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Cold water treatment
Burns, 8, 375-376
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Abstracts CLINICAL STUDIES Artificial skin An artificial skin consisting of a temporary silastic epidermis and a porous collagen chondroitin-6sulphate fibrillar dermis has been applied to the excised burned area of IO patients with burns covering more than half the body surface area. The artificial dermis resembles normal dermis for sufficiently long before it is catabolized to serve as a template for the synthesis of new connective tissue. This artificial skin closed the burned wound in a physiological sense for periods of up to 46 days before removal of the silastic epidermis so that autografting could then take place by reharvesting donor sites. Use of this artificial skin was associated with acceutible functional and cosmetic results. It can be easily sterilized and stored at room temperature and is capable oflarge-scale production. Burke J. F.. Yannas 1. V.. Ouinbv W. C. et al. (1981) Successful use of a physiologkally acceptable artificial skin in the treatment of extensive burn injury. Ann. sirrg. 194,4 I 3, Carnitine excretion The urinary excretion of total and free carnitine (3-hydroxy-4-trimethylaminobutyrate) was studied in I4 patients with burns covering between 30 and 90 per cent of the body surface area. This compound. which shuttles long-chain fatty acids across the acyl-CoA barrier of mitochondria was found at 6-fold increased concentrations compared with normal on the second day after burning and was still supranormal during the second and subsequent weeks. There was a significant direct relationship between the area of the burn and the mean rate of excretion during the first 8 days after burning. and a significant negative correlation between the ratios of acyl carnitine to free and total carnitine levels in the urine. Cederblad G., Larsson J.. Nordstrom H. et al. (I 98 I ) Urinary excretion of carnitine in burned patients. B~trr1.s8, 102. ANIMAL STUDIES Cold water treatment Immediate treatment of a scald of mouse ear skin with cold water (8-10 “C) resulted in only brief periods of arterlolar vasomotion and shortened the duration of
the venular dilatation by about 50 per cent. Compared with the findings in tissues not cooled, there was also reduced oedema formation in the burned tissues and no remote oedema formation in unburned tissues. This absence of remote oedema formation could also be produced by administration of cimetidine or depletion of tissue histamine content prior to burning. Cold water treatment significantly decreased tissue histamine loss from the burned tissues after injury presumably through inhibition of local and systemic histamine release. Boykin J. V.. Eriksson E.. Sholley M. M. et al. (I 98 I) Cold water treatment of scald injury and inhibition of histamine mediated burn edema. J. Snr,~. Rex 31, 1 I 1 Zinc distribution in burns Studies of the distribution of zinc using h5Zn have been made in rabbits with burns covering 20 per cent of the body surface. Soon after injury there was a rapid uptake of “$Zn into the spleen, the lungs. the wound, the kidneys and particularly into the liver, while the uptake of radioactive zinc was decreased in the brain. some muscle groups and particularly in bone. The zinc in plasma was bound to the albumin fraction. both of which decreased. The total amount of zinc appearing in the wound was considerably less than that in the liver, where the induction of a zinc-binding protein was shown in the cytosol. The synthesis of this protein may have an important regulatory role in zinc distribution following injury. Both bone and muscle appear to be labile sources ofzinc when the need for this ion is acute. van Rij A. M., Hall M. T.. Bray J. T. et al. (198 I) Zinc as an integral component of the metabolic response to trauma. Srrr~. GytmwI Oh.st~r 153,677. Histology of wounds covered with auto-
grafts and allografts
Intermingled autografts and allografts were applted to skin wounds in adult rabbits. Histoloaical studies of biopsies taken at the junction between the two types of grafts and midway between the autografts at 3-day intervals for 40 davs after transnlantation showed the rejection ofthe superficial allografts at the beginning of the second week following transplantation. The autograft epithelium rapidly grew into the space created in
Printedin
375
Great Britain
Abstracts CLINICAL STUDIES Artificial skin An artificial skin consisting of a temporary silastic epidermis and a porous collagen chondroitin-6sulphate fibrillar dermis has been applied to the excised burned area of IO patients with burns covering more than half the body surface area. The artificial dermis resembles normal dermis for sufficiently long before it is catabolized to serve as a template for the synthesis of new connective tissue. This artificial skin closed the burned wound in a physiological sense for periods of up to 46 days before removal of the silastic epidermis so that autografting could then take place by reharvesting donor sites. Use of this artificial skin was associated with acceutible functional and cosmetic results. It can be easily sterilized and stored at room temperature and is capable oflarge-scale production. Burke J. F.. Yannas 1. V.. Ouinbv W. C. et al. (1981) Successful use of a physiologkally acceptable artificial skin in the treatment of extensive burn injury. Ann. sirrg. 194,4 I 3, Carnitine excretion The urinary excretion of total and free carnitine (3-hydroxy-4-trimethylaminobutyrate) was studied in I4 patients with burns covering between 30 and 90 per cent of the body surface area. This compound. which shuttles long-chain fatty acids across the acyl-CoA barrier of mitochondria was found at 6-fold increased concentrations compared with normal on the second day after burning and was still supranormal during the second and subsequent weeks. There was a significant direct relationship between the area of the burn and the mean rate of excretion during the first 8 days after burning. and a significant negative correlation between the ratios of acyl carnitine to free and total carnitine levels in the urine. Cederblad G., Larsson J.. Nordstrom H. et al. (I 98 I ) Urinary excretion of carnitine in burned patients. B~trr1.s8, 102. ANIMAL STUDIES Cold water treatment Immediate treatment of a scald of mouse ear skin with cold water (8-10 “C) resulted in only brief periods of arterlolar vasomotion and shortened the duration of
the venular dilatation by about 50 per cent. Compared with the findings in tissues not cooled, there was also reduced oedema formation in the burned tissues and no remote oedema formation in unburned tissues. This absence of remote oedema formation could also be produced by administration of cimetidine or depletion of tissue histamine content prior to burning. Cold water treatment significantly decreased tissue histamine loss from the burned tissues after injury presumably through inhibition of local and systemic histamine release. Boykin J. V.. Eriksson E.. Sholley M. M. et al. (I 98 I) Cold water treatment of scald injury and inhibition of histamine mediated burn edema. J. Snr,~. Rex 31, 1 I 1 Zinc distribution in burns Studies of the distribution of zinc using h5Zn have been made in rabbits with burns covering 20 per cent of the body surface. Soon after injury there was a rapid uptake of “$Zn into the spleen, the lungs. the wound, the kidneys and particularly into the liver, while the uptake of radioactive zinc was decreased in the brain. some muscle groups and particularly in bone. The zinc in plasma was bound to the albumin fraction. both of which decreased. The total amount of zinc appearing in the wound was considerably less than that in the liver, where the induction of a zinc-binding protein was shown in the cytosol. The synthesis of this protein may have an important regulatory role in zinc distribution following injury. Both bone and muscle appear to be labile sources ofzinc when the need for this ion is acute. van Rij A. M., Hall M. T.. Bray J. T. et al. (198 I) Zinc as an integral component of the metabolic response to trauma. Srrr~. GytmwI Oh.st~r 153,677. Histology of wounds covered with auto-
grafts and allografts
Intermingled autografts and allografts were applted to skin wounds in adult rabbits. Histoloaical studies of biopsies taken at the junction between the two types of grafts and midway between the autografts at 3-day intervals for 40 davs after transnlantation showed the rejection ofthe superficial allografts at the beginning of the second week following transplantation. The autograft epithelium rapidly grew into the space created in