RESUMO
The objective of the work was to verify or rule out the hypothesis on the negative effect of incorrect prehospital and primary hospital care on the maturation of scars after thermal injuries with a depth of II.b or more. In a medium-term study the authors investigated the maturation of scars in children aged 3 months to 12 years with different quality of treatment during lay first aid, during prehospital and primary hospital care. They focused attention in particular on the formation of hypertrophic scars and possibly other complications during the functional and aesthetic stabilisation of the scar.
Assuntos
Queimaduras/terapia , Cicatriz Hipertrófica/prevenção & controle , Serviços Médicos de Emergência/normas , Serviço Hospitalar de Emergência/normas , Criança , Pré-Escolar , Cicatriz/terapia , Cicatriz Hipertrófica/etiologia , Cicatriz Hipertrófica/fisiopatologia , Humanos , Lactente , Assistência ao Paciente/normas , Resultado do TratamentoRESUMO
The authors present the results of a medium-term study in which they investigated the therapeutic effect of the silicone elastomer TopiGel on developing hypertrophic scars in a group of patients after burn injuries classified as IIb or deeper. The hitherto published results are very encouraging. This medium-term study confirmed the hypothesis that TopiGel has a positive effect on the reduction, stabilization and normalization of hypertrophic scars. In 48 patients (96%) out of a total of 50, stabilization of the scar occurred as well as its functional and cosmetic normalization, although the subjective view of the patients or parents (in case of pediatric patients) differed in some instances. In two children (4%) only a significant reduction of the scar occurred and not normalization, due to incorrect application of the gel by the parents, lack of adherence to basic hygienic principles or the recommended procedure of gel application. In case of repeated complications, treatment was not pursued. In two patients (4%) treatment was discontinued for a short time due to an allergic skin reaction subsequently, treatment was resumed until complete stabilization of the scar was achieved. The study ruled out a positive therapeutic effect of the silicone sheet on the painfulness of a scar and old, mature hypertrophic scars.
Assuntos
Queimaduras/complicações , Cicatriz Hipertrófica/terapia , Curativos Oclusivos , Elastômeros de Silicone , Adolescente , Adulto , Criança , Pré-Escolar , Cicatriz Hipertrófica/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Curativos Oclusivos/efeitos adversos , Elastômeros de Silicone/efeitos adversos , Géis de Silicone/efeitos adversosRESUMO
A 15-year-old boy had a history of a functional systolic murmur with systolic and diastolic murmurs and radiological evidence of left ventricular hypertrophy. The angiocardiogram demonstrated an aneurysm of the membranous septum, bicuspid aortic valve, dilatation of the left subclavian artery and left common carotid artery. Echocardiography showed a holosystolic prolapse of the mitral valve with mitral insufficiency and a bicuspid aortic valve with insignificant incompetence of the aortic valve. Classical TM mode echocardiography did not show an aneurysm of the membranous septum.
