results demonstrated that Graftskin formed a structurally complete skin replacement within 1 week of placement on full-thickness wounds on athymic mice, and effective skin coverage was provided for the 60-day observation period after grafting.

ISSN:0273-8481    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Severely burned patients experience a bone lesion consisting of markedly reduced bone formation and evidence of decreased resportion. The cause of the lesion may be multifactorial, but aluminum loading, which also occurs in patients with burns, has been documented to produce this type of injury in both humans and animals. To assess the risk of aluminum loading with patients with burns, we analyzed fluids, creams, and medication used in the management of acute burn injury for aluminum content. These substances were classified according to route of administration: cutaneous, enteral, or parenteral, to assess the risk of aluminum loading. Cutaneous exposure to aluminum is greatest from baths, which may provide up to 8 mg aluminum. However, the dynamics of aluminum entry into the blood via a damaged skin barrier are unclear. Enteral exposure to aluminum is no greater than daily dietary exposure. Parenteral sources of aluminum, especially 25% human serum albumin and calcium gluconate, provide the most significant risk of loading because of direct introduction of aluminum into die circulation. Substitution with a different brand of albumin and calcium chloride can reduce the parenteral aluminum load by as much as 95% and minimize any role aluminum may play in the pathogenesis of this bone lesion.

ISSN:0273-8481    

出版商:OVID    

年代:1994

数据来源: OVID