Clinical analysis of abdominal compartment syndrome in patients with serious burn injury / 中华烧伤杂志

<p><b>OBJECTIVE</b>To summarize the clinical management of abdominal compartment syndrome (ACS) in burn patients with severe burn injury.</p><p><b>METHODS</b>Twelve serious burn patients with abdominal compartment syndrome hospitalized in our center from January 2001 to April 2005 were enrolled in the study. Among them 3 patients were treated with conservative method, 4 with escharectomy of abdominal wall, 5 with laparotomy for decompression. The clinical results were analyzed statistically. Bladder pressure, central venous pressure, systolic blood pressure and arterial blood oxygen partial pressure (PaO2 ) were measured and compared before and after operation.</p><p><b>RESULTS</b>Among these 12 patients, 5 died with the overall mortality of 41.67%. But only 3 died among 9 patients undergone operation. Most of patients were oliguric,with abnormal bladder pressure, central venous pressure, and systolic blood pressure 24 hours before operation. But these parameters were significantly improved after operation ( P <0. 01).</p><p><b>CONCLUSION</b>Early abdominal escharectomy and timely abdominal decompression are vital for the management of ACS in burn patients.</p>

The influence of dermal template application on the p53 gene expression and apoptosis during wound repairing in burn patients / 中华烧伤杂志

<p><b>OBJECTIVE</b>To observe dynamically the influence of the application of dermal template on the p53 gene expression and apoptosis during wound repairing in burn patients.</p><p><b>METHODS</b>Twenty burn patients were enrolled in the study and were divided into experiment (E, n = 11) and control (C, n = 9) groups. The escharectomy wounds in patients with 3rd degree burn in E group were covered with dermal template overlain with thin split-thickness autograft, while those in C group were covered with thin split-thickness autograft only. Specimens were harvested from wounds of both groups at 1st, 2nd, 3rd, 4th and 5th post operative week (POW). The P53 expression and the apoptosis were assessed respectively by immunohistochemistry and by TUNEL kit. The change in cell number was observed after HE staining.</p><p><b>RESULTS</b>The P53 expression increased gradually along with the wound healing process from 1st to 4th POW, which was significantly higher than that in C group at 2nd, 3rd, and 4th POW (P < 0.05), and it reached the peak at 4th POW. Fibroblasts underwent apoptosis at 1st POW in E group, while apoptosis of the endothelial cells occurred mainly at 2nd and 3rd POW. There was obvious difference in the rate of apoptosis between the two groups in 3rd and 4th POW (P < 0.05). The numbers of fibroblasts and vascular endothelial cells in E group were smaller than those in C group.</p><p><b>CONCLUSION</b>Application of dermal template overlain with thin split-thickness autograft to wounds could induce P53 expression and cell apoptosis, thereby reduce scar formation, resulting in improvement of the quality of wound healing.</p>