Effect of motor imagery in the rehabilitation of burn patients.

Although there is ample evidence that motor imagery (MI) improves motor performance after CNS injury, it is still unknown whether MI may enhance motor recovery after peripheral injury and most especially in the rehabilitation of burn patients. This study aimed to investigate the effects of a 2-week MI training program combined with conventional rehabilitation on the recovery of motor functions in handed burn patients. Fourteen patients admitted to the Medical Burn Center were requested to take part in the study and were randomly assigned to the imagery or the control group. Behavioral data related to the ability to perform each successive step of three manual motor sequences were collected at five intervals during the medical procedure. The results provided evidence that MI may facilitate motor recovery, and the belief in the effectiveness of MI was strong in all patients. MI may substantially contribute to improve the efficacy of conventional rehabilitation programs. Hence, this technique should be considered as a reliable alternative method to help burn patients to recover motor functions.

[Not Available]. / L'Equin du Pied dans un Contexte de Brulure Grave - Interet du Bilan Photographique.

The incorrect position of the foot in talipes equinus is common in the framework of prolonged confinement to bed in a patient in deep sedation. In the context of severe burns, this incorrect position is difficult to prevent and its fixation by cutaneous shrinkage, which is often associated with a musculotendinous fibrosis, constitutes an important functional after-effect. The onset of talipes equinus is insidious and progressive, and it is therefore important to be watchful both in detection and in prevention. Regular photographic assessment makes it possible to predict its appearance and to take appropriate preventive or curative action.

[Cultured epidermis for the treatment of severe burns. A 2-year study (18 patients)]. / Les cultures d'épiderme pour le traitement des grands brûlés. Etude sur deux ans (18 patients).

AIM OF THE STUDY: For fifteen years, Edouard Herriot Burn Center has been using cultured epidermis provided by an hospital Laboratory. This means of production results in great freedom for their application compared with the centers who have to buy the cultured epidermis. In order to evaluate our clinical results, a two-year study has been performed. MATERIAL AND METHODS: Eighteen patients suffering acute burns were concerned. The average burned area was 68% of the total body surface (range 49 to 88). The average age was 31.6 years, ranging from 1 to 58, including two children. Even autologous or allogenic epidermis was used. In our series cultured epidermis was grafted according four different strategies. It was the preparation of the wound bed by skin allografts, the association of widely meshed auto-graft with cultured epidermis, the stimulation of the healing of extensive deep second degree burns with allogenic epidermis, and the coverage of skin auto-graft donor sites. RESULTS: Two patients died. For the survivors, the average hospital stay was 60 days (range 22 to 90), and on average 70 days over 70% TBSA burns. Cultured epidermis allowed the definitive coverage of 17% of the total body surface of the patients. This study supports the importance of a careful preparation of the patient for the engraftment of cultured epidermis. CONCLUSION: In our opinion, in spite of the difficulties of handling of cultured epidermis, they represent a precious means of coverage for the rapid and definitive healing of extensive burns over 70% TBSA.