An experimental study was designed on the treatment of 8 superficial burn wounds and 5 wounds after removing the split-thickness skin grafts with 200GS permanent magnetic flat dressings, and some of the wounds were chosen at random which did not received any treatment and would be served as control. It was noted that the volume of exudate in the treatment group was 11.9 50.7％ less than that of the control group, and the total protein, the albumin and globulin contents in the treatment cases were far less in exudate than those of the control cases. It was concluded that the magnetic therapy not only decresed the exudate, but also diminished the amount of total protein, albumin and globulin in the exudating fluid and it was of benefit to wound recovery.
OBJECTIVE: To explore an optimal method of recombinant human epidermal growth factor(rhEGF) application on the burn wounds of superficial II degree and profound II degree for accelerating its healing. METHODS: There were 180 burn wounds in 60 patients with the self-corresponding wound of the same degree as controls. The wounds of all patients were divided three regions(A, B, C). The wounds were treated once a day with 1% SD-Ag in region A as controls, with rhEGF(40 U/cm2) in region B, and with a combination of rhEGF(40 U/cm2) and Su Yu Ping (5 g) in region C. The wound healing time was recorded and compared. RESULTS: In regions A, B and C, the healing time of superficial II degree wound was (13.20 +/- 2.40) days, (10.20 +/- 2.20) days and (8.72 +/- 2.31) days (P lt; 0.01); that of profound II degree wound was (20.10 +/- 3.40) days, (17.20 +/- 3.12) days and (15.10 +/- 3.81) days respectively (P lt; 0.01, P lt; 0.05). The healed wound of profound II degree was elastic and tough in regions B and C, while that was not elastic and tough, and congestive in region A. CONCLUSION: The above results indicate that rhEGF can enhance burn wound healing markedly and that a combination rhEGF and Su Yu Ping has more significant effect than rhEGF alone and is recommended for clinical application.
Objective To observe the clinical effect of the human tissue engineered activeskin (ActivSkin) with full thickness on the donor site of the split thickness skin graft. Methods Nine patients with 18 wounds of the donor sites, and every p atient had 2 wounds. The wounds of each patient were randomly assigned to the therapy group and the control group. Autocontrol observation was performed. Nine donor sites of the split thickness skin graft were repaired with ActivSkin in the therapy group. Nine donor sites of the split thickness skin graft were repaired with the vash oil gauze in the control group. The wound pain, the time to complete closure, and the ratio of the complete healing in the ActivSkin therapy gro up was measured and compared with those in the control group. The donor sites of the split thickness skin graft were assessed at 180 days of the follow-up visit . Results The wound pain was obviously reduced after the harvest ing of the skin grafts in the therapy group. The time to complete closure on the donor sites of the split thickness skin graft was significantly shorter in the ActivSkin therap y group than in the control group (9.67±2.92 d vs.16.56±2.96 d, Plt;0.05 ). Both the ratios of the complete healing in the ActivSkin therapy group and the control group were 100%（Pgt;0.05）. The subsequent results showed that neit her the blister nor the residual wound occurred with an alleviated scar after the Ac tivSkin treatment. Conclusion ActivSkin can promote wound closure, prevent blister and residual wound, and alleviate scarring on the donor sites of the splitthickness skin graft after the ActivSkin treatment.
In order to correct the dysfunction of head and neck with scar contracture, since 1980, sixty-two cases were undertaken the operation by using local skin flap to repair the soft tissue defect after scar resection. The skin flaps included pedicled delto-thoracic skin flap in 26 cases, cervico-thoracic skin flaps in 25 cases, cervico-shoulder flaps in 6 cases, pedicled vascularized extralong delto-thoracic skin flap in 4 cases and free parascapular flap in 1 case. Sixty cases had total survival of the flaps and 2 flaps had partial necrosis. After 1 to 10 years follow-up, the appearance and function of neck were excellent. It was suggested that grafting local skin flap was a good method to treat cicatricial deformity of neck especially using the skin flap with pedicle and vascular bundle.
ObjectiveTo explore the effects of burn ward cleaning methods on multi-drug resistant bacteria infection, in order to improve and optimize the cleaning process and method. MethodsFrom November 2012 to October 2013, the cleaning and disinfection methods in our burn wards were regarded as the traditional cleaning methods, and from November 2013 to October 2014, the cleaning and disinfection methods were called the improved cleaning methods (new system cleaning methods). By retrospective analysis, we compared the infection rates of multi-drug resistant bacteria before and after the implementation of the new system cleaning methods. ResultsNew system methods were used in the ward environment cleaning and disinfection. The infection rate of multi-drug resistant bacteria before and after the implementation of the new system cleaning methods were 12.414‰ and 5.922‰ respectively. The methicillin resistant Staphylococcus aureus infection rate was 7.286‰ and 3.718‰, and the carbon-resistant Pseudomonas aeruginosa infection rate was 2.699‰ and 0.689‰. Both differences were significant (P < 0.05). The carbon-resistant Acinetobacter baumanii infection rate was 2.429‰ and 1.515‰ before and after the implementation of the new methods with no significant difference (P > 0.05). ConclusionAdopting new system to carry out cleaning can effectively reduce the infection rate of multi-drug resistant bacteria in the burn ward, and it is worthy of clinical popularization and application.
hrbondioxide laser knife was ued to excise 40 cases of burn crusts and late cicatrices and the resuIts were compored with that from the ordinary surgieal knife. The extent of tiSsue damage,the operative successful rate and the amount of bleeding were obsered in both groupe. It was proved that by using,earbondioxide laser knife to excIse the tissue resulted in very limited damage of tissue,it did not influence the tissue healing and the amount of bleeding was far less than that fro...
To investigate an effective method in clinical application of using different kinds of skin flaps for repair of the finger deep burns. Methods The groin skin flap, the paraumbilical skin flap, the volar digital advancement flap, the island flap from the dorsum of the index finger, the lateral digital neurovascular island flap, and the island skin flap nourished by the cutaneous nerve nutrient vessel of the dorsum were employed to repair 157 fingers in 101 patients (78 males, 23 females, aged 12-56 years, averaged 34.6 years) from January 1997 to December 2006. Of the 101patients, 37 had a deep partial thickness burn involving 59 fingers, and 64 hada full thickness burn involving 98 fingers. The soft tissue defects ranged in area from 1.0 cm×1.0 cm to 6.5 cm×6.0 cm. The interval between the injury and the operation was 4 hours to 5 days in 89 patients, and 18 to 27 days in the other 12 patients who also had infected wounds. The flaps ranged in size from 1.2 cm×1.2 cm to 7.8 cm×6.5 cm. The donor site was directly sutured in 84 patients, and the donor site was covered by a full thickness skin graft in the other 17 patients. Results After operation, 98 patients had an incision healing by first intention and the flaps survived well; the other 3 patients had congestion and necrosis in the flap edges, and had a delayed healing after the dressing changes. All the donor sites had a healing by first intention. The followup of all the patients for 224 months averaged 6.5 months revealed that 9 patients, who had been given the paraumbilical skin flap, had a fat and clumsy finger; 14 patients, who had been given the groin skin flap, also had a fat and clumsy finger; 3 patients developed congestion and necrosis at their edges. The remaining patients had a satisfactory survival of the skin flaps and a normallyshaped finger. The flaps had a good appearance, with the twopoint discrimination of 510 mm, the good finger motion ability, and the satisfactory finger appearance.Conclusion The volar digital advancement flap,the island flap from the dorsum of the index finger, the lateral digital neurov ascular island flap, and the island skin flap nourished by the cutaneous nerve nutrient vessel of the dorsum are good skin flaps for repair of the finger deep burns. The groin skin flap and the paraumbilical skin flap are also good skin flaps for repair of the deep burns of the mutiple fingers but the postoperative finger may become a bit fat and clumsy.
OBJECTIVE: To evaluate the application of skin and soft tissue expansion in the treatment of deformity due to extensive severe burn injury and repair of severe deep electrical burned scalp and skull with fresh wound. METHODS: From 1988, 83 cases of application of skin and soft tissue expansion were reported. In those patients with deformity due to severe burn of large area and with whole nasal defect, soft tissue expander was used under the forehead skin graft and venter frontalis, followed by reconstruction of nose with the expanded vascularized skin flap and carved cartilago costalis as nasal frame. In patients of severe deep electrical burned scalp and skull with fresh wound, skin and soft tissue expansion were used to repair the wound simultaneously with scalp burn alopecia, anesthetics and antibiotics injected into the extracapsular space of the expander in case of pain and infection. RESULTS: All of the cases were successfully treated with little pain and minimized infection. CONCLUSION: Skin and soft tissue expansion in a safe and reliable measure in the treatment of deformity due to extensive severe burn injury and repair of severe deep electrical burned scalp and skull with fresh wound.
Objective To explore the mechanism of full-thickness burn wound healing with autoskin grafting in fault hypodermis wound of granulation excision and to evaluate its effect.Methods By the techniques of clinical observation, histopathology, immunohistochemistry,TEM and FCM,we observed changes of the activity andstructure of grafted skin and the granulation tissue,collagnous fiber,microvessels,the ultramicrostructure of fibroblasts and the expression of basic fibroblast growth factor(bFGF) in the base of autoskin grafting in fault hypodermis wound in burned adult minipigs(Group A), and compared with traditional method of autoskingrafting on the basilar fibrous tissue wound of scraped partly granulation being(Group B) and control group (Group C, without treatment except de-fur).Results The grafted skin survived after 3 days of operation, and it had less injury and higher proliferative index(PI) in group A than in group B. The hyperplasiaof granulation tissue and vascular endothelial and the expression of bFGF were more evident in group A. After 5 days, the proliferation of endothelial cells and granulation and the protein synthesis of fibroblasts were more active in groupA, and at this moment, fresh collagen appeared and proliferated more actively in group B. After 7-14 days, epidermic structure and dermic microvascular density became normal gradually, the granulation on grafting base matured and transformed into fibrous connective tissue in group A. The same change deferred about 2 days in group B. After 21 days, the above pathologic change in group A was less than that in group B. After 3060 days of operation, Group A achieved much less contraction and transfiguration than Group B, and the grafted skin was tender and movable. Conclusion Autoskin grafting in fault hypodermis wound of granulation excision has a better effect than traditional operation.
Objective To explore the appl ication of damage control surgery (DCS) strategy in the treatment of severe burn-trauma combined injury. Methods From January 2004 to December 2009, 28 patients with severe burn-trauma combined injury received salvage treatment according to DCS, including 12 cases of burn combining injury at 2 sites, 6 cases ofburn combining injury at 3 sites, and 10 cases of burn combining injury at 4 sites or above. There were 18 males and 10 females with a median age of 39.5 years (range, 8-56 years). The burn area was 15% to 56% of total body surface area. The injury severity score a (ISS) was 25 to 56, and the traumatic index was 17 to 24. Lethal triad syndrome occurred in all patients. Of them, 16 cases were on admission immediatly after first-aid, and 12 cases were thansferred from other hospitals. The time from injury to hospital ization was 20 minutes to 36 hours. All patients were treated by immediate fluid resuscitation and emergent operation to control hemorrhage and contaminations. Biological dressings were used to seal the wounds provisionally. The systemic therapy was carried out as soon as the vital signs of the patients became stable. Results In 26 survivors, 23 achieved wound heal ing by first intention, 3 had a l ittle residual wound at discharge. The hospital ization days were 31 to 398 days (62 days on average). However, 1 patient died of multiple organ failure, another 1 patient died of severe cerebral trauma with refractory shock. Conclusion The DCS strategy is effective in reducing mortal ity of patients with severe burn-trauma combined injury.