Burns : journal of the International Society for Burn Injuries
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To assess the safety and efficacy of bioengineered skin substitutes in comparison with biological skin replacements and/or standard dressing methods in the management of burns, through a systematic review of the literature. ⋯ Additional methodologically rigorous randomised controlled trials with long-term follow-up would strengthen the evidence base for the use of bioengineered skin substitutes.
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Clinical Trial
The safety of nanocrystalline silver dressings on burns: a study of systemic silver absorption.
Wound dressings containing silver have been in widespread use for many years. However, there are few quantitative data on the systemic absorption of silver or whether there is associated clinical risk. ⋯ This study has confirmed our view that Acticoat products are safe for use on burns and they remain a standard part of treatment at our centre.
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Biobrane is a biosynthetic wound dressing, first used by Woodruff in 1979, which has many of the ideal properties of a dressing as outlined by Pruitt and Levine [Pruitt Jr BA, Levine NS. Characteristics and uses of biologic dressings and skin substitutes. ⋯ When used appropriately, it has been shown to reduce pain levels, healing time, inpatient stay and nursing requirements when compared to traditional dressings. We present the results of a national study concerning the use of Biobrane in the United Kingdom, highlight variations in practice, discuss the pertinent issues, make suitable recommendations and highlight the versatility of Biobrane as a wound dressing.
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Severe burn results in severe and unique physiological changes called burn shock. Historically, resuscitation has been guided by a combination of basic laboratory values, invasive monitoring and clinical findings, but the optimal guide to the endpoint of resuscitation still remains controversial. Two hundred and eighty patients, who were admitted to our Burn Unit, were enrolled in this prospective study. ⋯ Moreover, an outcome predictor of shock and effective resuscitation could be defined by evaluating the changes of BD on Day 1. Normalization of the BD within 24 h is associated with a better chance of survival. One explanation for this phenomenon might be the fact that many burn patients are still sub-optimally resuscitated; in summary, measuring PL and BD may help to identify critically injured patients either for enhancement of treatment, or selection of therapeutic options.