Burns : journal of the International Society for Burn Injuries
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This report presents the experience gained from 26 patients treated with autogenic cultured epithelial grafts (auto-CEG). All auto-CEG were applied to wounds clinically defined as full skin thickness injury. In total 89 separate sites were grafted. ⋯ An increased incidence of wound colonization with pathogenic species of bacteria corresponded with a decreased graft 'take'. Ps. aeruginosa and Staph. aureus were found to be present on 32.6 per cent and 60.5 per cent of wound swabs respectively, where 10 per cent or less 'take' of auto-CEG was seen, indicating that bacterial infection is in part responsible for graft failure. However, in 20.9 per cent of such instances, no growth of bacteria was detected, perhaps suggesting that certain wound beds may not present the correct physical environment necessary to support proliferating epithelial cells isolated from their underlying dermal component.
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A 17-year survey of all electrical burns admitted to the Department of Plastic and Reconstructive Surgery at the Kilpauk Medical College Hospital, Madras between 1973 and 1990 has been made. A total of 8040 cases of burns were treated in this Department and in this group 923 were pure electrical burns. ⋯ Most of the patients required primary reconstruction and this was delayed when the viability of tissues was in doubt. Human error was responsible for the injury in 68 per cent of patients and all the 64 patients who were below the age of 10 years belonged to this group.
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Prior to 1989 burns were resuscitated at the Burns Unit Frenchay Hospital according to the Mount Vernon formula. In 1989 a 33 per cent modification was introduced as suggested by Watson, Walker and Sanders. The aim of this study was to examine retrospectively the effects of the resuscitation protocols on morbidity and mortality. ⋯ No difference in morbidity or mortality was shown. However, the investigation did show that the 1989 patients achieved urine outputs indicative of overtransfusion. It is concluded that the Watson-Walker modification is unnecessary and possibly undesirable.
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The major psychological sequelae experienced by patients 1 year after burn injury were investigated. Data were collected on a consecutive series of adult burn patients, (n = 55), including major demographic and epidemiological characteristics. Participants (n = 23) completed the Hospital Anxiety Depression Scale (HADS), the Impact of Event Scale (IES) and a questionnaire covering functional impairment, visibility of the burn, experience of pain, etc. ⋯ The visibility of the burn was found to be a useful factor in the prediction of psychological outcome (P = 0.001-0.018). No additional variables were found to increase the significance of prediction. Patients indicated that practical advice in the form of staff-led discussions, before or immediately after discharge, would be the most valuable help.
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This report extends our earlier studies of the abnormal protein bands found in burn sera by use of Western blotting and ion exchange chromatography. The current studies indicated that some of the protein bands contained materials with immunosuppressive activity. ⋯ Many of the other proteins in the bands were found to be acute phase reactant proteins without immunosuppressive activity. Some proteins in these bands have not yet been characterized or tested for immunosuppressive activity.