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Silver sulphadiazine plus cerium salts
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Blister fluid and neutrophil chemotaxis Blister fluid has been used in the study of peripheral neutrophil chemotaxis to confirm that ‘chemotaxins’ are present in this fluid as well as in serum. The biological activity of blister fluid was similar to that produced by complement in serum and presumably was due to complement components in the blister fluid. Unlike the findings in serum, no inhibitors of chemotaxis were found in the samples of blister fluid, although it seemed logical to expect to find suppressors in this fluid if they are generated locally by the burn. Deitch E. A., Gelder F. and McDonald J. C. (1982) Biologic effect of blister fluid from thermal injuries on peripheral neutrophil chemotaxis. J. Trauma 22, 129. Silver sulphadiazine plus cerium salts Silver sulphadiazine with and without cerium salts was activity against tested in vitro for antimicrobial micro-organisms isolated from burn wounds. Compared to the effect of silver sulphadiazine alone, the addition of cerium salts generally reduced the diameter of the antimicrobial inhibitory zones around susceptible organisms. Sometimes complete nullification of the activity of the silver sulphadiazine was observed. Holder I. A. (1982) In vitro inactivation ofsilver sulphadiazine by the addition of cerium salts. Burns 8, 274. I mmunosuppression and T lymphocytes There is an impaired lymphocyte reactivity to phytohaemagglutinin and concanavalin A in burned patients with no evidence of sepsis when the burned area exceeds 20 per cent of the body surface. This hyporesponsiveness appeared 3-4 days after burning and was maximal by 7-8 days. Recovery occurred between 11 and 29 days depending on the severity of the bum. The serum from immunodepressed patients inhibited the response to phytohaemagglutinin and concanavalin A of normal lymphocytes. This immunosuppressive activity was present on the first or second day after burning and before the onset of lymphocyte hyporesponsiveness to mitogens and was no
Burns
Vol. g/No.
1
longer detectable on days 7-8 post bum, when patient lymphocytes showed the greatest hyporesponsiveness to the mitogens. This late depression was due to suppressor T cells. Campa M., Benedettini G., DeLibero G. et al. (1982) The suppressive activity of T lymphocytes and serum factors in burned patients. Burns 8,23 1. Studies of immune defence mechanisms Chemoluminigenic substrates have been used in the study of serum opsonic capacity and granulocyte oxygenation activity in 35 patients with bums covering 2-93 per cent of the body surface area. Alterations in granulocyte oxygenation activity were observed at the time of changes in clinical condition and sepsis was associated with a marked decrease in activity. An initial depression in opsonic capacity was noted at the time of admission of patients with bums exceeding 40 per cent of the body surface. Thereafter depression of opsonic capacity was temporally associated with sepsis. Allen R. C. and Pruitt B. A. (1982) Humoralphagocyte axis of immune defense in bum patients: chemiluminigenic probing. Arch. Surg. 117, 133.
SURGICAL TECHNIQUES Excisions with a heated scalpel A new type of scalpel with a thermostatically controlled heated cutting edge has been used for the tangential or full-thickness skin loss excision of bums. The control mechanism compensates quickly for varying rates of heat loss depending on the vascularity of the tissues and the rate of cutting. The heated scalpel has allowed excision of burned tissue in pigs and humans with much smaller blood loss than when the usual cold surgical scalpel is used. Graft take was at least as successful using the heated scalpel as with the usual cold scalpel. Levenson S. M., Gruber D. K., Grpber C. et al. (1982) A hemostatic scalpel for bum debridement. Arch. Surg. 117,213.
Blister fluid and neutrophil chemotaxis Blister fluid has been used in the study of peripheral neutrophil chemotaxis to confirm that ‘chemotaxins’ are present in this fluid as well as in serum. The biological activity of blister fluid was similar to that produced by complement in serum and presumably was due to complement components in the blister fluid. Unlike the findings in serum, no inhibitors of chemotaxis were found in the samples of blister fluid, although it seemed logical to expect to find suppressors in this fluid if they are generated locally by the burn. Deitch E. A., Gelder F. and McDonald J. C. (1982) Biologic effect of blister fluid from thermal injuries on peripheral neutrophil chemotaxis. J. Trauma 22, 129. Silver sulphadiazine plus cerium salts Silver sulphadiazine with and without cerium salts was activity against tested in vitro for antimicrobial micro-organisms isolated from burn wounds. Compared to the effect of silver sulphadiazine alone, the addition of cerium salts generally reduced the diameter of the antimicrobial inhibitory zones around susceptible organisms. Sometimes complete nullification of the activity of the silver sulphadiazine was observed. Holder I. A. (1982) In vitro inactivation ofsilver sulphadiazine by the addition of cerium salts. Burns 8, 274. I mmunosuppression and T lymphocytes There is an impaired lymphocyte reactivity to phytohaemagglutinin and concanavalin A in burned patients with no evidence of sepsis when the burned area exceeds 20 per cent of the body surface. This hyporesponsiveness appeared 3-4 days after burning and was maximal by 7-8 days. Recovery occurred between 11 and 29 days depending on the severity of the bum. The serum from immunodepressed patients inhibited the response to phytohaemagglutinin and concanavalin A of normal lymphocytes. This immunosuppressive activity was present on the first or second day after burning and before the onset of lymphocyte hyporesponsiveness to mitogens and was no
Burns
Vol. g/No.
1
longer detectable on days 7-8 post bum, when patient lymphocytes showed the greatest hyporesponsiveness to the mitogens. This late depression was due to suppressor T cells. Campa M., Benedettini G., DeLibero G. et al. (1982) The suppressive activity of T lymphocytes and serum factors in burned patients. Burns 8,23 1. Studies of immune defence mechanisms Chemoluminigenic substrates have been used in the study of serum opsonic capacity and granulocyte oxygenation activity in 35 patients with bums covering 2-93 per cent of the body surface area. Alterations in granulocyte oxygenation activity were observed at the time of changes in clinical condition and sepsis was associated with a marked decrease in activity. An initial depression in opsonic capacity was noted at the time of admission of patients with bums exceeding 40 per cent of the body surface. Thereafter depression of opsonic capacity was temporally associated with sepsis. Allen R. C. and Pruitt B. A. (1982) Humoralphagocyte axis of immune defense in bum patients: chemiluminigenic probing. Arch. Surg. 117, 133.
SURGICAL TECHNIQUES Excisions with a heated scalpel A new type of scalpel with a thermostatically controlled heated cutting edge has been used for the tangential or full-thickness skin loss excision of bums. The control mechanism compensates quickly for varying rates of heat loss depending on the vascularity of the tissues and the rate of cutting. The heated scalpel has allowed excision of burned tissue in pigs and humans with much smaller blood loss than when the usual cold surgical scalpel is used. Graft take was at least as successful using the heated scalpel as with the usual cold scalpel. Levenson S. M., Gruber D. K., Grpber C. et al. (1982) A hemostatic scalpel for bum debridement. Arch. Surg. 117,213.