摘要:

Fibrin plate assays revealed that human burn blister fluid represses plasmin-induced fibrinolysis. While this repression is significant, it is not as potent as that of human serum. Ibuprofen, a nonsteroidal anti-inflammatory drug, antagonizes blister fluid inhibition of fibrinolysis. The activity of ibuprofen appears to be unrelated to the synthesis of prostaglandins because other nonsteroidal drugs that were tested, such as indomethacin, imidazole, and tolmetin had significantly less antagonistic activity. This plasmin inhibition, which is contained in burn blister fluid, may contribute to vascular occlusion after burn injury, which leads to secondary dermal ischemia and necrosis in patients traumatized by burns.

ISSN:0273-8481    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Integra artificial skin is an effective means of treatment for full-thickness burns. In extensive burn injury the use of such skin substitutes may become the treatment of choice. The artificial skin consists of a dermal substitute of bovine collagen and chondroitin-6-sulfate and an epidermal layer of synthetic polysiloxane polymer (Silastic). Serial biopsy specimens were obtained from 131 patients during a period of 7 days to 2 years after application. In this histologic study, six sequential phases of repair were discerned. In addition, there were occasional unusual histologic features, eosinophilic infiltration, and/or macrophage-derived giant cell formation in the wound area; however, such findings did not clinically correlate with a negative response to Integra artificial skin. Good repair was obtained, with rare exceptions. An intact dermis was achieved as well as definitive closure of a complete epidermal layer with a minimum of scarring.

ISSN:0273-8481    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A copper slug heated with a soldering iron was used to produce full- and partial-thickness burns on the backs of mice. The untreated partial-thickness burns healed by outgrowth of epidermal cells from the hair follicles and adjoining skin, and the full-thickness burns formed linear scars. Skin equivalents containing isogeneic fibroblasts and epidermal cells were used to replace full-thickness burns; these grafts were fully vascularized and covered with a cornified epidermis within 2 weeks. The grafts maintained 34% of their original area at 180 days, but the full-thickness burns retained only 4.5% of the initial area. For the first 2 weeks, the splenic index in animals that received burns followed by surgical excision. and grafting was significantly greater than in the animals that had burns not followed by excision, but the difference was no longer significant by 21 days.

ISSN:0273-8481    

出版商:OVID    

年代:1990

数据来源: OVID

ISSN:0273-8481    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Artificial skin (Integra) has been developed as an effective treatment of full-thickness burns. The material consists of a bovine collagen and chondroitin-6-sulfate dermal matrix with a silicone rubber “epidermal” layer. After burn wound excision, the artificial skin is implanted. Only the temporary silicone rubber epidermal membrane is removed. The dermal collagen matrix is incorporated by the host. Serial serum samples were obtained from patients who had grafts of Integra artificial skin for the determination of the humoral immune response to Integra. Integra artificial skin presents few if any humoral immunologic problems to patients. Increased antibody activity to bovine skin collagen, bovine skin collagen with chondroitin sulfate, and human skin collagen was not considered immunologically significant.

ISSN:0273-8481    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A new surgical method for use on both burn wounds and donor sites of elderly patients with burns is presented. This procedure is based on dermolipectomy. During the period from January 1985 to December 1988, 20 operations were performed on 18 patients. This procedure was applied to 39 donor sites and to four burn wound sites. The most common donor site was the lateral trunk. There was only one postoperative death. Actual survival rates and predicted survival rates were compared, and in those patients with burns over 21% to 40% of total body surface area actual survival rates were better than the predicted rates.

ISSN:0273-8481    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Obesity is seldom recognized as a risk factor for the patient with burns. However, the overweight patient with burns presents major problems for the burn team, especially in the areas of wound care, pulmonary care, and general nursing care. One-hundred eighty adults (9.1% weighed more than 45 kg above ideal body weight or more than 100 kg in total weight. Mean weight was 110 kg, with 155 patients heavier than 100 kg. Mean age was 38 years with a mean burn size of 26% (11% full-thickness). The mortality rate was 21%, and respiratory and cardiovascular complications occurred in 33% of these patients. The obese patient presents problems disproportionate to burn size, burn location, and age. The obese patient's problems are related to weight. Care is often compromised by the physical constraints of a patient's size.

ISSN:0273-8481    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

Wound care is painful for die patient with a burn injury and tedious for die burn unit staff but necessary to remove exudates and debris and to limit infections. In an effort to circumvent daily dressing changes while ensuring optimal wound protection, Sildimac (Marion Laboratories, Kansas City, Mo.), a new drug delivery system for silver sulfadiazine, was developed. When silver sulfadiazine, a topical antimicrobial commonly used for die treatment of burns, is incorporated into die delivery system, die drug is released in a sustained fashion. We report here die results of a multicenter evaluation of die safety and efficiency of Sildimac for treatment of full-thickness burn wounds. Sildimac, when left in place for up to 4 days, appears to be as effective as twice-daily wound cleansing and application of Silvadene cream 1% (Marion Laboratories, Kansas City, Mo.) for die treatment of full-thickness burns.

ISSN:0273-8481    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

The present study was undertaken to establish an animal model of combined whole-body irradiation and thermal injury and to determine the effectiveness of early excision and closure of the burn wound in such a model. Whole-body irradiation over a range of doses resulted in a predictable mortality rate, with an LD50/30of 783 rad with 95% confidence limits of 737 and 823 rad. A controlled 10% body surface area full-thickness thermal injury resulted in no deaths in 30 animals. When combined with a standard nonlethal 10% thermal injury, varying doses of whole-body irradiation resulted in widely differing LD50/30values in three separate cohorts of rats. Excision and closure of a 10% burn 24 hours after exposure to 200 rads did not improve survival.

ISSN:0273-8481    

出版商:OVID    

年代:1990

数据来源: OVID

摘要:

A review of the literature and a combined burn center study of the University of Beijing and die University of Colorado Health Sciences Center looking at cancer arising from old burn injuries are reported. This study indicates that of the 21 patients 76% were male, with an age range from 15 to 67 years. The lag period for all cancers ranged from 8 months to 60 years. The distribution of die cancer was greatest in die extremities, with 71%, followed by die scalp, with 14%. Forty-three percent of die patients were treated by excision and skin grafting. Twenty-nine percent were treated by amputation, 24% had radiation therapy, and 5% received no treatment. Of die 76% who were followed up to 8 years, no deaths were reported.

ISSN:0273-8481    

出版商:OVID    

年代:1990

数据来源: OVID