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Prevention and management of visceral complications in severely burned shipman patients
Burns 3 3 S ( 2 0 0 7 ) S1–S172
S31
the respiratory tract injury of sulfur dioxide and nitrogen oxides, the methylene blue and sodium hyposulfite have no effect of detoxification. It is of great use that the burn wound receives exposure therapy with silver sulfadiazine. doi:10.1016/j.burns.2006.10.074 Prevention and management of visceral complications in severely burned shipman patients Chen Xue-Lin a,b a
Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, PR China Burns Centre, Changhai Hospital, Second Military Medical University, Shanghai, PR China E-mail address: [email protected].
b
Objective: To investigate the prevention methods and management of visceral complications in severely burned shipman patients. Methods: A retrospective review was undertaken to analyze the incidence and management of visceral complications in 31 severely burned shipman patients who admitted to our center during the period from February 1997 to May 2000. Thirty-two male-, age-, TBSA- and full thickness-matched non-shipman burns patients were selected randomly to form the control group. Results: The incidence of ARDS, stress ulcer bleeding and hepatic failure in shipman burns patients was 32.3%, 19.4% and 38.7% respectively, all of which were significantly higher than those in non-shipman burns patients. The generalized measures that emphasized on prior prevention methods were utilized to deal with the visceral complications. There were 30 cure and 1 death in shipman burns group, while all 32 non-shipman burns patients were cured. There was no significant difference in survival rate between two groups. Conclusion: Although there was a higher incidence of visceral complications, a satisfactory outcome of the shipman burns can be achieved under condition that the generalized measures that emphasized on prior prevention methods are undertaken. doi:10.1016/j.burns.2006.10.075 Co-graft of microporous xenogeneic acellular dermal matrix and autologous micoskin in the functional site with deep burns—A preliminary result Chen Xue-Lin a,b a
Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, PR China Burns Centre, Changhai Hospital, Second Military Medical University, Shanghai, PR China E-mail address: [email protected].
b
Objective: To investigate the effect of co-graft of microporous xenogeneic acellular dermal matrix (ADM) and autologous micoskin in the functional site with deep burns. Methods: Fresh pig skin was treated with Dispase ¢o` and detergent solution Triton X-100 to get xenogeneic ADM. Then the ADM was mechanically punched to make regular pores ranged from 500–800¦I`m in diameter, separated by a distance of 3–5 mm. The functional site was early excised followed by coverage with co-graft of microporous ADM and autologous micoskin, where as the opposite functional site was severed as control and covered with autologous micoskin only. The outcome measures were time of wound healing, the functional status, and scar quality. Results: Reject reaction was not found in all patients. There were no significant differences in wound healing time between groups. According to the histological analysis at 2 months post-burn, epidermis were continuous and intact and the dermal matrix was a kind of matrix with normal structure and organization of collagen without any cellular components. The skin was smooth and has a good elasticity and no blister or ulcer in the co-graft group. Scar quality and joint function was found to be significantly improved in the co-graft treatment group. Conclusion: Co-graft of microporous xenogeneic ADM and autologous micoskin represents a superior method for the functional site with deep burns. doi:10.1016/j.burns.2006.10.076 Surgical decision making based in an algorithm of clinical findings and monitoring alternatives for peripheral circumferencial burns of the extremities Piccolo P.P., Alves N.M.B., Piccolo N.P., Piccolo-Daher R., Piccolo-Daher S., Piccolo-Lobo R., Meirelles R.P.C., Piccolo M.T.S., Piccolo M.S., Piccolo N.S. ˆ ´ Brazil Pronto Socorro Para Queimaduras, Goiania, Goias, E-mail address: nelson [email protected] (N.P. Piccolo). Peripheral burns may require escaratomy, or even fasciotomy, to release pressure upon local tissues and to warrant improvement in circulation, for maintenance of perfusion to noble tissues such as nerves and small muscles in the hands and/or feet. Occasion-
S31
the respiratory tract injury of sulfur dioxide and nitrogen oxides, the methylene blue and sodium hyposulfite have no effect of detoxification. It is of great use that the burn wound receives exposure therapy with silver sulfadiazine. doi:10.1016/j.burns.2006.10.074 Prevention and management of visceral complications in severely burned shipman patients Chen Xue-Lin a,b a
Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, PR China Burns Centre, Changhai Hospital, Second Military Medical University, Shanghai, PR China E-mail address: [email protected].
b
Objective: To investigate the prevention methods and management of visceral complications in severely burned shipman patients. Methods: A retrospective review was undertaken to analyze the incidence and management of visceral complications in 31 severely burned shipman patients who admitted to our center during the period from February 1997 to May 2000. Thirty-two male-, age-, TBSA- and full thickness-matched non-shipman burns patients were selected randomly to form the control group. Results: The incidence of ARDS, stress ulcer bleeding and hepatic failure in shipman burns patients was 32.3%, 19.4% and 38.7% respectively, all of which were significantly higher than those in non-shipman burns patients. The generalized measures that emphasized on prior prevention methods were utilized to deal with the visceral complications. There were 30 cure and 1 death in shipman burns group, while all 32 non-shipman burns patients were cured. There was no significant difference in survival rate between two groups. Conclusion: Although there was a higher incidence of visceral complications, a satisfactory outcome of the shipman burns can be achieved under condition that the generalized measures that emphasized on prior prevention methods are undertaken. doi:10.1016/j.burns.2006.10.075 Co-graft of microporous xenogeneic acellular dermal matrix and autologous micoskin in the functional site with deep burns—A preliminary result Chen Xue-Lin a,b a
Department of Burns, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, PR China Burns Centre, Changhai Hospital, Second Military Medical University, Shanghai, PR China E-mail address: [email protected].
b
Objective: To investigate the effect of co-graft of microporous xenogeneic acellular dermal matrix (ADM) and autologous micoskin in the functional site with deep burns. Methods: Fresh pig skin was treated with Dispase ¢o` and detergent solution Triton X-100 to get xenogeneic ADM. Then the ADM was mechanically punched to make regular pores ranged from 500–800¦I`m in diameter, separated by a distance of 3–5 mm. The functional site was early excised followed by coverage with co-graft of microporous ADM and autologous micoskin, where as the opposite functional site was severed as control and covered with autologous micoskin only. The outcome measures were time of wound healing, the functional status, and scar quality. Results: Reject reaction was not found in all patients. There were no significant differences in wound healing time between groups. According to the histological analysis at 2 months post-burn, epidermis were continuous and intact and the dermal matrix was a kind of matrix with normal structure and organization of collagen without any cellular components. The skin was smooth and has a good elasticity and no blister or ulcer in the co-graft group. Scar quality and joint function was found to be significantly improved in the co-graft treatment group. Conclusion: Co-graft of microporous xenogeneic ADM and autologous micoskin represents a superior method for the functional site with deep burns. doi:10.1016/j.burns.2006.10.076 Surgical decision making based in an algorithm of clinical findings and monitoring alternatives for peripheral circumferencial burns of the extremities Piccolo P.P., Alves N.M.B., Piccolo N.P., Piccolo-Daher R., Piccolo-Daher S., Piccolo-Lobo R., Meirelles R.P.C., Piccolo M.T.S., Piccolo M.S., Piccolo N.S. ˆ ´ Brazil Pronto Socorro Para Queimaduras, Goiania, Goias, E-mail address: nelson [email protected] (N.P. Piccolo). Peripheral burns may require escaratomy, or even fasciotomy, to release pressure upon local tissues and to warrant improvement in circulation, for maintenance of perfusion to noble tissues such as nerves and small muscles in the hands and/or feet. Occasion-