Effects of different preservation solutions on skin graft epidermal cell viability and graft performance in a rat model.

This study sought to evaluate the viable epidermal cell count of skin stored at 4 degrees C in different media, and to determine the longest time that grafts could be stored and still be used for clinical application of skin grafts. Harvested rat skin grafts were divided into four groups: saline (group 1), Roswell Park Memorial Institute-1,640 solution (RPMI) (group 2), University of Wisconsin solution (UW) (group 3), and Histidine-tryptophan-ketoglutarate solution (HTK) (group 4). After the designated storage time (7, 14, 21, 28, or 35 days), grafts were divided into two parts. Skin grafts (3 cm x 3 cm) were then autotransplanted onto full-thickness circular wound beds. Percentages of viable keratinocytes (PVK) declined significantly for skin grafts stored in UW, HTK, and saline solutions (Kruskal-Wallis, P<0.05), while there was an insignificant decline in the PVK of skin grafts stored in RPMI until the 28th day of storage (Kruskal-Wallis, P>0.05). Compared with UW, HTK, and saline, grafts stored in RPMI had significantly higher percentages of PCNA at the 14th and 21st days of storage (Mann-Whitney U-test, P<0.05). Grafts stored in RPMI had significantly lower apoptosis rates than did grafts stored in UW or HTK (P<0.05). Based on these results, we conclude that RPMI-1640 provides a better environment for skin grafts by increased quality and survival time of skin grafts, as assessed by both microscopic and macroscopic investigations.

Knowledge, attitudes, and behavior of occupational physicians related to burn cases: a cross-sectional survey in Turkey.

The primary care of victims of burns at the workplace is provided by occupational physicians. In Turkey, the routine practice is to certify physicians for work in occupational medicine. The aim was to evaluate the knowledge, attitudes, and behavior of occupational physicians regarding burn cases. A total of 510 occupational physicians working in Ankara were surveyed by mail, and 101 (19.8%) physicians responded. Most of these physicians (n=67, 66.3%) had encountered burn cases within the prior year. The most frequent type of burn was scalds (n=55, 54.5%) followed by thermal burns (n=37, 36.6%). Of the respondents, 22 (21.8%) knew the most appropriate classification of burns. Regarding first-aid treatments prior to triage, only 4% chose the valid items. The mean rate of favourable attitudes of the participants toward first aid of different types of burn injuries was 70.8%. Only 31.7% of the physicians surveyed used up-to-date first-aid modalities. We conclude that Turkish occupational physicians have inadequate knowledge and inappropriate attitudes toward the first aid and primary care of burn victims. With the vital support of the Burn and Fire Disaster Institute at Baskent University, nationwide educational policies could be improved and assessed.

Current status of burn care facilities: a nationwide survey.

The problems associated with burn injuries are wide-ranging, and the social and economic impacts of burns affect all of society. Only burn units have the capability to properly care for these patients, and this specialization translates to increased costs. The aim of this study was to examine the current status of burn units in Turkey. There are no reliable epidemiological data on burns and burn units in our country, so we conducted our own survey. In March 2003, Turkey had 1198 hospitals with 159,290 patient beds. To collect data related to burn care centers, we mailed a questionnaire to every hospital (974 total sent) and a different questionnaire to every City Health Directorate (81 total sent). Seven hundred and seventy-seven hospitals (79.8%) responded, and the results indicate that the number of burn care centers has risen significantly in the past decade. At most centers, plastic-reconstructive surgeons and general surgeons are the physicians who care for burn patients. The survey findings indicate that Turkey needs many more burn centers, and also better quality units. In addition, in-service training of health care professionals is required. As well, a curriculum should be developed for continuous public education geared towards burn prevention and first aid.