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Haptoglobin therapy
146
Burns
(1985) 12,146148
Printedin
GreatBritain
Abstracts dressings for treatment Surg. 120, 743.
CLINICAL STUDIES Granulocytes
in fatal and non-fatal
burns
Measurements of the number of granulocyte stem cells (CFU-C) in peripheral blood from non-surviving and surviving patients indicates increasing numbers of cells in the survivors (to supra normal values) compared with falling numbers in the fatally burned patients. In these latter patients there may be a defect in stem cell production and/or cell differentiation. Peterson V. M., Robinson W. A., Wallner S. F. et al. (1985) Granulocyte stem cells are decreased in humans with fatal burns. J. Trauma 25, 413.
Amino acid input and metabolism The daily administration of either 18g amino acids per day or only 9.2 g per day or only isocaloric amounts of carbohydrate and fat were compared in patients with burns covering over 30 per cent of the body surface area. Significantly increased urinary excretion and intracellular muscle tissue concentrations of methionine were found in patients receiving the larger input of amino acids, probably reflecting a combined effect of both the injury and the large input. These patients also showed a reduced oxidation of sulphur amino acids to inorganic sulphate, a reflection of increased protein synthesis. The urinary excretion of 3-methyl histidine and mercaptolactate was significantly reduced in the patients receiving the large input of amino acidsprobably reflecting a reduced rate of body protein breakdown. Martensson J., Larsson J. and Schildt B. (1985) Metabolic effects of amino acid solutions in severely burned patients, with emphasis on sulfur amino acid metabolism and protein breakdown. Stand. J. Plust. Reconstr. Surg. 25, 427.
Comparison
of donor site dressings
The skin donor sites in 31 patients with burns which covered between 2 and 38.5 per cent of the body surface area were treated with either Biobrane or Scarlet Red. Biobrane was superior to Scarlet Red with respect to control of pain, accumulation of exudate beneath the dressings and time to complete healing. Both dressings were comparable with respect to adherence to the wound, the nature of the subdressing exudate and the incidence of cellulitis. Zapata-Sirvent R., Hansbrough J. F., Carroll W. et al. (1985) Comparison of Biobrane and Scarlet Red
Haptoglobin
of donor
site wounds.
Arch.
therapy
A study in ten patients with burns covering between 19 and 87.5 per cent of the body surface assessed the efficacy of haptoglobin transfusions in patients with haemoglobinuria. It was found that as long as free haemoglobin was present in the plasma, free haptoglobin could not be detected. The transfusion of haptoglobin caused a prompt fall in the level of plasma haemoglobin compared with the statistically significant persistence of free plasma haemoglobin in the control untreated patients. Some patients among those receiving transfusions of haptoglobin showed prolonged free haemoglobin in plasma and urine, which might have cleared had more haptoglobin been given. Yoshioka T., Sugiomoto T., Ukai T. et al. (1985) Haptoglobin therapy for possible prevention of renal failure following thermal injury. A clinical study. J. Trauma 25, 281.
Use of skeletal immobilization Sixty-eight burned hands were treated using skeletal immobilization. The best results were obtained with wounds that were circumferential or extended on to the forearm. Serious infective complications directly attributable to the skeletal traction were rare and peripheral nerve and arterial injuries were not observed. The technique appears to be safe and results in excellent sheet graft take and hand function; it is, however, not recommended when joints or tendons are involved or when the hand is easily splinted. Harnar T.. Enurav L.. Heimbach D. et al. (1985) Experience with gkeletal immobilisation after excision and grafting of severely burned hands. J. Trauma 25, 299.
Limiting wound aeruginosa
contamination
with
Ps.
A controlled trial in 65 patients with burns covering more than 15 per cent of the body surface area tested the effects of either 0.05 per cent chlorhexidine for bathing burn wounds or the topical application of a cream containing cerium nitrate and silver sulphadiazine. With respect to contamination of the wounds with Ps. aeruginosa, the cream containing cerium nitrate and silver sulphadiazine resulted in significantly less contamination than did treatment with chlorhexidine. The adherent eschar produced by treatment with
Burns
(1985) 12,146148
Printedin
GreatBritain
Abstracts dressings for treatment Surg. 120, 743.
CLINICAL STUDIES Granulocytes
in fatal and non-fatal
burns
Measurements of the number of granulocyte stem cells (CFU-C) in peripheral blood from non-surviving and surviving patients indicates increasing numbers of cells in the survivors (to supra normal values) compared with falling numbers in the fatally burned patients. In these latter patients there may be a defect in stem cell production and/or cell differentiation. Peterson V. M., Robinson W. A., Wallner S. F. et al. (1985) Granulocyte stem cells are decreased in humans with fatal burns. J. Trauma 25, 413.
Amino acid input and metabolism The daily administration of either 18g amino acids per day or only 9.2 g per day or only isocaloric amounts of carbohydrate and fat were compared in patients with burns covering over 30 per cent of the body surface area. Significantly increased urinary excretion and intracellular muscle tissue concentrations of methionine were found in patients receiving the larger input of amino acids, probably reflecting a combined effect of both the injury and the large input. These patients also showed a reduced oxidation of sulphur amino acids to inorganic sulphate, a reflection of increased protein synthesis. The urinary excretion of 3-methyl histidine and mercaptolactate was significantly reduced in the patients receiving the large input of amino acidsprobably reflecting a reduced rate of body protein breakdown. Martensson J., Larsson J. and Schildt B. (1985) Metabolic effects of amino acid solutions in severely burned patients, with emphasis on sulfur amino acid metabolism and protein breakdown. Stand. J. Plust. Reconstr. Surg. 25, 427.
Comparison
of donor site dressings
The skin donor sites in 31 patients with burns which covered between 2 and 38.5 per cent of the body surface area were treated with either Biobrane or Scarlet Red. Biobrane was superior to Scarlet Red with respect to control of pain, accumulation of exudate beneath the dressings and time to complete healing. Both dressings were comparable with respect to adherence to the wound, the nature of the subdressing exudate and the incidence of cellulitis. Zapata-Sirvent R., Hansbrough J. F., Carroll W. et al. (1985) Comparison of Biobrane and Scarlet Red
Haptoglobin
of donor
site wounds.
Arch.
therapy
A study in ten patients with burns covering between 19 and 87.5 per cent of the body surface assessed the efficacy of haptoglobin transfusions in patients with haemoglobinuria. It was found that as long as free haemoglobin was present in the plasma, free haptoglobin could not be detected. The transfusion of haptoglobin caused a prompt fall in the level of plasma haemoglobin compared with the statistically significant persistence of free plasma haemoglobin in the control untreated patients. Some patients among those receiving transfusions of haptoglobin showed prolonged free haemoglobin in plasma and urine, which might have cleared had more haptoglobin been given. Yoshioka T., Sugiomoto T., Ukai T. et al. (1985) Haptoglobin therapy for possible prevention of renal failure following thermal injury. A clinical study. J. Trauma 25, 281.
Use of skeletal immobilization Sixty-eight burned hands were treated using skeletal immobilization. The best results were obtained with wounds that were circumferential or extended on to the forearm. Serious infective complications directly attributable to the skeletal traction were rare and peripheral nerve and arterial injuries were not observed. The technique appears to be safe and results in excellent sheet graft take and hand function; it is, however, not recommended when joints or tendons are involved or when the hand is easily splinted. Harnar T.. Enurav L.. Heimbach D. et al. (1985) Experience with gkeletal immobilisation after excision and grafting of severely burned hands. J. Trauma 25, 299.
Limiting wound aeruginosa
contamination
with
Ps.
A controlled trial in 65 patients with burns covering more than 15 per cent of the body surface area tested the effects of either 0.05 per cent chlorhexidine for bathing burn wounds or the topical application of a cream containing cerium nitrate and silver sulphadiazine. With respect to contamination of the wounds with Ps. aeruginosa, the cream containing cerium nitrate and silver sulphadiazine resulted in significantly less contamination than did treatment with chlorhexidine. The adherent eschar produced by treatment with