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Necrotizing soft tissue infection (NSTI) is an uncommon but fatal and rapidly progressing disease which requires emergent recognition and prompt treatment. Patients of NSTI frequently suffer from large soft tissue defects, which require coverage of these defects by auto-skin graft or flap cover. It becomes a challenge to cover the soft tissue defects in an already sick patient. The patient of NSTI has a restricted skin graft donor site and a poor skin grafting bed. Here authors report a case of 50 years old female, known case of type 2 diabetes mellitus, who suffered from NSTI post intramuscular injection of the left gluteal region. Her left thigh, left gluteal region, lower back, pubic and perineal region were involved. She underwent multiple radical debridement’s followed by the use of Cadaveric human skin allografts to cover the raw area temporarily. Meanwhile, authors optimized the patient nutrition state and controlled the infections. Finally, raw areas were covered with an autologous skin graft, and the patient discharged in stable condition.
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BACKGROUND: There are various methods for the treatment and repair of deep second-degree burn wounds, which have diverse effects and have no uniform standards. Therefore, new technologies need to be developed. OBJECTIVE: To observe the therapeutic effect of controlled debridement and traditional treatment on deep second-degree burn wounds. METHODS: A total of 80 patients with deep second-degree burns from June 2015 to June 2018 were enrolled and divided into a positive control group and a controlled debridement group, with 40 patients in each group. The positive control group was coated with Bangerkang burn bacteriostatic cream, and the oil gauze was pressure-wrapped. The dressing was changed at 3, 6, 9, and 12 days after the injury. In the controlled debridement group, epidermal cell suspension was prepared according to the requirements of wound preparation and was sprayed onto the wound surface. The wound was then covered with Recell Kit self-contained protective film. The film was removed to keep the wound dry on the 3rd day after operation, and then the wound was observed at 6, 9, and 12 days after operation. The study protocol was approved by the Ethics Committee of the Xijing Hospital of the Air Force Military Medical University. All patients volunteered to participate in the study and sign an informed consent. Patient information was registered online and appropriate treatment was performed according to a random (software online) assignment. RESULTS AND CONCLUSION: At 3, 6, 9, and 12 days after operation, the bacterial content, wound pain score, wound infection score and pro-inflammatory factor level in the controlled debridement group were significantly lower than those in the positive control group (P < 0.05). Moreover, there was no complication in both groups. These findings reveal that epidermal cell implantation combined with controlled debridement for deep second-degree burn wounds can achieve remarkable outcomes, which can significantly accelerate wound healing, reduce infection and alleviate the suffering of patients.
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Introduction: Wounds resulting from various causes are the most common health problem in developing countries like India. Management of these wound is very difficult, requiring longer hospital stay, loss of income, psychological problems like depression. In our study, we used cadaveric donor skin as a temporary dressing material for wound cover and see the outcome of definitive splitthickness skin graft following cadaveric donor skin application. Previously cadaveric skin was used for covering the burns wound. Only very few studies are available regarding the use of cadaveric donor skin in the management of complicated wounds. Materials and methods: This was a prospective, non-randomized, uncontrolled study conducted in the Department of General Surgery, Government Stanley Medical College Hospital from October 2017 to September 2018. Once the wound scheduled for cadaveric grafting, the cadaveric skin was meshed in the laminar flow cabinet, the skin was washed in the normal saline, to ensure that all the preservative fluid had been removed. The skin is transported in a sterile container. The cadaveric graft was applied to the wound. No fixation done. Limb was immobilized using POP. Sterile was dressing done. Results: In our study 44 patients underwent cadaveric donor skin grafting. In 40 out of 44 patients (90.9%), the cadaveric donor skin had good take. All 40 patients underwent definitive split-thickness skin grafting. The mean graft take was 90.35%, with maximum graft take was 96% and minimum graft take was 82%. The standard deviation was 3.512%. When reviewing the literature which showed the success rate of STSG was 78% at closing 90% of the wound by 8 weeks. In our study, the mean duration of hospital stay was 34.2 days, with maximum of 57 days and a minimum of 17 days. Most Jim Jebakumar, S. Ranjith Kumar. Cadaveric donor skin allograft as a temporary dressing material in the management of complicated wounds. IAIM, 2019; 6(3): 65-72. Page 66 of the wounds required only single cadaveric graft application, 37 (84.1%) out of 44 patients and 7 patients (15.9%) required more than one cadaveric donor skin grafting. Conclusion: By this study, we can able to minimize the expenses by using the cadaveric skin to predict the success of definitive split-thickness skin grafting. We can also minimize the duration of hospital stay and prolonged use of antibiotics if the cadaveric skin take is successful.
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Objective To observe and evaluate the healing effect of medical skin collagen regeneration func-tional dressing on facial dermatitis.Methods 40 facial dermatitis patients who met the inclusion criteria were ran-domly divided into the observation group(group A)and control group(group B)averagely.Patients of group A were administrated with ketotifen tablets orally and with medical skin collagen regeneration functional dressing externally,while patients of group B were only orally administrated with ketotifen tablets.The total observation period last 15 days with a follow -up once after 2 days for both of the groups.Results The cure rates of group A after 12 day and 15 day were 63.2% and 65%,higher than the cure rates of group B(5.0% and 5.0%).The 12 day and 15 day cure rates of group A were significantly higher than those of group B(χ2 =14.83,15.82,all P <0.01).Conclusion Medical skin collagen regeneration dressing in combination with fexofenadine tablets provide a safe and effective healing func-tion to facial dermatitis.
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Objective To observe the effect of antipruritic lotion combined Fuyanxiao with biological dress-ing suppository in the treatment of vulvovaginal candidiasis in pregnancy(VVC)the clinical curative effect and the recurrence rate.Methods 236 patients with pregnancy complicated with VVC,would be in community were randomly divided into the two groups:combination treatment group,single drug group,118 cases in each.Combination therapy using antipruritic lotion combined Fuyanxiao biological dressing suppository combined treatment,the control group was treated by Fuyanxiao biological dressing suppository treatment,two groups of clinical efficacy and recurrence rate after the end of treatment were compared.Results The cure rate in the combined treatment group was 90.68%,which was higher than 57.62 % in the control group(χ2 =10.731,P <0.01);The recurrence rate in the combined treatment group was 3.39%,which was lower than 13.56% in the control group(χ2 =10.733,P <0.05).Conclusion The antipruritic lotion combined Fuyanxiao biological dressing suppository in the treatment of pregnancy with VVC can effectively improve the clinical symptoms of patients,reduce the recurrence rate.
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The aim of this study was to compare the bone density of bone defects treated with lyophilizated amniotic membrane (LAM) and collagen Membrane (CM), at 3 and 5 weeks. Two bone defects of 4 mm in diameter and 6 mm deep were created in left distal femoral diaphysis of New Zealand rabbits (n = 12). The animals were randomly divided into 2 groups. One of the defects was covered with lyophilized amniotic membrane (Rosa Chambergo Tissue Bank/National Institute of Child Health-IPEN, Lima, Peru) or collagen Membrane (Dentium Co, Seoul, Korea). The second was left uncovered (NC). The rabbits were killed after 3 and 5 weeks (3 rabbits/period). The results showed a high bone density and repair of the defect by new bone. The tomographic study revealed that the bone density of the defects treated with LAM at 3 weeks was equivalent to the density obtained with CM and higher density compared with NC (p <0.05). At 5 weeks, the bone density obtained with LAM was more than density CM and NC (p <0.05). The histomorphometric study showed no significant differences between LAM and CM at 3 and 5 weeks (p> 0.05). The results show that lyophilizated amniotic membrane provides bone density equal or higher to the collagen membrane.
El propósito de este estudio fue comparar la densidad ósea (DO) de defectos óseos tratados con membrana amniótica liofilizada (MAL) y membrana de colágeno (MC), a las 3 y 5 semanas. Se crearon dos defectos óseos, de 4 mm de diámetro y 6 mm de profundidad, en la diáfisis femoral distal izquierda de conejos Nueva Zelanda (n=12). Los animales fueron divididos aleatoriamente en 2 grupos. Uno de los defectos fue cubierto con membrana amniótica liofilizada (Banco de tejidos Rosa Chambergo/INSN-IPEN, Lima, Perú) o membrana de colágeno (Dentium Co, Seoul, Korea). El segundo se dejó sin cubrir (NC). Los conejos fueron sacrificados después de 3 y 5 semanas (3 conejos/periodo). Los resultados mostraron una alta DO y reparación del defecto por hueso neoformado. El estudio tomográfico reveló que la DO de los defectos tratados con MAL a las 3 semanas fue comparable a la densidad obtenida con MC y mayor comparado con la densidad de NC (p<0,05); mientras que a las 5 semanas fue mayor a la densidad de MC y NC (p<0,05). El estudio histomorfométrico no mostró diferencias significativas entre MAL y MC a las 3 y 5 semanas (p>0,05). Los resultados muestran que la membrana amniótica liofilizada brinda densidad ósea comparable o mayor que la membrana de colágeno.
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Animals , Rabbits , Biological Dressings , Bone Density , Bone Regeneration , Dental Implantation , Bone and Bones/pathology , Collagen , Cone-Beam Computed Tomography , Time Factors , Treatment OutcomeABSTRACT
Objective To investigate the clinical efficacy of biological dressing A covering bandage of Ⅲ° burn wounds given comprehensive treatment including dermabrasion.Methods For patients of non Ⅲ° ° burn wounds (deep Ⅱ ° and partial superficial Ⅲ ° wounds),28 cases in the treatment group,were given improved dermabrasion with tangential excision plus thin layer of skin graft from the body,the wounds were covered with biological dressing A bandage.21 patients in the control group were treated by traditional tangential excision,escharectomy and self-skin grafting.The clinical treatment effect was observed and compared between the two groups.Results The wounds were healed 2 ～ 3 weeks after surgery in treatment group,the cure rate of burns in patients with a total area of 40％ ～ 50％ TBSA was 99％,and after treatment the scar formation significantly reduced,self-donated skin significantly reduced,the hospital stay and postoperative recovery time of the patients were significantly shorter,patients were easier to accept.In the control group,the operation time was longer,the blood loss was more,the wounds had more scar healing wounds.The wound healing time of the treatment group was (14.8 ± 1.8) d,which was significantly shorter than (19.4 ± 3.0) d of the control group (P ＜ 0.05).Conclusion The improved grinding A scab plus biological dressings covering bandage has the advantages of simple operation,light damage,less complications,need less skin,to maximize retention of healthy tissue,wound healing speed up,healing scar lessened.
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Objective To investigate the clinical application of silver-containing biological dressing in covering transplanted meshed autografts for treatment of open wounds (burns and trauma) by comparing with traditional petrolatum gauge on meshed autografts. Methods Eighteen patients fulfilling the inclusion criteria were divided into two groups according to the operation methods. The meshed autografts in the experimental group (6 patients) were covered with silver-containing biological dressing and those in the control group (12 patients) were covered with petrolatum gauge. The demographic data, wound condition, wound infection after skin grafting, time of first post-operative inner layer dressing change, pain score during the first inner layer dressing change, and length of hospital stay were all observed. The survival rate of skin graft, wound infection rate and total cost of hospitalization were also calculated. Results The experimental group had significantly lower wound infection rate (0 vs 50. 0%, P<0. 05) and pain score at the first inner layer dressing change (2. 50 ± 1. 05 vs 5. 42 ± 2. 02, P<0. 01) after skin grafting compared with the control group. The period from skin grafting to the first post-operative change of inner layer dressing was significantly longer in the experimental group compared with that in the control group ([7. 50 ± 1. 05] d vs [4. 08 ± 1. 31] d, P<0. 01). The experimental group had a significantly shorter hospital stay compared with the control group ([14. 33 ± 1. 50] d vs [16. 42 ± 1. 93] d, P<0. 05). Moreover, the survival rate of skin grafting in the experimental group was significantly higher than that in the control group ([97. 50±1. 87] % vs [91. 42 ± 4. 48] %, P<0. 01). Conclusion Wound closing by meshed autografts with silver-containing biological dressing can increase the survival rate of skin graft, shorten wound healing time, reduce local pain, and obtain satisfactory outcome.
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O atendimento ao recém-nascido na unidade de terapia intensiva requer conhecimento teóricos-práticos no cuidado com a pele, tendo em vista que vários procedimentos levam à quebra desta barreira protetora e podem causar feridas severas. Além disso, é necessário favorecer sua maturidade em recém-nascidos prematuros. Diante disso, o estudo objetivou investigar a eficiência do uso da membrana semipermeável como recurso tecnológico a ser utilizado na pele do RNPT para redução das perdas de água transepidérmica e dos distúrbios hidroeletrolíticos. Estudo experimental, tipo ensaio clínico randomizado, realizado no período de março a agosto de 2008, na Unidade de Terapia Intensiva Neonatal (UTIN), da Maternidade Escola Assis Chateaubriand - MEAC, na cidade de Fortaleza-Ceará. A amostra foi constituída de 42 RNPTs que atenderam aos seguintes critérios de inclusão: ter peso <= 1.500 gramas e idade gestacional <= 32 semanas; permanecer na unidade durante pelo menos sete dias; não apresentar malformações graves que afetassem a integridade da pele; e o consentimento dado pelos pais e/ou responsáveis pelos RNs. As variáveis do estudo foram peso, balanço hídrico, densidade urinária, controle da glicemia, dosagem do sódio e a cota hídrica diária...
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Humans , Infant, Newborn , Infant, Newborn , Nursing , SkinABSTRACT
Objective To evaluate the effect of live frog skin in the treatment of deep partial thickness and full thickness burn. Methods 159 burned patients were randomly divided into two groups: wounds treated with frog skin or suckling pig skin. Wounds were covered by frog skin(35 cases) or by suckling pig skin(31 cases) after surgical debridement or when the crust began to dissolve for patients with deep partial thickness burns, and by frog skin (49 cases) or by sucking pig skin(44 cases) after surgical debridment or autologous skin grafting and escharetomy for patients with full thickness burns. There was no significant difference between the two groups in mean age, burn area and burn type. Results Compared with the suckling pig skin, frog skin could remarkably decrease days of wound recovery and antibiotics administration, and reduced incidence of wound infections and rejection in patients with full thickness burns. Conclusions Frog skin possessed more powerful anti-infection ability, and rare rejection phenomenon in the treatment of burn wounds. It may be a suitable biological dressing for burn wounds.