[Burn wounds after resuscitation of a newborn girl]. / Brandsår efter genoplivning af en nyfødt pige.

In resuscitation of an asphyctic newborn baby, a chemical hot pack was used for maintaining sufficient body temperature. The child lay for 45 min on the covered hot pack, which had a peak temperature of 54 degrees C. This led to a third degree burn (5% of BSA). The child needed split skin grafting. Control at four months of age showed a well-taken skingraft and the child was developing normally. We conclude that chemical hot packs should not be used for newborn babies unless the peak temperature in the packs is less than 44 degrees C.

[Pressure sores. Background and therapeutic strategy]. / Tryksår. Baggrund og behandlingsstrategi.

A pressure ulcer is based on local tissue pressure and other pathological conditions in the patient. Pressure-reducing devices can reduce the incidence of pressure sores. The staff must be familiar with the strategies for prevention and treatment of pressure sores. Conservative treatment is used for pressure sores with the potential for spontaneous healing in regions where unphysiological pressure can be avoided. Split skin transplantation is only useful in superficial, granulating pressure sores in regions where pressure and shear will be limited after healing and where a short healing time is desirable. Musculocutaneous flaps are indicated in regions suffering pressure or other mechanical strain or in certain risk patients. Pressure-reducing devices should be administered according to guidelines and used from the beginning of the period where they are needed.

[Electric injuries--cardiac monitoring?]. / Elektriske skader--kardial monitorering?

During the years 1980-1990, 49 patients (38 men and 11 women) were treated in the department for various electrical injuries. The average age was 27 years (2-78 years). Thirty-nine had suffered low voltage (less than 1000 volts) accidents and ten had suffered high voltage (more than 1000 volts) accidents. The incidence and type of cardiac arrest/loss of consciousness on the scene of the accident, myoglobinuria, acute fasciotomies, surgical interventions, amputations, cardiovascular complications and outcome is reported. The most important finding was that no cardiac abnormalities were seen even with the patients with a clinical primary cardiac arrest. In spite of this finding 18 of the patients were initially brought to a medical department for electrocardiographic monitoring. This could clearly delay surgical intervention, though it did not seem to affect the final outcome (with some reservations). It was concluded that only abnormal ECGs should indicate electrocardiographic monitoring. Otherwise an electrical injury is a surgical matter.

Split skin grafting of defects from fasciotomy after compartment syndrome.

Proper treatment of compartment syndrome is fasciotomy. Secondary skin defects often complicate the course and require skin-grafting procedures. The present investigation is a retrospective study based on 17 fasciotomies. Their courses are reported, and the possibility of primary skin excision with the purpose of delayed grafting is demonstrated. This procedure would probably reduce the number of hospital days and the number of surgical procedures.

Biologic wound coverings in burn treatment.

A review of biologic wound coverings currently in use is presented. These include homografts, xenografts, embryonic membranes, and tissue derivatives. The indications, advantages, and disadvantages of such materials are discussed. Finally, future research directions are suggested.

[Burns caused by electric surgical instruments]. / Forbraendinger ved anvendelse af el-kirurgi.

Employment of electric surgical instruments involves a potential risk of burning at the neutral electrode. These are frequently third degree burns. Skin grafting may shorten the course of the illness. The importance of good contact over the entire neutral electrode plate is emphasized.

Clinical results of grafting burns with epidermal Langerhans' cell depleted allograft overlay.

Twenty-one severely burned patients have received widely meshed and expanded autografts and allografts of epidermis depleted of Langerhans' cells. In 18 patients 80% or more of the grafts took successfully. Six patients (29%) died, three of inhalation injuries. Using allografts of epidermis depleted of Langerhans' cells means that larger burned areas can safely be grafted during one procedure.

Surgical relocation of retracted eponychion.

Burn wound contracture of the dorsal side of fingers often leads to retraction of the nailfold with exposure of the growth zone of the nail. Disfigured nails, extremely annoying to the patients, are the results. A surgical procedure and clinical results of 50 cases (fingers) are reported and commented on.

Occlusive dressing versus petroleum gauze on drainage wounds.

Two different wound dressings were tested on human drainage wounds. Improved healing was observed under an occlusive, oxygen-impermeable hydrocolloid dressing compared with petroleum gauze. Infection tendency was not increased under the occlusive dressing.

Effect of Solcoseryl on cadaveric split-skin oxygen consumption during 4 degrees C storage and in frozen biopsies.

Oxygen consumption rate in cadaveric split-skin biopsies was investigated. Biopsies were harvested at different times postmortem and stored at different temperatures in either Solcoseryl (a protein-free bovine hemodialysate) or placebo-containing media. During the first week of storage Solcoseryl had no influence on oxygen consumption. However, in the second and third weeks the oxygen consumption was improved by Solcoseryl.

In vitro suppression of the epidermal Langerhans' cells in necro split skin.

The effect of ultraviolet light B irradiation and glucocorticosteroid incubation on the epidermal Langerhans' cell density and tissue viability was investigated, in vitro, on human thin necro split skin.

Grafting of burns with widely meshed autograft split skin and Langerhans cell-depressed allograft split skin overlay.

Extensively burned patients suffer from lack of sufficient autologous donor skin. Meshing and wide expansion of the obtained split skin has met the requirement to a large degree. However, the wider the expansion, the less chance of a proper take. By covering widely expanded autografts with viable cadaver split skin, the take has been improved. If the epidermal Langerhans cells in the cadaver split skin are depressed by ultraviolet B light and glucocorticosteroids before grafting, a prolonged allograft take can be achieved and the healing of the underlying autografts is ensured for an extended period. Grafting results in 6 patients with extensive burns are reported.

Grafting with epidermal Langerhans cell depressed cadaver split skin.

Viable cadaver split skin is very useful as a temporary coverage of excised burns. However, the functional time on the patients is short (2-3 weeks) due to rejection of the tissue. By depression of the epidermal Langerhans cell by ultraviolet light B and glucocorticosteroid, a prolongation of the allograft survival can be obtained.

Nailfold retraction due to burn wound contracture. A surgical procedure.

Burn scar contracture on the dorsal aspect of fingers or toes often leads to retraction of the protecting nailfold, which may be extremely annoying to the patient. A surgical procedure for relocation of the nailfold is presented.

Viability in split-skin biopsies measured by a surface oxygen electrode.

A method for the evaluation of split-skin biopsies with an oxygen electrode is described. A Clark-type polarographic electrode is placed in controlled contact with the tissue in a thermostabilized chamber specially constructed for the purpose. The electrode allows the monitoring of the adjacent tissue-oxygen tension. Recordings on fresh tissue at different temperatures and post mortem tissue are performed. Fresh tissue yields oxygen-tension falls comparable to in vivo investigations performed by the transcutaneous oxygen electrode.