The efficacy of recombinant human activated protein C (rhAPC) vs antithrombin III (at III) vs heparin, in the healing process of partial-thickness burns: a comparative study.

This is an experimental study regarding the positive effect of recombinant human activated protein C (rhAPC) in the healing process of partial-thickness burns, in comparison to antithrombin III and heparin. On a porcine model we induced superficial partial-thickness and deep partial-thickness burns and performed intravenous administration of the elements of study during the first 48 h. The progress of the condition of the injured tissues was evaluated by histopathological examination at specific time intervals. The results showed an improved healing response of the specimens treated with rhAPC compared to those treated with antithrombin III, heparin, and placebo.

A fatal case of cutaneous zygomycosis in a patient with severe metabolic acidosis.

We present a case of cutaneous zygomycosis in a patient with an ureteroileostomy and severe metabolic acidosis, but without diabetes. The patient died despite multiple aggressive surgical interventions and antifungal therapy with liposomal amphotericin B. Ureteroileostomy-related acidosis can be a predisposing factor for zygomycosis. Metabolic acidosis can have a role in the severity of cutaneous disease.

[Attitudes of medical and nursing personnel on suicide].

This paper investigates the attitudes towards suicide among nursing and medical personnel of Rethimno General Hospital and the Community Health Centers of the county of Rethimno. The Suicide Behavior Attitudes Questionnaire (SBAQ) comprises of 21 visual analoque scale items and three subscales: i.e feelings when caring for a suicidal patient, professional capacity and right to suicide. Τhe study sample consisted of 104 members of the personnel, (48 doctors and 56 nurses). Nursing personnel tended to be more sympathetic towards the patient than doctors. More sympathetic attitudes were also expressed by women compared to men. Religious individuals expressed a more condemnatory attitude towards suicide, and a more sympathetic attitude towards the patient, compared to non religious ones. 26% of the total sample expressed the belief that suicide is not associated with a psychiatric disease. The need for training of the personnel is emphasized in order to give professional care to the difficult group of suicide attempters or patients with suicidal ideation.

The use of artificial skin in plastic surgery and burns.

The use of artificial skin restores the depth and the elasticity of the skin, through restoration of the dermis, with no significant morbidity. Thus we have permanent release of contractures and a pleasing contour with satisfactory functional and cosmetic results. Still, these advantages must be weighed against the necessity for meticulous surgical technique and intensive post-operative care, the waiting period and the cost of the product.

The Value and Prognostic Role of the CT Scan versus Chest Radiography in the Follow-up of Intubated Burn Patients with Possible Inhalation Injury.

The admission and follow-up chest radiographs as well as the follow-up CT scans of 13 burn patients admitted to our clinic requiring ventilatory support were analysed for signs of inhalation injury and pulmonary complications. The findings were compared with the results of the clinical examination, the blood gas tests, and bronchoscopy. Eleven out of the 13 patients underwent bronchoscopy revealing inhalation injury. The CT scan detected pleural effusion in two patients with a normal chest radiograph. In two patients the CT scan detected asymmetrical expansion between the right lung and the left. In one patient soft tissue oedema made evaluation of the chest radiograph impossible, while the CT revealed bilateral pleural effusions and consolidations or atelectasis in both the lower lobes. In one patient the CT scan detected oedema of consolidatory pattern in every lobe (superior middle-inferior), while the image in the chest radiograph was not similar. CT identified an area of consolidation in one patient in the right middle lobe with a normal chest radiograph. The results of the CT scan correlated with the clinical course and blood gas determinations, while similar findings in the chest radiograph were observed at a later stage. In conclusion, compared to chest radiographs, the CT scan often yielded additional information in the follow-up of intubated burn patients with inhalation injury. It can be performed in order to confirm and/or more precisely define the full extent of lung injury and is also feasible in patients who are critically ill and hard to move.