[The Biobrane glove in burn wounds of the hand. Evaluation of the functional and aesthetic outcome and comparison of costs with those of conventional wound management]. / Der Biobrane-Handschuh bei Verbrennungen der Hand. Bewertung des funktionellen und kosmetischen Ergebnisses und Kostenvergleich zur konventionellen Therapie.

BACKGROUND: While use of biocomposite temporary dressings in burn wounds is common practice, the complex anatomic structures of the hand make this treatment option challenging. For this reason, the Biobrane ((R)) Glove (Smith&Nephew) has been developed. However, limited information regarding burn treatment with Biobrane ((R)) Gloves can be found in the literature. PATIENTS AND METHODS: Functional and cosmetic outcomes of 13 second degree burn wounds of the hand in 10 patients treated with Biobrane ((R)) Gloves were evaluated using the Vancouver scar scale (VSS) and the DASH-score (disabilities of the arm, shoulder and hand). We evaluated wound healing times and questioned patients about pain related to Biobrane ((R)) Glove treatment in comparison to conventionally managed second degree burn wounds in other parts of the body and about acceptance of Biobrane ((R)) Glove treatment. In addition, we estimated the costs for use and wound management time for both Biobrane ((R)) Glove treatment and conventional wound management for 14 days. RESULTS: Burn wounds treated with Biobrane ((R)) Gloves had excellent functional and cosmetic outcomes [DASH score median of 0 (min. 0; max. 3.33) and VSS median of 3 (min. 0; max. 5)]. Wound healing times were lower (mean 9 days). According to patients' response to overall acceptance, 90% responded as being "very satisfied" with Biobrane ((R)) Glove treatment and 75% responded that Biobrane ((R)) Glove treatment was "much less painful" compared to conventional burn management. The material costs of the Biobrane ((R)) Glove treatment, over 14 days, were approx. double compared to conventional wound management costs. In contrast, the time required for conventional wound management over 14 days was four times longer than for treatment with Biobrane ((R)) Gloves. Thus, taking personnel expenses into consideration, total costs of Biobrane ((R)) Glove treatment are comparable to those of conventional wound management. CONCLUSION: Biobrane ((R)) Glove treatment of hand burns resulted in excellent functional and cosmetic outcomes, reduced pain compared to conventional wound management and high overall patient satisfaction. In conjunction with a significant reduction in wound management time, the Biobrane ((R)) Glove is an important and cost neutral tool in the treatment of second degree burn wounds of the hand.

[Rapid atrial stimulation in the treatment of atrial flutter (author's transl)]. / Hochfrequente Vorhofstimulation in der Behandlung des Vorhofflatterns.

Study on 35 patients suffering from atrial flutter, in which rapid atrial stimulation was made 40 times. Stimulation-catheters were introduced only by control of the intracardiac ecg without x-ray control. Sinus rhythm was restored in 31 cases, in 17 cases intermediate atrial fibrillation of varying length of duration. In 5 cases atrial fibrillation with normofrequent ventricular action was achieved. Appreciable complications were not seen. Essential advantages of the rapid atrial stimulation are the additional diagnostic information by the intracardiac ecg, the dispensable narcosis, the independence of a simultaneous medicamentous treatment, and the use in cases of sick sinus syndrome, too.

[Diagnosis of sick sinus syndrome: sinus node recovery time as a bedside-investigation (author's transl)]. / Zur Diagnose des Sinusknotensyndroms.

Prolonged sinus node recovery time is the most important diagnostic parameter of the sick sinus syndrome. In consideration of the therapeutic proceeding (antiarrhythmic drugs, pacemaker implantation or combination of these two therapeutic measures) an exact diagnostic proceeding is desirable. In 103 atrial stimulations we found in 42 cases a prolonged sinus node recovery time. There are shown details, which make the atrial stimulation practicable as a bedside-investigation.

[Studies on the differential diagnosis of carotid sinus syndrome and sick sinus syndrome (author's transl)]. / Beitrag zur Differentialdiagnose zwischen Karotissinus- und Sinusknotensyndrom.

55 patients suffering from syncopes or dizziness were investigated by atrial pacing and carotid sinus reflex. In 17 pts. the only pathologic finding was a prolonged sinus node recovery time, in 8 pts. a pathologic carotid sinus reflex. In 7 pts. both pathologic findings were present, a prolonged sinus node recovery time and a pathologic carotid sinus reflex. In 3 pts. suffering from atrial fibrillation in addition a pathologic carotid sinus reflex was found. In 20 pts. the findings were normal. It is concluded that sick sinus syndrome and carotid sinus syndrome are different diseases, which can be separated clearly.