ISSN:0273-8481    

出版商:OVID    

年代:1986

数据来源: OVID

ISSN:0273-8481    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

The effect of an increase in microvascular hydrostatic pressure, Pmv, and vasodilator prostanoids on initial burn edema formation and that occurring five to six days postburn was determined. Burn injuries in adult sheep and lymph flow, QL, were used as an indication of edema. A 2-3 mm Hg increase in Pmvat eight hours postburn resulted in a several-fold increase in protein-rich lymph flow, whereas inhibition of local release of prostacyclin had no beneficial effect. An increase in Pmvof 3 mm Hg at five days postburn still resulted in a two-fold increase in protein-rich QL. Stimulation of local prostanoid and other vasoactive mediators released with endotoxin did not accentuate QL, whereas ibuprofen injection had no beneficial effect. It was concluded that an increase in protein permeability was still present in burn tissue microvessels at five days. The rate of edema formation was markedly accentuated both initially and at five to six days by an increase in Pmv, whereas vasodilator prostanoids and inflammatory mediators released with local sepsis had no additional effect, suggesting maximum vasodilatation.

ISSN:0273-8481    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Sixty-eight patients underwent excisional therapy for deep thermal and full-thickness burns of the neck and face. The mean time of skin grafting of face and neck burns was 19.8 days postburn. Technically, excisional procedures of the face are extremely difficult, with massive blood loss and difficulty in removing nonviable tissue in contoured areas. The mean area grafted per patient was 528.7 Sq cm, or 3.6% of the total body surface area (TBSA). Blood loss was 700 cc per percent of TBSA excised. The skin grafting procedure was performed using closed-mesh skin grafting (CMSG). The placement of closed-mesh cuts in the direction of natural skin lines of the face and neck produced a final graft result that had the appearance of normal skin rather than the usual waxy appearance of sheet graft. Excisional therapy with application of CMSG resulted in improved final cosmetic appearance, with a marked decrease in hypertrophic scarring and contracture formation when used in association with pressure devices.

ISSN:0273-8481    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

The results of resurfacing full-thickness facial burns by excision of scar and skin grafting are compared with results of dermabrasion and overgrafting. Long-term esthetic results from the two techniques are comparable. With the dermabrasion technique, blood loss (93 ± 77 cc/esthetic unit) (mean ± SD) and operative time (75 ± 25 minutes/esthetic unit) (mean ± SD) are significantly reduced compared to blood loss (200 ± 67 cc /esthetic unit) (mean ± SD) and operative time (112 ± 36 minutes/esthetic unit) (mean ± SD) for full-thickness excision followed by grafting. Full-thickness skin grafts were not successfully used in conjunction with dermabrasion.

ISSN:0273-8481    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Epithelial cell grafts, grown in vitro, were used to supplement limited available autograft as permanent wound coverage in two children with burns over 95% of the body surface area. Effective clinical management of the epidermal cells was achieved with the use of normal saline and dry sterile dressings.

ISSN:0273-8481    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

Hydrofluoric acid burns commonly involve the hands. Treatment with subcutaneous injections of calcium gluconate into the fingers may be limited by the volumes needed to neutralize the fluoride ion. Hydrofluoric acid burns of the hand and fingers in a patient were treated with a topical DMSO/10% calcium gluconate solution and subcutaneous injections of 10% Ca gluconate. This clinical experience was then used to determine whether topical DMSO and 10% Ca gluconate would improve the treatment of experimental hydrofluoric acid burns. After hydrofluoric acid burns to the backs of 30 Sprague-Dawley rats, the animals were divided into six groups: (1) control, no treatment (2) topical 10% Ca gluconate; (3) 10% Ca gluconate subcutancously; (4) topical 100% DMSO; (5) topical DMSO/Ca gluconate and subcutaneous 10% Ca gluconate; and (6) topical DMSO/10% Ca gluconate.Group 5 showed the smallest increase in burn size, suggesting that the combined use of subcutaneous 10% Ca gluconate plus topical DMSO/Ca gluconate may act synergistically to prevent progression of this injury.

ISSN:0273-8481    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

This study confirms and extends previous observations on the use of air-fluidized support systems as an adjunct to burn care. Previous studies showed that because of the effects of decreased pressure, reduction of shearing forces, and reduction of moisture, airfluidized support was associated with a statistically significant increase in survivability of patients with posterior burns and inhalation injury. This study addresses the need for pressure- and moisture-reduced support of posterior donor and recipient sites. The air-fluidized support system eliminates the need for prone positioning, and an additional 18% to 25% BSA is available for donor site use without fear of complications. Superior results of split-thickness skin grafting to posterior surfaces, with the patient in the supine position, are also obtained.

ISSN:0273-8481    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

The tools of the speech-language pathologist include nonverbal communication skills, assistance in evaluating comprehension, and assessment of pediatric development and interaction. These skills are used by the burn team to care for ventilator-dependent or non-English-speaking patients; assess ability to give informed consent; provide coma stimulation programs; and evaluate possible child abuse or neglect. Methods, especially nonverbal communication devices used during a 21-month period, are described.

ISSN:0273-8481    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

The cost of care was reviewed for 96 patients who required hospitalization for treatment of burns of less than 25% TBSA during 1983. Of 52 patients (mean burn size 9.5% TBSA) who required skin grafting, 26 (50%) were treated entirely as outpatients prior to surgery; another 18 (32%) were initially hospitalized, discharged, and readmitted for grafting. The mean hospital cost for patients requiring grafting was $11,196. Payment according to DRG code 458 would have resulted in a mean positive balance of $2,363 per patient compared to actual costs. In 44 patients (mean burn size 8.4% TBSA) who were admitted to hospital but did not require skin grafting, the mean hospital cost was $2,010. Payment based on DRG code 460 would have produced a mean positive balance of $4,746 per patient. Although treatment of uncomplicated burns of less than 25% TBSA is financially feasible within proposed DRG guidelines, there was wide variation in financial balance for individual patients, thus documenting a lack of correlation between DRG payments and hospital costs for burns of a given severity.

ISSN:0273-8481    

出版商:OVID    

年代:1986

数据来源: OVID