Expression of vascular endothelial growth factor in deep second-degree scald wounds in rats.

OBJECTIVE: To observe the expression of vascular endothelial growth factor(VEGF)in deep second-degree scald wounds,with an attempt to further explore the role of VEGF in burn wound healing. METHODS: Totally 36 adult Wistar rats were randomized into two groups: the scald group(30 rats)and the control group(6 rats). In the scald group,rat models of deep second-degree scald wounds were established. Full-thickness tissues of the wounds were collected respectively 1,3,7,14,and 21 days after the modeling. The expressions of the VEGF mRNA and protein were detected with real-time quantitative PCR and Western blot,respectively. In the control group,the same procedures were performed but without modeling. RESULTS: Compared with the control group,the expressions of VEGF mRNA and proteins were significantly higher in the scald group(P<0.05). The expression levels reached the peak on day 1,gradually decreased on day 3,reached the lowest points on day 14,but increased again on day 21. CONCLUSIONS: VEGF is involved in the healing of scald burns. The expression of VEGF during the wound healing is closely correlated with the wound angiogenesis.

Experience in the treatment of patients with burns covering more than 90% TBSA and full-thickness burns exceeding 70% TBSA.

OBJECTIVE: The objective of this study was to explore our experience in the treatment of serious burn patients (total burn surface area [TBSA] > 90% and full thickness burns > 70% TBSA). METHODS: Thirty patients who were admitted to our unit over a period of 12 years were analyzed retrospectively; 23 cases (76.7%) were successfully treated. RESULTS: There were seven out of 12 cases (58.3%) in the first 5 years and 16 out of 18 cases (88.9%) in the latter 7 years of the study period. CONCLUSIONS: It is concluded that: 1) giving electrolyte-free fluids (around 3700 ml) and the maintenance of hourly urine output at 70 ml or more appear to be beneficial in resuscitation therapy; 2) the first operative procedure should be undertaken early, at about the third day after injury; 3) a higher percentage area of eschar to be excised in the first operation is encouraged and eschar excision of up to 40% or more is preferable; 4) controlling the area of exposed wound under 5% in the entire therapeutic course is essential in the prevention of burn infection; 5) emphasis should be placed on the vital role of a dehumidifier in reducing the incidence of fungal infection; and 6) early enteral nutrition with the use of growth hormone in correcting the nutritional state of the patient is also emphasized.