WorldWideScience

Sample records for superficial partial-thickness burns

  1. Orofacial contracture management outcomes following partial thickness facial burns.

    Science.gov (United States)

    Clayton, N A; Ward, E C; Maitz, P K M

    2015-09-01

    To examine clinical outcomes following non-surgical exercise for contracture management post partial thickness orofacial burn. A cohort of 229 patients with partial thickness orofacial burn was recruited over 3 years. Orofacial contracture management combining exercise and stretching was initiated within 48h of admission and continued until functional goals were consistently achieved. A second cohort of 120 healthy controls was recruited for normative comparison. Vertical and horizontal mouth opening measures were recorded at the start and completion of orofacial intervention for patients and once only for controls. At commencement of intervention, participants with orofacial burns had significantly (porofacial contracture management for patients with partial thickness orofacial burn. Despite this, some functional loss remained with patients demonstrating persistent reduced vertical mouth opening at conclusion of treatment compared to their healthy counterparts. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  2. Steel Wool-Aided Dermabrasion of Deep Partial-Thickness Burns.

    Science.gov (United States)

    Yontar, Yalcin; Coruh, Atilla; Dinc, Nadire; Kontas, Olgun

    2016-10-07

    Early tangential excision of the burn wound is essential for removal of necrotic tissue and promotion of burn wound healing process. However, the depth of the burn wound is not easily assessed during the tangential excision performed by hand-held dermatomes, and it may be possible to excise unburned vital dermis unnecessarily, which aids in primary epithelization of the burn wound by adnexal structures. We herein present early clinical results of steel wool-aided dermabrasion in patients with deep partial-thickness burns. This is a retrospective case study of 23 consecutive hospitalized patients with deep partial-thickness burns. All of the steel wool-aided dermabrasions were performed under general anesthesia within 48 hours after injury. Patients were excluded from the study if the admission was not within 24 hours after injury, and if the burn wound was entirely superficial partial- or full-thickness. Thirteen male and 10 female patients with a mean age of 26.2 ± 17.1 years were enrolled in the study. During the follow-up period, all of the patients had burn wounds primary epithelized on postburn day 15.1 ± 1.8, without any complications. None of the patients exhibited a mortal course, and redebridement or skin grafting of the previously dermabraded deep partial-thickness burn wounds were not required in any of the patients. Steel wool-aided dermabrasion is an easy, cost-effective, and reliable technique for the treatment of deep partial-thickness burns, which provides complete removal of necrotic tissue, preserves the vital dermis, reduces the requirement for skin grafting, and decreases length of hospital stay.

  3. Use of Suprathel® for partial thickness burns in children.

    Science.gov (United States)

    Highton, Lyndsey; Wallace, Christopher; Shah, Mamta

    2013-02-01

    We evaluated the use of Suprathel(®), a synthetic skin substitute, for partial thickness burns in children. Thirty-three children (20 females, 13 males; mean age 29 months, range 5 months to 11 years) with burns were treated with Suprathel(®). The burns were superficial partial thickness (n=24) or mid-dermal (n=19); the median %TBSA was 4% (range 1-13%). Suprathel(®) was applied after debridement, followed by Vaseline gauze, dry gauze and crepe bandage. The outer dressings were changed every 5-10 days unless clinical problems dictated otherwise. Median healing time was 16 days (range 9-38 days). Ten patients took longer than 21 days to heal, of whom four developed hypertrophic scarring, which was strongly associated with wound infection (pburns was not significantly different (p=0.494). Suprathel(®) is an effective skin substitute for the treatment of partial thickness burns in children. The majority of burns in children are mixed depth, and Suprathel(®) has the advantage that it may also be used to treat mid-dermal burns. It behaves like a biological dressing but is not animal derived, so is acceptable to all religious and ethnic groups. Further studies to evaluate the efficacy and cost effectiveness of Suprathel(®) compared to other dressings in children are warranted. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  4. Optimal treatment of partial thickness burns in children: a systematic review.

    Science.gov (United States)

    Vloemans, A F P M; Hermans, M H E; van der Wal, M B A; Liebregts, J; Middelkoop, E

    2014-03-01

    A large part of the patient population of a burn centre consists of children, most of whom are younger than four years. The majority of these young children suffer from superficial and deep partial thickness scald burns that may easily deepen to full thickness burns. A proper wound therapy, that prevents infection and ensures a moist wound condition, might prevent the deterioration of the wound. Therefore, we performed a systematic review of wound management and dressing materials to select the best treatment option for children with burns. A search in Medline and Embase revealed 51 articles for a critical appraisal. The articles were divided into randomized controlled trials, cohort studies and a group of case-reports. Total appraisal did not differ much amongst the groups; the level of evidence was highest in the randomized controlled trials and lowest in the case-reports. In 16 out of 34 comparative studies, silver sulfadiazine or a silver sulfadiazine/chlorhexidine-gluconate combination was the standard of wound care treatment. The competitor dressing was Biobrane(®) in six studies and amnion membrane in three. Tulle gauze, or tulle gauze impregnated with an antibacterial addition were the standard of care treatment in seven studies. In general, membranous dressings like Biobrane(®) and amnion membrane performed better than the standard of care on epithelialization rate, length of hospital stay and pain for treatment of partial thickness burns in children. However, hardly any of the studies investigated long-term results like scar formation.

  5. Partial-thickness corneal tissue restoration after a chemical burn

    Directory of Open Access Journals (Sweden)

    Galan A

    2016-04-01

    Full Text Available Alessandro Galan, Anton Giulio Catania, Giuseppe Lo Giudice San Paolo Ophthalmic Center, San Antonio Hospital, Padova, Italy Purpose: We describe a case of full-thickness corneal restoration after an acute corneal burn with an acid agent. Methods: A 32-year-old male reported painful discomfort, redness, photophobia, and a decrease in visual acuity in the left eye after a unilateral burn with an acid agent. Slit-lamp examination revealed massive corneal melting involving necrotic sequestrum of the entire corneal surface. Surgical approach was carried out in order to preserve residual ocular tissues. Results: Extensive corneal–conjunctival layer curettage of the necrotic tissue was performed showing perfectly clear undamaged deep lamellar corneal layers. The patient underwent multilayered amniotic membrane transplantation and total capsular–conjunctival flap in order to preserve ocular tissue from further melting or corneal perforation. A complete and spontaneous “restitutio ad integrum” of the corneal layers was shown during the follow-up. The cornea was perfectly clear with restored normal anatomical architecture. Conclusion: In this case, a spontaneous full-thickness corneal tissue restoration occurred after an acute chemical burn. Studies about the mechanisms whereby different cells interact and replicate within the stroma may unveil the biology behind corneal regeneration and transparency. Keywords: amniotic membrane, chemical burn, corneal healing

  6. Effect of Topical Platelet-Rich Plasma on Burn Healing After Partial-Thickness Burn Injury.

    Science.gov (United States)

    Ozcelik, Umit; Ekici, Yahya; Bircan, Huseyin Yuce; Aydogan, Cem; Turkoglu, Suna; Ozen, Ozlem; Moray, Gokhan; Haberal, Mehmet

    2016-06-05

    BACKGROUND To investigate the effects of platelet-rich plasma on tissue maturation and burn healing in an experimental partial-thickness burn injury model. MATERIAL AND METHODS Thirty Wistar albino rats were divided into 3 groups of 10 rats each. Group 1 (platelet-rich plasma group) was exposed to burn injury and topical platelet-rich plasma was applied. Group 2 (control group) was exposed to burn injury only. Group 3 (blood donor group) was used as blood donors for platelet-rich plasma. The rats were killed on the seventh day after burn injury. Tissue hydroxyproline levels were measured and histopathologic changes were examined. RESULTS Hydroxyproline levels were significantly higher in the platelet-rich plasma group than in the control group (P=.03). Histopathologically, there was significantly less inflammatory cell infiltration (P=.005) and there were no statistically significant differences between groups in fibroblast development, collagen production, vessel proliferations, or epithelization. CONCLUSIONS Platelet-rich plasma seems to partially improve burn healing in this experimental burn injury model. As an initial conclusion, it appears that platelet-rich plasma can be used in humans, although further studies should be performed with this type of treatment.

  7. The optimal duration and delay of first aid treatment for deep partial thickness burn injuries.

    Science.gov (United States)

    Cuttle, Leila; Kempf, Margit; Liu, Pei-Yun; Kravchuk, Olena; Kimble, Roy M

    2010-08-01

    Using our porcine model of deep dermal partial thickness burn injury, various durations (10min, 20min, 30min or 1h) and delays (immediate, 10min, 1h, 3h) of 15 degrees C running water first aid were applied to burns and compared to untreated controls. The subdermal temperatures were monitored during the treatment and wounds observed weekly for 6 weeks, for re-epithelialisation, wound surface area and cosmetic appearance. At 6 weeks after the burn, tissue biopsies were taken of the scar for histological analysis. Results showed that immediate application of cold running water for 20min duration is associated with an improvement in re-epithelialisation over the first 2 weeks post-burn and decreased scar tissue at 6 weeks. First aid application of cold water for as little as 10min duration or up to 1h delay still provides benefit.

  8. [Application of high-frequency ultrasound in dermabrasion of patients with deep partial-thickness burns].

    Science.gov (United States)

    Zang, C Y; Cao, Y Q; Xue, W J; Zhao, R; Zhang, M; Zhang, Y H; Feng, Z; Wang, Y B

    2017-02-20

    Objective: To investigate the application of high-frequency ultrasound in dermabrasion of patients with deep partial-thickness burns. Methods: Twenty-six patients with deep partial-thickness burns conforming to the study criteria were hospitalized in our unit from March 2015 to March 2016. Patients were all performed with dermabrasion. The structure of skin tissue and blood flow signals of uninjured side and wounds before dermabrasion, and those of wounds immediately post dermabrasion and on post dermabrasion day (PDD) 1, 3, 5, 7, 10, 14, and 21 were detected with high-frequency ultrasound, and the percentage of blood flow signals was calculated. According to the results of comparison between percentage of blood flow signals of wounds and that of normal skin before dermabrasion, patients were divided into no significant decrease group (NSD, n=19) and significant decrease group (SD, n=7). Wound healing time of patients in two groups was recorded. Data were processed with analysis of variance of repeated measurement, LSD test, t test and Chi-square test. The correlation between the percentage of blood flow signals of wounds before dermabrasion and wound healing time of 26 patients were analyzed by Spearman correlation analysis. Results: (1) Epidermis of normal skin of patients in two groups before dermabrasion showed continuous smooth linear hyperecho, which was stronger than that of dermis, and boundary of dermis and subcutaneous tissue showed stronger discontinuous linear echo than that of dermis, which gradually transited to subcutaneous tissue. In group NSD, epidermis of wound of patients before dermabrasion showed intermittent rough linear echo, which was weaker than that of normal skin epidermis, and there was no obvious abnormity of boundary between dermis and subcutaneous tissue. Immediately post dermabrasion and on PDD 1, no linear hyperecho of epidermis was observed, showing complete attrition of epidermis, and the echo of dermis and subcutaneous tissue had

  9. Estimating the time and temperature relationship for causation of deep-partial thickness skin burns.

    Science.gov (United States)

    Abraham, John P; Plourde, Brian; Vallez, Lauren; Stark, John; Diller, Kenneth R

    2015-12-01

    The objective of this study is to develop and present a simple procedure for evaluating the temperature and exposure-time conditions that lead to causation of a deep-partial thickness burn and the effect that the immediate post-burn thermal environment can have on the process. A computational model has been designed and applied to predict the time required for skin burns to reach a deep-partial thickness level of injury. The model includes multiple tissue layers including the epidermis, dermis, hypodermis, and subcutaneous tissue. Simulated exposure temperatures ranged from 62.8 to 87.8°C (145-190°F). Two scenarios were investigated. The first and worst case scenario was a direct exposure to water (characterized by a large convection coefficient) with the clothing left on the skin following the exposure. A second case consisted of a scald insult followed immediately by the skin being washed with cool water (20°C). For both cases, an Arrhenius injury model was applied whereby the extent and depth of injury were calculated and compared for the different post-burn treatments. In addition, injury values were compared with experiment data from the literature to assess verification of the numerical methodology. It was found that the clinical observations of injury extent agreed with the calculated values. Furthermore, inundation with cool water decreased skin temperatures more quickly than the clothing insulating case and led to a modest decrease in the burn extent. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  10. Assessment of Deep Partial Thickness Burn Treatment with Keratin Biomaterial Hydrogels in a Swine Model

    Directory of Open Access Journals (Sweden)

    D. Poranki

    2016-01-01

    Full Text Available Partial thickness burns can advance to full thickness after initial injury due to inadequate tissue perfusion and increased production of inflammatory cytokines, which has been referred to as burn wound progression. In previous work, we demonstrated that a keratin biomaterial hydrogel appeared to reduce burn wound progression. In the present study, we tested the hypothesis that a modified keratin hydrogel could reduce burn wound progression and speed healing. Standardized burn wounds were created in Yorkshire swine and treated within 30 minutes with keratin hydrogel (modified and unmodified, collagen hydrogel, or silver sulfadiazine (SSD. Digital images of each wound were taken for area measurements immediately prior to cleaning and dressing changes. Wound tissue was collected and assessed histologically at several time points. Wound area showed a significant difference between hydrogels and SSD groups, and rates of reepithelialization at early time points showed an increase when keratin treatment was used compared to both collagen and SSD. A linear regression model predicted a time to wound closure of approximately 25 days for keratin hydrogel while SSD treatment required 35 days. There appeared to be no measurable differences between the modified and unmodified formulations of keratin hydrogels.

  11. Effect of Extracorporeal Shock Wave Treatment on Deep Partial-Thickness Burn Injury in Rats: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Gabriel Djedovic

    2014-01-01

    Full Text Available Extracorporeal shock wave therapy (ESWT enhances tissue vascularization and neoangiogenesis. Recent animal studies showed improved soft tissue regeneration using ESWT. In most cases, deep partial-thickness burns require skin grafting; the outcome is often unsatisfactory in function and aesthetic appearance. The aim of this study was to demonstrate the effect of ESWT on skin regeneration after deep partial-thickness burns. Under general anesthesia, two standardized deep partial-thickness burns were induced on the back of 30 male Wistar rats. Immediately after the burn, ESWT was given to rats of group 1 (N=15, but not to group 2 (N=15. On days 5, 10, and 15, five rats of each group were analyzed. Reepithelialization rate was defined, perfusion units were measured, and histological analysis was performed. Digital photography was used for visual documentation. A wound score system was used. ESWT enhanced the percentage of wound closure in group 1 as compared to group 2 (P<0.05. The reepithelialization rate was improved significantly on day 15 (P<0.05. The wound score showed a significant increase in the ESWT group. ESWT improves skin regeneration of deep partial-thickness burns in rats. It may be a suitable and cost effective treatment alternative in this type of burn wounds in the future.

  12. Effect of extracorporeal shock wave treatment on deep partial-thickness burn injury in rats: a pilot study.

    Science.gov (United States)

    Djedovic, Gabriel; Kamelger, Florian Stefan; Jeschke, Johannes; Piza-Katzer, Hildegunde

    2014-01-01

    Extracorporeal shock wave therapy (ESWT) enhances tissue vascularization and neoangiogenesis. Recent animal studies showed improved soft tissue regeneration using ESWT. In most cases, deep partial-thickness burns require skin grafting; the outcome is often unsatisfactory in function and aesthetic appearance. The aim of this study was to demonstrate the effect of ESWT on skin regeneration after deep partial-thickness burns. Under general anesthesia, two standardized deep partial-thickness burns were induced on the back of 30 male Wistar rats. Immediately after the burn, ESWT was given to rats of group 1 (N = 15), but not to group 2 (N = 15). On days 5, 10, and 15, five rats of each group were analyzed. Reepithelialization rate was defined, perfusion units were measured, and histological analysis was performed. Digital photography was used for visual documentation. A wound score system was used. ESWT enhanced the percentage of wound closure in group 1 as compared to group 2 (P < 0.05). The reepithelialization rate was improved significantly on day 15 (P < 0.05). The wound score showed a significant increase in the ESWT group. ESWT improves skin regeneration of deep partial-thickness burns in rats. It may be a suitable and cost effective treatment alternative in this type of burn wounds in the future.

  13. Randomized Controlled Trial of Polyhexanide/Betaine Gel Versus Silver Sulfadiazine for Partial-Thickness Burn Treatment.

    Science.gov (United States)

    Wattanaploy, Saruta; Chinaroonchai, Kusuma; Namviriyachote, Nantaporn; Muangman, Pornprom

    2017-03-01

    Silver sulfadiazine is commonly used in the treatment of partial-thickness burns, but it sometimes forms pseudo-eschar and delays wound healing. Polyhexanide/betaine gel, a new wound cleansing and moisturizing product, has some advantages in removing biofilm and promotes wound healing. This study was designed to compare clinical efficacy of polyhexanide/betaine gel with silver sulfadiazine in partial-thickness burn treatment. From September 2013 to May 2015, 46 adult patients with partial-thickness burn ≥10% total body surface area that were admitted to the Burn Unit of Siriraj Hospital within 48 hours after injury were randomly allocated into 2 groups. One group was treated with polyhexanide/betaine gel, and the other group was treated with silver sulfadiazine. Both groups received daily dressing changes and the same standard care given to patients with burns in this center. Healing times in the polyhexanide/betaine gel group and silver sulfadiazine group were 17.8 ± 2.2 days and 18.8 ± 2.1 days, respectively ( P value .13). There were no significant differences in healing times, infection rates, bacterial colonization rates, and treatment cost in both groups. The pain score of the polyhexanide/betaine gel group was significantly less than the silver sulfadiazine group at 4 to 9 days after treatment ( P polyhexanide/betaine gel group was better than that in the silver sulfadiazine group. These data indicate the need for adequately designed studies to elicit the full potential of polyhexanide gel as a wound dressing for partial-thickness burn wounds.

  14. Preparation of asiaticoside-loaded coaxially electrospinning nanofibers and their effect on deep partial-thickness burn injury.

    Science.gov (United States)

    Zhu, Lifei; Liu, Xiaoyan; Du, Lina; Jin, Yiguang

    2016-10-01

    Sodium alginate and chitosan were in favor of wound healing. However, the two polymers were not compatible in one formulation due to the electrostatic interaction. Coaxially electrospinning technology could make two or more noneletrospun polymers to be electrospun in independent core and shell layer. Asiaticoside-loaded coaxially electrospinning nanofibers of alginate, polyvinyl alcohol (PVA) and chitosan (alginate/PVA/chitosan) were prepared and evaluated. Morphologies and microstructure of nanofibers were observed with scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Drug release in vitro of coaxial nanofibers was also evaluated. Deep partial-thickness burn injury were established and used to evaluate the improved healing effect of asiaticoside-loaded coaxial nanofibers. Drug-loaded coaxial nanofibers prepared with the optimized formulations and technologies had the obvious core-shell structure. Coaxial nanofibers showed faster drug release profiles in vitro and this facilitated wound healing. Its healing effect on rats with deep partial-thickness burn injury was also significant based on morphology, wound healing ratio, and pathological sections. Positive expression of vascular endothelial growth factor (VEGF), cluster of differentiation 31 (CD31), and proliferating cell nuclear antigen (PCNA), and down regulation of tumor necrosis factor (TNF) and interleukin-6 (IL-6) also validated the improved effect of wound healing. In general, the asiaticoside-loaded coaxial nanofibers had obvious core-shell structure with smooth surface and uniform diameter. Its healing effect on deep partial-thickness burn injury of rats was obvious. Asiaticoside-loaded coaxial nanofibers provide a novel promising option for treatment of deep partial-thickness burn injury.

  15. The application of human umbilical cord blood mononuclear cells in the management of deep partial thickness burn

    Directory of Open Access Journals (Sweden)

    Yefta Moenadjat

    2013-05-01

    Full Text Available Background: Wound healing in burn is a complex process and early complete wound closure still enfaces many problems. Application of stem cells is found to be the future method of wound healing. Among the available sources of allogenic stem cells, umbilical cord blood is quite easy to be obtained, has less ethical issue, and contain multipotent stem cells, which are characterized by low immunogenicity. The study aims to evaluate the potential of human umbilical cord blood mononuclear cells (hUCBMNCs treatment in the management of deep partial thickness burns. Methods: Twenty patients with deep partial thickness burns were treated with topical application of 2 x 107 hUCBMNCs and silver sulfadiazine (SSD cream on the comparable wound size in the other sites. The treatments were applied for six times in every two consecutive days. Wound surface area was measured with Visitrak® on day 0, 7, and 11. Pain intensity was evaluated using Wong Baker’s faces scale on each wound dressing change. Histology examination was performed in some samples of collected skin biopsy of the newly re-epithelialized area of hUCBMNCs and SSD-treated wound at the end of treatment. HLA typing is used to evaluate the issue of safety. Wilcoxon signed rank test was used to compare the rate of wound healing. Results: Sixteen patients of hUCBMNCs-treated showed a significant wound closure in faster than SSD-treated; measured on day 7 (p = 0.041 and day 11 (p = 0.021. Number of patients with reduced pain intensity, from approximately scale 3 to 1/0 on day 7 and 11, were higher in hUCBMNCs-treated compared to SSD-treated wound. In spite of the HLA-mismatch, no allergic reaction, rejection, and infection found on hUCBMNCs-treated wound suggested the safety of this therapy. Histology examination found the formation of dermal-epidermal junction and rete ridges equal to the normal skin on hUCBMNCs-treated wounds. Conclusion: hUCBMNCs are effective and safe to promote re

  16. Full and Partial Thickness Burns from Spontaneous Combustion of E-Cigarette Lithium-Ion Batteries with Review of Literature.

    Science.gov (United States)

    Treitl, Daniela; Solomon, Rachele; Davare, Dafney L; Sanchez, Rafael; Kiffin, Chauniqua

    2017-07-01

    In recent years, the use of electronic cigarettes (e-cigarettes) has increased worldwide. Most electronic nicotine delivery systems use rechargeable lithium-ion batteries, which are relatively safe, but in rare cases these batteries can spontaneously combust, leading to serious full and partial thickness burn injuries. Explosions from lithium-ion batteries can cause a flash fire and accelerant-related burn injuries. A retrospective chart review was conducted of 3 patients with lithium-ion battery burns seen at our Level I community-based trauma center. Clinical presentation, management, and outcome are presented. All 3 patients sustained burn injuries (total body surface area range 5-13%) from the spontaneous combustion of lithium-ion batteries used for e-cigarettes. All patients were treated with debridement and local wound care. All fully recovered without sequelae. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians can expect to treat burn cases due to spontaneous lithium-ion battery combustion as e-cigarette use continues to increase. The cases presented here are intended to bring attention to lithium-ion battery-related burns, prepare physicians for the clinical presentation of this burn mechanism, and facilitate patient education to minimize burn risk. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Management of partial thickness burn of the dorsum skin in a 3-year ...

    African Journals Online (AJOL)

    The hair around the burns area was clipped, the wound was debrided and cleansed ... for wound dressing with pure honey® which continued until complete healing was ... re-infection and aided the lesion to proceed to the remodeling phase.

  18. Randomized controlled single center study comparing a polyhexanide containing bio-cellulose dressing with silver sulfadiazine cream in partial-thickness dermal burns.

    Science.gov (United States)

    Piatkowski, A; Drummer, N; Andriessen, A; Ulrich, D; Pallua, N

    2011-08-01

    A prospective, randomized, controlled single center study was designed to evaluate clinical efficacy of a polyhexanide containing bio-cellulose dressing (group B) compared to a silver-sulfadiazine cream (group A) in sixty partial-thickness burn patients. Local ethics committee approval was obtained and patients consented. Parameters were: pain reduction (VAS), healing time and wound bed condition, comparing day 0 (start) versus day 14 (end), as well as, ease of dressing use and treatment costs. All completed the study (n=30/n=30) and were included in the ITT analysis, with a total of 72 burns (group A: n=38, group B: n=34). We noted no differences in healing time. Pain reduction was significantly faster and better in group B (ppolyhexanide containing bio-cellulose dressing to be a safe and cost effective treatment for partial-thickness burns. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

  19. Sustainable antimicrobial effect of silver sulfadiazine-loaded nanosheets on infection in a mouse model of partial-thickness burn injury.

    Science.gov (United States)

    Ito, Keisuke; Saito, Akihiro; Fujie, Toshinori; Nishiwaki, Keisuke; Miyazaki, Hiromi; Kinoshita, Manabu; Saitoh, Daizoh; Ohtsubo, Shinya; Takeoka, Shinji

    2015-09-01

    Partial-thickness burn injury has the potential for reepithelialization and heals within 3weeks. If the wound is infected by bacteria before reepithelization, however, the depth of disruption increases and the lesion easily progresses to the full-thickness dermal layers. In the treatment of partial-thickness burn injury, it is important to prevent the wound area from bacterial infection with an antimicrobial dressing. Here, we have tested the antimicrobial properties of polymeric ultra-thin films composed of poly(lactic acid) (termed "PLA nanosheets"), which have high flexibility, adhesive strength and transparency, and silver sulfadiazine (AgSD), which exhibits antimicrobial efficacy. The AgSD-loaded nanosheet released Ag(+) for more than 3days, and exerted antimicrobial efficacy against methicillin-resistant Staphylococcus aureus (MRSA) in an in vitro Kirby-Bauer test. By contrast, a cell viability assay indicated that the dose of AgSD used in the PLA nanosheets did not show significant cytotoxicity toward fibroblasts. In vivo evaluation using a mouse model of infection in a partial-thickness burn wound demonstrated that the nanosheet significantly reduced the number of MRSA bacteria on the lesion (more than 10(5)-fold) and suppressed the inflammatory reaction, thereby preventing a protracted wound healing process.

  20. A randomized trial comparing ReCell system of epidermal cells delivery versus classic skin grafts for the treatment of deep partial thickness burns.

    Science.gov (United States)

    Gravante, G; Di Fede, M C; Araco, A; Grimaldi, M; De Angelis, B; Arpino, A; Cervelli, V; Montone, A

    2007-12-01

    Our purpose was to directly compare results obtained with the ReCell system and the classic skin grafting for epidermal replacement in deep partial thickness burns. We recruited all patients with deep partial thickness burns admitted at the Burn Centre of S. Eugenio Hospital in Rome over 2 years. Enrollment was conducted with a controlled strategy--sampling chart--that allowed homogeneous groups (ReCell and skin grafting) for age, gender, type of burns and total burn surface area (TBSA). We evaluated as primary endpoints of the study the (i) time for complete epithelization (both treated area and biopsy site) and (ii) aesthetic and functional quality of the epithelization (color, joint contractures). Secondary endpoints were the assessment of infections, inflammations or any adverse effects of the ReCell procedure, particular medications assumed, postoperative pain. Eighty-two patients were analyzed in two homogeneous groups. All of them received adequate epidermal replacement, but skin grafting was faster than ReCell (pskin grafting but, harvesting minor areas, can open possible future applications in the management of large-burns patients.

  1. Semapimod reduces the depth of injury resulting in enhanced re-epithelialization of partial-thickness burns in swine.

    Science.gov (United States)

    Singer, Adam J; McClain, Steve A; Hacht, Gabriele; Batchkina, Galina; Simon, Marcia

    2006-01-01

    Studies suggest that tumor necrosis factor alpha (TNF-alpha) plays a role in burn pathogenesis. We conducted a randomized controlled experiment in swine to determine whether a novel macrophage inhibitor, semapimod (formerly known as CNI-1493), would blunt the local production of TNF-alpha, interleukin (IL)-1, and IL-6 in burns leading to less injury extension and faster re-epithelialization. After creating second-degree burns, animals received one or two intravenous boluses of semapimod 1 mg/kg or normal saline, and all burns were treated with silver sulfadiazine. The depth of follicular necrosis and thrombosis was reduced by either one or two doses of semapimod (P=.04 and .02, respectively). However, no differences were noted between groups in cytokine levels. Depth of scarring was similar in all groups. We conclude that Semapimod reduces the depth of follicular necrosis and thrombosis after second-degree burns in swine, indirectly resulting in more rapid re-epithelialization. However, this affect does not appear to be mediated by reduced local TNF-alpha, IL-1, or IL-6 protein levels.

  2. Treatment of deep partial thickness burns in small burned area by heparin sodimn cream%肝素钠乳膏治疗小面积深Ⅱ度烧伤的临床观察

    Institute of Scientific and Technical Information of China (English)

    王志刚; 胡启翔; 陈秀瑛

    2009-01-01

    Objective To explore the effect of heparin sodium cream on partial thickness burns. Methods From January 2004 to January 2007, fifty-five cases of deep partial thickness in total burned surface area (TBSA) with 1% to 5% burn wound were treated by Heparin sodium cream(the heparin group). Fifty cases of deep partial thickness burned patients with the same TBSA treated by povidone iodine (the povidone iodine group). Results The average healing time of the heparin group was (18.5±2.2) days and the average healing time of the povidone iodine group was (22.5±3.6) days. Follow-ups during 3 months to 1 year after treatment showed that sear proliferation in the heparin group was much less than that in the povidone iodine group, and even no sear proliferation was observed in some patients. Conclusion Heparin sodium cream on deep partial thickness burns with small burned area could shorten the healing time and inhibit sear proliferation.%目的 探讨肝素钠乳膏治疗小面积看深Ⅱ度烧伤创面的临床应用效果.方法 应用肝素钠乳膏治疗1%~5%总烧伤面积深Ⅱ度烧伤患者55例(肝素治疗组),同期保痂治疗1%~5%总烧伤面积深Ⅱ度烧伤患者50例(碘伏治疗组).观察创面愈合时间及愈合质量情况.治愈患者经过3个月~1年随诊,了解瘢痕增生情况.结果 肝素治疗组创面愈合时间为(18.5±2.2)d,碘伏治疗组愈合时问为(22.5±3.6)d,2组差异有统计学意义(P<0.05),肝素治疗组瘢痕增生情况较碘伏治疗组明显减轻或无瘢痕增生.结论 肝素钠乳膏可促进小面积深Ⅱ度烧伤创面愈合,减轻瘢痕增生.

  3. The changing pattern of stem cell markers of sweat gland in deep partial-thickness burn wound%深Ⅱ度烧伤创面汗腺干细胞标志物的变化规律

    Institute of Scientific and Technical Information of China (English)

    姜笃银; 宗宪磊; 付小兵; 王魏; 单菲

    2009-01-01

    burn wound ( DPBW, n = 37 ), superficial partial-thickness burn wound ( SPBW, n = 21 ), and normal skin ( NS, n=10) were harvested. Expressions of cytokeratin 10 (CK10), bcl-2, P63, CK14 and CK19 of epi-thelial cells in glandular secretory portion (GSP) in DPBW, SPBW and NS were detected with immunohisto-chemical double staining method. Results In NS, CK1g, CK14 and CK10 expressed in medium intensi-ty in GSP epithelial cells, P63 and CK14 weakly expressed in basal myoepithelial cells, while no expression of bcl-2 or P63 was observed in all CK10 positive terminally differentiated cells. In SPBW, no change of the construction of GSP and above-mentioned proteins during healing process was observed. In DPBW, as exam-ined on 7th post burn day ( PBD), expression of P63 and bcl-2 in GSP epithelial cells was enhanced. In DPBW on 8-10 PBD, bcl-2, P63, CK19 and CK14 strongly positive solid island-like epithelial structure was formed by proliferation, migration and squamous epithelization of basal cells. Such structure, along with granulation tissue, migrated towards the superficial layer of wounds. The hyperplasia of squamous epithelium resulted in complete reepithelialization. In DPBW, bcl-2, CK14, CK19 and P63 still strongly expressed in hyper-pruliferative epidermal basal and superbasal layers on 13-30 day after healing. Conclusions Dur-ing the natural healing process of DPBW, monolayer epithelium (CK19 and CK10 positive) of GSP slowly develops into stratified squamous epithelium (bcl-2, P63, CK19, and CK14 positive), suggesting that the epithelial-epidermal transdifferentiation of GSP undergoes slow retrodifferentiation process of stem cells andtransient amplifying cells, resulting in the imbalance between lagged growth of epithelium and the hyperplasia of granulation tissue, constituting one of the important mechanisms of disturbance in DPBW repair.

  4. Reduction in skin grafting after the introduction of hydrofiber dressings in partial thickness burns: a comparison between a hydrofiber and silver sulphadiazine.

    Science.gov (United States)

    Dokter, J; Boxma, H; Oen, I M M H; van Baar, M E; van der Vlies, C H

    2013-02-01

    The aim of this study was to compare clinical outcome of children with scald burns treated with a hydrofiber dressing (Aquacel(®), Convatec Inc.) with the former standard of care with silver sulfadiazine (Flammazine(®); Solvay Pharmaceuticals), considering surgical intervention and length of stay (LOS). A retrospective study of all consecutive children from zero to four years with primary scald burns up to 10% admitted to the Burn Centre of the Maasstad Hospital Rotterdam between January 1987 and January 2010 were reviewed. For data collection a prospective computerized database was used. For comparison the study period was divided into two periods representing the period before and after the introduction of the hydrofiber dressing (HFD), respectively 1987-1999 (period 1) and 1999-2010 (period 2). Over the whole study period 27.3% of 502 patients treated with silver sulfadiazine (Ag-SD) underwent surgery, while before the introduction of HFD 30.5% of 338 Ag-SD treated patients were operated upon. After the introduction of the HFD 20.7% of 164 patients treated with Ag-SD eventually underwent skin grafting, a significant difference with the 11.6% of 302 patients whose wounds were dressed with HFD (pburns up to 10% TBSA burned in children aged 0-4 years after the introduction of hydrofiber dressings. The mode of treatment with this wound dressing also limited hospital length of stay. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  5. A study on early eschar grinding for prevention & treatment of infection in patients with large area of deep partial thickness burns%大面积深度烧伤早期磨痂防治感染的研究

    Institute of Scientific and Technical Information of China (English)

    袁仕安; 肖荣; 林国安; 尚新志; 孟进松; 李文军; 杨晓东

    2014-01-01

    Objective To investigate the relationship between early eschar grinding and infection in the patients with large area of deep partial thickness burns. Methods Prospective studies were conducted in 35 patients with more than 30% TBSA of deep partial thickness burns. The patients were divided into eschar grinding group (EG group) and conservative care group (CC group) according to the different treatments regimes. The burn wounds of 17 patients in CC group were treated with 0.2% bromogeramine solution and 1% sulfadiazine silver cream,and changed dressings everyday. The 18 patients in EG group were treated with dermabrasion under general anesthesia within 48 hours after admission. The occurrence of systemic inflammatory response syndrome (SIRS) and sepsis,development of serum lipopolysaccharide (LPS),TNF-α,IL-6,and IL-8 were compared between the two groups. Results The patients in EG group were healed averagely within 14.1 days,while those in CC group within 19.8 days. The incidence rate of SIRS and sepsis in EG group was 31%,lower than that of CC group(85%). The serum levels of LPS, IL-6 and IL-8 of EG group were also lower than CC group. Conclusion Early eschar grinding of large area deep partial thickness burns under general anesthesia not only can shortenwound healing time but avoid burn wound and systemic infection.%目的:研究早期大面积深Ⅱ度烧伤磨痂与烧伤感染的关系。方法对35例烧伤面积>30%且创面以深Ⅱ度烧伤为主的烧伤患者,进行前瞻性研究。按对创面处理的方式不同,将其分为早期磨痂组和保痂组。保痂组17例,用苯扎溴铵简单清创,创面用磺胺嘧啶银乳膏包扎处理,并上悬浮床或翻身床,换药治疗。早期磨痂组18例,休克纠正后,48 h内在全麻下行磨痂术,用钢丝球磨除创面的坏死组织,刚好有小出血点为止,创面冲洗后,再用术尔泰纱布湿敷,最后将生物敷料(脱细胞猪皮)覆盖创面,外

  6. 坏死组织对深二度烧伤创面进行性加深的影响%Effect of necrotic tissue on progressive injury in deep partial thickness burn wounds

    Institute of Scientific and Technical Information of China (English)

    陆树良; 向军; 青春; 金曙雯; 廖镇江; 史济湘

    2002-01-01

    目的 为探讨深二度烧伤创面坏死组织持续存在对创面组织进行性损害的影响。方法 将7例施行削痂手术的深Ⅱ度烧伤患者创面分为手术前、手术后、和坏死组织存在的未手术创面,并分别获取创面组织标本,测定创面组织释放IL-8、EGF、bFGF、PDGF-AB水平以及观察组织形态学变化。结果 7例未手术创面组织在体外组织培养中释放IL-8水平较削痂手术后创面水平有明显升高(P<0.001);同时,未手术创面EGF、bFGF、PDGF-AB水平与其配对的削痂手术后创面比较均呈明显降低(P<0.05-<0.005)。局部组织形态学观察亦显示,坏死组织存在的未手术创面除有大量中性粒细胞浸润外,坏死范围较手术前扩大,残留的少量皮肤附件因炎症扩大而消失,而削痂后创面的炎性反应较未手术和手术前有明显减轻,无坏死范围的进一步扩大,甚至可见新生肉芽形成和部分表皮修复。结论 创面坏死组织持续存在不仅是创面愈合过程的抑制因素,而且还可能因炎症反应加强或持续存在而导致创面进一步加深,使创面愈合更为延迟。削痂手术作为一种去除坏死组织的主动手段,对促进创面愈合有积极意义。%Objective To evaluate the influence of necrotic tissue on progressive injury in deep partial thickness burn wounds.Methods Tissue specimens were cultured both for estimation of IL-8, EGF, bFGF, PDGF-AB and histopathological examination, from the pre-operation, post-operation, and non-operation wounds from seven patients with deep partial thickness burn.Results In seven specimens from the non-operation group, IL-8 release increased compared with those in the post-operation group (P<0.001), while the levels of EGF, bFGF, PDGF-AB release were lower than those in the post-operation group. Histopathological examination revealed that in the non-operation group, the degree of neutrophil

  7. Investigating the depth of thermal burns in elephants

    Directory of Open Access Journals (Sweden)

    A. Shakespeare

    2006-06-01

    Full Text Available Histological examination of burn injuries in elephants revealed that the depth was not as severe as expected from clinical observation. Although the actual burn depth was deep, the thickness of elephant skin, especially the dermis, resulted in the lesions being classified as less severe than expected. Examination of skin samples from selected areas showed that most lesions were either superficial (1st degree or superficial partial-thickness (superficial 2nd degree burns with the occasional deep partial thickness (deep 2nd degree wound. These lesions however, resulted in severe complications that eventually led to the death of a number of the elephants.

  8. Surgical wound debridement sequentially characterized in a porcine burn model with multispectral imaging.

    Science.gov (United States)

    King, Darlene R; Li, Weizhi; Squiers, John J; Mohan, Rachit; Sellke, Eric; Mo, Weirong; Zhang, Xu; Fan, Wensheng; DiMaio, J Michael; Thatcher, Jeffrey E

    2015-11-01

    Multispectral imaging (MSI) is an optical technique that measures specific wavelengths of light reflected from wound site tissue to determine the severity of burn wounds. A rapid MSI device to measure burn depth and guide debridement will improve clinical decision making and diagnoses. We used a porcine burn model to study partial thickness burns of varying severity. We made eight 4 × 4 cm burns on the dorsum of one minipig. Four burns were studied intact, and four burns underwent serial tangential excision. We imaged the burn sites with 400-1000 nm wavelengths. Histology confirmed that we achieved various partial thickness burns. Analysis of spectral images show that MSI detects significant variations in the spectral profiles of healthy tissue, superficial partial thickness burns, and deep partial thickness burns. The absorbance spectra of 515, 542, 629, and 669 nm were the most accurate in distinguishing superficial from deep partial thickness burns, while the absorbance spectra of 972 nm was the most accurate in guiding the debridement process. The ability to distinguish between partial thickness burns of varying severity to assess whether a patient requires surgery could be improved with an MSI device in a clinical setting. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  9. 烫伤消疤软膏对猪深Ⅱ度烧伤创面愈合影响的实验研究%Experimental study on the effects of Tang Shang Xiao Ba burn ointment on deep partial thickness burn wound healing in pigs

    Institute of Scientific and Technical Information of China (English)

    黄康; 陈玉林; 刘旺; 俞为荣; 郇京宁; 夏照帆

    2001-01-01

    Objective To observe the effects of TangShangXiaoBa burn ointment (TSXBBO) on deep partial thickness burn wound healing in pigs,and to investigate the possible mechanism of this traditional Chinese medicine in accelerating burn wound healing.Method A model of deep partial thickness burn wound in pigs was used.All wounds were divided into two groups,one side TSXBBO,and another control After topical application of TSXBBO to burn wound in pigs.the biopsies of burn wound were taken for measuring hydroxyproline contents,percentage of G0/G1- phase and percentage of s- phase in full skin cells of burn wound,water contents,rates of burn wound healing and pathological changes ingroup of TSXBBO and control at 1,3,5,7,10 and 14 day postburn.Result The hydroxyproline contents,the percentage of s- phase in full skin cells of burn wound and the rates of burn wound healing were all higher,and the water contents and percentage of G0/G1- phase were less in group TSXBBO than the control group.Conclusion It is suggested that topical application of TSXBBO to deep partial thickness burn wound in pigs may stimulate collagen synthesis,accelarate keratinocyte proliferation,reduce dropsy of burn wound and enhance wound healing.%目的观察烫伤消疤软膏对猪深Ⅱ度烧伤创面愈合影响。方法采用猪深Ⅱ度烧伤模型,创面外用烫伤消疤软膏,通过伤后不同时相点创面取材,检测烧伤创面羟脯氨酸( OHP)含量、创面细胞 DNA含量和细胞周期变化、创面含水量、创面愈合率及组织病理形态学变化。结果创面外用烫伤消疤软膏后创面羟脯氨酸含量、创面细胞 S期细胞百分比、创面愈合率均高于烧伤对照组,而创面含水量、创面细胞 G0/G1期细胞百分比均低于烧伤对照组。结论烧伤创面外用烫伤消疤软膏可增强胶原合成,促进上皮细胞增殖,减轻烧伤创面早期水肿,加速烧伤创面愈合。

  10. Experimental study of vacuum-assisted closure on deep partial-thickness burn wound of pig%封闭负压治疗对猪深Ⅱ度烧伤创面的影响

    Institute of Scientific and Technical Information of China (English)

    陈斓; 谢卫国; 叶子青; 赵超莉; 栾夏刚

    2015-01-01

    Objective To investigate the effect of Vacuum-assisted closure(VAC)technology on deep partial-thickness burn wound of pigs.Methods A total of 1 8 deep partial-thickness burn wounds were established by the temperature and pressure controlled perm instrument on 3 ordinary pigs back symmetrically,6 per pig.The wounds were randomly divided into 3 groups:which were treated by vacuum-assisted closure therapy with continuous model,discontinuous model or treated by conventional dressing therapy corresponding.The wounds were placed without any treatment in 24 hours,after that,the two VAC therapy groups were given corresponding modes of vacuum-assisted closure treatment with the pressure of-1 25mmHg,while conventional dressing therapy group received iodophor vaseline gauze dressing treatment. The dates of wound area,wound healing rate were collected and analyzed at right away、3、6、9、1 4 days post treatment.Specimens from wounds were harvested for histopathology observation,including cell proliferation index and the number of vascular endothelial cells.The dates were analyzed by one way ANOVA and multiple group comparison with LSD-t test.Results (1 )On the third day after treatment,the healing rate of VAC therapy group with continuous model and discontinuous model were (1 8.51 ±4.38)%,(1 4.26 ± 5.98)%,which were higher than the conventional dressing therapy group(3.86 ±2.35)%(t =56.552、40.1 39,P ★ 0.05, =0.001 ).On 3 d,the healing rate of both VAC therapy group were (24.74 ± 3.25)%,20.55 ±3.43)%,which were still higher than the conventional dressing therapy group(1 3.41 ± 4.08)%(t =5.473,3.432,P ★ 0.05,=0.004).On 9 d,those were (49.81 ±3.88)%,(46.96 ± 3.1 6)%,which were higher than the conventional dressing therapy group(34.29 ±6.69)%(t =5.563, 4.541 ,P ★ 0.05).(2)The healing time of VAC therapy group of continuous model was (1 1 .67 ±0.52) d,while that discontinuous model was (1 1 .50 ±1 .05)d,both were statistically difference compared to the

  11. Partial Thickness Rotator Cuff Tears: Current Concepts

    Science.gov (United States)

    Matthewson, Graeme; Beach, Cara J.; Nelson, Atiba A.; Woodmass, Jarret M.; Ono, Yohei; Boorman, Richard S.; Lo, Ian K. Y.; Thornton, Gail M.

    2015-01-01

    Partial thickness rotator cuff tears are a common cause of pain in the adult shoulder. Despite their high prevalence, the diagnosis and treatment of partial thickness rotator cuff tears remains controversial. While recent studies have helped to elucidate the anatomy and natural history of disease progression, the optimal treatment, both nonoperative and operative, is unclear. Although the advent of arthroscopy has improved the accuracy of the diagnosis of partial thickness rotator cuff tears, the number of surgical techniques used to repair these tears has also increased. While multiple repair techniques have been described, there is currently no significant clinical evidence supporting more complex surgical techniques over standard rotator cuff repair. Further research is required to determine the clinical indications for surgical and nonsurgical management, when formal rotator cuff repair is specifically indicated and when biologic adjunctive therapy may be utilized. PMID:26171251

  12. Effect of Paeonol on LC3 expression of liver tissues in mice with liver injury induced by deep partial thickness burns wound%丹皮酚对烫伤诱导小鼠肝损伤肝组织自噬蛋白LC3表达的影响

    Institute of Scientific and Technical Information of China (English)

    薄红兵; 王晓彬; 王希; 甘学文

    2014-01-01

    目的:探讨丹皮酚对烫伤诱导小鼠肝损伤肝组织自噬蛋白LC3表达的影响。方法小鼠随机分为空白组、模型组和丹皮酚组,用90℃热水建立烫伤模型,丹皮酚组小鼠在建模前1 h用丹皮酚溶液(60 mg· kg-1)灌胃。观察建模后第2,6,12,24 h小鼠血清丙氨酸氨基转移酶( ALT)与血清天门冬氨酸氨基转移酶( AST)水平变化及肝组织LC3表达情况。结果丹皮酚可有效降低小鼠血清ALT、AST水平,与模型组比较差异有统计学意义,同时可以使肝组织LC3表达增加(均P<0.05)。结论丹皮酚通过增加自噬蛋白LC3表达对深Ⅱ度烫伤诱导的肝损伤具有保护作用。%Objective To explore the effect of Paeonol on LC 3 expre-ssion of liver tissues in mice with liver injury induced by deep partial thickness burns wound .Methods Mice were randomly divided into con-trol group, model group and Paeonol group .The deep partial thickness burns wound model was made by 90 ℃ water , and the Paeonol group were intragastric administration treatment of Paeonol solution ( 60 mg· kg-1 ).The levels of alanine aminotransferase (ALT) and aspartate aminotransferase ( AST ) in the serum were respectively measured and LC3 expression of liver tissue was observed between 2 h,6 h,12 h,24 h after model established .Results The levels of ALT and AST in the serum of Paeonol group reduced obviously .Compared Paeonol group with model group , the differences were statistically significant ( P <0.05 ) . Meanwhile , Paeonol could induce LC 3 expression of liver tissues .The effects of high -dosage group and medium - dosage group were especially conspicuous .Conclusion Paeonol has better protective effect on liver injury induced with deep Partial thickness burns wound , the mechanism of which is mainly related with inducing LC 3 expression and inhibiting apoptosis of the liver cells .

  13. Assessing burn depth in tattooed burn lesions with LASCA Imaging.

    Science.gov (United States)

    Krezdorn, N; Limbourg, A; Paprottka, F J; Könneker; Ipaktchi, R; Vogt, P M

    2016-09-30

    Tattoos are on the rise, and so are patients with tattooed burn lesions. A proper assessment with regard to burn depth is often impeded by the tattoo dye. Laser speckle contrast analysis (LASCA) is a technique that evaluates burn lesions via relative perfusion analysis. We assessed the effect of tattoo skin pigmentation on LASCA perfusion imaging in a multicolour tattooed patient. Depth of burn lesions in multi-coloured tattooed and untattooed skin was assessed using LASCA. Relative perfusion was measured in perfusion units (PU) and compared to various pigment colours, then correlated with the clinical evaluation of the lesion. Superficial partial thickness burn (SPTB) lesions showed significantly elevated perfusion units (PU) compared to normal skin; deep partial thickness burns showed decreased PU levels. PU of various tattoo pigments to normal skin showed either significantly lower values (blue, red, pink) or significantly increased values (black) whereas orange and yellow pigment showed values comparable to normal skin. In SPTB, black and blue pigment showed reduced perfusion; yellow pigment was similar to normal SPTB burn. Deep partial thickness burn (DPTB) lesions in tattoos did not show significant differences to normal DPTB lesions for black, green and red. Tattoo pigments alter the results of perfusion patterns assessed with LASCA both in normal and burned skin. Yellow pigments do not seem to interfere with LASCA assessment. However proper determination of burn depth both in SPTB and DPTB by LASCA is limited by the heterogenic alterations of the various pigment colours.

  14. 应用负压治疗技术修复小儿浅Ⅱ度烫伤创面的效果观察%Efficacy observation on application of negative pressure therapy in the treatment of superficial partial-thickness scald wound in children

    Institute of Scientific and Technical Information of China (English)

    申传安; 柴家科; 庹晓晔; 蔡建华; 李东杰; 张琳; 朱华; 蔡金东

    2013-01-01

    目的 观察应用负压治疗技术修复小儿浅Ⅱ度烫伤创面的效果. 方法 将2009年8月-2012年5月笔者单位收治的307例浅Ⅱ度烫伤患儿按照随机数字表法进行分组,负压治疗组145例、对照组162例.负压治疗组患儿于伤后72 h内进行负压治疗(压力为-16 kPa),伤后第9天结束;对照组患儿采用传统的包扎换药方式治疗.对比2组患儿治疗过程中的体温变化、创面修复情况及换药次数;对比负压治疗组治疗前后的创面细菌培养情况,记录负压治疗组治疗后1、2、3d每百分之一烫伤面积的引流液量.数据比较行t检验或x2检验. 结果 负压治疗组患儿出现发热的比例为26.9% (39/145),显著低于对照组[63.6% (103/162),x2 =41.419,P<0.01].伤后第9天,负压治疗组138例患儿的创面完全上皮化愈合,7例零星残余创面经碘伏消毒换药后2d愈合.负压治疗组创面愈合时间为(9.2±0.6)d,明显短于对照组[(10.1±1.6)d,t=6.895,P<0.01].负压治疗组患儿的换药次数为(2.05±0.22)次,显著少于对照组[(4.82±0.81)次,t=39.878,P<0.01].负压治疗组治疗前,17例创面分泌物细菌培养结果呈阳性;治疗后,7例未愈创面分泌物细菌培养结果均为阴性.负压治疗组引流液量与创面大小成正比,治疗后第1、2、3天每百分之一烫伤面积引流液量分别为(9.8±3.2)、(6.2±2.1)、(4.1±1.6)mL. 结论 负压治疗可显著减少换药次数,通过引流创面渗液减轻感染和炎症反应进而促进创面愈合,是治疗小儿浅Ⅱ度烫伤的安全有效方法.%Objective To observe the effect of negative pressure therapy in the treatment of superficial partial-thickness scald in children.Methods Three hundred and seven children with superficial partial-thickness scald hospitalized from August 2009 to May 2012 were divided into negative pressure therapy group (NPT,n =145) and control group (C,n =162) according to the random number table.Patients in

  15. Dielectric measurement in experimental burns: a new tool for burn depth determination?

    Science.gov (United States)

    Papp, Anthony; Lahtinen, Tapani; Härmä, Markku; Nuutinen, Jouni; Uusaro, Ari; Alhava, Esko

    2006-03-01

    There has been a lack of methods to provide quantitative information of local tissue edema after burn injury. Noninvasive dielectric measurements provide this information. The measured value, the dielectric constant, is directly related to the amount of water in tissue. Using probes of different sizes, the measurements give information from different tissue depths. The aim of this study was to characterize edema formation at different tissue depths and to examine whether the dielectric measurements could be used to distinguish partial- and full-thickness burns in pigs. An experimental animal study with pigs (n = 6) was performed in which dielectric measurements were taken of superficial, partial-thickness, and full-thickness burns for 72 hours. There was an increase in tissue water content in the superficial dermis in the partial-thickness burns at 48 hours. In whole dermis, the superficial burns resulted in increased tissue water content at 8 hours, and the partial-thickness burns resulted in increased tissue water content at 8, 24, and 72 hours. In deep burns, the water content was significantly decreased in the superficial dermis at 24 hours. All burns resulted in a considerable increase in fat water content. The dielectric probes could be used to differentiate partial- and full-thickness burns as early as 8 hours after burn. Receiver operating curve analysis of the measurements indicated 70 to 90 percent sensitivity and 80 to 100 percent specificity after 8 hours. The dielectric measurements provide a sensitive and noninvasive method for examining tissue edema and differentiate partial- and full-thickness burns in experimental burns. Thus, they are of clinical interest for early burn depth determination.

  16. An experimental study on the effects of NGF on the wound healing of deep partial thickness burn in pigs%神经生长因子加速猪深Ⅱ度烧伤创面愈合的实验

    Institute of Scientific and Technical Information of China (English)

    吕国忠; 杨敏杰; 顾在秋; 陈玉林; 韦多; 路长林

    2001-01-01

    Objective   To investigate the effects of nerve growth factor (NGF) on wound healing of deep partial thickness burn in pigs. Methods   Six pigs of about 20 kg each were employed as the model.Twenty-four deep partial thickness burn wounds (2.5 cm in diameter per wound )were made on the back of each pig by temperature and pressure controller.Six wounds were set to be one group.The wounds were randomly divided into 4 groups,i.e.control group (applied with normal saline,C),three treatment groups with NGF topically applied in doses of 1,2.5 and 5 μg/ml,respectively.Histological examination,determination of hydroxyproline,analysis of cellular DNA cycle and wound healing time in every groups were carried out on 3,5 and 9 postburn days(PBD). Results  The proliferation rate of epithelia was much more active in treatment groups than in control group.Epithelization of the wound in treatment groups was earlier than of that in control group.The hydroxyproline content in treatment groups exhibited an increment after a prior decrement,especially on 5 PBD when the content was much lower in the treatment groups.The analysis of cellular DNA cycle indicated that cell number of S phase in treatment groups was obviously more than that in the control group.Furthermore,the wound healing time in treatment groups was much shorter than that in control group.Conclusion Local application of NGF might promote the wound healing of deep partial thickness burn.%目的 探讨神经生长因子(nerve growth factors,NGF)对猪烧伤创面愈合的影响 。方法小白家猪6只,用控温控压仪在其背部制成24个直径为2.5 cm 的深Ⅱ度创面,随机分为4组,每6个创面为1组,即等渗盐水对照组,NGF 1、2.5、5 μg/ml治疗组。治疗后3、5、9 d进行组织学检查、羟脯氨酸测定、细胞DNA周期分析及各组创面愈合时间比较。 结果 治疗组上皮增生活跃且上皮化较对照组提前;治疗组创面组织羟脯氨酸

  17. Effect of recombinant human granulocyte-macrophage colony stimulating factor on wound healing in patients with deep partial thickness burn%重组人粒细胞巨噬细胞集落刺激因子对深Ⅱ度烧伤创面的治疗作用

    Institute of Scientific and Technical Information of China (English)

    王志勇; 刘群; 张勤; 廖镇江; 韩春茂; 吕国忠; 罗成群; 陈炯; 杨时昕; 杨晓东

    2008-01-01

    Objective To evaluate the efficacy and safety of recombinant human granulocyte-macrophage colony stimulating factor(rhGM-CSF)hydrogel in wound healing in patients with deep partial thickness burn. Methods The study was a multicenter,randomized,double-blind,placebo-controlled parallel clinical trial.Three hundred and twenty-one patients(302 cases finally fulfilled the protocol)with deep partial thickness burn were divided into A group(n=200,with treatment of rhGM-CSF hytrogel,100 μg/10 g/100 Cm2/d),C group(n=102,with treatment of placebo).Side-effect,systemic condition,wound healing time,wound healing rate,and total effective rate at different time points were observed. Results There were no obvious differences in vital signs,wound secretion,wound edge reaction,blood and urine routine,liver and kidney function between two groups(P>0.05).No side-effect was observed.The median wound healing time was 17 days in A group,which was obviously shorter than that in C group(20 days,P0.05),无不良反应.用药组创面愈合时间的中位数为17 d,低于对照组(20 d,P<0.01).用药第8、14、20、28天,用药组平均创面愈合率分别为24.5%、70.5%、95.3%、99.6%,均高于对照组(15.1%、51.4%、84.6%、97.1%,P<0.01).用药8、14、20 d用药组的总有效率显著高于对照组(P<0.01). 结论 rhGM-CSF凝胶剂能促进深Ⅱ度烧伤创面愈合,并且有一定的安全性.

  18. New biological temporary skin cover Xe-Derma(®) in the treatment of superficial scald burns in children.

    Science.gov (United States)

    Zajicek, Robert; Matouskova, Eva; Broz, Ludomir; Kubok, Richard; Waldauf, Petr; Königova, Radana

    2011-03-01

    Xe-Derma® is a new dry sterile biological cover derived from acellular pig dermis. Hydrated Xe-Derma® displays bio-mechanical features similar to the normal skin. The aim of the present study was to compare the efficacy of Xe-Derma® with hydrocolloid dressing Askina THINSite® for treatment of superficial burns in children in a prospective study. In a prospective study, 86 patients (5 months to 7 years of age) with superficial scald burns on a surface area of 1-35% BSA were enrolled. In the course of the study, 43 patients were treated with Xe-Derma® and 43 patients with Askina THINSite®. We collected data including the percentage of BSA covered with biological or synthetic material, epithelization time, the number of complete conversions (deepening of 100% of covered area into deep dermal wound) under each cover, the number and extent of partial conversions (deepening of less then 100% of covered area into deep dermal wound), infectious complications, the number of reapplications of the temporary cover and the extent in square centimetres of dressing material needed for successful healing of 1% BSA. No significant difference in the epithelization time, percentage of conversion from superficial to deep dermal burns and percentage of infectious complication was detected between the two groups. However, patients in the Xe-Derma® group were burned on a more extensive burn surface area (p ≤ 0.028). Xe-Derma® showed adherence to the wound and therefore there has been no need to be changed The number of reapplications and therefore also the number of square centimetres needed for successful healing of 1% BSA were statistically higher in the Askina THINSite® group (p skin covers in the treatment of superficial scald burns in children. Copyright © 2010 Elsevier Ltd and ISBI. All rights reserved.

  19. 外用重组人粒细胞巨噬细胞集落刺激因子凝胶治疗深Ⅱ度烧伤创面临床疗效观察%Clinical curative effect observation of recombinant human granulocyte-macrophage colony-stimulating factor gel on wound healing in patients with deep partial thickness burns

    Institute of Scientific and Technical Information of China (English)

    温春泉; 赵筱卓; 张国安

    2016-01-01

    目的:观察外用重组人粒细胞巨噬细胞集落刺激因子凝胶对深Ⅱ度烧伤创面的治疗效果。方法选择2013年12月至2014年11月北京大学第四临床医学院收治的深Ⅱ度烧伤患者50例,烧伤面积为10%~30%总体表面积( TBSA)。采用随机数字表法,将患者分为试验组和对照组,每组各25例。对照组创面行常规清创后应用莫匹罗星软膏涂抹并包扎;试验组创面在常规清创基础上局部外用重组人粒细胞巨噬细胞集落刺激因子凝胶及莫匹罗星软膏后包扎,分别比较两组患者的创面愈合时间,治疗7、14、21、28 d时的创面愈合率,观察两组患者的生命体征和不良反应发生情况。采用χ2检验、t检验对两组患者资料数据进行比较、分析。结果试验组创面愈合时间(19.6±2.5)d低于对照组(27.3±3.4)d,差异有统计学意义(t=26.407,P<0.05),伤后7、14、21、28 d试验组创面愈合率分别为(29.8±4.6)%、(74.0±7.1)%、(98.2±2.6)%、(100.0±0.0)%,明显高于对照组(20.6±4.5)%、(52.0±8.2)%、(79.6±5.0)%、(97.3±2.6)%,差异均有统计学意义(t=-7.090、-10.050、-16.289、-4.993,P值均小于0.05)。且用药后两组患者生命体征、血常规、尿常规及肝、肾功能均正常,无不良反应发生。结论应用外用重组人粒细胞巨噬细胞集落刺激因子凝胶可加速深Ⅱ度烧伤创面愈合。%Objective To observe the effect of recombinant human granulocyte-macrophage colony-stimulating factor ( rhGM-CSF ) gel for deep partial thickness burns. Methods Fifty patients from the Fourth Clinical Medical College of Peking University at December 2013 to November 2014 with deep partial thickness burns at 10%-30% total body surface area ( TBSA) were randomly assigned into treatment group ( conventional debridement and application of rhGM-CSF and mupirocin ointment ) and control group ( conventional debridement and application of mupirocin ointment ) , with each group of 25

  20. Diagnosis of the deep partial-thickness burn wound of Skh-1 mouse with Optical Coherence Tomography%光学相干断层成像技术诊断深Ⅱ度烧伤创面实验研究

    Institute of Scientific and Technical Information of China (English)

    刘淑华; 谢卫国; Mathias Kremer; Hans Guenther Machens; Eva Maria Lankenau; Gereon Huettmann

    2010-01-01

    Objective To evaluate the application value of Optical Coherence Tomography (OCT)in the diagnosis of the depth of burn wound. Methods Deep partial-thickness scald models of Skh-1 mice were reproduced using self-made steam scald appliance. The scald wounds were scanned with OCT 3 hours,or 3 and 8 days after injury respectively. Scanned wound tissue was harvested for histological examination right after each episode of OCT imaging. Normal skin of mice was scanned and examined with the abovementioned methods at the same time. Results Compared with those of the normal skin, collagen in the dermis was denatured after steam scald, and it was imaged as vanishing or reduction in birefringence in OCT detection. The structure change intensity was related to the pathological process of the wounds and consistent with the corresponding histological results. Conclusions OCT is a noninvasive technique. It can be used to diagnose the depth of burn wound in real time.%目的 评估光学相干断层成像技术(OCT)在诊断烧伤创面深度方面的应用价值.方法 应用自制的小鼠蒸气烫伤装置,制作Skh-1小鼠深Ⅱ度烫伤模型,分别于伤后3 h、3 d和8 d以OCT扫描创面行动态检测,同步采集创面组织行组织病理学检查;同时扫描小鼠正常部位皮肤并行组织病理学检查. 结果蒸气烫伤小鼠皮肤真皮胶原降解,与其正常部位皮肤相比,在OCT扫描检测中表现为双折射光信号的丢失或减弱,其变化强度与创面病变过程相关,且与组织病理学切片结果一致. 结论 OCT作为无创的创面检测技术,可用于烧伤创面动态检测.

  1. 重组人粒细胞巨噬细胞集落刺激因子凝胶对深 II度烧伤创面愈合的影响及其机理分析%Effects of recombinant human granulocyte-macrophage colony-stimulating factor on debridement of deep partial-thickness burn

    Institute of Scientific and Technical Information of China (English)

    刘继松; 赵经纬; 章祥洲; 杜娟; 方勇

    2015-01-01

    Objective To determine the effect of recombinant human granulocyte-macrophage colony-stimulating factor ( rhGM-CSF) on debridement of eschar in deep partial thickness scalding wound and the mechanism for debridement of rhGM-CSF.Methods A total of 70 SD rats were scalded on the back.A deep partial-thickness burn was created in all the rats.The scalded rats were randomly divided into a control group( C) and an experimental group ( E) .Observations of the wounds were conducted by photograph at various time-points.In addition,the removal time of wound eschar in all animals was recorded.The percentages of removal area in the wounds were calculated by image analysis software in various time-points.ELISA was used to detect the expression of NE,MMP-1,and MMP-9.Results The average removal-time of eschar in the experimental group was 10.73 ±2.47d,which was much shorter than that in the control group's 14.26 ±2.65d(P<0.01).The time of wound heal-ing in the experimental group was 16.21 ±1.27d,which was significantly shorter than that in the control group's 18.05 ±1. 36d(P<0.01).The levels of NE,MMP-1 and MMP-9 in the experimental group were significantly higher than that in the con-trol group from day 3 to 7 after injury(P<0.01).Conclusion RhGM-CSF gel may promote debridement and wound healing in deep partial thickness burn,the mechanism of which may be associated with upregulation of expression of the enzyme activi-ty.%目的:验证重组人粒细胞巨噬细胞集落刺激因子( rhGM-CSF)对深II度烧伤溶痂和愈合的效果并分析其可能的机理。方法70只SD大鼠制成背部深II度烧伤创面后随机分为实验组和对照组,分别于制创后1、3、5、7、10、14和21d观察2组动物创面情况并摄像,记录创面愈合时间;用图像分析软件计算不同时相点的溶痂率;ELISA法测定创面弹力蛋白酶(NE)和基质金属蛋白酶(MMP-1、MMP-9)的蛋白表达。结果实验组创面溶痂时间为(10

  2. Superficial Burn Wound Healing with Intermittent Negative Pressure Wound Therapy Under Limited Access and Conventional Dressings

    Science.gov (United States)

    Honnegowda, Thittamaranahalli Muguregowda; Padmanabha Udupa, Echalasara Govindarama; Rao, Pragna; Kumar, Pramod; Singh, Rekha

    2016-01-01

    BACKGROUND Thermal injury is associated with several biochemical and histopathological alteration in tissue. Analysis of these objective parameters in research and clinical field are common to determine healing rate of burn wound. Negative pressure wound therapy has been achieved wide success in treating chronic wounds. This study determines superficial burn wound healing with intermittent negative pressure wound therapy under limited access and conventional dressings METHODS A total 50 patients were randomised into two equal groups: limited access and conventional dressing groups. Selective biochemical parameters such as hydroxyproline, hexosamine, total protein, and antioxidants, malondialdhyde (MDA), wound surface pH, matrix metalloproteinase-2 (MMP-2), and nitric oxide (NO) were measured in the granulation tissue. Histopathologically, necrotic tissue, amount of inflammatory infiltrate, angiogenesis and extracellular matrix deposition (ECM) were studied to determine wound healing under intermittent negative pressure. RESULTS Patients treated with limited access have shown significant increase in the mean hydroxyproline, hexosamine, total protein, reduced glutathione (GSH), glutathione peroxidase (GPx), and decrease in MDA, MMP-2, wound surface pH, and NO. Histopathologic study showed that there was a significant difference after 10 days of treatment between limited access vs conventional dressing group, Median (Q1, Q3)=3 (2, 4.25) vs 2 (1.75, 4). CONCLUSION Limited access was shown to exert its beneficial effects on wound healing by increasing ground substance, antioxidants and reducing MMP-2 activity, MDA, NO and providing optimal pH, decreasing necrotic tissue, amount of inflammatory infiltrate, increasing ECM deposition and angiogenesis. PMID:27853690

  3. US appearance of partial-thickness supraspinatus tendon tears: Application of the string theory. Pictorial essay.

    Science.gov (United States)

    Guerini, H; Fermand, M; Godefroy, D; Feydy, A; Chevrot, A; Morvan, G; Gault, N; Drapé, J L

    2012-02-01

    The supraspinatus tendon is composed of 5 different layers consisting of intertwining bundles. On a front portion of the tendon, the layers become coated bundles which insert on the trochanter. At the insertion, the superficial or bursal surface of the tendon corresponding to the tendon fibers in contact with the subacromial bursa can be distinguished from the deep surface corresponding to the fibers in contact with the glenohumeral joint. A tendon tear may involve partial or total disruption of the tendon fibers and is called full-thickness tear if it affects the entire tendon, and partial-thickness tear if it involves only part of the tendon. Partial-thickness tears of the supraspinatus tendon include lesions of the superficial, deep and central surface or tendon delamination.A contrast enhanced examination requires injection of contrast agent into the joint (arthrography followed by computed tomography (CT) or magnetic resonance imaging (MRI)) to study the deep surface, and injection into the subacromial bursa (bursography followed by CT) to study the superficial surface. MRI and ultrasound (US) examination allow the study of these different tendon layers without the use of contrast agent (which is not possible at CT).

  4. Influence of granulocyte macrophagecolony stimulating factor on the expression of angiopoietin-1 in deep partial thickness burn wound in rats%粒细胞-巨噬细胞集落刺激因子对大鼠深Ⅱ度烫伤创面血管生成素-1表达的影响

    Institute of Scientific and Technical Information of China (English)

    赵菁玲; 徐盈斌; 唐锦明; 舒斌; 薛亮; 谢举临; 祁少海; 刘旭盛

    2013-01-01

    目的 观察粒细胞-巨噬细胞集落刺激因子(GM-CSF)对大鼠深Ⅱ度烫伤创面愈合过程中血管生成素-1(Ang-1)表达的影响.方法 建立SD大鼠深Ⅱ度烫伤模型,按自身对照的方法将创面随机分为GM-CSF实验组和对照组.分别取伤后1、3、7、14、21 d创面皮肤组织,采用实时荧光定量逆转录-聚合酶链反应(FQ-PCR)分析Ang-1的mRNA表达;免疫组织化学法和Western blot法检测创面Ang-1蛋白的表达;免疫组织化学法检测创面CD31的表达,计算微血管密度(MVD).结果 创面Ang-1的mRNA表达量于伤后1、3d呈下降趋势,实验组(1.44±0.20、0.30 ±0.17)低于对照组(2.36±0.18、1.34±0.24) (P <0.05);之后其表达量逐渐升高,伤后7、14、21 d实验组(4.52±0.21、8.47±0.14、7.52±0.20)均明显高于对照组(2.71±0.12、3.69±0.24、3.07±0.17)(P<0.05).实验组创面Ang-1的蛋白表达量于伤后1、3d可见显著下降(0.491±0.055、0.181±0.025),与对照组(0.735±0.080、0.436±0.071)比较明显降低(P<0.05);之后其表达量持续升高,至伤后14 d达峰值,实验组(0.821±0.060、1.257±0.225、1.126±0.131)较对照组(0.701±0.078、0.825±0.072、0.733±0.073)明显增高(P<0.05).实验组创面于伤后第3天起见较多CD31阳性血管并逐渐增多,MVD值在伤后3、7、14、21 d(9.5±1.8、23.4±2.9、38.4±3.1、24.6±2.5)均明显高于对照组(4.0±1.9、10.5±2.0、22.9±2.7、15.1±2.6,P<0.05).结论 GM-CSF降低Ang-1在烧伤创面愈合早期的表达,有利于创面血管新生;促进Ang-1在愈合中、后期表达,利于创面血管成熟,加快创面愈合.%Objective To investigate the influence of granulocyte macrophage colony stimulating factor (GM-CSF) on the expression of angiopoietin-1 (Ang-1) in deep partial thickness burn wound in rats.Methods The models of deep partial thickness burn wounds on the back in Spregue-Dawley (SD) rats were established.The paired wounds on the same rats were randomly

  5. 硫化氢对深Ⅱ度烧伤大鼠创面巨噬细胞分泌细胞因子的影响%Effects of hydrogen sulfide on the secretion of cytokines in macrophages of deep partial-thickness burn wound in rats

    Institute of Scientific and Technical Information of China (English)

    李毅; 徐东波; 王洪瑾

    2016-01-01

    Objective To analyze the effects of exogenous hydrogen sulfide on the secretion of growth factors basic fibroblast growth factor (bFGF) and transforming growth factor β1 (TGF-β1),as well as inflammatory mediators tumor necrosis factor α (TNF-α) and interleukin 1β (IL-1β) in macrophages of deep partial-thickness burn wound in rats.Methods Seventy-eight SD rats were divided into normal control group (n =6),pure burn group,sodium hydrosulfide group,propargylglycine (PPG) group,and sodium hydrosulfide + PPG group according to the random number table,with 18 rats in each of the latter four groups.Rats in normal control group did not receive any treatment,while rats in the other four groups were inflicted with 5% total burn surface area deep partial-thickness scald (hereinafter referred to as burn) on the back.Immediately after burn,rats in pure burn group,sodium hydrosulfide group,and group PPG were intraperitoneally injected with saline 2 mL/kg,sodium hydrosulfide 56 μmol/kg,and PPG 45 mg/kg respectively,while those in sodium hydrosulfide + PPG group were intraperitoneally injected with sodium hydrosulfide 56 μmol/kg and PPG 45 mg/kg,once a day till the day before harvesting specimen.Six rats of normal control group fed for one week,and 6 rats from each of the rest four groups on post injury day (PID) 3,7,14 were collected respectively.Normal skin on the back of rats in normal control group and tissue in the base of wound of rats in the other four groups were harvested to isolate macrophages,and then the content of bFGF,TGF-β1,TNF-α,and IL-1β in culture supernatant of macrophages was detected with enzyme-linked immunosorbent assay.Data were processed with one-way analysis of variance,analysis of variance of factorial design,and LSD test.Results Compared with that of normal control group [(42.6 ± 2.5) and (18 ± 4) pg/mL],the content of bFGF and TGF-β1 in culture supernatant of macrophages of rats in pure burn group was obviously increased at each time

  6. The Introduction of a Protocol for the Use of Biobrane for Facial Burns in Children

    Directory of Open Access Journals (Sweden)

    A. D. Rogers

    2011-01-01

    Full Text Available Biobrane has become an indispensible dressing with three established indications in acute burns care at our institution: (1 as the definitive dressing of superficial partial thickness facial burns, (2 after tangential excision of deep burns when autograft or cadaver skin is unavailable, and (3 for graft reduction. This paper details our initial experience of Biobrane for the management of superficial partial thickness facial burns in children and the protocol that was compiled for its optimal use. A retrospective analysis of theatre records, case notes and photographs was performed to evaluate our experience with Biobrane over a one-year period. Endpoints included length of stay, analgesic requirements, time to application of Biobrane, healing times, and aesthetic results. Historical controls were used to compare the results with our previous standard of care. 87 patients with superficial partial thickness burns of the face had Biobrane applied during this period. By adhering to the protocol we were able to demonstrate significant reductions in hospital stay, healing time, analgesic requirements, nursing care, with excellent cosmetic results. The protocol is widely accepted by all involved in the optimal management of these patients, including parents, anaesthetists, and nursing staff.

  7. Effect of Dermabrasion and ReCell® on Large Superficial Facial Scars Caused by Burn, Trauma and Acnes

    Institute of Scientific and Technical Information of China (English)

    Pan-xi Yu; Wen-qi Diao; Zuo-liang Qi; Jing-long Cai

    2016-01-01

    Objective To explore the effects of dermabrasion combined with ReCell® on large superficial facial scars caused by burn, trauma and acnes. Methods Nineteen patients with large superficial facial scars were treated by the same surgeon with dermabrasion combined with ReCell®. According to the etiology, patients were classified into post-burning group (n=5), post-traumatic group (n=7) and post-acne group (n=7). Fifteen patients completed the follow-ups, 5 patients in each group. Healing time, complication rate, the preoperative and 18-month-post-operative assessments using Patient Satisfaction Score (PSS), Vancouver Scar Scale (VSS), and Patient and Observer Scar Assessment Scale (POSAS) of each group were analyzed to compare the effect of the combined therapy on outcomes. Results The healing time of post-burning group (19.6±4.0 days), post-traumatic group (15.8±2.6 days), and post-acne group (11.4±3.1 days) varied remarkably (F=7.701,P=0.007). The complication rates were 60%, 20%, and 0 respectively. The post-operative POSAS improved significantly in all groups (P<0.05), where the most significant improvement was shown in the post-acne group (P<0.05). The post-operative PSS and VSS improved only in the post-traumatic group and post-acne group (allP<0.05), where the more significant improvement was also shown in the post-acne group (P<0.05). Conclusions The combined treatment of dermabrasion and ReCell® has remarkable effect on acne scars, moderate effect on traumatic scars and is not suggested for burn scars. POSAS should be applied to assess the therapeutic effects of treatments for large irregular scars.

  8. Phase Ⅳ clinical trial for external use of recombinant human granulocyte-macrophage colony-stimulating factor gel in treating deep partial-thickness burn wounds%外用重组人粒细胞巨噬细胞集落刺激因子凝胶制剂治疗深Ⅱ度烧伤创面Ⅳ期临床研究

    Institute of Scientific and Technical Information of China (English)

    刘健; 廖镇江; 张勤

    2016-01-01

    Objective To evaluate the clinical efficacy and safety of external use of recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) gel on deep partial-thickness burn wounds.Methods Sixty-eight hospitals in our country including our unit performed a phase Ⅳ clinical trial for rhGM-CSF gel in patients (conforming to the study criteria) with deep partial-thickness burn wounds from November 2010 to July 2012.Multicenter,randomized,positive-homogenous-controlled,and open trial method was used in the trial,and patients from 10 hospitals were grouped into the positive-homogenous-controlled trial,while patients from the other 58 hospitals were grouped into open trial.(1) Controlled trial.Patients were divided into rhGM-CSF group and conventional treatment group (CT) with the ratio of 1:1 according to the stratified randomization method.Wounds of patients in rhGM-CSF group were coated with rhGM-CSF gel,and wounds of patients in group CT were covered by gauze with iodophor.Scores of wound exudate and wound edge response before treatment and on treatment day (TD) 2,4,8,10,14,20,and 28 were conventionally evaluated.Wound healing rates on TD 8,10,14,20,and 28 were calculated.Complete wound healing time and overall efficiency including cure,excellence,progress,and invalid situation on TD 28 were recorded.Safety indexes including vital signs and laboratory test indexes before and during treatment,and adverse reactions during treatment were observed.(2) Open trial.Wounds of patients in this trail were all coated with rhGM-CSF gel.Complete wound healing time,overall efficiency,and safety indexes of patients were recorded as in controlled trial.Data were processed with CMH-x2 test,Fisher's exact test,signed rank sum test,paired t test,Log-Rank test,and Wilcoxon rank sum test.Results (1) Controlled trail.A total of 366 patients from 10 hospitals were included in this trial,and 358 cases with 177 cases in rhGM-CSF group and 181 cases in group CT finished the

  9. Angiogenin expression in burn blister fluid: implications for its role in burn wound neovascularization.

    Science.gov (United States)

    Pan, Shin-Chen; Wu, Li-Wha; Chen, Chung-Lin; Shieh, Shyh-Jou; Chiu, Haw-Yen

    2012-01-01

    Deep partial thickness burn (DPTB) wound fluids have a greater propensity for establishing neovascularization than did superficial partial thickness burn (SPTB) wound fluids in our previous study. To investigate the factors responsible for this activity, cytokine array and enzyme-linked immunosorbent assay were used to perform an expression analysis of angiogenic factors in burn fluid. Although present in approximately equal amounts in both SPTB and DPTB blister fluids from burn patients, angiogenin does appear to be involved in the ability of DPTB blister fluid to promote neovascularization in vitro and in vivo. Angiogenin alone was sufficient to induce endothelial differentiation of circulating angiogenic cells (CAC) without vascular endothelial growth factor A involvement. In addition, angiogenin was positively associated with CAC differentiation in the burn blister fluid. Blocking the effect of angiogenin in burn blister fluids resulted in a significant reduction of endothelial cell proliferation, CAC differentiation, and new blood vessels formation in vivo. Moreover, immunohistochemistry revealed that high angiogenin expression colocalizes with high vascularity in human burn wounds at day 7, further supporting our hypothesis that angiogenin is involved in burn wound neovascularization. © 2012 by the Wound Healing Society.

  10. Fire walking in Singapore-a study of the distribution of burns.

    Science.gov (United States)

    Sayampanathan, Andrew A

    2011-05-01

    Fire walking is a religious ritual practiced by predominantly Indians and some Chinese living in Singapore. Eighteen new cases of burns, directly related to a firewalking ceremony on 05 October 09, were studied as to the pattern of burns. Burns on the soles of the feet occurred in 17 patients. All these injuries were superficial or partial thickness burns. There were no deep dermal burns. The extent of burns ranged from 0.25% to 1.5% of body surface area. Burns due to falls accounted for one casualty. He sustained a mixture of deep dermal and partial thickness burns, and the extent of burns was 20% of body surface area. A new classification for the distribution of burns related to fire walking was developed based on the mechanism of injury. It was predictive of the anatomical distribution of burns, the extent of burns (in terms of body surface area), the depth of burns and the general severity of the injury: Copyright © 2010 Elsevier Ltd and ISBI. All rights reserved.

  11. Effectiveness of Aloe Vera gel compared with 1% silver sulphadiazine cream as burn wound dressing in second degree burns.

    Science.gov (United States)

    Shahzad, Muhammad Naveed; Ahmed, Naheed

    2013-02-01

    To assess the efficacy of Aloe Vera gel compared with 1% silver sulfadiazine cream as a burn dressing for the treatment of superficial and partial thickness burns. This Interventional Comparative study was carried out at the Burn unit and Plastic surgery department, Nishtar Hospital Multan, Pakistan from July 2008 to December 2010. A total of 50 patients with superficial and partial thickness burns were divided into two equal groups randomly by consecutive sampling method, one group was dressed with Aloe Vera gel while the other was treated with 1% silversulphadiazine cream, and the results regarding duration of wound epithelialization, pain relief and cost of treatment were compared. In patients treated with Aloe Vera gel, healing of burn wounds were remarkably early than those patients treated with 1% silver sulfadiazine. All the patients of Aloe Vera group were relieved of pain earlier than those patients who were treated with SSD. Thermal burns patients dressed with Aloe Vera gel showed advantage compared to those dressed with SSD regarding early wound epithelialization, earlier pain relief and cost-effectiveness.

  12. The effect of Coriander cream on healing of superficial second degree burn wound

    Directory of Open Access Journals (Sweden)

    Abolfazl Abbas Zadeh

    2015-12-01

    Full Text Available Background: Coriander with the binominal name of Corianda Sativum, is one of the oldest medicinal plants ever known to man. Anti-inflammatory, anti-microbial, and anti-fungal effects of its oil has been mentioned in numerous studies. This study examines the impact of coriander cream on wound healing of the second-degree singe burn. Methods: In this experimental study which was performed in the animal lab of the Hazrat Fatemeh Hospital in Tehran, 48 adult male rats with an approximate weight of 250-300 grams, with deep burns of 2 cm 4×2 dimensions were prepared and divided into 4 groups of 12. We used silver sulfadiazine cream, alpha ointment, coriander cream and vaseline gauze (control group dressings in burn wound of the groups 1 to 4 respectively. At the end of the study (30 days, rats were euthanized with a high dose of thiopental and the wounds were evaluated on days 10 and 17 with a punch biopsy. Samples were fixed with 10% formalin on histopathology slide using haematoxylin and eosin (H&E staining (to assess and determine the presence of inflammatory cells. The amount of fibrin and collagen at the site were evaluated using a software program ImageJ, version 1.45 (National Institutes of Health, Bethesda, Maryland, USA. Results: The mean of wound surface area in the first photography was no significant (P= 0. 135. The rate of wound healing in alpha ointment and coriander cream had better outcomes than either of the other two groups (P= 0.000. The healing of the wound in silver sulfadiazine group was significantly less than other groups. Pathology results showed a statistically significant difference between the four groups (coriander, alpha, SSD and control, based on the Kruskal-Wallis test. These relate to (1 polymorphonuclear in the first (P= 0.032 and the second series (P= 0.003, (2 Angiogenesis in the second series (P= 0.004. (3 Fibrosis in the first series (P= 0.024 and the second series (P= 0.000. Conclusion: The results of this study

  13. Treatment of secondary burn wound progression in contact burns-a systematic review of experimental approaches.

    Science.gov (United States)

    Schmauss, Daniel; Rezaeian, Farid; Finck, Tom; Machens, Hans-Guenther; Wettstein, Reto; Harder, Yves

    2015-01-01

    After a burn injury, superficial partial-thickness burn wounds may progress to deep partial-thickness or full-thickness burn wounds, if kept untreated. This phenomenon is called secondary burn wound progression or conversion. Burn wound depth is an important determinant of patient morbidity and mortality. Therefore, reduction or even the prevention of secondary burn wound progression is one goal of the acute care of burned patients. The objective of this study was to review preclinical approaches evaluating therapies to reduce burn wound progression. A systematic review of experimental approaches in animals that aim at reducing or preventing secondary burn wound progression was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) guidelines. The selected references consist of all the peer-reviewed studies performed in vivo in animals and review articles published in English, German, Italian, Spanish, or French language relevant to the topic of secondary burn wound progression. We searched MEDLINE, Cochrane Library, and Google Scholar including all the articles published from the beginning of notations to the present. The search was conducted between May 3, 2012 and December 26, 2013. We included 29 experimental studies in this review, investigating agents that maintain or increase local perfusion conditions, as well as agents that exhibit an anti-coagulatory, an anti-inflammatory, or an anti-apoptotic property. Warm water, simvastatin, EPO, or cerium nitrate may represent particularly promising approaches for the translation into clinical use in the near future. This review demonstrates promising experimental approaches that might reduce secondary burn wound progression. Nevertheless, a translation into clinical application needs to confirm the results compiled in experimental animal studies.

  14. New treatment strategies to reduce burn wound progression

    Directory of Open Access Journals (Sweden)

    Schmauss, Daniel

    2014-01-01

    Full Text Available [english] Background: After a burn injury certain superficial partial-thickness burn wounds spontaneously progress into deep partial-thickness or full-thickness burn wounds. This poorly understood phenomenon is called burn wound progression. The aim of this study was to investigate whether treatment strategies using warm water (preservation of microcirculation on the one side and erythropoietin (EPO (molecule with anti-inflammatory, anti-apoptotic, vasodilatory and neoangiogenic properties can prevent, delay and/or reduce secondary burn wound progression in a rat model.Methods: We used a burn comb model in 63 rats, creating eight rectangular contact burns (2x1 cm each intercalated by unburned zones (2x0.5 cm prone to burn wound progression. In a first experimental set we treated burn wounds with locally applied warm (37°C or cold (17°C water for 20 minutes.In a second experimental set, animals were treated systemically with EPO at two different dosages of 500 and 2,500 IU/kg bodyweight (bw and initiated at 2 different time-points (45 minutes vs. 6 hours after burn injury. Evaluation of microcirculatory perfusion, interspace necrosis and burn depth was performed using respectively laser Doppler flowmetry, planimetry and histology. For statistical analysis the two-way ANOVA-test followed by an adequate post-hoc test (Bonferroni were used. Results: In untreated control animals a conversion from superficial to full-thickness burns was observed within 24 hours. Warm and cold water treatment significantly delayed burn depth progression, nevertheless after 4 days, burn depth was similar in all three groups. Warm water significantly reduced interspace necrosis compared to untreated controls and cold water with a significantly improved perfusion in the warm water group. Surface extension and particularly burn depth progression were significantly decreased by EPO only if administered at a dosage of bw and initiated 45 minutes after burn injury. EPO

  15. Comparing oil based ointment versus standard practice for the treatment of moderate burns in Greece: a trial based cost effectiveness evaluation

    Directory of Open Access Journals (Sweden)

    Carayanni Vilelmine J

    2011-12-01

    Full Text Available Abstract Background The local treatment of burn wounds has long been a subject of debate. The objective of this study was to compare the cost and the effectiveness of Moist Exposed Burn Ointment -MEBO versus a combination of povidone iodine plus bepanthenol cream for partial thickness burns. Methods The study was carried out in the Burn Center of a state hospital in Athens, Greece. 211 patients needing conservative therapy were prospectively selected according to the depth of the burn wound. The treatment was allocated according to the Stratified Randomization Design. The outcomes measured were mean cost of in-hospital stay, rate of complications, time of 50% wound healing, pain scores, in hospital stay diminution. We have adopted a societal perspective. Results In the total groups MEBO presented lower cost, (although not significantly different: p = 0.10 and better effectiveness. The data suggest that MEBO is the dominant therapy for superficial partial burn wound with significantly lower costs and significantly higher effectiveness due to a lesser time of recovery and consequently lower time of hospitalization and follow-up. MEBO presented similar percentages of complications with the comparator, lower pain levels and smaller time of no healthy appearance of the burn limits for superficial partial thickness burns. Conclusions The data suggested that topical application of MEBO may be considered for further investigation as a potential first-line treatment modality for superficial partial thickness burns. Trial registration The trial has been registered on the International Standard Randomised Controlled Trial Number Register (ISRCTN and given the registration number ISRCTN74058791.

  16. The progression of burn depth in experimental burns: a histological and methodological study.

    Science.gov (United States)

    Papp, A; Kiraly, K; Härmä, M; Lahtinen, T; Uusaro, A; Alhava, E

    2004-11-01

    This study was designed to create a reproducible model for experimental burn wound research in pigs. Previously, the thicker paraspinal skin has been used. We used the more human-like ventral skin to create burns of different depths. Contact burns were created to 11 pigs using a brass plate heated to 100 degrees C in boiling water. Different contact times were used to create burns of different depths. In pigs 1-6, the follow-up time was 72 h and in pigs 7-11 24 h. Burn depth was determined by histology. Histologically, samples were classified into five anatomical layers: epidermis, upper one-third of the dermis, middle third of the dermis, deepest third of the dermis and subcutaneous fat. The location of both thromboses and burn marks were evaluated, respectively. The 1 s contact time lead to a superficial thermal injury, 3 s to a partial thickness and 9 s to a full thickness injury. A progression of burn depth was found until 48 h post-injury. The intra-observer correlation after repeated histological analyses of burn depths by the same histopathologist and the repeatability of burn depth creation yielded kappa coefficients 0.83 and 0.92, respectively. a reproducible burn model for further research purposes was obtained.

  17. Noncontact imaging of burn depth and extent in a porcine model using spatial frequency domain imaging.

    Science.gov (United States)

    Mazhar, Amaan; Saggese, Steve; Pollins, Alonda C; Cardwell, Nancy L; Nanney, Lillian; Cuccia, David J

    2014-08-01

    The standard of care for clinical assessment of burn severity and extent lacks a quantitative measurement. In this work, spatial frequency domain imaging (SFDI) was used to measure 48 thermal burns of graded severity (superficial partial, deep partial, and full thickness) in a porcine model. Functional (total hemoglobin and tissue oxygen saturation) and structural parameters (tissue scattering) derived from the SFDI measurements were monitored over 72 h for each burn type and compared to gold standard histological measurements of burn depth. Tissue oxygen saturation (stO₂) and total hemoglobin (ctHbT) differentiated superficial partial thickness burns from more severe burn types after 2 and 72 h, respectively (p burns from all burn types immediately after injury (p burn types from each other after 24 h (p burn depth as measured by vimentin immunostain (r² > 0.89). These results show promise for the use of SFDI-derived tissue scattering as a correlation to burn depth and the potential to assess burn depth via a combination of SFDI functional and structural parameters.

  18. Current concepts on burn wound conversion-A review of recent advances in understanding the secondary progressions of burns.

    Science.gov (United States)

    Salibian, Ara A; Rosario, Angelica Tan Del; Severo, Lucio De Almeida Moura; Nguyen, Long; Banyard, Derek A; Toranto, Jason D; Evans, Gregory R D; Widgerow, Alan D

    2016-08-01

    Burn wound conversion describes the process by which superficial partial thickness burns convert into deeper burns necessitating surgical intervention. Fully understanding and thus controlling this phenomenon continues to defy burn surgeons. However, potentially guiding burn wound progression so as to obviate the need for surgery while still bringing about healing with limited scarring is the major unmet challenge. Comprehending the pathophysiologic background contributing to deeper progression of these burns is an essential prerequisite to planning any intervention. In this study, a review of articles examining burn wound progression over the last five years was conducted to analyze trends in recent burn progression research, determine changes in understanding of the pathogenesis of burn conversion, and subsequently examine the direction for future research in developing therapies. The majority of recent research focuses on applying therapies from other disease processes to common underlying pathogenic mechanisms in burn conversion. While ischemia, inflammation, and free oxygen radicals continue to demonstrate a critical role in secondary necrosis, novel mechanisms such as autophagy have also been shown to contribute affect significantly burn progression significantly. Further research will have to determine whether multiple mechanisms should be targeted when developing clinical therapies.

  19. Efficacy and Tolerability of Fitostimoline in Two Different Forms (Soaked Gauzes and Cream) and Citrizan Gel in the Topical Treatment of Second-Degree Superficial Cutaneous Burns

    OpenAIRE

    Patrizia Martini; Carlo Mazzatenta; Giorgio Saponati

    2011-01-01

    A total of 227 patients (mean age 41.3 years, 52% females) with at least one second-degree superficial cutaneous burn of thermal origin of a smallest transverse diameter ≥20 mm and a largest transverse diameter ≤90 mm were randomised to receive the topical application of aqueous extract of Triticum vulgare (Fitostimoline) in two different forms (soaked gauzes and cream) or catalase of horse origin in form of gel (Citrizan Gel), given up to healing or to a maximum of 20 days. The rate of lesio...

  20. Noninvasive measurement of burn wound depth applying infrared thermal imaging (Conference Presentation)

    Science.gov (United States)

    Jaspers, Mariëlle E.; Maltha, Ilse M.; Klaessens, John H.; Vet, Henrica C.; Verdaasdonk, Rudolf M.; Zuijlen, Paul P.

    2016-02-01

    In burn wounds early discrimination between the different depths plays an important role in the treatment strategy. The remaining vasculature in the wound determines its healing potential. Non-invasive measurement tools that can identify the vascularization are therefore considered to be of high diagnostic importance. Thermography is a non-invasive technique that can accurately measure the temperature distribution over a large skin or tissue area, the temperature is a measure of the perfusion of that area. The aim of this study was to investigate the clinimetric properties (i.e. reliability and validity) of thermography for measuring burn wound depth. In a cross-sectional study with 50 burn wounds of 35 patients, the inter-observer reliability and the validity between thermography and Laser Doppler Imaging were studied. With ROC curve analyses the ΔT cut-off point for different burn wound depths were determined. The inter-observer reliability, expressed by an intra-class correlation coefficient of 0.99, was found to be excellent. In terms of validity, a ΔT cut-off point of 0.96°C (sensitivity 71%; specificity 79%) differentiates between a superficial partial-thickness and deep partial-thickness burn. A ΔT cut-off point of -0.80°C (sensitivity 70%; specificity 74%) could differentiate between a deep partial-thickness and a full-thickness burn wound. This study demonstrates that thermography is a reliable method in the assessment of burn wound depths. In addition, thermography was reasonably able to discriminate among different burn wound depths, indicating its potential use as a diagnostic tool in clinical burn practice.

  1. Comparison between cryopreserved and glycerol-preserved allografts in a partial-thickness porcine wound model.

    Science.gov (United States)

    Yoon, Cheonjae; Lim, Kihwan; Lee, Sungjun; Choi, Yanghwan; Choi, Youngwhan; Lee, Jungsuk

    2016-03-01

    Human skin allografts are one of the best temporary biological coverings for severely burned patients. Cryopreserved (CPA) and glycerol-preserved (GPA) allografts are the most widely used types. This study compared the allograft efficiency of both preservation methods under the same conditions. To simulate actual clinical conditions, we used a porcine wound model. In addition, we evaluated the macroscopic and microscopic scoring of graft performance for each method. Porcine cadaver skin 1 mm thick was obtained from one pig. Cryopreserved skin cell viability was 20.8 %, glycerol-preserved skin was 9.08 %, and fresh skin was 58.6 %. We made ten partial-thickness wounds each in two pigs. The take rates on day 2 were 96.23 and 82.65 % in the GPA and CPA group (both n = 9), respectively. After 1 week, the take rates of both groups were nearly equal. The removal rate at week 5 was 98.87 and 94.41 % in the GPA and CPA group, respectively. On microscopic findings at week 2, inflammation was greater in the CPA group. Other findings such as fibroblast hyperplasia and neovascularization were not significantly different between both groups. At week 5, the score of collagen fiber synthesis was 2.67 ± 0.47 and 2.33 ± 0.47 in the GPA and CPA group, respectively. The epidermal-dermal junction was 2.22 ± 0.79 and 2.00 ± 0.47 in the GPA and CPA group, respectively. These findings suggest that wound healing takes longer in the CPA group. The preservation method of allografts is not a absolute factor in the wound healing process in this wound model.

  2. Treatment of Partial Thickness Burns with a Novel Extracellular Matrix in Rats (Rattus norvegicus)

    Science.gov (United States)

    2016-12-20

    bandaging material were then applied to protect the wound and rats were housed on sterile bedding. The rats were examined and dressings changed at...provide a complete evaluation of the cellular and immune response to these materials .

  3. Anti-scar Treatment for Deep Partial-thickness Burn Wounds

    Science.gov (United States)

    2016-10-01

    Alexa Fluor 647-conjugated Phalloidin (1:40) for actin filaments, Hoechst 33342 (1:2000) for nuclei (white round bodies), and anti-Vinculin mouse mAb...1:300) detected with Alexa Fluor 568-conjugated goat anti-mouse secondary antibody (1:1000) for focal adhesions. Note the stress fibers (actin...prepare pirfenidone is different dosage forms (cream, gel , and ointment) for use in the treatment experiments. Name: Jorge Medina Project Role: Post

  4. Too hot to trot (barefoot)… A study of burns in children caused by sun heated surfaces in Queensland, Australia.

    Science.gov (United States)

    Asquith, Catherine; Kimble, Roy; Stockton, Kellie

    2015-02-01

    The aim of this study was to quantify and describe the characteristics of burns in children caused by sun heated surfaces. Children presenting between January 2013 and February 2014 with a burn due to sun heated surfaces were included in the study. Fifteen children were identified representing 1.7% of new burns. The mean age was 18.3 months. All burns occurred during the warmer months between 11a.m. and 4p.m. and the feet were commonly involved. Most cases occurred in the child's home garden but six cases occurred in public play areas. Metal was the most common surface involved. Most burns were superficial partial thickness with two burns deep dermal partial thickness and one child needed a skin graft. Burns due to sun heated surfaces are relatively frequent. Parents need to be aware that in summer surfaces can become hot enough to cause burns to bare feet in young children. Play areas need to be shaded or covered in surfaces that do not become hot enough to cause burns and metal objects should not be left in the sun in children's play areas.

  5. Significant chemical burns associated with dermal exposure to laundry pod detergent.

    Science.gov (United States)

    Russell, Jason L; Wiles, Devin A; Kenney, Brian; Spiller, Henry A

    2014-09-01

    Concentrated laundry pods have been reported to cause significant clinical effects including oropharyngeal burns and respiratory distress requiring intubation. Dermal burns have been reported, but no incidents of serious isolated dermal injury have been published. We report a case of significant, isolated dermal injury as a result of dermal exposure to a concentrated laundry detergent pod. Total body surface area partial thickness burns in this case were estimated at approximately 2 % with an additional 4-5 % of total body surface area (TBSA) displaying superficial burns/chemical dermatitis. Health-care providers should be aware of this complication and should perform thorough dermal decontamination in the event of an exposure. Parents should be educated regarding the dangers associated with dermal exposure to laundry pod compounds and the need to secure these items away from children as well as proper decontamination techniques should an exposure occur.

  6. Burns

    Science.gov (United States)

    A burn is damage to your body's tissues caused by heat, chemicals, electricity, sunlight, or radiation. Scalds from hot ... and gases are the most common causes of burns. Another kind is an inhalation injury, caused by ...

  7. [Meta-analysis on the diagnostic value of laser Doppler imaging for burn depth].

    Science.gov (United States)

    Huang, Y; Qiu, L; Mei, A L; Li, J X

    2017-05-20

    Objective: To evaluate the value of laser Doppler imaging (LDI) in diagnosing deep or superficial partial-thickness burn wound with meta-analysis. Methods: Databases including PubMed, Cochrane Library were searched using key words " burn, burns, burn depth, laser Doppler imaging, laser Doppler perfusion imaging, LDI, LDPI" , and Chinese Journals Full-text Database, Wanfang Database, VIP Database were searched using Chinese key words ",,,," to obtain the published trials of LDI in diagnosing deep or superficial partial-thickness burn wound from the establishment of each database to October 2015. The risk of bias and applicability concerns of the included studies were evaluated by Quality Assessment of Diagnostic Accuracy Studies-2. Data were processed with Meta-DiSc 1.4 statistical software. The heterogeneity among the included studies was evaluated. The pooled estimates of LDI in diagnosing deep or superficial partial-thickness burn wound in the included studies, including sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, as well as the area under the curve of summary receiver operating characteristic and index of Q(*) were calculated. The stability of results of the overall pooled estimates of the included studies was validated by sensitivity analysis. The sources of heterogeneity among the included studies were sought through subgroup analysis. The publication bias caused by the results of the included studies was evaluated by drawing the Deek's funnel plot. Results: A total of 5 articles conforming to the inclusion criteria, involving 138 patients and 179 burn wounds, were included. One of the included studies had low risk of bias, while the other 4 studies had high/unclear risk of bias. In applicability concern aspect, one of the included studies had high/unclear concerns regarding applicability, while the other 4 studies had low concerns regarding applicability. There was no heterogeneity caused by threshold

  8. Dual-imaging system for burn depth diagnosis.

    Science.gov (United States)

    Ganapathy, Priya; Tamminedi, Tejaswi; Qin, Yi; Nanney, Lillian; Cardwell, Nancy; Pollins, Alonda; Sexton, Kevin; Yadegar, Jacob

    2014-02-01

    Currently, determination of burn depth and healing outcomes has been limited to subjective assessment or a single modality, e.g., laser Doppler imaging. Such measures have proven less than ideal. Recent developments in other non-contact technologies such as optical coherence tomography (OCT) and pulse speckle imaging (PSI) offer the promise that an intelligent fusion of information across these modalities can improve visualization of burn regions thereby increasing the sensitivity of the diagnosis. In this work, we combined OCT and PSI images to classify the degree of burn (superficial, partial-thickness and full-thickness burns). Algorithms were developed to integrate and visualize skin structure (with and without burns) from the two modalities. We have completed the proposed initiatives by employing a porcine burn model and compiled results that attest to the utility of our proposed dual-modal fusion approach. Computer-derived data indicating the varying burn depths were validated through immunohistochemical analysis performed on burned skin tissue. The combined performance of OCT and PSI modalities provided an overall ROC-AUC=0.87 (significant at pdual-imaging system for wound tracking are underway.

  9. Efficacy and tolerability of fitostimoline in two different forms (soaked gauzes and cream) and citrizan gel in the topical treatment of second-degree superficial cutaneous burns.

    Science.gov (United States)

    Martini, Patrizia; Mazzatenta, Carlo; Saponati, Giorgio

    2011-01-01

    A total of 227 patients (mean age 41.3 years, 52% females) with at least one second-degree superficial cutaneous burn of thermal origin of a smallest transverse diameter ≥20 mm and a largest transverse diameter ≤90 mm were randomised to receive the topical application of aqueous extract of Triticum vulgare (Fitostimoline) in two different forms (soaked gauzes and cream) or catalase of horse origin in form of gel (Citrizan Gel), given up to healing or to a maximum of 20 days. The rate of lesion healing at end of study was significantly higher in patients treated with Fitostimoline (gauzes 97.3%, cream 91.5%) than in those receiving catalase (84.5%). The pooled Fitostimoline groups were also significantly more effective than catalase gel in reducing total symptoms score, pain at medication, pain at rest, and burning at end of study. Both formulations of Fitostimoline and catalase gel were well tolerated in terms of adverse effects in the site of application.

  10. Efficacy and Tolerability of Fitostimoline in Two Different Forms (Soaked Gauzes and Cream and Citrizan Gel in the Topical Treatment of Second-Degree Superficial Cutaneous Burns

    Directory of Open Access Journals (Sweden)

    Patrizia Martini

    2011-01-01

    Full Text Available A total of 227 patients (mean age 41.3 years, 52% females with at least one second-degree superficial cutaneous burn of thermal origin of a smallest transverse diameter ≥20 mm and a largest transverse diameter ≤90 mm were randomised to receive the topical application of aqueous extract of Triticum vulgare (Fitostimoline in two different forms (soaked gauzes and cream or catalase of horse origin in form of gel (Citrizan Gel, given up to healing or to a maximum of 20 days. The rate of lesion healing at end of study was significantly higher in patients treated with Fitostimoline (gauzes 97.3%, cream 91.5% than in those receiving catalase (84.5%. The pooled Fitostimoline groups were also significantly more effective than catalase gel in reducing total symptoms score, pain at medication, pain at rest, and burning at end of study. Both formulations of Fitostimoline and catalase gel were well tolerated in terms of adverse effects in the site of application.

  11. Utilization of laser Doppler flowmetry and tissue spectrophotometry for burn depth assessment using a miniature swine model.

    Science.gov (United States)

    Lotter, Oliver; Held, Manuel; Schiefer, Jennifer; Werner, Ole; Medved, Fabian; Schaller, Hans-Eberhard; Rahmanian-Schwarz, Afshin; Jaminet, Patrick; Rothenberger, Jens

    2015-01-01

    Currently, the diagnosis of burn depth is primarily based on a visual assessment and can be dependent on the surgeons' experience. The goal of this study was to determine the ability of laser Doppler flowmeter combined with a tissue spectrophotometer to discriminate burn depth in a miniature swine burn model. Burn injuries of varying depth, including superficial-partial, deep-partial, and full thickness, were created in seven Göttingen minipigs using an aluminium bar (100 °C), which was applied to the abdominal skin for periods of 1, 3, 6, 12, 30, and 60 seconds with gravity alone. The depth of injury was evaluated histologically using hematoxylin and eosin staining. All burns were assessed 3 hours after injury using a device that combines a laser light and a white light to determine blood flow, hemoglobin oxygenation, and relative amount of hemoglobin. The blood flow (41 vs. 124 arbitrary units [AU]) and relative amount of hemoglobin (32 vs. 52 AU) were significantly lower in full thickness compared with superficial-partial thickness burns. However, no significant differences in hemoglobin oxygenation were observed between these depths of burns (61 vs. 60%). These results show the ability of laser Doppler flowmeter and tissue spectrophotometer in combination to discriminate between various depths of injury in the minipig model, suggesting that this device may offer a valuable tool for burn depth assessment influencing burn management. © 2014 by the Wound Healing Society.

  12. Hyaluronic acid covers in burn treatment: a systematic review

    Directory of Open Access Journals (Sweden)

    Michel Marcos Dalmedico

    2016-06-01

    Full Text Available Abstract OBJECTIVE To evaluate the effectiveness of hyaluronic acid in the healing of partial thickness burns. METHOD Systematic review of randomized controlled trials on the use of hyaluronic acid for the topical treatment of skin burns, based on recommendations of the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS Two randomized controlled trials that analyzed 143 patients with partial thickness burns and/or deep partial thickness burns were selected. They compared the application of hyaluronic acid 0.2% associated to silver sulfadiazine 1% 5g/cm2 versus silver sulfadiazine 1% 5g/cm2 alone for the outcome of complete healing. CONCLUSION This review emphasizes the need for new well-designed randomized controlled trials to establish the therapeutic relevance of hyaluronic acid with respect to the healing of burns of partial thickness or deep partial thickness.

  13. Detection of partial-thickness tears in ligaments and tendons by Stokes-polarimetry imaging

    Science.gov (United States)

    Kim, Jihoon; John, Raheel; Walsh, Joseph T.

    2008-02-01

    A Stokes polarimetry imaging (SPI) system utilizes an algorithm developed to construct degree of polarization (DoP) image maps from linearly polarized light illumination. Partial-thickness tears of turkey tendons were imaged by the SPI system in order to examine the feasibility of the system to detect partial-thickness rotator cuff tear or general tendon pathology. The rotating incident polarization angle (IPA) for the linearly polarized light provides a way to analyze different tissue types which may be sensitive to IPA variations. Degree of linear polarization (DoLP) images revealed collagen fiber structure, related to partial-thickness tears, better than standard intensity images. DoLP images also revealed structural changes in tears that are related to the tendon load. DoLP images with red-wavelength-filtered incident light may show tears and related organization of collagen fiber structure at a greater depth from the tendon surface. Degree of circular polarization (DoCP) images exhibited well the horizontal fiber orientation that is not parallel to the vertically aligned collagen fibers of the tendon. The SPI system's DOLP images reveal alterations in tendons and ligaments, which have a tissue matrix consisting largely of collagen, better than intensity images. All polarized images showed modulated intensity as the IPA was varied. The optimal detection of the partial-thickness tendon tears at a certain IPA was observed. The SPI system with varying IPA and spectral information can improve the detection of partial-thickness rotator cuff tears by higher visibility of fiber orientations and thereby improve diagnosis and treatment of tendon related injuries.

  14. A pilot evaluation study of high resolution digital thermal imaging in the assessment of burn depth.

    Science.gov (United States)

    Hardwicke, Joseph; Thomson, Richard; Bamford, Amy; Moiemen, Naiem

    2013-02-01

    Thermal imaging is a tool that can be used to determine burn depth. We have revisited the use of this technology in the assessment of burns and aim to establish if high resolution, real-time technology can be practically used in conjunction with clinical examination to determine burn depth. 11 patients with burns affecting upper and lower limbs and the anterior and posterior trunk were included in this study. Digital and thermal images were recorded at between 42 h and 5 days post burn. When compared to skin temperature, full thickness burns were significantly cooler (pburns (pburns were not significantly different in temperature than non-burnt skin (p>0.05). Typically, full thickness burns were 2.3°C cooler than non-burnt skin; deep partial thickness burns were 1.2°C cooler than non-burnt skin; whilst superficial burns were only 0.1°C cooler. Thermal imaging can correctly determine difference in burn depth. The thermal camera produces images of high resolution and is quick and easy to use. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  15. Biomechanical analysis of articular-sided partial-thickness rotator cuff tear and repair.

    Science.gov (United States)

    Mihata, Teruhisa; McGarry, Michelle H; Ishihara, Yoko; Bui, Christopher N H; Alavekios, Damon; Neo, Masashi; Lee, Thay Q

    2015-02-01

    Articular-sided partial-thickness rotator cuff tears are common injuries in throwing athletes. The superior shoulder capsule beneath the supraspinatus and infraspinatus tendons works as a stabilizer of the glenohumeral joint. To assess the effect of articular-sided partial-thickness rotator cuff tear and repair on shoulder biomechanics. The hypothesis was that shoulder laxity might be changed because of superior capsular plication in transtendon repair of articular-sided partial-thickness rotator cuff tears. Controlled laboratory study. Nine fresh-frozen cadaveric shoulders were tested by using a custom shoulder-testing system at the simulated late-cocking phase and acceleration phase of throwing motion. Maximum glenohumeral external rotation angle, anterior translation, position of the humeral head apex with respect to the glenoid, internal impingement area, and glenohumeral and subacromial contact pressures were measured. Each specimen underwent 3 stages of testing: stage 1, with the intact shoulder; stage 2, after creation of articular-sided partial-thickness tears of the supraspinatus and infraspinatus tendons; and stage 3, after transtendon repair of the torn tendons by using 2 suture anchors. Articular-sided partial-thickness tears did not significantly change any of the shoulder biomechanical measurements. In the simulated late-cocking phase, transtendon rotator cuff repair resulted in decreased maximum external rotation angle by 4.2° (P = .03), posterior shift of the humeral head (1.1-mm shift; P = .02), decreased glenohumeral contact pressure by 1.7 MPa (56%; P = .004), and decreased internal impingement area by 26.4 mm(2) (65%; P infraspinatus tears decreased glenohumeral and subacromial contact pressures at time zero; these changes might lead to reduced secondary subacromial and internal impingements and consequently progression to full-thickness rotator cuff tear. However, repair of the tendons decreased anterior translation and external rotation and

  16. Comparisons of the Various Partial-Thickness Rotator Cuff Tears on MR Arthrography and Arthroscopic Correlation

    Energy Technology Data Exchange (ETDEWEB)

    Chun, Kyung Ah; Kim, Min Sung; Kim, Young Joo [Catholic University of Korea Uijeongbu St.Mary' s Hospital, Uijeongbu (Korea, Republic of)

    2010-10-15

    To assess the diagnostic performance of MR arthrography in the diagnosis of the various types of partial-thickness rotator cuff tears by comparing the MR imaging findings with the arthroscopic findings. The series of MR arthrography studies included 202 patients consisting of 100 patients with partial-thickness rotator cuff tears proved by arthroscopy and a control group of 102 patients with arthroscopically intact rotator cuffs, which were reviewed in random order. At arthroscopy, 54 articularsided, 26 bursal-sided, 20 both articular- and bursal-sided partial-thickness tears were diagnosed. The MR arthrographies were analyzed by two radiologists for articular-sided tears, bursal-sided tears, and both articular- and bursal-sided tears of the rotator cuff. The sensitivity and specificity of each type of partial-thickness tears were determined. Kappa statistics was calculated to determine the interand intra-observer agreement of the diagnosis of partial-thickness rotator cuff tears. The sensitivity and specificity of the various types of rotator cuff tears were 85% and 90%, respectively for articular-sided tears, 62% and 95% for bursal- sided tears, as well as 45% and 99% for both articular- and bursal-sided tears. False-negative assessments were primarily observed in the diagnosis of bursal-sided tears. Conversely, both articular- and bursal-sided tears were overestimated as full-thickness tears. Inter-observer agreement was excellent for the diagnosis of articular-sided tears (k = 0.70), moderate (k = 0.59) for bursal-sided tears, and fair (k = 0.34) for both articular- and bursal-sided tears, respectively. Intra-observer agreement for the interpretation of articular- and bursal-sided tears was excellent and good, respectively, whereas intra-observer agreement for both articular- and bursal-sided tears was moderate. MR arthrography is a useful diagnostic tool for partial-thickness rotator cuff tears, but has limitations in that it has low sensitivity in bursal- and

  17. Burns

    Science.gov (United States)

    To help prevent burns: Install smoke alarms in your home. Check and change batteries regularly. Teach children about fire safety and the danger of matches and fireworks. Keep children from climbing on top of a stove ...

  18. BACTERIAL PROFILE IN BURN WOUNDS WITH SPECIAL REFERENCE TO ANTIMICROBIAL AGENTS AND TOPICAL APPLICATIONS IN A TERTIARY CARE HOSPITAL- A 2 YEAR PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Rajesh Kumar Dora

    2017-08-01

    Full Text Available BACKGROUND Burn is one of the most devastating condition. It is seen in all age groups from a baby to the elderly. Burn injuries pose a big challenge to the medical fraternity. Burn injuries can have an effect on the skin, respiratory, cardio vascular, renal, haematological, G.I, musculoskeletal, eye, immune system, metabolism and nutrition. Burns may be Superficial or partial thickness where the epidermis is involved, full thickness when all the layers of skin are involved and deep burn. MATERIALS AND METHODS Total of 64 patients who have attended the OPD and Casualty with burn injuries and given consent for the study were studied in a period of 2 years duration in the Department of Surgery, S.C.B. Medical College and Hospital, Cuttack. RESULTS Burn injury is a common health hazard. These injurues are seen in low socio economic status because of poverty, overcrowding, poor condition of living and ignorance regarding precautions to be taken during fire accidents Incidence is high in females. Male burns are attributed to. Male burns may be attributed to alcohol, smoking and domestic violence which is seen in our study. Burns can be due to accidents, suicidal or homicidal. The percentage of body surface area in burns is calculated as per Wallace rule of nine’s. It helps to estimate the percentage of burn and the fluid estimation is done. Burn injuries produce irreversible cell protein denaturation. Cytoplasmic coagulation, blockage of thermolabile enzymes and cell death. Most burn deaths occur in the developing world particularly in South East Asia CONCLUSION Burn injuries are frequently seen. The contribute to almost 20% of admissions in the tertiary care hospitals. In the present study in S.C.B. Medical College and hospital, Cuttack, Odisha female burn patients in the third decade of life was the commonest. Those patients are mostly house wives and they have a close proximity to the kitchen. Some of the deaths were dowry related and are either

  19. Myocardial infarct associated with a partial thickness left atrial tear in a dog with mitral insufficiency.

    Science.gov (United States)

    Sleeper, Meg M; Maczuzak, Meredith E; Bender, Susan J

    2015-09-01

    A 10-year-old male neutered cavalier King Charles Spaniel with a 1-year history of degenerative mitral valve disease presented for dyspnea and severe weakness. He was diagnosed with congestive heart failure, systolic dysfunction, presumptive myocardial infarction and a left atrial thrombus based on thoracic radiographs, electrocardiogram and echocardiographic findings. Clinical signs also suggested right foreleg embolism. The dog was euthanized due to the grave prognosis and a postmortem evaluation was performed. The postmortem examination confirmed myocardial infarction and was thought to be due to embolic showering from the thrombus attached to a partial thickness left atrial endocardial tear.

  20. Alteration of Biomechanical Properties of Skin During the Course of Healing of Partial-thickness Wounds.

    Science.gov (United States)

    Held, Manuel; Rothenberger, Jens; Tolzmann, Dascha; Petersen, Wiebke; Schaller, Hans-Eberhard; Rahmanian-Schwarz, Afshin

    2015-05-01

    The incidence of partial-thickness wounds is high and, until recently, little was known about the alteration of the biomechanical properties of the skin in these wounds during the course of healing. The aim of this study was to demonstrate the biomechanical changes in skin elasticity. Fourteen standardized skin defects were created on the back of fourteen adult male Lewis rats (Charles River Laboratories International, Inc, Wilmington, MA) using a skin dermatome. Biomechanical properties of the skin were determined every 10 days over a period of 3 months using a skin elasticity measurement device (Cutometer MPA 580, Courage and Khazaka, Cologne, Germany). Calculated elasticity (UE), firmness of skin (R0), and overall elasticity (R8) were assessed. In addition, histological evaluation was performed in regard to quality of skin. After an initial decrease of UE, R0, and R8 until 30 days after surgery, the values of R0 and R8 increased between day 50 and day 60. Starting on day 60, a further decrease of values was indicated. The alteration of biomechanical properties of skin is a function of tissue structure. The presented results demonstrate the complex changes of skin biomechanical properties in the course of healing of partial-thickness wounds. This study could serve as a model to compare the effectiveness of different wound dressings in regard to skin elasticity.

  1. Early depth assessment of local burns by dermoscopy: a new frontier of dermoscopic evaluation.

    Science.gov (United States)

    Mihara, Kyomi; Shindo, Hajime; Mihara, Hiroya; Ohtani, Minako; Nagasaki, Kotaro; Katoh, Norito

    2012-05-03

    This article has been retracted. See Notice of Retraction. To investigate the effectiveness of early depth assessment of local burns, the depth of which is difficult to assess with the naked eye, by dermoscopy. The morphological findings of burn wounds were prospectively evaluated by dermoscopy and videomicroscopy. Prior to dermoscopic and videomicroscopic measurement, clinical assessment was performed. All patients received conservative treatment for 21 days after injury. A burns unit at a primary care hospital. Thirty-two patients with 41 intermediate-depth local burn wounds were included. Inclusion criteria were time to presentation greater than 24 hours after injury and total burn size greater than 1% and less than 10% of the total body surface area. Primary healing within 21 days (superficial partial thickness) and failure of primary healing within 21 days (deep partial thickness). The accuracy, sensitivity, and specificity of the assessment according to the algorithm proposed in this study were evaluated by dermoscopy, and the accuracy of the dermoscopic measurements was compared with videomicroscopic measurements and clinical assessments. The results of dermoscopic measurements according to the proposed algorithm showed an accuracy of 93%, sensitivity of 86%, and specificity of 100%. The dermoscopic measurements were significantly more accurate compared with clinical assessment (P = .01). Dermoscopy is a noninvasive, portable, relatively inexpensive, and effective approach for assessment of the burn wound healing potential. It is more accurate if compared with clinical observation in burn depth assessment. It has a broader utility and is equally or more accurate compared with the more expensive videomicroscopy.

  2. Biomechanical Skin Property Evaluation for Wounds Treated With Synthetic and Biosynthetic Wound Dressings and a Newly Developed Collagen Matrix During Healing of Superficial Skin Defects in a Rat Models.

    Science.gov (United States)

    Held, Manuel; Engelke, Anne-Sophie; Tolzmann, Dascha Sophie; Rahmanian-Schwarz, Afshin; Schaller, Hans-Eberhard; Rothenberger, Jens

    2016-09-01

    There is a high prevalence of superficial wounds such as partial-thickness burns. Treatment of these wounds frequently includes temporary application of wound dressings. The aim of this study was to compare a newly developed collagen matrix with commonly used temporary skin dressings for treatment of partial-thickness skin defects. Through a skin dermatome, 42 standardized superficial skin defects were generated on the back of 28 adult male Lewis rats. The wounds were treated with a synthetic wound dressing (Suprathel, Polymedics Innovations Inc, Woodstock, GA) (n = 14), a biosynthetic skin dressing (Biobrane, Smith & Nephew, Hull, UK) (n = 14), or a newly developed bovine collagen matrix, Collagen Cell Carrier (Viscofan BioEngineering, Weinheim, Germany) (n = 14). Biomechanical properties of the skin were determined and compared every 10 days over a 3-month period of using the Cutometer MPA 580 (Courage + Khazaka Electronic GmbH, Cologne, Germany). As opposed to healthy skin, statistically significant differences were detected between days 10 and 30, and between days 60 and 80, for calculated elasticity (Ue), firmness of skin (R0), and overall elasticity (R8). After 3 months, no statistically significant differences in skin elasticity were detected between the different wound dressings. The presented results give an opportunity to compare the wound dressings used for treatment with respect to skin elasticity and reveal the potential of the bovine collagen matrix in the treatment of superficial skin defects; therefore the results facilitate further evaluation of collagen matrix in surgical applications and regenerative medicine.

  3. Analysis of wax burn cases presenting to an Emergency Department in Hong Kong during the Chinese Mid-Autumn festival.

    Science.gov (United States)

    Tam, Michael Man-kit; Cheung, Wai lun

    2003-06-01

    Records of patients presenting to the Emergency Department (ED) of the Prince of Wales Hospital with wax burns during Mid-Autumn festival from 1998 to 2001 were retrieved and analyzed. There were 26 patients in total (21 males, 5 females). Annual attendances from 1998 to 2001 were 11, 7, 4 and 4, respectively. Age ranged from 1 to 33 years (median age: 11.5). Most patients were injured by molten wax (n=23, 88.5%), the rest were burnt by flame (n=3, 11.5%). Partial thickness burn (superficial and deep) was the most common (n=23, 88.4%). Superficial burn accounted for the rest (n=3, 11.5%). No patient had full thickness burn. All patients had <5% of body surface area (BSA) burnt, with the majority only involving <1% BSA (n=16, 61.5%). The commonest sites of injury were the lower limbs (n=15, 57.7%), the upper limbs (n=8, 30.8%) and face (n=7, 26.9%). Three patients (11.5%) had multiple sites burnt. Only eight patients (30.8%) required burns surgeon's consultation, out of which seven (26.9%) required in-patient treatment. Most burns caused by or related to boiling wax were minor. The declining incidence is the combined result of legislation, product modification, education and publicity.

  4. 扬刺法针刺配合燃酒疗法治疗急性踝关节扭伤疗效观察%Efficacy Observation on Multiple Superficial Needling Combined with Alcohol Burning Method Treating Acute Ankle Sprain

    Institute of Scientific and Technical Information of China (English)

    高锋

    2016-01-01

    目的:观察扬刺法针刺配合燃酒疗法治疗急性踝关节扭伤的临床疗效.方法:86例急性踝关节扭伤患者随机分为治疗组和对照组各43例,治疗组采用扬刺法针刺配合燃酒疗法,对照组采用刺络拔罐治疗,观察两组疗效.结果:治疗组总有效率为100.00%,显著高于对照组的88.37%(P<0.01).结论:扬刺法针刺配合燃酒疗法治疗急性踝关节扭伤疗效肯定,值得临床推广应用.%Objective: To observe the clinical effect of multiple superficial needling combined with alcohol burning method treating acute ankle sprain. Methods:86 cases of acute ankle sprain were randomly divided into treatment group and control group with each of 43 cases, treatment group adopted multiple superficial needling combined with alcohol burning method, control group with bloodletting puncture and cupping therapy, the cura-tive effect of the two groups were observed. Results:The total effective rate of treatment group was 100.00%, significantly higher than that of control group by 88.37% (P<0.01). Conclusion:The efficacy of multiple superficial needling combined with alcohol burning method treating acute ankle sprain is definite, being worthy of clinical application.

  5. Lower muscle regenerative potential in full-thickness supraspinatus tears compared to partial-thickness tears.

    Science.gov (United States)

    Lundgreen, Kirsten; Lian, Oystein Bjerkestrand; Engebretsen, Lars; Scott, Alex

    2013-12-01

    Rotator cuff tears are associated with secondary rotator cuff muscle pathology, which is definitive for the prognosis of rotator cuff repair. There is little information regarding the early histological and immunohistochemical nature of these muscle changes in humans. We analyzed muscle biopsies from patients with supraspinatus tendon tears. Supraspinatus muscle biopsies were obtained from 24 patients undergoing arthroscopic repair of partial- or full-thickness supraspinatus tendon tears. Tissue was formalin-fixed and processed for histology (for assessment of fatty infiltration and other degenerative changes) or immunohistochemistry (to identify satellite cells (CD56+), proliferating cells (Ki67+), and myofibers containing predominantly type 1 or 2 myosin heavy chain (MHC)). Myofiber diameters and the relative content of MHC1 and MHC2 were determined morphometrically. Degenerative changes were present in both patient groups (partial and full-thickness tears). Patients with full-thickness tears had a reduced density of satellite cells, fewer proliferating cells, atrophy of MHC1+ and MHC2+ myofibers, and reduced MHC1 content. Full-thickness tears show significantly reduced muscle proliferative capacity, myofiber atrophy, and loss of MHC1 content compared to partial-thickness supraspinatus tendon tears.

  6. Limited diagnostic accuracy of magnetic resonance imaging and clinical tests for detecting partial-thickness tears of the rotator cuff.

    Science.gov (United States)

    Brockmeyer, Matthias; Schmitt, Cornelia; Haupert, Alexander; Kohn, Dieter; Lorbach, Olaf

    2017-09-23

    The reliable diagnosis of partial-thickness tears of the rotator cuff is still elusive in clinical practise. Therefore, the purpose of the study was to determine the diagnostic accuracy of MR imaging and clinical tests for detecting partial-thickness tears of the rotator cuff as well as the combination of these parameters. 334 consecutive shoulder arthroscopies for rotator cuff pathologies performed during the time period between 2010 and 2012 were analyzed retrospectively for the findings of common clinical signs for rotator cuff lesions and preoperative MR imaging. These were compared with the intraoperative arthroscopic findings as "gold standard". The reports of the MR imaging were evaluated with regard to the integrity of the rotator cuff. The Ellman Classification was used to define partial-thickness tears of the rotator cuff in accordance with the arthroscopic findings. Descriptive statistics, sensitivity, specificity, positive and negative predictive value were calculated. MR imaging showed 80 partial-thickness and 70 full-thickness tears of the rotator cuff. The arthroscopic examination confirmed 64 partial-thickness tears of which 52 needed debridement or refixation of the rotator cuff. Sensitivity for MR imaging to identify partial-thickness tears was 51.6%, specificity 77.2%, positive predictive value 41.3% and negative predictive value 83.7%. For the Jobe-test, sensitivity was 64.1%, specificity 43.2%, positive predictive value 25.9% and negative predictive value 79.5%. Sensitivity for the Impingement-sign was 76.7%, specificity 46.6%, positive predictive value 30.8% and negative predictive value 86.5%. For the combination of MR imaging, Jobe-test and Impingement-sign sensitivity was 46.9%, specificity 85.4%, positive predictive value 50% and negative predictive value 83.8%. The diagnostic accuracy of MR imaging and clinical tests (Jobe-test and Impingement-sign) alone is limited for detecting partial-thickness tears of the rotator cuff. Additionally

  7. Autologous transplantation of RPE with partial-thickness choroid after mechanical debridement of Bruch membrane in the rabbit.

    Science.gov (United States)

    Hu, Yuntao; Zhang, Taoran; Wu, Jianguo; Li, Ying; Lu, Xinrong; Qian, Fang; Yin, Zhengqin; Ma, Zhizhong

    2008-07-01

    An improved translocation technique for autologous retinal pigment epithelium (RPE) transplantation is presented. The graft consists of a sheet of a partial-thickness choroid with RPE attached. Twenty-seven pigmented rabbits were used in this study. After mechanical debridement of Bruch membrane, partial-thickness RPE-choroid sheets were transplanted onto the subretinal space in 25 rabbits. The animals were examined by fundus photographs and fluorescein angiographs and were killed postoperatively at 1, 2, 4, 12, and 24 weeks. Eyecups containing the grafts were examined by light microscopy and immunohistochemistry. In addition, two partial-thickness RPE-choroid sheets were analyzed by transmission electron microscopy (TEM). TEM revealed that the partial-thickness RPE-choroid graft consisted of retinal pigment epithelial cells, Bruch membrane, choriocapillaris, and ruptured middle vessels. The thickness of the graft was approximately 50 to 60 microm. Fluorescein angiography revealed neither fluorescein leakage nor staining in the graft at early or late phase. Light microscopy revealed that in 17 experiments in which the graft survived, the neural retina remained intact; however, in eight experiments with unsuccessful grafts, the neural retina degenerated. The surviving graft showed revascularization and monolayered retinal pigment epithelial cells. Furthermore, in sections in which the neural retina over the graft remained intact, all retinal pigment epithelial cells in the graft and rhodopsin in photoreceptor outer segments were positively labeled with anticellular retinaldehyde-binding protein antibodies and anti-opsin antibodies, respectively. A partial-thickness RPE-choroid graft showed improved integration with the host choroid and photoreceptors. This technique has the potential to be a treatment for age-related macular degeneration.

  8. Periorbital burns – a 6 year review of management and outcome.

    Science.gov (United States)

    Fitzgerald O'Connor, Edmund; Frew, Q; Din, A; Pleat, J; Ashraff, S; Ghazi-Nouri, S; El-Muttardi, N; Philp, B; Dziewulski, P

    2015-05-01

    Periorbital burns are an infrequent but potentially devastating injury. This study aimed to elucidate the spectrum of such injuries presenting to a UK burns centre and the outcome achieved in the cases requiring periorbital reconstruction for the restoration of function and form. Patients admitted to a UK regional burns centre between January 2005 and January 2011 with periorbital burns were identified from the Patient Administration System (PAS), theatre logs and the International Burns Injury database (IBID). Multiple parameters were assessed using patient notes, ITU and hospital image databases. Over 6 years, 167 patients with facial burns requiring surgery were treated, including 103 patients with eyelid burns. The mean burn size was 33% total body surface area. The eyelid burn depth varied; 67% superficial partial thickness, 17% deep dermal and 16% full thickness. Two patients lost complete vision in one eye, one patient underwent amniotic membrane grafting. In total 16 patients required periorbital reconstruction to maintain eye closure, with 1.8 operations on average per patient. Acute surgery was required in 11 patients, whilst late intervention (>3 months) was needed in 5, 2 patients had both acute and delayed surgery. Of the 5 late intervention patients 4 were treated with full thickness skin grafts and 1 with a Z plasty. Average time for final reconstruction with delayed surgery was 4.5 months. The goal in management of periorbital burns is preservation of vision, prevention of future complications and restoration of an acceptable aesthetic outcome. Total visual loss is thankfully rare, but early ophthalmology intervention is vital given the evidence of corneal damage as a brief therapeutic window exists. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  9. Hair bleaching and skin burning

    National Research Council Canada - National Science Library

    Forster, K; Lingitz, R; Prattes, G; Schneider, G; Sutter, S; Schintler, M; Trop, M

    2012-01-01

    .... We report a unique case of a 16-yr-old girl who suffered full-thickness chemical and thermal burns to the nape of her neck and superficial burns to the occiput after her hair had been dyed blond...

  10. Autologous tenocyte implantation, a novel treatment for partial-thickness rotator cuff tear and tendinopathy in an elite athlete.

    Science.gov (United States)

    Wang, Allan W; Bauer, Stefan; Goonatillake, Matthew; Breidahl, William; Zheng, Ming-Hao

    2013-01-11

    Tendinopathy and small partial-thickness tears of the rotator cuff tendon are common presentations in sports medicine. No promising treatment has yet been established. Corticosteroid injections may improve symptoms in the short term but do not primarily treat the tendon pathology. Ultrasound-guided autologous tenocyte implantation (ATI) is a novel bioengineered treatment approach for treating tendinopathy. We report the first clinical case of ATI in a 20-year-old elite gymnast with a rotator cuff tendon injury. The patient presented with 12 months of increasing pain during gymnastics being unable to perform most skills. At 1 year after ATI the patient reported substantial improvement of clinical symptoms. Pretreatment and follow-up MRIs were reported and scored independently by two experienced musculoskeletal radiologists. Tendinopathy was improved and the partial-thickness tear healed on 3 T MRI. The patient was able to return to national-level competition.

  11. Clinical application of hydrogel dressing Aquacel-Ag in treatment of superficialburns%水凝胶敷料爱康肤银在浅Ⅱ度烧伤创面治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    刁永力; 王书军; 陈濛

    2012-01-01

    Objective: To evaluate the clinical effects of hydrogel dressing Aquacel-Ag in treatment of superficial II burns. Methods: Using random select method, 30 patients whose burn areas covered with hydrogel dressing Aquacel-Ag(hydrogel dressing Aquacel-Ag group) and 30 patients whose burn areas coped with SD-Ag(SD-Ag group) were picked as research objects. The healing time, the frequency of dressing changes and the dressing pain score were compared between the two groups. Meanwhile, the wound secretion was taken for bacteria culturing, blood routine test, blood biochemical test and adverse effect were closely monitered during the treatment. Results: Compared with SD-Ag group, hydrogel dressing Aquacel-Ag group exhibited a significantly shorter healing time (P 0. 05). There was no direct relationship between the laboratory abnormalities and the therapeutic measures, and most patients had no uncomfortable chief complaint. Conclusions: Hydrogel dressing Aquacel-Ag could shorten the healing time, decrease frequency of dressing change and reduce dressing pain score for superficialburns. It has an antimicrobial property similar to SD-Ag for superficialburns and shows no noticeable adverse effect. So, it is worth clinical further application.%目的:探讨水凝胶敷料爱康肤银在浅Ⅱ度烧伤创面治疗中的作用.方法:采用随机抽选法,选择2年内在我科接受水凝胶敷料爱康肤银换药(爱康肤银换药组)及磺胺嘧啶银乳膏换药(磺胺嘧啶银组)治疗的浅Ⅱ度烧伤患者各30例,分别统计两组创面的愈合时间、换药次数、换药时疼痛评分.取创面分泌物进行细菌培养,同时监测两组患者在治疗期间血常规、血生化及不良反应.结果:爱康肤银换药组较磺胺嘧啶银组创面愈合时间缩短(P<0.05)、换药次数减少(P<0.05),换药时疼痛评分降低(P<0.05).两组创面细菌培养阳性率差异无统计学意义(P>0.05).另外,治疗期间两组患者

  12. Ultrasound and Functional Assessment of Transtendinous Repairs of Partial-Thickness Articular-Sided Rotator Cuff Tears.

    Science.gov (United States)

    Ostrander, Roger V; Klauser, Jeffrey M; Menon, Sanjay; Hackel, Joshua G

    2017-03-01

    Partial-thickness articular-sided rotator cuff tears are a frequent source of shoulder pain. Despite conservative measures, some patients continue to be symptomatic and require surgical management. However, there is some controversy as to which surgical approach results in the best outcomes for grade 3 tears. The purpose of this study was to evaluate repair integrity and the clinical results of patients treated with transtendinous repair of high-grade partial-thickness articular-sided rotator cuff tears. Our hypothesis was that transtendinous repairs would result in reliable healing and acceptable functional outcomes. Case series; Level of evidence, 4. Twenty patients with a minimum follow-up of 2 years were included in the study. All patients underwent arthroscopic repair of high-grade partial-thickness rotator cuff tears utilizing a transtendinous technique by a single surgeon. At latest follow-up, the repair integrity was evaluated using ultrasound imaging, and functional scores were calculated. Ultrasound evaluation demonstrated that 18 of 20 patients had complete healing with a normal-appearing rotator cuff. Two patients had a minor residual partial tear. Sixteen of 20 patients had no pain on visual analog scale. Four patients complained of mild intermittent residual pain. All patients were rated as "excellent" by both the University of California at Los Angeles Shoulder Score and the Simple Shoulder Test. The transtendon technique for the repair of articular-sided high-grade partial rotator cuff tears results in reliable tendon healing and excellent functional outcomes.

  13. Examination of the Early Diagnostic Applicability of Active Dynamic Thermography for Burn Wound Depth Assessment and Concept Analysis.

    Science.gov (United States)

    Prindeze, Nicholas J; Fathi, Payam; Mino, Matthew J; Mauskar, Neil A; Travis, Taryn E; Paul, Dereck W; Moffatt, Lauren T; Shupp, Jeffrey W

    2015-01-01

    Despite advances in perfusion imaging, burn wound imaging technology continues to lag behind that of other fields. Quantification of blood flow is able to predict time for healing, but clear assessment of burn depth is still questionable. Active dynamic thermography (ADT) is a noncontact imaging modality capable of distinguishing tissue of different thermal conductivities. Utilizing the abnormal heat transfer properties of the burn zones, we examined whether ADT was useful in the determination of burn depth in a model of early burn wound evaluation. Duroc pigs (castrated male; n = 3) were anesthetized, and two burns were created with an aluminum billet at 3 and 12 seconds. These contact times resulted in superficial partial and deep partial thickness burn wounds, respectively. ADT and laser Doppler imaging (LDI) imaging were performed every 30 minutes postburn for a total of five imaging sessions ending 150 minutes postburn. For ADT, imaging excitation was performed for 42-120 seconds with dual quartz-infrared lamps, and subsequent infrared image capture was performed for 300 seconds. MATLAB-assisted image analysis was performed to determine burn zone region of interest thermal relaxation and characteristic patterns. LDI was performed with a moorLDI system, and biopsies were captured for histology following the 150-minute imaging session. Both ADT and LDI imaging modalities are able to detect different physical properties at 30, 60, 90 120, and 150 minutes postburn with statistical significance (P burn depth. This preliminary work confirms that ADT can measure burn depth and is deserving of further research either as a stand-alone imaging technology or in combination with a device to assess perfusion.

  14. Effects of burn location and investigator on burn depth in a porcine model.

    Science.gov (United States)

    Singer, Adam J; Toussaint, Jimmy; Chung, Won Taek; Thode, Henry C; McClain, Steve; Raut, Vivek

    2016-02-01

    In order to be useful, animal models should be reproducible and consistent regardless of sampling bias, investigator creating burn, and burn location. We determined the variability in burn depth based on biopsy location, burn location and investigator in a porcine model of partial thickness burns. 24 partial thickness burns (2.5 cm by 2.5 cm each) were created on the backs of 2 anesthetized pigs by 2 investigators (one experienced, one inexperienced) using a previously validated model. In one of the pigs, the necrotic epidermis covering each burn was removed. Five full thickness 4mm punch biopsies were obtained 1h after injury from the four corners and center of the burns and stained with Hematoxylin and Eosin and Masson's trichrome for determination of burn depth by a board certified dermatopathologist blinded to burn location and investigator. Comparisons of burn depth by biopsy location, burn location and investigator were performed with t-tests and ANOVA as appropriate. The mean (SD) depth of injury to blood vessels (the main determinant of burn progression) in debrided and non-debrided pigs pooled together was 1.8 (0.3)mm, which included 75% of the dermal depth. Non-debrided burns were 0.24 mm deeper than debrided burns (PBurn depth increased marginally from cephalic to caudal in non-debrided burns, but showed no statistical differences for these locations, in debrided burns. Additionally, there were also no statistical differences in burn depths from midline to lateral in either of these burn types. Burn depth was similar for both investigators and among biopsy locations. Burn depth was greater for caudal locations in non-debrided burns and overall non-debrided burns were deeper than debrided burns. However, burn depth did not differ based on investigator, biopsy site, and medial-lateral location. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  15. Effect of nonpeptide NK1 receptor antagonist L-703,606 on the edema formation in rats at early stage after deep partial-thickness skin scalding

    Institute of Scientific and Technical Information of China (English)

    Ke Tao; Hong-Tao Wang; Bi Chen; Bo-Tao Wang; Zhi-Yuan Li; Xiong-Xiang Zhu; Chao-Wu Tang; Da-Hai Hu

    2013-01-01

    Objective: To investigate the effect and the relevant potential mechanism of nonpeptide neurokinin 1 (NK1) receptor antagonist L-703,606 in the edema formation after burn injury.Method:L-703,606 treatment was performed in Sprague-Dawley (SD) rats at early stage after deep partial-thickness skin scalding. One hundred and fifty two adult male SD rats were used in the study and randomly divided into sham scald (SS, n=8), scald control (SC, n=48), and L-703,606 treatment (LT, n=48) groups. The rats in SC and LT groups were subjected to 20% total body surface area (TBSA) deep partial-thickness skin scalding. Modified Evans blue extravasation, tracing electron microscopy by lanthanum nitrate and mean water content assay were employed to observe and detect the changes of vascular permeability, ultrastructure and edema formation in adjacent tissue to the wounds and in the jejuna of rats at early stage (72 h) after scald. Results:The pathological increase of vascular permeability in the periwound tissue and jejunum of rats in LT group were significantly lower than that in SC group (P<0.01), and recuperated earlier. Meanwhile, the changes of water contents of corresponding tissues in LT group were lighter than those in SC group (P<0.01). The ultrastructural changes of the microvessels in the peri-wound tissue of LT group showed that the junctions between microvascular endothelium cells were more narrow than those of SC group, moreover, and the number of opening and the engorgement and cavitation of the vascular endothelium cells decreased, the areosis and edema in perivascular tissue lightened, and the precipitation of the high eletron density lanthanum tracing agent in the interspace of the tissue decreased significantly in LT group. Conclusions: It is concluded that nonpeptide NK1-receptor antagonist L-703,606 could lighten the vascular permeability and edema formation in the periwound tissue and jejunum, and accelerate the normalization process of pathological changes in

  16. Photoreceptors repair by autologous transplantation of retinal pigment epithelium and partial-thickness choroid graft in rabbits.

    Science.gov (United States)

    Zhang, Taoran; Hu, Yuntao; Li, Ying; Wu, Jianguo; Zhao, Lin; Wang, Changguan; Liu, Yuling; Yin, Zhengqin; Ma, Zhizhong

    2009-06-01

    To investigate whether autologous retinal pigment epithelium (RPE) and a partial-thickness graft can repair degenerated photoreceptors overlying a mechanically damaged Bruch's membrane. Twenty-one pigmented rabbits were used in the study. Abrasive debridement of the RPE was performed with a metal cannula after superior retinal bleb detachment in 20 rabbits. The graft was prepared beneath the inferior retina and was transplanted to the debridement area 14 days later. Debridement-only sites served as the control. Tissue sections were evaluated by light microscopy and transmission electron microscopy at 7 days, 1 month, and 3 months after transplantation, corresponding to 21 days, 45 days, and 3 months after debridement, respectively. When analyzed at 7 days after transplantation, short buds of inner segment with regularly organized outer nuclear layer were observed. The outer segments (OS) were of insufficient length to be observed, but by 1 and 3 months, a significant elongation of the OS was detected. In control retinas from 21 days (corresponding to 7 days after transplantation) to 3 months after RPE debridement, the outer nuclear layer cells were disorganized and diminished. This study showed that autologous RPE and partial-thickness choroid graft have the capacity not only to support photoreceptor cell survival, but also to initiate early repair mechanisms, as exhibited by outer segment regeneration.

  17. Bad advice; bad burn: a new problem in burn prevention.

    Science.gov (United States)

    Deans, L; Slater, H; Goldfarb, I W

    1990-01-01

    Deep partial-thickness burns had been inflicted on the perineal area of an infant who was recently treated in our Burn Center. The burns were a result of advice to the patient's mother by a pediatrician. The doctor told her to use a hair dryer to prevent diaper rash. We surveyed pediatricians, well-baby clinics, and pediatric nurse practitioners in our area and found that approximately half of them advised the use of hair dryers to treat or prevent diaper rash. We tested four widely available hand-held hair dryers to determine potential for inflicting burn injury. All of the dryers are capable of delivering air heated to at least 53 degrees C after 2 minutes of use. We believe that warnings against the use of hair dryers for perineal hygiene should be included in burn prevention programs.

  18. Magnetic resonance arthrography including ABER view in diagnosing partial-thickness tears of the rotator cuff: Accuracy, and inter- and intra-observer agreements

    Energy Technology Data Exchange (ETDEWEB)

    Jung, Joon-Yong; Jee, Won-Hee; Chun, Ho Jong; Ahn, Myeong Im (Dept. of Radiology, Seoul St. Mary' s Hospital, School of Medicine, Catholic Univ. of Korea, Seoul (Korea)), e-mail: whjee@catholic.ac.kr; Kim, Yang-Soo (Dept. of Orthopedic Surgery, Seoul St. Mary' s Hospital, School of Medicine, Catholic Univ. of Korea, Seoul (Korea))

    2010-03-15

    Background: Partial-thickness tear of the rotator cuff is a common cause of shoulder pain. Magnetic resonance (MR) arthrography has been described as a useful measure to diagnose rotator cuff abnormalities. Purpose: To determine the reliability and accuracy of MR arthrography with abduction and external rotation (ABER) view for the diagnosis of partial-thickness tears of the rotator cuff. Material and Methods: Among patients who underwent MR arthrographies, 22 patients (12 men, 10 women; mean age 45 years) who had either partial-thickness tear or normal tendon on arthroscopy were included. MR images were independently scored by two observers for partial-thickness tears of the rotator cuff. Interobserver and intraobserver agreements for detection of partial-thickness tears of the rotator cuff were calculated by using kappa coefficients. The differences in areas under the receiver operating characteristic (ROC) curves were assessed with a univariate Z-score test. Differences in sensitivity and specificity for interpretations based on different imaging series were tested for significance using the McNemar statistic. Results: Sensitivity, specificity, and accuracy of each reader on MR imaging without ABER view were 83%, 90%, and 86%, and 83%, 80%, and 82%, respectively, whereas on overall interpretation including ABER view, the sensitivity, specificity, and accuracy of each reader were 92%, 70%, and 82%, and 92%, 80%, and 86%, respectively. Including ABER view, interobserver agreement for partial-thickness tear increased from kappa=0.55 to kappa=0.68. Likewise, intraobserver agreements increased from kappa=0.79 and 0.53 to kappa=0.81 and 0.70 for each reader, respectively. The areas under the ROC curves for each reader were 0.96 and 0.90, which were not significantly different. Conclusion: Including ABER view in routine sequences of MR arthrography increases the sensitivity, and inter- and intraobserver agreements for detecting partial-thickness tear of rotator cuff

  19. 烧伤膏外用对浅Ⅱ度水火烫伤创面愈后色素沉着的影响%Effects of burn ointment external application on the hyperpigmentation after healing wound of superficial Ⅱ degree burns of water and fire

    Institute of Scientific and Technical Information of China (English)

    黄树林; 徐茂奇

    2011-01-01

    Objective To investigate the effects of burn ointment external application on the hyperpigmenta-tion after healing wound of superficial II degree burns of water and fire. Methods 84 patients with burns of water and fire were randomly divided into two groups. Patients in two groups received basic therapy including debridement and antibiotics. 40 cases in treatment group received external application of burn ointment No. I at early period and burn ointment No. II at late period. Control group received external application of silver sulfadiazine cream. The frequency of dressing in two groups was a time every other day, a week for a course of treatment. After two courses wound healing time were recorded. The status of hyperpigmentation after wound healing was observed three months later. The ratio of hyperpigmentation area and burn area was calculated. Results Wound healing time, the incidence of hyperpigmentation and the ratio of hyperpigmentation area and burn area in the treatment group (13. 63 + 1.51 d, 20.0% , 15.25 ±3.80) were lower than those in control group (14.70 ±1.34 d, 40.9% , 25.60 ±5.40, P <0. 01, P <0.05). Conclusion External application of burn ointment can significantly reduce healing time, prevent and reduce hyperpigmentation.%目的 观察烧伤膏外用对浅Ⅱ度水火烫伤创面愈后色素沉着的影响.方法 将84例水火烫伤患者随机分为2组,2组均予常规清创、抗感染等基础治疗,治疗组40例早期予烧伤膏Ⅰ号外用,后期予烧伤膏Ⅱ号外用;对照组44例加磺胺嘧啶银乳膏外用治疗.2组均隔日换药1次,1周为1个疗程,治疗2个疗程.统计2组创面修复时间.嘱患者3个月后复诊,观察记录是否发生创面修复后色素沉着,统计色素沉着面积/烧伤面积值.结果 治疗组40例,创面修复时间( 13.63±1.51)d,色素沉着发生率20.0% (8/40),色素沉着面积/烧伤面积为5% ~ 30%,平均(15.25±3.80)%;对照组44例,创面修复时间(14.70±1

  20. Biobrane versus 1% silver sulfadiazine in second-degree pediatric burns

    NARCIS (Netherlands)

    Barret, JP; Dziewulski, P; Ramzy, PI; Wolf, SE; Desai, MH; Herndon, DN

    2000-01-01

    Partial-thickness burns in children have been treated for many years by daily, painful rubbing, washing, and cleansing of the burn wound, followed by topical application of antimicrobial creams. Pain and impaired wound healing are the main problems. We hypothesized that the treatment of second-degre

  1. 特重度烧伤患儿一体化救治与康复%Integration of burn treatment and rehabilitation for a child with extremely severe burn

    Institute of Scientific and Technical Information of China (English)

    李鸿明; 张家平; 陈建; 宋华培; 刘秋石; 范鑫; 彭毅志; 吴军

    2015-01-01

    This article reports the successful experience of integration of burn treatment and rehabilitation for a child suffering from 91% TBSA flame burn injury (with 60% TBSA full-thickness injury,30% TBSA deep partial-thickness injury,and 1% TBSA superficial partial-thickness injury),severe inhalation injury,severe burn shock,stress ulcer,gastrointestinal bleeding and atelectasis of the right upper lung.The patient was given effective fluid infusion against shock,treatment for gastrointestinal bleeding,and other effective supportive treatment for functions of various organs after being admitted to our burn ward.When vital signs became stable at 30 hours post injury,bedside rehabilitation was begun.On post injury day (PID) 4,escharectomy was performed for both lower limbs,followed by microskin grafting and allogeneic skin covering.On PID 10,invasive infection of multi-drug resistant bacteria was found with accompanied high fever,and at the same time allograft began to disintegrate,with dissolution of large area of eschar,leading to a raw surface reaching 86% TBSA.Following debridement,dressing,application of compound polymyxin B ointment,temporary covering of wounds with porcine acellular dermal matrix,adjustment of antibiotics,patient's condition was finally stabilized.From PID 28 on,split-thickness skin grafting was conducted 7times,and the raw surface of 75% TBSA involving the upper and lower limbs and trunk was successfully covered.At the same time,our rehabilitation team launched comprehensive rehabilitation measures comprising active exercise,occupational therapy,prevention of scar formation,organ function training and psychological intervention.Finally,the patient was able to walk unaided and fed herself when the wounds were almost entirely healed in 3 months after injury.Oriented forwards functional rehabilitation,strong cooperation between team members,and synchronous effective implementation of burn treatment and rehabilitation in the whole process

  2. Randomized controlled trial of the absorbency of four dressings and their effects on the evaporation of burn wounds

    Institute of Scientific and Technical Information of China (English)

    CHEN Jiong; HAN Chun-mao; SU Guo-liang; TANG Zhi-jian; SU Shi-jie; LIN Xiao-wei

    2007-01-01

    Background Wound dressings are divided into traditional and new types. The new dressings are thought to accelerate wound healing. The purpose of this study was to supplement the scanty data on the absorbency of the new dressings and their effects on evaporation from the burn surface.Methods The water absorption rate of four dressings (carbon fiber dressing, hydrogel dressing, silver nanoparticle dressing, and vaseline gauze) were measured by the immersion-weight gain method. A total of 120 inpatients with 10%superficial partial-thickness burn wounds were randomly assigned to four groups, each with 30 participants. Carbon fiber dressing, hydrogel dressing, and silver nanoparticle dressing were used in groups A, B, and C as the primary dressing,and traditional vaseline gauze was used in group D as the control. Multi-spot evaporation from normal skin and naked wound, and from wounds covered with each of the four dressings was measured post-burn on days 1, 3, 5, and 7 by an EP-I evaporimeter under conditions of 21 ℃ -22 ℃ ambient temperature and 74%-78% humidity.Results The absorption rates of the four dressings were 988% with carbon fiber dressing, 96% with silver nanoparticle,41% with vaseline gauze, and 6% with hydrogel. Evaporation from the naked burn wounds was about 1/3 higher than from normal skin (P<0.01). Compared with wounds without applied dressing, evaporation from dressed wounds decreased and was time-dependent (P<0.01). The evaporation of wounds with carbon fiber dressing was the lowest ((13.40±2.82)ml·h-1·m-2,P<0.01) on day 1 post-burn,compared with the other groups.Conclusion All four dressings have water retention capacity while carbon fiber dressing has the highest absorption rate and shows the best containment and evaporation from the burn wound.

  3. Economics of pediatric burns.

    Science.gov (United States)

    Bass, Michael J; Phillips, Linda G

    2008-07-01

    Sustaining a burn injury sets in motion a cycle of pain, disfigurement, and a search for survival. In pediatric burns, the injury extends to the parents where fear, ignorance, and helplessness forever change their lives. Pediatric burn injuries are caused by fire, hot liquids, clothing irons, hair curlers, caustic substances like drain cleaner, the grounding of an electrical source, and exposure to radiation. Efficiency in the delivery of pediatric burn care is critical. Maximizing resource utilization means continual self-evaluation and economic analysis of therapeutic modalities. Griffiths et al found that most childhood burns are due to scalds, which can be treated for $1061 per percent burn. Paddock et al reduced the cost of treating superficial pediatric burns and reduced the length of stay in hospital using silver-impregnated gauze over traditional methods. Barrett et al found improved cosmesis of skin grafts using cultured epithelial autografts but at a substantially increased cost. Corpron et al showed that pediatric burn units that treat burns >10% total body surface area and operative treatment of pediatric burns regardless of size generate positive revenue. There is a paucity of evidentiary pediatric burn economic data. More research is needed to address areas of pediatric burn care inefficiency. Improving knowledge of cost in all health care endeavors will create competition and drive down expenditures.

  4. Valoration of burned body surface; area in patients of San Vicente de Paúl University Hospital, Medellín, 2004 Evaluación de la superficie corporal quemada en pacientes del Hospital Universitario San Vicente de Paúl, Medellín, 2004

    Directory of Open Access Journals (Sweden)

    Marco Antonio Hoyos Franco

    2007-03-01

    Full Text Available INTRODUCTION: The estimation of the burned surface area has a huge importance for the acute management and prognosis of the burn victim It has been revised the different methods available for the assessment of the burn extent and some resuscitation basic concepts. MATERIALS AND METHODS: A retrospective descriptive study was made based on the information took from medical records of patients from the burn unit of the San Vicente de Paul University Hospital in Medellín (Col during 2004. The initial diagnosis of the burn extension made by the remittent clinician was compared with the ones made by experience clinicians at the emergency room and by the plastic surgeon at the Burn Unit. The results obtained were processed with the package Statistic 6.0 (Stafsoft Inc and it was considered significant a p value < 0.05. The variables are presented as absolute values and with their respective percentages. RESULTS AND CONCLUSIONS: There were 329 attended patients. 60% of them had mistaken or incomplete diagnosis, and 39.3% of the diagnosis made at our emergency room were incomplete or incorrect. We found more frequently overestimation than underestimation of the burn surface area. In most of the cases mistakes were made that modified the burn category (mild, moderate, and severe. It is necessary to improve basic knowledge about burn care in the inexperience clinicians. INTRODUCCIÓN: la evaluación de la superficie corporal quemada tiene gran importancia para el tratamiento inicial y el pronóstico del paciente quemado. Se revisan los diferentes métodos para evaluar la superficie corporal quemada y algunos conceptos básicos de reanimación. MATERIALES Y MÉTODOS: se realizó un estudio descriptivo, retrospectivo y transversal a partir de las historias clínicas de los pacientes quemados hospitalizados en el Hospital Universitario San Vicente de Paúl (HUSVP de Medellín durante el año 2004. Se compararon los diagnósticos de extensión quemada emitidos

  5. Objective evaluation of burn and post-surgical scars and the accuracy of subjective scar type judgment

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Background The true proliferation degree of bum and operation scars during their maturation was poorly defined. The objective of this study was to provide a quantitative evaluation of the proliferation degree of deep-partial thickness bum and surgical suture wound scars after wound healing and the accuracy of subjective judgment of scar types. Methods A total of 423 patients in the burn group and 667 patients in the suture wound group were enrolled in this study. Objective scar measurement (by negative-positive moulage) was carried out at 3, 6 and 12 months after wound healing in 1090 patients from different regions in China. The KruskaI-Wallis H test and chi-square test were used in the statistical analysis. Results The median degrees of scar proliferation were 0.03 cm at 3 months, 0.03 cm at 6 months and 0 cm at 12 months in the burn group and 0.05 cm, 0.04 cm and 0.04 cm respectively in the suture wound group. At 3 and 6 months post wound healing, there was no significant difference in scar proliferation between the groups (P>0.01). After 1 year, burn scars displayed evidence of atrophy (P<0.01). Although the degree of scar proliferation differed among the four scar types (P<0.01), the ranges of scar height in the four scar types largely overlapped when judged in a subjective manner, especially in proliferation and superficial scars. Conclusions Scar atrophy occurs after one year in burns, but not in the surgical suture wound group. It is important to take anti-scar therapy for surgical wounds as well as burn wounds. The various scar types could not be judged precisely in a subjective manner.

  6. Partial-thickness articular surface rotator cuff tears in patients over the age of 35: Etiology and intra-articular associations

    Directory of Open Access Journals (Sweden)

    Chetan S Modi

    2012-01-01

    Full Text Available Purpose: Partial-thickness articular-sided rotator cuff tears have a multifactorial etiology and are associated with degeneration of the tendon. They are often described as an injury of the young athlete, although they are also found in the older population. The aim of this study was to investigate the frequency and associations of partial-thickness articular-sided tears in patients over the age of 35 years. Design: Retrospective Materials and Methods: A retrospective study of all arthroscopic procedures for rotator cuff pathology in patients over the age of 35 years over a 2-year period by a single surgeon was performed. The included patients were divided into two groups based on the arthroscopic findings: those with a partial-thickness articular-sided rotator cuff tear and those with pure tendinopathy. The groups were then compared to identify the associated pathology with the rotator cuff lesions. 2×2 contingency table analysis and unpaired Student′s t-test were used for statistical analysis. Results: One hundred patients were included in the study of whom 62 had a partial articular-sided tear. Those with a partial articular-sided tear were older (P=0.0001, were more commonly associated with a documented injury (P=0.03, and more commonly had biceps degeneration (P=0.001 and synovitis (P=0.02 within the joint. Conclusion: Partial-thickness articular-sided tears are a common occurrence in patients requiring arthroscopic surgery for rotator cuff pathology over the age of 35 years. This probably reflects an injury in an already degenerate cuff. This would support the theory of intrinsic degeneration of the tendon in this age group and probably represent a different etiology to those seen in the young athletes. Level of Evidence: Level 3

  7. Fibroblast growth factor-2 promotes the repair of partial thickness defects of articular cartilage in immature rabbits but not in mature rabbits.

    Science.gov (United States)

    Yamamoto, Tetsuya; Wakitani, Shigeyuki; Imoto, Kazuhiko; Hattori, Takako; Nakaya, Hiroyuki; Saito, Masanobu; Yonenobu, Kazuo

    2004-08-01

    To investigate cartilage response to fibroblast growth factor-2 (FGF-2) with increasing age in vivo, we examined the effect of FGF-2 on partial thickness defects of immature and mature rabbits. Sixty-nine Japanese white rabbits (34 immature rabbits, 35 mature rabbits) were examined. We made experimental partial thickness defects in articular cartilage of the knees. Then, we injected FGF-2 into the knees eight times, immediately after surgery and every 2 days for 2 weeks. A single dose of FGF-2 was 10 ng/0.1 ml or 100 ng/0.1 ml. In the control group, 0.1 ml saline was injected on the same time schedule. The rabbits were sacrificed at intervals following surgery that ranged from 2 to 48 weeks. The specimens were stained with toluidine blue and examined microscopically. We used a modified semiquantitative scale for evaluating the histological appearance of repair. In immature rabbits, the cartilage repair in the FGF-2 (100 ng)-treated group was significantly better than that of the other groups. The defects were almost completely repaired with chondrocytes that showed a round to polygonal morphology, and large amounts of extracellular matrix with intense metachromatic staining. In mature rabbits, however, there was apparently no effect from FGF-2 in either group. Application of FGF-2 facilitated cartilage repair in partial thickness defects in immature rabbits, but not in mature ones.

  8. Effect of evaporative surface cooling on thermographic assessment of burn depth

    Science.gov (United States)

    Anselmo, V. J.; Zawacki, B. E.

    1977-01-01

    Differences in surface temperature between evaporating and nonevaporating, partial- and full-thickness burn injuries were studied in 20 male, white guinea pigs. Evaporative cooling can disguise the temperature differential of the partial-thickness injury and lead to a false full-thickness diagnosis. A full-thickness burn with blister intact may retain enough heat to result in a false partial-thickness diagnosis. By the fourth postburn day, formation of a dry eschar may allow a surface temperature measurement without the complication of differential evaporation. For earlier use of thermographic information, evaporation effects must be accounted for or eliminated.

  9. Human beta defensin is absent in burn blister fluid.

    Science.gov (United States)

    Ortega, M R; Ganz, T; Milner, S M

    2000-12-01

    Defensins are a family of cationic antimicrobial peptides that participate in innate host defence. Human beta defensin-2 (HBD-2) is produced by human keratinocytes, and has a potent bactericidal activity against a wide spectrum of microorganisms. We have recently shown that expression of HBD-2 is present in normal skin and lost in the full-thickness burn wound. Defensins have been found in the blister fluid of chronic wounds. Our study was designed to examine blister fluid from partial-thickness burns for defensin content. Fluid from five patients was collected from partial-thickness burn blisters, and then analysed by sandwich Enzyme-Linked Immunosorbent Assay (ELISA) with a monoclonal antibody and rabbit polyclonal antibody to HBD-2. The assay was validated against a Western blot assay for HBD-2 in samples of bronchoalveolar lavage fluid from patients with inflammatory lung disease. No HBD-2 was detectable in any of the burn blister fluids analysed. HBD-2 is lost in the full-thickness burn wound, and we have now demonstrated its absence in burn blister fluid. This finding represents evidence of a host defence defect within the burn wound and suggests a possible therapeutic role for antimicrobial peptides in the management of burn wounds.

  10. Full thickness burn caused by exposure to giant hogweed: delayed presentation, histological features and surgical management.

    LENUS (Irish Health Repository)

    Chan, Jeffrey C Y

    2012-02-01

    We report the case of a 10-year-old boy with a full thickness chemical burn on his right pretibial area due to phytophotodermatitis (PPD) following contact with giant hogweed (Heracleum mantegazzianum). Although cutaneous burns due to plants are a well-established cause of chemical burn, previous reports described partial thickness burns that healed with conservative measures. This patient presented to our unit two weeks after the initial injury with an established full thickness burn. Debridement and split thickness skin grafting was required. We presented the histological features of the debrided skin specimen and discussed potential factors leading to this unexpected full thickness injury.

  11. Efficacy of glutathione mesotherapy in burns: an experimental study.

    Science.gov (United States)

    Buz, A; Görgülü, T; Olgun, A; Kargi, E

    2016-12-01

    Thermal burns are the leading cause of trauma worldwide. Currently, no consensus on optimal treatment of deep partial-thickness (second-degree) burns has emerged, as reflected by the wide variability in available wound-care materials. The relative efficacies of products used for treatment of partial-thickness thermal burns remain unclear. Mesotherapy features intradermal administration of various agents, depending on burn location. In the present experimental study, we explored the efficacy of mesotherapy used to treat partial-thickness thermal burns in 50 male Wistar rats divided into five groups of equal number. No procedure was performed after infliction of thermal burns in control group (Group 1). Mesotherapy was applied with physiological saline in sham group (Group 2), glutathione, taurine, and L-carnitine were separately applied in Group 3, Group 4, and Group 5, respectively. Mesotherapeutic agents were injected intradermally into the reticular layer of the dermis using the point technique. The first course of mesotherapy was given within the first 2 h after infliction of thermal burns, and therapy was continued to day 10. On day 22, unhealed thermal burn areas were measured prior to sacrifice, and biopsies covering the total areas of burns were performed to allow of pathological evaluation. Group 3 (the glutathione group) showed the best extent of healing, followed by Group 4 (the taurine group) and Group 5 (the L-carnitine group). The healed thermal burn areas in these groups were significantly greater than those in the control and sham groups (P = 0.001). All of healing, acute and chronic inflammation, the amount of granulation tissue, the level of fibroblast maturation, the amount of collagen, the extent of re-epithelization and neovascularization, and ulcer depth were scored upon pathological examination of tissue cross-sections. The best outcomes were evident in the glutathione group, with statistical significance. Although wound healing in the L

  12. Hydrocolloid dressing in pediatric burns may decrease operative intervention rates.

    LENUS (Irish Health Repository)

    Martin, Fiachra T

    2010-03-01

    Partial-thickness scalds are the most common pediatric burn injury, and primary management consists of wound dressings to optimize the environment for reepithelialization. Operative intervention is reserved for burns that fail to heal using conservative methods. Worldwide, paraffin-based gauze (Jelonet) is the most common burn dressing; but literature suggests that it adheres to wounds and requires more frequent dressing change that may traumatize newly epithelialized surfaces. Hydrocolloid dressings (DuoDERM) provide an occlusive moist environment to optimize healing and are associated with less frequent dressing changes.

  13. Burn Pits

    Science.gov (United States)

    ... Enter ZIP code here Enter ZIP code here Burn Pits Burn Pits Registry Studies Photo: U.S. Department ... the health of deployed Veterans. Health effects from burn pit smoke Toxins in burn pit smoke may ...

  14. Burn Institute

    Science.gov (United States)

    ... Now Help keep local seniors safe from fire! Burn Survivor Support If you are reading this, chances ... year – a burn injury. Learn more Fire and Burn Prevention Each year, the Burn Institute provides fire ...

  15. Effect of Cactus Extracts on the Expression of VEGF and FGF-2 in Rats with Superficial Second-degree Burns%仙人掌提取物对浅Ⅱ度烫伤小鼠VEGF及FGF-2表达的影响

    Institute of Scientific and Technical Information of China (English)

    陈世兴; 王亮; 杨哲; 颜栋; 辛毅; 张翠丽

    2011-01-01

    In order to determine the effects of wild cactus extracts and edible cactus extracts on the expression of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor 2 (FGF-2) at the superficial second-degree burns.the superficial second-degree burned mice were divided into four groups randomly;wild cactus extracts treated group, edible cactus extracts treated group, drag treated group, and burned group (the wound without treatment). Expression of growth factor of VEGF and FGF-2 were measured by western-blotting. Expressions of VEGF and FGF-2 were higher in wild cactus extracts treated group and edible cactus extracts treated group than those in other groups, but they were different in wild cactus extracts treated group and edible cactus extracts treated group. In conclusion, both wild cactus ex.acts and edible cactus extracts enhanced the expression of VEGF and FGF and promoted wound healing.%为探讨野生仙人掌和食用仙人掌提取物对浅Ⅱ度烫伤小鼠内源性血管内皮生长因子(VEGF)及碱性成纤维细胞生长因子(FGF-2)表达的影响,建立小鼠浅Ⅱ度烫伤模型.野生、食用仙人掌提取物组(浓度均为12.5 mg/mL),药物组(京万红),烫伤组(生理盐水),每天2次涂药并观察创面,分别在3 d和7 d各组取5只小鼠处死,取烫伤组织提取蛋白并检测VEGF、FGF-2的表达状况.仙人掌组中VEGF及FGF-2的表达量均高于烫伤组,且两种仙人掌组VEGF及FCF-2的表达量有差异.即仙人掌提取物能提高VEGF及FGF-2的表达量并能促进创面的修复.

  16. 电刀浅筋膜层切痂中厚皮移植治疗手深度烧伤的临床价值分析%Analysis of the clinical value of electric knife superficial fascia escharectomy and split thickness skin grafting in the treatment of deep hand burn

    Institute of Scientific and Technical Information of China (English)

    田宝祥; 樊华; 蔺海龙; 杨雄; 刘洋; 魏纯琳; 刘凤彬

    2014-01-01

    目的:探讨应用早期电刀浅筋膜层切痂大张自体中厚皮移植技术对手部深度烧伤患者实施治疗的临床效果。方法:2011年6月-2013年6月收治深度手部烧伤患者74例,随机分为对照组和治疗组各37例。治疗组采用早期电刀浅筋膜层切痂大张自体中厚皮移植技术治疗;对照组采用传统手术方法。比较两组临床疗效。结果:治疗组手部烧伤病情治疗效果明显优于对照组;手术操作时间、术后恢复治疗时间、手部功能和外观复常时间明显短于对照组;围手术期不良反应例数明显少于对照组。结论:应用早期电刀浅筋膜层切痂大张自体中厚皮移植技术对患有深度手部烧伤的患者实施治疗的临床效果非常明显。%Objective:To investigate the clinical effect of application of early electric knife superficial fascia escharectomy autologous split thickness skin grafting technique on patients with hand deep burn.Methods:74 cases with hand deep burn were selected from June 2011 to June 2013.They were randomly divided into the treatment group and the control group with 37 cases in each.The treatment group were treated with early electric knife superficial fascia escharectomy autologous split thickness skin grafting technique treatment;the control group were treated with traditional operation method.Compare the clinical effect of the two groups.Results:Treatment effect of hand burns in patients of the treatment group was better than that of the control group;the operation time,postoperative recovery time,hand function and appearance of the recovery time were shorter than those of the control group;peri operation period of adverse reactions were significantly less than the control group.Conclusion:Application of early electric knife superficial fascia escharectomy autologous split thickness skin grafting technique on patients with hand deep burn can have an obviously treatment effect.

  17. Superficies de segundo orden

    OpenAIRE

    Salazar Salazar, Luis Álvaro

    1987-01-01

    Este trabajo se propone poner al alcance de estudiantes de primeros semestres de carreras de aplicación de la matemática, un algoritmo proporcionado por el álgebra lineal, para tratar con mas generalidad, agilidad y libertad unos objetos de la geometría analítica de no fácil manipulación por otros métodos y que se conocen como superficies de segundo orden o superficies cuádricas. En este orden de ideas, el autor considera importante que con este tratamiento se incluya este tema en una asignat...

  18. Clinical Experience: Using Dehydrated Human Amnion/Chorion Membrane Allografts for Acute and Reconstructive Burn Care.

    Science.gov (United States)

    Reilly, Debra Ann; Hickey, Sean; Glat, Paul; Lineaweaver, William C; Goverman, Jeremy

    2017-02-01

    Amniotic membrane is immunologically privileged and is a reservoir of growth factors and cytokines known to modulate inflammation and enhance the healing process, while also possessing antimicrobial, antifibrosis, and antiscarring properties. These properties establish a strong argument for using amniotic membrane derived products as a treatment for burns. The purpose of this article is to describe the use of commercially available dehydrated human amnion/chorion membrane allografts in patients with partial-thickness and full-thickness burns.

  19. Comparison of silver nylon wound dressing and silver sulfadiazine in partial burn wound therapy.

    Science.gov (United States)

    Abedini, Fereydoon; Ahmadi, Abdollah; Yavari, Akram; Hosseini, Vahid; Mousavi, Sarah

    2013-10-01

    The study aims to perform a comparative assessment of two types of burn wound treatment. To do the assessment, patients with partial thickness burn wounds with total body surface area nylon wound dressing or silver sulfadiazine cream. Efficacy of treatment, use of analgesics, number of wound dressing change, wound infection and final hospitalisation cost were evaluated. The study showed silver nylon wound dressing significantly reduced length of hospital stay, analgesic use, wound infection and inflammation compared with silver sulfadiazine.

  20. Effects of a topical aqueous oxygen emulsion on collagen deposition and angiogenesis in a porcine deep partial-thickness wound model.

    Science.gov (United States)

    Li, Jie; Ollague Sierra, Jose; Zhu, Linjian; Tang, Ling; Rahill, Kirah; El-Sabawi, Bassim; Liu-Mares, Wen; Mertz, Patricia M; Davis, Stephen C

    2013-10-01

    A porcine deep partial-thickness wound model was used to evaluate the effects of a newly developed topical aqueous oxygen emulsion (TOE) on wound repair. The wounds were treated with TOE, which contains super-saturated oxygen or vehicle control. Semiquantitative immunofluorescent staining was performed to examine protein production for type I and type III collagen and vascular endothelial growth factor (VEGF). Immunofluorescent staining revealed higher protein levels of type I and type III collagen and VEGF in the TOE treatment group. Histological analysis also revealed improved angiogenesis and granulation tissue formation with topical TOE treatment and was consistent with the protein expression. In addition, the histology examination demonstrated faster epithelialization in wounds treated with TOE. The study suggests that sustained high levels of oxygen released by TOE may promote the process of wound repair through increasing collagen deposition and angiogenesis as well as stimulating epithelialization.

  1. Keystone Perforator Island Flap as an Alternative Reconstructive Option for Partial Thickness Alar Defects Up to 1.5 Centimeters.

    Science.gov (United States)

    Kostopoulos, Epameinondas; Agiannidis, Christos; Konofaos, Petros; Kotsakis, Ioannis; Champsas, Grigorios; Frangoulis, Marios; Papadopoulos, Othon; Casoli, Vincent

    2016-07-01

    The ala is a unique landmark of the nose disposing aesthetic and functional properties. The head and neck area is the main site of appearance of nonmelanoma skin cancer. One third of them are located in the nose with an alar preponderance compared with other nasal subunits. Correction of alar defects is a challenging reconstructive task. The keystone perforator island flap (KPIF) was introduced as an alternative in nasal reconstruction by senior authors. In the present case series, KPIFs' application is introduced into the alar subunit as an alternative, versatile, and reproducible reconstructive option, even for the novice plastic surgeon. From April 2014 to September 2015, patients presenting with partial thickness alar defects (≤1.5 cm) secondary to tumor extirpation sustained reconstruction with different types of KPIF. A total of 31 patients (mean age of 72 years) were treated with various types of KPIF. The mean diameter of the defect was 1.14 cm. The vast majority of reconstructions concerned a type IV KPIF (18/31 or 58.1%). Sometimes an upward alar retraction was noted. A minimal rim wedge excision was performed (≤0.3 mm) using counterbalancing correcting sutures. All flaps survived without any sign of venous congestion, whereas the rim healed uneventfully. The mean follow-up period was 6.5 months. KPIF was introduced as a single-stage alternative reconstructive option for partial thickness alar defects, completing author's experience with this flap into such a challenging and aesthetically critical anatomic area.

  2. Repair versus shaving of partial-thickness articular-sided tears of the upper subscapularis tendon. A prospective randomized controlled trial

    Science.gov (United States)

    RANDELLI, PIETRO; ARRIGONI, PAOLO; ALIPRANDI, ALBERTO; SDAO, SILVANA; RAGONE, VINCENZA; D’AMBROSI, RICCARDO; RANDELLI, FILIPPO; CABITZA, PAOLO; BANFI, GIUSEPPE

    2015-01-01

    Purpose the purpose of this study was to evaluate whether treating partial-thickness articular-sided tears of the upper subscapularis (SSC) tendon with a dedicated suture anchor would result in an internal rotation strength improvement compared with simple shaving of the SSC tendon and footprint. Methods twenty-six patients with a limited SSC tendon tear (equal or inferior to the most superior centimeter) in association with a posterosuperior cuff lesion were prospectively randomized to two treatments: repair with a dedicated suture anchor versus shaving of the tendon and footprint. The patients also underwent long head of the biceps (LHB) treatment and posterosuperior cuff tear repair. In each patient the following parameters were measured both preoperatively and at a minimum follow-up of 2.5 years: strength in internal rotation in the bear-hug testing position (using a digital tensiometer), DASH score and Constant scores. MRI assessment of tendon healing was performed at the final follow-up. Results twenty of the 26 patients (76%) were reviewed after a mean follow-up time of 42 months: 11 patients had undergone SSC tendon repair and nine simple shaving. At final follow-up no significant differences were found between the repaired and shaving group in strength in internal rotation (9.5 ± 3.8 kg versus 10.3±5.4 kg; p=0.7). The DASH score and Constant score also failed to show significant differences between the two groups. Furthermore, no significant difference in SSC tendon healing rate was observed on MRI evaluation. Conclusions partial-thickness articular-sided tear of the upper SSC tendon in association with a posterosuperior rotator cuff repair and LHB treatment, when limited to the superior centimeter of the SSC tendon, shows a comparable performance in terms of strength in internal rotation either after simple shaving or a tendon-to-bone repair. Level of evidence Level II, prospective comparative study. PMID:26889466

  3. [Tactics of treatment for extended burns of various affection depth].

    Science.gov (United States)

    Kovalenko, O M

    2012-02-01

    Investigation was based on analysis of the treatment results of 75 children, suffering extended superficial and deep skin burns squared 15-30% of body surface. There was proved, that sequence of excision of superficial and deep necrotic scab influences the burn disease course. There was elaborated algorithm of sequence of the operative treatment stages in patients, suffering extended superficial skin burns, coexisting with deep burns, the superficial necrotic scab definitely, was excised after trauma and a deep one--in the second stage. The superficial and deep necrotic scab excision before 7-9th day after trauma have promoted significant reduction of the intoxication syndrome severity, the middle molecular mass peptides, indices of peroxidal oxidization of lipids, oxidizing modification of proteins, clinical signs of SIRS, rate of septic complications in 1.75 times, the stationary treatment time of severely ill patients by (7.2 +/- 1.5) days.

  4. Hair bleaching and skin burning.

    Science.gov (United States)

    Forster, K; Lingitz, R; Prattes, G; Schneider, G; Sutter, S; Schintler, M; Trop, M

    2012-12-31

    Hairdressing-related burns are preventable and therefore each case is one too many. We report a unique case of a 16-yr-old girl who suffered full-thickness chemical and thermal burns to the nape of her neck and superficial burns to the occiput after her hair had been dyed blond and placed under a dryer to accelerate the highlighting procedure. The wound on the nape of the neck required surgical debridement and skin grafting. The grafted area resulted in subsequent scar formation.

  5. Common Superficial Bursitis.

    Science.gov (United States)

    Khodaee, Morteza

    2017-02-15

    Superficial bursitis most often occurs in the olecranon and prepatellar bursae. Less common locations are the superficial infrapatellar and subcutaneous (superficial) calcaneal bursae. Chronic microtrauma (e.g., kneeling on the prepatellar bursa) is the most common cause of superficial bursitis. Other causes include acute trauma/hemorrhage, inflammatory disorders such as gout or rheumatoid arthritis, and infection (septic bursitis). Diagnosis is usually based on clinical presentation, with a particular focus on signs of septic bursitis. Ultrasonography can help distinguish bursitis from cellulitis. Blood testing (white blood cell count, inflammatory markers) and magnetic resonance imaging can help distinguish infectious from noninfectious causes. If infection is suspected, bursal aspiration should be performed and fluid examined using Gram stain, crystal analysis, glucose measurement, blood cell count, and culture. Management depends on the type of bursitis. Acute traumatic/hemorrhagic bursitis is treated conservatively with ice, elevation, rest, and analgesics; aspiration may shorten the duration of symptoms. Chronic microtraumatic bursitis should be treated conservatively, and the underlying cause addressed. Bursal aspiration of microtraumatic bursitis is generally not recommended because of the risk of iatrogenic septic bursitis. Although intrabursal corticosteroid injections are sometimes used to treat microtraumatic bursitis, high-quality evidence demonstrating any benefit is unavailable. Chronic inflammatory bursitis (e.g., gout, rheumatoid arthritis) is treated by addressing the underlying condition, and intrabursal corticosteroid injections are often used. For septic bursitis, antibiotics effective against Staphylococcus aureus are generally the initial treatment, with surgery reserved for bursitis not responsive to antibiotics or for recurrent cases. Outpatient antibiotics may be considered in those who are not acutely ill; patients who are acutely ill

  6. SUPERFICIAL CERVICAL PLEXUS BLOCK

    Directory of Open Access Journals (Sweden)

    Komang Mega Puspadisari

    2014-01-01

    Full Text Available Superficial cervical plexus block is one of the regional anesthesia in  neck were limited to thesuperficial fascia. Anesthesia is used to relieve pain caused either during or after the surgery iscompleted. This technique can be done by landmark or with ultrasound guiding. The midpointof posterior border of the Sternocleidomastoid was identified and the prosedure done on thatplace or on the level of cartilage cricoid.

  7. Accidental burns during surgery.

    Science.gov (United States)

    Demir, Erhan; O'Dey, Dan Mon; Pallua, Norbert

    2006-01-01

    The purpose of this report is to increase awareness of intraoperative burns during standard procedures, to discuss their possible causes and warning signs and to provide recommendations for prevention and procedures to follow after their occurrence. A total of 19 patients associated with intraoperative burn accidents were treated surgically and analyzed after a mean follow-up of 5 +/- 3.5 months. Review included retrospective patient chart analysis, clinical examination, and technical device and equipment testing. A total of 15 patients recently underwent cardiac surgery, and 4 pediatric patients recovered after standard surgical procedures. A total of 15 patients had superficial and 4 presented with deep dermal or full-thickness burns. The average injured TBSA was 2.1 +/- 1% (range, 0.5-4%). Delay between primary surgery and consultation of plastic surgeons was 4.5 +/- 3.4 days. A total of 44% required surgery, including débridment, skin grafting or musculocutaneous gluteus maximus flaps, and the remaining patients were treated conservatively. Successful durable soft-tissue coverage of the burn region was achieved in 18 patients, and 1 patient died after a course of pneumonia. Technical analysis demonstrated one malfunctioning electrosurgical device, one incorrect positioned neutral electrode, three incidents occurred after moisture under the negative electrode, eight burns occurred during surgery while fluid or blood created alternate current pathways, five accidents were chemical burns after skin preparation with Betadine solution, and in one case, the cause was not clear. The surgical team should pay more attention to the probability of burns during surgery. Early patient examination and immediate involvement of plastic and burn surgeons may prevent further complications or ease handling after the occurrence.

  8. Assessment of burn depth and burn wound healing potential.

    Science.gov (United States)

    Monstrey, Stan; Hoeksema, Henk; Verbelen, Jos; Pirayesh, Ali; Blondeel, Phillip

    2008-09-01

    The depth of a burn wound and/or its healing potential are the most important determinants of the therapeutic management and of the residual morbidity or scarring. Traditionally, burn surgeons divide burns into superficial which heal by rapid re-epithelialization with minimal scarring and deep burns requiring surgical therapy. Clinical assessment remains the most frequent technique to measure the depth of a burn wound although this has been shown to be accurate in only 60-75% of the cases, even when carried out by an experienced burn surgeon. In this article we review all current modalities useful to provide an objective assessment of the burn wound depth, from simple clinical evaluation to biopsy and histology and to various perfusion measurement techniques such as thermography, vital dyes, video angiography, video microscopy, and laser Doppler techniques. The different needs according to the different diagnostic situations are considered. It is concluded that for the initial emergency assessment, the use of telemetry and simple burn photographs are the best option, that for research purposes a wide range of different techniques can be used but that, most importantly, for the actual treatment decisions, laser Doppler imaging is the only technique that has been shown to accurately predict wound outcome with a large weight of evidence. Moreover this technique has been approved for burn depth assessment by regulatory bodies including the FDA.

  9. Effect of glenohumeral abduction angle on the mechanical interaction between the supraspinatus and infraspinatus tendons for the intact, partial-thickness torn, and repaired supraspinatus tendon conditions.

    Science.gov (United States)

    Andarawis-Puri, Nelly; Kuntz, Andrew F; Ramsey, Matthew L; Soslowsky, Louis J

    2010-07-01

    Rotator cuff tears are difficult to manage because of the structural and mechanical inhomogeneity of the supraspinatus tendon. Previously, we showed that with the arm at the side, the supraspinatus and infraspinatus tendons mechanically interact such that conditions that increase supraspinatus tendon strain, such as load or full-thickness tears, also increase infraspinatus tendon strain. This suggests that the infraspinatus tendon may shield the supraspinatus tendon from further injury while becoming at increased risk of injury itself. In this study, the effect of glenohumeral abduction angle on the interaction between the two tendons was evaluated for supraspinatus tendon partial-thickness tears and two repair techniques. Principal strains were quantified in both tendons for 0 degrees , 30 degrees , and 60 degrees of glenohumeral abduction. Results showed that interaction between the two tendons is interrupted by an increase in abduction angle for all supraspinatus tendon conditions evaluated. Infraspinatus tendon strain was lower at 30 degrees and 60 degrees than at 0 degrees abduction angle. In conclusion, interaction between the supraspinatus and infraspinatus tendons is interrupted with increase in abduction angle. Additionally, 30 degrees abduction should be further evaluated for management of rotator cuff tears and repairs as it is the angle at which both supraspinatus and infraspinatus tendon strain is decreased.

  10. Arthroscopic Repair of Articular Surface Partial-Thickness Rotator Cuff Tears: Transtendon Technique versus Repair after Completion of the Tear—A Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Yohei Ono

    2016-01-01

    Full Text Available Articular surface partial-thickness rotator cuff tears (PTRCTs are commonly repaired using two different surgical techniques: transtendon repair or repair after completion of the tear. Although a number of studies have demonstrated excellent clinical outcomes, it is unclear which technique may provide superior clinical outcomes and tendon healing. The purpose was to evaluate and compare the clinical outcomes following arthroscopic repair of articular surface PTRCT using a transtendon technique or completion of the tear. A systematic review of the literature was performed following PRISMA guidelines and checklist. The objective outcome measures evaluated in this study were the Constant Score, American Shoulder and Elbow Surgeons score, Visual Analogue Scale, physical examination, and complications. Three studies met our criteria. All were prospective randomized comparative studies with level II evidence and published from 2012 to 2013. A total of 182 shoulders (mean age 53.7 years; mean follow-up 40.5 months were analyzed as part of this study. Both procedures provided excellent clinical outcomes with no significant difference in Constant Score and other measures between the procedures. Both procedures demonstrated improved clinical outcomes. However, there were no significant differences between each technique. Further studies are required to determine the long-term outcome of each technique.

  11. Superficies de placer

    OpenAIRE

    Delli Gatti, Romina

    2012-01-01

    La presente tesis cuenta con 28 pinturas en distintos formatos y tama- ños a través de los cuales la artista investiga diferentes objetos de su entorno cotidiano que le resultan agradables y pueden llegar a transformar anímicamente. De esta manera se van construyendo superficies ideales, relacionadas principalmente con lo cotidiano y lo intimo, lo orgánico, lo industrial, el diseño textil y lo abstracto. Es un intento por generar o prolongar una sensación visual de agrado y placer a tra...

  12. Characteristics of burn deaths from 2003 to 2009 in a burn center: A retrospective study

    Directory of Open Access Journals (Sweden)

    Jian Chen

    2013-09-01

    Full Text Available Mortality remains one of the most important end-point quality control parameters to evaluate a burn care system. We retrospectively reviewed the characteristics and multiple organ dysfunction syndrome (MODS patterns of burn deaths in our center from January 2003 to December 2009. The mortality rate during this time period was 2.3%. Fifty-six patients died, including 49 males and 7 females. The mean survival time was 28.45 ± 24.60 days. The burn percentage was (76.70 ± 26.86 % total burn surface area (TBSA, with (27.74 ± 24.95 % deep-partial thickness burns and (46.88 ± 33.84 % full-thickness burns. Inhalation injury was diagnosed in 36 (64.29% patients. Patients who had undergone an operation, particularly in the first week post-burn, had a significantly longer survival time. An average of 5.50 ± 1.35 malfunctioning organs per patient and a mean sequential organ failure assessment (SOFA score of 13.91 ± 3.65 were observed. The most frequently malfunctioning organs were involved in the respiratory, hematologic, circulatory, and central nervous systems. Most of the organ damage occurred during the first week post-burn, followed by 4 weeks later, with relatively less organ damage observed in the third week. Among patients with a TBSA over 50%, non-survivors had larger burn sizes (particularly larger full-thickness burns and a higher incidence of inhalation injury compared with survivors; non-survivors were also more likely to have microorganism-positive blood and sputum cultures. In conclusion, burn deaths are related to a higher burn percentage, inhalation injury, MODS, and infection. Early operation may help improve survival duration.

  13. Epidemiology of outpatient burns in Tehran: an analysis of 4813 cases.

    Science.gov (United States)

    Taghavi, Morteza; Rasouli, Mohammad R; Boddouhi, Nosratollah; Zarei, Mohammad Reza; Khaji, Ali; Abdollahi, Morteza

    2010-02-01

    This study aims to demonstrate the epidemiologic characteristics of outpatient burn injuries in Tehran. This cross-sectional study was performed over a 1-year period in a referral burn centre in Tehran and included all outpatient burns. The required data were recorded by two trained physicians. Of the 4813 studied patients, including 293 infants, 2901 patients (60%) were male (Pburns were non-intentional (n=4808) and 70.5% of the injuries occurred at home. Housewives consisted of 24% of the burn patients. With respect to the site of burn, multiple injuries were the most frequent (53%) followed by upper extremities (37%). Most of the burns (96%) were partial thickness. Significant association was present between the aetiology and depth of burn (Pchildren younger than 10 years are at greater risk of these injuries and therefore should be the target for preventive strategies.

  14. Paediatric burns anaesthesia: the things that make a difference

    African Journals Online (AJOL)

    2014-10-21

    Oct 21, 2014 ... the presence of inhalational injury, and the rapidity of wound closure and burn ... experience. At a later stage, reconstructive and plastic surgery .... Appearance. Healing. Superficial: Epidermis. Momentary exposure. • Sunburn.

  15. Detection of partial-thickness supraspinatus tendon tears: is a single direct MR arthrography series in ABER position as accurate as conventional MR arthrography?

    Energy Technology Data Exchange (ETDEWEB)

    Schreinemachers, Saskia A. [Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Onze Lieve Vrouwe Gasthuis, Amsterdam (Netherlands); Hulst, Victor P.M. van der; Woude, Henk-Jan van der [Onze Lieve Vrouwe Gasthuis, Department of Radiology, Amsterdam (Netherlands); Willems, W.J. [Onze Lieve Vrouwe Gasthuis, Orthopaedic Surgery, Amsterdam (Netherlands); Bipat, Shandra [University of Amsterdam (NL). Department of Radiology, Academic Medical Center (Netherlands)

    2009-10-15

    The purpose of this study was to retrospectively evaluate sensitivity and specificity of a single magnetic resonance (MR) arthrography series in abduction external rotation (ABER) position compared with conventional MR arthrography for detection of supraspinatus tendon tears, with arthroscopy as gold standard, and to assess interobserver variability. Institutional review board approval was obtained; informed consent was waived. MR arthrograms of 250 patients (170 men and 80 women; mean age, 36 years) were retrospectively and independently evaluated by three observers. Oblique coronal T1-weighted fat-suppressed images, proton density, and T2-weighted images and axial T1-weighted images and oblique sagittal T1-weighted fat-suppressed images were analyzed to detect supraspinatus tendon tears. Separately, a single T1-weighted fat-suppressed oblique axial series in ABER position was evaluated. Both protocols were scored randomly without knowledge of patients' clinical history and arthroscopy results. Tears were subclassified, based on articular surface integrity and extension (Lee classification). Interobserver agreement was assessed by kappa statistics for all patients. Ninety-two of 250 patients underwent arthroscopy; sensitivity and specificity of ABER and conventional MR arthrography were calculated and compared using paired McNemar test. Weighted kappa values of ABER and conventional MR arthrography were 0.48-0.65 and 0.60-0.67, respectively. According to arthroscopy, 69 of 92 patients had an intact cuff, and 23 patients had a cuff tear (16 partial thickness and seven full thickness). There were no statistically significant differences between ABER and conventional MR arthrography regarding sensitivity (48-61% and 52-70%, respectively) and specificity (80-94% and 91-95%). Sensitivity and specificity of a single T1-weighted series in ABER position and conventional MR arthrography are comparable for assessment of rotator cuff tears. (orig.)

  16. Preservation of bursal-sided tendon in partial-thickness articular-sided rotator cuff tears: a novel arthroscopic transtendon anatomic repair technique.

    Science.gov (United States)

    Shin, Sang-Jin; Jeong, Jae-Hoon; Jeon, Yoon Sang; Kim, Rag Gyu

    2016-12-01

    The purpose of this study was to introduce a novel arthroscopic transtendon anatomic repair technique that spares the intact bursal-sided tendon in articular-sided partial-thickness rotator cuff tears (PTRCT) and to present shoulder functional outcomes in patients with symptomatic articular-sided PCRCT that involves more than 50 % of its thickness after arthroscopic repair using a novel technique. Eighteen patients with symptomatic articular-sided PCRCT involving more than 50 % of the tendon's thickness underwent arthroscopic repair using a devised technique. The devised technique restores only the torn articular portion of the rotator cuff at the anatomical footprint using a suture anchor, and preserves the integrity of the corresponding bursal-sided tendon by tying knots at the most lateral bursal side on the subacromial space. Clinical and functional outcome using ASES and Constant scores were evaluated. The structural integrity of the rotator cuff was evaluated by MRI at 6 months postoperatively. Pain relief and shoulder functional outcomes were encouraging during the recovery phase after operation. ASES (preoperative 54.0 ± 10.3 to postoperative 92.6 ± 8.0), Constant score (61.2 ± 8.5-88.0 ± 5.3), VAS for pain (4.9 ± 2.6-0.6 ± 0.7) improved significantly after arthroscopic transtendon anatomic repair (p rotator cuff retears on 6-month MRI. No complications related to surgical procedures had occurred. The devised technique of arthroscopic transtendon repair provided satisfactory functional outcomes without postoperative discomforts. This technique minimizes over-tightening of the articular layer and reduces tension mismatches between the articular and bursal layers, which are considered as important factors for improvement of postoperative shoulder motion.

  17. Evidence against Participation of Mast Cell Histamine in Formation of Burn Wound Edema

    Science.gov (United States)

    1982-01-01

    mast cell is the principal source of tissue histamine, the contribution of this cell to edema formation in rats with a standard 30% total body surface area (TBSA) partial-thickness burn was investigated. Degranulating the mast cells prior to burn injury evoked no difference in the amount of edema formed compared with that in rats with normal mast cells. Substantially lower systemic levels of histamine were observed in the plasma of this group of rats after burn injury, which confirmed that degranulation of mast cells affected histamine

  18. Reconstruction of bilateral axillary post burn contracture in a 3 year old: A case report

    Institute of Scientific and Technical Information of China (English)

    Krishna kumar. A; SUN Bing-wei

    2010-01-01

    A 2 year old male child was admitted with history of accidental pouring by boiling water all over the body resulting in 51% surface area burns involving the posterior and lateral thoracic region, both the upper limbs in the proximal regions near the shoulder, anterior and posterior abdomen and pubic region with second and third degree severe burns. After correcting the dehydration a series of procedures were performed including anti-shock, wound debridement under GA, etc. At 20 days post-burn, after making sure the wound was healthy a partial thickness skin grafting was done. During rehabilitation, bilateral axillary suffered contracture with hypertrophic scar(Fig 1).

  19. Scald Burns

    Science.gov (United States)

    Safety Tips & Info Scald Burns Thousands of scald burns occur annually, and ALL are preventable! The two high-risk populations are children under the age ... the single most important factor in preventing scald burns. Increased awareness is the key to scald prevention! ...

  20. Multispectral and Photoplethysmography Optical Imaging Techniques Identify Important Tissue Characteristics in an Animal Model of Tangential Burn Excision.

    Science.gov (United States)

    Thatcher, Jeffrey E; Li, Weizhi; Rodriguez-Vaqueiro, Yolanda; Squiers, John J; Mo, Weirong; Lu, Yang; Plant, Kevin D; Sellke, Eric; King, Darlene R; Fan, Wensheng; Martinez-Lorenzo, Jose A; DiMaio, J Michael

    2016-01-01

    Burn excision, a difficult technique owing to the training required to identify the extent and depth of injury, will benefit from a tool that can cue the surgeon as to where and how much to resect. We explored two rapid and noninvasive optical imaging techniques in their ability to identify burn tissue from the viable wound bed using an animal model of tangential burn excision. Photoplethysmography (PPG) imaging and multispectral imaging (MSI) were used to image the initial, intermediate, and final stages of burn excision of a deep partial-thickness burn. PPG imaging maps blood flow in the skin's microcirculation, and MSI collects the tissue reflectance spectrum in visible and infrared wavelengths of light to classify tissue based on a reference library. A porcine deep partial-thickness burn model was generated and serial tangential excision accomplished with an electric dermatome set to 1.0 mm depth. Excised eschar was stained with hematoxylin and eosin to determine the extent of burn remaining at each excision depth. We confirmed that the PPG imaging device showed significantly less blood flow where burn tissue was present, and the MSI method could delineate burn tissue in the wound bed from the viable wound bed. These results were confirmed independently by a histological analysis. We found these devices can identify the proper depth of excision, and their images could cue a surgeon as to the preparedness of the wound bed for grafting. These image outputs are expected to facilitate clinical judgment in the operating room.

  1. Moist Exposed Burn Ointment in the Management of Burn Wound%湿润烧伤膏在烧伤创面治疗中的作用

    Institute of Scientific and Technical Information of China (English)

    V·贾亚拉曼

    2012-01-01

      Management of burns remains one of the greatest challenges in burn care. Local management of a burn wound requires early wound debridement and an optimum environment to stimulate epithelialisation and cellular prolifera-tion. Protocol was developed as early as 30 years ago for the management of burns that includes early excision and SSG cov-erage. The results were not perfect. The quality of healed skin as well as the prominence of hypertrophic scar needs to ex-plore the novel approaches. Wound healing assessment was made in burn wounds in 100 patients treated with MEBO cream and in 100 patients with Silver Sulpha Diazine Cream at the Kilpauk Medical College Hospital, Burns Unit. The comparative analysis is presented to assess the wound healing pattern in both the groups. Moist exposed burn ointment has been used with success in the management of deep superficial partial thickness and deep partial thickness burns in our department. The MEBO cream creates a physiological moist environment over the wound inducing an anti-inflammatory effect. It provides a nutritive base for the wound and debrides the wound eschar and expedites wound epithelialisation. The purpose of this study was to prospectively evaluate the outcome of the use of MEBO for second degree burns. Between August 2010 to May 2011 period 100 patients with second degree burns underwent MEBO cream application and were compared with 100 patients who had silver sulphadiazine cream . The result was analysed for the nature of wound debridement, reduction of inflammation, healing pattern, scar and pigmentation, MEBO provides excellent skin pigmentation and minimal visible scar.%  烧伤治疗一直是烧伤领域中的一大难题.烧伤创面的局部治疗要求早期清创,并为创面提供一个适宜的环境刺激上皮形成和细胞的分化.早在30年前,烧伤的标准化治疗方案就已经形成,包括早期切痂及韧厚皮移植,但治疗效果不尽人意.为了改善愈合后的皮

  2. Burn Rehabilitation

    Directory of Open Access Journals (Sweden)

    Koray Aydemir

    2011-07-01

    Full Text Available Burn injuries are important in terms of causing serious disability and threatening life. With the establishment of modern burn treatment units and advances in acute care management contributed to a reduced mortality rate over the last decades. As a result of improved outcome, more attention has to be given to a comprehensive burn rehabilitation program. Burn rehabilitation is a process that starts from day of admission and continues for months or sometimes years after the initial event. The term ‘burn rehabilitation’ incorporates the physical, physiological and social aspects of care. Burns can leave a patient with severely debilitating and deforming contractures, which can lead to significant disability when left untreated. Burn rehabilitation aims to prevent the possible complications, minimalize joint contractures and deformities, increase range of motion, control hypertrophic scarring, achieve the best possible functional capacity and to regain the patients vocational and recreational activities. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 70-7

  3. Thermal Injury Model in the Rabbit Ear with Quantifiable Burn Progression and Hypertrophic Scar.

    Science.gov (United States)

    Friedrich, Emily E; Niknam-Bienia, Solmaz; Xie, Ping; Jia, Sheng-Xian; Hong, Seok Jong; Mustoe, Thomas A; Galiano, Robert D

    2017-04-01

    Hypertrophic scar is a major clinical outcome of deep-partial thickness to full thickness thermal burn injury. Appropriate animal models are a limitation to burn research due to the lack of, or access to, animal models which address the endpoint of hypertrophic scar. Lower species, such as rodents, heal mainly by contracture, which limits the duration of study. Higher species, such as pigs, heal more similarly to humans, but are associated with high cost, long duration for scar development, challenges in quantifying scar hypertrophy, and poor manageability. Here we present a quantifiable deep-partial thickness burn model in the rabbit ear. Burns were created using a dry-heated brass rod for 10 s and 20 s at 90°C. At the time of eschar excision on day 3, excisional wounds were made on the contralateral ear for comparison. Burn wound progression, in which the wound size expands over time is a major distinction between excisional and thermal injuries, was quantified at 1 h and 3 d after the injuries using calibrated photographs and histology and the size of the wounds was found to be unchanged from the initial wound size at 1 h, but 10% in the 20 s burn wounds at 3 d. A quantifiable hypertrophic scar, measured by histology as the scar elevation index, was present in both 20 s burn wounds and excisional wounds at day 35. ImageJ measurements revealed that the 20 s burn wound scars were 22% larger than the excisional wound scars and the 20 s burn scar area measurements from histology were 26% greater than in the excisional wound scar. The ability to measure both burn progression and scar hypertrophy over a 35-day time frame suits this model to screening early intervention burn wound therapeutics or scar treatments in a burn-specific scar model. This article is protected by copyright. All rights reserved.

  4. Epidemiology and outcome of burns: early experience at the country's first national burns centre.

    Science.gov (United States)

    Iqbal, Tariq; Saaiq, Muhammad; Ali, Zahid

    2013-03-01

    This study aims to document the epidemiologic pattern and outcome of burn injuries in the country's first national burn centre. This case series study was conducted over a 2-year period at Burns Care Centre (BCC), Pakistan Institute of Medical Sciences (PIMS), Islamabad. The study included all burn injury patients who primarily presented to and were managed at the centre. Those patients who presented more than 24 h after injury or those who were initially managed at some other hospital were excluded from the study. Initial assessment and diagnosis was made by thorough history, physical examination and necessary investigations. Patients with major burns, high voltage electric burns and those needing any surgical interventions were admitted for indoor management. Patients with minor burns were discharged home after necessary emergency management, home medication and follow-up advice. The sociodemographic profile of the patients, site of sustaining burn injury, type and extent (total body surface area (TBSA), skin thickness involved and associated inhalational injury) of burn and outcome in terms of survival or mortality, etc., were all recorded on a proforma. The data were subjected to statistical analysis. Out of a total of 13,295 patients, there were 7503 (56.43%) males and 5792 (43.56%) females. The mean age for adults was 33.63±10.76 years and for children it was 6.71±3.47 years. The household environment constituted the commonest site of burns (68%). Among all age groups and both genders, scalds were the commonest burns (42.48%), followed by flame burns (39%) and electrical burns (9.96%). The affected mean TBSA was 10.64±11.45% overall, while for the hospitalised subset of patients the mean TBSA was 38.04±15.18%. Most of the burns were partial thickness (67%). Inhalation injury was found among 149 (1.12%) patients. Most of the burns were non-intentional and only 96 (0.72%) were intentional. A total of 1405 patients (10.58%) were admitted while the remainder

  5. Quantitative Assessment of Graded Burn Wounds in a Porcine Model using Spatial Frequency Domain Imaging (SFDI) and Laser Speckle Imaging (LSI)

    Science.gov (United States)

    2014-09-08

    data to the extent of burn damage as indicated via histological analysis. Changes in reduced scattering coefficient and blood flow could be used to...A. McGrouther, “Burn depth and its histological measurement,” Burns 27(2), 154–160 (2001). 5. H. Hoeksema, K. Van De Sijpe, T. Tondu, M. Hamdi, K...J. R. Freisen, M. A. Levasseur, B. J. Schattka, M. G. Sowa, and J. S. Fish , “Noninvasive measurement of edema in partial thickness burn wounds,” J

  6. Factors affecting the depth of burns occurring in medical institutions.

    Science.gov (United States)

    Cho, Young Soon; Choi, Young Hwan; Yoon, Cheonjae; You, Je Sung

    2015-05-01

    Most cases of burns occurring in medical institutions are associated with activities involving heat. It is very difficult to detect these burns. To date, there are few reports on burns occurring in medical institutions. The purpose of this paper was to analyze the etiology of burns occurring in medical institutions and to elucidate the factors affecting burn depth. We conducted a retrospective analysis of the medical records of patients who visited our center from April 2008 to February 2013. This study enrolled all patients with burns occurring in the medical institution during or related to treatment. We excluded burn patients whose burns were not related to treatment (for example, we excluded patients with scalding burns that occurred in the hospital cafeteria and pediatric patients with hot water burns from the water purifier). However, patients with burns that occurred in the recovery room after general anesthesia were included. A total of 115 patients were enrolled in this study. The average patient age was 41.5 years, with more women than men (M:F=31:84). There were 29 cases (25.3%) of superficial burns (first-degree and superficial second-degree) and 86 cases (74.7%) of deep burns (deep second-degree and third-degree). Hot packs were the most common cause of burns (27 cases, 23.5%), followed by laser therapy, heating pads, and grounding pads, accounting for 15 cases each. There were 89 cases (77.4%) of contact burns and 26 cases (22.6%) of non-contact burns. The most common site of burns was the lower extremities (41 cases, 35.7%). The burn site and contact burns were both factors affecting burn depth. The rate of deep burns was higher in patients with contact burns than in those with non-contact burns (odds ratio 4.26) and was associated with lower body burns (odds ratio 2.85). In burns occurring in medical institutions, there is a high probability of a deep burn if it is a contact burn or occurs in the lower body. Therefore, safety guidelines are needed

  7. Social support correlates with survival in patients with massive burn injury.

    Science.gov (United States)

    Muangman, Pornprom; Sullivan, Stephen R; Wiechman, Shelley; Bauer, Gregory; Honari, Shari; Heimbach, David M; Engrav, Loren H; Gibran, Nicole S

    2005-01-01

    Large burn size, inhalation injury, age, and associated trauma increase the rate of mortality after burns. However, not all patients with large burns and significant risk factors die. In this study, we wanted to determine other presenting factors that might indicate a survival benefit for burn patients with large burns. We reviewed charts of 36 patients with burns > or =60% TBSA that were aggressively resuscitated at the University of Washington Burn Center from 1990 to 2000 to determine whether survivors of large burns exhibit presenting variables that predict survival. Patients who had comfort care measures initiated at admission were excluded from this analysis. Survivors (n = 16) and nonsurvivors (n = 20) had no significant differences in age, total burn size, inhalation injury, or need for escharotomy. Full-thickness burn size was significantly smaller for survivors (58%) than for nonsurvivors (73%; P = .02). Survivors (81%) were more likely than nonsurvivors to have social support (35%; P = .007). A full-thickness burn > or =80 % TBSA was the only variable uniformly associated with mortality, suggesting that patients who survive large burns have a partial-thickness component that heals without surgery. The difference in degree of social support was one unique distinction that may impact patient survival and is worth further investigation.

  8. Characteristics of thermal burns in children admitted to an Israeli pediatric surgical ward.

    Science.gov (United States)

    Serour, Francis; Gorenstein, Arkadi; Boaz, Mona

    2008-04-01

    Reports of burn injuries in children are usually made by highly specialized burn units. Our facility admits children with burns covering burns are transferred to burn units at tertiary care facilities. To review our experience with thermal burns. We conducted a retrospective review of all thermal burns admitted to our hospital during a 5 year period. Among 266 patients (69.2% boys) aged 3.5 +/- 3.6 years, children burn. Partial thickness burns were sustained by 96.6% of children and TBSA burned was 4.2 +/- 3.6%. The mean hospital stay was 3.8 +/- 4.5 days, and was significantly prolonged in girls (4.6 +/- 4.8 vs. 3.5 +/- 4.3 days, P = 0.01). Percent TBSA burned was correlated with patient age (r = 0.12, P = 0.04) and length of hospital stay (r = 0.6, P patients (2.3%) (mean age 3.4 +/- 2.3 years) were hospitalized in the Pediatric Intensive Care Unit due to toxin-mediated illness. Children under the age of 3 years are at increased risk for burn injury, but older children sustain more extensive injuries. Prevention and awareness are needed for child safety.

  9. Successful skin homografting from an identical twin in a severely burned patient.

    Science.gov (United States)

    Turk, Emin; Karagulle, Erdal; Turan, Hale; Oguz, Hakan; Abali, Ebru Sakallioglu; Ozcay, Necdet; Moray, Gokhan; Haberal, Mehmet

    2014-01-01

    Flame burns are a serious condition and usually have high morbidity and mortality because they affect large areas of the body surface as well as the lungs. In these patients, it is especially difficult to find healthy skin for grafting if they have more than 70% third-degree burns. Repeated autografting or synthetic wound care materials are the only treatment options to cover burned areas. Partial-thickness skin grafting from the patient's identical twin sibling may be an alternative treatment option, if possible. Here, we report a patient with severe flame injury treated with skin from his identical twin. The patient had third-degree burns covering 70% of his body surface. Initial treatment consisted of fluid and electrolyte replacement, daily wound care, and surgical debridements, as well as nutritional support. After initial treatment, we performed a successful skin grafting from his identical twin. Skin grafting between identical twins might be an alternate method for severely burned patients.

  10. Clinical study of nanosilver/porcine acellular dermal matrix dressing in the treatment of superficial second degree burn wounds%纳米银-猪脱细胞真皮基质敷料治疗浅Ⅱ度烧伤创面的临床观察

    Institute of Scientific and Technical Information of China (English)

    胡晓文; 郝天智; 张华

    2016-01-01

    天的创面愈合率明显优于其余两组,差异均有统计学意义( P值均小于0.05);创面愈合时间显著短于其余两组,比较差异均有统计学意义(P值均小于0.05)。结论纳米银-猪脱细胞真皮基质敷料具有抗感染、促进创面愈合及减轻换药痛觉的作用。%Objective To observe the clinical effect of nanosilver/porcine acellular dermal matrix dressing on superficial second degree burn wounds. Methods From January 2014 to December 2015,90 patients with superficial second degree burn were treated and observed in the Department of Burns and Plastics Surgery, General Hospital of Beijing Military Region. According to the order of admission and random number table, the patients were randomly divided into 3 groups, nanosilver dressing group, porcine acellular dermal matrix dressing group and nanosilver/porcine acellular dermal matrix dressing group, each group of 30 patients. On the day of admission, the wounds areas were calculated by taking pictures and the wound secretion was taken for bacterial culture by using the throat swab, burn wounds were treated with debridement, then apply nanosilver dressing, porcine acellular dermal matrix dressing and nanosilver/porcine acellular dermal matrix dressing on the wounds. On the 5th day after treatment , the wound secretion was taken for bacterial culture by using the throat swab again. Pain score was assessed by asking and observing the changes of pain in patients after dressing change. On the 7th day after treatment, the wounds areas were calculated by taking pictures. The wound healing rate was calculated. Wound healing time was recorded. The data were compared by using one-way ANOVA test, SNK-q test and Chi-square test. Results On the 5th day after treatment, the wound bacterial culture results of nanosilver dressing group, porcine acellular dermal matrix dressing group and nanosilver/porcine acellular dermal matrix dressing group were 2(6.6%),9(30. 0%),1(3. 3%),there were

  11. Modern trends in fluid therapy for burns.

    Science.gov (United States)

    Tricklebank, Stephen

    2009-09-01

    The majority of burn centres use the crystalloid-based Parkland formula to guide fluid therapy, but patients actually receive far more fluid than the formula predicts. Resuscitation with large volumes of crystalloid has numerous adverse consequences, including worsening of burn oedema, conversion of superficial into deep burns, and compartment syndromes. Resuscitation fluids influence the inflammatory response to burns in different ways and it may be possible, therefore to affect this response using the appropriate fluid, at the appropriate time. Starches are effective volume expanders and early use of newer formulations may limit resuscitation requirements and burn oedema by reducing inflammation and capillary leak. Advanced endpoint monitoring may guide clinicians in when to 'turn off' aggressive fluid therapy and therefore avoid the problems of over-resuscitation.

  12. Investigate the skin multidisciplinary rehabilitation treatment for repairing pigmented after hearing of Ⅱ degree facial superficial burns%皮肤康复综合治疗在面部浅Ⅱ度烧伤愈后色素沉着治疗中的临床应用

    Institute of Scientific and Technical Information of China (English)

    张媛媛; 卢军玲

    2011-01-01

    Objective To investigate the effect of skin multidisciplinary rehabilitation treatment for reducing face pigmentation after burn. Methods A total of 186 patients with Ⅱ degree of facial superficial burns who were treated in our Burn and Plastic Surgery Department in recent 13 years. According to the different treat ment ways , they were randomly divided into control ( 72 patients ) , treatment( 56 patients ) ,and improved group( 58 patients ). Comprehensive treatment and effect were observed after skin wound healed. In control group, the injury sites were covered with repair mask for about 30 min, after that washed and coated with repair cream. In treatment group, Chinese herbal medicine ion spray machine spray treatment with asiaticoside ointment massage was applied to scar firstly, and then the Chinese herbal medicine mask was used for 30 min, washed and coated with repair cream at last. In improved group, the basic skin care procedure was same as that of the treatment group, but the procedure of treating pigmented spots with freckle cream and ion importing exporting method was taken between massage and Chinese herbal medicine freckle facial mask applying. Those treatments repeated every 2 days and 10 times for a course. Results The cure rates in the improved, treatment and control group were 96. 55% , 71. 42%and 33. 33% , respectively the difference being statistically significant. Conclusion The improved treatmet is the ideal one and the earlier starting the better rehabilitation.%目的 探讨皮肤康复综合治疗对减轻烧伤后面部皮肤愈合后色素沉着的作用.方法 收集解放军总医院第一附属医院1997~2010年间面部浅Ⅱ度烧伤患者186例,根据所接受治疗方式的不同,分为对照组72例、治疗组56例、改进组58例,创面愈合后即开始皮肤康复治疗并进行观察.对照组为将调制好的面膜粉加适量蒸馏水调成糊状均匀敷于患处,约30 min后洗净,涂修复霜后为1次治疗.

  13. Superficial Priming in Episodic Recognition

    Science.gov (United States)

    Dopkins, Stephen; Sargent, Jesse; Ngo, Catherine T.

    2010-01-01

    We explored the effect of superficial priming in episodic recognition and found it to be different from the effect of semantic priming in episodic recognition. Participants made recognition judgments to pairs of items, with each pair consisting of a prime item and a test item. Correct positive responses to the test item were impeded if the prime…

  14. In vivo terahertz imaging of rat skin burns

    Science.gov (United States)

    Tewari, Priyamvada; Kealey, Colin P.; Bennett, David B.; Bajwa, Neha; Barnett, Kelli S.; Singh, Rahul S.; Culjat, Martin O.; Stojadinovic, Alexander; Grundfest, Warren S.; Taylor, Zachary D.

    2012-04-01

    A reflective, pulsed terahertz (THz) imaging system was used to acquire high-resolution (d10-90/ λ~1.925) images of deep, partial thickness burns in a live rat. The rat's abdomen was burned with a brass brand heated to ~220°C and pressed against the skin with contact pressure for ~10 sec. The burn injury was imaged beneath a Mylar window every 15 to 30 min for up to 7 h. Initial images display an increase in local water concentration of the burned skin as evidenced by a marked increase in THz reflectivity, and this likely correlates to the post-injury inflammatory response. After ~1 h the area of increased reflectivity consolidated to the region of skin that had direct contact with the brand. Additionally, a low reflecting ring of tissue could be observed surrounding the highly reflective burned tissue. We hypothesize that these regions of increased and decreased reflectivity correlate to the zones of coagulation and stasis that are the classic foundation of burn wound histopathology. While further investigations are necessary to confirm this hypothesis, if true, it likely represents the first in vivo THz images of these pathologic zones and may represent a significant step forward in clinical application of THz technology.

  15. Burn Depth Estimation Using Thermal Excitation and Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Dickey, F.M.; Holswade, S.C.; Yee, M.L.

    1998-12-17

    Accurate estimation of the depth of partial-thickness burns and the early prediction of a need for surgical intervention are difficult. A non-invasive technique utilizing the difference in thermal relaxation time between burned and normal skin may be useful in this regard. In practice, a thermal camera would record the skin's response to heating or cooling by a small amount-roughly 5{degrees} Celsius for a short duration. The thermal stimulus would be provided by a heat lamp, hot or cold air, or other means. Processing of the thermal transients would reveal areas that returned to equilibrium at different rates, which should correspond to different burn depths. In deeper thickness burns, the outside layer of skin is further removed from the constant-temperature region maintained through blood flow. Deeper thickness areas should thus return to equilibrium more slowly than other areas. Since the technique only records changes in the skin's temperature, it is not sensitive to room temperature, the burn's location, or the state of the patient. Preliminary results are presented for analysis of a simulated burn, formed by applying a patch of biosynthetic wound dressing on top of normal skin tissue.

  16. Effect of recombinant human granulocyte-macrophage colony stimulating factor gel on melting crust in deep partial thickness scalding rats%GM-CSF 凝胶对 SD 大鼠深 II度烧伤创面溶痂的影响

    Institute of Scientific and Technical Information of China (English)

    杜娟; 刘继松; 章祥洲; 赵经伟; 方勇; 姚敏; 俞为荣

    2014-01-01

    目的:观察重组人粒细胞巨噬细胞集落刺激因子( rhGM-CSF)对深II度烧伤创面坏死组织溶痂和促进创面愈合的作用效果。方法 SD大鼠70只用热液烧伤的方法(75℃、8 s)制成背部深II度烧伤创面,烧伤大鼠随机分为实验组和对照组(每组35只)。对照组( C组):创面局部外用不含rhGM-CSF的凝胶基质,实验组( E组):创面局部外用rhGM-CSF凝胶(100μg/10 g)。分别于制创后1、3、5、7、10、14和21 d观察2组动物创面情况并摄像,记录创面溶痂时间;用图像分析软件计算不同时相点的溶痂率;并于不同的时相点取创面组织, HE染色观察创面组织形态及修复情况。结果从烧伤后第5天起各时相点,实验组大鼠创面溶痂率与对照组表现出差异;实验组创面溶痂时间为(10.73±2.47)d较对照组(14.26±2.65)d显著缩短(P<0.01);实验组和对照组创面愈合时间分别为(16.21±1.27)d和(18.05±1.36)d,差异有非常显著性(P<0.01)。结论外源性rhGM-CSF的应用可促进深II度烧伤创面溶痂,从而促进深II度烧伤创面愈合。%Objective To explore the effect of recombinant human granulocyte-macrophage colony-stimulating factor ( rh-GM-CSF) gel on crust melting and wound healing of deep partial thickness scalding SD rats .Methods A total of 70 SD rats were scalded on the back using the method of thermal-water burns at 75℃for 8s.A deep partial-thickness burn was created in all the rats.The scalded rats were randomly divided into two groups (35 for each group).The control group(C) was treated with gel matrix while the experiment group ( E) was treated with rhGM-CSF gel .The wounds treatment of the two groups lasted 21 days.Observations of the wounds were made by photograph at various time-points.In addition, the removal time of wound eschar in all the rats was recorded .The percentages of removal area in the

  17. Superficie

    OpenAIRE

    Corna, Pablo María

    2015-01-01

    En la época posclásica del derecho romano se buscó, por parte del Estado y ciudadanos, utilizar ciertos terrenos que formaban parte de su patrimonio para arrendarlos por largo término —y a veces a perpetuidad— a personas que tenían el derecho de edificar o plantar mediante el pago de un precio llamado pensio o solárium. En el siglo II de nuestra era ya era utilizado para asentar tribus romanizadas en la frontera del imperio como para el cultivo de vid y los olivos que demoran varios...

  18. Superficie

    OpenAIRE

    Corna, Pablo María

    2015-01-01

    En la época posclásica del derecho romano se buscó, por parte del Estado y ciudadanos, utilizar ciertos terrenos que formaban parte de su patrimonio para arrendarlos por largo término —y a veces a perpetuidad— a personas que tenían el derecho de edificar o plantar mediante el pago de un precio llamado pensio o solárium. En el siglo II de nuestra era ya era utilizado para asentar tribus romanizadas en la frontera del imperio como para el cultivo de vid y los olivos que demoran varios años e...

  19. In vivo burn diagnosis by camera-phone diffuse reflectance laser speckle detection.

    Science.gov (United States)

    Ragol, S; Remer, I; Shoham, Y; Hazan, S; Willenz, U; Sinelnikov, I; Dronov, V; Rosenberg, L; Bilenca, A

    2016-01-01

    Burn diagnosis using laser speckle light typically employs widefield illumination of the burn region to produce two-dimensional speckle patterns from light backscattered from the entire irradiated tissue volume. Analysis of speckle contrast in these time-integrated patterns can then provide information on burn severity. Here, by contrast, we use point illumination to generate diffuse reflectance laser speckle patterns of the burn. By examining spatiotemporal fluctuations in these time-integrated patterns along the radial direction from the incident point beam, we show the ability to distinguish partial-thickness burns in a porcine model in vivo within the first 24 hours post-burn. Furthermore, our findings suggest that time-integrated diffuse reflectance laser speckle can be useful for monitoring burn healing over time post-burn. Unlike conventional diffuse reflectance laser speckle detection systems that utilize scientific or industrial-grade cameras, our system is designed with a camera-phone, demonstrating the potential for burn diagnosis with a simple imager.

  20. Burns (For Parents)

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Burns KidsHealth > For Parents > Burns A A A What's ... outlets, etc.) overexposure to the sun Types of Burns Burns are often categorized as first-, second-, or ...

  1. Tissue engineered fetal skin constructs for pediatric burns

    Science.gov (United States)

    Norbury, William B; Jeschke, Marc G; Herndon, David N

    2005-01-01

    The management of patients with partial thickness (second degree) burns is problematic due to the different treatments needed for varying depths of injury. A report recently published in The Lancet describes a novel treatment for deep second degree burns using a fetal skin construct (FSC). The authors included eight pediatric patients with small second degree burns. They showed that FSCs reduced the need for autografting of deep second degree burns, with little hypertrophy of new skin and no skin contraction. This technology is new and exciting, but in our opinion several issues must be addressed before FSCs can enter the clinical arena. All of the patients were included in the treatment group, and therefore no comparison with conventional skin substitutes was possible. There is no mention of the use of laser Doppler in any initial assessment of patients. The debridement carried out before application of the FSC is not elaborated upon, and the surface areas involved in the study were very small in most cases, which limits the relevance to patients with larger burns. The use of FSCs gives us an additional option in a range of possible treatments for this notoriously difficult-to-treat patient group. PMID:16356232

  2. Evaluation of oral-motor movements and facial mimic in patients with head and neck burns by a public service in Brazil

    Directory of Open Access Journals (Sweden)

    Dicarla Motta Magnani

    2015-05-01

    Full Text Available OBJECTIVES: The purpose of this study was to analyze the characteristics of oral-motor movements and facial mimic in patients with head and neck burns. METHODS: An observational descriptive cross-sectional study was conducted with patients who suffered burns to the head and neck and who were referred to the Division of Orofacial Myology of a public hospital for assessment and rehabilitation. Only patients presenting deep partial-thickness and full-thickness burns to areas of the face and neck were included in the study. Patients underwent clinical assessment that involved an oral-motor evaluation, mandibular range of movement assessment, and facial mimic assessment. Patients were divided into two groups: G1 - patients with deep partial-thickness burns; G2 - patients with full-thickness burns. RESULTS: Our final study sample comprised 40 patients: G1 with 19 individuals and G2 with 21 individuals. The overall scores obtained in the clinical assessment of oral-motor organs indicated that patients with both second- and third-degree burns presented deficits related to posture, position and mobility of the oral-motor organs. Considering facial mimic, groups significantly differed when performing voluntary facial movements. Patients also presented limited maximal incisor opening. Deficits were greater for individuals in G2 in all assessments. CONCLUSION: Patients with head and neck burns present significant deficits related to posture, position and mobility of the oral myofunctional structures, including facial movements.

  3. Paediatric suicidal burns: A growing concern.

    Science.gov (United States)

    Segu, Smitha; Tataria, Rachana

    2016-06-01

    An alarming rise in rates of paediatric population committing self-immolation acts is a growing social and medical problem. In recent times there seems to be a rising concern in paediatric population. A study was conducted at a government tertiary care burn centre over 5 years in paediatric age group of middle and upper lower class families. Most had deep partial thickness burns. Psychiatric and personality disorder were found in 24.03% and 31.46% patients respectively. Kerosene was the main agent chosen to inflict injury. The average length of hospital stay was 19.8 days. The crude mortality rate observed was 38.2%. With cultural and socio-economic changes children and adolescents are exposed to increased levels of stress and peer pressure leaving them vulnerable. A multidisciplinary care involving medical, psychological and social support is required. Identifying children at risk and proper counselling and support can form an important strategy at prevention rather than cure. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  4. Pediatric burn wound impetigo after grafting.

    Science.gov (United States)

    Aikins, Kimberly; Prasad, Narayan; Menon, Seema; Harvey, John G; Holland, Andrew J A

    2015-01-01

    Modern burn care techniques have reduced the risk of infection of the acute burn wound, resulting in more rapid healing and a lower incidence of graft loss. Secondary breakdown may still occur. The loss of epithelium in association with multifocal superficial abscesses and ulceration has been termed burns impetigo. This may result in considerable morbidity and require prolonged treatment. The events preceding development, the impact on the patient, and the ideal treatment appear unclear and poorly reported. In 5 years, between 2006 and 2011, 406 pediatric burns were treated with skin grafts, with 7% developing burns impetigo. Time to resolution ranged from 5 to 241 days: the mean time to complete healing was greatest with conservative management (96 days), followed by antibacterial dressings (37 days), oral antibiotics (36 days), topical steroids (16 days), and oral antibiotics in combination with topical steroids (13.5 days). Burns impetigo resulted in significant morbidity, requiring multiple visits to the treatment center and prolonged symptoms. Delay in diagnosis and treatment resulted in worse outcomes. Prompt consideration of burns impetigo should occur when postgraft patients present with suggestive clinical signs and treatment with oral antibiotics plus topical steroids should be considered.

  5. An unusual electrical burn caused by alkaline batteries

    Directory of Open Access Journals (Sweden)

    Tyng-Luen Roan

    2015-02-01

    Full Text Available Electrical burns caused by low-voltage batteries are rarely reported. We recently encountered a male patient who suffered from a superficial second-degree burn over his left elbow and back. The total body surface area of the burn was estimated to be 6%. After interviewing the patient, the cause was suspected to be related to the explosion of a music player on the left-side of his waist, carried on his belt while he was painting a bathroom wall. Elevated creatine kinase levels and hematuria indicated rhabdomyolysis and suggested an electrical burn. Initial treatment was done in the burn intensive care unit with fluid challenge and wound care. The creatine kinase level decreased gradually and the hematuria was gone after 4 days in the intensive care unit. He was then transferred to the general ward for further wound management and discharged from our burn center after a total of 11 days without surgical intervention.

  6. Burning vasculitis.

    Science.gov (United States)

    Chadha, Priyanka; Hobday, Dorian; O'Connor, Edmund Fitzgerald; D'Cruz, David

    2016-04-26

    We present the case of a 69-year-old man who was found collapsed close to a heat source and admitted to hospital for severe sepsis. He was also found to have widespread blistering and ulceration of his right leg; however, a history was unobtainable due to reduced consciousness levels. The leg lesions had the initial appearance of mixed depth burns and a management plan was made to transfer the patient to a burns unit for debridement. It was subsequently noted that the patient had a previous diagnosis of seropositive erosive rheumatoid arthritis. A biopsy of the leg lesion was performed and a diagnosis of rheumatoid vasculitis confirmed. Treatment with systemic steroids, intravenous antibiotics and intravenous immunoglobulin therapy for severe hypogammaglobulinaemia was started, and the patient was not transferred for surgical debridement. Rheumatoid vasculitis is a rare and extremely serious complication of rheumatoid arthritis that can manifest in a number of ways, occasionally mimicking other conditions. This case is essential to raise awareness of rare, severe rheumatoid vasculitis and of the potential for its misdiagnosis as a mixed depth burn.

  7. The use of botulinum toxin in the management of burns itching: preliminary results.

    Science.gov (United States)

    Akhtar, N; Brooks, P

    2012-12-01

    Itching is a common and well recognised problem following burns. As the underlying pathways involved in burns itch have been identified, different pharmacological agents have been introduced to improve the effectiveness of management regimes. We present preliminary data from an on-going study in the use of botulinum toxin as a novel agent in the treatment of this problem. Patients with recalcitrant itching secondary to burns treated with Botox(©) were identified. Data pertaining to burn size, depth and management were recorded. The delay in the onset of the itch, its severity and the speed and duration of any improvement in symptoms were also noted. 10 patients were identified. 1 patient was excluded. Average follow-up was 11.3 months. All patients had deep partial thickness to full thickness burns. Eight patients underwent grafting. The average burn was 24% TBSA. 87.5% of patients rated their burns itch as being severe (>7 on the pain scale). Following the administration of Botox(©) this fell to 0 out of 10 at 4 weeks. The average duration of the symptom free period was nine months (range 3-18 months). Botox(©) can successfully be used to treat burns itch that are resistant to conventional therapies. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  8. Epidemiology of burns caused by moxibustion in Korea.

    Science.gov (United States)

    Yoon, Cheonjae; Cho, Young Soon; Park, Seungchoon; Chung, Sung Phil; Choi, Young Hwan

    2016-11-01

    Moxibustion, a traditional Chinese treatment that uses dried Artemisia argyi, is a common cause of burns treated in Korean hospitals. We aimed to examine the characteristics of moxibustion-induced burns. This retrospective study examined the records of 59 patients who were treated for moxibustion-induced burns (April 2014-October 2015). All patients completed a questionnaire regarding their general characteristics and moxibustion use. The patients included 16 men and 43 women (average age: 49.1 years, 68 burn sites). Superficial second-degree burns were present at 21 sites, deep second- or third-degree burns at 44 sites, and unknown burns at 3 sites. The most common sites were the lower extremities, abdomen, and upper extremities. The most common practitioners were the patients (27/59, 45.7%) and Oriental medicine practitioners (23/59, 38.9%). The most common locations were the patient's home, Oriental medicine clinic, and moxibustion clinic. The most common reason for moxibustion was pain. Only the burn site was significantly associated with burn depth, and non-abdominal sites were 9.37-fold more likely to involve deep burns (vs. abdominal sites). Korean patients routinely undergo moxibustion, and care must be taken when using moxibustion at non-abdominal sites, due to the risk of deep burns. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  9. Late sequelae of superficial irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Hood, I.C.; Young, J.E.

    1984-10-01

    Superficial irradiation results in well recognized late sequelae including not only sclerosis and atrophy of skin and subcutaneous tissue, but also the development of benign and malignant tumors of skin and adjacent structures. The long latency between irradiation and its late effects allowed the early uncontrolled use of radiation treatment for benign conditions. The subsequent recognition of the causal relationship between tumors and previous irradiation has restricted its use to more appropriate purposes, although it is possible that it is still overused in some areas of dermatologic practice. Clinicians need to be aware of the time interval between irradiation and the development of its late sequelae, and the incidence of these sequelae. Appropriate irradiation exposure history should be a part of the evaluation of every patient.

  10. Investigation of the behaviour of a LILW superficial repository under aircraft impact

    Energy Technology Data Exchange (ETDEWEB)

    Lo Frano, Rosa, E-mail: rosa.lofrano@ing.unipi.it; Stefanini, Lorenzo

    2016-04-15

    Highlights: • Safety assessment of a LILW superficial repository. • Investigation of the consequences of an aircraft impact with fuel burning. • Experimental material properties. • Numerical simulation of aircraft impact with fuel burning accident by MSC.MARC{sup ©} code. • Demonstration that the overall integrity resulted is guaranteed. - Abstract: Safety and security are the two fundamental aspects to guarantee when designing a LILW superficial repository. Because of its safety concern, we have to prove, and build confidence in, the primary and secondary consequences of the crashing will be acceptable. These goals are obtained generally by means of safety assessment supported by calculations. This study is intended to investigate the performance of a superficial repository subjected to aircraft impact and fuel burning. To the purpose a superficial repository similar to that of El Cabril has been considered. Moreover to be confident the facility is safe and that the consequences of such a type of accident on the environment and humans are negligible, an appropriate safety assessment was carried out. The potential damage that aircraft impact could bring into the repository has been therefore analysed and discussed. To attain the intent load functions, calculated according to the Riera approach, and the maximum temperature reached by fuel during its combustion have been considered. FEM (thermo-mechanical) simulations have been done, by MSC{sup ©} Marc code, assuming damaging phenomena of concrete and material properties variation with the temperature. The obtained results showed that an empty superficial repository with a wall thickness, ranging from 0.7 to 1 m, is not sufficient to avoid penetration. Nevertheless even in presence of a reduced strength and of (cone) cracking and plugging, the overall integrity resulted guaranteed.

  11. Accuracy of early burn depth assessment by laser Doppler imaging on different days post burn.

    Science.gov (United States)

    Hoeksema, Henk; Van de Sijpe, Karlien; Tondu, Thiery; Hamdi, Moustapha; Van Landuyt, Koenraad; Blondeel, Phillip; Monstrey, Stan

    2009-02-01

    Accurate diagnosis of burn depth is essential in selecting the most appropriate treatment. Early assessment of burn depth by clinical means only has been shown to be inaccurate, resulting in unnecessary operations or delay of grafting procedures. Laser Doppler imaging (LDI) was reported as an objective technique to determine the depth of a burn wound, but the accuracy on very early days post burn has never been investigated yet. In 40 patients with intermediate depth burns, we prospectively evaluated and compared the accuracy of the LDI measurements with the clinical assessments on days 0, 1, 3, 5, 8. Clinical evaluation of the depth of the burn was performed by two observers blinded to the LDI images. Accuracies were assessed by comparison with outcome: healing times longer than 21 days were considered to be equivalent to a biopsy finding of a deep dermal wound. Obviously superficial and full thickness wounds were excluded. LDI flux level was used for LDI prediction of outcome: less than 220PU to predict non-healing at day 21. The accuracies of burn depth assessments on the day of burn and post burn days 0, 1, 3, 5 and 8 using LDI were 54%, 79.5%, 95%, 97% and 100% compared with clinical assessment accuracies of 40.6%, 61.5%, 52.5%, 71.4% and 100%, respectively. LDI accuracy was significantly higher than clinical accuracy on day 3 (pBurn depth conversion was also considered. This is the first study to quantify the advantage of LDI scanning over clinical assessments during these important early after burn days.

  12. First Aid: Burns

    Science.gov (United States)

    ... Your 1- to 2-Year-Old First Aid: Burns KidsHealth > For Parents > First Aid: Burns A A A Scald burns from hot water and other liquids are the most common burns in early childhood. Because burns range from mild ...

  13. First Aid: Burns

    Science.gov (United States)

    ... Old Feeding Your 8- to 12-Month-Old Feeding Your 1- to 2-Year-Old First Aid: Burns KidsHealth > For Parents > First Aid: Burns Print A A A Scald burns from hot water and other liquids are the most common burns in early childhood. Because burns range from mild to life threatening, ...

  14. Superficial siderosis in the central nervous system

    Energy Technology Data Exchange (ETDEWEB)

    Pythinen, J. [Oulu Univ. (Finland). Dept. of Diagnostic Radiology; Paeaekkoe, E. [Oulu Univ. (Finland). Dept. of Diagnostic Radiology; Ilkko, E. [Oulu Univ. (Finland). Dept. of Diagnostic Radiology

    1995-02-01

    We describe a rare entity, superficial siderosis of the central nervous system, due to multiple small episodes of subarachnoid haemorrhage from any source. Non-specific neurological findings are associated with deposition of iron-containing pigments in the leptomeninges and superficial layers of the cortex. T2-weighted magnetic resonance imaging demonstrates characteristic low signal in the meninges. (orig.)

  15. [THERMOMETRY APPLICATION FOR ESTIMATION OF THE SKIN BURNS DEPTH].

    Science.gov (United States)

    Kovalenko, A O

    2015-04-01

    Determination of the burn wound depth, using noncontact infrared thermometry, permits to predict the burn affection severity, basing on the revealed difference between local, perifocal temperature and temperature in certain nonaffected areas of the body surface. The temperature difference (ΔT) over 1 °C constitutes a strict criterion of the skin burn presence. The temperature 34 °C have been considered a border one for the skin burns. If the burn wound temperature in 24 h after trauma was lower 34 °C and ΔT 2 °C and more, it have witnessed the presence of deep burn of the skin. High sensitivity (87%) and specificity (96%) of thermometric test in 24 h after trauma were established. In epidermal burns the temperature of the burn wounds have constituted (35.9 ± 0.3) °C at average, in superficial burns of the skin--(35.1 ± 0.6) °C, and in the deep burns--(33.6 ± 0.8) °C.

  16. Burn wound: Pathophysiology and its management by herbal plants

    Directory of Open Access Journals (Sweden)

    Dhirender Kaushik

    2013-01-01

    Full Text Available In human body, wound healing is a normal biological phenomenon. Burns may be acute or chronic depending upon the source and its time of exposure. Burn wounds may be superficial, partial or full thickness wounds. When skin comes in contact with higher temperature, protein denaturation takes place due to which the plasma membrane integrity is lost. When skin is burned, a number of inflammatory mediators and releasing agents such as histamine, nitric oxide, oxygen free radicals, eicosanoid products, tumor necrosis factors, and interleukins etc., are released at the site. For wound healing mechanism, the keratinocytes has to move from uninjured site to the burned area. For deeper burns this process takes a long time. By some unknown mechanisms, burn wounds may convert from one form to another form. So burn wound depth must be accurately measured before starting the treatment to prevent the complications. Burns can be induced in experimental animals by using different models. Many treatments such as herbal drugs, topical agents, gene therapy, volume therapy, and rehabilitation can be employed. This review article mainly deals with the theoretical and practical aspects of burn wound healing. Some burn wound healing plants with their chemical constituents, plant part used, uses and animal models are described here.

  17. Superficial Circumflex Iliac Artery Perforator Flap for Dorsalis Pedis Reconstruction.

    Science.gov (United States)

    Tashiro, Kensuke; Yamashita, Shuji

    2017-04-01

    Reconstruction of dorsalis pedis with soft tissue is challenging because it needs to preserve thin structure to ensure that the patient will be able to wear shoes. Here, we report the use of a thin superficial circumflex iliac artery perforator (SCIP) flap in dorsalis pedis reconstruction. A 67-year-old man presented with a third-degree burn, which exposed his extensor tendons. A thin SCIP flap from the left inguinal region measuring 15 × 4 cm was transferred to the dorsalis pedis region. Postoperatively, no major cosmetic or functional problems were observed. Because the invasiveness of the donor site is nearly same between SCIP flap and skin graft from inguinal region, SCIP flap is better solution in point of textural qualities for dorsalis pedis reconstruction.

  18. Burns (For Parents)

    Science.gov (United States)

    ... Child What Kids Say About: Handling Stress Anxiety, Fears, and Phobias Community Service: A Family's Guide to Getting ... What's in this article? Common Causes Types of Burns First-Degree Burns Second-Degree Burns ...

  19. Cochlear implantation in superficial siderosis.

    Science.gov (United States)

    Kim, Chong-Sun; Song, Jae-Jun; Park, Min-Hyun; Kim, Young Ho; Koo, Ja-Won

    2006-08-01

    Superficial siderosis (SS) of the central nervous system has been thought to be a rare condition that generates progressive hearing loss, ataxia, pyramidal signs, and dementia. The main cause of hearing loss by SS is thought to be neuronal. Because there is no histopathologic report of the human temporal bone in SS, there is a debate about the possibility of cochlear involvement. We present a 25-year-old man who was investigated for bilateral progressive sensorineural hearing loss and vestibular failure after head trauma. On brain MRI, SS of the central nervous system was detected. Distortion product otoacoustic emission (DPOAE) and auditory brainstem response (ABR) showed no response on both sides. However, integrity of the eighth nerve was proved by the electrical ABR test on the right side and the patient benefited significantly from cochlear implantation. The sensorineural hearing loss in SS seems to be related to cochlear damage as well as neuronal damage. So, cochlear implantation would be a hearing rehabilitation modality for the sensorineural hearing loss caused by SS.

  20. Silicon superficial texturing bypulsed laser

    Directory of Open Access Journals (Sweden)

    Ponce, L.

    1998-04-01

    Full Text Available Texturing of silicon surfaces with pulsed laser is made. The method is based on the formation of laser- induced periodic surface structure (LIPSS. The process is temporary characterized through the dynamic reflectance, thus determining the formation threshold of the structure. Relation between the different textures and the spectral reflectance of the samples before and after the treatment is also characterized. The mean value of spectral reflectance decreases up to a 6 %.

    Se realiza el texturado de superficies de silicio con un láser pulsado mediante la formación de una estructura periódica inducida por láser (LIPSS. Se caracteriza el proceso mediante reflectancia dinámica, determinándose el umbral de formación de la estructura. Se caracteriza el nivel de texturado midiendo la reflectancia espectral de las muestras antes y después del tratamiento. El valor medio de la reflectancia espectral disminuye hasta el 6 %.

  1. Spontaneous Healing and Treatment Alternatives in Burns

    Directory of Open Access Journals (Sweden)

    Mehmet Bozkurt

    2013-06-01

    Full Text Available Tissue losses that may occur in certain burn wounds may heal spontaneously without requiring any surgical intervention. However, this spontaneous healing is usually observed in smaller and superficial burn wounds, whereas surgical intervention may be indispensable in the tissue damages that occur in deeper and larger-scale burns treated using classical methods. Although surgery is frequently applied in the treatment of burn wounds, the variety of methods that enhance spontaneous healing are increasing in number. For this purpose, these methods involve the prevention of the wound from drying and maintaining a physiological and aseptic moisturization. On the other hand, especially in burn wounds with extensive tissue loss, the lack of adequate skin donor areas gives rise to the need for a cover material alternative to the skin. For these reasons, efforts to develop equivalent materials that may replace the original skin are progressing rapidly nowadays. The increase in the variety and advantages of the materials, which are developed using state-of-the-art bioengineering methods in the light of modern technologies, is quite promising. [Arch Clin Exp Surg 2013; 2(3.000: 186-196

  2. Hot asphalt burns: a review of injuries and management options.

    Science.gov (United States)

    Bosse, George M; Wadia, Shernaz A; Padmanabhan, Pradeep

    2014-07-01

    Hot asphalt burns to human tissue can increase the likelihood of infection and potential conversion of partial thickness to full-thickness injuries. Successful intervention for hot asphalt burns requires immediate and effective cooling of the asphalt on the tissue followed by subsequent gradual removal of the cooled asphalt. A review of the literature reveals that multiple substances have been used to remove asphalt, including topical antibiotics, petroleum jelly, a commercial product known as De-Solv-It (ORANGE-SOL, Chandler, AZ), sunflower oil, baby oil, liquid paraffin, butter, mayonnaise, and moist-exposed burn ointment (MEBO). Although many of these products may be effective in the removal of asphalt, they may not be readily available in an emergency department setting. Topical antibiotics are readily available, are more commonly described in the medical literature, and would be expected to be effective in the removal of asphalt. We developed guidelines for on scene (first-aid) management and the initial care of such patients upon presentation to a health care facility. These guidelines emphasize the principles of early cooling, gradual removal of adherent asphalt using topical antibiotics, and avoidance of the use of topical agents, which are likely to result in tissue toxicity.

  3. Natural and synthetic polymers for wounds and burns dressing.

    Science.gov (United States)

    Mogoşanu, George Dan; Grumezescu, Alexandru Mihai

    2014-03-25

    In the last years, health care professionals faced with an increasing number of patients suffering from wounds and burns difficult to treat and heal. During the wound healing process, the dressing protects the injury and contributes to the recovery of dermal and epidermal tissues. Because their biocompatibility, biodegradability and similarity to macromolecules recognized by the human body, some natural polymers such as polysaccharides (alginates, chitin, chitosan, heparin, chondroitin), proteoglycans and proteins (collagen, gelatin, fibrin, keratin, silk fibroin, eggshell membrane) are extensively used in wounds and burns management. Obtained by electrospinning technique, some synthetic polymers like biomimetic extracellular matrix micro/nanoscale fibers based on polyglycolic acid, polylactic acid, polyacrylic acid, poly-ɛ-caprolactone, polyvinylpyrrolidone, polyvinyl alcohol, polyethylene glycol, exhibit in vivo and in vitro wound healing properties and enhance re-epithelialization. They provide an optimal microenvironment for cell proliferation, migration and differentiation, due to their biocompatibility, biodegradability, peculiar structure and good mechanical properties. Thus, synthetic polymers are used also in regenerative medicine for cartilage, bone, vascular, nerve and ligament repair and restoration. Biocompatible with fibroblasts and keratinocytes, tissue engineered skin is indicated for regeneration and remodeling of human epidermis and wound healing improving the treatment of severe skin defects or partial-thickness burn injuries.

  4. Scanning electron microscopy of superficial white onychomycosis*

    Science.gov (United States)

    de Almeida Jr., Hiram Larangeira; Boabaid, Roberta Oliveira; Timm, Vitor; Silva, Ricardo Marques e; de Castro, Luis Antonio Suita

    2015-01-01

    Superficial white onychomycosis is characterized by opaque, friable, whitish superficial spots on the nail plate. We examined an affected halux nail of a 20-year-old male patient with scanning electron microscopy. The mycological examination isolated Trichophyton mentagrophytes. Abundant hyphae with the formation of arthrospores were found on the nail's surface, forming small fungal colonies. These findings showed the great capacity for dissemination of this form of onychomycosis. PMID:26560225

  5. Treatment of superficial mycoses: review - part II

    OpenAIRE

    2013-01-01

    Superficial fungal infections of the hair, skin and nails are a major cause of morbidity in the world. Choosing the right treatment is not always simple because of the possibility of drug interactions and side effects. The first part of the article discusses the main treatments for superficial mycoses - keratophytoses, dermatophytosis, candidiasis, with a practical approach to the most commonly-used topical and systemic drugs , referring also to their dosage and duration of use. Promising new...

  6. Treatment of superficial mycoses: review - part II*

    OpenAIRE

    2013-01-01

    Superficial fungal infections of the hair, skin and nails are a major cause of morbidity in the world. Choosing the right treatment is not always simple because of the possibility of drug interactions and side effects. The first part of the article discusses the main treatments for superficial mycoses - keratophytoses, dermatophytosis, candidiasis, with a practical approach to the most commonly-used topical and systemic drugs , referring also to their dosage and duration of use. Promising new...

  7. Burn Depth Estimation Based on Infrared Imaging of Thermally Excited Tissue

    Energy Technology Data Exchange (ETDEWEB)

    Dickey, F.M.; Hoswade, S.C.; Yee, M.L.

    1999-03-05

    Accurate estimation of the depth of partial-thickness burns and the early prediction of a need for surgical intervention are difficult. A non-invasive technique utilizing the difference in thermal relaxation time between burned and normal skin may be useful in this regard. In practice, a thermal camera would record the skin's response to heating or cooling by a small amount-roughly 5 C for a short duration. The thermal stimulus would be provided by a heat lamp, hot or cold air, or other means. Processing of the thermal transients would reveal areas that returned to equilibrium at different rates, which should correspond to different burn depths. In deeper thickness burns, the outside layer of skin is further removed from the constant-temperature region maintained through blood flow. Deeper thickness areas should thus return to equilibrium more slowly than other areas. Since the technique only records changes in the skin's temperature, it is not sensitive to room temperature, the burn's location, or the state of the patient. Preliminary results are presented for analysis of a simulated burn, formed by applying a patch of biosynthetic wound dressing on top of normal skin tissue.

  8. Burn Injuries: Burn Depth, Physiopathology and Type of Burns

    Directory of Open Access Journals (Sweden)

    Kemalettin Koltka

    2011-07-01

    Full Text Available A significant burn injury is a serious and mortal event. The most important threat to life is hypovolemic shock with complex pathophysiologic mechanisms. Burn depth is classified as first, second, or third degree. Local inflammatory response results a vasodilatation and an increase in vascular permeability. A burn injury is a three dimensional ischemic wound. Zone of coagulation is the zone with maximum damage. Zone of stasis consists of damaged but viable tissues, the tissue is salvageable. In zone of hyperemia tissue perfusion is increased. At the beginning, cardiac output falls and systemic vascular resistance increases; cardiac performance improves as hypovolemia is corrected with fluid resuscitation. While cardiac output increases systemic vascular resistance falls below normal values and a hypermetabolic state develops. Pulmonary vascular resistance increases immediately after thermal injury and this is more prolonged. To avoid secondary pulmonary complications, the smallest resuscitation volume of fluids that maintains adequate tissue perfusion should be given. Changes parallel to the cardiovascular response develop in other organ systems. The reasons of burn injury can be thermal, electrical, chemical or radiation. It is important to know the exact mechanism of burn injury because of different therapies for a specific cause. In this review information about burn depth, local and systemic responses to burn injury and major causes of burn injury are presented. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl:1-6

  9. Emergency in Burn; Burn in Emergency

    Directory of Open Access Journals (Sweden)

    Yalcin Bayram

    2012-06-01

    Full Text Available Physicians who first meet with burned patients are often emergency service employees. When the patient was admitted to emergency service, especially in patients with major burn injury, is a matter should be dealt with strongly. Before sending the patients to a burn center, some interventions could became life saving which should be done as a first line treatment. Herein, review of the literature related to emergency burn treatment was performed and presented to all physicians as a summary guide. In addition, some questions such as how should be physician, who first meet with the burned patient, evaluated the patient, what should be physician paid attention, which principles should be employed for fluid replacement, how should be approached to burn wound are tried to be addressed. [TAF Prev Med Bull 2012; 11(3.000: 365-368

  10. An optimized animal model for partial and total skin thickness burns studies.

    Science.gov (United States)

    Campelo, Ana Paula Bomfim Soares; Campelo, Marcio Wilker Soares; Britto, Gerly Anne de Castro; Ayala, Alejandro Pedro; Guimarães, Sergio Botelho; Vasconcelos, Paulo Roberto Leitão de

    2011-01-01

    Development of an improved animal model for studying skin burns in rats. Twenty-four male Wistar rats were randomly assigned to four groups (n=6): G1-Control, G2- T100°C, G3-T150°C and G4-T200°C. Two 10 x 10 mm squares were outlined with a sterile surgical marker on each side and along the vertebral column using a prepared template positioned between the anterior and posterior limbs. G2-G4 rats were subjected to 100°C, 150°C and 200ºC thermal burns, respectively. G1 rats served as controls. Burns were inflicted by applying a copper plate connected to an electronic temperature controlling device to the dorsal skin of anesthetized rats. Four burns were produced on each animal (total area: 4 cm²/animal) leaving about 1 cm of undamaged skin between burn areas. Analgesia was administered during 24 h after burn injury by adding 30 mg codeine phosphate hemihydrate to 500 ml tap water. The application of 100°C and 150ºC resulted in partial thickness skin burns with central reepithelialization of the burned area only at 100°C. In G4 group the whole thickness of the skin was injured without central reepithelialization. However, there was marginal reepithelialization in all groups. The model studied is inexpensive and easily reproducible, enabling the achievement of controlled burns with partial or total impairment of the skin in experimental animals.

  11. Silk fibroin/gelatin electrospun nanofibrous dressing functionalized with astragaloside IV induces healing and anti-scar effects on burn wound.

    Science.gov (United States)

    Shan, Ying-Hui; Peng, Li-Hua; Liu, Xin; Chen, Xi; Xiong, Jie; Gao, Jian-Qing

    2015-02-20

    Functional wound dressing has provided new challenges for researchers who focus on burn to improve skin graft quality, reduce scarring, and develop a pluristratified dermal or epidermal construct of a burn wound. This study aimed to investigate the effect of a silk fibroin/gelatin (SF/GT) electrospun nanofibrous dressing loaded with astragaloside IV (AS) on deep partial-thickness burn wound. AS-loaded SF/GT-blended nanofibrous dressing was prepared by electrospinning nanotechnology. The optimal ratio (25:75) of silk fibroin to gelatin was further optimized by evaluating ATR-FTIR characteristics, mechanical properties, porosity, swelling rate, degradation, and release profile of the AS-loaded SF/GT nanofibrous dressing. In contrast to the blank control, the AS-loaded SF/GT nanofibrous dressing promoted cell adhesion and proliferation with good biocompatibility in vitro (pscar formation in vivo by stimulating wound closure (ptypes of collagen, and improving collagen organization. These results showed that SF/GT nanofibrous dressing is a promising topical drug delivery system. Furthermore, AS-functionalized SF/GT nanofibrous dressing is an excellent topical therapeutic that could be applied to promote healing and elicit anti-scar effects on partial-thickness burn wound.

  12. Superficial Temporal Artery Pseudoaneurysm: A Case Report

    Science.gov (United States)

    Younus, Syed Muneeb; Imran, Muhammad; Qazi, Rabia

    2015-01-01

    Pseudoaneurysms of the superficial temporal artery are an uncommon vascular lesion of the external carotid system and most often the result of blunt head trauma. The frequency of pseudoaneurysms of the superficial temporal artery developing after craniotomy is exceedingly low and only a few cases have been reported. We present a case of pseudoaneurysm of this type in a 45-year-old male who underwent craniotomy for excision of meningioma. One month postoperatively, the craniotomy flap exhibited an enormous diffuse pulsate swelling. The suspected diagnosis of pseudoaneurysm arising from superficial temporal artery was confirmed on angiography. Surgical excision was done and no recurrences of the tumor or aneurysm were noted on subsequent follow up. PMID:26501064

  13. Crude oil burning mechanisms

    DEFF Research Database (Denmark)

    van Gelderen, Laurens; Malmquist, L.M.V.; Jomaas, Grunde

    2015-01-01

    In order to improve predictions for the burning efficiency and the residue composition of in-situ burning of crude oil, the burning mechanism of crude oil was studied in relation to the composition of its hydrocarbon mixture, before, during and after the burning. The surface temperature, flame...... to the predictions of four conceptual models that describe the burning mechanism of multicomponent fuels. Based on the comparisons, hydrocarbon liquids were found to be best described by the Equilibrium Flash Vaporization model, showing a constant gas composition and gasification rate. The multicomponent fuels...... followed the diffusion-limited gasification model, showing a change in the hydrocarbon composition of the fuel and its evaporating gases, as well as a decreasing gasification rate, as the burning progressed. This burning mechanism implies that the residue composition and burning efficiency mainly depend...

  14. Treatment of superficial mycoses: review - part II*

    Science.gov (United States)

    Dias, Maria Fernanda Reis Gavazzoni; Bernardes-Filho, Fred; Quaresma-Santos, Maria Victória Pinto; Amorim, Adriana Gutstein da Fonseca; Schechtman, Regina Casz; Azulay, David Rubem

    2013-01-01

    Superficial fungal infections of the hair, skin and nails are a major cause of morbidity in the world. Choosing the right treatment is not always simple because of the possibility of drug interactions and side effects. The first part of the article discusses the main treatments for superficial mycoses - keratophytoses, dermatophytosis, candidiasis, with a practical approach to the most commonly-used topical and systemic drugs , referring also to their dosage and duration of use. Promising new, antifungal therapeutic alternatives are also highlighted, as well as available options on the Brazilian and world markets. PMID:24474103

  15. Treatment of superficial mycoses: review. Part II.

    Science.gov (United States)

    Dias, Maria Fernanda Reis Gavazzoni; Bernardes-Filho, Fred; Quaresma-Santos, Maria Victória Pinto; Amorim, Adriana Gutstein da Fonseca; Schechtman, Regina Casz; Azulay, David Rubem

    2013-01-01

    Superficial fungal infections of the hair, skin and nails are a major cause of morbidity in the world. Choosing the right treatment is not always simple because of the possibility of drug interactions and side effects. The first part of the article discusses the main treatments for superficial mycoses - keratophytoses, dermatophytosis, candidiasis, with a practical approach to the most commonly-used topical and systemic drugs , referring also to their dosage and duration of use. Promising new, antifungal therapeutic alternatives are also highlighted, as well as available options on the Brazilian and world markets.

  16. Learn Not To Burn.

    Science.gov (United States)

    English, Nancy; Hendricks, Charlotte M.

    1997-01-01

    Describes the "Learn Not to Burn Preschool Program," a low-cost fire safety awareness and burn prevention curriculum for young children. The program promotes eight burn prevention methods--including practicing an escape plan--using developmentally appropriate learning objectives to increase children's fire safety knowledge, skill, and…

  17. Minor burns - aftercare

    Science.gov (United States)

    ... the burn: Use cool water, not ice. The extreme cold from ice can injure the tissue even more. If possible, especially if the burn is caused by chemicals, hold the burned skin under cool running water for 10 to 15 minutes until it ...

  18. Optimization of burn referrals

    DEFF Research Database (Denmark)

    Reiband, Hanna K; Lundin, Kira; Alsbjørn, Bjarne

    2014-01-01

    INTRODUCTION: Correct estimation of the severity of burns is important to obtain the right treatment of the patient and to avoid over- and undertriage. In this study we aimed to assess how often the guidelines for referral of burn injured patients are met at the national burn centre (NBC), Denmar...

  19. Epidemiology of burns

    NARCIS (Netherlands)

    Dokter, Jan

    2016-01-01

    The aim of this thesis is to understand the epidemiology, treatment and outcomes of specialized burn care in The Netherlands. This thesis is mainly based on historical data of the burn centre in Rotterdam from 1986, combined with historical data from the burn centres in Groningen and Beverwijk from

  20. Risk Factors for Hypotension in Urgently Intubated Burn Patients

    Science.gov (United States)

    2012-01-01

    superficial tissue damage, the recovery phase represents ischemia reperfusion injury relat ed to burn shock state and extensive intravenous fluid resuscitation...state is necessary to maintain adequate perfusion and heart filling in this shock state. It makes sense that propofol may have a dramatic and enhanced...massively edematous and thus by definition hypovolemic ; and multiple studies, including Hoka’s in 1998 [11], have associated hypovolemia with an

  1. [Treatment of extensive acute radiation burn and its complications].

    Science.gov (United States)

    Li, Ye-yang; Wang, Jin-lun; Li, Gang; Lin, Wei-hua; Liang, Min; Huang, Jun; Sun, Jing-en

    2013-06-01

    This article reports the treatment of a patient suffered from acute radiation burn covering 41% TBSA, with deep partial-thickness and full-thickness injury, produced by exposure to a large-scale industrial electron accelerator. An open wound began to appear and enlarged gradually 10 weeks after the exposure. Serious wound infection with methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa, pneumonia, respiratory failure, systemic inflammatory response syndrome, nephropathy and hypoproteinemia developed successively since 3 weeks after the wound formation. Skin grafts failed to survive, resulting in enlargement of the wound. After being treated with proper measures, including parenteral nutrition, respiratory support with a ventilator, appropriate antibiotics, steroid administration for nephropathy, deep debridement for wounds followed by skin grafting, the patient was cured and discharged after undergoing 15 operations in 500 days. The clinical condition of an extensive acute radiation burn is complicated. We should pay close attention to the changes in functions of organs, and strengthen the therapeutic strategies to support the function of organs to reduce the incidence of systemic complications. The control of the infection and the timely and effective repair of the wound are still the key points of the treatment of an extensive local radiation injury.

  2. Engineered alternative skin for partial and full-thickness burns

    Science.gov (United States)

    Wessels, Quenton

    2014-01-01

    Engineered alternative skin in all its forms and shapes serve to provide temporary or permanent wound closure such as in the case of partial and full-thickness burns. The need for collagen-based regeneration templates is motivated by the fact that dermal regeneration of full-thickness injuries does not occur spontaneously and is inundated by contraction and scarring. Partial-thickness burns in turn can regress as a result of infection and improper treatment and require appropriate treatment. Nylon-silicone laminates such as Biobrane®, and more recently AWBAT®, address this by serving as a temporary barrier. Enhanced collagen-based scaffolds today, although not perfect, remain invaluable. Our initial approach was to characterize the design considerations and explore the use of collagen in the fabrication of a dermal regeneration matrix and a silicone-nylon bilaminate. Here we expand our initial research on scaffold fabrication and explore possible strategies to improve the outcome of collagen-scaffold medicated wound healing. PMID:24651001

  3. Engineered alternative skin for partial and full-thickness burns.

    Science.gov (United States)

    Wessels, Quenton

    2014-01-01

    Engineered alternative skin in all its forms and shapes serve to provide temporary or permanent wound closure such as in the case of partial and full-thickness burns. The need for collagen-based regeneration templates is motivated by the fact that dermal regeneration of full-thickness injuries does not occur spontaneously and is inundated by contraction and scarring. Partial-thickness burns in turn can regress as a result of infection and improper treatment and require appropriate treatment. Nylon-silicone laminates such as Biobrane(®), and more recently AWBAT(®), address this by serving as a temporary barrier. Enhanced collagen-based scaffolds today, although not perfect, remain invaluable. Our initial approach was to characterize the design considerations and explore the use of collagen in the fabrication of a dermal regeneration matrix and a silicone-nylon bilaminate. Here we expand our initial research on scaffold fabrication and explore possible strategies to improve the outcome of collagen-scaffold medicated wound healing.

  4. Partial Burn Laws in Propellant Erosive Burning

    Directory of Open Access Journals (Sweden)

    S.V. Finjakov

    1999-04-01

    Full Text Available Experimental and computer methods were developed for investigating the combustion phenomena in the propellants which burn in streams of hot gas flowing along the burn surfaces of the propellants. The experimental investigations allowed establishment of different dependencies for erosive burning. Computer solutions of the problem for double-base (DB propellants showed a good agreement with the experimental results. The suggested variant of modified theory considers the change of heat release in solids, the real burn surface roughness, the nonisothermality of boundary layer and the effect of gas mass blow from the propellant burn surface into the gas stream. This modified theory was used for studying burn laws at 30-1000 atm and up to gas stream sound velocities for different DB propellants. It was found that gas stream leads to splitting of the propellant burn laws, m = bp/sup v/. Pressure power (v, in this case depends on gas stream velocity (W, diameter of the propellant tube canal (d and gas stream temperature (T/sub w/. It is because of this that these burn laws were named partial burn laws. They have the form (m = bp/sup w(omega/ w,d,T/sub w/ -const. The dependencies w(omega = f(w,d,T/sub w/ were obtained by the modified theory. It was found that omega values mainly decrease when pressure increases beginning from ~200 to 400 atm and they can decrease up to w(omega = 0,1- 0,3. Similar results can be obtained for composite propellants.

  5. Care for the Critically Injured Burn Patient Modulation of Burn Scars Through Laser Deliver of Stem Cells

    Science.gov (United States)

    2013-10-01

    Nucleic acid analysis would rely on development of porcine specific primers. We have developed and verified porcine specific primers for Collagen ...effectiveness of these novel delivery systems and cell-based therapies for third degree burns in a porcine model. We will test the hypothesis that...treated samples. There was a tendency to observe thickened (keloidal) collagen bundles throughout the superficial, mid and deep dermis in control

  6. Superficial Urothelial Cancer in the Prostatic Urethra

    Directory of Open Access Journals (Sweden)

    Ziya Kirkali

    2006-01-01

    Full Text Available Transitional cell carcinoma (TCC is a multifocal disease of the urinary tract that can also involve the prostatic urethra (PU. The exact incidence of superficial involvement of the PU in patients with bladder TCC is not well known. Bladder TCC may involve the prostate in 12—40% of the patients and the degree of involvement can include urethral mucosa, ducts, acini, and stroma of the gland, which has been shown to affect the outcome. Risk factors for superficial urothelial cancer in the PU are high-grade, multifocal bladder TCC and presence of carcinoma in situ (CIS in the bladder. While visible tumors are easy to detect and resect, controversy still exists regarding the optimal technique to identify prostatic involvement by TCC. Prostatic urethral sampling by a transurethral resection biopsy or a cold-cup biopsy, particularly in the high-risk group of bladder cancer patients, has been recommended for detecting prostatic urethral involvement. Management of superficial prostatic involvement by TCC is also unclear. Currently, there is increasing recognition of the value of conservative treatment options with intravesical agents when there is superficial involvement of the PU. Particularly, intravesical bacillus Calmette-Guèrin (BCG seems to be an effective treatment alternative in the management of superficial involvement of the PU by TCC. Close follow-up by cystoscopy and PU biopsy at 3-month intervals, particularly in intermediate and high-risk patients who respond to intravesical therapy and in whom cystectomy is appropriate, is recommended in order to detect persistent tumor, recurrences, or progression.

  7. Superficial urothelial cancer in the prostatic urethra.

    Science.gov (United States)

    Kirkali, Ziya; Canda, A Erdem

    2006-02-28

    Transitional cell carcinoma (TCC) is a multifocal disease of the urinary tract that can also involve the prostatic urethra (PU). The exact incidence of superficial involvement of the PU in patients with bladder TCC is not well known. Bladder TCC may involve the prostate in 12-40% of the patients and the degree of involvement can include urethral mucosa, ducts, acini, and stroma of the gland, which has been shown to affect the outcome. Risk factors for superficial urothelial cancer in the PU are high-grade, multifocal bladder TCC and presence of carcinoma in situ (CIS) in the bladder. While visible tumors are easy to detect and resect, controversy still exists regarding the optimal technique to identify prostatic involvement by TCC. Prostatic urethral sampling by a transurethral resection biopsy or a cold-cup biopsy, particularly in the high-risk group of bladder cancer patients, has been recommended for detecting prostatic urethral involvement. Management of superficial prostatic involvement by TCC is also unclear. Currently, there is increasing recognition of the value of conservative treatment options with intravesical agents when there is superficial involvement of the PU. Particularly, intravesical bacillus Calmette-Guèrin (BCG) seems to be an effective treatment alternative in the management of superficial involvement of the PU by TCC. Close follow-up by cystoscopy and PU biopsy at 3-month intervals, particularly in intermediate and high-risk patients who respond to intravesical therapy and in whom cystectomy is appropriate, is recommended in order to detect persistent tumor, recurrences, or progression.

  8. The use of banked skin in the Burns Centre of Verona

    Science.gov (United States)

    Bosco, Federica; Governa, Maurizio; Rossati, Leonardo; Vigato, Enrico; Vassanelli, Aurora; Aprili, Giuseppe; Franchini, Massimo

    2011-01-01

    Background. The use of glycerol and subsequent research enabling the conservation of tissues over time have led to the establishment and development of tissue banks, first in the USA and then in Europe. The Verona Tissue Bank was instituted in 2003 as the Regional Centre for the storage of skin and bone, adding to the already existing Italian banks at Turin, Milan, Cesena and Siena. This retrospective study analyses the use of banked skin (autologous and allogeneic grafts) from April 2003 (date of starting activity) to December 2007, in 171 patients with burns and four with necrotising fasciitis at the Burns Centre of Verona. Materials and methods. Homologous skin was used for superficial and deep skin burns to protect the residual structures, thus facilitating healing by spontaneous re-epithelialisation, and for deep burns after eschar removal to clean and prepare the base of the lesion for the definitive autologous graft. The placement of a homologous graft alone led to spontaneous healing of lesions in 65 patients (36 aged >15 years and 29 aged skin burns, while the remaining 106 patients (84 aged >15 years and 22 aged burns underwent surgery. Conclusions. The results obtained confirm the essential role of banked skin in covering superficial burns in order to protect important underlying structures and in deep burns by guaranteeing a good preparation of the base of the lesion for the subsequent definitive autologous graft. PMID:21251463

  9. [The pain from burns].

    Science.gov (United States)

    Latarjet, J

    2002-03-01

    The painful events associated with the treatment of a severe burn can, because of their long-lasting and repetitive characteristics, be one of the most excruciating experiences in clinical practice. Moreover, burn pain has been shown to be detrimental to burn patients. Although nociception and peripheral hyperalgesia are considered the major causes of burn pain, the study of more hypothetical mechanisms like central hyperalgesia and neuropathic pain may lead to a better understanding of burn pain symptoms and to new therapeutic approaches. Continuous pain and intermittent pain due to therapeutic procedures are two distinct components of burn pain. They have to be evaluated and managed separately. Although continuous pain is by far less severe than intermittent pain, the treatment is, in both cases, essentially pharmacological relying basically on opioids. Because of wide intra- and inter-individual variations, protocols will have to leave large possibilities of adaptation for each case, systematic pain evaluation being mandatory to achieve the best risk/benefit ratio. Surprisingly, the dose of medication decreases only slowly with time, a burn often remaining painful for long periods after healing. Non pharmacological treatments are often useful and sometimes indispensable adjuncts; but their rationale and their feasibility depends entirely on previous optimal pharmacological control of burn pain. Several recent studies show that burn pain management is inadequate in most burn centres.

  10. Efficacy of propranolol in wound healing for hospitalized burn patients.

    Science.gov (United States)

    Mohammadi, Ali Akbar; Bakhshaeekia, Alireza; Alibeigi, Peyman; Hasheminasab, Mohammad Jalal; Tolide-ei, Hamid Reza; Tavakkolian, Ahmad Reza; Mohammadi, Mohammad Kazem

    2009-01-01

    Burn patients have the highest metabolic rate among critically ill or injured patients. Because propranolol decreases energy expenditure and muscle protein catabolism, in this study, we hypothesized that propranolol would improve healing process and decrease wound-healing time. This study was a double-blind randomized clinical trial; a total of 79 burn patients who referred to this center from January 2006 to January 2007 fulfilled the inclusion criteria. Thirty-seven patients were randomly placed in propranolol group and 42 in control group. The propranolol group received propranolol orally with the dose of 1 mg/kg/d and maximum dose of 1.98 mg/kg/d given in six divided doses. This dose was adjusted to decrease the resting heart rate by 20% from each patient's baseline value. The control group received placebo. The most common cause of burn in both groups was flame followed by flash. Patients with superficial burns in the propranolol group needed less time to heal for acceptable wound healing in superficial burns (16.13+/-7.40 days vs 21.52+/-7.94 days; P=.004). We also found that patients with deep burn injury needed less time to be ready for skin graft (28.23+/-8.43 days vs 33.46+/-9.17 days; P=.007) when compared to that of the control group. The use of propranolol decreased the size of the burn wound that finally needed skin graft. Patients in the propranolol group with an average burn size of 31.42% TBSA finally needed 13.75% of TBSA skin graft compared with that of control patients with an average burn size of 33.61% TBSA who needed 18.72% of TBSA skin graft, and patients in the control group with an average burn size of 33.61% TBSA finally needed 18.72% of TBSA skin graft (P=.006). Patients in the propranolol group had a shorter hospital stay period than the control group (30.95+/-8.44 days vs 24.41+/-8.11 days; P=.05). Administration of propranolol, improved burn wound healing, and decreased healing time and hospital stay period. The use of propranolol

  11. Dermoscopic insight into skin microcirculation--Burn depth assessment.

    Science.gov (United States)

    Mihara, Kyomi; Nomiyama, Tomoko; Masuda, Koji; Shindo, Hajime; Yasumi, Maki; Sawada, Takahiro; Nagasaki, Kotaro; Katoh, Norito

    2015-12-01

    To investigate the effectiveness of dermoscopic observation of skin microcirculation, the dermal capillary integrity of burn wounds was evaluated by dermoscopy according to a proposed algorithm that is designed to distinguish burn wounds between superficial dermal burns: SDB, and deep dermal burns: DDB. As the gold standard for comparison, two widely accepted endpoints of primary healing within 21 days (SDB) or over 21 days after injury (DDB) were used. A number of dermatologists conducted diagnostic imaging by dermoscopy. Comparison among polarized noncontact dermoscopy (PNCD), polarized contact dermoscopy (PCD) and nonpolarized contact dermoscopy (NPD) was also conducted. Images from the three modalities were evaluated for color, pattern and qualitative differences among them. The results of dermoscopy measurements according to the proposed algorithm showed accuracy of 96.7%, sensitivity of 100.0% and specificity of 94.4%. Dermoscopy measurements were significantly more accurate than clinical assessment (p<0.05). The recognition of dots increased for NPD, vessels were most clearly observed under PCD and colours tended to be more distinctly recognized under polarized light. Dermoscopy is a useful and simple tool to evaluate not only epidermal and superficial dermal skin components but also the skin microcirculation. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  12. Burns and epilepsy.

    Science.gov (United States)

    Berrocal, M

    1997-01-01

    This is a report of the first descriptive analytic study of a group of 183 burn patients, treated in the Burn Unit at the University Hospital of Cartagena, Colombia during the period since January 1985 until December 1990. There is presented experience with the selected group of 24 patients in whom the diagnosis of burn was associated with epilepsy. There is also analysed and described the gravity of the scars sequels, neurological disorders, the complication of the burn and an impact of this problem on the patient, his (her) family and the community. It is very important to report that there was found Neurocisticercosis in 66.6% of the group of burn patients with epilepsy, and it is probably the first risk factor of burn in this group.

  13. Multilocus sequence typing of Candida albicans isolates from Burn Intensive Care Unit (BICU) in Iran

    NARCIS (Netherlands)

    Afsarian, Mohammad H; Badali, Hamid; Boekhout, Teun; Shokohi, Tahereh; Katiraee, Farzad

    2015-01-01

    Burn intensive care unit patients are specifically exposed to deep-seated nosocomial infections caused by Candida albicans. Superficial carriage of C. albicans is a potential source of infection and dissemination, and typing methods could be useful to trace the different isolates. Multilocus sequenc

  14. The Burning Saints

    DEFF Research Database (Denmark)

    Xygalatas, Dimitris

    . Carrying the sacred icons of the saints, participants dance over hot coals as the saint moves them. The Burning Saints presents an analysis of these rituals and the psychology behind them. Based on long-term fieldwork, The Burning Saints traces the historical development and sociocultural context......, The Burning Saints presents a highly original analysis of how mental processes can shape social and religious behaviour....

  15. Management of Hand Burns

    Directory of Open Access Journals (Sweden)

    Fatih Irmak

    2017-09-01

    Full Text Available Objective: The hand is one of the most frequently affected body parts by burn injuries with a rate of 80% among all burn wounds. Early and effective treatment ensures the best chance of survival as well as a good functional prognosis. The aim of this study was to determine the epidemiology, variation, relationship between etiology and hospital stay, clinical features, and management of hand burns. Material and Methods: This retrospective study was conducted the University of Health Sciences; Şişli Hamidiye Etfal Application and Research Center, Departmant of Plastic, Reconstructive and Aesthetic Surgery and the Intensive Burn Care Unit between April 2009 and April 2014. Burns were assessed based on etiology, anatomical location, percentage of total body surface area affected, and depth of injury. Treatment was categorized as conservative, elective operative, or urgent operative. Results: In the study period, 788 patients were admitted to our Burn Unit. Of these, 240 were females (30.5% and 548 were males (69.5%. The most common type of burn injury in this study was thermal injury (695 cases; 88.2%, followed by electrical injury (67 cases; 8.5%, and chemical, frictional or unknown injuries (26 cases; 3.3%. Majority (more than 85% of the patients had second-degree burns, and some had third-degree burns. Conclusions: Burns commonly affect the hands, and many functional problems may develop if appropriate basic treatments are neglected. The best treatment for burns is prevention. Appropriate indoor arrangement and simple but effective measures that can be taken at home can significantly reduce burn trauma exposure.

  16. Management of Outpatient Burns

    OpenAIRE

    Waslen, G. D.

    1986-01-01

    The severity of burns depends on the depth and extent of body surface involved. The total body surface area (TBSA) involved can be estimated by the ‘rule of nines’; body locations are 9% of body surface or multiples of nine. Depth and TBSA can be used to classify burns as minor, moderate, or critical. Diagnosis depends on history and physical examination. Most burns can be treated in an outpatient setting. Treatment should include debriding necrotic tissue, preventing infection and encouragin...

  17. Biobrane: a retrospective analysis of outcomes at a specialist adult burns centre.

    Science.gov (United States)

    Hubik, Daniel John; Wasiak, Jason; Paul, Eldho; Cleland, Heather

    2011-06-01

    This study is a retrospective analysis of 168 adult burns patients who received definitive treatment for partial thickness burns with Biobrane at a specialist burns centre. Our aim was to establish whether Biobrane served as a reliable, definitive treatment option or whether further treatment and allocation of surgical and nursing resources was required after application. We conducted a retrospective two year chart review (January 1 2007 and December 31 2008) of patients admitted to the Victorian Adult Burns Service, in Melbourne, Australia. Use of Biobrane was associated with the need for further treatment interventions in a total of 74 patients (44%). Of these, Biobrane failure was found to be associated with infection in 28 cases (37.8%) and 48 (65%) patients underwent further surgery. A total of 87 patients (52%) had burns that took greater than three weeks from the time of injury to full re-epithelisation. Factors found to be associated with Biobrane failure were female gender, increasing percentage surface area of Biobrane application and when Biobrane was used in conjunction with split skin grafting to another area. The application of Biobrane to burns of mid-dermal or 'indeterminate' depth in our institution has resulted in high rates of return to theatre, positive wound cultures and delayed healing, and the recognition of the need to re-conceptualise the principles of use of this product. The use of Biobrane in smaller mid dermal or mixed depth burns may lead to increased operations and use of other hospital resources, without clear evidence of improved outcomes. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

  18. Gelam (Melaleuca spp. Honey-Based Hydrogel as Burn Wound Dressing

    Directory of Open Access Journals (Sweden)

    Rozaini Mohd Zohdi

    2012-01-01

    Full Text Available A novel cross-linked honey hydrogel dressing was developed by incorporating Malaysian honey into hydrogel dressing formulation, cross-linked and sterilized using electron beam irradiation (25 kGy. In this study, the physical properties of the prepared honey hydrogel and its wound healing efficacy on deep partial thickness burn wounds in rats were assessed. Skin samples were taken at 7, 14, 21, and 28 days after burn for histopathological and molecular evaluations. Application of honey hydrogel dressings significantly enhanced (P<0.05 wound closure and accelerated the rate of re-epithelialization as compared to control hydrogel and OpSite film dressing. A significant decrease in inflammatory response was observed in honey hydrogel treated wounds as early as 7 days after burn (P<0.05. Semiquantitative analysis using RT-PCR revealed that treatment with honey hydrogel significantly (P<0.05 suppressed the expression of proinflammatory cytokines (IL-1α, IL-1β, and IL-6. The present study substantiates the potential efficacy of honey hydrogel dressings in accelerating burn wound healing.

  19. What factors control superficial lava dome explosivity?

    Science.gov (United States)

    Boudon, Georges; Balcone-Boissard, Hélène; Villemant, Benoît; Morgan, Daniel J.

    2015-09-01

    Dome-forming eruption is a frequent eruptive style and a major hazard on numerous volcanoes worldwide. Lava domes are built by slow extrusion of degassed, viscous magma and may be destroyed by gravitational collapse or explosion. The triggering of lava dome explosions is poorly understood: here we propose a new model of superficial lava-dome explosivity based upon a textural and geochemical study (vesicularity, microcrystallinity, cristobalite distribution, residual water contents, crystal transit times) of clasts produced by key eruptions. Superficial explosion of a growing lava dome may be promoted through porosity reduction caused by both vesicle flattening due to gas escape and syn-eruptive cristobalite precipitation. Both processes generate an impermeable and rigid carapace allowing overpressurisation of the inner parts of the lava dome by the rapid input of vesiculated magma batches. The relative thickness of the cristobalite-rich carapace is an inverse function of the external lava dome surface area. Explosive activity is thus more likely to occur at the onset of lava dome extrusion, in agreement with observations, as the likelihood of superficial lava dome explosions depends inversely on lava dome volume. This new result is of interest for the whole volcanological community and for risk management.

  20. HISTOPATHOLOGY OF MARGINAL SUPERFICIAL PERIODONTIUM AT MENOPAUSE

    Directory of Open Access Journals (Sweden)

    A. Georgescu

    2012-03-01

    Full Text Available Premises: Sexual hormones may affect the general health condition of women, as early as puberty, continuing during pregnancy and also after menopause. Variations of the hormonal levels may cause different – either local or general – pathological modifications. Sexual hormones may also affect periodontal status, favourizing gingival inflammations and reducing periodontal resistance to the action of the bacterial plaque. Scope: Establishment of the correlations between the debut or the manifestation of menopause and the modifications produced in the superficial periodontium. Materials and method: Clinical and paraclinical investigations were performed on female patients with ages between 45 and 66 years, involving macroscopic, microscopic and radiological recording of the aspect of the superificial periodontium (gingiva. Results: Analysis of the histological sections evidenced atrophic and involutive modifications in the marginal superficial periodontium of female patients at menopause. Conclusions: Sexual hormones intervene in the histological equilibrium of the marginal superficial periodontium, influencing the periodontal health status, which explains the correlation between the subjective symptomatology specific to menopause and the histopatological aspect at epithelial level.

  1. Burns in pregnancy.

    Science.gov (United States)

    Maghsoudi, Hemmat; Samnia, Roya; Garadaghi, Abasad; Kianvar, Hadi

    2006-03-01

    A 9-year prospective study of burns in pregnant women hospitalized at the Sina hospital burn center was conducted to determine the etiology and outcome of pregnant patients. Fifty-one patients (27.45% self-inflicted, 72.55% unintentional) were identified and stratified by age, burn size, presence or absence of inhalation injury, trimester of pregnancy, maternal and fetal mortality, and cause of burn. The mean patient age was 24.2 years. There were 20 maternal deaths and 23 fetal deaths. The majority of which (maternal: 13 and fetal: 13) were among self-inflicted burned pregnant women. The mean burn size was 37.7%, and was significantly larger for nonsurvivors of mother than survivors (68.8% versus 17.6%; pburned body surface area exceeds 40%, both maternal and fetal mortality reaches 100%. Inhalation injuries were strongly associated with large burns, and were presents in all suicide patients. Kerosene ignition (68.6% of all patients, 100% of self-inflicted patients) was the most common type of burn. Large burn size was the strongest predictor of mortality of mother and fetus followed by the presence of inhalation injury.

  2. Extensive burns caused by the abusive use of photosensitizing agents.

    Science.gov (United States)

    Braye, F; Latarjet, J; Foyatier, J L; Comparin, J P; Tranchand, P; Boucaud, C

    1997-01-01

    Psoralens are photosensitizing agents used in dermatology as reinforcements in psoralen ultraviolet A-range therapy. We report observations of 14 young women hospitalized for severe burns caused by abusive use of psoralens. The burns were of superficial and deep second-degree depth and covered more than 76% of the body surface on average. All patients needed fluid resuscitation. Hospital stay was 11 days on average. Healing was obtained without skin grafting in all cases. Among the six patients who responded to the mailed questionnaire, negative effects are now present in all patients as inflammatory peaks. Two patients have esthetic sequelae such as dyschromia and scars. The misuse of photosensitizing agents poses many problems. These accidents are very expensive. The largeness of the burned surface can involve a fatal prognosis. And finally, one can suspect that a much larger portion of the population regularly uses these products without any serious accident. In this case carcinogenesis can be expected.

  3. Tolerance and safety of superficial chemical peeling with salicylic acid in various facial dermatoses

    Directory of Open Access Journals (Sweden)

    Iqbal Zafar

    2005-03-01

    Full Text Available BACKGROUND: Chemical peeling is a skin-wounding procedure that may have some potentially undesirable side-effects. AIMS: The present study is directed towards safety concerns associated with superficial chemical peeling with salicylic acid in various facial dermatoses. METHODS: The study was a non-comparative and a prospective one. Two hundred and sixty-eight patients of either sex, aged between 10 to 60 years, undergoing superficial chemical peeling for various facial dermatoses (melasma, acne vulgaris, freckles, post-inflammatory scars/pigmentation, actinic keratoses, plane facial warts, etc. were included in the study. Eight weekly peeling sessions were carried out in each patient. Tolerance to the procedure and any undesirable effects noted during these sessions were recorded. RESULTS: Almost all the patients tolerated the procedure well. Mild discomfort, burning, irritation and erythema were quite common but the incidence of major side-effects was very low and these too, were easily manageable. There was no significant difference in the incidence of side-effects between facial dermatoses (melasma, acne and other pigmentary disorders. CONCLUSION: Chemical peeling with salicylic acid is a well tolerated and safe treatment modality in many superficial facial dermatoses.

  4. Burns and military clothing.

    Science.gov (United States)

    McLean, A D

    2001-02-01

    Burn injury is a ubiquitous threat in the military environment. The risks during combat are well recognised, but the handling of fuel, oil, munitions and other hot or flammable materials during peacetime deployment and training also imposes an inherent risk of accidental burn injury. Over the last hundred years, the burn threat in combat has ranged from nuclear weapons to small shoulder-launched missiles. Materials such as napalm and white phosphorus plainly present a risk of burn, but the threat extends to encompass personnel in vehicles attacked by anti-armour weapons, large missiles, fuel-air explosives and detonations/conflagrations on weapons platforms such as ships. Large numbers of burn casualties were caused at Pearl Harbor, in Hiroshima and Nagasaki, Vietnam, during the Arab/Israeli Wars and in the Falkland Islands conflict. The threat from burns is unlikely to diminish, indeed new developments in weapons seek to exploit the vulnerability of the serviceman and servicewoman to burns. Clothing can be a barrier to some types of burn--both inherently in the properties of the material, but also by trapping air between clothing layers. Conversely, ignition of the clothing may exacerbate a burn. There is hearsay that burnt clothing products within a wound may complicate the clinical management, or that materials that melt (thermoplastic materials) should not be worn if there is a burn threat. This paper explores the incidence of burn injury, the mechanisms of heat transfer to bare skin and skin covered by materials, and the published evidence for the complication of wound management by materials. Even light-weight combat clothing can offer significant protection to skin from short duration flash burns; the most vulnerable areas are the parts of the body not covered--face and hands. Multilayered combat clothing can offer significant protection for short periods from engulfment by flames; lightweight tropical wear with few layers offers little protection. Under

  5. Critical issues in burn care.

    Science.gov (United States)

    Holmes, James H

    2008-01-01

    Burn care, especially for serious burn injuries, represents a considerable challenge for the healthcare system. The American Burn Association has established a number of strategies for the management of burn patients and dedicates its efforts and resources to promoting and supporting burn-related research, education, care, rehabilitation, and prevention, often in collaboration with other organizations. The American Burn Association has recommended that patients with serious burns be referred to a designated burn center, ie, a hospital outfitted with specialized personnel and equipment dedicated to burn care. Burn centers have been operational for over 50 years, but the complexity and costs of providing specialized burn care have given rise to a number of critical administrative and political issues. These include logistical limitations imposed by the uneven national distribution of burn centers and a potential shortage of burn beds, both during everyday conditions and in the event of a mass disaster. Burn surgeon shortages have also been identified, stemming, in part, from a lack of specialized burn care training opportunities. There is currently a lack of quality outcome data to support evidence-based recommendations for burn care, and burn care centers are compromised by problems obtaining reimbursement for the care of uninsured and publicly insured out-of-state burn patients. Initiatives are underway to maintain efficient burn care facilities that are fully funded, easily accessible, and most importantly, provide optimal, evidence-based care on a daily basis, and are well-equipped to handle a surge of patients during a disaster situation.

  6. Pain in burn patients.

    Science.gov (United States)

    Latarjet, J; Choinère, M

    1995-08-01

    While severe pain is a constant component of the burn injury, inadequate pain management has been shown to be detrimental to burn patients. Pain-generating mechanisms in burns include nociception, primary and secondary hyperalgesia and neuropathy. The clinical studies of burn pain characteristics reveal very clear-cut differences between continuous pain and pain due to therapeutic procedures which have to be treated separately. Some of the main features of burn pain are: (1) its long-lasting course, often exceeding healing time, (2) the repetition of highly nociceptive procedures which can lead to severe psychological disturbances if pain control is inappropriate. Pharmaco-therapy with opioids is the mainstay for analgesia in burned patients, but non-pharmacological techniques may be useful adjuncts. Routine pain evaluation is mandatory for efficient and safe analgesia. Special attention must be given to pain in burned children which remains too often underestimated and undertreated. More educational efforts from physicians and nursing staff are necessary to improve pain management in burned patients.

  7. Nutrition of burned patients.

    Science.gov (United States)

    Gudaviciene, Daiva; Rimdeika, Rytis; Adamonis, Kestutis

    2004-01-01

    Burns form 5-12% of all traumas. About 2,200 of patients are annually hospitalized in Lithuania. In most cases people of the employable age get burned. The treatment is often long-lasting, and afterwards recovered patients often have invalidity from burn sequels. The mortality of hospitalized burned patients is about 10%. The most common causes of death are pulmonary edema, pneumonia, sepsis and multiorgan failure. All these complications are related with insufficient nutrition. These complications are extremely frequent and dangerous for patients with more than 20% of body burned. The nutritional support of burned patient gives a possibility to increase the survival probability, to decrease complication rate and hospitalization time. Currently in Lithuania there are no standards for burned patient nutrition. More attention is given to strategy of surgical strategy and techniques, as well as antibiotic therapy. This article is the review of the different aspects of artificial nutrition of burned patient: indications, modes of nutrition, mixtures and terms of nutritional support.

  8. A Descriptive Study of the Temporal Patterns of Volume and Contents Change in Human Acute Burn Edema: Application in Evidence-Based Intervention and Research Design.

    Science.gov (United States)

    Edgar, Dale W; Fear, Mark; Wood, Fiona M

    2016-01-01

    Edema after burn contributes significantly to burn wound depth conversion. In humans after burn injury, there is a lack of detailed understanding of the contents and temporal changes in volume of acute tissue edema. The novel findings of these studies relate to the collection of edema fluid after partial-thickness burn injury. Edema volume peaks on day 1 after burn without formal fluid resuscitation. The studies indicated that the peak was on day 2 for a resuscitated burn. In contrast, animal studies suggest that the peak of edema occurs by or before day 1 after injury. The findings confirm the pitfalls of evidence derived from animal models and assuming direct transference to humans. Postburn edema was demonstrated to be a high-protein fluid (ie, ≥10 g/L) for the duration of the inflammatory period. The presence of high-protein edema presents greater challenges to clinicians developing novel treatment options. The rate of volume change over time tapered to insignificant levels after day 4 following burn. Greater than 98% of the edema contents was fluid. However, the size of particulate matter did not preclude it passing through patent lymphatic collectors. The results indicate a necessity for urgent postburn intervention, which should incorporate the active stimulation of the lymphatic system to improve efficacy of edema removal.

  9. Non-ablative fractional laser provides long-term improvement of mature burn scars

    DEFF Research Database (Denmark)

    Taudorf, Elisabeth H; Danielsen, Patricia L; Paulsen, Ida F

    2015-01-01

    BACKGROUND AND OBJECTIVES: Non-ablative fractional laser-treatment is evolving for burn scars. The objective of this study was to evaluate clinical and histological long-term outcome of 1,540 nm fractional Erbium: Glass laser, targeting superficial, and deep components of mature burn scars......-Patient-and-Observer-Scar-Assessment-Scale (mPOSAS, 1 = "normal skin", 10 = "worst imaginable scar"). Secondary outcomes included histology, patient satisfaction (0-10), patient-assessed improvement, and safety. RESULTS: Study was completed by 17 of 20 randomized patients with normotrophic (n = 11), hypertrophic (n = 5) or atrophic (n = 1...... of scar-appearance. CONCLUSIONS: Combined superficial and deep non-ablative fractional laser-treatments induce long-term clinical and histological improvement of mature burn scars....

  10. Burning mouth syndrome

    Directory of Open Access Journals (Sweden)

    K A Kamala

    2016-01-01

    Full Text Available Burning mouth syndrome (BMS is multifactorial in origin which is typically characterized by burning and painful sensation in an oral cavity demonstrating clinically normal mucosa. Although the cause of BMS is not known, a complex association of biological and psychological factors has been identified, suggesting the existence of a multifactorial etiology. As the symptom of oral burning is seen in various pathological conditions, it is essential for a clinician to be aware of how to differentiate between symptom of oral burning and BMS. An interdisciplinary and systematic approach is required for better patient management. The purpose of this study was to provide the practitioner with an understanding of the local, systemic, and psychosocial factors which may be responsible for oral burning associated with BMS, and review of treatment modalities, therefore providing a foundation for diagnosis and treatment of BMS.

  11. Hand chemical burns.

    Science.gov (United States)

    Robinson, Elliot P; Chhabra, A Bobby

    2015-03-01

    There is a vast and ever-expanding variety of potentially harmful chemicals in the military, industrial, and domestic landscape. Chemical burns make up a small proportion of all skin burns, yet they can cause substantial morbidity and mortality. Additionally, the hand and upper extremity are the most frequently involved parts of the body in chemical burns, and therefore these injuries may lead to severe temporary or permanent loss of function. Despite this fact, discussion of the care of these injuries is sparse in the hand surgery literature. Although most chemical burns require only first response and wound care, some require the attention of a specialist for surgical debridement and, occasionally, skin coverage and reconstruction. Exposure to certain chemicals carries the risk of substantial systemic toxicity and even mortality. Understanding the difference between thermal and chemical burns, as well as special considerations for specific compounds, will improve patient treatment outcomes.

  12. [Chickenpox, burns and grafts].

    Science.gov (United States)

    Rojas Zegers, J; Fidel Avendaño, L

    1979-01-01

    An outbreak of chickenpox that occurred at the Burns Repair Surgery Unit, Department of Children's Surgery, Hospital R. del Río, between June and November, 1975, is reported. 27 cases of burned children were studied, including analysis of correlations of the stages and outcome of the disease (varicela), the trauma (burns) and the graft (repair surgery). As a result, the authors emphasize the following findings: 1. Burns and their repair are not aggravating factors for varicella. In a small number of cases the exanthema looked more confluent in the graft surgical areas and in the first degree burns healing spontaneously. 2. Usually there was an uneventful outcome of graft repair surgery on a varicella patient, either during the incubation period, the acme or the convalescence. 3. The fact that the outmost intensity of secondary viremia of varicella occurs before the onset of exanthemia, that is, during the late incubation period, is confirmed.

  13. Crude oil burning mechanisms

    DEFF Research Database (Denmark)

    van Gelderen, Laurens; Malmquist, Linus Mattias Valdemar; Jomaas, Grunde

    2015-01-01

    In order to improve predictions for the burning efficiency and the residue composition of in-situ burning of crude oil, the burning mechanism of crude oil was studied in relation to the composition of its hydrocarbon mixture, before, during and after the burning. The surface temperature, flame...... height, mass loss rate and residues of three hydrocarbon liquids (n-octane, dodecane and hexadecane), two crude oils (DUC and REBCO) and one hydrocarbon liquid mixture of the aforementioned hydrocarbon liquids were studied using the Crude Oil Flammability Apparatus. The experimental results were compared...... to the predictions of four conceptual models that describe the burning mechanism of multicomponent fuels. Based on the comparisons, hydrocarbon liquids were found to be best described by the Equilibrium Flash Vaporization model, showing a constant gas composition and gasification rate. The multicomponent fuels...

  14. Estructura electrónica de superficies: estados de superficie y estados resonantes del calcio

    OpenAIRE

    H. Herrera; César Mora

    2006-01-01

    En este artículo presentamos un estudio detallado de la estructura electrónica de bandas de superficies orientadas (001) y (110) de cristales cúbicos centrados en la cara del Ca. Para nuestro estudio utilizamos la aproximación de enlace fuerte y el método de acoplamiento de la función de Green de superficie. Primero, construimos hamiltonianos de enlace fuerte en el formalismo de Slater Koster (SK). Utilizamos una base ortogonal de nueve orbitales atómicos (spd) por átomo en la celda unitaria....

  15. Cost-effectiveness of laser Doppler imaging in burn care in the Netherlands

    Directory of Open Access Journals (Sweden)

    Hop M Jenda

    2013-02-01

    Full Text Available Abstract Background Early accurate assessment of burn depth is important to determine the optimal treatment of burns. The method most used to determine burn depth is clinical assessment, which is the least expensive, but not the most accurate. Laser Doppler imaging (LDI is a technique with which a more accurate (>95% estimate of burn depth can be made by measuring the dermal perfusion. The actual effect on therapeutic decisions, clinical outcomes and the costs of the introduction of this device, however, are unknown. Before we decide to implement LDI in Dutch burn care, a study on the effectiveness and cost-effectiveness of LDI is necessary. Methods/design A multicenter randomised controlled trial will be conducted in the Dutch burn centres: Beverwijk, Groningen and Rotterdam. All patients treated as outpatient or admitted to a burn centre within 5 days post burn, with burns of indeterminate depth (burns not obviously superficial or full thickness and a total body surface area burned of ≤ 20% are eligible. A total of 200 patients will be included. Burn depth will be diagnosed by both clinical assessment and laser Doppler imaging between 2–5 days post burn in all patients. Subsequently, patients are randomly divided in two groups: ‘new diagnostic strategy’ versus ‘current diagnostic strategy’. The results of the LDI-scan will only be provided to the treating clinician in the ‘new diagnostic strategy’ group. The main endpoint is the effect of LDI on wound healing time. In addition we measure: a the effect of LDI on other patient outcomes (quality of life, scar quality, b the effect of LDI on diagnostic and therapeutic decisions, and c the effect of LDI on total (medical and non-medical costs and cost-effectiveness. Discussion This trial will contribute to our current knowledge on the use of LDI in burn care and will provide evidence on its cost-effectiveness. Trial registration NCT01489540

  16. Eradication of superficial fungal infections by conventional and novel approaches: a comprehensive review.

    Science.gov (United States)

    Kumar, Lalit; Verma, Shivani; Bhardwaj, Ankur; Vaidya, Shubha; Vaidya, Bhuvaneshwar

    2014-02-01

    During the last two decades, the occurrence of fungal infections either superficial or systemic has been increasing. Moreover, fungal infections become more difficult to treat when they show coupling with immunogenic diseases like AIDS. Superficial fungal infections are associated with skin, nail and eye and are less prominent to systemic infection. However, it may be dangerous if not treated properly. It is usually observed that conventional formulations including cream, powder, gels etc. are used to treat skin fungal infections even for the deep seated fungal infections. However, these formulations show various side-effects on the application site like burning, redness and swelling. Further, due to the immediate release of drug from these formulations they can stimulate the immune system of body generating high impact allergic reactions. Deep seated fungal infections like invasive aspergillosis and invasive candidiasis may be more difficult to treat because the drug released from conventional topical formulation can not reach at the target site due to the low penetration capacity. Similarly, in case of fungal infection of nail and eye, conventional formulations show problem of less bioavailability. Thus, to overcome the drawbacks of conventional therapy a lot of research works have been carried out to develop novel formulations of antifungal drugs to deliver them superficially. Novel formulations explored for the skin delivery of antifungal drugs include liposomes, niosomes, ethosomes, microemulsions, nanoparticles, microspheres and micelles. These formulations show extended or sustained release of drug, minimizing the side effect on application site, enhancing bioavailability and reducing the dosing frequency. Further, these formulations also show penetration into the deep skin to treat invasive fungal infections. Novel formulations explored in treatment of fungal infections of eye are liposomes and nanoparticles and whether for nail fungal infections

  17. A unique variation of superficial palmar arch

    Directory of Open Access Journals (Sweden)

    Jiji PJ

    2009-09-01

    Full Text Available We present a unique variation in the arterial pattern of superficial palmar arch in which it was completed by one of the large terminal branches of radial artery. The origin of the arteria radialis indicis was also peculiar that it was arising from the communicating branch of the radial artery and further reinforced by the first dorsal metacarpal artery that joined it after reaching the volar aspect. Pertinent anatomical knowledge regarding the variations of the palmar arch is significant for the purposes of microvascular repairs and re-implantations.

  18. Clinical application and viability of cryopreserved cadaveric skin allografts in severe burn: a retrospective analysis.

    Science.gov (United States)

    Cleland, Heather; Wasiak, Jason; Dobson, Hannah; Paul, Michelle; Pratt, George; Paul, Eldho; Herson, Marisa; Akbarzadeh, Shiva

    2014-02-01

    Cadaveric cutaneous allografts are used in burns surgery both as a temporary bio-dressing and occasionally as definitive management of partial thickness burns. Nonetheless, limitations in the understanding of the biology of these grafts have meant that their role in burns surgery continues to be controversial. A review of all patients suffering 20% or greater total body surface area (TBSA) burns over an eight year period that received cadaveric allografts were identified. To investigate whether tissue viability plays a role in engraftment success, five samples of cryopreserved cadaveric cutaneous allograft processed at the Donor Tissue Bank of Victoria (DTBV) were submitted to our laboratory for viability analysis using two methods of Trypan Blue Exclusion and tetrazolium salt (MTT) assays. During the study period, 36 patients received cadaveric allograft at our institution. The average total burn surface area (TBSA) for this group of patients was 40% and all patients received cadaveric skin as a temporizing measure prior to definitive grafting. Cadaveric allograft was used in complicated cases such as wound contamination, where synthetic dressings had failed. Viability tests showed fewer than 30% viability in processed allografts when compared to fresh skin following the thawing process. However, the skin structure in the frozen allografts was histologically well preserved. Cryopreserved cutaneous cadaveric allograft has a positive and definite role as an adjunct to conventional dressing and grafting where available, particularly in patients with large TBSA burns. The low viability of cryopreserved specimens processed at DTBV suggests that cell viability in cadaveric allograft may not be essential for its clinical function as a wound dressing or even as permanent dermal substitute. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  19. Superficial microcirculation flow measurement using polarized light

    Science.gov (United States)

    Wu, Jiwei; Morgan, S. P.; Xiao, Yunshi

    2008-12-01

    Depth discrimination of polarized light is used in investigating laser Doppler measurement of the superficial microcirculation in tissue. Using polarization Monte Carlo simulation, temporal point spread function and power spectral distribution of backscattered polarization remaining light firstly are used to prove polarized light to be valid in measuring moving blood cell perfusion and mean flow velocity. Then simulation of layered medium model demonstrate that relationships between blood flow perfusion and mean frequency shift are linear to medium flowing velocity, and the Doppler shift information in polarization remaining light mainly comes from lower layer medium up to about 14 times of mean free path (MFP) of medium investigated and can be considered that Doppler effects come only from lower layer of the medium. Simulations in three-layer tissue model show that moving blood cell perfusion and mean blood cell moving velocity calculated from polarization remaining are much more sensitive to lower layer flow velocity variation, and more irrelevant to deeper layer flow rate fluctuations, that further confirms Doppler measurement from polarization remaining light to be effective for superficial microcirculation in tissue. Factors affecting Laser Doppler measurement like medium absorption, percentage of moving particles in blood detector size are discussed.

  20. Prescribed burning plan : Stillwater NWR : de Braga Burn Unit 67

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This 1991 Annual Prescribed Burning Plan for Stillwater NWR calls for all 67 acres of the de Braga burn unit to be burned. The objective of this burn is to remove...

  1. Wound healing activities of different extracts of Centella asiatica in incision and burn wound models: an experimental animal study

    Directory of Open Access Journals (Sweden)

    Somboonwong Juraiporn

    2012-07-01

    Full Text Available Abstract Background The efficacy of Centella asiatica for incision and burn wounds are not fully understood. Here, we report the wound healing activities of sequential hexane, ethyl acetate, methanol, and water extracts of Centella asiatica in incision and partial-thickness burn wound models in rats. Methods Male Sprague–Dawley rats weighing 250–300 g were randomly divided into incision and burn wound groups. Each group was stratified into seven subgroups: (1 untreated; (2 NSS-; (3 Tween 20®- (vehicle control; (4 hexane extract-; (5 ethyl acetate extract-; (6 methanol extract-; and (7 aqueous extract-treated groups. The test substances were applied topically once daily. The tensile strength of the incision wound was measured on the seventh day after wound infliction. The general appearance and degree of wound healing of the burn wound were assessed on Days 3, 7, 10 and 14 after burn injury and prior to histopathological evaluation. Results On the seventh day after wound infliction, the tensile strength of incision wound in all extract-treated groups was significantly higher than that of the vehicle control (Tween 20®, but comparable to the NSS-treated group. The degrees of healing in the burn wound with the four extracts were significantly higher than that of the control on Days 3, 10 and 14. Histopathological findings on Day 14 after burn injury revealed prominent fibrinoid necrosis and incomplete epithelialization in the control and untreated groups, whereas fully developed epithelialization and keratinization were observed in all extract-treated groups. Analysis by thin layer chromatography demonstrated that the phyto-constituents β-sitosterol, asiatic acid, and asiaticoside and madecassocide were present in the hexane, ethyl acetate and methanol extracts, respectively. Conclusions All extracts of Centella asiatica facilitate the wound healing process in both incision and burn wounds. Asiatic acid in the ethyl acetate extract seemed to

  2. PBXN-110 Burn Rate Estimate

    Energy Technology Data Exchange (ETDEWEB)

    Glascoe, E

    2008-08-11

    It is estimated that PBXN-110 will burn laminarly with a burn function of B = (0.6-1.3)*P{sup 1.0} (B is the burn rate in mm/s and P is pressure in MPa). This paper provides a brief discussion of how this burn behavior was estimated.

  3. Management of burn wounds.

    Science.gov (United States)

    Schiestl, Clemens; Meuli, Martin; Trop, Marija; Neuhaus, Kathrin

    2013-10-01

    Small and moderate scalds in toddlers are still the most frequent thermal injuries the pediatric surgeons have to face today. Over the last years, surgical treatment of these patients has changed in many aspects. Due to new dressing materials and new surgical treatment strategies that are particularly suitable for children, today, far better functional and aesthetic long-term results are possible. While small and moderate thermal injuries can be treated in most European pediatric surgical departments, the severely burned child must be transferred to a specialized, ideally pediatric, burn center, where a well-trained multidisciplinary team under the leadership of a (ideally pediatric) burn surgeon cares for these highly demanding patients. In future, tissue engineered full thickness skin analogues will most likely play an important role, in pediatric burn as well as postburn reconstructive surgery.

  4. Burn Wise Awareness Kit

    Science.gov (United States)

    Health and safety outreach materials in the form of an awareness kit. Designed specifically for state, local, and tribal air agencies working to reduce wood smoke pollution, it includes best burn tips, social media m

  5. Molten Metal Burns

    OpenAIRE

    Kahn, Arthur M.; McCrady-Kahn, Virginia L.

    1981-01-01

    Molten metal burns are a frequent industrial injury among workers in foundries. The injury is typically small but very deep. Usually the depth and seriousness of these injuries is not recognized immediately by emergency department or industrial clinic physicians.

  6. New Fashioned Book Burning.

    Science.gov (United States)

    Gardner, Robert

    1997-01-01

    Reports on results of a teacher's experiment in book burning as a lesson accompanying the teaching of Ray Bradbury's "Fahrenheit 451." Discusses student reactions and the purpose of or justification for the experimental lesson. (TB)

  7. Smartphone applications in burns.

    Science.gov (United States)

    Wurzer, Paul; Parvizi, Daryousch; Lumenta, David B; Giretzlehner, Michael; Branski, Ludwik K; Finnerty, Celeste C; Herndon, David N; Tuca, Alexandru; Rappl, Thomas; Smolle, Christian; Kamolz, Lars P

    2015-08-01

    Since the introduction of applications (apps) for smartphones, the popularity of medical apps has been rising. The aim of this review was to demonstrate the current availability of apps related to burns on Google's Android and Apple's iOS store as well as to include a review of their developers, features, and costs. A systematic online review of Google Play Store and Apple's App Store was performed by using the following search terms: "burn," "burns," "thermal," and the German word "Verbrennung." All apps that were programmed for use as medical apps for burns were included. The review was performed from 25 February until 1 March 2014. A closer look at the free and paid calculation apps including a standardized patient was performed. Four types of apps were identified: calculators, information apps, book/journal apps, and games. In Google Play Store, 31 apps were related to burns, of which 20 were calculation apps (eight for estimating the total body surface area (TBSA) and nine for total fluid requirement (TFR)). In Apple's App Store, under the category of medicine, 39 apps were related to burns, of which 21 were calculation apps (19 for estimating the TBSA and 17 for calculating the TFR). In 19 out of 32 available calculation apps, our study showed a correlation of the calculated TFR compared to our standardized patient. The review demonstrated that many apps for medical burns are available in both common app stores. Even free available calculation apps may provide a more objective and reproducible procedure compared to manual/subjective estimations, although there is still a lack of data security especially in personal data entered in calculation apps. Further clinical studies including smartphone apps for burns should be performed. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  8. Burn mouse models

    DEFF Research Database (Denmark)

    Calum, Henrik; Høiby, Niels; Moser, Claus

    2014-01-01

    Severe thermal injury induces immunosuppression, involving all parts of the immune system, especially when large fractions of the total body surface area are affected. An animal model was established to characterize the burn-induced immunosuppression. In our novel mouse model a 6 % third-degree b......Severe thermal injury induces immunosuppression, involving all parts of the immune system, especially when large fractions of the total body surface area are affected. An animal model was established to characterize the burn-induced immunosuppression. In our novel mouse model a 6 % third......-degree burn injury was induced with a hot-air blower. The third-degree burn was confirmed histologically. At 48 h, a decline in the concentration of peripheral blood leucocytes was observed in the group of mice with burn wound. The reduction was ascribed to the decline in concentration of polymorphonuclear...... neutrophil leucocytes and monocytes. When infecting the skin with Pseudomonas aeruginosa, a dissemination of bacteria was observed only in the burn wound group. Histological characterization of the skin showed an increased polymorphonuclear neutrophil granulocytes dominated inflammation in the group of mice...

  9. Burns Caused by Medical Therapy

    Science.gov (United States)

    2016-06-07

    fear of litigation, patients with such injuries, even if the injuries are minor, arc often referred to a burn center for care. Burn injury...the potential burn hazards found elsewhere in the hospital. Even fewer studies have addressed the burn risks posed by medical therapy administered...35. Mills GH, Ralph S). Bums due to pulse oximetry [ letter ]. Anaesthesia 1992j47:276·7. 36. Shdlock: FG, Kana! E. Burns associated with the use of

  10. Metabolomic change precedes apple superficial scald symptoms.

    Science.gov (United States)

    Rudell, David R; Mattheis, James P; Hertog, Maarten L A T M

    2009-09-23

    Untargeted metabolic profiling was employed to characterize metabolomic changes associated with 'Granny Smith' apple superficial scald development following 1-MCP or DPA treatment. Partial least-squares discriminant analyses were used to link metabolites with scald, postharvest treatments, and storage duration. Models revealed metabolomic differentiation between untreated controls and fruit treated with DPA or 1-MCP within 1 week following storage initiation. Metabolic divergence between controls and DPA-treated fruit after 4 weeks of storage preceded scald symptom development by 2 months. alpha-Farnesene oxidation products with known associations to scald, including conjugated trienols, 6-methyl-5-hepten-2-one, and 6-methyl-5-hepten-2-ol, were associated with presymptomatic as well as scalded control fruit. Likewise, a large group of putative triterpenoids with mass spectral features similar to those of ursolic acid and beta-sitosterol were associated with control fruit and scald. Results demonstrate that extensive metabolomic changes associated with scald precede actual symptom development.

  11. Condiciones de la superficie deslizamiento con falla

    Directory of Open Access Journals (Sweden)

    María Cecilia Sierra B.

    2011-06-01

    Full Text Available Se modelan seis (6 taludes can diferentes ángulos de inclinación y peso unitario de 1.8 ton/m3, módulo de Young de 500 ton/m2 y relación de Poisson de 0.45. En cada uno de estos taludes se calculan los esfuerzos a través del talud y se determinan los puntos que están sometidos a mayores esfuerzos cortantes, correspondiendo estos a los estados de esfuerzos mas críticos, La ubicación de estos puntos es por donde comenzará y terminará la superficie de falla. Se obtiene un gráfico de diseño que permite obtener la pendiente máxima que debe tener un talud para que no se presente falla local en ningún punto.

  12. Volumetric and superficial characterization of carbon activated; Caracterizacion volumetrica y superficial de carbon activado

    Energy Technology Data Exchange (ETDEWEB)

    Carrera G, L.M.; Garcia S, I.; Jimenez B, J.; Solache R, M.; Lopez M, B.; Bulbulian G, S.; Olguin G, M.T. [Departamento de Quimica, Gerencia de Ciencias Basicas, Instituto Nacional de Investigaciones Nucleares, A.P. 18-1027, 11801 Mexico D.F. (Mexico)

    2000-07-01

    The activated carbon is the resultant material of the calcination process of natural carbonated materials as coconut shells or olive little bones. It is an excellent adsorbent of diluted substances, so much in colloidal form, as in particles form. Those substances are attracted and retained by the carbon surface. In this work is make the volumetric and superficial characterization of activated carbon treated thermically (300 Centigrade) in function of the grain size average. (Author)

  13. Traumatic aneurysm of superficial temporal artery. CT demonstration

    Energy Technology Data Exchange (ETDEWEB)

    Sharma, A.; Tyagi, G.; Sahai, A.; Baijal, S.S. (G.B. Pant Hospital and M.A. Medical Coll., New Delhi (India). Dept. of Neurosurgery G.B. Pant Hospital and M.A. Medical Coll., New Delhi (India). Dept. of Radiology)

    1991-12-01

    A case of traumatic pseudo-aneurysm of the superficial temporal artery documented on Computed tomography (CT) and angiography is described in a 55-year-old female, who was treated by surgical excision. Computed tomographic appearance of this lesion is illustrated. This represents, to our knowledge, the first CT demonstration of traumatic aneurysm of superficial temporal artery within a large subgaleal haematoma. (orig.).

  14. Risk factors associated with acquiring superficial fungal infections in ...

    African Journals Online (AJOL)

    school children in South Western Nigeria: a comparative study. Olaide Oke Olutoyin1, Olaniyi ... Keywords: Risk factors, school children, skin, superficial fungal infections. ..... study with poor hygiene, malnutrition, overcrowding and poor general social ... cial determinants of health that influence the presence of superficial ...

  15. Psychiatric aspects of burn

    Directory of Open Access Journals (Sweden)

    Dalal P

    2010-10-01

    Full Text Available Burn injuries and their subsequent treatment cause one of the most excruciating forms of pain imaginable. The psychological aspects of burn injury have been researched in different parts of the world, producing different outcomes. Studies have shown that greater levels of acute pain are associated with negative long-term psychological effects such as acute stress disorder, depression, suicidal ideation, and post-traumatic stress disorder for as long as 2 years after the initial burn injury. The concept of allostatic load is presented as a potential explanation for the relationship between acute pain and subsequent psychological outcomes. A biopsychosocial model is also presented as a means of obtaining better inpatient pain management and helping to mediate this relationship.

  16. Bacteriological profile of burn patients at Yekatit 12 Hospital Burn ...

    African Journals Online (AJOL)

    admin

    injuries, creating a formidable public health problem. (3). Despite major ... change with time. Thus, to have an in-depth knowledge .... Table 4: Antibiotic resistance pattern of bacterial isolates from burn wound at Yekatit 12 hospital burn center.

  17. [Effect of severe burn on growth and development and the level of growth hormone in mice].

    Science.gov (United States)

    Wang, Fei; Qiu, Lin; Liu, Cuiping; Tian, Xiaofei; Xiao, Jun

    2014-02-01

    To analyze the changes in body growth, learning and memory capabilities, exercise capacity, and the level of growth hormone (GH) in mice suffering from severe burn. One hundred and four healthy BALB/c mice aged from 3 to 4 weeks were divided into normal control group (NC, without treatment) , 7 s burn group (inflicted with 20%TBSA deep partial-thickness burn on the back), 10 s burn group (inflicted with 20%TBSA full-thickness burn on the back), and negative control group (simulating the treatment of two burn groups without injury) according to the random number table, with 26 mice in each group. The body weight, body length, and tail length of 8 mice in each group were measured before burn. Respectively 6 mice of two burn groups were sacrificed on post burn day (PBD) 1, 3, and 7 for determination of serum level of GH with enzyme-linked immunosorbent assay kit. The remaining 8 mice in each of the two burn groups were raised to adulthood. The body weight, body length, and tail length were measured on PBD 62, and the increased percentages of body weight, body length, and tail length were calculated. Morris water maze tests, including escape latency on PBD 66, 67, and 68, frequency of stepping over the platform location and proportion of staying time in the target quadrant on PBD 69, were used to examine the learning and memory capabilities. The time of loaded swimming and the time of pole-climbing on PBD 70 were used to assess the exercise capacity. Above-mentioned indexes were also determined in the two control groups at the same time points. Data were processed with one-way analysis of variance; Welch test was applied when equal variance was not assumed; independent samples t test was applied for paired comparison. (1) The level of GH of mice in 7 s burn group on PBD 1 [(3 021 ± 506) pg/mL] was lower than that of group NC [(3 728 ± 412) pg/mL, t = 2.656, P 0.05), while the increased percentages of other indexes of mice in the two burn groups were lower than those

  18. An assessment of burn care professionals' attitudes to major burn.

    LENUS (Irish Health Repository)

    Murphy, A D

    2008-06-01

    The resuscitation of severe burn remains a controversial area within the burn care profession. There is ongoing debate as to what percentage burn is associated with a sufficient quality of life to support initial resuscitation efforts. We conducted a survey of delegates at the 39th Annual Meeting of the British Burns Association (2005), regarding attitudes towards resuscitation following major burns. Respondents were asked the maximum percentage total body surface area (TBSA) burn beyond which they would not wish to be resuscitated. They were also asked what maximum TBSA they perceived to be commensurate with an acceptable quality of life (QOL). One hundred and forty three of 300 delegates responded to the questionnaire. Thirty three percent of respondents would not wish to be resuscitated with 50-75% TBSA burns or greater. A further 35% would not wish to have life-sustaining intervention with 75-95% TBSA burns or greater. The remaining 32% indicated that they would not want resuscitation with TBSA burns>95%. Regardless of TBSA affected, 16% would not wish resuscitation if they had full thickness facial burns, a further 10% did not want resuscitation if both their hands and faces were affected. Our survey demonstrates the diversity of personal preference amongst burn care professionals. This would suggest that a unifying philosophy regarding the resuscitation of extensive burns will remain elusive.

  19. 烧伤后24小时内削痂对深Ⅱ度创面局部炎症反应的影响%Influence of tangential excision within 24 postburn hours on the local wound inflammatory response in patients with deep partial thickness burn

    Institute of Scientific and Technical Information of China (English)

    陆树良; 廖镇江; 向军; 王志勇; 杨丽英; 金曙雯; 史济湘

    2005-01-01

    目的探讨烧伤后24 h内行削痂手术对深Ⅱ度创面局部炎症反应以及组织损害的影响. 方法选择12例烧伤患者,伤后24 h内对深Ⅱ度创面行削痂手术,将患者同一创面分为3个标本采集区,即手术前、手术后和未手术区.手术前标本取自削痂术前创面,手术后和未手术区创面标本于伤后5-7 d获取.采用组织培养和比色法测定创面组织释放白细胞介素(IL)8、髓过氧化物酶(MPO)和丙二醛(MDA)的水平,通过HE和Masson染色对创面组织坏死程度进行形态学观察. 结果削痂手术后,患者创面组织局部释放IL-8、MPO、MDA的水平分别为(6.83±1.85)μg/L、(4.07±0.87)U/g、(8.94±5.66)μmol/g,与未手术创面比较明显降低(P<0.01).形态学观察显示,手术前创面有凝固性坏死灶;未手术创面炎症反应明显,坏死组织范围扩大;削痂手术后创面局部的炎症反应得到改善,未见坏死组织范围扩大. 结论伤后24 h内行削痂手术,可以改善深Ⅱ度烧伤创面局部的炎症反应,防止创面进行性加深,有利于创面及早愈合.

  20. 伤后24 h内削痂对深二度创面局部炎症反应的影响%THE EFFECTS OF TANGENTIAL EXCISION ON WOULD INFLAMMATORY RESPONSE WITH IN 24 HOURS POST-BURN IN PATIENTS WITH DEEP PARTIAL THICKNESS BURE

    Institute of Scientific and Technical Information of China (English)

    王润秀; 陆树良; 林源; 向军; 乔亮; 农庆文; 张立明; 王志勇; 金曙雯; 廖镇江; 史济湘

    2002-01-01

    目的:探讨伤后24 h内削痂手术对深二度烧伤创面局部炎症反应以及组织进行性损害的影响.方法:12例烧伤患者深二度创面在伤后24 h内行削痂手术,每例患者实验创面分为3个研究区域,即手术前、手术后和未手术实验区.手术前标本取自削痂术前创面,而手术后和未手术实验区标本则于伤后5~7 d获取,采用组织培养和ELISA技术测定创面组织释放IL-8的水平,并对创面组织中炎性反应和创面组织坏死程度进行形态学观察和半定量分析.结果:伤后24 h内削痂手术后,创面组织局部释放IL-8的水平虽较手术前有显著升高(P<0.01),但与未手术创面比较则呈现明显降低(P<0.001);此外,创面局部组织形态学观察显示,削痂手术后创面局部的炎症反应较未削痂创面明显减轻(P<0.05),未手术创面除有大量中性粒细胞浸润外,坏死组织范围亦较削痂后创面明显扩大.结论:伤后24 h内削痂手术可以改善创面局部的炎症反应,改善创面进行性加深的发生,有利于深Ⅱ度烧伤创面愈合.

  1. 芦荟提取物对烫伤大鼠创面组织一氧化氮及内皮素含量的影响%The effects of aloe extract on nitric oxide and endothelin levels in deep-partial thickness burn wound tissue in rat

    Institute of Scientific and Technical Information of China (English)

    吕瑞林; 吴伯瑜; 陈晓东; 江琼

    2006-01-01

    目的 观察芦荟凝胶和芦荟粗多糖对烫伤大鼠创面组织含水量及一氧化氮(NO)和内皮素(ET)含量的影响.方法 将42只Wistar大鼠背部造成4个直径为3 cm的深Ⅱ度烫伤创面.伤后创面分别外敷质量分数5%芦荟粗多糖膏、质量分数10%芦荟凝胶膏、质量分数1%磺胺嘧啶银(SD-Ag)霜和等渗盐水.根据创面用药的不同分为芦荟粗多糖组、芦荟凝胶组、SD-Ag组、等渗盐水组.伤后4、12、24、48 h及7、14、21 d每时相点处死6只大鼠,取创面全层皮肤测定组织含水量、NO和ET含量,计算NO/ET值.另取6只大鼠不烫伤,作为正常对照组,检测指标同前.结果 伤后12、24、48 h,芦荟粗多糖组[(73.4±3.8)%、(76.6±3.0)%、(70.6±3.8)%]和芦荟凝胶组[(74.5±2.6)%、(77.1±3.6)%、(71.2±3.1)%]创面组织含水量显著低于SD-Ag组[(80.1±4.1)%、(80.5±3.9)%、(76.1±3.8)%,P<0.05];伤后7~21 d,除SD-Ag组伤后7 d仍显著高于正常对照组(P<0.05)外,其他各组均基本恢复到正常水平.伤后12 h各烫伤组创面组织NO含量升高达峰值,随后下降,到伤后21 d仍显著高于正常对照组(P<0.05);伤后12、24 h,芦荟粗多糖组和芦荟凝胶组创面组织NO含量明显低于SD-Ag组及等渗盐水组(P<0.05).伤后7 d或14 d各烫伤组创面组织ET含量增加达高峰,随后下降;伤后7、14 d均显著高于正常对照组(P<0.05).伤后12 h各组NO/ET值达峰值,随后下降,伤后14 d基本恢复至正常水平,其中芦荟粗多糖组伤后7 dNO/ET值即恢复至正常水平,但其他3组仍显著高于正常对照组.结论 芦荟粗多糖和芦荟凝胶能有效减少烫伤后早期创面组织NO的释放、优化NO/ET值、减轻血管炎性反应、减少渗出和水肿.

  2. 生肌玉红膏对深Ⅱ度烧伤模型小鼠创面愈合情况及单核巨噬细胞吞噬功能的影响%Influences of Shengji Yuhong Ointment on the case of wound healing and mononuclear macrophage phagocytosis in mouse with deep partial-thickness burn

    Institute of Scientific and Technical Information of China (English)

    董小鹏; 王丽娟; 赵春霖; 于博

    2012-01-01

    目的 探讨生肌玉红膏对深Ⅱ度烧伤小鼠创面愈合的影响及对小鼠单核巨噬细胞吞噬功能的影响.方法 将30只小鼠制成深Ⅱ度烧伤模型后,随机分为烧伤模型组、美宝湿润烧伤膏(MEBO)组、生肌玉红膏组,每组10只.烧伤创面分别给予生理盐水、美宝湿润烧伤膏、生肌玉红膏治疗,2次/d.观察生肌玉红膏治疗后创面愈合情况,并用碳粒廓清法测定小鼠单核巨噬细胞吞噬功能.结果 与烧伤模型组比较,生肌玉红膏组小鼠创面愈合率提高,创面愈合时间缩短(P<0.05),单核巨噬细胞吞噬功能增强(P<0.05).结论 生肌玉红膏可有效促进烧伤创面愈合,提高单核巨噬细胞吞噬功能是其可能的作用机制之一.

  3. Back Bay Wilderness burning support

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This document is a memorandum concerning prescribed burns between members of the Bureau of Sport Fisheries and Wildlife. It states that burning should be supported...

  4. Phoenix Society for Burn Survivors

    Science.gov (United States)

    ... Medical Professionals Phoenix Society is the leader in connecting the burn recovery community and creating resources for survivors. Since 1977, we have partnered with survivors, families, health care professionals, burn centers, and the fire ...

  5. UNILATERAL INCOMPLETE SUPERFICIAL PALMAR ARCH: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Subhankar Chakraborty

    2015-12-01

    Full Text Available The functional importance of hand is revealed by its rich vascularity contributed by superficial and deep palmar arches (SPA and DPA.Superficial palmar arch is located superficial to flexor tendons, and deep palmar arch deep to lumbrical muscles. Variations are found more often in SPA than DPA, later being more or less constant. During routine undergraduate dissection, we observed, unilateral incomplete SPA being formed by superficial palmar branches of ulnar and radial artery in the right hand of a male cadaver. These two arteries remained independent without anastomosis forming incomplete arch (SPA.The superficial branch of ulnar artery entered hand superficial to flexor retinaculum and supplied middle, ring and little finger by three branches. The superficial branch of radial artery via its two branches supplied index finger and thumb. Classical SPA formation was seen on left side. The presence of an incomplete SPA as in this case is a potential danger in RA harvesting for CABG.Variations in SPA play a pivotal role in microvascular surgical procedures of hand, RAinterventions and arterial graft applications.

  6. Prevalence of superficial siderosis following singular, acute aneurysmal subarachnoid hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Lummel, N.; Bochmann, K. [Ludwig-Maximilian-University, Department of Neuroradiology, Klinikum Grosshadern, Munich (Germany); Bernau, C. [Leibniz-Rechenzentrum, Munich (Germany); Thon, N. [Ludwig-Maximilian-University, Department of Neurosurgery, Klinikum Grosshadern, Munich (Germany); Linn, J. [Technical University, Department of Neuroradiology, Klinikum Dresden, Dresden (Germany)

    2015-04-01

    Superficial siderosis is presumably a consequence of recurrent bleeding into the subarachnoid space. The objective of this study was to assess the prevalence of superficial siderosis after singular, aneurysmal subarachnoid hemorrhage (SAH) in the long term. We retrospectively identified all patients who presented with a singular, acute, aneurysmal SAH at our institution between 2010 and 2013 and in whom a magnetic resonance imaging (MRI) including T2*-weighted imaging was available at least 4 months after the acute bleeding event. MRI scans were judged concerning the presence and distribution of superficial siderosis. Influence of clinical data, Fisher grade, localization, and cause of SAH as well as the impact of neurosurgical interventions on the occurrence of superficial siderosis was tested. Seventy-two patients with a total of 117 MRIs were included. Mean delay between SAH and the last available MRI was 47.4 months (range 4-129). SAH was Fisher grade 1 in 2 cases, 2 in 4 cases, 3 in 10 cases, and 4 in 56 cases. Superficial siderosis was detected in 39 patients (54.2 %). In all patients with more than one MRI scan, localization and distribution of superficial siderosis did not change over time. Older age (p = 0.02) and higher degree of SAH (p = 0.03) were significantly associated with the development of superficial siderosis. Superficial siderosis develops in approximately half of patients after singular, aneurysmal SAH and might be more common in patients with an older age and a greater amount of blood. However, additional factors must play a role in whether a patient is prone to develop superficial siderosis or not. (orig.)

  7. The year in burns 2008.

    Science.gov (United States)

    Wolf, Steven E

    2009-12-01

    For 2008, approximately 1200 original burn research articles were published in scientific journals using the English language. This article reviews those with the most impact on burn treatment according to the Editor of one of the major journals (Burns). As in the previous year's review, articles were divided into the following topic areas: epidemiology, wound characterisation, critical care physiology, inhalation injury, infection, metabolism and nutrition, psychological considerations, pain management, rehabilitation, and burn reconstruction. Each selected article is mentioned briefly with editorial comment.

  8. TIRES, OPEN BURNING

    Science.gov (United States)

    The chapter describes available information on the health effects from open burning of rubber tires. It concentrates on the three known sources of detailed measurements: (1) a small-scale emissions characterization study performed by the U.S. EPA in a facility designed to simulat...

  9. Chemical burn or reaction

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000059.htm Chemical burn or reaction To use the sharing features on this page, please enable JavaScript. Chemicals that touch skin can lead to a reaction on the skin, throughout the body, or both. ...

  10. PLASTIC SURGERY AND BURNS

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    Objective Endotoxin as the inciting agentof cytokines and other mediators, whose highlevel expression correlates with the septicshock and MOF, has been the one of leadingcauses of death in ICU. Methods For treatingsepsis and MOF caused by endotoxin, the anti-lipid A of LPS antibody was used. 19 burned

  11. S-C复合制剂在临床的应用和研究%Application and Study of the S-C Compound Agent in Burned Patients

    Institute of Scientific and Technical Information of China (English)

    严根荣; 陈国华

    2003-01-01

    173 patients with burn injury were admitted to Shanghai Power Hosptial from 2001 to 2002.These patients include 116 malesand 57 females with a mean age of 33 years. Ther bum injury involved 15% ± 2.3% per cent of TBSA(Total Body Surface Area). With fullthickness burn of 5.5 % ± 1.2% per cent of TBSA.These patients with burn injury were charged medicine by the S. C compound agent,57 casesof burned patients were changed medicine by silver sulfadiazin as a control. S. C compound agent is consisted of cerium nitrate,silver salt andsome additive agent etc. It is possessed of good anti - infection curative effects. Therefore many bacteriums that include Staphylococcus aureus,pseudomonas, aeruginosa, E. coli, E. cloacae, proteus, and some C. albicans etc have been killed by S. C compound agent in vitro, anantimicrobial susceptibility testing in vitro that includes a disk agar diffusion test and a dilution test namely minimal inhibitory concentration, MIChas approved it. Therefore, the wound healing time of partial thickness bum in an experimmt group was significant in statistics ( P < 0.05) ascompared with a control; group. No side - effects, no allergic reactions occurred in all course of applyning S. C compound agent for burned patients.

  12. Comportamiento hidráulico de los sistemas de riego por goteo superficial y sub superficial

    OpenAIRE

    2011-01-01

    Para su evaluación el sistema de riego fue montado con un diseño experimental completamente aleatorizado, con cuatro tratamientos, uno con el sistema de riego por goteo superficial y tres con sistemas de riego por goteo sub superficiales con emisores soterrados a 15, 30 y 45 centímetros de profundidad. Se realizaron evaluaciones de laboratorio y de campo de los principales parámetros hidráulicos del sistema, al inicio de la primera campaña de riego y al final de la tercera, obteniéndose en el...

  13. Superficial cervicovaginal myofibroblastoma: report of four cases and literature review

    Institute of Scientific and Technical Information of China (English)

    WANG Qi-feng; WU Yu-yu; WANG Jian

    2010-01-01

    @@ In 2001, Laskin et al~1 firstly described a series of 14 seemly distinctive mesenchymal tumors that occurred exclusively in the superficial lamina propria of the vagina and cervix of middle to old-aged women. They proposed the term "superficial cervicovaginal myofibroblastoma (SCVM)" to highlight the unique features of this tumor: the superficial subepithelial location and myofibroblastic differentiation of the tumor cells. SCVM appears less well recognized with only three additional reports have been documented in the English literatures.~(2-4) In this study, we described four new cases of SCVM to further characterize the clinical and pathological features of this rare entity.

  14. Superficial Fibromatosis Mimicking Glomus Tumor of the Second Toe.

    Science.gov (United States)

    Jo, Hyang Jeong; Chae, Soo Uk; Kim, Gang Deuk; Kim, Yeung Jin; Choi, Deok Hwa; Park, Jae In

    2015-09-01

    Various types of tumor can occur in the subungual space, including glomus tumors, subungual exostosis, hemangioma, epidermal cysts, and malignant tumors. While fibromatosis can occur at various sites throughout the body, it is very rarely seen in the toe. Here, we are the first to report a case of superficial fibromatosis mimicking a glomus tumor in the subungual space of the second toe. The presentation of this condition shows the possibility of encountering uncommon superficial fibromatosis in the distal phalanx of the toe, and suggests that superficial fibromatosis should be included in the differential diagnosis of a glomus tumor in the toe.

  15. Revisión sobre modelado de superficies complejas

    Directory of Open Access Journals (Sweden)

    Juan D. Osorio

    2004-01-01

    Full Text Available Este artículo presenta una revisión de las técnicas más empleadas para la obtención de modelos computacionales de superficies complejas. Estas representaciones están siendo utilizadas en diversas áreas de la industria mediante procedimientos de ingeniería reversa. Las tres principales categorías son las superficies funcionales (implícitas, paramétricas y las superficies complejas simplicial (mallas triangulares. Se realiza un paralelo entre estos métodos y se exponen las ventajas y las desventajas de cada una de estas representaciones.

  16. Modern management of paediatric burns

    African Journals Online (AJOL)

    2010-03-01

    Mar 1, 2010 ... Jackson's. 3-dimensional burn wound model describes 3 zones: • a central zone ... the burn.7 Care must be taken not to induce hypothermia in larger burns – especially in .... Fluid therapy thereafter consists of 2 components ...

  17. Antibody conjugate radioimmunotherapy of superficial bladder cancer

    Directory of Open Access Journals (Sweden)

    Alan Perkins

    2002-09-01

    Full Text Available The administration of antibody conjugates for cancer therapy is now proving to be of clinical value. We are currently undertaking a programme of clinical studies using the monoclonal antibody C595 (IgG3 which reacts with the MUC1 glycoprotein antigen that is aberrantly expressed in a high proportion of bladder tumours. Radioimmunoconjugates of the C595 antibody have been produced with high radiolabelling efficiency and immunoreactivity using Tc-99m and In-111 for diagnostic imaging, and disease staging and the cytotoxic radionuclides Cu-67 and Re-188 for therapy of superficial bladder cancer. A Phase I/II therapeutic trail involving the intravesical administration of antibody directly into the bladder has now begun.A administração de anticorpos conjugados para o tratamento do câncer está agora provando ser de valor clínico. Nós estamos atualmente realizando um programa de estudos clínicos usando o anticorpo monoclonal C595 (IgG3 que reage com a glicoproteína MUC1 que está aberrantemente expressa numa alta proporção de tumores de bexiga. Tem sido produzidos radioimunoconjugados do anticorpo C595, com alta eficiência de radiomarcação e a imunoreatividade, usando-se o Tc-99m e In-111, para o diagnóstico por imagem e estagiamento de doenças. Tem sido produzidos, também, radionuclídeos citotóxicos (Cu-67 e Re-188 para o tratamento de cânceres superficiais de bexiga. A fase terapêutica I/II já se iniciou, envolvendo a administração intravesical do anticorpo diretamente na bexiga.

  18. Hemipelvic irradiation for superficial bladder cancer

    Energy Technology Data Exchange (ETDEWEB)

    Tashiro, Kazuya; Machida, Toyohei; Ooishi, Yukihiko; Ueda, Masataka; Kido, Akira; Wada, Tetsuro; Yoshigoe, Fukuo; Yamashita, Takashi; Mochizuki, Sachio

    1985-02-01

    In 15 patients with superficial bladder cancer hemipelvic irradiation was performed for prevention of relapse of cancer and decrease in side effects with following results. All patients received TUR-Bt at our department during the six years period from 1978 to 1983. As to stages, one was classified as Ta, 11 as T 1 and 3 as T 2, and pathologic diagnosis was transitional epithelial carcinoma of grade 1 in 1 case, grade 2 in 8 cases and grade 3 in 6 cases. Irradiation was started from the 7 th to 14 th day after TUR-Bt. At first, hemipelvic anterior and posterior field including the field from the affected pelvis to 1 to 2 cm beyond the midline toward the contralateral side and from the aortic bifurcation to the prostatic urethra were irradiated at a dose of 45 Gy. Then, whole bladder field was given an additional rotation irradiation of 20 Gy. The mean observation period was 43 months (ranging from 12 to 79 months) and relapse of cancer was observed in 6 cases out of 15 cases (40%). The site of relapse was in the irradiated site in 2 cases, contralateral site in 3 cases and both side in 1 cases. However, in all of the relapsed cases no aggravation in differential degree or progression in stage was observed. As the side effects, radiation cystitis developed as a delayed damage in 1 case. Thus, although no efficacy for prevention of relapse which we had expected was not seen, this irradiation method effectively inhibited the progression of lesion and development of delayed damage. (author).

  19. Missense Variant in MAPK Inactivator PTPN5 Is Associated with Decreased Severity of Post-Burn Hypertrophic Scarring.

    Directory of Open Access Journals (Sweden)

    Ravi F Sood

    Full Text Available Hypertrophic scarring (HTS is hypothesized to have a genetic mechanism, yet its genetic determinants are largely unknown. The mitogen-activated protein kinase (MAPK pathways are important mediators of inflammatory signaling, and experimental evidence implicates MAPKs in HTS formation. We hypothesized that single-nucleotide polymorphisms (SNPs in MAPK-pathway genes would be associated with severity of post-burn HTS.We analyzed data from a prospective-cohort genome-wide association study of post-burn HTS. We included subjects with deep-partial-thickness burns admitted to our center who provided blood for genotyping and had at least one Vancouver Scar Scale (VSS assessment. After adjusting for HTS risk factors and population stratification, we tested MAPK-pathway gene SNPs for association with the four VSS variables in a joint regression model. In addition to individual-SNP analysis, we performed gene-based association testing.Our study population consisted of 538 adults (median age 40 years who were predominantly White (76% males (71% admitted to our center from 2007-2014 with small-to-moderate-sized burns (median burn size 6% total body surface area. Of 2,146 SNPs tested, a rare missense variant in the PTPN5 gene (rs56234898; minor allele frequency 1.5% was significantly associated with decreased severity of post-burn HTS (P = 1.3×10-6. In gene-based analysis, PTPN5 (P = 1.2×10-5 showed a significant association and BDNF (P = 9.5×10-4 a borderline-significant association with HTS severity.We report PTPN5 as a novel genetic locus associated with HTS severity. PTPN5 is a MAPK inhibitor expressed in neurons, suggesting a potential role for neurotrophic factors and neuroinflammatory signaling in HTS pathophysiology.

  20. Missense Variant in MAPK Inactivator PTPN5 Is Associated with Decreased Severity of Post-Burn Hypertrophic Scarring.

    Science.gov (United States)

    Sood, Ravi F; Arbabi, Saman; Honari, Shari; Gibran, Nicole S

    2016-01-01

    Hypertrophic scarring (HTS) is hypothesized to have a genetic mechanism, yet its genetic determinants are largely unknown. The mitogen-activated protein kinase (MAPK) pathways are important mediators of inflammatory signaling, and experimental evidence implicates MAPKs in HTS formation. We hypothesized that single-nucleotide polymorphisms (SNPs) in MAPK-pathway genes would be associated with severity of post-burn HTS. We analyzed data from a prospective-cohort genome-wide association study of post-burn HTS. We included subjects with deep-partial-thickness burns admitted to our center who provided blood for genotyping and had at least one Vancouver Scar Scale (VSS) assessment. After adjusting for HTS risk factors and population stratification, we tested MAPK-pathway gene SNPs for association with the four VSS variables in a joint regression model. In addition to individual-SNP analysis, we performed gene-based association testing. Our study population consisted of 538 adults (median age 40 years) who were predominantly White (76%) males (71%) admitted to our center from 2007-2014 with small-to-moderate-sized burns (median burn size 6% total body surface area). Of 2,146 SNPs tested, a rare missense variant in the PTPN5 gene (rs56234898; minor allele frequency 1.5%) was significantly associated with decreased severity of post-burn HTS (P = 1.3×10-6). In gene-based analysis, PTPN5 (P = 1.2×10-5) showed a significant association and BDNF (P = 9.5×10-4) a borderline-significant association with HTS severity. We report PTPN5 as a novel genetic locus associated with HTS severity. PTPN5 is a MAPK inhibitor expressed in neurons, suggesting a potential role for neurotrophic factors and neuroinflammatory signaling in HTS pathophysiology.

  1. Clinical application of cultured epithelial autografts on acellular dermal matrices in the treatment of extended burn injuries.

    Science.gov (United States)

    Fang, Taolin; Lineaweaver, William C; Sailes, Frederick C; Kisner, Carson; Zhang, Feng

    2014-11-01

    Achieving permanent replacement of skin in extensive full-thickness and deep partial-thickness burn injuries and chronic wounds remains one of the fundamental surgical problems. Presently, split-thickness skin grafts are still considered the best material for surgical repair of an excised burn wound. However, in burns that affect greater than 50% of total body surface area, the patient has insufficient areas of unaffected skin from which split-thickness skin grafts can be harvested. The use of cultured epithelial (or epidermal) autografts (CEAs) has achieved satisfactory results. But the take rate of CEAs is poor in full-thickness bed or in chronically infected area. Providing temporary cover with allograft skin, or a more permanent allodermis, may increase clinical take. This review aims to (1) describe the use of CEAs in the regeneration of the epidermis, (2) introduce the application of the acellular dermal matrices (ADMs) in the clinics, and (3) enhance understanding of the CEAs applied with ADM as an appropriate strategy to treat the extended burn injuries. The current evidence regarding the cultured epithelial cell or keratinocyte autograft and dermal grafts applied in the treatment of burn injuries was investigated with an extensive electronic and manual search (MEDLINE and EMBASE). The included literature (N=136 publications) was critically evaluated focusing on the efficacy and safety of this technique in improving the healing of the deep dermal and full-thickness burn injuries. This review concluded that the use of ADM with CEAs is becoming increasingly routine, particularly as a life-saving tool after acute thermal trauma.

  2. Analysis of the microcirculation after soft tissue reconstruction of the outer ear with burns in patients with severe burn injuries.

    Science.gov (United States)

    Medved, Fabian; Medesan, Raluca; Rothenberger, Jens Martin; Schaller, Hans-Eberhard; Schoeller, Thomas; Manoli, Theodora; Weitgasser, Lennart; Naumann, Aline; Weitgasser, Laurenz

    2016-07-01

    Reconstruction of soft tissue defects of the ear with burns remains one of the most difficult tasks for the reconstructive surgeon. Although numerous reconstructive options are available, the results are often unpredictable and worse than expected. Besides full and split skin grafting, local random pattern flaps and pedicled flaps are frequently utilized to cover soft tissue defects of the outer auricle. Because of the difficulty and unpredictable nature of outer ear reconstruction after burn injury, a case-control study was conducted to determine the best reconstructive approach. The microcirculatory properties of different types of soft tissue reconstruction of the outer ear with burns in six severely burned Caucasian patients (three men and three women; mean age, 46 years (range, 22-70)) were compared to those in the healthy tissue of the outer ear using the O2C device (Oxygen to See; LEA Medizintechnik, Gießen, Germany). The results of this study revealed that the investigated microcirculation parameters such as the median values of blood flow (control group: 126 AU), relative amount of hemoglobin (control group: 59.5 AU), and tissue oxygen saturation (control group: 73%) are most similar to those of normal ear tissue when pedicled flaps based on the superficial temporal artery were used. These findings suggest that this type of reconstruction is superior for soft tissue reconstruction of the outer ear with burns in contrast to random pattern flaps and full skin grafts regarding the microcirculatory aspects. These findings may improve the knowledge on soft tissue viability and facilitate the exceptional and delicate process of planning the reconstruction of the auricle with burns.

  3. Burn epidemiology and cost of medication in paediatric burn patients.

    Science.gov (United States)

    Koç, Zeliha; Sağlam, Zeynep

    2012-09-01

    Burns are common injuries that cause problems to societies throughout the world. In order to reduce the cost of burn treatment in children, it is extremely important to determine the burn epidemiology and the cost of medicines used in burn treatment. The present study used a retrospective design, with data collected from medical records of 140 paediatric patients admitted to a burn centre between 1 January 2009 and 31 December 2009. Medical records were examined to determine burn epidemiology, medication administered, dosage, and duration of use. Descriptive statistical analysis was completed for all variables; chi-square was used to examine the relationship between certain variables. It was found that 62.7% of paediatric burns occur in the kitchen, with 70.7% involving boiling water; 55.7% of cases resulted in third-degree burns, 19.3% required grafting, and mean duration of hospital stay was 27.5 ± 1.2 days. Medication costs varied between $1.38 US dollars (USD) and $14,159.09, total drug cost was $46,148.03 and average cost per patient was $329.63. In this study, the medication cost for burn patients was found to be relatively high, with antibiotics comprising the vast majority of medication expenditure. Most paediatric burns are preventable, so it is vital to educate families about potential household hazards that can be addressed to reduce the risk of a burn. Programmes are also recommended to reduce costs and the inappropriate prescribing of medication.

  4. Antibacterial properties of tualang honey and its effect in burn wound management: a comparative study

    Directory of Open Access Journals (Sweden)

    Nasir Nur-Azida

    2010-06-01

    Full Text Available Abstract Background The use of honey as a natural product of Apis spp. for burn treatment has been widely applied for centuries. Tualang honey has been reported to have antibacterial properties against various microorganisms, including those from burn-related diagnoses, and is cheaper and easier to be absorbed by Aquacel dressing. The aim of this study is to evaluate the potential antibacterial properties of tualang honey dressing and to determine its effectiveness as a partial thickness burn wound dressing. Methods In order to quantitate the bioburden of the swabs, pour plates were performed to obtain the colony count (CFU/ml. Swabs obtained from burn wounds were streaked on blood agar and MacConkey agar for bacterial isolation and identification. Later, antibacterial activity of Aquacel-tualang honey, Aquacel-Manuka honey, Aquacel-Ag and Aquacel- plain dressings against bacteria isolated from patients were tested (in-vitro to see the effectiveness of those dressings by zone of inhibition assays. Results Seven organisms were isolated. Four types of Gram-negative bacteria, namely Enterobacter cloacae, Klebsiella pneumoniae, Pseudomonas spp. and Acinetobacter spp., and three Gram-positive bacteria, namely Staphylococcus aureus, coagulase-negative Staphylococcus aureus (CONS and Streptococcus spp., were isolated. Total bacterial count decreased on day 6 and onwards. In the in-vitro antibacterial study, Aquacel-Ag and Aquacel-Manuka honey dressings gave better zone of inhibition for Gram positive bacteria compared to Aquacel-Tualang honey dressing. However, comparable results were obtained against Gram negative bacteria tested with Aquacel-Manuka honey and Aquacel-Tualang honey dressing. Conclusions Tualang honey has a bactericidal as well as bacteriostatic effect. It is useful as a dressing, as it is easier to apply and is less sticky compared to Manuka honey. However, for Gram positive bacteria, tualang honey is not as effective as usual care

  5. The year in burns 2011.

    Science.gov (United States)

    Wolf, Steven E; Arnoldo, Brett D

    2012-12-01

    For 2011, approximately 1746 original research articles in burns were published in English in scientific journals. This article reviews those with the most potential impact on for burn therapeutics and outcomes according to the Editor of one of the major journals (Burns) and his colleague. As done previously, articles were found and divided into these topic areas: epidemiology of injury and burn prevention, wound and scar characterisation, acute care and critical care, inhalation injury, infection, psychological considerations, pain and itching management, rehabilitation and long-term outcomes, and burn reconstruction. Each selected article is mentioned briefly with editorial comment.

  6. Mass spectrometry based data of the blister fluid proteome of paediatric burn patients

    Directory of Open Access Journals (Sweden)

    Tuo Zang

    2016-09-01

    Full Text Available The data presented here are associated with the article “The blister fluid proteome of paediatric burns” (Zang et al., 2016 [1]. Burn injury is a highly traumatic event for children. The degree of burn severity (superficial-, deep-, or full-thickness injury often dictates the extent of later scar formation which may require long term surgical operation or skin grafting. The data were obtained by fractionating paediatric burn blister fluid samples, which were pooled according to burn depth and then analysed using data dependent acquisition LC–MS/MS. The data includes a table of all proteins identified, in which burn depth category they were found, the percentage sequence coverage for each protein and the number of high confidence peptide identifications for each protein. Further Gene Ontology enrichment analysis shows the significantly over-represented biological processes, molecular functions, and cellular components of the burn blister fluid proteome. In addition, tables include the proteins associated with the biological processes of “wound healing” and “response to stress” as examples of highly relevant processes that occur in burn wounds.

  7. First-aid with warm water delays burn progression and increases skin survival.

    Science.gov (United States)

    Tobalem, M; Harder, Y; Tschanz, E; Speidel, V; Pittet-Cuénod, B; Wettstein, R

    2013-02-01

    First aid treatment for thermal injuries with cold water removes heat and decreases inflammation. However, perfusion in the ischemic zone surrounding the coagulated core can be compromised by cold-induced vasoconstriction and favor burn progression. The aim of this study is to evaluate the effect of local warming on burn progression in the rat comb burn model. 24 male Wistar rats were randomly assigned to either no treatment (control) or application of cold (17 °C) or warm (37 °C) water applied for 20 min. Evolution of burn depth, interspace necrosis, and microcirculatory perfusion were assessed with histology, planimetry, respectively with Laser Doppler flowmetry after 1 h, as well as 1, 4, and 7 days. Consistent conversion from a superficial to a deep dermal burn within 24 h was obtained in control animals. Warm and cold water significantly delayed burn depth progression, however after 4 days the burn depth was similar in all groups. Interspace necrosis was significantly reduced by warm water treatment (62±4% vs. 69±5% (cold water) and 82±3% (control); pcold water and 80±2% for control, pwater provided an additional benefit by improving the microcirculatory perfusion, which translated into increased tissue survival. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  8. Airbag-related chest wall burn as a marker of underlying injury: a case report

    Directory of Open Access Journals (Sweden)

    Monkhouse Simon J

    2008-03-01

    Full Text Available Abstract Introduction This case of a man who sustained an airbag-induced thoracic injury and burn, highlights the potential harm that can be caused by airbags. It also serves to illustrate that a surface burn which looks small and benign can actually be a surface marker of a more serious injury. Staff working in emergency departments need to be aware of the risk of possible airbag-associated injuries. Case presentation A 65-year-old man was the driver in a frontal collision. He was wearing a seatbelt. The airbag was activated and caused a superficial chest wall burn. Initial chest x-rays were unremarkable but following deterioration in his condition, a computed tomography scan revealed a serious sternal fracture. The location of the fracture was marked on the surface by the burn. Conclusion Airbags can cause significant chest wall injuries and burns. Surface burns at the point of impact should not be dismissed as trivial as the forces involved can cause significant injury. We recommend that all people with chest wall injuries and/or burns due to airbags should have more detailed chest imaging as initial emergency radiographs can be falsely reassuring.

  9. Superficial Radiation Therapy for the Treatment of Nonmelanoma Skin Cancers.

    Science.gov (United States)

    McGregor, Sean; Minni, John; Herold, David

    2015-12-01

    Superficial radiation therapy has become more widely available to dermatologists. With the advent of more portable machines, it has become more convenient for dermatology practices to employ in an office-based setting. The goal of this paper is to provide a deeper insight into the role of superficial radiation therapy in dermatology practice and to review the current literature surrounding its use in the treatment of both basal and squamous cell carcinomas.

  10. Functional Compartmentalization of the Human Superficial Masseter Muscle

    OpenAIRE

    Guzmán-Venegas, Rodrigo A.; Biotti Picand, Jorge L.; Francisco J Berral de la Rosa

    2015-01-01

    Some muscles have demonstrated a differential recruitment of their motor units in relation to their location and the nature of the motor task performed; this involves functional compartmentalization. There is little evidence that demonstrates the presence of a compartmentalization of the superficial masseter muscle during biting. The aim of this study was to describe the topographic distribution of the activity of the superficial masseter (SM) muscle's motor units using high-density surface e...

  11. Imaging of the most frequent superficial soft-tissue sarcomas

    Energy Technology Data Exchange (ETDEWEB)

    Morel, Melanie; Taieb, Sophie; Ceugnart, Luc [Centre Oscar Lambret, Department of Radiology, Lille (France); Penel, Nicolas [Centre Oscar Lambret, Department of Oncology, Lille (France); Mortier, Laurent [Centre Hospitalier Universitaire de Lille, Department of Dermatology, Hopital Claude Huriez, Lille (France); Vanseymortier, Luc [Centre Oscar Lambret, Department of Surgery, Lille (France); Robin, Y.M. [Centre Oscar Lambret, Departement of Pathology, Lille (France); Gosset, Pierre [Groupement Hospitalier de l' Institut Catholique-Faculte Libre de Medecine de Lille, Department of Pathology, Hopital Saint-Philibert, Lomme (France); Cotten, Anne [Centre Hospitalier Universitaire de Lille, Department of Musculoskeletal Radiology, Centre Hopital Roger Salengro, Lille (France)

    2011-03-15

    Superficial soft-tissue sarcomas are malignant mesenchymal tumors located within the cutaneous and/or subcutaneous layers. Most superficial soft-tissue sarcomas are low-grade tumors; yet, the risk of local recurrence is high, and initial wide surgery is the main prognostic factor. Some of these superficial sarcomas may grow, following an infiltrative pattern, and their real extent may be underestimated clinically. Imaging techniques are useful to determine precisely the real margins of the tumor, especially in cases of clinically doubtful or recurrent or large superficial lesions. Imaging tools enable one to determine the relationship with the superficial fascia separating the subcutaneous layer from the underlying muscle. In our institution ultrasonographic examination is followed by magnetic resonance (MR) imaging when the size of the lesion exceeds 3-5 cm. Imaging assessment is performed prior to biopsy, enabling optimal surgical management. Imaging features of the main superficial sarcomas are detailed in the following article, according to their major locations: those arising in the epidermis and/or dermis, which are most often diagnosed by dermatologists, and the subcutaneous sarcomas. (orig.)

  12. [Hydrofluoric acid burns].

    Science.gov (United States)

    Holla, Robin; Gorter, Ramon R; Tenhagen, Mark; Vloemans, A F P M Jos; Breederveld, Roelf S

    2016-01-01

    Hydrofluoric acid is increasingly used as a rust remover and detergent. Dermal contact with hydrofluoric acid results in a chemical burn characterized by severe pain and deep tissue necrosis. It may cause electrolyte imbalances with lethal consequences. It is important to identify high-risk patients. 'High risk' is defined as a total affected body area > 3% or exposure to hydrofluoric acid in a concentration > 50%. We present the cases of three male patients (26, 31, and 39 years old) with hydrofluoric acid burns of varying severity and describe the subsequent treatments. The application of calcium gluconate 2.5% gel to the skin is the cornerstone of the treatment, reducing pain as well as improving wound healing. Nails should be thoroughly inspected and possibly removed if the nail is involved, to ensure proper healing. In high-risk patients, plasma calcium levels should be evaluated and cardiac monitoring is indicated.

  13. [Burning mouth syndrome (glossalgia)].

    Science.gov (United States)

    2014-01-01

    Burning mouth syndrome (glossalgia) is manifested by oral pin and tingling sensations, numbness and even burning and severe pains, more frequently in the tongue. Unpleasant sensations may involve the anterior two thirds of the tongue or be extended to the front part of the hard palate and the mucous membrane of the lower lip. This condition is characterized by "mirror" and "food dominant" symptoms, disordered salivation, dysgeusia, or psychological disorders. The disease shows a chronic course. Its etiology may be multifactorial. There are no universally accepted diagnostic criteria; the diagnosis of glossalgia is made to rule out all other causes. A thorough examination should be conducted to establish a differential diagnosis. Glossalgia occurs primarily in middle-aged and elderly people. Women get sick much more frequently than men of the same age. Glossalgia remains difficult to treat. Continuous symptomatic treatment and follow-up help relieve its symptoms.

  14. Drenaje suplementario del sistema venoso superficial en colgajos pediculados Supplementary drainage of superficial venous system in pedicled flaps

    Directory of Open Access Journals (Sweden)

    A. Fernández García

    2012-06-01

    Full Text Available Los colgajos pediculados pueden sufrir edema y congestión debido a que su drenaje a trevés del sistema venoso superfical es imposible y el flujo hacia el sistema profundo a nivel del pedículo es precario. Esta situación suele evolucionar hacia la necrosis parcial o la pérdida total del colgajo en pocas horas. La apertura del sistema venoso superficial permite el drenaje adecuado de los tejidos transferidos y evita estas complicaciones. Este artículo analiza el papel de las anastomosis microquirúrgicas en el sistema venoso superficial de los colgajos pediculados. Esta técnica permite comunicar el sistema venoso superfical de los tejidos transferidos con el sistema venoso superficial del territorio que rodea al defecto. Presentamos los resultados obtenidos con esta técnica en colgajos de perforante en hélice, colgajos miocutáneos, colgajos neurocutáneos y colgajos fasciograsos volteados.The pedicled flaps can suffer edema and congestion due to the impossibility of drainage toward the superficial venous system and the precarious flow via the deep system at the level of the pedicle. The evolution of this situation is usually partial necrosis or total loss of the flap in a few hours. The opening of the venous superficial system achieves an appropriate drainage of the transfered tissues and avoids these complications. In this article we analyze the role of the microsurgical anastomosis at the level of the superficial venous system of pedicled flaps. This technique allows to communicate the superficial venous system of the transfered tissues with the superficial venous system of the territory around the defect. We report the results with this method in propeller perforator flaps, miocutaneous flaps, neurocutaneous flaps and adipofascial turn over flaps.

  15. Lack of Methylene Blue Staining in Superficial Epithelia as a Possible Marker for Superficial Lateral Spread of Bile Duct Cancer

    Directory of Open Access Journals (Sweden)

    I. Maetani

    1996-01-01

    epithelia. The cancerous epithelia stained significantly less often than either the normal (p = 0.000005 or the metaplastic (p = 0.001 epithelia. Evaluation of methylene blue staining during PTCS revealed that this stain was absorbed by the cholangial epithelia, not superficially stuck to it. The difference in methylene blue staining properties between the cancerous and normal epithelia could be helpful to clarify the boundary of superficial lateral spread of bile duct cancer.

  16. Amniotic membrane transplant with superficial keratectomy in superficial corneal degenerations: Efficacy in a rural population of north India

    Directory of Open Access Journals (Sweden)

    Rao Aparna

    2008-01-01

    Full Text Available Aim: To evaluate the applicability and efficacy of superficial keratectomy with transplantation of preserved amniotic membrane in superficial corneal degenerations in a rural population of Northern India in terms of visual improvement and surface regularization. Settings: Peripheral referral center in rural north India. Materials and Methods: This was a prospective non-comparative interventional case series where 24 eyes of 20 farmers from peripheral rural areas (M:F = 19:1 with visually significant superficial degenerative disorders (15 eyes with climatic droplet keratopathy one of which was associated with Salzmann nodular degeneration and nine eyes with band-shaped keratopathy were subjected to amniotic membrane transplantation (single or multiple layer combined with superficial keratectomy. Subjective and objective outcomes after surgery were evaluated and analyzed and statistical significance of the outcomes in various disorders was evaluated. Results: Eighty-eight per cent (21 eyes had symptomatic relief from distressing preoperative symptoms while postoperative visual improvement by two or more lines was achieved in 23 eyes (96% over a mean follow-up period of 26.8 ± 10.2 months. The surface irregularity present preoperatively was relieved in 23 cases while postoperative decline of vision with visually significant scarring was seen in one case (4%, which was labeled as failure. Conclusions: Amniotic membrane transplant with superficial keratectomy helped achieve subjective comfort, visual rehabilitation and clinical regularization of the corneal surface in superficial corneal degenerations during the mean followup of 26.8 ± 10.2 months in rural setups.

  17. The hair color-highlighting burn: a unique burn injury.

    Science.gov (United States)

    Peters, W

    2000-01-01

    A unique, preventable, 2.8 x 3.7-cm, full-thickness scalp burn resulted after a woman underwent a professional color-highlighting procedure at a hair salon. The burn appeared to result from scalp contact with aluminum foil that had been overheated by a hair dryer during the procedure. The wound required debridement and skin grafting and 3 subsequent serial excisions to eliminate the resulting area of burn scar alopecia. The preventive aspects of this injury are discussed.

  18. Biochemical composition of the superficial layer of articular cartilage.

    Science.gov (United States)

    Crockett, R; Grubelnik, A; Roos, S; Dora, C; Born, W; Troxler, H

    2007-09-15

    To gain more information on the mechanism of lubrication in articular joints, the superficial layer of bovine articular cartilage was mechanically removed in a sheet of ice that formed on freezing the cartilage. Freeze-dried samples contained low concentrations of chondroitin sulphate and protein. Analysis of the protein by SDS PAGE showed that the composition of the sample was comparable to that of synovial fluid (SF). Attenuated total reflection infrared (ATR-IR) spectroscopy of the dried residue indicated that the sample contained mostly hyaluronan. Moreover, ATR-IR spectroscopy of the upper layer of the superficial layer, adsorbed onto silicon, showed the presence of phospholipids. A gel could be formed by mixing hyaluronan and phosphatidylcholine in water with mechanical properties similar to those of the superficial layer on cartilage. Much like the superficial layer of natural cartilage, the surface of this gel became hydrophobic on drying out. Thus, it is proposed that the superficial layer forms from hyaluronan and phospholipids, which associate by hydrophobic interactions between the alkyl chains of the phospholipids and the hydrophobic faces of the disaccharide units in hyaluronan. This layer is permeable to material from the SF and the cartilage, as shown by the presence of SF proteins and chondroitin sulphate. As the cartilage dries out after removal from the joint, the phospholipids migrate towards the surface of the superficial layer to reduce the surface tension. It is also proposed that the highly efficient lubrication in articular joints can, at least in part, be attributed to the ability of the superficial layer to adsorb and hold water on the cartilage surface, thus creating a highly viscous boundary protection.

  19. [The organization of burn care].

    Science.gov (United States)

    Latarjet, Jacques

    2002-12-15

    In 2002, the organisation of burn care is confronted to a great deficiency in burn epidemiological datas. The main mechanisms of hospitalized burns are somehow wellknown in industrialized countries: about 60% scalds and 30% flame burns; as well as the place of occurrence (60% at home, and 20% at work), and the risk groups (3 times more important for the age group 0-4 years old). The incidence of burns needing medical care (all levels) (250/100,000 inh/yr) or hospitalization (15-20/100,000 inh/yr) is much more uncertain. The statistics of Diagnosis Related Groups (DRG), for hospitalized patients will allow in France very shortly to know more about the most rational ways of dispatching and treating them. They already show that only 30% of hospitalized burned patients are treated in specialized facilities.

  20. Superficial dose evaluation of four dose calculation algorithms

    Science.gov (United States)

    Cao, Ying; Yang, Xiaoyu; Yang, Zhen; Qiu, Xiaoping; Lv, Zhiping; Lei, Mingjun; Liu, Gui; Zhang, Zijian; Hu, Yongmei

    2017-08-01

    Accurate superficial dose calculation is of major importance because of the skin toxicity in radiotherapy, especially within the initial 2 mm depth being considered more clinically relevant. The aim of this study is to evaluate superficial dose calculation accuracy of four commonly used algorithms in commercially available treatment planning systems (TPS) by Monte Carlo (MC) simulation and film measurements. The superficial dose in a simple geometrical phantom with size of 30 cm×30 cm×30 cm was calculated by PBC (Pencil Beam Convolution), AAA (Analytical Anisotropic Algorithm), AXB (Acuros XB) in Eclipse system and CCC (Collapsed Cone Convolution) in Raystation system under the conditions of source to surface distance (SSD) of 100 cm and field size (FS) of 10×10 cm2. EGSnrc (BEAMnrc/DOSXYZnrc) program was performed to simulate the central axis dose distribution of Varian Trilogy accelerator, combined with measurements of superficial dose distribution by an extrapolation method of multilayer radiochromic films, to estimate the dose calculation accuracy of four algorithms in the superficial region which was recommended in detail by the ICRU (International Commission on Radiation Units and Measurement) and the ICRP (International Commission on Radiological Protection). In superficial region, good agreement was achieved between MC simulation and film extrapolation method, with the mean differences less than 1%, 2% and 5% for 0°, 30° and 60°, respectively. The relative skin dose errors were 0.84%, 1.88% and 3.90%; the mean dose discrepancies (0°, 30° and 60°) between each of four algorithms and MC simulation were (2.41±1.55%, 3.11±2.40%, and 1.53±1.05%), (3.09±3.00%, 3.10±3.01%, and 3.77±3.59%), (3.16±1.50%, 8.70±2.84%, and 18.20±4.10%) and (14.45±4.66%, 10.74±4.54%, and 3.34±3.26%) for AXB, CCC, AAA and PBC respectively. Monte Carlo simulation verified the feasibility of the superficial dose measurements by multilayer Gafchromic films. And the rank

  1. [Epidemiology of burns in France].

    Science.gov (United States)

    Latarjet, Jacques; Ravat, François

    2012-01-01

    As with most traumas, the epidemiology of the "burn" health-event has long been neglected by public health doctors and rarely considered by burns specialists. There were therefore few verified data and many approximations and preconceived ideas. The gathering of information recently undertaken in France enables the reliability of the data to be improved and the diagnostic and demographic elements relating to hospitalised patients with burns to be established.

  2. Genital burns and vaginal delivery.

    Science.gov (United States)

    Pant, R; Manandhar, V; Wittgenstein, F; Fortney, J A; Fukushima, C

    1995-07-01

    Obstetric complications may result from burn scarring in the genital area. Women in developing countries typically squat around cooking fires, and burns are common. This recent case in Nepal describes obstructed labor in a young woman whose genital area had extensive scarring from a cooking fire injury. Proper antenatal assessment by health care providers can reduce the risk to mothers and infants of the consequences of a birth canal damaged or obstructed by burn scarring.

  3. Curbing Inflammation in Burn Patients

    Directory of Open Access Journals (Sweden)

    Jayme A. Farina

    2013-01-01

    Full Text Available Patients who suffer from severe burns develop metabolic imbalances and systemic inflammatory response syndrome (SIRS which can result in multiple organ failure and death. Research aimed at reducing the inflammatory process has yielded new insight into burn injury therapies. In this review, we discuss strategies used to curb inflammation in burn injuries and note that further studies with high quality evidence are necessary.

  4. Augmentation of quality of wound healing of deep burn%更进一步提高深度烧伤创面修复质量

    Institute of Scientific and Technical Information of China (English)

    黄晓元

    2009-01-01

    This article summarizes methods of repair of massive and deep wounds, elucidates how to improve wound healing quality and avoid scar deformity after deep hum. A part of denatured dermis (non-necrotic)in deep partial-thickness burn, "mixed degree" burn, even in full-thickness burn wounds before forming eschar can be preserved and covered with autolo-gous skin, thereby to avoid secondary damage to the structure of subcutaneous tissue and the junction of dermis-adipose, thus to result in good functions, appearance, and survival rate. After skin grafting, wound healing quality and appearance are im-proved, joint function and elasticity of skin are enhanced, the degree of scar contracture is relieved due to preservation of nor-mal adipose tissue after escharectomy. The study of composite artifical skin will be actively developed in the future. Tissue-en-gineering skin and stem cells can be successfully used in pa-tients with deep burns for starless healing with restoration of physiological functions in a short period.

  5. Nutrition Support in Burn Patients

    Directory of Open Access Journals (Sweden)

    Cem Aydoğan

    2012-08-01

    Full Text Available Severe burn trauma causes serious metabolic derangements. Increased metabolic rate which is apart of a pathophysiologic characteristic of burn trauma results in protein-energy malnutrition. This situation causes impaired wound healing, muscle and fat tissue’s breakdown, growth retardation in children and infections. Nutrition support is vital in the treatment strategies of burn victims to prevent high mortal and disabling complications in this devastating trauma. Our aim in this study is to review management of nutrition in burn victims. (Journal of the Turkish Society Intensive Care 2012; 10: 74-83

  6. A primer on burn resuscitation

    Directory of Open Access Journals (Sweden)

    Bacomo Ferdinand

    2011-01-01

    Full Text Available Since the early 1900s, the scope of burn resuscitation has evolved dramatically. Due to various advances in pre-hospital care and training, under-resuscitation of patients with severe burns is now relatively uncommon. Over-resuscitation, otherwise known as "fluid creep", has emerged as one of the most important problems during the initial phases of burn care over the past decade. To avoid the complications of over-resuscitation, careful hourly titration of fluid rates based on compilation of various clinical end points by a bedside provider is vital. The aim of this review is to provide a practical approach to the resuscitation of severely burned patients.

  7. Ice & Fire: the Burning Question

    DEFF Research Database (Denmark)

    van Gelderen, Laurens; Jomaas, Grunde

    2017-01-01

    With the Arctic opening up to new shipping routes and increased oil exploration and production due to climate change, the risk of an Arctic oil spill is increasing. Of the classic oil spill response methods (mechanical recovery, dispersants and in-situ burning), in-situ burning is considered...... to be particularly a suitable response method in the Arctic. In-situ burning aims to remove the oil from the marine environment by burning it from the water surface. A recent Ph.D. thesis from the Technical University of Denmark has provided some new insights with respect to the fire science behind this response...

  8. Marginally Stable Nuclear Burning

    Science.gov (United States)

    Strohmayer, Tod E.; Altamirano, D.

    2012-01-01

    Thermonuclear X-ray bursts result from unstable nuclear burning of the material accreted on neutron stars in some low mass X-ray binaries (LMXBs). Theory predicts that close to the boundary of stability oscillatory burning can occur. This marginally stable regime has so far been identified in only a small number of sources. We present Rossi X-ray Timing Explorer (RXTE) observations of the bursting, high-inclination LMXB 4U 1323-619 that reveal for the first time in this source the signature of marginally stable burning. The source was observed during two successive RXTE orbits for approximately 5 ksec beginning at 10:14:01 UTC on March 28, 2011. Significant mHz quasi-periodic oscillations (QPO) at a frequency of 8.1 mHz are detected for approximately 1600 s from the beginning of the observation until the occurrence of a thermonuclear X-ray burst at 10:42:22 UTC. The mHz oscillations are not detected following the X-ray burst. The average fractional rms amplitude of the mHz QPOs is 6.4% (3 - 20 keV), and the amplitude increases to about 8% below 10 keV.This phenomenology is strikingly similar to that seen in the LMXB 4U 1636-53. Indeed, the frequency of the mHz QPOs in 4U 1323-619 prior to the X-ray burst is very similar to the transition frequency between mHz QPO and bursts found in 4U 1636-53 by Altamirano et al. (2008). These results strongly suggest that the observed QPOs in 4U 1323-619 are, like those in 4U 1636-53, due to marginally stable nuclear burning. We also explore the dependence of the energy spectrum on the oscillation phase, and we place the present observations within the context of the spectral evolution of the accretion-powered flux from the source.

  9. Exercise following burn injury.

    Science.gov (United States)

    de Lateur, Barbara J; Shore, Wendy S

    2011-05-01

    Fatigue is a major barrier to recovery for burned individuals. Studies indicate that a slow return to normal or near-normal muscle strength is the natural course of recovery. With no special interventions, other than the "usual care" tailored to the needs of the individual, postburn patients will make gradual improvement in strength and aerobic capacity. Using the principle of initial condition (the worse the initial condition, the greater the response to exercise intervention) the authors outline an augmented exercise program that should result in a robust improvement in aerobic capacity.

  10. Accidental Cutaneous Burns Secondary to Salbutamol Metered Dose Inhaler

    Directory of Open Access Journals (Sweden)

    Ashutosh Kale

    2010-01-01

    Full Text Available We report a case of accidental cutaneous burns caused by salbutamol metered dose inhaler. A 9-year-old boy underwent dental extraction at a children's hospital and was incidentally noted to have burn injuries on dorsum of both hands. On questioning, the boy revealed that a few days ago his 14-year-old brother, who is an asthmatic, playfully sprayed his salbutamol metered dose inhaler on the back of both his hands with the inhaler's mouth piece being in direct contact with the patient's skin. On examination, there was a rectangular area of erythema with superficial peeling on the dorsum of both hands, the dimensions of which exactly matched those of the inhaler's mouthpiece. It is possible that the injury could have been a chemical burn from the pharmaceutical/preservative/propellant aerosol or due to the physical effect of severe cooling of the skin or mechanical abrasive effect of the aerosol blasts or a combination of some or all the above mechanisms. This case highlights the importance of informing children and parents of the potentially hazardous consequences of misusing a metered dose inhaler.

  11. Oral Rehydration Therapy in Burn Patients

    Science.gov (United States)

    2014-04-24

    Burn Any Degree Involving 20-29 Percent of Body Surface; Burn Any Degree Involving 30-39 Percent of Body Surface; Burn Any Degree Involving 40-49 Percent of Body Surface; Burn Any Degree Involving 50-59 Percent of Body Surface; Burn Any Degree Involving 60-65 Percent of Body Surface

  12. How to manage burns in primary care.

    OpenAIRE

    Waitzman, A. A.; Neligan, P C

    1993-01-01

    Burns are common injuries; more than 200,000 occur in Canada annually. Nearly all burn injuries can be managed on on outpatient basis. Appropriate treatment depends on burn depth, extent, and location. Special types of burns, such as chemical, tar, and electrical injuries, need specific management strategies. Prevention through education is important to reduce the incidence of burns.

  13. Long-term evolution of superficial optic disc drusen

    DEFF Research Database (Denmark)

    Malmqvist, Lasse; Lund-Andersen, Henrik; Hamann, Steffen

    2017-01-01

    with hereditary ODD were included. RESULTS: Mean age at initial and follow-up examination was, respectively, 16.8 and 73.3 years. The median follow-up time was 56 years. A minimal or non-existing change in superficial ODD anatomy (size and number) was seen in 10 of 12 eyes. There was a tendency towards more......PURPOSE: Optic disc drusen (ODD) is hyaline deposits in the optic nerve head seen in 1-2% of the population. Long-term evolution of ODD anatomy and visual field defects in ODD patients is a key factor for learning more about pathophysiology and prognosis of the condition. With a median follow......-up period of 56 years, this is the first study that evaluates superficial optic disc anatomy and visual fields in patients with ODD over a life span. METHODS: Observational case series investigating progression of superficial optic disc anatomy and visual fields in ODD patients. Eight patients...

  14. Física de superficies: métodos experimentales

    OpenAIRE

    2012-01-01

    Hace unos 30 años se empezó con el estudio de superficies sólidas y hoy son muchos los investigadores que en el mundo entero se dedican al estudio de las propiedades físicas y químicas de superficies e interfaces.La motivación radica en que en las interacciones entre los diversos sistemas que componen nuestro universo se hallan involucradas sus superficies, razón suficiente para captar la importancia de su estudio para la vida humana y su repercusión tecnológica y económica. A ella habría que...

  15. Case report: cochlear implantation in a patient with superficial siderosis.

    Science.gov (United States)

    Ryan, Michelle; Piplica, Doris; Zhang, Ming

    2014-12-01

    This is a retrospective case review study. Current understanding of cochlear implantation in patients with superficial siderosis is limited, with roughly 15 reported cases worldwide. The purpose of this study is to report an additional case of cochlear implantation in a patient with superficial siderosis and to contribute to the current literature available on outcomes of implantation in these individuals. One cochlear implant user with superficial siderosis in a tertiary referral center. Therapeutic and rehabilitative. Open set speech perception word scores increased from 0% preimplantation with bilateral hearing aids to 8% postimplantation in the bimodal condition (cochlear implant in the left ear and hearing aid in the right ear). Phoneme scores increased from 16% preimplantation to 36% postimplantation. The patient also demonstrated improvement from 38% preimplantation to 83% postimplantation on a closed set word test. Performance on open set recorded sentences did not improve; however, open set sentences administered live voice revealed an increase in performance from 4% preimplantation to 25% postimplantation in the auditory only condition and from 59% to 86% in the auditory-visual condition. For this patient with superficial siderosis, only marginal improvements in test scores at 11 months postimplantation were seen. Minimally, the use of a cochlear implant did prevent further deterioration of auditory performance. Therefore, patients with superficial siderosis who choose to proceed with cochlear implantation may still report perceived benefit from the maintenance of speech perception abilities even in the presence of minimal improvement. Rapid deterioration in hearing thresholds and speech discrimination before implantation may be an indicator of an actively progressing case of superficial siderosis, which may suggest possible limited benefit from cochlear implantation.

  16. UV radiation sensors with unitary and binary superficial barrier

    Science.gov (United States)

    Dorogan, Valerian; Vieru, Tatiana; Kosyak, V.; Damaskin, I.; Chirita, F.

    1998-07-01

    UV radiation sensors with unitary and binary superficial barrier, made on the basis of GaP - SnO2 and GaAs - AlGaAs - SnO2 heterostructures, are presented in the paper. Technological and constructive factors, which permit to realize a high conversion efficiency and to exclude the influence of visible spectrum upon the photoanswer, are analyzed. It was established that the presence of an isotypical superficial potential barrier permits to suppress the photoanswer component formed by absorption of visible and infrared radiation in semiconductor structure bulk.

  17. PHOTODYNAMIC DIAGNOSIS AND FLUORESCENCE SPECTROSCOPY IN SUPERFICIAL BLADDER CANCER

    Directory of Open Access Journals (Sweden)

    I. G. Rusakov

    2009-01-01

    Full Text Available A comprehensive fluorescence technique has been developed to study the urinary bladder mucosa in patients with superficial bladder cancer (BC, by using alasense, white light cystoscopy, fluorescence cytoscopy, and local fluorescence spectroscopy in vivo. Quantification of urothelium fluorescence in the red emission foci of 5-ALA-induced protophorphyrin, with the local autofluorescence intensity being borne in mind, has been shown to increase the specificity of photodynamic diagnosis of superficial BC from 70 to 85% (p ≤ 0.05 and the total accuracy of the technique from 80 to 86%.  

  18. Burn, thermal - close-up (image)

    Science.gov (United States)

    ... first degree burns cause only reddening of the epidermis (outer layer of the skin), as seen in this photograph. Second degree burns cause blistering and extend into the dermis (lower layer of skin). Third degree burns cause ...

  19. Nutritional management of the burn patient

    African Journals Online (AJOL)

    role include: evaporative water loss from the burn wound, bacterial contamination of the burn ... leucocytes and fibroblasts in the burned area.2 Providing exogenous glucose ... immune function, poor wound healing and exacerbation of protein.

  20. Fires and Burns Involving Home Medical Oxygen

    Science.gov (United States)

    ... nfpa.org Fires and Burns Involving Home Medical Oxygen The air is normally 21% oxygen. Oxygen is not flammable, but fire needs it to burn. ¾ When more oxygen is present, any fire that starts will burn ...

  1. Corneal Protection for Burn Patients

    Science.gov (United States)

    2013-10-01

    Houston, TX Purpose:Patients with severe facial burns often suffer indirect damage to their eyes. Burn wound contracture of the periocular skin...periocular muscles , are injured and the protective blink reflex is lost. With loss of the blink reflex the patient quickly develops exposure keratitis

  2. Wanted: Clean Coal Burning Technology

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    China is intent on developing clean coal burning technology, an objective it can achieve through installing desulfurization facilities at coal-burning power plants that will control SO2 emissions and environmental pollution. According to kuo Yi, deputy director general of the Department of Science and Technology of the State Environmental Protection Agency, China is a major coal-buming country:

  3. The year in burns 2013.

    Science.gov (United States)

    Wolf, Steven E; Phelan, Herbert A; Arnoldo, Brett D

    2014-12-01

    Approximately 3415 research articles were published with burns in the title, abstract, and/or keyword in 2013. We have continued to see an increase in this number; the following reviews articles selected from these by the Editor of one of the major journals (Burns) and colleagues that in their opinion are most likely to have effects on burn care treatment and understanding. As we have done before, articles were found and divided into the following topic areas: epidemiology of injury and burn prevention, wound and scar characterization, acute care and critical care, inhalation injury, infection, psychological considerations, pain and itching management, rehabilitation and long-term outcomes, and burn reconstruction. The articles are mentioned briefly with notes from the authors; readers are referred to the full papers for details.

  4. The biology of burn injury.

    Science.gov (United States)

    Evers, Lars H; Bhavsar, Dhaval; Mailänder, Peter

    2010-09-01

    Burn injury is a complex traumatic event with various local and systemic effects, affecting several organ systems beyond the skin. The pathophysiology of the burn patient shows the full spectrum of the complexity of inflammatory response reactions. In the acute phase, inflammation mechanism may have negative effects because of capillary leak, the propagation of inhalation injury and the development of multiple organ failure. Attempts to mediate these processes remain a central subject of burn care research. Conversely, inflammation is a necessary prologue and component in the later-stage processes of wound healing. In this review, we are attempting to present the current science of burn wound pathophysiology and wound healing. We also describe the evolution of innovative strategies for burn management.

  5. Tromboflebite superficial: epidemiologia, fisiopatologia, diagnóstico e tratamento Superficial thrombophlebitis: epidemiology, physiopathology, diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Marcone Lima Sobreira

    2008-06-01

    Full Text Available A tromboflebite superficial de membros inferiores é doença de ocorrência comum, estando associada a diversas condições clínicas e cirúrgicas. Historicamente considerada doença benigna, devido à sua localização superficial e ao fácil diagnóstico, o tratamento foi conservador durante muito tempo, na maioria dos casos. Entretanto, relatos recentes de freqüências altas de complicações tromboembólicas associadas - 22 a 37% para trombose venosa profunda e até 33% para embolia pulmonar - alertaram para a necessidade de abordagens diagnósticas e terapêuticas mais amplas, visando diagnosticar e tratar essas possíveis complicações. A possibilidade da coexistência dessas e de outras desordens sistêmicas (colagenoses, neoplasias, trombofilias interfere na avaliação e influencia a conduta terapêutica, que pode ser clínica, cirúrgica ou combinada. No entanto, devido à falta de ensaios clínicos controlados e às incertezas quanto a sua história natural, o diagnóstico e o tratamento da tromboflebite superficial continuam indefinidos. Neste trabalho, foi feita uma revisão da literatura analisando-se a epidemiologia, fisiopatologia e estado atual do diagnóstico e tratamento da tromboflebite superficial.Superficial thrombophlebitis of the lower limbs is a commonly occurring disease, and it is associated with various clinical and surgical conditions. Historically considered to be a benign disease due to its superficial location and easy diagnosis, its treatment was, for a long time, conservative in most cases. Nevertheless, recent reports of high frequency and associated thromboembolic complications, which vary from 22 to 37% for deep venous thrombosis and up to 33% for pulmonary embolism, have indicated the need for broader diagnostic and therapeutic approaches in order to diagnose and treat such possible complications. The possibility of coexistence of these and other systemic disorders (collagenosis, neoplasia, thrombophilia

  6. Interpolación y ajuste de superficies en componentes mecánicos digitalizados empleando superficies B-Spline

    OpenAIRE

    2014-01-01

    Este documento de tesis tiene el propósito de describir una metodología para obtener nubes de puntos que representen a superficies (o parches de geometría compleja) de piezas mecánicas que pueden ser replicadas en la industria. Estos puntos se obtuvieron utilizando el método de interpolación superficial B-Spline que deben cumplir un margen de error conocido y controlado de acuerdo a las tolerancias de fabricación utilizados en estos procesos de fabricación. En primer lugar e...

  7. Diagnostic and therapeutic challenges in superficial CNS siderosis

    DEFF Research Database (Denmark)

    Kondziella, Daniel; Lindelof, M.; Haziri, Donika

    2015-01-01

    that neurodegeneration due to haemosiderin-associated iron toxicity becomes irreversible with time. CONCLUSION: Surgical therapy in superficial CNS siderosis is rarely achieved. We suggest that prospective, large-scale multicentre studies are needed to search for non-surgical therapies that reverse (or prevent) ongoing...... neurotoxicity due to accumulating iron toxicity. FUNDING: not relevant. TRIAL REGISTRATION: not relevant....

  8. Anterior urethral recurrence of superficial bladder cancer: its clinical significance.

    Directory of Open Access Journals (Sweden)

    Saika T

    2003-12-01

    Full Text Available The aim of this study was to reveal the clinical features of anterior urethral recurrence in patients with superficial bladder cancer, and to determine the appropriate treatment. Three hundred and three patients with superficial bladder cancer, who were newly diagnosed and initially treated conservatively in our hospital between 1965 and 1990, were followed for at least 5 years and their clinical outcomes were analyzed. Clinical factors, including anterior urethral recurrence, were evaluated statistically regarding tumor progression. Eight patients (2.6% had anterior urethral recurrence following superficial bladder cancer. Twenty-four patients (7.9% had tumor progression and 149 (49.2% had tumor recurrence. In a multivariate analysis using a logistic model, anterior urethral recurrence was the most important factor, followed by histological grade. Four of 5 patients who were treated for anterior urethral recurrent tumors by transurethral resection showed progression and died of the cancer within one year. Two of the remaining three patients who underwent radical cysto-urethrectomy at the time of anterior urethral recurrence survived. Anterior urethral recurrence following superficial bladder cancer is a predictor for rapid subsequent malignant progression. Once there is anterior urethral recurrence, radical intensive therapy, including radical cysto-urethrectomy, should be carried out immediately.

  9. Superficies bioactivas en implantología: una nueva perspectiva

    Directory of Open Access Journals (Sweden)

    A. Cutando

    2007-02-01

    Full Text Available Actualmente, tras años de investigación en implantología, en los cuales se han realizado muchos trabajos, en donde se han estudiado diferentes tipos de superficies de implantes, lisas y rugosas, en un intento de mejorar, tanto en el tiempo como en la calidad , la osteointegración, se ha concluido que los implantes de superficie rugosa con un intervalo de rugosidad entre 1,0-2,0 nm, son los que parecen dar una mejor respuesta ósea y mejores resultados clínicos, pero desde un punto de vista exclusivamente mecánico. Hoy en día las investigaciones se centran en el desarrollo de superficies denominadas bioactivas, las cuales son capaces de interaccionar con el hueso que rodea al implante, como ocurre cuando el implante es revestido con carbonato cálcico o bien con flúor. Pero sabemos que dentro del metabolismo óseo, juegan importantes papeles, moléculas, como son la melatonina y la hormona del crecimiento entre otras, las cuales deben de ser tenidas en cuenta a la hora de hablar de osteointegración. Se realiza una breve descripción de la fisiología de ambas moléculas y se valora su aplicación al concepto de superficie bioactiva en implantología.

  10. Superficial Needling Therapy for Tennis Elbow in 40 Cases

    Institute of Scientific and Technical Information of China (English)

    GE Heng-bi; XIAO Yuan-chun

    2003-01-01

    Superficial needling therapy was employed to treat 40 cases of tennis elbow. For the cases of qi and blood stagnation, cupping therapy was added. Thirty-eight cases were cured after one treatment and 2 cases were cured after two treatments.

  11. Frey′s Syndrome as a Sequela of Superficial Parotidectomy

    Directory of Open Access Journals (Sweden)

    Rishi Kumar Bali

    2006-01-01

    The disorder is characterized by unilateral sweating and flushing of facial skin in the area of parotid gland occurring during meals. We present a case of a patient who developed symptoms of Frey Syndrome 4 months after undergoing superficial parotidectomy on left side.

  12. Atypical Presentation of Fibrolipomatous Hamartoma of Superficial Peroneal Nerve.

    Science.gov (United States)

    Dhinsa, Baljinder Singh; Lidder, Surjit; Abbasian, Ali

    2016-01-01

    Fibrolipomatous hamartoma is a rare presentation in the foot. An accurate diagnosis is key, with magnetic resonance imaging findings considered definitive. The management is dependent on the symptoms. We present an atypical presentation of fibrolipomatous hamartoma of the superficial peroneal nerve and discuss the current published data.

  13. Superficial dermatomycoses: a prospective clinico-mycological study

    Directory of Open Access Journals (Sweden)

    Surekha A

    2015-01-01

    Full Text Available Background: Dermatomycoses are more prevalent in India due to favourable climatic conditions, poverty, poor hygiene and overcrowding. Sparse published data are available regarding superficial dermatomycoses from India. Methods: In this prospective study, demographic characteristics, clinical spectrum and risk factors for the development were studied in 198 patients with superficial dermatomycoses. Results: Their mean age was 34.1 ± 15.3 years; there were 108 (54.5% males. Majority of the patients (50.5% belonged to upper-lower socio-economic status (Class IV as per modified Kuppuswamy’s classification. Most of the patients (69.7% had presented with dermatophytoses. Among superficial dermatomy-coses, tinea corporis was the most common (29.3% clinical type. Potassium hydroxide mount was positive in 77.7% and culture was positive in 30.8%. Trichophyton rubrum was the most common species isolated (64%. Multivariable analysis using logistic regression revealed older age (> 50 years to be an independent predictor for the development of tinea corporis (p<0.001. Conclusions: Our observations suggest that superficial dermatomycoses are an important cause of morbidity and should be carefully searched for especially in the elderly so that effective curative treatment can be instituted.

  14. Tattoo removal by superficial dermabrasion. Five-year experience.

    Science.gov (United States)

    Clabaugh, W A

    1975-04-01

    A 5-year clinical experience using superficial dermabrasion to remove tattoos is presented. This procedure can be done quickly in the office with low patient risk. Good pigment removal is obtained with little or no scar formation. Cases are presented which are typical of the 250 tattoos removed in the last 5 years.

  15. Major Superficial White Matter Abnormalities in Huntington's Disease

    Science.gov (United States)

    Phillips, Owen R.; Joshi, Shantanu H.; Squitieri, Ferdinando; Sanchez-Castaneda, Cristina; Narr, Katherine; Shattuck, David W.; Caltagirone, Carlo; Sabatini, Umberto; Di Paola, Margherita

    2016-01-01

    Background: The late myelinating superficial white matter at the juncture of the cortical gray and white matter comprising the intracortical myelin and short-range association fibers has not received attention in Huntington's disease. It is an area of the brain that is late myelinating and is sensitive to both normal aging and neurodegenerative disease effects. Therefore, it may be sensitive to Huntington's disease processes. Methods: Structural MRI data from 25 Pre-symptomatic subjects, 24 Huntington's disease patients and 49 healthy controls was run through a cortical pattern-matching program. The surface corresponding to the white matter directly below the cortical gray matter was then extracted. Individual subject's Diffusion Tensor Imaging (DTI) data was aligned to their structural MRI data. Diffusivity values along the white matter surface were then sampled at each vertex point. DTI measures with high spatial resolution across the superficial white matter surface were then analyzed with the General Linear Model to test for the effects of disease. Results: There was an overall increase in the axial and radial diffusivity across much of the superficial white matter (p < 0.001) in Pre-symptomatic subjects compared to controls. In Huntington's disease patients increased diffusivity covered essentially the whole brain (p < 0.001). Changes are correlated with genotype (CAG repeat number) and disease burden (p < 0.001). Conclusions: This study showed broad abnormalities in superficial white matter even before symptoms are present in Huntington's disease. Since, the superficial white matter has a unique microstructure and function these abnormalities suggest it plays an important role in the disease. PMID:27242403

  16. Major Superficial White Matter Abnormalities in Huntington disease

    Directory of Open Access Journals (Sweden)

    Owen Robert Phillips

    2016-05-01

    Full Text Available BackgroundThe late myelinating superficial white matter at the juncture of the cortical gray and white matter comprising the intracortical myelin and short-range association fibers has not received attention in Huntington’s disease. It is an area of the brain that is late myelinating and is sensitive to both normal aging and neurodegenerative disease effects. Therefore, it may be sensitive to Huntington’s disease processes. MethodsStructural MRI data from 25 Pre-symptomatic subjects, 24 Huntington’s disease patients and 49 healthy controls was run through a cortical pattern-matching program. The surface corresponding to the white matter directly below the cortical gray matter was then extracted. Individual subject’s Diffusion Tensor Imaging (DTI data was aligned to their structural MRI data. Diffusivity values along the white matter surface were then sampled at each vertex point. DTI measures with high spatial resolution across the superficial white matter surface were then analyzed with the General Linear Model to test for the effects of disease. ResultsThere was an overall increase in the axial and radial diffusivity across much of the superficial white matter (p < 0.001 in Pre-symptomatic subjects compared to controls. In Huntington’s disease patients increased diffusivity covered essentially the whole brain (p < 0.001. Changes are correlated with genotype (CAG repeat number and disease burden (p < 0.001.ConclusionsThis study showed broad abnormalities in superficial white matter even before symptoms are present in Huntington’s disease. Since the superficial white matter has a unique microstructure and function these abnormalities suggest it plays an important role in the disease.

  17. Thermal injuries induce gene expression of endogenous c-fos, c-myc and bFGF in burned tissues

    Institute of Scientific and Technical Information of China (English)

    付小兵; 顾小曼; 孙同柱; 杨银辉; 孙晓庆; 盛志勇

    2003-01-01

    Objective To investigate the expression sequence and distribution characteristics of the protooncogenes c-fos, c-myc and endogenous basic fibroblast growth factor (bFGF ) genes in burned tissues, and to explore the possible effects of changes in the se genes' functions on wound healing. Methods Partial-thickness burns of 30% TBSA were established on backs of Wistar rats. Insitu hybridization and histological methods were used to detect expression of c-fos, c-myc and bFGF genes in normal and burned tissue at 3 h, 6 h, 1 d, 3 d , 7 d and 14 d postburn. Results Although expression of c-fos and c-myc genes and bFGF gene could be found in normal skin, the expression of all three were markedly induced by burn wounds and the expression models in sequence and distribution were quite different. Expre ssion of c-fos gene increased and peaked at 6 h. Signals were mainly localiz ed in both nuclei of dermal fibroblasts and monocytes. The expression of bFGF gene increased at 6 h and peaked at 1 d postburn, and was distributed in the cyt oplasm of fibroblasts. C-myc gene peaked 3 d postburn and was also distributed in the cytoplasm of fibroblasts. Conclusions These results indicated that thermal injury could induce the expression of c-fos, c-myc and bFGF at gene level, showing phasic control and regional distributi on. The phasic expression of these genes suggests that there is an interaction between protooncogenes and bFGF, which may play an important role in wound heali ng. The different expressions of c-fos and c-myc play an inducing role in reg ulating bFGF, and in turn affect wound healing.

  18. Functional Outcomes Following Burn Injury.

    Science.gov (United States)

    Ryan, Colleen M; Parry, Ingrid; Richard, Reginald

    Major advances in functional recovery following burn injury over the last ten years include the development of conceptual framework for disability assessment and its application burn recovery, the description of the long-term outcomes in the burn population, and progress in basic science research leading to new treatments that improve long-term functional outcomes. Future tasks and challenges include the development of common data elements and standards for burn recovery in order to measure and optimize the path toward functional recovery. The development of patient-reported outcome measures with benchmarks for recovery over time has the potential to improve patient-provider communication and quality of patient-centered care. The study of burn recovery should include an examination of resiliency along with the study of disabilities following burn injury. Better understanding of the mechanisms, impact and modulation of hypermetabolism and inflammation following burn injury is essential to improve functional recovery. Continued basic science and clinical research must focus on scar modulation and skin replacements and address recalcitriant problems such as heterotopic ossification. Health tracking technologies should be leveraged to understand and optimize physical therapy interventions.

  19. Sedation and Analgesia in Burn

    Directory of Open Access Journals (Sweden)

    Özkan Akıncı

    2011-07-01

    Full Text Available Burn injury is one of the most serious injuries that mankind may face. In addition to serious inflammation, excessive fluid loss, presence of hemodynamic instability due to intercurrent factors such as debridements, infections and organ failure, very different levels and intensities of pain, psychological problems such as traumatic stress disorder, depression, delirium at different levels that occur in patient with severe burn are the factors which make it difficult to provide the patient comfort. In addition to a mild to moderate level of baseline permanent pain in burn patients, which is due to tissue damage, there is procedural pain as well, which occurs by treatments such as grafting and dressings, that are severe, short-term burst style 'breakthrough' pain. Movement and tactile stimuli are also seen in burn injury as an effect to sensitize the peripheral and central nervous system. Even though many burn centers have established protocols to struggle with the pain, studies show that pain relief still inadequate in burn patients. Therefore, the treatment of burn pain and the prevention of possible emergence of future psychiatric problems suc as post-traumatic stress disorder, the sedative and anxiolytic agents should be used as a recommendation according to the needs and hemodynamic status of individual patient. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 26-30

  20. Rehabilitation of the burn patient

    Directory of Open Access Journals (Sweden)

    Procter Fiona

    2010-10-01

    Full Text Available Rehabilitation is an essential and integral part of burn treatment. It is not something which takes place following healing of skin grafts or discharge from hospital; instead it is a process that starts from day one of admission and continues for months and sometimes years after the initial event. Burns rehabilitation is not something which is completed by one or two individuals but should be a team approach, incorporating the patient and when appropriate, their family. The term ′Burns Rehabilitation′ incorporates the physical, psychological and social aspects of care and it is common for burn patients to experience difficulties in one or all of these areas following a burn injury. Burns can leave a patient with severely debilitating and deforming contractures, which can lead to significant disability when left untreated. The aims of burn rehabilitation are to minimise the adverse effects caused by the injury in terms of maintaining range of movement, minimising contracture development and impact of scarring, maximising functional ability, maximising psychological wellbeing, maximising social integration

  1. Topical agents in burn care

    Directory of Open Access Journals (Sweden)

    Momčilović Dragan

    2002-01-01

    Full Text Available Introduction Understanding of fluid shifts and recognition of the importance of early and appropriate fluid replacement therapy have significantly reduced mortality in the early post burn period. After the bum patient successfully passes the resuscitation period, the burn wound represents the greatest threat to survival. History Since the dawn of civilization, man has been trying to find an agent which would help burn wounds heal, and at the same time, not harm general condition of the injured. It was not until the XX century, after the discovery of antibiotics, when this condition was fulfilled. In 1968, combining silver and sulfadiazine, fox made silver-sulfadiazine, which is a 1% hydro-soluble cream and a superior agent in topical treatment of burns today. Current topical agents None of the topical antimicrobial agents available today, alone or combined, have the characteristics of ideal prophylactic agents, but they eliminate colonization of burn wound, and invasive infections are infrequent. With an excellent spectrum of activity, low toxicity, and ease of application with minimal pain, silver-sulfadiazine is still the most frequently used topical agent. Conclusion The incidence of invasive infections and overall mortality have been significantly reduced after introduction of topical burn wound antimicrobial agents into practice. In most burn patients the drug of choice for prophylaxis is silver sulfadiazine. Other agents may be useful in certain clinical situations.

  2. Safety and efficacy of excision and direct closure in acute burns surgery: outcome analysis in a prospective series of 100 patients and a survey of UK burns surgeons' attitudes.

    Science.gov (United States)

    Bain, Charles J; Wang, Tim; McArthur, Gordon; Williams, Greg; Atkins, Joanne; Jones, Isabel

    2014-12-01

    Many burns surgeons avoid excision and direct closure of acute burns owing to concerns over wound dehiscence, scarring and infection. There is no evidence in the literature to support this practice. We present outcomes of a prospective series of 100 patients who underwent excision and direct closure of 138 burns over a 2-year period, along with results from a survey sent to 33 senior burns surgeons to gauge attitudes towards direct closure in burns surgery. 47% of survey respondents never perform direct closure. Dehiscence was cited as the most common concern, followed by hypertrophic scarring (HTS). In our cohort, the superficial dehiscence rate was 12% and the HTS rate was 16%, with no scarring contractures. Patients with healing time greater than 14 days were more likely to develop HTS (p=0.008), as were those with wound dehiscence (p=0.014). Patients undergoing part-grafting in addition to direct closure took significantly longer to heal than those undergoing direct closure alone (p=0.0002), with the donor site or graft delaying healing in the majority. Excision and direct closure of acute burn wounds avoids donor site morbidity and has an acceptable complication rate. It is a safe and effective treatment for full thickness burns in selected cases.

  3. Reduction of burn scar formation by halofuginone-eluting silicone gel sheets: a controlled study on nude mice.

    Science.gov (United States)

    Zeplin, Philip H

    2012-03-01

    Burn scar formations can cause disfiguration and loss of dermal function. The purpose of this study was to examine whether application of modified silicone gel sheets with an antifibrotic drug halofuginone-eluting hybrid surface produce an effect on scar development. There were a total of 2 animal groups. The athymic nude mice (nu/nu) of both groups underwent transplantation of full-thickness human skin grafts onto their backs and setting of partial thickness burn injury. The status of local scar development was observed over a period of 3 months after the application of silicone gel sheets and also after application of surface-modified halofuginone-eluting silicone gel sheets. Subsequently, via real-time polymerase chain reaction, the cDNA levels from key mediators of scar formation (transforming growth factor beta, COL1A1, connective tissue growth factor, fibroblast growth factor 2, matrix metalloproteinase 2, matrix metalloproteinase 9) were established and statistically evaluated. In comparison with uncoated silicone gel sheets, the application of halofuginone-eluting silicone gel sheets lead to a significant difference in gene expression activity in scar tissue. Halofuginone-eluting hybrid surface silicone gel sheets significantly increase the antiscarring effect of adhesive silicone gel sheets by deceleration and downregulation of scar development by normalization of the expression activity.

  4. Colloids in Acute Burn Resuscitation.

    Science.gov (United States)

    Cartotto, Robert; Greenhalgh, David

    2016-10-01

    Colloids have been used in varying capacities throughout the history of formula-based burn resuscitation. There is sound experimental evidence that demonstrates colloids' ability to improve intravascular colloid osmotic pressure, expand intravascular volume, reduce resuscitation requirements, and limit edema in unburned tissue following a major burn. Fresh frozen plasma appears to be a useful and effective immediate burn resuscitation fluid but its benefits must be weighed against its costs, and risks of viral transmission and acute lung injury. Albumin, in contrast, is less expensive and safer and has demonstrated ability to reduce resuscitation requirements and possibly limit edema-related morbidity. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. [Reconstruction of facial burn sequelae].

    Science.gov (United States)

    Foyatier, J L; Comparin, J P; Boulos, J P; Bichet, J C; Jacquin, F

    2001-06-01

    The deep burns of the face can lead to horrible scars functionally and aesthetically. Treatment of these scars need several surgical interventions frequently and during many years. In our region we deal with this type of wounds as team work, multidisciplinary approach carrying out many process starting by emergency treatment of acute burns till the social rehabilitation. The expansion technique was great help in improving the shape of scars, by using the expanding skin as full thickness grafts. Reconstruction of the anatomical units and application of aesthetic techniques (like rhinoplasty, lifting, tattooing and autologous fat injections) participate equally in improving the quality of results. Many examples of treatments of burns scars are shown.

  6. Double-skin paddled superficial temporofascial flap for the reconstruction of full-thickness cheek defect.

    Science.gov (United States)

    Kilinc, Hidir; Geyik, Yilmaz; Aytekin, Ahmet Hamdi

    2013-01-01

    The most common causes of cheek defects include trauma, burn, and tumor resections. In the reconstruction of the defects in this region, it is essential to use similar or adjacent tissue considering the aesthetic and functional properties. For this purpose, numerous local, regional, or distant free flaps were described. The local flaps harvested from the head and neck region are the most frequent methods because of the similar skin color, texture, and compatibility with cheek.In this study, the reconstruction in a 29-year-old male patient who had a full-thickness cheek defect due to tumor resection on the left side was performed, wherein a hairless skin island was carried through the frontal branch of superficial temporal artery for oral mucosa, and a hairy skin island through the parietal branch of the same pedicle was carried for the bearded skin defect. No complication occurred postoperatively and both aesthetic and functional satisfactory results were obtained, providing the oral mucosal and natural beard integrity. Donor-site scarring and temporal alopecia were recorded as the disadvantages of this method.This technique is a useful method for the reconstruction of full-thickness cheek defects because of its advantages including compatibility of color and texture, reliable blood supply, requiring single-session procedure, and being able to carry 2 different skin islands on the same pedicle.

  7. Diagnostic accuracy of laser Doppler imaging in burn depth assessment: Systematic review and meta-analysis.

    Science.gov (United States)

    Shin, Jin Yong; Yi, Hyung Suk

    2016-11-01

    Accurate assessment of burn depth is important for determination of treatment modality. Laser Doppler imaging (LDI) is known to be an objective and effective measurement tool in burn depth assessment. Our study evaluated the diagnostic accuracy of LDI across enrolled studies and subgroups. A systematic literature review and meta-analysis were performed using MEDLINE, EMBASE, and Cochrane databases. Data from LDI cases were extracted from all primary studies and categorized into four cell values (true positives, false positives, true negatives, and false negatives). Subgroup analyses were performed according to perfusion units of LDI, clinical criteria of superficial and deep burns during the treatment period, and publication date of enrolled studies. The search strategy identified 321 publications. After screening, 10 articles were selected for review. The pooled sensitivity and specificity of LDI in all enrolled studies and subgroups were found to be similarly high. However, the sensitivity of LDI in our meta-analysis was not as high as that identified in previous studies. Although LDI in burn depth assessment was identified as an accurate measurement tool in this meta-analysis, careful clinical assessment should be performed along with LDI in patients with deep burns. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  8. Human Amniotic Membrane Dressing: an Excellent Method for Outpatient Management of Burn Wounds

    Directory of Open Access Journals (Sweden)

    Ali Akbar Mohammadi

    2009-03-01

    Full Text Available Background: Burns are among the most common traumas indeveloping countries, which consume large amounts of medicalresources. It is important to find an appropriate materialfor dressing of burn wounds that improves healing and is readilyavailable, easily applicable, and economical.Methods: In a single-blind randomized controlled clinicaltrial from March to October 2006, 211 patients with less than20% burn were enrolled into two groups. The first group contained104 patients with average burn of 11.90± 3.80% of totalbody surface area (TBSA for whom amnion dressing wasused. The second group composed of 107 patients with averageburn of 12.30± 4.14% of TBSA treated with routine silversulfadiazine dressing.Results: Amniotic membrane usage was accompanied by accelerationin wound healing, less need for skin graft, and lesspain. The mean healing time in superficial parts of burnwounds in the amnion group was significantly shorter than thecontrol group (9.50±2.13 v 14.30±2.60 days; P value < 0.01.The extent of the wound with granulation tissue which neededskin graft was less in the amnion group (2.10 ± 2.21% v 4.20±1.44%; P value < 0.01.Conclusion: Widespread use of amniotic membrane dressingis recommended for limited burn wound management.

  9. Hair dryer burns in children.

    Science.gov (United States)

    Prescott, P R

    1990-11-01

    Three children with burn injuries caused by home hair dryers are described. In one patient the injury was believed to be accidental, and in the other two cases the injuries were deliberately caused by a caretaker. The lack of prior experience with hair dryer burns initially led to suspicion of other causes. The characteristics of each case aided in the final determination of accidental vs nonaccidental injury. These cases prompted testing of home hair dryers to determine their heat output. At the highest heat settings, the dryers rapidly generated temperatures in excess of 110 degrees C. After the dryers were turned off, the protective grills maintained sufficient temperatures to cause full-thickness burns for up to 2 minutes. These cases and the results of testing demonstrate that hair dryers must be added to the list of known causes of accidental and nonaccidental burns in children.

  10. The Burning Truth(s)

    African Journals Online (AJOL)

    The pathophysiology caused by a severe burn is complicated and involves changes in all ... The interstitial pressure and intravascular oncotic pressures decrease while the ... South African Family Practice 2014; 56(6):24-26. Open Access ...

  11. Chemistry of Cigarette Burning Processes

    Directory of Open Access Journals (Sweden)

    Chen P

    2014-12-01

    Full Text Available Cigarette-burning and the smoke-formation processes and smoke composition are important topics for understanding cigarette performance. This paper proposes the molecular formulas representing the active components of bright, burley, and Oriental tobaccos and a basic chemistry model of the cigarette burning processes. Previous knowledge of the cigarette burning processes and smoke formation helped to establish parameters in deriving the basic chemistry equations. The proposed chemistry provides a brief view of the mechanisms of the cigarette burning during puffing and interpuff smoldering, and can be used to interpret and predict the smoke composition for cigarettes made from bright, burley, and Oriental tobaccos. Based on the proposed chemistry, the effect of ventilation on smoke component deliveries is discussed and the reaction heat of the puffing process is estimated.

  12. Burns, hypertrophic scar and galactorrhea.

    Science.gov (United States)

    Karimi, Hamid; Nourizad, Samad; Momeni, Mahnoush; Rahbar, Hosein; Momeni, Mazdak; Farhadi, Khosro

    2013-07-01

    An 18-year-old woman was admitted to Motahari Burn Center suffering from 30% burns. Treatment modalities were carried out for the patient and she was discharged after 20 days. Three to four months later she developed hypertrophic scar on her chest and upper limbs. At the same time she developed galactorrhea in both breasts and had a disturbed menstrual cycle four months post-burn. On investigation, we found hyperprolactinemia and no other reasons for the high level of prolactin were detected.She received treatment for both the hypertrophic scar and the severe itching she was experiencing. After seven months, her prolactin level had decreased but had not returned to the normal level. It seems that refractory hypertrophic scar is related to the high level of prolactin in burns patients.

  13. Burns, hypertrophic scar and galactorrhea

    Directory of Open Access Journals (Sweden)

    Hamid Karimi

    2013-07-01

    Full Text Available An 18-year old woman was admitted to Motahari Burn Center suffering from 30% burns. Treatment modalities were carried out for the patient and she was discharged after 20 days. Three to four months later she developed hypertrophic scar on her chest and upper limbs .At the same time she developed galactorrhea in both breasts and had a disturbed menstrual cycle four months post-burn. On investigation, we found hyperprolactinemia and no other reasons for the high level of prolactin were detected. She received treatment for both the hypertrophic scar and the severe itching she was experiencing. After seven months, her prolactin level had decreased but had not returned to the normal level. It seems that refractory hypertrophic scar is related to the high level of prolactin in burns patients.

  14. Regimes Of Helium Burning

    CERN Document Server

    Timmes, F X

    2000-01-01

    The burning regimes encountered by laminar deflagrations and ZND detonations propagating through helium-rich compositions in the presence of buoyancy-driven turbulence are analyzed. Particular attention is given to models of X-ray bursts which start with a thermonuclear runaway on the surface of a neutron star, and the thin shell helium instability of intermediate-mass stars. In the X-ray burst case, turbulent deflagrations propagating in the lateral or radial directions encounter a transition from the distributed regime to the flamlet regime at a density of 10^8 g cm^{-3}. In the radial direction, the purely laminar deflagration width is larger than the pressure scale height for densities smaller than 10^6 g cm^{-3}. Self-sustained laminar deflagrations travelling in the radial direction cannot exist below this density. Similarily, the planar ZND detonation width becomes larger than the pressure scale height at 10^7 g cm^{-3}, suggesting that a steady-state, self-sustained detonations cannot come into exista...

  15. Corneal Protection for Burn Patients

    Science.gov (United States)

    2014-11-01

    Amniotic Membrane for the Treatment of Severe Exposure Keratopathy in the New Zealand White Rabbit Introduction: Patients with severe facial burns...often suffer indirect damage to their eyes as a sequela of ocular surface exposure keratopathy. Burn wound contracture of the periocular skin causes...inflammatory properties, amniotic membrane has developed into a mainstay of treatment to help maintain the ocular surface when skin grafting is delayed

  16. Treatment of Palm Burns in Children

    OpenAIRE

    Argirova, M.; Hadzhiyski, O.

    2005-01-01

    The timing and methods of treatment of palm burns in children vary widely. From January 2002 to November 2004, 492 children with burns - 125 of them with hand burns or other body burns - were hospitalized and treated at the N.I. Pirogov Clinic for Burns and Plastic Surgery in Bulgaria. Fifty-four children (for a total of 73 burned hands) presented isolated palm burns.Twenty-two hands were operated on. In this review we present the incidence, causes, treatment methods, functional results, and ...

  17. Chemical and Common Burns in Children.

    Science.gov (United States)

    Yin, Shan

    2017-05-01

    Burns are a common cause of preventable morbidity and mortality in children. Thermal and chemical burns are the most common types of burns. Their clinical appearance can be similar and the treatment is largely similar. Thermal burns in children occur primarily after exposure to a hot surface or liquid, or contact with fire. Burns are typically classified based on the depth and total body surface area, and the severity and onset of the burn can also depend on the temperature and duration of contact. Chemical burns are caused by chemicals-most commonly acids and alkalis-that can damage the skin on contact. In children, the most common cause of chemical burns is from household products such as toilet bowl cleaners, drain cleaners, detergents, and bleaches. Mild chemical burns generally cause redness and pain and can look similar to other common rashes or skin infections, whereas severe chemical burns are more extreme and may cause redness, blistering, skin peeling, and swelling.

  18. Burn treatment in the elderly.

    Science.gov (United States)

    Keck, M; Lumenta, D B; Andel, H; Kamolz, L P; Frey, M

    2009-12-01

    The population of elderly patients is expected to rise continuously over the next decades due to global demographic changes. The elderly seem to be most vulnerable to burns and their management remains undoubtedly a challenge. A clear age margin for elderly patients is not yet defined, but most studies adhere to the inclusion of patients 65 years and above, but the general condition and social situation must be taken into account. The understanding of the physiological basis of aging and its related pathophysiological changes has only marginally influenced treatment and decision making in elderly burn patients. When looking at treatment regimens currently applied in elderly burn patients, the discussion of standards in intensive care as well as surgical strategies is ongoing. However, trends towards a moderate, non-aggressive resuscitation approach and careful inclusion of key parameters like physiological age, pre-burn functional status and premorbid conditions, seem to be useful guidelines for interdisciplinary treatment decisions. Once ordered for surgical treatment, the amount of body surface area operated in one session should be adapted to the general status of the patient. Even if older burn victims have a reported higher mortality rate than younger patients, improved therapeutic options have contributed to a reduced mortality rate even in the elderly over the last decades. As a result of improved outcome, more attention has to be given to a comprehensive rehabilitation program. This review will give an overview of the current literature and will draw attention to specific topics related to this important subpopulation of burn patients.

  19. Erosive burning of solid propellants

    Science.gov (United States)

    King, Merrill K.

    1993-01-01

    Presented here is a review of the experimental and modeling work concerning erosive burning of solid propellants (augmentation of burning rate by flow of product gases across a burning surface). A brief introduction describes the motor design problems caused by this phenomenon, particularly for low port/throat area ratio motors and nozzleless motors. Various experimental techniques for measuring crossflow sensitivity of solid propellant burning rates are described, with the conclusion that accurate simulation of the flow, including upstream flow development, in actual motors is important since the degree of erosive burning depends not only on local mean crossflow velocity and propellant nature, but also upon this upstream development. In the modeling area, a brief review of simplified models and correlating equations is presented, followed by a description of more complex numerical analysis models. Both composite and double-base propellant models are reviewed. A second generation composite model is shown to give good agreement with data obtained in a series of tests in which composite propellant composition and heterogeneity (particle size distribution) were systematically varied. Finally, the use of numerical models for the development of erosive burning correlations is described, and a brief discussion of scaling is presented.

  20. DIFFERENTIATING PERIMORTEM AND POSTMORTEM BURNING

    Directory of Open Access Journals (Sweden)

    Brahmaji Master

    2015-01-01

    Full Text Available One of the most challenging cases in forensic medicine is ascertaining the cause of death of burnt bodies under suspicious circumstances. The key questions that arise at the time of investigation include: 1  Was the person alive or dead prior to fire accident?  Did the victim die because of burn?  If death was not related to burns, could burns play a role in causing death?  Were the burns sustained accidentally, did the person commit suicide or was the person murdered?  Are the circumstances suggesting an attempt to conceal crime?  How was the fire started?  How was the victim identified?  In case of mass fatalities, who died first? Postmortem burning of corpses is supposed to be one of the ways to hide a crime. Differentiating the actual cause of death in burn patients is therefore important. Medical examiners usually focus on the defining the changes that occur in tissues while forensic anthropologists deal with the changes related to the bone with or without any the influence of other tissues. Under the circumstances of fire, differentiating the perimortem trauma from that of postmortem cause of bone fractures is vital in determining the cause and motive of death

  1. Iron metabolism in burned children.

    Science.gov (United States)

    Belmonte, J A; Ibáñez, L; Ras, M R; Aulesa, C; Vinzo, J; Iglesias, J; Carol, J

    1999-07-01

    The administration of iron supplementation in children with burns has been a subject of controversy. Recent studies argue against its use in the acute phase of stress. To assess whether iron metabolism parameters show significant differences in the acute phase and the recovery phase of burn, 21 patients (age range: 17 months to 13 years) with burns of more than 10% of body surface who had not received blood transfusions or iron supplementation were studied. Sideraemia, ferritin, transferrin, transferrin saturation index (TSI) and C-reactive protein (CRP) were assessed both in the acute and the recovery phase after burn. Sideraemia, transferrin, and TSI were significantly lower in the acute than in the recovery phase (17.3 +/- 3 vs 53.8 +/- 6.6 microg/dL, 190.5 +/- 15 vs 287.9 +/- 14.3 mg/dL and 7.7 +/- 1.3 vs 15.4 +/- 1.6%, P 1.5 vs 0.7 +/- 0.2 mg/dL, P = 0.016 and P 2 years), the observed differences persisted. Hyposideraemia is a frequent finding in the acute phase of paediatric burns and is accompanied by increased ferritin levels and decreased transferrin concentrations. The low iron values tend to recover without the use of iron supplementation suggesting an endogenous block of iron release in the acute phase and indicates that iron therapy should be not recommended in the initial period of stress of the burned patient.

  2. A combined chemo-mechanical approach for aesthetic management of superficial enamel defects

    NARCIS (Netherlands)

    Ardu, S.; Benbachir, N.; Stavridakis, M.; Dietschi, D.L.; Krejci, I.; Feilzer, A.J.

    2009-01-01

    Objective The aim of this article is to describe an easy technique for managing small superficial defects in light to medium fluorosis. Method and materials The proposed technique is based on a selective abrasion of the superficial enamel and a recreation of the superficial macro and micro morpholog

  3. A combined chemo-mechanical approach for aesthetic management of superficial enamel defects

    NARCIS (Netherlands)

    Ardu, S.; Benbachir, N.; Stavridakis, M.; Dietschi, D.L.; Krejci, I.; Feilzer, A.J.

    2009-01-01

    Objective The aim of this article is to describe an easy technique for managing small superficial defects in light to medium fluorosis. Method and materials The proposed technique is based on a selective abrasion of the superficial enamel and a recreation of the superficial macro and micro morpholog

  4. Rugosidad y textura de superficies: experimentos y simulaciones

    Directory of Open Access Journals (Sweden)

    Watson L. Vargas

    2006-01-01

    Full Text Available En este trabajo se aplican algunos elementos de la geometría fractal al estudio y caracterización de la rugosidad superficial. Los materiales bajo estudio consisten en agregados naturales, de amplia aplicación en la industria de la construcción. Se aplican tanto técnicas experimentales basadas en análisis de imágenes como modelos teóricos. En particular se explora el potencial de la lacunaridad –un método de análisis derivado de la geometría fractal, para describir patrones y dispersión espacial. Los resultados ilustran su aplicación en la caracterización de rugosidad superficial. Se discuten igualmente, limitaciones y ventajas de esta aproximación.

  5. Effects of superficial gas velocity on process dynamics in bioreactors

    Science.gov (United States)

    Devi, T. T.; Kumar, B.

    2014-06-01

    Present work analyzes the flow hydrodynamics and mass transfer mechanisms in double Rushton and CD-6 impeller on wide range (0.0075-0.25 m/s) of superficial gas velocity ( v g) in a gas-liquid phase bioreactor by employing computational fluid dynamics (CFD) technique. The volume averaged velocity magnitude and dissipation rate are found higher with increasing superficial gas velocity. Higher relative power draw ( P g/ P 0) is predicted in CD-6 than the Rushton impeller but no significant difference in volume averaged mass transfer coefficient ( k L a) observed between these two types of impeller. The ratio of power draw with mass transfer coefficient has been found higher in CD-6 impeller (25-50 %) than the Rushton impeller.

  6. Variation in the Branching Pattern of the Superficial Palmar Arch

    Directory of Open Access Journals (Sweden)

    Sumalatha S

    2016-05-01

    Full Text Available In this article we describe a rare variation in the superficial palmar arch (SPA encountered during routine cadaveric dissection. SPA was formed by the superficial branches of ulnar and radial arteries which provided a proper digital branch to the ulnar side of the little finger and three common palmar digital branches to the medial four digits. Additionally a first common digital artery was seen to emerge from the radial side of SPA which further divided into the arteria princeps pollicis and arteria radialis indicis. We also found a small communicating branch between the arteria princeps pollicis and the radial artery in the anatomical snuff box. Such arterial variations in the palm due to alteration in the developmental sequence remains a crucial issue in the reconstructive hand surgeries, especially while dealing with the innovative microsurgical procedures, where these varied patterns act as pivotal points around which successful results of various advanced surgical procedures revolve.

  7. Movimiento superficial del glaciar rocoso de las Argualas

    Directory of Open Access Journals (Sweden)

    Sanjosé, J. J.

    1995-12-01

    Full Text Available At present the Argualas rock glacier is active and it flows to a surface axial mean velocity of 22,3 cm/year. The flow velocities have been determinated by surveying techniques made between 1991 and 1994. This technic complements the geomorphological observations and deepens in the knov/ledge of the glacier surface dynamics.

    El glaciar rocoso de las Argualas es activo en la actualidad y fluye a una velocidad media axial en superficie de 22.3 cm/año. El flujo se ha determinado median te las técnicas de auscultación topográfica realizadas entre los años 1991 y 1994. Esta técnica ha permitido complementar el análisis geomorfológico, profundizado en el estudio de la dinámica superficial del glaciar.

  8. Endoscopic removal or ablation of oesophageal and gastric superficial tumours.

    Science.gov (United States)

    Deprez, P H; Aouattah, T; Piessevaux, H

    2006-01-01

    Endoscopic mucosal resection was developed in Eastern countries as a curative treatment for superficial carcinomas in the stomach and oesophagus. Experience in Western countries is more recent and limited due to less frequent diagnosis of early gastric cancers compared to the Japanese and Korean populations and to more frequent use of ablation techniques such as argon plasma coagulation and photodynamic therapy in pre-neoplastic lesions and superficial tumours. This review summarizes the respective indications, advantages, disadvantages, limitations and complications of the different ablative and resection techniques in the upper gastrointestinal tract. Several methods are described such as electrocoagulation, argon plasma coagulation, photodynamic therapy, lift and cut resection, cap assisted aspiration and band ligation mucosectomy, and endoscopic submucosal dissection. Local results in more than 170 patients managed with endoscopic resection of oesophageal high grade dysplasia or squamous cell carcinoma and gastric or Barrett's epithelium high grade dysplasia or adenocarcinoma furthermore demonstrate the safety and effectiveness of endoscopic resection practiced in experienced centres.

  9. Causative agents of superficial mycoses in Istanbul, Turkey: retrospective study.

    Science.gov (United States)

    Koksal, Fatma; Er, Emine; Samasti, Mustafa

    2009-09-01

    The aim of the present study was to determine the percentage of agents, which can give rise to superficial fungal infections in Istanbul, Turkey. Between 2000 and 2007, the clinical samples collected from 8,200 patients attending the outpatient Dermatology Clinic at Mihrimahsultan Medical Center were examined by direct microscopy and culture. Pathogen fungi were detected in 5,722 of the patients. Of the isolates were 4,218 (74%) dermatophytes, 1,196 (21%) Candida sp., 170 (3%) Malassezia furfur, and 138 (2%) Trichosporon sp. Among the dermatophytes, Trichophyton sp. was the most common isolate followed by Epidermophyton floccosum (243) and Microsporum sp. Among the Candida species, C. albicans (549) was also frequently found. Onychomycosis was the most prevalent type of infection, followed by tinea pedis, tinea cruris, tinea corporis, and tinea capitis. In conclusion, our study showed that the most common isolated agents from superficial infections were T. rubrum being Candida sp. the second most prevalent.

  10. Burn Injury Arise From Flying Balloon Toys

    OpenAIRE

    Yalcin Kulahci; Fatih Zor; Mehmet Bozkurt; Serdar Ozturk; Mustafa Sengezer

    2007-01-01

    Many of peoples are faced minor or major burn injuries in their life. Even the most widespread burn cause is flame injuries, too different burn cause pointed out in literature like Acetylen burns. The cases which imply in literature, mostly causes from explosion of high pressure acetylene tube, metal oxygene patch flame or carbide lamp using from cave explorers. An interesting acetylene burn cause in Turkey was publised by the authors. This cases was to come into being from flying toy balloon...

  11. Measurement of the angle of superficial tension by images

    Science.gov (United States)

    Yanez M., Javier; Alonso R., Sergio

    2006-02-01

    When a liquid is deposited on a surface, this one form a certain angle with respect to the surface, where depending on its value, it will conclude that so hard it is his adhesion with the surface. By means of the analysis of images we looked for to measure this angle of superficial tension. In order to make this measurement, we propose a technique by means of projective transformations and one method of regression to estimation parameters to conic fitting.

  12. Cervical Spinal Meningeal Melanocytoma Presenting as Intracranial Superficial Siderosis

    Directory of Open Access Journals (Sweden)

    Savitha Srirama Jayamma

    2015-01-01

    Full Text Available Meningeal melanocytoma is a rare pigmented tumor of the leptomeningeal melanocytes. This rare entity results in diagnostic difficulty in imaging unless clinical and histopathology correlation is performed. In this case report, we describe a case of meningeal melanocytoma of the cervical region presenting with superficial siderosis. Extensive neuroradiological examination is necessary to locate the source of the bleeding in such patients. Usually, the patient will be cured by the complete surgical excision of the lesion.

  13. Superficial urinary bladder tumors treatment results: A 10-year experience

    Directory of Open Access Journals (Sweden)

    Stanković Jablan

    2007-01-01

    Full Text Available Background/Aim. The most common urinary bladder tumors are superficial tumors. Due to their tension to relapse and progress towards deeper layers after surgical therapy, an adequate therapy significantly contributed to the improvement of the results of urinary bladder tumors treatment. Staging and gradus of the tumor, presence of the carcinoma in situ (CIS or relapses significantly influenced the choice of the therapy. The aim of this study was to ascertain the effectiveness of the intravesicelly applied BCG (Bacille Colmette - Guerin vaccine or chemiotherapy in the prevention of the relapses and further progression of superficial urinary bladder tumors. Methods. All of the diagnosed superficial tumors of bladder were removed by transurethral resection (TUR. After receiving the patohistological finding they were subjected to adjuvant therapy, immune BCG vaccine or chemiotherapy (epirubicin, doxorubicin, mitomycin-C. The third group did not accept adjuvant therapy, but had regularly scheduled cystoscopic controls. The appearance of relapses, progression of stage and grades of the tumor, as well as possible unwanted effects of adjuvant therapy were registered. Results. The applied immunotherapy (BCG influenced decreased tumor relapses (7% and statistically important difference between patients who had taken adjuvant chemotherapy (relapses 18.4% and those without this therapy was acknowledged. Grades of tumor did not show statistically significant difference on tumor relapse. A significantly longer period of time in the appearance of tumor relapse after BCG (29.33 months, had significant importance comparing to chemio (9.44 months or non-taken adjuvant therapy (9.84 months. Very small number of unwanted effects suggested an obligatory undertaking adjuvant therapy after TUR of superficial tumors. Conclusion. A significant decrease of relapses as well as avoidance of further progression of urinary bladder tumors, has introduced adjuvant therapy in

  14. Transient superficial peroneal nerve palsy after anterior cruciate ligament reconstruction

    OpenAIRE

    Majed Alrowaili

    2016-01-01

    A 19-year-old male subject was diagnosed with medial meniscal, lateral meniscal and anterior cruciate ligament (ACL) tear. The symptoms did not subside after 4 months of physical therapy, and he underwent arthroscopic partial medial and lateral meniscectomy and ACL reconstruction. Immediately after the patient woke up from general anesthesia, he started experience loss of sensation in the area of superficial peroneal nerve with inverted dorsiflexion of foot and ankle. Instantly, the bandage a...

  15. Differences in excitability between median and superficial radial sensory axons.

    Science.gov (United States)

    Fujimaki, Yumi; Kanai, Kazuaki; Misawa, Sonoko; Shibuya, Kazumoto; Isose, Sagiri; Nasu, Saiko; Sekiguchi, Yukari; Ohmori, Shigeki; Noto, Yu-ichi; Kugio, Yumiko; Shimizu, Toshio; Matsubara, Shiro; Lin, Cindy S Y; Kuwabara, Satoshi

    2012-07-01

    The aim of this study was to investigate differences in excitability properties of human median and superficial radial sensory axons (e.g., axons innervating the glabrous and hairy skin in the hand). Previous studies have shown that excitability properties differ between motor and sensory axons, and even among sensory axons between median and sural sensory axons. In 21 healthy subjects, threshold tracking was used to examine excitability indices such as strength-duration time constant, threshold electrotonus, supernormality, and threshold change at the 0.2 ms inter-stimulus interval in latent addition. In addition, threshold changes induced by ischemia for 10 min were compared between median and superficial radial sensory axons. Compared with radial sensory axons, median axons showed shorter strength-duration time constant, greater threshold changes in threshold electrotonus (fanning-out), greater supernormality, and smaller threshold changes in latent addition. Threshold changes in both during and after ischemia were greater for median axons. These findings suggest that membrane potential in human median sensory axons is more negative than in superficial radial axons, possibly due to greater activity of electrogenic Na(+)/K(+) pump. These results may reflect adaptation to impulses load carried by median axons that would be far greater with a higher frequency. Biophysical properties are not identical in different human sensory axons, and therefore their responses to disease may differ. Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  16. Glans-preserving surgery for superficial penile cancer.

    Science.gov (United States)

    Li, Pengchao; Song, Ninghong; Yin, Changjun; Zhang, Wei; Li, Jie; Hua, Lixin; Wang, Zengjun; Cheng, Gong

    2012-01-01

    In this study, we investigated the safety and feasibility of glans-preserving surgery for superficial penile squamous cell carcinoma. Young patients with penile primary tumors exhibiting favorable histologic features were best suited for organ-sparing procedures, enabling them to avoid sexual disturbances. The study included 12 patients, 38-53 years of age (median age 46 years), with superficial lesions involving the glans penis, coronary sulcus, or shaft skin. After clinical staging and grading, those patients were offered a glans-preserving procedure to preserve the normal appearance and functional integrity of the glans penis. Of the 12 patients referred, the tumors were TaG1 in 4 patients, TaG2 in 3, TisG1 in 1, TisG2 in 1, T1G1 in 2, and T1G2 in 1. All patients returned to normal sexual activity 1 month postoperatively. Sexual function and sexual satisfaction were well maintained after surgery. The cosmetic results were considered satisfying/very satisfying by 83% (10 of 12 patients). Follow-up data were available on 12 patients at a mean follow-up of 62.5 months. Only 1 patient had recurrence 6 months after surgery, which was managed by a second glans-preserving surgery without recurrence. With careful patient selection and vigilant follow-up, anatomically suitable superficial penile cancer can be offered this glans-preserving surgery, while preserving function of the penis wherever possible.

  17. A Study of Superficial Mycosis in South Gujarat Region

    Directory of Open Access Journals (Sweden)

    Parul Patel, Summaiya Mulla, Disha Patel, Gaurishankar Shrimali

    2010-12-01

    Full Text Available Aim: To know the seroprevalence of clinical pattern of dermatophytosis and non – dermatophytic fungi (superficial mycosis with most common fungal pathogen in the South Gujarat region of the India. Methods: A clinical and mycological study of superficial mycosis was conducted on 198 cases (127 male and 71 female. Direct microscopy by KOH mount and culture was undertaken to isolate the fungal pathogen in each case. Results: 123 out of 198 cases (62.12% were positive by direct microscopy in which 58 (29.29% were positive by culture. The commonest age group involved was 21 – 30 years. Tinea corporis was the most common clinical presentation and Trichopyton rubrum was the most common fungal pathogen isolated. Non dermatophytic fungus like pityriasis versicolor and yeast like candida species were isolated in 17(22.67% cased and 8 (10.67% cases respectively. Conclusion: It was concluded that along with dermatophytes, nondermatophytic fungi are also emerging as important causes of superficial mycosis.

  18. Pattern of childhood burn injuries and their management outcome at Bugando Medical Centre in Northwestern Tanzania

    Directory of Open Access Journals (Sweden)

    Chalya Phillipo L

    2011-11-01

    Full Text Available Abstract Background Burn injuries constitute a major public health problem and are the leading cause of childhood morbidity and mortality worldwide. There is paucity of published data on childhood burn injuries in Tanzania, particularly the study area. This study was conducted to describe the pattern of childhood burn injuries in our local setting and to evaluate their management outcome. Methods A cross sectional study was conducted at Bugando Medical Centre (in Northwestern Tanzania over a 3-year period from January 2008 to December 2010. Data was collected using a pre-tested coded questionnaire and statistical analyses performed using SPSS software version 15.0. Results A total of 342 burned children were studied. Males were mainly affected. Children aged = 2 were the majority accounting for 45.9% of cases. Intentional burn injuries due to child abuse were reported in 2.9% of cases. Scald was the most common type of burns (56.1%. The trunk was the most commonly involved body region (57.3%. Majority of patients (48.0% sustained superficial burns. Eight (2.3% patients were HIV positive. Most patients (89.8% presented to the hospital later than 24 h. The rate of burn wound infection on admission and on 10th day were 32.4% and 39.8% respectively.Staphylococcus aureus were more common on admission wound swabs, with Pseudomonas aeruginosa becoming more evident after 10th day. MRSA was detected in 19.2% of Staphylococcus aureus. Conservative treatment was performed in 87.1% of cases. Surgical treatment mainly skin grafting (65.9% was performed in 44 (12.9% of patients. The overall average of the length of hospital stay (LOS was 22.12 ± 16.62 days. Mortality rate was 11.7%. Using multivariate logistic regression analysis; age of the patient, type of burn, delayed presentation, clothing ignition, %TBSA and severity of burn were found to be significantly associated with LOS (P P Conclusion Childhood burn injuries still remain a menace in our

  19. Caracterización físico-química de la superficie de 9 implantes dentales con 3 distintos tratamientos de superficie

    OpenAIRE

    Rodríguez Rius, Daniel; García Sabán, Francisco

    2005-01-01

    Existen diversos tratamientos de superficie aplicados a los implantes dentales. El objetivo del presente estudio es comparar las características físico-químicas de la superficie de implantes dentales de titanio sometidos a diversos tratamientos de superficie. 9 implantes dentales procedentes del mismo lote de fabricación fueron separados en 3 grupos y sometidos a 3 tipos de tratamiento de superficie diferentes: mecanizado, grabado ácido y un ataque químico denominado Avan...

  20. Tweens feel the burn: "salt and ice challenge" burns.

    Science.gov (United States)

    Roussel, Lauren O; Bell, Derek E

    2016-05-01

    To review our institution's experience with frostbite injury secondary to "salt and ice challenge" (SIC) participation. We conducted a retrospective analysis of intentional freezing burns from 2012 to 2014. Demographics, depth and location of burn, total body surface area of burn, treatment, time to wound healing, length of stay, complications, and motives behind participation were analyzed. Five patients were seen in the emergency department for intentional freezing burns that resulted from SIC (all females; mean age: 12.3 years; range age: 10.0-13.2 years). Mean total body surface area was 0.408%. Salt and ice was in contact with skin for >10 min for two patients, >20 min for two patients, and an unknown duration for one patient. Complications included pain and burn scar dyschromia. Four patients cited peer pressure and desire to replicate SIC as seen on the Internet as their motivation in attempting the challenge. SIC has become a popular, self-harming behavior among youths. Increased public education, and provider and parent awareness of SIC are essential to address this public health concern.

  1. Surgical management of burn flexion and extension contractures of the toes.

    Science.gov (United States)

    Chang, Jessica B; Kung, Theodore A; Levi, Benjamin; Irwin, Todd; Kadakia, Anish; Cederna, Paul S

    2014-01-01

    Burn contracture of the toes is a devastating sequela of thermal injury to the foot. Without proper treatment of toe burn contractures, patients suffer from significant functional and social limitations, including difficulties with activities of daily living. The authors classify the severity of toe burn scar contractures (TBSCs) by considering important characteristics of the deformity and tailor definitive surgical treatment based on the individual needs of the patient's condition. A retrospective review was performed on 20 patients who underwent a total of 32 reconstructive operations involving 275 TBSC procedures from 2000 to 2010. Multiple clinical, functional, and anatomic criteria were used to describe each patient's contracture as mild, moderate, or severe. Mild TBSC involved scarring of the superficial tissues only with no functional impairment; these were treated with scar release or local tissue rearrangement. Moderate TBSC involved soft tissue shortages requiring skin grafts and occasional closed joint capsulotomy. Severe TBSC caused the greatest impairment in function and involved burn injury to deeper structures. For these difficult contractures, a patient-specific technique was paramount to optimal reconstruction. There were six, three, and 11 patients with mild, moderate, and severe TBSC, respectively. The mean number of primary procedures per toe increased with increasing burn complexity from 1.1 procedures for mild, 1.5 for moderate, and 1.8 for severe groups, with severe TBSC undergoing more primary procedures overall (13.7 in severe vs 2.8 in mild TBSC). Complication rates per toe were highest for severe TBSC (59.0%). Only severe TBSC received secondary operations, and overall contracture recurrence was 35%. An individualized surgical approach based on TBSC severity is recommended for addressing burn contracture of the toes. Careful analysis of the clinical, functional, and anatomic characteristics of the burned foot determines the severity of

  2. Burn Patient Expectations from Nurses

    Directory of Open Access Journals (Sweden)

    Sibel Yilmaz sahin

    2014-02-01

    Full Text Available AIM: Burn is a kind of painful trauma that requires a long period of treatment and also changes patients body image. For this reason, nursing care of burn patients is very important. In this study in order to provide qualified care to the burned patients, patient and #8217;s expectations from nurses were aimed to be established. METHODS: Patients and #8217; expectations were evaluated on 101 patients with burn in Ministry of Health Ankara Numune Education and Research Hospital Burn Service and Gulhane Military Medical Academy Education and Research Hospital Burn Center. A questionnaire which was developed by the researchers was used for collecting data. The questions on the questionnaire were classified into four groups to evaluate the patients and #8217; expectations about communication, information, care and discharge. Data was evaluated by using SPSS 12 package software. RESULTS: In this study, 48.5% of patients were at 18-28 age group, 79.2% were male and 51.5% of patients were employed. Almost all of patients expect nurses to give them confidence (98% and to give them information about latest developments with the disease. Patients prior expectation from nurses about care was to do their treatments regularly (100% and to take the necessary precautions in order to prevent infection (100%. 97% of patient expect nurses to give them information about the drugs, materials and equipment that they are going to use while discharge. CONCLUSION: As a result we found that burn patient expectations from nurses about communication, information, care and discharge were high. [TAF Prev Med Bull 2014; 13(1.000: 37-46

  3. Harborview burns--1974 to 2009.

    Directory of Open Access Journals (Sweden)

    Loren H Engrav

    Full Text Available BACKGROUND: Burn demographics, prevention and care have changed considerably since the 1970s. The objectives were to 1 identify new and confirm previously described changes, 2 make comparisons to the American Burn Association National Burn Repository, 3 determine when the administration of fluids in excess of the Baxter formula began and to identify potential causes, and 4 model mortality over time, during a 36-year period (1974-2009 at the Harborview Burn Center in Seattle, WA, USA. METHODS AND FINDINGS: 14,266 consecutive admissions were analyzed in five-year periods and many parameters compared to the National Burn Repository. Fluid resuscitation was compared in five-year periods from 1974 to 2009. Mortality was modeled with the rBaux model. Many changes are highlighted at the end of the manuscript including 1 the large increase in numbers of total and short-stay admissions, 2 the decline in numbers of large burn injuries, 3 that unadjusted case fatality declined to the mid-1980s but has changed little during the past two decades, 4 that race/ethnicity and payer status disparity exists, and 5 that the trajectory to death changed with fewer deaths occurring after seven days post-injury. Administration of fluids in excess of the Baxter formula during resuscitation of uncomplicated injuries was evident at least by the early 1990s and has continued to the present; the cause is likely multifactorial but pre-hospital fluids, prophylactic tracheal intubation and opioids may be involved. CONCLUSIONS: 1 The dramatic changes include the rise in short-stay admissions; as a result, the model of burn care practiced since the 1970s is still required but is no longer sufficient. 2 Fluid administration in excess of the Baxter formula with uncomplicated injuries began at least two decades ago. 3 Unadjusted case fatality declined to ∼6% in the mid-1980s and changed little since then. The rBaux mortality model is quite accurate.

  4. Harborview burns--1974 to 2009.

    Science.gov (United States)

    Engrav, Loren H; Heimbach, David M; Rivara, Frederick P; Kerr, Kathleen F; Osler, Turner; Pham, Tam N; Sharar, Sam R; Esselman, Peter C; Bulger, Eileen M; Carrougher, Gretchen J; Honari, Shari; Gibran, Nicole S

    2012-01-01

    Burn demographics, prevention and care have changed considerably since the 1970s. The objectives were to 1) identify new and confirm previously described changes, 2) make comparisons to the American Burn Association National Burn Repository, 3) determine when the administration of fluids in excess of the Baxter formula began and to identify potential causes, and 4) model mortality over time, during a 36-year period (1974-2009) at the Harborview Burn Center in Seattle, WA, USA. 14,266 consecutive admissions were analyzed in five-year periods and many parameters compared to the National Burn Repository. Fluid resuscitation was compared in five-year periods from 1974 to 2009. Mortality was modeled with the rBaux model. Many changes are highlighted at the end of the manuscript including 1) the large increase in numbers of total and short-stay admissions, 2) the decline in numbers of large burn injuries, 3) that unadjusted case fatality declined to the mid-1980s but has changed little during the past two decades, 4) that race/ethnicity and payer status disparity exists, and 5) that the trajectory to death changed with fewer deaths occurring after seven days post-injury. Administration of fluids in excess of the Baxter formula during resuscitation of uncomplicated injuries was evident at least by the early 1990s and has continued to the present; the cause is likely multifactorial but pre-hospital fluids, prophylactic tracheal intubation and opioids may be involved. 1) The dramatic changes include the rise in short-stay admissions; as a result, the model of burn care practiced since the 1970s is still required but is no longer sufficient. 2) Fluid administration in excess of the Baxter formula with uncomplicated injuries began at least two decades ago. 3) Unadjusted case fatality declined to ∼6% in the mid-1980s and changed little since then. The rBaux mortality model is quite accurate.

  5. BCG and the treatment of superficial bladder cancer.

    Science.gov (United States)

    Moss, J T; Kadmon, D

    1991-12-01

    In this report, we review the evolution of bacillus Calmette-Guérin (BCG) immunotherapy as a legitimate form of treatment in superficial, nonmuscle-invasive bladder cancer. In the US, an estimated 45,000 new cases of bladder cancer are diagnosed each year and the annual death rate approaches 11,000. Approximately 70 percent of these cancers are superficial at the time of initial presentation. The treatment of superficial bladder cancer has three objectives: (1) eradication of existing disease, (2) prophylaxis against tumor recurrence, and (3) prevention of tumor progression (either muscular invasion, metastatic spread, or both). Cystectomy generally is reserved for muscle-invasive disease. Transurethral resection of the bladder tumor is the preferred initial therapy. Intravesical instillations of various chemotherapeutic agents following transurethral resection have been extensively investigated. Some of the common agents used include thiotepa, mitomycin, and doxorubicin. Despite such treatment efforts, however, over 40 percent of patients with superficial bladder cancer experience a recurrence of their tumor within three years. Approximately half of these recurrences either present as less-well-differentiated tumors or have already penetrated into the bladder musculature, metastasized, or both. Since Morales et al. first introduced intravesical BCG vaccine for prophylaxis as well as for treatment of superficial bladder tumors in 1976, support has grown rapidly for its use as an alternative to chemotherapy. When used with prophylactic intent following transurethral resection, recurrence rates are lower than those achieved with other agents. In addition, BCG is emerging as the consensus drug of choice for treating carcinoma in situ of the bladder. The mechanisms by which BCG exerts its antitumor activity remain largely unknown. BCG is thought to stimulate a localized, nonspecific inflammatory response that leads to subsequent shedding of tumor cells. A large body

  6. Superficial perineal leiomyosarcoma in an adolescent female and a review of the literature including vulvar leiomyosarcomas

    DEFF Research Database (Denmark)

    Grove, A; Backman Nøhr, S

    1992-01-01

    differentiated and showed immunoreactivity for alpha-smooth muscle actin and desmin. A review of the literature on superficial leiomyosarcomas indicates that superficial perineal leiomyosarcomas may be more aggressive than superficial leiomyosarcomas in general. As the presented tumour occurred in a female......Superficial perineal leiomyosarcomas are rare, with only three previously reported examples. We encountered a superficial (deep subcutaneous) perineal leiomyosarcoma in a 17-year-old female. At follow-up two years after a wide excision, there were no signs of recurrence. The tumour was well...

  7. [Effects of lappaconitine on pain and inflammatory response of severely burned rats and the mechanism].

    Science.gov (United States)

    Yang, C L; Wei, Z R; Zhang, T H; Zeng, X Q; Wu, B H

    2017-06-20

    Objective: To explore the effects of lappaconitine (LA) on pain and inflammatory response of severely burned rats and the mechanism. Methods: Forty SD rats were divided into healthy+ normal saline group, sham injury+ normal saline group, pure burn group, burn+ LA group, and healthy+ LA group according to the random number table (the same dividing method below), with 8 rats in each group. Rats in pure burn and burn+ LA groups were inflicted with about 32% total body surface area deep partial-thickness scald (hereinafter referred to as burn) on the back and right hind. Rats in sham injury+ normal saline group were sham injured. Rats in burn+ LA group were intraperitoneally injected with 1 g/L LA solution in the dosage of 4 mL/kg at 2.0 h before injury and post injury hour (PIH) 0 (immediately), 24.0, 48.0, and 72.0. Rats in healthy+ LA group were intraperitoneally injected with LA solution in the same dose at the same time points as above, and rats in healthy+ normal saline and sham injury+ normal saline groups were intraperitoneally injected with normal saline in the dose of 4 mL/kg at the same time points as above. At 1.5 h before injury and PIH 12.5, 24.5, 36.5, 48.5, and 72.5, the paw withdrawal mechanical threshold (PWMT) of injured rats was detected, and their pain behaviors were observed. The same observation and detection were conducted in rats without injury in the two groups at the same time points as above. Another 32 SD rats were divided into normal saline group, trinitrophenyl (TNP)-ATP group, minocyline group, pyridoxal-phosphate-6-azophenyl-2', 4'-disulfonic acid (PPADS) group, with 8 rats in each group, and all the rats were inflicted with the same burn injury as above. At PIH 48.0, rats in normal saline group were intrathecally injected with 10 μL normal saline; rats in TNP-ATP group were intrathecally injected with 10 μL TNP-ATP in the concentration of 30 nmol/μL; rats in minocyline group were intrathecally injected with 10 μL minocyline in the

  8. Outcomes of outpatient management of pediatric burns.

    Science.gov (United States)

    Brown, Matthew; Coffee, Tammy; Adenuga, Paul; Yowler, Charles J

    2014-01-01

    The literature surrounding pediatric burns has focused on inpatient management. The goal of this study is to characterize the population of burned children treated as outpatients and assess outcomes validating this method of burn care. A retrospective review of 953 patients treated the burn clinic and burn unit of a tertiary care center. Patient age, burn etiology, burn characteristics, burn mechanism, and referral pattern were recorded. The type of wound care and incidence of outcomes including subsequent hospital admission, infection, scarring, and surgery served as the primary outcome data. Eight hundred and thirty children were treated as outpatients with a mean time of 1.8 days for the evaluation of burn injury in our clinic. Scalds accounted for 53% of the burn mechanism, with burns to the hand/wrist being the most frequent area involved. The mean percentage of TBSA was 1.4% for the outpatient cohort and 8% for the inpatient cohort. Burns in the outpatient cohort healed with a mean time of 13.4 days. In the outpatient cohort, nine (1%) patients had subsequent admissions and three (0.4%) patients had concern for infection. Eight patients from the outpatient cohort were treated with excision and grafting. The vast majority of pediatric burns are small, although they may often involve more critical areas such as the face and hand. Outpatient wound care is an effective treatment strategy which results in low rates of complications and should become the standard of care for children with appropriate burn size and home support.

  9. LA50 in burn injuries.

    Science.gov (United States)

    Seyed-Forootan, K; Karimi, H; Motevalian, S A; Momeni, M; Safari, R; Ghadarjani, M

    2016-03-31

    Burn injuries put a huge financial burden on patients and healthcare systems. They are the 8th leading cause of mortality and the 13th most common cause of morbidity in our country. We used data from our Burn Registry Program to evaluate risk factors for mortality and lethal area fifty percent (LA50) in all burn patients admitted over two years. We used multiple logistic regressions to identify risk factors for mortality. LA50 is a reliable aggregate index for hospital care quality and a good measure for comparing results, also with those of other countries. 28,690 burn patients sought medical attention in the Emergency Department, and 1721 of them were admitted. Male to female ratio was 1,75:1. 514 patients were under 15 years old. Median age was 25 (range: 3 months - 93 years). Overall, probability of death was 8.4%. LA50 was 62.31% (CI 95%: 56.57-70.02) for patients aged 15 and over and 72.52% (CI 95%: 61.01-100) for those under 15. In the final model, we found that Adjusted OR was significant for age, female sex, TBSA and inhalation injury (P age and inhalation injury were the main risk factors for death. Authorities should pay special attention to these variables, especially in prevention programs, to reduce mortality and improve patient outcome. Children have better outcome than adults given equal burn size. Suicide rates are higher for women than men in our country.

  10. Topical management of facial burns.

    Science.gov (United States)

    Leon-Villapalos, Jorge; Jeschke, Marc G; Herndon, David N

    2008-11-01

    The face is the central point of the physical features of the human being. It transmits expressions and emotions, communicates feelings and allows for individual identity. It contains complex musculature and a pliable and unique skin envelope that reacts to the environment through a vast network of nerve endings. The face hosts vital areas that make phonation, feeding, and vision possible. Facial burns disrupt these anatomical and functional structures creating pain, deformity, swelling, and contractures that may lead to lasting physical and psychological sequelae. The management of facial burns may include operative and non-operative treatment or both, depending on the depth and extent of the burn. This paper intends to provide a review of the available options for topical management of facial burns. Topical agents will be defined as any agent applied to the surface of the skin that alters the outcome of the facial burn. Therefore, the classic concept of topical therapy will be expanded and developed within two major stages: acute and rehabilitation. Comparison of the effectiveness of the different treatments and relevant literature will be discussed.

  11. Telemedicine and burns: an overview.

    Science.gov (United States)

    Atiyeh, B; Dibo, S A; Janom, H H

    2014-06-30

    Access to specialized burn care is becoming more difficult and is being restricted by the decreasing number of specialized burn centers. It is also limited by distance and resources for many patients, particularly those living in poverty or in rural medically underserved communities. Telemedicine is a rapidly evolving technology related to the practice of medicine at a distance through rapid access to remote medical expertise by telecommunication and information technologies. Feasibility of telemedicine in burn care has been demonstrated by various centers. Its use facilitates the delivery of care to patients with burn injuries of all sizes. It allows delivery of acute care and can be appropriately used for a substantial portion of the long-term management of patients after a burn by guiding less-experienced surgeons to treat and follow-up patients more appropriately. Most importantly, it allows better effective triage which reduces unnecessary time and resource demanding referrals that might overwhelm system capacities. However, there are still numerous barriers to the implementation of telemedicine, including technical difficulties, legal uncertainties, limited financial support, reimbursement issues, and an inadequate evidence base of its value and efficiency.

  12. Quantitative long term measurements of burns in a rat model using spatial frequency domain imaging and laser speckle imaging (Conference Presentation)

    Science.gov (United States)

    Ponticorvo, Adrien; Rowland, Rebecca A.; Baldado, Melissa L.; Kennedy, Gordon T.; Saager, Rolf B.; Choi, Bernard; Durkin, Anthony J.

    2016-04-01

    The ability to accurately assess burn wound severity in a timely manner is a critical component of wound management as it dictates the course of treatment. While full thickness and superficial burns can be easily diagnosed through visual inspection, burns that fall in between these categories are difficult to classify. Additionally, the ability to better quantify different stages of wound healing from a burn of any severity would be important for evaluating the efficacy of different treatment options. Here we present a longitudinal (28 day) study that employs spatial frequency domain imaging (SFDI) and laser speckle imaging (LSI) as non-invasive technologies to characterize in-vivo burn wounds and healing in a murine model. Burn wounds were created using an established technique of a brass comb heated to a given temperature and applied for a set amount of time. They were imaged immediately after the initial injury and then at 2, 4, 7, 14, 21, and 28 days following the injury. Biopsies were taken on the day of the injury in order to verify the extent of the burn damage as well as at different time points after the injury in order to visualize different stages of inflammation and healing. The results of this study suggest that the reduced scattering coefficient measured using SFDI and blood flow as measured using LSI have the potential to provide useful metrics for quantifying the severity of burn injuries as well as track the different stages associated with wound healing progression.

  13. BACTERIOLOGICAL STUDY OF BURNS INFECTION

    Directory of Open Access Journals (Sweden)

    Shareen

    2015-10-01

    Full Text Available A burn is a wound in which there is coagulative necrosis of the tissue, majority of which are caused by heat. Burn injury is a major public health problem in many areas of the world. Burns predispose to infection by damaging the protective barrier function of the skin, thus facilitating the entry of pa thogenic microorganisms and by inducing systemic immunosuppression . (1 OBJECTIVE : The present study was therefore undertaken to isolate and identify the aerobic bacterial flora in burn patients and its antibiotic susceptibility pattern. MATERIAL & METHODS : A total of 100 patients admitted with different degree of burns were studied. Wound swabs were taken with aseptic precautions by dry sterile cotton swab sticks. These swabs were transported to the microbiology laboratory and the isolates were identified based on standard microbiological methods. Antibiotic susceptibility testing was done by Kirby Bauer’s disc diffusion method. RESULT : A total of 127 bacterial pathogens were isolated from 100 patients. Of these, 69% were monomicrobial in nature and 28% wer e polymicrobial. The most frequent cause of infection was found to be Staphylococcus aureus (39.4%, followed by Pseudomonas aeruginosa (14.2%, Klebsiella pneumonia (13.4%, E.coli (8.7% and Acinetobacter species (7.9%.Out of the total Staphylococcus au reus isolates, 19 were Methicillin sensitive and 31 were Methicillin resistant (MRSA. All the MRSA strains were 100% sensitive to Vancomycin and Linezolid. The Pseudomonas aeruginosa isolates were most sensitive to Amikacin (9 4.4%, Fluroquinolones (61.1% . CONCLUSION : Staphylococcus aureus and Pseudomonas aeruginosa were major causes of infection in burn wounds. Therefore it is necessary to implement urgent measures for restriction of nosocomial infections, sensible limitation on the use of antimicrobial agents, strict disinfection and hygiene.

  14. [Enteral nutrition in burn patients].

    Science.gov (United States)

    Pereira, J L; Garrido, M; Gómez-Cía, T; Serrera, J L; Franco, A; Pumar, A; Relimpio, F; Astorga, R; García-Luna, P P

    1992-01-01

    Nutritional support plays an important role in the treatment of patients with burns. Due to the severe hypercatabolism that develops in these patients, oral support is insufficient in most cases, and this makes it essential to initiate artificial nutritional support (either enteral or parenteral). Enteral nutrition is more physiological than parenteral, and data exist which show that in patients with burns, enteral nutrition exercises a protective effect on the intestine and may even reduce the hypermetabolic response in these patients. The purpose of the study was to evaluate the effectiveness and tolerance of enteral nutritional support with a hypercaloric, hyperproteic diet with a high content of branched amino acids in the nutritional support of patients suffering from burns. The study included 12 patients (8 males and 4 females), admitted to the Burns Unit. Average age was 35 +/- 17 years (range: 21-85 years). The percentage of body surface affected by the burns was 10% in two cases, between 10-30% in three cases, between 30-50% in five cases and over 50% in two cases. Initiation of the enteral nutrition was between twenty-four hours and seven days after the burn. The patients were kept in the unit until they were discharged, and the average time spent in the unit was 31.5 days (range: 17-63 days). Total energetic requirements were calculated based on Harris-Benedict, with a variable aggression factor depending on the body surface burned, which varied from 2,000 and 4,000 cal day. Nitrogenous balance was determined on a daily basis, and plasmatic levels of total proteins, albumin and prealbumin on a weekly basis. There was a significant difference between the prealbumin values at the initiation and finalization of the enteral nutrition (9.6 +/- 2.24 mg/dl compared with 19.75 +/- 5.48 mg/dl; p diet was very good, and only mild complications such as diarrhoea developed in two patients. Enteral nutrition is a suitable nutritional support method for patients with

  15. American Burn Association Practice Guidelines: Burn Shock Resuscitation

    Science.gov (United States)

    2008-02-01

    valid OMB control number. 1. REPORT DATE 01 JAN 2008 2. REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE American Burn Association...colloid or saline solutions. Clin Sci 1964; 26:429–43. 21. Markley K, Bocanegra M, Bazan A, et al. Clinical evaluation of saline solution therapy in

  16. Ingeniería de superficies y su impacto medioambiental

    Directory of Open Access Journals (Sweden)

    Agüero, A.

    2007-02-01

    Full Text Available Surface engineering addresses the modification of the microstructure and/or composition of the surface of components by mechanical, physical or chemical methods that may imply adding a material in order to change the surface properties of said component. One of its most important consequences is the significant increase of the useful life of a variety of components in a large number of industrial applications. Moreover, it contributes to energy savings by increasing efficiencies as it allows higher combustion temperatures, by allowing the use of lighter components and by significant friction reduction. In this paper, surface engineering is introduced, as well as its different modalities, examples of industrial applications and positive and negative environmental impacts.

    La ingeniería de superficies consiste en la modificación de la microestructura y/o la composición superficial de un componente mediante métodos mecánicos, físicos o químicos, que pueden implicar el aporte de otro material para cambiar las propiedades superficiales del mencionado componente. Una de sus consecuencias más importantes es que permite alargar significativamente, la vida útil de todo tipo de componentes empleados en un gran número de aplicaciones industriales. Por otra parte, contribuye al ahorro energético por permitir el aumento de las temperaturas de combustión consiguiendo una mayor eficiencia, por contribuir a la reducción de peso y por colaborar de forma significativa a disminuir la fricción entre componentes. En el presente trabajo se introduce la ingeniería de superficies, sus diferentes modalidades, algunos ejemplos de sus aplicaciones industriales y las interacciones, positivas y negativas, con el medio ambiente.

  17. Endoscopic mucosectomy: an alternative treatment for superficial esophageal cancer.

    Science.gov (United States)

    Lambert, R

    2000-01-01

    Recent trends in the management of superficial esophageal cancer consist of improved detection, pretherapeutic staging and reliable criteria for curative endoscopic therapy. The endoscopic treatment is legitimate when the cancer is at an early stage, intra-epithelial or microinvasive (m1 or m2) and N0. Submucosal cancer should not be treated with a curative intent by endotherapy. Concerning squamous cell cancer, the oriental and occidental pathologists include high-grade dysplasia in the same group as intramucosal cancer. The distinction is however maintained for adenocarcinoma in the Barrett's esophagus. Indications of endoscopic rather than surgical treatment rely on: (1) the small size of the tumor (not more than 2 cm in diameter); (2) the endoscopic morphology in the type 0 of the Japanese classification with the flat subtypes IIa and IIb rather than type IIc--there is high risk of submucosal invasion for the polypoid (type I) or ulcerated superficial cancer (type III); and (3) the endoscopic ultrasound staging, with confirmed integrity of the hyperechoic submucosal layer. The high-frequency (20 MHz) miniprobe is preferred to the standard (7.5 MHz) instrument. The elective procedure for tumor eradication is endoscopic mucosectomy. The technique is associated with a 6.8% risk of severe complications (hemorrhage or perforation) and a recurrence rate of 3%-7%. The 5-year survival rate is similar to that of surgery (over 80%). In the small group of patients with superficial esophageal cancer (less than 10% of the disease) endoscopic treatment may now be proposed in about 30% of cases, surgery is preferred for submucosal cancer and for neoplasia with a large surface. Areas of high-grade dysplasia in the Barrett's esophagus offer a new and increasing sector of indications. The concurrent endoscopic procedure of destruction--photodynamic therapy--is preferred for the destruction of lesions with poorly delineated limits.

  18. Functional compartmentalization of the human superficial masseter muscle.

    Directory of Open Access Journals (Sweden)

    Rodrigo A Guzmán-Venegas

    Full Text Available Some muscles have demonstrated a differential recruitment of their motor units in relation to their location and the nature of the motor task performed; this involves functional compartmentalization. There is little evidence that demonstrates the presence of a compartmentalization of the superficial masseter muscle during biting. The aim of this study was to describe the topographic distribution of the activity of the superficial masseter (SM muscle's motor units using high-density surface electromyography (EMGs at different bite force levels. Twenty healthy natural dentate participants (men: 4; women: 16; age 20±2 years; mass: 60±12 kg, height: 163±7 cm were selected from 316 volunteers and included in this study. Using a gnathodynamometer, bites from 20 to 100% maximum voluntary bite force (MVBF were randomly requested. Using a two-dimensional grid (four columns, six electrodes located on the dominant SM, EMGs in the anterior, middle-anterior, middle-posterior and posterior portions were simultaneously recorded. In bite ranges from 20 to 60% MVBF, the EMG activity was higher in the anterior than in the posterior portion (p-value = 0.001.The center of mass of the EMG activity was displaced towards the posterior part when bite force increased (p-value = 0.001. The topographic distribution of EMGs was more homogeneous at high levels of MVBF (p-value = 0.001. The results of this study show that the superficial masseter is organized into three functional compartments: an anterior, a middle and a posterior compartment. However, this compartmentalization is only seen at low levels of bite force (20-60% MVBF.

  19. Functional compartmentalization of the human superficial masseter muscle.

    Science.gov (United States)

    Guzmán-Venegas, Rodrigo A; Biotti Picand, Jorge L; de la Rosa, Francisco J Berral

    2015-01-01

    Some muscles have demonstrated a differential recruitment of their motor units in relation to their location and the nature of the motor task performed; this involves functional compartmentalization. There is little evidence that demonstrates the presence of a compartmentalization of the superficial masseter muscle during biting. The aim of this study was to describe the topographic distribution of the activity of the superficial masseter (SM) muscle's motor units using high-density surface electromyography (EMGs) at different bite force levels. Twenty healthy natural dentate participants (men: 4; women: 16; age 20±2 years; mass: 60±12 kg, height: 163±7 cm) were selected from 316 volunteers and included in this study. Using a gnathodynamometer, bites from 20 to 100% maximum voluntary bite force (MVBF) were randomly requested. Using a two-dimensional grid (four columns, six electrodes) located on the dominant SM, EMGs in the anterior, middle-anterior, middle-posterior and posterior portions were simultaneously recorded. In bite ranges from 20 to 60% MVBF, the EMG activity was higher in the anterior than in the posterior portion (p-value = 0.001).The center of mass of the EMG activity was displaced towards the posterior part when bite force increased (p-value = 0.001). The topographic distribution of EMGs was more homogeneous at high levels of MVBF (p-value = 0.001). The results of this study show that the superficial masseter is organized into three functional compartments: an anterior, a middle and a posterior compartment. However, this compartmentalization is only seen at low levels of bite force (20-60% MVBF).

  20. An improved MRI guided ultrasound system for superficial tumor hyperthermia

    Science.gov (United States)

    Zhu, Mengyuan; Shen, Guofeng; Su, Zhiqiang; Chen, Sheng; Wu, Hao

    2017-03-01

    Among many methods in tumor treatment, ultrasound hyperthermia is characterized by non-invasiveness, and it has been proven very effective for clinical treatment. But the problem of monitoring temperature limits its development. MRI-based temperature mapping techniques are safe compared with invasive methods and have been applied to detect temperature changes for a variety of applications. Among these techniques, the proton resonance frequency (PRF) method is relatively advanced. With a temperature measuring experiment and experiment conducted on tumors inside rabbit legs, the effectiveness of PRF method has been proved. This paper is to introduce an MRI guided ultrasound superficial tumor hyperthermia instrument based on PRF method.

  1. Composicion y deformacion de curvas, superficies y volumenes de bezier

    OpenAIRE

    Canchoa Quispe, Alessandri

    1998-01-01

    El presente trabajo enfoca el problema de la composición y deformación de cla¬vas, superficies y volúmenes de Bézier. Los algoritmos para encontrar los puntos de control de la composición (F=Fog) de simplejos o formas de producto tensorial de Bézier g:Rn -> RwyF:RN->Rd a partir de los puntos de control de g y F tienen aplicaciones práctica en el CAGD (Computer Aided Geometric Design). Estos algoritmos inicialmente fue presentado por DeRose [DeRo 88]: el algoritmo producto para la deformación ...

  2. Aneurysm of the superficial palmar arch: a case report.

    Science.gov (United States)

    Estrella, Emmanuel P; Lee, Ellen Y

    2008-01-01

    Aneurysms of the hand are uncommon lesions. The most common location is the ulnar artery. We present a case of a young female who consulted us for a hand mass with a history of trauma to the hand. Pre-operative arteriogram showed a superficial palmar arch aneurysm. The mass was excised and the arch was reconstructed using a reversed Y-shaped vein graft. Fourteen months after surgery, there was no recurrence of the aneurysm and the patient only reported occasional cold intolerance.

  3. Endoscopic and biopsy diagnoses of superficial, nonampullary, duodenal adenocarcinomas

    Science.gov (United States)

    Kakushima, Naomi; Kanemoto, Hideyuki; Sasaki, Keiko; Kawata, Noboru; Tanaka, Masaki; Takizawa, Kohei; Imai, Kenichiro; Hotta, Kinichi; Matsubayashi, Hiroyuki; Ono, Hiroyuki

    2015-01-01

    AIM: To investigate the accuracy of endoscopic or biopsy diagnoses of superficial nonampullary duodenal epithelial tumors (NADETs). METHODS: Clinicopathological data were reviewed for 84 superficial NADETs from 74 patients who underwent surgery or endoscopic resection between September 2002 and August 2014 at a single prefectural cancer center. Superficial NADETs were defined as lesions confined to the mucosa or submucosa. Demographic and clinicopathological data were retrieved from charts, endoscopic and pathologic reports. Endoscopic reports included endoscopic diagnosis, location, gross type, diameter, color, and presence or absence of biopsy. Endoscopic diagnoses were made by an endoscopist in charge of the examination before biopsy specimens were obtained. Endoscopic images were obtained using routine, front-view, high-resolution video endoscopy, and chromoendoscopy with indigocarmine was performed for all lesions. Endoscopic images were reviewed by at least two endoscopists to assess endoscopic findings indicative of carcinoma. Preoperative diagnoses based on endoscopy and biopsy findings were compared with histological diagnoses of resected specimens. Sensitivity, specificity, and accuracy were assessed for endoscopic diagnosis and biopsy diagnosis. RESULTS: The majority (81%) of the lesions were located in the second portion of the duodenum. The median lesion diameter was 14.5 mm according to final histology. Surgery was performed for 49 lesions from 39 patients, and 35 lesions from 35 patients were endoscopically resected. Final histology confirmed 65 carcinomas, 15 adenomas, and 3 hyperplasias. A final diagnosis of duodenal carcinoma was made for 91% (52/57) of the lesions diagnosed as carcinoma by endoscopy and 93% (42/45) of the lesions diagnosed as carcinoma by biopsy. The sensitivity, specificity, and accuracy of endoscopic diagnoses were 80%, 72%, and 78%, respectively, whereas those of biopsy diagnoses were 72%, 80%, and 74%, respectively

  4. Protect the Ones You Love: Burns Safety

    Science.gov (United States)

    ... Child Abuse and Neglect Prevention Youth Violence Prevention Burn Prevention Recommend on Facebook Tweet Share Compartir We ... to prevent leading causes of child injury, like burns, is a step toward this goal. Every day, ...

  5. Topical Pain Relievers May Cause Burns

    Science.gov (United States)

    ... Consumers Consumer Updates Topical Pain Relievers May Cause Burns Share Tweet Linkedin Pin it More sharing options ... rare, have ranged from mild to severe chemical burns with use of such brand-name topical muscle ...

  6. A review of hydrofluoric acid burn management.

    Science.gov (United States)

    McKee, Daniel; Thoma, Achilleas; Bailey, Kristy; Fish, Joel

    2014-01-01

    Hydrofluoric acid (HF) causes a unique chemical burn. Much of the current treatment knowledge of HF burns is derived from case reports, small case series, animal studies and anecdotal evidence. The management can be challenging because clinical presentation and severity of these burns vary widely. Plastic surgeons managing burn patients must have a basic understanding of the pathophysiology, the range of severity in presentation and the current treatment options available for HF burns. The present article reviews the current understanding of the pathophysiology and systemic effects associated with severe HF burns. Furthermore, it distinguishes between minor and life-threatening HF burns and describes several of the basic techniques that are available to treat patients with HF burns.

  7. Effects of Topical Emu Oil on Burn Wounds in the Skin of Balb/c Mice

    Science.gov (United States)

    Afshar, Mohammad; Ghaderi, Reza; Zardast, Mahmoud; Delshad, Parvin

    2016-01-01

    The goal of this study was to determine the effect of topical Emu oil on the healing of burn wounds and hair follicle restoration in superficial II-degree burns in the skin of Balb/c mice. Thirty-two male Balb/c mice with burns on the back of the neck were divided into two groups: The Emu oil group received topical Emu oil twice daily, whereas the control was left untreated. Skin biopsies were obtained on days 4, 7, 10, and 14 of the experiment. Then the specimens were viewed with Olympus SZX research microscope. The Emu oil treated burns were found to heal more slowly and inflammation lasted longer in this group. The number of hair follicles in the margins of the wounds increased through time in the Emu oil group compared to the control group. Also, the hair follicles in the Emu oil group were in several layers and seemed to be more active and mature. Moreover, Emu oil had a positive effect on fibrogenesis and synthesis of collagen. The findings indicate that although Emu oil delays the healing process, it has a positive effect on wound healing and it increases the number of hair follicles in the margins of the wound. PMID:27069472

  8. Effects of Topical Emu Oil on Burn Wounds in the Skin of Balb/c Mice

    Directory of Open Access Journals (Sweden)

    Mohammad Afshar

    2016-01-01

    Full Text Available The goal of this study was to determine the effect of topical Emu oil on the healing of burn wounds and hair follicle restoration in superficial II-degree burns in the skin of Balb/c mice. Thirty-two male Balb/c mice with burns on the back of the neck were divided into two groups: The Emu oil group received topical Emu oil twice daily, whereas the control was left untreated. Skin biopsies were obtained on days 4, 7, 10, and 14 of the experiment. Then the specimens were viewed with Olympus SZX research microscope. The Emu oil treated burns were found to heal more slowly and inflammation lasted longer in this group. The number of hair follicles in the margins of the wounds increased through time in the Emu oil group compared to the control group. Also, the hair follicles in the Emu oil group were in several layers and seemed to be more active and mature. Moreover, Emu oil had a positive effect on fibrogenesis and synthesis of collagen. The findings indicate that although Emu oil delays the healing process, it has a positive effect on wound healing and it increases the number of hair follicles in the margins of the wound.

  9. Intradermal endothelin-1 excites bombesin-responsive superficial dorsal horn neurons in the mouse.

    Science.gov (United States)

    Akiyama, T; Nagamine, M; Davoodi, A; Iodi Carstens, M; Cevikbas, F; Steinhoff, M; Carstens, E

    2015-10-01

    Endothelin-1 (ET-1) has been implicated in nonhistaminergic itch. Here we used electrophysiological methods to investigate whether mouse superficial dorsal horn neurons respond to intradermal (id) injection of ET-1 and whether ET-1-sensitive neurons additionally respond to other pruritic and algesic stimuli or spinal superfusion of bombesin, a homolog of gastrin-releasing peptide (GRP) that excites spinal itch-signaling neurons. Single-unit recordings were made from lumbar dorsal horn neurons in pentobarbital-anesthetized C57BL/6 mice. We searched for units that exhibited elevated firing after id injection of ET-1 (1 μg/μl). Responsive units were further tested with mechanical stimuli, bombesin (spinal superfusion, 200 μg·ml(-1)·min(-1)), heating, cooling, and additional chemicals [histamine, chloroquine, allyl isothiocyanate (AITC), capsaicin]. Of 40 ET-1-responsive units, 48% responded to brush and pinch [wide dynamic range (WDR)] and 52% to pinch only [high threshold (HT)]. Ninety-three percent responded to noxious heat, 50% to cooling, and >70% to histamine, chloroquine, AITC, and capsaicin. Fifty-seven percent responded to bombesin, suggesting that they participate in spinal itch transmission. That most ET-1-sensitive spinal neurons also responded to pruritic and algesic stimuli is consistent with previous studies of pruritogen-responsive dorsal horn neurons. We previously hypothesized that pruritogen-sensitive neurons signal itch. The observation that ET-1 activates nociceptive neurons suggests that both itch and pain signals may be generated by ET-1 to result in simultaneous sensations of itch and pain, consistent with observations that ET-1 elicits both itch- and pain-related behaviors in animals and burning itch sensations in humans.

  10. Burn Prevention for Families with Children with Special Needs

    Medline Plus

    Full Text Available ... Burns and Scalds Burn Prevention for Families With Children With Special Needs Watch this video to learn ... know about burn prevention if you have a child with special needs. Read our burn prevention tips | ...

  11. Imaging acute thermal burns by photoacoustic microscopy

    OpenAIRE

    Zhang, Hao F.; Maslov, Konstantin; Stoica, George; Wang, Lihong V.

    2006-01-01

    The clinical significance of a burn depends on the percentage of total body involved and the depth of the burn. Hence a noninvasive method that is able to evaluate burn depth would be of great help in clinical evaluation. To this end, photoacoustic microscopy is used to determine the depth of acute thermal burns by imaging the total hemoglobin concentration in the blood that accumulates along the boundaries of injuries as a result of thermal damage to the vasculature. We induce acute thermal ...

  12. Burns, metabolism and nutritional requirements.

    Science.gov (United States)

    Mendonça Machado, N; Gragnani, A; Masako Ferreira, L

    2011-01-01

    To review the nutritional evaluation in burned patient, considering the literature descriptions of nutritional evaluation and energy requirements of these patients. Thermal injury is the traumatic event with the highest metabolic response in critically ill patients. Various mathematical formulas have been developed to estimate nutritional requirements in burned patient. Indirect Calorimetry is the only method considered gold standard for measuring caloric expenditure. A survey of the literature and data was collected based on official data bases, LILACS, EMBASE and PubMed. The metabolic changes involved in hypermetabolism are designed to supply energy to support immune function, brain activity, wound healing, and preservation of body tissues. Body weight is considered the easiest indicator and perhaps the best to assess the nutritional status. The most common formulas utilized in these patients are the Curreri, Pennisi, Schofield, Ireton-Jones, Harris-Benedict and the ASPEN recommendations. For children is the Mayes and World Health Organization formula. The majority of mathematical formulas overestimate the nutritional needs. The regular use of Indirect Calorimetry supplies adequate nutritional support to the burn patient. The traditional nutritional evaluation considers anthropometry, biochemical markers and estimation of nutritional requirements. The weight provides a basis for decisions that are established in the clinical context. Classic parameters can be adapted to intensive care environment. The use of Indirect Calorimetry is crucial to ensure the safety of the nutritional support of burn patients and this should be widely encouraged.

  13. Antibiotics and the burn patient.

    Science.gov (United States)

    Ravat, François; Le-Floch, Ronan; Vinsonneau, Christophe; Ainaud, Pierre; Bertin-Maghit, Marc; Carsin, Hervé; Perro, Gérard

    2011-02-01

    Infection is a major problem in burn care and especially when it is due to bacteria with hospital-acquired multi-resistance to antibiotics. Moreover, when these bacteria are Gram-negative organisms, the most effective molecules are 20 years old and there is little hope of any new product available even in the distant future. Therefore, it is obvious that currently available antibiotics should not be misused. With this aim in mind, the following review was conducted by a group of experts from the French Society for Burn Injuries (SFETB). It examined key points addressing the management of antibiotics for burn patients: when to use or not, time of onset, bactericidia, combination, adaptation, de-escalation, treatment duration and regimen based on pharmacokinetic and pharmacodynamic characteristics of these compounds. The authors also considered antibioprophylaxis and some other key points such as: infection diagnosis criteria, bacterial inoculae and local treatment. French guidelines for the use of antibiotics in burn patients have been designed up from this work. Copyright © 2009 Elsevier Ltd and ISBI. All rights reserved.

  14. Abdominal Complications after Severe Burns

    Science.gov (United States)

    2009-05-01

    abdominal compartment syndrome, schemic bowel, biliary disease , peptic ulcer disease and astritis requiring laparotomy, small bowel obstruction, rimary fungal...complications in- luded trauma exploratory laparotomy, abdominal com- artment syndrome, ischemic bowel, biliary disease , peptic lcer disease and gastritis, large...because it was almost uniformly ssociated with serious lethal burns. This was in the period efore effective gastric acid control, explaining the high

  15. The superficial ulnar artery: development and clinical significance Artéria ulnar superficial: desenvolvimento e relevância clínica

    Directory of Open Access Journals (Sweden)

    Srinivasulu Reddy

    2007-09-01

    Full Text Available The principal arteries of the upper limb show a wide range of variation that is of considerable interest to orthopedic surgeons, plastic surgeons, radiologists and anatomists. We present here a case of superficial ulnar artery found during the routine dissection of right upper limb of a 50-year-old male cadaver. The superficial ulnar artery originated from the brachial artery, crossed the median nerve anteriorly and ran lateral to this nerve and the brachial artery. The superficial ulnar artery in the arm gave rise to a narrow muscular branch to the biceps brachii. At the elbow level the artery ran superficial to the bicipital aponeurosis where it was crossed by the median cubital vein. It then ran downward and medially superficial to the forearm flexor muscles, and then downward to enter the hand. At the palm, it formed the superficial and deep palmar arches together with the branches of the radial artery. The presence of a superficial ulnar artery is clinically important when raising forearm flaps in reconstructive surgery. The embryology and clinical significance of the variation are discussed.As principais artérias do membro superior apresentam uma ampla variação, que é relativamente importante a cirurgiões ortopédicos e plásticos, radiologistas e anatomistas.Apresentamosumcaso de artéria ulnar superficial encontrada durante dissecção de rotina de membro superior direito de um cadáver masculino de 50 anos de idade.Aartéria ulnar superficial originava-se da artéria braquial, cruzava o nervo mediano anteriormente e percorria lateralmente esse nervo e a artéria braquial. A artéria ulnar superficial no braço deu origem a um ramo muscular estreito do músculo bíceps braquial. Ao nível do cotovelo, a artéria percorria superficialmente a aponeurose bicipital, onde era cruzada pela veia cubital mediana. Percorria, então, em sentido descendente e medialmente superficial aos músculos flexores do antebraço, e então descendia para

  16. Use of previously burned skin as random cutaneous local flaps in pediatric burn reconstruction

    NARCIS (Netherlands)

    Barret, JP; Herndon, DN; McCauley, RL

    2002-01-01

    Reconstruction after post-burn scarring remains a challenge. It is especially true in the severely burned patient, who normally presents with a paucity of donor sites Healed skin from areas that had been burned and skin from grafted areas (termed as previously burned skin) have been occasionally use

  17. Use of previously burned skin as random cutaneous local flaps in pediatric burn reconstruction

    NARCIS (Netherlands)

    Barret, JP; Herndon, DN; McCauley, RL

    Reconstruction after post-burn scarring remains a challenge. It is especially true in the severely burned patient, who normally presents with a paucity of donor sites Healed skin from areas that had been burned and skin from grafted areas (termed as previously burned skin) have been occasionally

  18. 30 CFR 816.87 - Coal mine waste: Burning and burned waste utilization.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Coal mine waste: Burning and burned waste utilization. 816.87 Section 816.87 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT...-SURFACE MINING ACTIVITIES § 816.87 Coal mine waste: Burning and burned waste utilization. (a) Coal mine...

  19. 30 CFR 817.87 - Coal mine waste: Burning and burned waste utilization.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Coal mine waste: Burning and burned waste utilization. 817.87 Section 817.87 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT...-UNDERGROUND MINING ACTIVITIES § 817.87 Coal mine waste: Burning and burned waste utilization. (a) Coal mine...

  20. MHD control in burning plasmas MHD control in burning plasmas

    Science.gov (United States)

    Donné, Tony; Liang, Yunfeng

    2012-07-01

    Fusion physics focuses on the complex behaviour of hot plasmas confined by magnetic fields with the ultimate aim to develop a fusion power plant. In the future generation of tokamaks like ITER, the power generated by the fusion reactions substantially exceeds the external input power (Pfusion}/Pin >= 10). When this occurs one speaks of a burning plasma. Twenty per cent of the generated fusion power in a burning plasma is carried by the charged alpha particles, which transfer their energy to the ambient plasma in collisions, a process called thermalization. A new phenomenon in burning plasmas is that the alpha particles, which form a minority but carry a large fraction of the plasma kinetic energy, can collectively drive certain types of magneto-hydrodynamic (MHD) modes, while they can suppress other MHD modes. Both types of MHD modes can have desirable effects on the plasma, as well as be detrimental to the plasma. For example, the so-called sawtooth instability, on the one hand, is largely responsible for the transport of the thermalized alpha particles out of the core, but, on the other hand, may result in the loss of the energetic alphas before they have fully thermalized. A further undesirable effect of the sawtooth instability is that it may trigger other MHD modes such as neoclassical tearing modes (NTMs). These NTMs, in turn, are detrimental to the plasma confinement and in some cases may even lead to disruptive termination of the plasma. At the edge of the plasma, finally, so-called edge localized modes or ELMs occur, which result in extremely high transient heat and particle loads on the plasma-facing components of a reactor. In order to balance the desired and detrimental effects of these modes, active feedback control is required. An additional complication occurs in a burning plasma as the external heating power, which is nowadays generally used for plasma control, is small compared to the heating power of the alpha particles. The scientific challenge

  1. Drenaje suplementario del sistema venoso superficial en colgajos pediculados Supplementary drainage of superficial venous system in pedicled flaps

    OpenAIRE

    Fernández García,A.; C. Fernández Pascual; R.A. Moreno Villalba; Ll. Gerrero Navarro

    2012-01-01

    Los colgajos pediculados pueden sufrir edema y congestión debido a que su drenaje a trevés del sistema venoso superfical es imposible y el flujo hacia el sistema profundo a nivel del pedículo es precario. Esta situación suele evolucionar hacia la necrosis parcial o la pérdida total del colgajo en pocas horas. La apertura del sistema venoso superficial permite el drenaje adecuado de los tejidos transferidos y evita estas complicaciones. Este artículo analiza el papel de las anastomosis microqu...

  2. Clinical Evaluation of Superficial Fungal Infections in Children

    Directory of Open Access Journals (Sweden)

    Ragıp Ertaş

    2015-12-01

    Full Text Available Objective: This retrospective study was referred to evaluate 51 cases of superficial mycoses, referred to our Pediatric Dermatology outpatient clinic in one year. Methods: We reviewed following data for all patients: age, gender, accompanied diseases, clinical types, localization and treatment. Superficial mycotic infections were diagnosed on the basis of clinical picture, direct microscopy and some of them were confirmed by fungal cultures. Results: Our patients comprised 33 boys (64.7% and 18 girls (35.3%, with an average age of 6.2 years (range 4 months to 17 years. Eighteen patients (35.3% had dermatophytes on the scalp. Clinical forms, in the order of frequency, were: tinea capitis profunda in 10 patients (19.6%, tinea capitis superficialis in 8 patients (15.8%, tinea unguium in 8 patients (15.8%. Tinea capitis (35.3% was the most frequent form of dermatomycosis. The most common symptom was the pruritus. Thirty (58% patients were treated with local antimycotics and 21 (42% patients were treated with systemic terbinafine or itraconazole. Conclusion: In this study it was found that, tinea capitis was the most frequent form of dermatomycosis and onychomycosis in children are not uncommon as it is mentioned. The data also suggest that topical antifungal agents may be effective and well-tolerated in the treatment of onychomycosis and tinea capitis in children.

  3. Superficially located enlarged lymphoid follicles characterise nodular gastritis.

    Science.gov (United States)

    Okamura, Takuma; Sakai, Yasuhiro; Hoshino, Hitomi; Iwaya, Yugo; Tanaka, Eiji; Kobayashi, Motohiro

    2015-01-01

    Nodular gastritis is a form of chronic Helicobacter pylori gastritis affecting the gastric antrum and characterised endoscopically by the presence of small nodular lesions resembling gooseflesh. It is generally accepted that hyperplasia of lymphoid follicles histologically characterises nodular gastritis; however, quantitative analysis in support of this hypothesis has not been reported. Our goal was to determine whether nodular gastritis is characterised by lymphoid follicle hyperplasia.The number, size, and location of lymphoid follicles in nodular gastritis were determined and those properties compared to samples of atrophic gastritis. The percentages of high endothelial venule (HEV)-like vessels were also evaluated.The number of lymphoid follicles was comparable between nodular and atrophic gastritis; however, follicle size in nodular gastritis was significantly greater than that seen in atrophic gastritis. Moreover, lymphoid follicles in nodular gastritis were positioned more superficially than were those in atrophic gastritis. The percentage of MECA-79 HEV-like vessels was greater in areas with gooseflesh-like lesions in nodular versus atrophic gastritis.Superficially located hyperplastic lymphoid follicles characterise nodular gastritis, and these follicles correspond to gooseflesh-like nodular lesions observed endoscopically. These observations suggest that MECA-79 HEV-like vessels could play at least a partial role in the pathogenesis of nodular gastritis.

  4. Suction based mechanical characterization of superficial facial soft tissues.

    Science.gov (United States)

    Weickenmeier, J; Jabareen, M; Mazza, E

    2015-12-16

    The present study is aimed at a combined experimental and numerical investigation of the mechanical response of superficial facial tissues. Suction based experiments provide the location, time, and history dependent behavior of skin and SMAS (superficial musculoaponeurotic system) by means of Cutometer and Aspiration measurements. The suction method is particularly suitable for in vivo, multi-axial testing of soft biological tissue including a high repeatability in subsequent tests. The campaign comprises three measurement sites in the face, i.e. jaw, parotid, and forehead, using two different loading profiles (instantaneous loading and a linearly increasing and decreasing loading curve), multiple loading magnitudes, and cyclic loading cases to quantify history dependent behavior. In an inverse finite element analysis based on anatomically detailed models an optimized set of material parameters for the implementation of an elastic-viscoplastic material model was determined, yielding an initial shear modulus of 2.32kPa for skin and 0.05kPa for SMAS, respectively. Apex displacements at maximum instantaneous and linear loading showed significant location specificity with variations of up to 18% with respect to the facial average response while observing variations in repeated measurements in the same location of less than 12%. In summary, the proposed parameter sets for skin and SMAS are shown to provide remarkable agreement between the experimentally observed and numerically predicted tissue response under all loading conditions considered in the present study, including cyclic tests.

  5. A study of uniaxial tension on the superficial dermal microvasculature.

    Science.gov (United States)

    Barnhill, R L; Bader, D L; Ryan, T J

    1984-05-01

    A spring-loaded apparatus was designed to apply uniaxial tension to forearm skin in 17 human subjects--10 normals, 6 psoriatics, and 1 patient with scleroderma. Simultaneously, the effects of stretching on the upper dermal vasculature were observed stereomicroscopically. Progressive changes (collapse) in the superficial microvasculature--vertical capillary loops and horizontal subpapillary plexus--with increasing tension were photographed. Force and strains were recorded at the points of disappearance of virtually all vessels. An average force of 11.9 newtons (N), accompanied by a mean strain of 10.3%, resulted in occlusion of all vessels. A much higher force (18.5 N) was necessary to occlude blood flow in the 1 patient with scleroderma. In summary, we have described a new technique for the study of mechanical forces on the blood supply of the epidermis. The data have shown that uniaxial tension has important effects on the superficial dermal microvasculature, resulting in impedance and obliteration of blood flow at relatively low magnitudes.

  6. Aneurysms of the superficial venous system: classification and treatment

    Directory of Open Access Journals (Sweden)

    Ronald G. Bush

    2014-11-01

    Full Text Available Superficial venous aneurysms are rarely described and they may remain indolent or become the source for pulmonary emboli. A system of classification and treatment protocol according to size and location is proposed. Three hundred thirty patients were evaluated for symptomatic venous disease (C2-C6 over a 2-year period. A proposed designation for venous aneurysm is described. Patients fulfilling this criterion are described in reference to site of involvement, histologic findings, and method of treatment. Five percent of patients met the criteria for venous aneurysm. Nine aneurysms of the greater saphenous vein were identified. Three aneurysms were proximal to the subterminal valve and the rest were distal. Six aneurysms of the anterior accessory greater saphenous vein (AAGSV were identified. Three aneurysms of the AAGSV spontaneously thrombosed. Two patients presented with aneurysms of the small saphenous vein. Histology revealed thickened intima, smooth muscle and adventitia. Aneurysm designation relates to diameter of normal and contiguous vein. All superficial venous aneurysms in close proximity to the junction of the femoral or popliteal vein should be ligated. Classification of venous aneurysms should include the AAGSV, which may present with spontaneous thrombosis.

  7. A review of hydrofluoric acid burn management

    OpenAIRE

    McKee, Daniel; Thoma, Achilleas; Bailey, Kristy; Fish, Joel

    2014-01-01

    The clinical presentation and severity of hydrofluoric acid burns vary considerably, making management particularly challenging. Given that current knowledge of HF burns is derived from small case series, case reports, animal studies and anecdotal evidence, this narrative review discusses the current understanding of the effects associated with severe hydrofluoric acid burns, describing the mechanism of injury, systemic toxicity and treatment options.

  8. Titanium tetrachloride burns to the eye.

    OpenAIRE

    Chitkara, D K; McNeela, B. J.

    1992-01-01

    We present eight cases of chemical burns of the eyes from titanium tetrachloride, an acidic corrosive liquid. However it causes severe chemical burns which have a protracted course and features more akin to severe alkali burns. Injuries related to titanium tetrachloride should be treated seriously and accordingly appropriate management is suggested.

  9. Intentional burns in Nepal: a comparative study.

    Science.gov (United States)

    Lama, Bir Bahadur; Duke, Janine M; Sharma, Narayan Prasad; Thapa, Buland; Dahal, Peeyush; Bariya, Nara Devi; Marston, Wendy; Wallace, Hilary J

    2015-09-01

    Intentional burns injuries are associated with high mortality rates, and for survivors, high levels of physical and psychological morbidity. This study provides a comprehensive assessment of intentional burn admissions to the adult Burns Unit at Bir Hospital, Kathmandu, Nepal, during the period 2002-2013. A secondary data analysis of de-identified data of patients hospitalized at Bir Hospital, Kathmandu, with a burn during the period of 1 January 2002 to 31 August 2013. Socio-demographic, injury and psychosocial factors of patients with intentional and unintentional burns are described and compared. Chi-square tests, Fisher's exact test and Wilcoxon rank sum tests were used to determine statistical significance. There were a total of 1148 burn admissions of which 329 (29%) were for intentional burn, 293 (26%) were self-inflicted and 36 (3%) were due to assault. Mortality rates for intentional burns were approximately three times those for unintentional burns (60 vs. 22%). When compared to unintentional burns, patients with intentional burns were more likely to be female (79 vs. 48%), married (84 vs. 67%), younger (25 vs. 30 years), have more extensive burns (total body surface area, %: 55 vs. 25) and higher mortality (60 vs. 22%). Intentional burns were more likely to occur at home (95 vs. 67%), be caused by fire (96 vs. 77%), and kerosene was the most common accelerant (91 vs. 31%). A primary psychosocial risk factor was identified in the majority of intentional burn cases, with 60% experiencing adjustment problems/interpersonal conflict and 32% with evidence of a pre-existing psychological condition. A record of alcohol/substance abuse related to the patient or other was associated with a greater proportion of intentional burns when compared with unintentional burns (17 vs. 4%). The majority of intentional burn patients were female. Almost all intentional burns occurred in the home and were caused by fire, with kerosene the most common accelerant used. Underlying

  10. Quantitative assessment of graded burn wounds using a commercial and research grade laser speckle imaging (LSI) system

    Science.gov (United States)

    Ponticorvo, A.; Rowland, R.; Yang, B.; Lertsakdadet, B.; Crouzet, C.; Bernal, N.; Choi, B.; Durkin, A. J.

    2017-02-01

    Burn wounds are often characterized by injury depth, which then dictates wound management strategy. While most superficial burns and full thickness burns can be diagnosed through visual inspection, clinicians experience difficulty with accurate diagnosis of burns that fall between these extremes. Accurately diagnosing burn severity in a timely manner is critical for starting the appropriate treatment plan at the earliest time points to improve patient outcomes. To address this challenge, research groups have studied the use of commercial laser Doppler imaging (LDI) systems to provide objective characterization of burn-wound severity. Despite initial promising findings, LDI systems are not commonplace in part due to long acquisition times that can suffer from artifacts in moving patients. Commercial LDI systems are being phased out in favor of laser speckle imaging (LSI) systems that can provide similar information with faster acquisition speeds. To better understand the accuracy and usefulness of commercial LSI systems in burn-oriented research, we studied the performance of a commercial LSI system in three different sample systems and compared its results to a research-grade LSI system in the same environments. The first sample system involved laboratory measurements of intralipid (1%) flowing through a tissue simulating phantom, the second preclinical measurements in a controlled burn study in which wounds of graded severity were created on a Yorkshire pig, and the third clinical measurements involving a small sample of clinical patients. In addition to the commercial LSI system, a research grade LSI system that was designed and fabricated in our labs was used to quantitatively compare the performance of both systems and also to better understand the "Perfusion Unit" output of commercial systems.

  11. Incidence and characteristics of chemical burns.

    Science.gov (United States)

    Koh, Dong-Hee; Lee, Sang-Gil; Kim, Hwan-Cheol

    2017-05-01

    Chemical burns can lead to serious health outcomes. Previous studies about chemical burns have been performed based on burn center data so these studies have provided limited information about the incidence of chemical burns at the national level. The aim of this study was to evaluate the incidence and characteristics of chemical burns using nationwide databases. A cohort representing the Korean population, which was established using a national health insurance database, and a nationwide workers' compensation database were used to evaluate the incidence and characteristics of chemical burns. Characteristics of the affected body region, depth of burns, industry, task, and causative agents were analyzed from two databases. The incidence of chemical burns was calculated according to employment status. The most common regions involving chemical burns with hospital visits were the skin followed by the eyes. For skin lesions, the hands and wrists were the most commonly affected regions. Second degree burns were the most common in terms of depth of skin lesions. The hospital visit incidence was 1.96 per 10,000 person-year in the general population. The compensated chemical burns incidence was 0.17 per 10,000 person-year. Employees and the self-employed showed a significantly increased risk of chemical burns undergoing hospital visits compared to their dependents. Chemical burns on the skin and eyes are almost equally prevalent. The working environment was associated with increased risk of chemical burns. Our results may aid in estimating the size of the problem and prioritizing prevention of chemical burns. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  12. Love burns: An essay about bride burning in India.

    Science.gov (United States)

    Jutla, Rajni K; Heimbach, David

    2004-01-01

    Each year in countries like India, thousands of young women are burned to death or afflicted with fatal burns. They are victims of dowry deaths. The husband and/or in-laws have determined that the dowry, a gift given from the daughter's parents to the husband, was inadequate and therefore attempt to murder the new bride to make the husband available to remarry or to punish the bride and her family. Unfortunately, this is a domestic issue that is often ignored or minimized, and the prosecution is often inadequate. This review article illustrates various scenarios of dowry deaths, investigates different predispositions, summarizes the current legislation, and proposes solutions to this problem. One hopes that the exposure of this problem may curtail its rampant, yet well-hidden, prevalence.

  13. Pediatric burn rehabilitation: Philosophy and strategies

    Directory of Open Access Journals (Sweden)

    Shohei Ohgi

    2013-09-01

    Full Text Available Burn injuries are a huge public health issue for children throughout the world, with the majority occurring in developing countries. Burn injuries can leave a pediatric patient with severely debilitating and deforming contractures, which can lead to significant disability when left untreated. Rehabilitation is an essential and integral part of pediatric burn treatment. The aim of this article was to review the literature on pediatric burn rehabilitation from the Medline, CINAHL, and Web of Science databases. An attempt has been made to present the basic aspects of burn rehabilitation, provide practical information, and discuss the goals and conceptualization of rehabilitation as well as the development of rehabilitation philosophy and strategies.

  14. Management of post burn hand deformities

    Directory of Open Access Journals (Sweden)

    Sabapathy S

    2010-10-01

    Full Text Available The hand is ranked among the three most frequent sites of burns scar contracture deformity. One of the major determinants of the quality of life in burns survivors is the functionality of the hands. Burns deformities, although largely preventable, nevertheless do occur when appropriate treatment is not provided in the acute situation or when they are part of a major burns. Reconstructive procedures can greatly improve the function of the hands. Appropriate choice of procedures and timing of surgery followed by supervised physiotherapy can be a boon for a burns survivor.

  15. 急性大面积放射线烧伤及其并发症的救治%Treatment of extensive acute radiation burn and its complications

    Institute of Scientific and Technical Information of China (English)

    李叶扬; 汪锦伦; 李罡; 林伟华; 梁岷; 黄峻; 孙敬恩

    2013-01-01

    This article reports the treatment of a patient suffered from acute radiation burn covering 41% TBSA,with deep partial-thickness and full-thickness injury,produced by exposure to a large-scale industrial electron accelerator.An open wound began to appear and enlarged gradually 10 weeks after the exposure.Serious wound infection with methicillin-resistant Staphylococcus aureus and Pseudomonas aeruginosa,pneumonia,respiratory failure,systemic inflammatory response syndrome,nephropathy and hypoproteinemia developed successively since 3 weeks after the wound formation.Skin grafts failed to survive,resulting in enlargement of the wound.After being treated with proper measures,including parenteral nutrition,respiratory support with a ventilator,appropriate antibiotics,steroid administration for nephropathy,deep debridement for wounds followed by skin grafting,the patient was cured and discharged after undergoing 15 operations in 500 days.The clinical condition of an extensive acute radiation burn is complicated.We should pay close attention to the changes in functions of organs,and strengthen the therapeutic strategies to support the function of organs to reduce the incidence of systemic complications.The control of the infection and the timely and effective repair of the wound are stiil the key points of the treatment of an extensive local radiation injury.

  16. Superficie regladas y desarrollables a lo largo de curvas Bézier.

    OpenAIRE

    Londoño Arboleda, Mauricio Alejando

    2010-01-01

    Se estudian superficies regladas y se abordan sus elementos básicos como la línea de estricción y el parámetro de distribución. Se estudian algoritmos para el diseño de superficies desarrollables, a saber el algoritmo de Aumann y el algoritmo proyectivo de Pottmann, en este ´ ultimo las superficies desarrollables racionales de Bezier se interpretan como curvas en el espacio proyectivo dual (P3).Se estudia de manera exhaustiva el problema de diseño de superficies desarrollables de grado polino...

  17. Superficial aponeurosis of human gastrocnemius is elongated during contraction: implications for modeling muscle-tendon unit.

    Science.gov (United States)

    Muramatsu, Tadashi; Muraoka, Tetsuro; Kawakami, Yasuo; Fukunaga, Tetsuo

    2002-02-01

    Two questions were addressed in this study: (1) how much strain of the superficial aponeurosis of the human medial gastrocnemius muscle (MG) was obtained during voluntary isometric contractions in vivo, (2) whether there existed inhomogeneity of the strain along the superficial aponeurosis. Seven male subjects, whose knees were extended and ankles were flexed at right angle, performed isometric plantar flexion while elongation of superficial aponeurosis of MG was determined from the movements of the intersections made by the superficial aponeurosis and fascicles using ultrasonography. The strain of the superficial aponeurosis at the maximum voluntary contraction, estimated from the elongation and length data, was 5.6+/-1.2%. There was no significant difference in strain between the proximal and distal parts of the superficial aponeurosis. Based on the present result and that of our previous study for the same subjects (J. Appl. Physiol 90 (2001) 1671), a model was formulated for a contracting uni-pennate muscle-tendon unit. This model, which could be applied to isometric contractions at other angles and therefore of wide use, showed that similar strain between superficial and deep aponeuroses of MG contributed to homogeneous fascicle length change within MG during contractions. These findings would contribute to clarifying the functions of the superficial aponeurosis and the effects of the superficial aponeurosis elongation on the whole muscle behavior.

  18. A rare variant of the superficial ulnar artery, and its clinical implications: a case report

    Directory of Open Access Journals (Sweden)

    Senanayake Kithsiri J

    2007-11-01

    Full Text Available Abstract The superficial ulnar artery is a rare variation of the upper limb arterial system that arises from the brachial or axillary artery and runs superficial to the muscles arising from the medial epicondyle 123. The incidence is about 0.7 to 7% 145. In our routine dissections we found a superficial ulnar artery, which crossed the cubital fossa superficial to the bicipital aponeurosis making it highly vulnerable to intra-arterial injection. This is a rare variation that every medical and nursing staff member should know about.

  19. New type of sauna-related burn: conductive contact burn.

    Science.gov (United States)

    Shin, Seung Jun; Yoo, Heon; Park, Myong Chul

    2013-01-01

    A 70-year-old woman visited a Korean-style hot dry sauna room. The patient had a medical history of hypertension and hyperlipidemia. During the sauna, the patient slept for 30 minutes. During the sleep, the right medial thigh was covered with a fully wet towel. The patient sustained a second-degree burn on the right medial thigh area with multiple bullas. On physical examination, erythema, heating sensation, and swelling around the bullas were noted. The patient was admitted and received intravenous antibiotics for 7 days. A dressing with Silmazine 1% cream (sulfadiazine) was applied twice a day for prevention of local infection. The patient was discharged on day 14 without complication. In this case, the mechanism of the burn was different. Hot air has much thermal energy but is not conducted to the skin directly. A wet towel will have a relatively higher thermal capacity or heat capacity than a dry or damp towel, and the sodden water might be a medium for the conduction of thermal energy. Owing to the global popularity of sauna bathing, it is important to recognize all sources of sauna-related burns.

  20. Modelling burned area in Africa

    Directory of Open Access Journals (Sweden)

    V. Lehsten

    2010-10-01

    Full Text Available The simulation of current and projected wildfires is essential for predicting crucial aspects of vegetation patterns, biogeochemical cycling as well as pyrogenic emissions across the African continent. This study uses a data-driven approach to parameterize two burned area models applicable to dynamic vegetation models (DVMs and Earth system models (ESMs. We restricted our analysis to variables for which either projections based on climate scenarios are available, or that are calculated by DVMs, and we consider a spatial scale of one degree as the scale typical for DVMs and ESMs. By using the African continent here as an example, an analogue approach could in principle be adopted for other regions, for global scale dynamic burned area modelling.

    We used 9 years of data (2000–2008 for the variables: precipitation over the last dry season, the last wet season and averaged over the last 2 years, a fire-danger index (the Nesterov index, population density, and annual proportion of area burned derived from the MODIS MCD45A1 product. Two further variables, tree and herb cover were only available for 2001 as a remote sensing product. Since the effect of fires on vegetation depends strongly on burning conditions, the timing of wildfires is of high interest too, and we were able to relate the seasonal occurrence of wildfires to the daily Nesterov index.

    We parameterized two generalized linear models (GLMs, one with the full variable set (model VC and one considering only climate variables (model C. All introduced variables resulted in an increase in model performance. Model VC correctly predicts the spatial distribution and extent of fire prone areas though the total variability is underrepresented. Model VC has a much lower performance in both aspects (correlation coefficient of predicted and observed ratio of burned area: 0.71 for model VC and 0.58 for model C. We expect the remaining variability to be attributed to additional

  1. What factors control the superficial lava dome explosivity?

    Science.gov (United States)

    Boudon, Georges; Balcone-Boissard, Hélène; Villemant, Benoit; Morgan, Daniel J.

    2015-04-01

    Dome-forming eruption is a frequent eruptive style; lava domes result from intermittent, slow extrusion of viscous lava. Most dome-forming eruptions produce highly microcrystallized and highly- to almost totally-degassed magmas which have a low explosive potential. During lava dome growth, recurrent collapses of unstable parts are the main destructive process of the lava dome, generating concentrated pyroclastic density currents (C-PDC) channelized in valleys. These C-PDC have a high, but localized, damage potential that largely depends on the collapsed volume. Sometimes, a dilute ash cloud surge develops at the top of the concentrated flow with an increased destructive effect because it may overflow ridges and affect larger areas. In some cases, large lava dome collapses can induce a depressurization of the magma within the conduit, leading to vulcanian explosions. By contrast, violent, laterally directed, explosions may occur at the base of a growing lava dome: this activity generates dilute and turbulent, highly-destructive, pyroclastic density currents (D-PDC), with a high velocity and propagation poorly dependent on the topography. Numerous studies on lava dome behaviors exist, but the triggering of lava dome explosions is poorly understood. Here, seven dome-forming eruptions are investigated: in the Lesser Antilles arc: Montagne Pelée, Martinique (1902-1905, 1929-1932 and 650 y. BP eruptions), Soufrière Hills, Montserrat; in Guatemala, Santiaguito (1929 eruption); in La Chaîne des Puys, France (Puy de Dome and Puy Chopine eruptions). We propose a new model of superficial lava-dome explosivity based upon a textural and geochemical study (vesicularity, microcrystallinity, cristobalite distribution, residual water contents, crystal transit times) of clasts produced by these key eruptions. Superficial explosion of a growing lava dome may be promoted through porosity reduction caused by both vesicle flattening due to gas escape and syn-eruptive cristobalite

  2. Lower body lift with superficial fascial system suspension.

    Science.gov (United States)

    Lockwood, T

    1993-11-01

    Multiple body contour deformities of the trunk and thighs are commonly treated in separate stages to limit postoperative complications and disability. Recent advances in the surgical design of the medial thigh lift and the lateral thigh/buttock lift along with an understanding of the functional anatomy of the superficial fascial system have significantly improved results and decreased complications of trunk/thigh lifts. The enhanced safety of current trunk/thigh lifts has allowed new combinations to treat multiple body contour deformities in a single stage. Laxity of the entire lower trunk and thigh regions can be treated in one stage in selected patients. The lower body lift combines the transverse flank/thigh/buttock lift and the fascial anchoring medial thigh lift in one operation. In addition to the expected tightening of the flank, buttocks, and total thighs, this procedure results in a surprising degree of epigastric and hypogastric tightening of mild to moderate abdominal laxity without direct surgical undermining or umbilical transposition. Ten patients having the lower body lift alone or in combination with liposuction and other body contouring procedures were followed for 6 to 24 months. The primary indication for surgery is moderate to severe soft-tissue laxity of the lower trunk and thighs with minimal or mild residual fat deposits. Skin contour irregularities due to skin laxity (cellulite of laxity) or to postliposuction adhesions are frequently present and may be severe. Patients with significant fat deposits may be treated initially with liposuction 3 to 4 months earlier to become candidates for this procedure. Key technical elements of this procedure include (1) both supine and lateral decubitus positioning with the hip flexed and abducted to allow overcorrection, (2) appropriate direct surgical undermining through superficial fascial system zones of adherence in the superior thigh while avoiding the lymphatics of the femoral triangle, (3) more

  3. Methylated spirit burns: an ongoing problem.

    Science.gov (United States)

    Jansbeken, J R H; Vloemans, A F P M; Tempelman, F R H; Breederveld, R S

    2012-09-01

    Despite many educational campaigns we still see burns caused by methylated spirit every year. We undertook a retrospective study to analyse the impact of this problem. We retrospectively collected data of all patients with burns caused by methylated spirit over twelve years from 1996 to 2008. Our main endpoints were: incidence, age, mechanism of injury, total body surface area (TBSA) burned, burn depth, need for surgery and length of hospital stay. Ninety-seven patients with methylated spirit burns were included. During the study period there was no decrease in the number of patients annually admitted to the burn unit with methylated spirit burns. 28% of the patients (n=27) were younger than eighteen years old, 15% (n=15) were ten years old or younger. The most common cause of burns was carelessness in activities involving barbecues, campfires and fondues. Mean TBSA burned was 16% (SD 12.4). 70% (n=68) had full thickness burns. 66% (n=64) needed grafting. Mean length of hospital stay was 23 days (SD 24.7). The use of methylated spirit is an ongoing problem, which continues to cause severe burns in adults and children. Therefore methylated spirit should be banned in households. We suggest sale only in specialised shops, clear labelling and mandatory warnings. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  4. Occupational burns treated in emergency departments.

    Science.gov (United States)

    Reichard, Audrey A; Konda, Srinivas; Jackson, Larry L

    2015-03-01

    Despite reported declines, occupational burn injuries remain a workplace safety concern. More severe burns may result in costly medical treatment and long-term physical and psychological consequences. We used the National Electronic Injury Surveillance System-Occupational Supplement to produce national estimates of burns treated in emergency departments (EDs). We analyzed data trends from 1999 to 2008 and provided detailed descriptions of 2008 data. From 1999 to 2008 there were 1,132,000 (95% CI: ±192,300) nonfatal occupational burns treated in EDs. Burn numbers and rates declined approximately 40% over the 10 years. In 2008, men and younger workers 15-24 years old had the highest rates. Scalds and thermal burns accounted for more than 60% of burns. Accommodation and food service, manufacturing, and construction industries had the largest number of burns. Despite declining burn rates, emphasis is needed on reducing burn hazards to young food service workers and using job specific hazard analyses to prevent burns. © 2015 Wiley Periodicals, Inc.

  5. Perineal burn care: French working group recommendations.

    Science.gov (United States)

    Bordes, Julien; Le Floch, Ronan; Bourdais, Ludovic; Gamelin, Alexandre; Lebreton, Françoise; Perro, Gérard

    2014-06-01

    Burns to the perineum are frequently exposed to faeces. Diverting colostomy is often described to prevent faecal soiling. Because this technique is invasive with frequent complications, use of non-surgical devices including specifically designed faecal management systems has been reported in perineal burns. In order to standardise the faecal management strategy in patients with perineal burns, a group of French experts was assembled. This group first evaluated the ongoing practice in France by analysing a questionnaire sent to every French burn centre. Based on the results of this study and on literature data, the experts proposed recommendations on the management of perineal burns in adults. Specifically designed faecal management systems are the first-line method to divert faeces in perineal burns. The working group proposed recommendations and an algorithm to assist in decisions in the management of perineal burns in four categories of patients, depending on total burn skin area, depth and extent of the perineal burn. In France, non-surgical devices are the leading means of faecal diversion in perineal burns. The proposed algorithm may assist in decisions in the management of perineal burns. The expert group emphasises that large clinical studies are needed to better evaluate these devices. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  6. [Current treatment strategies for paediatric burns].

    Science.gov (United States)

    Küntscher, M V; Hartmann, B

    2006-06-01

    Paediatric burns occupy the third place in the severe accident statistics in Germany after traffic injuries and drowning. The paper reviews current treatment concepts of pre-hospital management, fluid resuscitation and surgical therapy in paediatric burned patients. Specific features in the approximation of the total body surface area burn and indications for transfer of paediatric burn victims to specialized units are discussed. The therapy of severe paediatric burns requires an interdisciplinary team consisting of especially skilled plastic or paediatric surgeons,anaesthetists, psychiatrists or psychologists, specifically trained nurses, physiotherapists and social workers. The rehabilitation process starts basically with admission to the burn unit. A tight cooperation between therapists and the relatives of the paediatric burn victim is needed for psychological recovery and reintegration into society.'The adaptation to the suffered trauma resulting in life-long disability and disfigurement is the main task of psychotherapy.

  7. Septicemia: The Principal Killer of Burns Patients

    Directory of Open Access Journals (Sweden)

    B. R. Sharma

    2005-01-01

    Full Text Available Burn injury is a major problem in many areas of the world and it has been estimated that 75% of all deaths following burns are related to infection. Burns impair the skin’s normal barrier function thus allowing microbial colonization of the burn wounds and even with the use of topical antimicrobial agents, contamination is almost unavoidable. It is therefore essential for every burn institution to determine its specific pattern of burn wound microbial colonization, time related changes in predominant flora and antimicrobial resistance profiles. This would allow early management of septic episodes with proper empirical systemic antibiotics before the results of microbiologic culture becomes available, thus improving the overall infection-related morbidity and mortality. We attempted to examine the factors affecting risk of infection; strategies for infection control and prevention in burn victims.

  8. Adult campfire burns: two avenues for prevention.

    Science.gov (United States)

    Klein, Matthew B; Heimbach, David M; Honari, Shari; Engrav, Loren H; Gibran, Nicole S

    2005-01-01

    Campfires are a common component of outdoor festivities. Pediatric campfire burns have been well described. Adult campfire injuries also are common and have several important distinguishing characteristics. We performed a retrospective review of adult patients admitted with campfire burns to our burn center from July 1998 to July 2003. Medical records were reviewed with attention to mechanism of injury, intoxication level, burn size, and surgeries performed. A total of 27 patients with this injury were treated as inpatients over the course of the study period. Two distinct mechanisms of injury emerged: 1) contact with the campfire and 2) flash/flame injuries from igniting the fire. Eighty-one percent (13/16) of patients who sustained contact burns were intoxicated, as compared with 11% (1/11) of those who sustained flash/flame injuries. Nearly half of the patients with contact burns and more than half the patients with flash/flame burns required excision and grafting.

  9. BURN SEVERITY MAPPING IN AUSTRALIA 2009

    Directory of Open Access Journals (Sweden)

    R. McKinley

    2012-07-01

    Full Text Available In 2009, the Victoria Department of Sustainability and Environment estimated approximately 430,000 hectares of Victoria Australia were burned by numerous bushfires. Burned Area Emergency Response (BAER teams from the United States were deployed to Victoria to assist local fire managers. The U.S. Geological Survey Earth Resources Observation and Science Center (USGS/EROS and U.S. Forest Service Remote Sensing Applications Center (USFS/RSAC aided the support effort by providing satellite-derived "soil burn severity " maps for over 280,000 burned hectares. In the United States, BAER teams are assembled to make rapid assessments of burned lands to identify potential hazards to public health and property. An early step in the assessment process is the creation of a soil burn severity map used to identify hazard areas and prioritize treatment locations. These maps are developed primarily using Landsat satellite imagery and the differenced Normalized Burn Ratio (dNBR algorithm.

  10. Pre-hospital care in burn injury

    Directory of Open Access Journals (Sweden)

    Shrivastava Prabhat

    2010-10-01

    Full Text Available The care provided to the victims of burn injury immediately after sustaining burns can largely affect the extent and depth of the wound. Although standard guidelines have been formulated by various burn associations, they are still not well known to public at large in our country. In burn injuries, most often, the bystanders are the first care providers. The swift implementation of the measures described in this article for first aid in thermal, chemical, electrical and inhalational injuries in the practical setting, within minutes of sustaining the burn, plays a vital role and can effectively reduce the morbidity and mortality to a great extent. In case of burn disasters, triage needs to be carried out promptly as per the defined protocols. Proper communication and transport from the scene of the accident to the primary care centre and onto the burn care facility greatly influences the execution of the management plans

  11. Polarized Reflectance Measurement of Burned Skin Tissues

    Science.gov (United States)

    de Pedro, Hector Michael; Chang, Chuan-I.; Zarnani, Faranak; Glosser, Robert; Maas, D.; Idris, A.

    2011-10-01

    In the US, there are over 400,000 burn victims with 3,500 deaths in 2010. Recent evidence suggests that early removal of burn tissues can significantly increase the success of their recovery, since burns continue to spread and damage surrounding tissues after hours of injury. The rationale behind this procedure is that burns trigger the body's immune system to overreact, causing additional damage. Therefore, it is important to distinguish burn areas so that it can be removed. The problem with this is that it is difficult to recognize the margins of the burn area. In our project, we use polarized reflectance as a tool to identify the burned tissues from unburned ones.

  12. Structural effects in photopolymerized sodium AMPS hydrogels crosslinked with poly(ethylene glycol) diacrylate for use as burn dressings.

    Science.gov (United States)

    Nalampang, Kanarat; Panjakha, Rachanida; Molloy, Robert; Tighe, Brian J

    2013-01-01

    Synthetic hydrogel polymers were prepared by free radical photopolymerization in aqueous solution of the sodium salt of 2-acrylamido-2-methylpropane sulfonic acid (Na-AMPS). Poly(ethylene glycol) diacrylate (PEGDA) and 4,4'-azo-bis(4-cyanopentanoic acid) were used as the crosslinker and UV-photoinitiator, respectively. The effects of varying the Na-AMPS monomer concentration within the range of 30-50% w/v and the crosslinker concentration within the range of 0.1-1.0% mol (relative to monomer) were studied in terms of their influence on water absorption properties. The hydrogel sheets exhibited extremely high swelling capacities in aqueous media which were dependent on monomer concentration, crosslink density, and the ionic strength and composition of the immersion medium. The effects of varying the number-average molecular weight of the PEGDA crosslinker from [Formula: see text] = 250 to 700 were also investigated. Interestingly, it was found that increasing the molecular weight and therefore the crosslink length at constant crosslink density decreased both the rate of water absorption and the equilibrium water content. Cytotoxicity testing by the direct contact method with mouse fibroblast L929 cells indicated that the synthesized hydrogels were nontoxic. On the basis of these results, it is considered that photopolymerized Na-AMPS hydrogels crosslinked with PEGDA show considerable potential for biomedical use as dressings for partial thickness burns. This paper describes some structural effects which are relevant to their design as biomaterials for this particular application.

  13. Superficial Granulomatous Pyoderma Gangrenosum of the Penis: A Case Report

    Directory of Open Access Journals (Sweden)

    Shyamala S. Gopi

    2006-01-01

    Full Text Available Classic type of pyoderma gangrenosum (PG is an uncommon ulceronecrotic cutaneous disease of uncertain aetiology characterised by broad zones of confluent ulceration with violaceous undermined margins. Some 50% of cases are associated with systemic diseases. The superficial granulomatous variant of pyoderma gangrenosum (SGPG of the external genitalia is extremely rare Patients with this condition develop single or multiple ulcerated skin lesions often with sinus tract formation. The majority of these lesions were found on the trunk and limbs. SGPG is less likely to be associated with underlying disease processes than classic PG. We present a 58 year-old with recalcitrant penile ulceration demonstrated to be SGPG on biopsy. Although rare and poorly recognised, the histological features are sufficiently typical to allow the correct diagnosis to be established.

  14. Transient Superficial Peroneal Nerve Palsy After Anterior Cruciate Ligament Reconstruction.

    Science.gov (United States)

    Alrowaili, Majed

    2016-04-26

    A 19-year-old male subject was diagnosed with medial meniscal, lateral meniscal and anterior cruciate ligament (ACL) tear. The symptoms did not subside after 4 months of physical therapy, and he underwent arthroscopic partial medial and lateral meniscectomy and ACL reconstruction. Immediately after the patient woke up from general anesthesia, he started experience loss of sensation in the area of superficial peroneal nerve with inverted dorsiflexion of foot and ankle. Instantly, the bandage and knee brace was removed and a diagnosis of compartment syndrome was ruled out. After eight hours, post-operatively, the patient started receiving physiotherapy. He complained of numbness and tingling in the same area. After 24 h, post-operatively, the patient started to regain dorsiflexion and eversion gradually. Two days after the surgery, the patient exhibited complete recovery of neurological status.

  15. MRI evaluation of superficial soft tissue lesions in children

    Energy Technology Data Exchange (ETDEWEB)

    Jabra, A.A. (Russel H. Morgan Dept. of Radiology and Radiological Sciences, Johns Hopkins Medical Institutions, Baltimore, MD (United States)); Taylor, G.A. (Russel H. Morgan Dept. of Radiology and Radiological Sciences, Johns Hopkins Medical Institutions, Baltimore, MD (United States))

    1993-10-01

    The role of MRI in the evaluation of superficial soft tissue lesions in children has not been well established. We present our experience with MRI in the evaluation of nineteen children with a variety of cutaneous and subcutaneous lesions. We find MRI to have a definite role in the evaluation of these lesions particularly when determining extent or depth of involvement would affect medical or surgical management. MRI has a less well defined role in tissue determination. Spin echo T1 and T2 weighted images were sufficient for evaluation in most cases. Fat suppression images added additional information in fatty tumors. The MRI appearance of juvenile hyaline fibromatosis and lipoblastomatosis has not been previously described and is included in this study. (orig.)

  16. Multiple superficial basal cell carcinomas (basalomatosis) following cobalt irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Wollenberg, A.; Przybilla, B. [Muenchen Univ. (Germany). Dermatologische Klinik und Poliklinik; Peter, R.U. [Federal Armed Forces Medical Academy, Munich (Germany). Inst. of Radiobiology

    1995-10-01

    Basalomatosis is an uncommon skin condition characterized by the occurrence of multiple basal cell carcinomas. Many cases reported in the literature have been attributed to arsenic treatment in psoriasis patients. We report a patient with basalomatosis caused by cobalt-60 ({sup 60}Co) irradiation. A 55-year-old farmer developed 43 basal cell carcinomas 20 years after treatment of an immuno-blastoma with {sup 60}Co irradiation. All the tumours were located within the radiation fields. Other possible causes of basalomatosis, such as arsenic intoxication and basal cell naevus syndrome, were excluded. The patient`s multiple superficial basal cell carcinomas probably represent a late adverse effect of the {sup 60}Co irradiation. (Author).

  17. Superficial stellate cells of the dorsal cochlear nucleus

    Directory of Open Access Journals (Sweden)

    Pierre F. Apostolides

    2014-06-01

    Full Text Available The dorsal cochlear nucleus (DCN integrates auditory and multisensory signals at the earliest levels of auditory processing. Proposed roles for this region include sound localization in the vertical plane, head orientation to sounds of interest, and suppression of sensitivity to expected sounds. Auditory and non-auditory information streams to the DCN are refined by a remarkably complex array of inhibitory and excitatory interneurons, and the role of each cell type is gaining increasing attention. One inhibitory neuron that has been poorly appreciated to date is the superficial stellate cell. Here we review previous studies and describe new results that reveal the surprisingly rich interactions that this tiny interneuron has with its neighbors, interactions which enable it to respond to both multisensory and auditory afferents.

  18. Tratamento superficial dos agregados reciclados de RCD com hidrofugantes.

    OpenAIRE

    Winnie Franco Santos

    2016-01-01

    A proposta busca reduzir a absorção de água dos agregados reciclados de Resíduos de Construção e Demolição (RCD), através do tratamento de sua superfície com hidrofugante, de maneira que estes não aumentem o consumo de água tampouco reduzam a resistência mecânica. Os agregados reciclados de RCD foram caracterizados quanto à granulometria, morfologia, porosidade, ângulo de contato aparente, absorção de água, análise de imagem e rugosidade superficial. Em seguida, os mesmos foram tratados super...

  19. Transient superficial peroneal nerve palsy after anterior cruciate ligament reconstruction

    Directory of Open Access Journals (Sweden)

    Majed Alrowaili

    2016-06-01

    Full Text Available A 19-year-old male subject was diagnosed with medial meniscal, lateral meniscal and anterior cruciate ligament (ACL tear. The symptoms did not subside after 4 months of physical therapy, and he underwent arthroscopic partial medial and lateral meniscectomy and ACL reconstruction. Immediately after the patient woke up from general anesthesia, he started experience loss of sensation in the area of superficial peroneal nerve with inverted dorsiflexion of foot and ankle. Instantly, the bandage and knee brace was removed and a diagnosis of compartment syndrome was ruled out. After eight hours, post-operatively, the patient started receiving physiotherapy. He complained of numbness and tingling in the same area. After 24 h, post-operatively, the patient started to regain dorsiflexion and eversion gradually. Two days after the surgery, the patient exhibited complete recovery of neurological status.

  20. Fluconazole Pharmacokinetics in Burn Patients

    Science.gov (United States)

    Boucher, Bradley A.; King, Stephen R.; Wandschneider, Heidi L.; Hickerson, William L.; Hanes, Scott D.; Herring, Vanessa L.; Canada, Todd W.; Hess, Mary M.

    1998-01-01

    The pharmacokinetics of fluconazole in nine adult patients with severe (30 to 95% total body surface area) burns were studied. There was no significant difference in half-life (t1/2), clearance (CL), or volume of distribution (V) over time in five patients on days 3 and 8 of the study (P > 0.05). Combined parameter estimates (means ± standard deviations) for all nine patients for the two study periods were as follows: t1/2, 24.4 ± 5.8 h; CL, 0.36 ± 0.09 ml/min/kg; and V, 0.72 ± 0.12 liters/kg. These estimates of t1/2 and CL in burn patients were approximately 13% shorter and 30% more rapid, respectively, than the most extreme estimates reported for other populations. PMID:9559811

  1. Zinc supplementation in burn patients.

    Science.gov (United States)

    Caldis-Coutris, Nancy; Gawaziuk, Justin P; Logsetty, Sarvesh

    2012-01-01

    Micronutrient supplementation is a common practice throughout many burn centers across North America; however, uncertainty pertaining to dose, duration, and side effects of such supplements persists. The authors prospectively collected data from 23 hospitalized patients with burn sizes ranging from 10 to 93% TBSA. Each patient received a daily multivitamin and mineral supplement, 50 mg zinc (Zn) daily, and 500 mg vitamin C twice daily. Supplements were administered orally or enterally. Albumin, prealbumin, C-reactive protein, serum Zn, and serum copper were measured weekly during hospital admission until levels were within normal reference range. Our study concluded that 50 mg daily dose of Zn resulted in normal serum levels in 19 of 23 patients at discharge; 50 mg Zn supplementation did not interfere with serum copper levels; and Zn supplements, regardless of administration route, did not result in gastrointestinal side effects.

  2. Southeast U.S. burns

    Science.gov (United States)

    Maggs, William Ward

    Human beings were responsible for most of 12,000 forest fires in the southeastern United States that burned for 10 days in late October and early November 1987. 910 km2, mostly hardwood forest, were destroyed in the fires, with arson and carelessness as the primary causes, according to the U.S. Department of Agriculture Forest Service.Measured in monetary terms, the toll was more than $40 million in resource and property damage. While the amount of forest burned did not rival the 3390 km2 lost to fires in the western United States last summer, the human impact was severe in the southeast and all along the East Coast. Favorable winds blew smoke from the southern and central Appalachians as far north as New England and as far east as Delaware, and cool fall air close to the ground prevented the smoke from rising, thickening the air in many northeastern cities on November 8 and 9.

  3. Wood-burning stoves worldwide

    DEFF Research Database (Denmark)

    Luis Teles de Carvalho, Ricardo

    , the advanced gasifiers and automatic stoves (Digital and Forced air) were identified to be among the best performing technologies. In spite of the fact that the thermal efficiency of the most advanced type of heating stoves (Gasifier) is around twice larger than that achieved for the most advanced type......More than any time in our history, the wood-burning stove continues to be the most popular technology used for cooking and heating worldwide. According to the World Health Organization and recent scientific studies, the inefficient use of solid-fuels in traditional stoves constitutes the major...... global environmental health risk, since these sources are important contributors to fine particulate matter (PM2.5) in the ambient air that increase climate and health risks. This thesis explores the social-technical dimensions of both the use of wood-burning stoves (WBSs) and transition to the use...

  4. Biosensores: Un Acercamiento a La Resonancia del Plasmon Superficial.

    Directory of Open Access Journals (Sweden)

    Nardo Ramírez Frómeta

    2005-01-01

    Full Text Available Los biosensores, o los sensores basados sobre materiales biológicos, son utilizados en la actualidad en una amplia variedad de disciplinas, incluyendo la industria alimenticia, la medicina, y la ciencia ambiental. Está llegando a ser cada vez más importante para los investigadores y los científicos en éstos y otros campos tener una comprensión de los diversos tipos de biosensores que puedan ser utilizados, los principios detrás de ellos, así como sus ventajas y limitaciones. El énfasis especial se ha dedicado a los biosensores de resonancia del plasmon superficial (SPR. El biosensor óptico basado en la técnica SPR ha ganado atención debido a su velocidad de detección, alta especificidad, alta sensibilidad y posibilidad de análisis en tiempo real. El dispositivo SPR detecta cambios mínimos en el índice de refracción de la superficie de detección y de su vecindad inmediata. Esta detección altamente sensible se basa en una excitación colectiva de los electrones (los plasmons superficiales en una película metálica sobre un substrato (Ej. cristal, conduciendo a la absorción total de la luz en un ángulo particular de incidencia el cual es dependiente de los índices de refracción de cualquiera de los lados de la película metálica.

  5. Corneoscleral burn during phacoemulsification surgery.

    Science.gov (United States)

    Majid, M A; Sharma, M K; Harding, S P

    1998-10-01

    We report a case in which a severe corneoscleral burn occurred during phacoemulsification surgery. The equipment-tuning process was uneventful and routine surgery was expected. Severe tissue injury occurred because the anterior chamber collapsed momentarily and the phaco tip touched corneoscleral tissue. We discuss mechanisms by which this type of injury may occur and the likely cause in our case. We also suggest methods to reduce the incidence.

  6. Burn injuries related to suicide.

    Science.gov (United States)

    Persley, G V; Pegg, S P

    1981-02-07

    Of 1060 admissions to the burns unit, Royal Brisbane Hospital, over a 12-year period, there were 30 cases (2.8%) of attempted suicide. Fourteen (47%) of these patients died. The psychosocial features of people using self-ignition as a method of suicide are consistent with those of suicide in general. The morbidity if high and the outcome is often fatal, especially for those using a flammable liquid.

  7. Candidemia in major burns patients.

    Science.gov (United States)

    Renau Escrig, Ana I; Salavert, Miguel; Vivó, Carmen; Cantón, Emilia; Pérez Del Caz, M Dolores; Pemán, Javier

    2016-06-01

    Major burn patients have characteristics that make them especially susceptible to candidemia, but few studies focused on this have been published. The objectives were to evaluate the epidemiological, microbiological and clinical aspects of candidemia in major burn patients, determining factors associated with a poorer prognosis and mortality. We conducted a retrospective observational study of candidemia between 1996 and 2012 in major burn patients admitted to the La Fe University Hospital, Valencia, Spain. The study included 36 episodes of candidemia in the same number of patients, 55.6% men, mean age 37.33 years and low associated comorbidity. The incidence of candidemia varied between 0.26 and 6.09 episodes/1000 days stay in the different years studied. Candida albicans was the most common species (61.1%) followed by Candida parapsilosis (27.8%). Candidemia by C. krusei, C. glabrata or C. tropicalis were all identified after 2004. Central vascular catheter (CVC) was established as a potential source of candidemia in 36.1%, followed by skin and soft tissues of thermal injury (22.2%) and urinary tract (8.3%). Fluconazole was used in 19 patients (52.7%) and its in vitro resistance rate was 13.9%. The overall mortality was 47.2%, and mortality related to candidemia was 30.6%. Factors associated with increased mortality were those related to severe infection and shock. CVC was the most usual focus of candidemia. Fluconazole was the most common antifungal drug administered. The management of candidemia in major burn patients is still a challenge. © 2016 Blackwell Verlag GmbH.

  8. American Burn Association Consensus Statements

    Science.gov (United States)

    2013-08-01

    medications (eg, propranolol , morphine, sertraline)13,15,16 should be a research pri- ority. Improved pain management has also been sug- gested as a...2000;232:455–65. 2. Jeschke MG, Norbury WB, Finnerty CC, Branski LK, Herndon DN. Propranolol does not increase inflammation, sepsis, or infectious...SE, Matin S, Herndon DN, Wolfe RR. A submaximal dose of insulin promotes net skel- etal muscle protein synthesis in patients with severe burns. Ann

  9. Rehabilitation of the Burned Hand

    Science.gov (United States)

    2009-01-01

    13 Mallet and swan-neck deformities Thermal injury to the terminal slip of the extensor tendon can result in loss of DIP joint extension or mallet...deformity. Injury to the terminal slip can be a result of direct thermal injury or tendon ischemia induced as the injured tendon is compressed between...elastic bandage or self-adherent wrap may be necessary. Cotton socks over the splint may prevent the child from removing the splint. Contact burns

  10. American Burn Association consensus conference to define sepsis and infection in burns.

    Science.gov (United States)

    Greenhalgh, David G; Saffle, Jeffrey R; Holmes, James H; Gamelli, Richard L; Palmieri, Tina L; Horton, Jureta W; Tompkins, Ronald G; Traber, Daniel L; Mozingo, David W; Deitch, Edwin A; Goodwin, Cleon W; Herndon, David N; Gallagher, James J; Sanford, Art P; Jeng, James C; Ahrenholz, David H; Neely, Alice N; O'Mara, Michael S; Wolf, Steven E; Purdue, Gary F; Garner, Warren L; Yowler, Charles J; Latenser, Barbara A

    2007-01-01

    Because of their extensive wounds, burn patients are chronically exposed to inflammatory mediators. Thus, burn patients, by definition, already have "systemic inflammatory response syndrome." Current definitions for sepsis and infection have many criteria (fever, tachycardia, tachypnea, leukocytosis) that are routinely found in patients with extensive burns, making these current definitions less applicable to the burn population. Experts in burn care and research, all members of the American Burn Association, were asked to review the literature and prepare a potential definition on one topic related to sepsis or infection in burn patients. On January 20, 2007, the participants met in Tucson, Arizona to develop consensus for these definitions. After review of the definitions, a summary of the proceedings was prepared. The goal of the consensus conference was to develop and publish standardized definitions for sepsis and infection-related diagnoses in the burn population. Standardized definitions will improve the capability of performing more meaningful multicenter trials among burn centers.

  11. [Treatment of burns in infants].

    Science.gov (United States)

    Foyatier, J L; Latarjet, J; Comparin, J P; Zaragori, M; Robert, A; Braye, F; Weill, E; Masson, C L

    1995-10-01

    Because of the potential severity of their residual deformities, burn injuries in infants justify an early management in specialized centres when they cover more than 5% of body surface and in every case when hands, face, or external genitalia are concerned. Cooling with cold water is the first aid treatment to be performed as early as possible after the injury. The treatment in specialized centres must be both general and surgical. General treatment includes fluid and electrolyte therapy, temperature control, appropriate nutrition and pain suppression. Pain suppression is a major part of the treatment and morphine must be largely used. Surgical treatment starts as soon as the patient arrives in the centre and is eventually performed under general anesthesia: all the burned areas are covered with occlusive dressings. Infections are prevented by systematic cultures and adjusted antibiotic therapy. A vigorous rehabilitation program must be instituted as soon as possible: massages, compressive clothes, splints, physical therapy, plastic surgery. Primary prevention by sustained parental education is important in order to reduce the frequency of burn injuries in infants.

  12. Epidemiologic evaluation of patients with major burns and recommendations for burn prevention.

    Science.gov (United States)

    Ciftçi, Ilhan; Arslan, Kemal; Altunbaş, Zeynep; Kara, Fatih; Yilmaz, Hüseyin

    2012-03-01

    Burns are an important health problem in our country and in the world. In our study, we aimed to epidemiologically analyze the patients who were hospitalized in a burn unit that serves 3 million individuals in Central Anatolia. Records of 457 patients who had been hospitalized in the burn unit during the period 2008-2010 were analyzed retrospectively. Patients were assessed in terms of gender, age, burn area, burn depth, admission time to the health center, burn region, and factors causing burns. Most (44.6%) of the patients were in the 0-5 age group. Burn surface area was detected as 11.6 +/- 8.5%. Patients had reached the health center in 252.8 +/- 892.5 minutes. While 82.7% of the patients had second degree bums, 17.3% had third degree burns. Most burns were on the extremities (39.6%). The most common burn agent was scalds with hot liquids (54.1%). In our study, children in the 0-5 age group were found to be the most commonly affected group with respect to indoor burns. The basic contributing factor is that children spend more time in the house and are more active. Scalding burns may be prevented when greater care is taken when using hot liquids that may lead to indoor burns. Informing parents on this issue is of first priority.

  13. Self-inflicted burns in soldiers.

    Science.gov (United States)

    Gronovich, Yoav; Binenboym, Rami; Tuchman, Izhak; Eizenman, Nirit; Golan, Jacob

    2013-10-01

    Self-inflicted burns are a multidisciplinary medical challenge. In contrast to the more common motive of attempted suicide in self-infliction of a burn, usually of a serious degree, a second motive is malingering. Motivation of this nature has been exhibited among Israeli soldiers who inflict on themselves low- to moderate-degree burns to obtain dismissal from mandatory military service. The purpose of our study is to investigate and define this phenomenon. A retrospective analysis was performed on a population of 75 soldiers admitted to our Medical Center during the year 2010 with the diagnosis of any sort of burn. We set up a database including all relevant information about the burns including date and time of occurrence, cause, body location, depth of burn injury, area and shape of burn, etiology, and prescribed treatment. The summer was found to be the season with the highest incidence of burns. As far as the day of the week was influential, we found that the greater percentage of burns occurred at the beginning of the week. Most of the burns involved a minor surface area on the dorsal aspect of the foot. Scalding with hot water was the most common cause of burn. Eighty-one percent of the burns were atypical, being well demarcated.Most of the burn cases happened at home with no witnesses to the event. Sixty-one percent of the patients were not admitted to the hospital and were conservatively treated. Israeli soldiers tend to inflict burns on themselves for ulterior motives. Such burns are almost always minor with a small trauma area and sharp demarcations, and hence can be differentiated from other self-inflicted burns described in the literature. We found that most of the burns occur when the soldiers are on vacation at home. This is probably because the privacy allows them to carry out their act undisturbed. It is important to raise the awareness of attending physicians to the characteristics of these burns. Such patients should be evaluated by medical teams

  14. Increasing the utility of the Functional Assessment for Burns Score: Not just for major burns.

    Science.gov (United States)

    Smailes, Sarah T; Engelsman, Kayleen; Rodgers, Louise; Upson, Clara

    2016-02-01

    The Functional Assessment for Burns (FAB) score is established as an objective measure of physical function that predicts discharge outcome in adult patients with major burn. However, its validity in patients with minor and moderate burn is unknown. This is a multi-centre evaluation of the predictive validity of the FAB score for discharge outcome in adult inpatients with minor and moderate burns. FAB assessments were undertaken within 48 h of admission to (FAB 1), and within 48 h of discharge (FAB 2) from burn wards in 115 patients. Median age was 45 years and median burn size 4%. There were significant improvements in the patients' FAB scores (pburns.

  15. Escoamento superficial em Latossolo Amarelo distrófico típico sob diferentes agroecossistemas no nordeste paraense Runoff in Oxisol under different agroecosystems in the northeast part of Pará State

    Directory of Open Access Journals (Sweden)

    Cristiane F. G. da Costa

    2013-02-01

    Full Text Available Na bacia dos igarapés Timboteua e Buiuna, no Estado do Pará, avaliou-se a influência das mudanças de uso da terra e do manejo do solo sobre as taxas de escoamento superficial. Foram estabelecidas 18 parcelas experimentais (1 m² sendo três em cada um dos seis agroecossistemas avaliados, a saber: i Capoeira de 20 anos (CP; ii Sistema agroflorestal / derruba-e-queima (SQ; iii Sistema agroflorestal / corte-e-trituração (ST; iv Cultivo de mandioca / corte-e-trituração - Roça (RT; v Cultivo de mandioca / derruba-e-queima - Roça (RQ; vi Pastagem / derruba-e-queima (PQ. Adicionalmente foram instalados, na mesma localidade, dois pluviômetros e três coletores de água de chuva (CH para monitoramento da precipitação. Em 26 datas ao longo da estação chuvosa de 2010, foram coletadas 234 amostras, obtendo-se alta correlação entre volumes precipitado e escoado. O agroecossistema de Pastagem (PQ degradada apresentou o maior valor de 54,53% do total de escoamento superficial medido nesta pesquisa, e o SAF, que estava em recuperação de 7 anos após uma queima, o menor valor de 1,11%. O escoamento superficial decresceu dos agroecossistemas de menor para os sistemas de maior percentagem de material orgânico.In the watershed of the Timboteua and Buiuna streams in the State of Pará, the effect of land use change and soil management on the runoff rates was evaluated. Eighteen experimental plots (1 m² were established, three in each one of the six evaluated agroecosystems as follows: i 20 years Secondary vegetation ("Capoeira" (CP, ii Agroforestry system / slash-and-burn (SQ, iii Agroforestry system / chop-and-mulch (ST, iv Cassava crop / chop-and-mulch (RT, v Cassava crop / slash-and-burn (RQ, vi Cattle pasture / slash-and-burn (PQ. Nearby these plots two rain gauges and three rainwater collectors for monitoring of precipitation were also installed. Along 2010 rainy season 234 samples were collected on 26 different dates. A strong correlation

  16. Trifurcation of superficial brachial artery: a rare case with its clinico-embryological implications.

    Science.gov (United States)

    Gupta, N; Anshu, A; Dada, R

    2014-01-01

    Literatures on vasculature of upper limbs are crammed with reports of distinctly deviant version of normally prevalent vessels having modified origins, altered branching and odd courses. A unique anatomical variation in vascular pattern was observed during routine dissection of right upper limb in gross anatomy laboratory, AIIMS, New Delhi, India. The brachial artery was placed superficial to median nerve in the arm and therefore it was called superficial brachial artery. In the cubital fossa, 2.8 cm distal to intercondylar line of elbow joint, this superficial brachial artery terminated by trifurcation into radial, common interosseous and ulnar branches. Strikingly the ulnar branch, after its origin ran superficially over the median nerve and epitrochlear superficial flexor group of muscles of forearm in succession for the initial third of its course in the forearm, consequently it was addressed as superficial ulnar artery. The existence of superficial brachial artery in place of normal brachial artery, its termination by trifurcation into radial, common interosseous and superficial ulnar arteries with remarkably different courses, leads to confusing disposition of structures in the arm, cubital fossa and in the forearm and collectively makes this myriad of anatomical variations even rarer. The clinico-embryological revelations for combination of these unconventional observations, apprises and guides the specialized medical personnel attempting blind and invasive procedures in brachium and ante-brachium. This case report depicts the anatomical perspective and clinical implications on confronting a rare variant vasculature architecture pattern of upper limb.

  17. Chronic exertional compartment syndrome of the superficial posterior compartment: Soleus syndrome.

    Science.gov (United States)

    Gross, Christopher E; Parekh, Bela J; Adams, Samuel B; Parekh, Selene G

    2015-01-01

    Chronic exertional compartment syndrome (CECS) represents the second most-common cause of exertional leg pain with incidence of 27-33%. CECS of the superficial posterior compartment, or soleus syndrome, is rare and has only been discussed briefly in the literature. We discuss the management of two patients with bilateral soleus syndrome or CECS of the superficial posterior compartment.

  18. Estudio del estado físico-mecánico de superficies tratadas por deformación plástica superficial. // Study of the mechanical and physical behavior of surfaces treated by superficial plastic deformation.

    Directory of Open Access Journals (Sweden)

    O. Boada Carrazana

    2003-05-01

    Full Text Available El presente trabajo aborda lo referente al estado del arte de la modelación y el comportamiento de las superficies tratadapor deformación plástica superficial (DPS. Se hace una breve descripción de la modelación elástica y plástica, de la teoríade la plasticidad y de las dislocaciones y se dan algunos resultados sobre la modelación del rodilado usando las técnicasde simulación y modelación, como el método de los elementos finitos, a partir del cual se obtienen los modelosmatemáticos para calcular las tensiones y deformaciones máximas.Palabras claves: deformación plástica superficial, rodilado, bruñido por rodillo, elementos finitos,modelación.____________________________________________________________________________Abstract.This paper deals with the state of the art of modelation and the behaviour of surfaces treated by superficial plasticdeformation. It is given a brief description of the elastic and plastic modelation, theory of plasticity and dislocations, andshowed some results about modelation of roller burnishing using simulation techniques like finite elements method toobtain the mathematics models in order to calculate the maximum stresses and strains.Key words: Superficial plastic deformation, roller burnishing, finite elements method, modelation.

  19. Acute pain management in burn patients

    DEFF Research Database (Denmark)

    Gamst-Jensen, Hejdi; Vedel, Pernille Nygaard; Lindberg-Larsen, Viktoria Oline

    2014-01-01

    management addresses and alleviates these complications. The aim of our study was to compare clinical guidelines for pain management in burn patients in selected European and non-European countries. We included pediatric guidelines due to the high rate of children in burn units. METHOD: The study had...... patients. The most highly recommended guidelines provided clear and accurate recommendations for the nursing and medical staff on pain management in burn patients. We recommend the use of a validated appraisal tool such as the AGREE instrument to provide more consistent and evidence-based care to burn......OBJECTIVE: Burn patients suffer excruciating pain due to their injuries and procedures related to surgery, wound care, and mobilization. Acute Stress Disorder, Post-Traumatic Stress Disorder, chronic pain and depression are highly prevalent among survivors of severe burns. Evidence-based pain...

  20. The anatomy of the superficial external pudendal artery: a quantitative study Anatomia da artéria pudenda superficial externa: estudo quantitativo

    Directory of Open Access Journals (Sweden)

    Osvaldir Lanzoni La Falce

    2006-10-01

    Full Text Available The importance of the superficial external pudendal artery in cases of lower limb obstructive arteriopathies has been established, and a perfect knowledge of its anatomy is desirable for the creation of successful flaps involving it. However, little information is available on the morphometry of this artery. PURPOSE: In this study, we conducted a quantitative investigation of the superficial external pudendal artery as the basis for skin grafts. METHOD: Twenty-five right and left sides of the inguinal region of male cadavers were dissected. After retracting the skin at the inguinal region, the femoral vessels and the sapheno-femoral junction were exposed. The following aspects were then analyzed: 1 the presence of the superficial external pudendal artery, 2 the place of origin of the superficial external pudendal artery and the common trunk, 3 the duplication of the superficial external pudendal artery, 4 the distance from the superficial external pudendal artery or the common trunk to the inguinal ligament, and 5 the diameter of the superficial external pudendal artery. RESULTS: The results were the following: 1 superficial external pudendal arteries were found in 46 of 50 sides (92%; 2 they originated from the femoral artery in 45 cases and from the deep femoral artery in only 1 case; 3 the arteries were found duplicated in 21 cases (46%, as a common trunk in 11 cases (24%, and as a single artery in 14 cases (30%; 4 the distance from the superficial external pudendal artery to the inguinal ligament ranged from 0.8 cm to 8.5 cm; from the common trunk, it ranged from 3.5 cm to 6.7 cm; 5 the diameter of the superficial external pudendal artery ranged from 1.2 mm to 3.8 mm; and 6 the diameter of the common trunk ranged from 1.35 mm to 5.15 mm. CONCLUSION: The results show that the superficial external pudendal artery generally originates from the femoral artery. It was found as a common trunk, duplicated, or as a single artery. There was a great

  1. High-lateral-tension abdominoplasty with superficial fascial system suspension.

    Science.gov (United States)

    Lockwood, T

    1995-09-01

    Modern abdominoplasty techniques were developed in the 1960s. The advent of liposuction has reduced the need for classic abdominoplasty and allowed more aesthetic sculpting of the entire trunk. However, the combination of significant truncal liposuction and classic abdominoplasty is not recommended due to the increased risk of complications. Although the surgical principles of classic abdominoplasty certainly have stood the test of time, they are based on two theoretical assumptions that may be proved to be inaccurate. The first assumption is that wide direct undermining to costal margins is essential for abdominal flap advancement. In fact, discontinuous undermining allows effective loosening of the abdominal flap while preserving vascular perforators. The second inaccurate assumption is that with aging and weight fluctuations (including pregnancy), abdominal skin relaxation occurs primarily in the vertical direction from the xiphoid to the pubis. This is true in the lower abdomen, but in most patients a strong superficial fascial system adherence to the linea alba in the epigastrium limits vertical descent. Epigastric laxity frequently results from a progressive horizontal loosening due to relaxation of the tissue along the lateral trunk. Experience with the lower-body lift procedure has shown that significant lateral truncal skin resection results in epigastric tightening. In these patients, the ideal abdominoplasty pattern would resect as much or more laterally than centrally, leading to more natural abdominal contours. Fifty patients who underwent high-lateral-tension abdominoplasty with and without significant truncal liposuction and other aesthetic procedures were followed for 4 to 16 months. The primary indication for surgery was moderate to severe laxity of abdominal skin and muscle with or without truncal fat deposits. Complication rates were equal to or less than those of historical controls and did not increase with significant adjunctive liposuction

  2. Fluid management in major burn injuries

    Directory of Open Access Journals (Sweden)

    Haberal Mehmet

    2010-10-01

    Full Text Available It is a widely accepted fact that severe fluid loss is the greatest problem faced following major burn injuries. Therefore, effective fluid resuscitation is one of the cornerstones of modern burn treatment. The aim of this article is to review the current approaches available for modern trends in fluid management for major burn patients. As these current approaches are based on various experiences all over the world, the knowledge is essential to improve the status of this patient group.

  3. Vitamin E Supplementation in Burn Patients

    Science.gov (United States)

    2015-10-01

    AWARD NUMBER: W81XWH-12-1-0429 TITLE: Vitamin E Supplementation in Burn Patients PRINCIPAL INVESTIGATOR: Perenlei Enkhbaatar, MD., PhD...NOTES 14. ABSTRACT Our recent findings demonstrate that burn injury significantly depleted stores of vitamin E in adipose tissue of children by nearly...oxidative stress. The objectives of our proposal were to a) attenuate alpha-tocopherol depletion in burn patients by vitamin E supplementation, b) to

  4. Infection control in severely burned patients

    OpenAIRE

    Coban, Yusuf Kenan

    2012-01-01

    In the last two decades, much progress has been made in the control of burn wound infection and nasocomial infections (NI) in severely burned patients. The continiually changing epidemiology is partially related to greater understanding of and improved techniques for burn patient management as well as effective hospital infection control measures. With the advent of antimicrobial chemotherapeutic agents, infection of the wound site is now not as common as, for example, urinary and blood strea...

  5. Managing burn patients in a fire disaster: Experience from a burn unit in Bangladesh.

    Science.gov (United States)

    Mashreky, S R; Bari, S; Sen, S L; Rahman, A; Khan, T F; Rahman, F

    2010-09-01

    Although burn disaster is not a frequent event, with urbanisation and industrialisation, burn disaster is becoming an emerging problem in Bangladesh. On 3 June 2010, a fire disaster killed 124 people in Neemtali, Dhaka, Bangladesh. This paper narrates the management of burn patients of this disaster in the burn unit of Dhaka Medical College Hospital. The burn unit managed 192 burn victims of the disaster. Forty-two victims were admitted and 150 of them received primary care at the emergency room and were sent back home. Ten patients among 42 in-patients died. The in-patient mortality was 23.8%. Burn unit in Dhaka Medical College Hospital is the only burn management centre in Bangladesh. Proper planning and coordinated effort by all sectors and persons concerned were the key elements in this successful management.

  6. Managing burn patients in a fire disaster: Experience from a burn unit in Bangladesh

    Directory of Open Access Journals (Sweden)

    Mashreky S

    2010-10-01

    Full Text Available Although burn disaster is not a frequent event, with urbanisation and industrialisation, burn disaster is becoming an emerging problem in Bangladesh. On 3 June 2010, a fire disaster killed 124 people in Neemtali, Dhaka, Bangladesh. This paper narrates the management of burn patients of this disaster in the burn unit of Dhaka Medical College Hospital. The burn unit managed 192 burn victims of the disaster. Forty-two victims were admitted and 150 of them received primary care at the emergency room and were sent back home. Ten patients among 42 in-patients died. The in-patient mortality was 23.8%. Burn unit in Dhaka Medical College Hospital is the only burn management centre in Bangladesh. Proper planning and coordinated effort by all sectors and persons concerned were the key elements in this successful management.

  7. The Hand Burn Severity (HABS) score: A simple tool for stratifying severity of hand burns.

    Science.gov (United States)

    Bache, Sarah E; Fitzgerald O'Connor, Edmund; Theodorakopoulou, Evgenia; Frew, Quentin; Philp, Bruce; Dziewulski, Peter

    2017-02-01

    Hand burns represent a unique challenge to the burns team due to the intricate structure and unrivalled functional importance of the hand. The initial assessment and prognosis relies on consideration of the specific site involved as well as depth of the burn. We created a simple severity score that could be used by referring non-specialists and researchers alike. The Hand Burn Severity (HABS) score stratifies hand burns according to severity with a numerical value of between 0 (no burn) and 18 (most severe) per hand. Three independent assessors scored the photographs of 121 burned hands of 106 adult and paediatric patients, demonstrating excellent inter-rater reliability (r=0.91, pburn depth alone. The HABS score is a simple to use tool to stratify severity at initial presentation of hand burns which will be useful when referring, and when reporting outcomes. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  8. Patient safety measures in burn care: do National reporting systems accurately reflect quality of burn care?

    Science.gov (United States)

    Mandell, Samuel P; Robinson, Ellen F; Cooper, Claudette L; Klein, Matthew B; Gibran, Nicole S

    2010-01-01

    Recently, much attention has been placed on quality of care metrics and patient safety. Groups such as the University Health-System Consortium (UHC) collect and review patient safety data, monitor healthcare facilities, and often report data using mortality and complication rates as outcomes. The purpose of this study was to analyze the UHC database to determine if it differentiates quality of care across burn centers. We reviewed UHC clinical database (CDB) fields and available data from 2006 to 2008 for the burn product line. Based on the September 2008 American Burn Association (ABA) list of verified burn centers, we categorized centers as American Burn Association-verified burn centers, self-identified burn centers, and other centers that are not burn units but admit some burn patients. We compared total burn admissions, risk pool, complication rates, and mortality rates. Overall mortality was compared between the UHC and National Burn Repository. The UHC CDB provides fields for number of admissions, % intensive care unit admission, risk pool, length of stay, complication profiles, and mortality index. The overall numbers of burn patients in the database for the study period included 17,740 patients admitted to verified burn centers (mean 631 admissions/burn center/yr or per 2 years), 10,834 for self-identified burn centers (mean 437 admissions/burn center/yr or per 2 years), and 1,487 for other centers (mean 11.5 admissions/burn center/yr or per 2 years). Reported complication rates for verified burn centers (21.6%), self-identified burn centers (21.3%), and others (20%) were similar. Mortality rates were highest for self-identified burn centers (3.06%), less for verified centers (2.88%), and lowest for other centers (0.74%). However, these outcomes data may be misleading, because the risk pool criteria do not include burn-specific risk factors, and the inability to adjust for injury severity prevents rigorous comparison across centers. Databases such as the

  9. Medical management of paediatric burn injuries: best practice.

    Science.gov (United States)

    Kim, Leo K P; Martin, Hugh C O; Holland, Andrew J A

    2012-04-01

    Burns commonly occur in children and their first aid remains inadequate despite burn prevention programmes. While scald injuries predominate, contact and flame burns remain common. Although typically less severe injuries overall than those in adults, hypertrophic scarring complicating both the burn wound and even donor sites occur more frequently in children. The heterogeneous nature of burn wounds, coupled with the difficulties associated with the early clinical assessment of burn depth, has stimulated the application of novel technologies to predict burn wound outcome. This review explores current best practice in the management of paediatric burns, with a focus on prevention, optimal first aid, resuscitation, burn wound prediction and wound management strategies.

  10. Burn site groundwater interim measures work plan.

    Energy Technology Data Exchange (ETDEWEB)

    Witt, Jonathan L. (North Wind, Inc., Idaho Falls, ID); Hall, Kevin A. (North Wind, Inc., Idaho Falls, ID)

    2005-05-01

    This Work Plan identifies and outlines interim measures to address nitrate contamination in groundwater at the Burn Site, Sandia National Laboratories/New Mexico. The New Mexico Environment Department has required implementation of interim measures for nitrate-contaminated groundwater at the Burn Site. The purpose of interim measures is to prevent human or environmental exposure to nitrate-contaminated groundwater originating from the Burn Site. This Work Plan details a summary of current information about the Burn Site, interim measures activities for stabilization, and project management responsibilities to accomplish this purpose.

  11. Burn healing plants in Iranian Traditional Medicine

    Directory of Open Access Journals (Sweden)

    Sh. Fahimi

    2015-11-01

    Full Text Available Burns are known as one of the most common forms of injury with devastating consequences. Despite the discovery of several antiseptics, burn wound healing has still remained a challenge to modern medicine. Herbal products seem to possess moderate efficacy with no or less toxicity and are less expensive compared to synthetic drugs. Burn is a well-known disorder in Iranian Traditional Medicine (ITM. Iranian physicians have divided burns into various types based on the cause and recommended treatment for each type. According to ITM references, herbal therapy was the major treatment prescribed by Iranian physicians for burns. In the present study, seven ancient Iranian medical texts were screened for the herbs with burn healing effects along with their applied dosage forms. The medicinal herbs were listed and scored based on the frequency of their repetition. Moreover, the best scientific name that was suitable for each plant as well as surveying modern studies about their biological effects has been carried out. In our investigation eighteen plants with seven topical application categories have been obtained as the most frequent herbs for burn healing in ITM. Modern studies have revealed that these plants have shown some biological activities such as anti-inflammatory, antimicrobial and antioxidant effects which might establish the relationship between the mentioned activities and burn wound healing property. This list can provide a suitable resource for future researches in the field of burn treatment.

  12. Aeromonas hydrophila in a burn patient.

    Science.gov (United States)

    Yasti, Ahmet Cinar; Otan, Emrah; Doganay, Mutlu; Kama, Nuri A

    2009-01-01

    Infectious consequences are still a major problem and leading cause of mortality in burn patients. Among others, aeromonads need special concern because they mimic pseudomonal infections; however, they have a more rapid progression with considerable mortality if undiagnosed promptly. Here, we present a major burn case extinguished with tap water pooled in a tank. With the possibility of aeromonal infection in mind, the patient underwent aggressive debridement with proper antibiotic medication, which resulted in a successful patient management. Aeromonads should always be kept in mind in burn cases that contacted with tanked water or soil after the burn.

  13. Hospital costs associated with pediatric burn injury.

    Science.gov (United States)

    Klein, Matthew B; Hollingworth, William; Rivara, Frederick P; Kramer, C Bradley; Askay, Shelley W; Heimbach, David M; Gibran, Nicole S

    2008-01-01

    Modern burn care is a resource intensive endeavor requiring specialized equipment, personnel, and facilities in order to provide optimum care. The costs associated with burn injury to both patients and society as a whole can be multifaceted and large. The purpose of this study was to evaluate the association between hospital costs, patient characteristics, and injury factors in a cohort of pediatric patients admitted to a regional burn center. We performed a review of the hospital charges accrued by pediatric patients (age dollar costs using an inflation index and a cost to charge ratio. Univariate and multivariate regressions were performed to identify the factors most significantly associated with cost. In addition, we performed a subset cost analysis for patients with burns more than 20% TBSA. A total of 1443 pediatric patients (age dollars was dollars 9026 (SD = dollars 25,483; median = dollars 2138). Area of full thickness burn was the only patient or injury factor significantly associated with greater hospital costs (P < .05) on multivariate analysis. No single anatomic area was associated with increased hospital costs when adjusted for total overall burn size. Injury severity was the most significant factor impacting index hospitalization costs following pediatric burn injury. Further studies defining the long-term societal costs impact of burn injury are needed as are studies that evaluate the impact of burn injury on quality of life.

  14. Renal failure in burn patients: a review.

    Science.gov (United States)

    Emara, S S; Alzaylai, A A

    2013-03-31

    Burn care providers are usually challenged by multiple complications during the management of acute burns. One of the most common complications worldwide is renal failure. This article reviews the various aspects of renal failure management in burn patients. Two different types of renal failures develop in these patients. The different aetiological factors, incidence, suspected prognosis, ways of diagnosing, as well as prevention methods, and the most accepted treatment modalities are all discussed. A good understanding and an effective assessment of the problem help to reduce both morbidity and mortality in burn management.

  15. Cutaneous osteosarcoma arising from a burn scar

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Min A.; Yi, Jaehyuck [Kyungpook National University, Department of Radiology, College of Medicine, Daegu (Korea, Republic of); Kyungpook National University Hospital, Department of Radiology, Daegu (Korea, Republic of); Chae, Jong Min [Kyungpook National University, Department of Pathology, College of Medicine, Daegu (Korea, Republic of)

    2017-04-15

    Tumors that develop in old burn scars are usually squamous cell carcinomas. Sarcomas have also been reported, albeit rarely. To our knowledge, there has been only one case report of an extraskeletal osteosarcoma arising in a prior burn scar reported in the English-language literature, mainly discussing the clinicopathological features. Herein, we present a case of cutaneous osteosarcoma visualized as a mineralized soft-tissue mass arising from the scar associated with a previous skin burn over the back. This seems to be the first report describing the imaging features of a cutaneous osteosarcoma from an old burn scar. (orig.)

  16. High burn rate solid composite propellants

    Science.gov (United States)

    Manship, Timothy D.

    High burn rate propellants help maintain high levels of thrust without requiring complex, high surface area grain geometries. Utilizing high burn rate propellants allows for simplified grain geometries that not only make production of the grains easier, but the simplified grains tend to have better mechanical strength, which is important in missiles undergoing high-g accelerations. Additionally, high burn rate propellants allow for a higher volumetric loading which reduces the overall missile's size and weight. The purpose of this study is to present methods of achieving a high burn rate propellant and to develop a composite propellant formulation that burns at 1.5 inches per second at 1000 psia. In this study, several means of achieving a high burn rate propellant were presented. In addition, several candidate approaches were evaluated using the Kepner-Tregoe method with hydroxyl terminated polybutadiene (HTPB)-based propellants using burn rate modifiers and dicyclopentadiene (DCPD)-based propellants being selected for further evaluation. Propellants with varying levels of nano-aluminum, nano-iron oxide, FeBTA, and overall solids loading were produced using the HTPB binder and evaluated in order to determine the effect the various ingredients have on the burn rate and to find a formulation that provides the burn rate desired. Experiments were conducted to compare the burn rates of propellants using the binders HTPB and DCPD. The DCPD formulation matched that of the baseline HTPB mix. Finally, GAP-plasticized DCPD gumstock dogbones were attempted to be made for mechanical evaluation. Results from the study show that nano-additives have a substantial effect on propellant burn rate with nano-iron oxide having the largest influence. Of the formulations tested, the highest burn rate was a 84% solids loading mix using nano-aluminum nano-iron oxide, and ammonium perchlorate in a 3:1(20 micron: 200 micron) ratio which achieved a burn rate of 1.2 inches per second at 1000

  17. Stimulation of Superficial Zone Protein/Lubricin/PRG4 by Transforming Growth Factor-β in Superficial Zone Articular Chondrocytes and Modulation by Glycosaminoglycans.

    Science.gov (United States)

    Cuellar, Araceli; Reddi, A Hari

    2015-07-01

    Superficial zone protein (SZP), also known as lubricin and proteoglycan 4 (PRG4), plays an important role in the boundary lubrication of articular cartilage and is regulated by transforming growth factor (TGF)-β. Here, we evaluate the role of cell surface glycosaminoglycans (GAGs) during TGF-β1 stimulation of SZP/lubricin/PRG4 in superficial zone articular chondrocytes. We utilized primary monolayer superficial zone articular chondrocyte cultures and treated them with various concentrations of TGF-β1, in the presence or absence of heparan sulfate (HS), heparin, and chondroitin sulfate (CS). The cell surface GAGs were removed by pretreatment with either heparinase I or chondroitinase-ABC before TGF-β1 stimulation. Accumulation of SZP/lubricin/PRG4 in the culture medium in response to stimulation with TGF-β1 and various exogenous GAGs was demonstrated by immunoblotting and quantitated by enzyme-linked immunosorbent assay. We show that TGF-β1 and exogenous HS enhanced SZP accumulation of superficial zone chondrocytes in the presence of surface GAGs. At the dose of 1 ng/mL of TGF-β1, the presence of exogenous heparin inhibited SZP accumulation whereas the presence of exogenous CS stimulated SZP accumulation in the culture medium. Enzymatic depletion of GAGs on the surface of superficial zone chondrocytes enhanced the ability of TGF-β1 to stimulate SZP accumulation in the presence of both exogenous heparin and CS. Collectively, these results suggest that GAGs at the surface of superficial zone articular chondrocytes influence the response to TGF-β1 and exogenous GAGs to stimulate SZP accumulation. Cell surface GAGs modulate superficial zone chondrocytes' response to TGF-β1 and exogenous HS.

  18. Development of a Skin Burn Predictive Model adapted to Laser Irradiation

    Science.gov (United States)

    Sonneck-Museux, N.; Scheer, E.; Perez, L.; Agay, D.; Autrique, L.

    2016-12-01

    Laser technology is increasingly used, and it is crucial for both safety and medical reasons that the impact of laser irradiation on human skin can be accurately predicted. This study is mainly focused on laser-skin interactions and potential lesions (burns). A mathematical model dedicated to heat transfers in skin exposed to infrared laser radiations has been developed. The model is validated by studying heat transfers in human skin and simultaneously performing experimentations an animal model (pig). For all experimental tests, pig's skin surface temperature is recorded. Three laser wavelengths have been tested: 808 nm, 1940 nm and 10 600 nm. The first is a diode laser producing radiation absorbed deep within the skin. The second wavelength has a more superficial effect. For the third wavelength, skin is an opaque material. The validity of the developed models is verified by comparison with experimental results (in vivo tests) and the results of previous studies reported in the literature. The comparison shows that the models accurately predict the burn degree caused by laser radiation over a wide range of conditions. The results show that the important parameter for burn prediction is the extinction coefficient. For the 1940 nm wavelength especially, significant differences between modeling results and literature have been observed, mainly due to this coefficient's value. This new model can be used as a predictive tool in order to estimate the amount of injury induced by several types (couple power-time) of laser aggressions on the arm, the face and on the palm of the hand.

  19. Deciding Where to Burn: Stakeholder Priorities for Prescribed Burning of a Fire-Dependent Ecosystem

    Directory of Open Access Journals (Sweden)

    Jennifer K. Costanza

    2011-03-01

    Full Text Available Multiagency partnerships increasingly work cooperatively to plan and implement fire management. The stakeholders that comprise such partnerships differ in their perceptions of the benefits and risks of fire use or nonuse. These differences inform how different stakeholders prioritize sites for burning, constrain prescribed burning, and how they rationalize these priorities and constraints. Using a survey of individuals involved in the planning and implementation of prescribed fire in the Onslow Bight region of North Carolina, we examined how the constraints and priorities for burning in the longleaf pine (Pinus palustris ecosystem differed among three stakeholder groups: prescribed burn practitioners from agencies, practitioners from private companies, and nonpractitioners. Stakeholder groups did not differ in their perceptions of constraints to burning, and development near potentially burned sites was the most important constraint identified. The top criteria used by stakeholders to decide where to burn were the time since a site was last burned, and a site's ecosystem health, with preference given to recently burned sites in good health. Differences among stakeholder groups almost always pertained to perceptions of the nonecological impacts of burning. Prescribed burning priorities of the two groups of practitioners, and particularly practitioners from private companies, tended to be most influenced by nonecological impacts, especially through deprioritization of sites that have not been burned recently or are in the wildland-urban interface (WUI. Our results highlight the difficulty of burning these sites, despite widespread laws in the southeast U.S. that limit liability of prescribed burn practitioners. To avoid ecosystem degradation on sites that are challenging to burn, particularly those in the WUI, conservation partnerships can facilitate demonstration projects involving public and private burn practitioners on those sites. In summary

  20. Saphenous Vein Sparing Superficial Inguinal Dissection in Lower Extremity Melanoma

    Directory of Open Access Journals (Sweden)

    Muhammed Beşir Öztürk

    2014-01-01

    Full Text Available Aim. The classic inguinal lymph node dissection is the main step for the regional control of the lower extremity melanoma, but this surgical procedure is associated with significant postoperative morbidity. The permanent lymphedema is the most devastating long-term complication leading to a significant decrease in the patient’s quality of life. In this study we present our experience with modified, saphenous vein sparing, inguinal lymph node dissections for patients with melanoma of the lower extremity. Methods. Twenty one patients (10 women, 11 men who underwent saphenous vein sparing superficial inguinal lymph node dissection for the melanoma of lower extremity were included in this study. The effects of saphenous vein sparing on postoperative complications were evaluated. Results. We have observed the decreased rate of long-term lymphedema in patients undergoing inguinal lymphadenectomy for the lower extremity melanoma. Conclusion. The inguinal lymphadenectomy with saphenous vein preservation in lower extremity melanoma patients seems to be an oncologically safe procedure and it may offer reduced long-term morbidity.