ABSTRACT
The outcomes of the Optimelle® dressing line use were analyzed. The effectiveness and safety of these therapeutic dressings in patients with thermal injury have been proven. A significant therapeutic effect was shown with the combination use of the proposed dressings, depending on the phase of the wound process and the depth of tissue injury due to hot fluid. Possible complications, particularly allergic reactions and contact dermatitis, were identified. Prevention and adequate local non-surgical therapy of complications are described. Three clinical cases are presented.
Subject(s)
Burns , Humans , Child , Burns/complications , Burns/diagnosis , Burns/therapy , BandagesABSTRACT
The aim of the study was to evaluate the efficacy and safety of the Collost bioplastic material in the treatment of borderline and mosaic burns. MATERIALS AND METHODS: We conducted a prospective multicenter study, which included 94 patients aged 1 to 12 years with thermal skin burns (grade II-III by ICD-10). Patients were divided into four groups. In groups 1-3, various forms of the Collost bioplastic material were used (group 1 - 7% gel, group 2 - membranes, group 3 - powder) in combination with hydrocolloid dressings containing Ag+ ions. Patients of the control group (group 4) underwent the traditional local conservative treatment using hydrocolloid dressings alone. Concomitant therapy was similar in all of the participating centers. The total follow-up period was 4 weeks from the date of burn injury. RESULTS: On day 14, there were 23 cases (92%) of complete epithelization in group 1, 13 cases (68.4%) - in group 2, 21 cases (78%) - in group 3, and 9 cases (39.1%) - in group 4. The data from groups 1 and 3 significantly differed from those in control (p<0.05). The epithelialization of the burned skin in the Collost groups (7% gel and powder) was on average one week faster compared to the control. CONCLUSION: The Collost bioplastic material (in the form of gel or powder) in combination with hydrocolloid dressings can be a functional and inexpensive alternative to autografts in the treatment of borderline and mosaic burns.
ABSTRACT
In the blood of children (n=16) with large thermal skin burns (> 20% of total body surface), luminol-dependent chemiluminescence (CL) of neutrophils stimulated with phorbol-12-myristate-13-acetate (PMA) and myeloperoxidase (MPO) activity in neutrophils and plasma were assayed in the early period (1-7 post-burn days). PMA-stimulated neutrophils in thermally injured patients produced higher CL than those in a reference group of healthy children (n=24), p<0.01. MPO activity was elevated in neutrophils and plasma in 40% and 57% of patients' blood samples, respectively. The albumin fraction isolated from plasma of burned patients enhanced the PMA-stimulated CL response of blood samples from healthy volunteer. Our results suggest that the acute inflammatory response induced by thermal injury involves activation of neutrophils and is accompanied by MPO release into the plasma. MPO-mediated modification of serum albumin induces its capacity to prime neutrophils and thus to enhance further inflammatory reaction.
Subject(s)
Burns/blood , Neutrophils/enzymology , Peroxidase/blood , Burns/pathology , Child , Child, Preschool , Female , Humans , Inflammation/blood , Inflammation/pathology , Male , Neutrophils/pathology , Serum Albumin/metabolismSubject(s)
Anti-Bacterial Agents/therapeutic use , Bandages, Hydrocolloid , Burns , Staphylococcus/drug effects , Wound Healing/drug effects , Bandages, Hydrocolloid/classification , Bandages, Hydrocolloid/trends , Burns/etiology , Burns/microbiology , Burns/physiopathology , Burns/therapy , Child, Preschool , Female , Granulation Tissue/drug effects , Granulation Tissue/physiopathology , Humans , Infant , Male , Monitoring, Physiologic , Staphylococcus/isolation & purification , Time Factors , Trauma Severity Indices , Treatment OutcomeSubject(s)
Bandages, Hydrocolloid , Burns , Granulation Tissue/drug effects , Silver Sulfadiazine/administration & dosage , Wound Healing/drug effects , Wound Infection , Anti-Infective Agents, Local/administration & dosage , Bacteriological Techniques , Burns/complications , Burns/diagnosis , Burns/microbiology , Burns/therapy , Child, Preschool , Female , Humans , Infant , Male , Time Factors , Trauma Severity Indices , Treatment Outcome , Wound Infection/diagnosis , Wound Infection/drug therapy , Wound Infection/microbiologySubject(s)
Anti-Bacterial Agents/therapeutic use , Debridement/methods , Negative-Pressure Wound Therapy/methods , Occlusive Dressings , Wounds and Injuries/therapy , Child , Combined Modality Therapy , Humans , Monitoring, Physiologic , Trauma Severity Indices , Treatment Outcome , Vacuum , Wound Healing , Wounds and Injuries/etiology , Wounds and Injuries/physiopathologyABSTRACT
Cultured allogenic fibroblasts labeled with fluorescent acridine orange and transplanted onto burn wound virtually completely disappear from the wound surface within 2 days (are destroyed). Study of wound morphology by light autoradiography and quantitative analysis showed a stimulating effect of transplanted fibroblasts on wound healing. This effect, irrespective of the initial state of the wound, is always directed at accelerated formation of connective tissue similar to the derma and capable of epithelialization.
Subject(s)
Burns/pathology , Burns/surgery , Fibroblasts/transplantation , Acridine Orange/metabolism , Adult , Autoradiography , Biopsy , Cell Division , Cells, Cultured , Child, Preschool , Fibroblasts/cytology , Fibroblasts/metabolism , Fluorescent Dyes/metabolism , Humans , Male , Skin/metabolism , Skin/pathology , Transplantation, Homologous , Wound HealingSubject(s)
Burns/surgery , Fibroblasts/transplantation , Skin/cytology , Wound Healing , Adolescent , Body Surface Area , Burns/pathology , Cells, Cultured , Child , Child, Preschool , Critical Illness , Humans , InfantABSTRACT
The authors have developed a unique method of treating extensive burns by transplantation of the cultivated cells on the affected area. The main elements of the transplant are not keratinocytes but fibroblasts, and this is a principal difference with other methods. The transplanted fibroblasts actively synthesize DNA, collagen, fibronectin, glycosaminoglycanes which comprise the extracellular matrix formed by cells. The method is simple, cost-effective, provides high percentage of fibroblast transplant survival, essential acceleration of the burn area epithelialization as compared to other methods. This method was applied in the treatment of 517 patients in various hospitals of the country.
Subject(s)
Burns/surgery , Skin Transplantation/methods , Skin/cytology , Adult , Cells, Cultured , Child , Fibroblasts/cytology , Humans , Treatment OutcomeABSTRACT
The article discusses some experience in organizing medical care for children injured during the crash in Bashkiria in June, 1989. Twenty-eight children with extensive Degrees II--IIIa, IVb burns were treated in the burn department of Children's Clinical Hospital No. 9, Moscow; 24 of them were discharged in a satisfactory condition, 4 children with a burn of more than 50% of body surface died. Simultaneous admission of the injured during a crash creates organizational, therapeutic, and psychological difficulties. The authors consider it necessary to create a special reserve of equipment, instruments, and drugs in the leading therapeutic centers, to train some of the general surgeons in problems of treatment of burn injuries, and engage, without fail, a psychoneurologist in the treatment.
Subject(s)
Accidents , Burns , Disasters , Emergency Medical Services/organization & administration , Patient Admission , Railroads , Bashkiria , Body Surface Area , Burns/diagnosis , Burns/etiology , Burns/therapy , Child , Female , Humans , Traumatology/methodsABSTRACT
On the basis of expert estimation of 208 case records of the children, who died from thermal trauma, the structure and causes of lethality in burn shock, toxemia and septicotoxemia were studied. The organization and therapeutico-diagnostic errors were analysed. The concept of "critical burn" was defined for the children of different age.
