Burns : journal of the International Society for Burn Injuries
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The field of wound healing and tissue repair has advanced rapidly in the last decade, with this there is an increasing emphasis on the importance of the functional and cosmetic outcomes following injury. Integra artificial skin is the most widely used synthetic skin substitute and is reported to have better outcomes in relation to the appearance and elasticity when compared to split thickness skin grafting (SSG). A review of the literature reveals very few trials that are based on an objective evaluation of Integra treated scars as compared to SSGs. This research aimed to provide objective data on the long-term outcome of Integra. ⋯ With advances in medicine we are increasingly able to modulate wound healing and the resultant scars. In order to assess new and often costly treatments the need for objective scar measurement tools have become apparent. Integra has been advocated to improve scarring from injury. However, there have been few studies to evaluate the long-term outcome of Integra as compared to traditional methods such as SSG. In the past scar evaluation has been based on subjective scores by patients and clinicians. Now the mechanical properties of the skin can be evaluated using simple bioengineering methods such as the Cutometer Suction Device. Using this device our study has objectively demonstrated that the elastic properties of areas treated with Integra is comparable to normal skin.
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To determine if patients receiving topical amphotericin B in combination with 5% mafenide acetate solution will acquire systemically detectable levels of amphotericin B. ⋯ We conclude that 5% mafenide acetate/amphotericin B (2 mcg/ml) solution, applied to excised and grafted burn wounds, does not produce clinically relevant serum levels of amphotericin B. Based on our observations, this topical regimen is safe.
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To identify treatment-related factors associated with mortality in massively burned adult patients. ⋯ Sepsis, ventilator dependence (indicating severe respiratory complications), and low platelet counts (indicating thrombocytopenia) are associated with increased mortality risk in adult patients with massive burns. Methods should be sought to ameliorate these complications during treatment in burn-care units.
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Platelet-rich plasma stimulates angiogenesis, promoting vascular in-growth and fibroblast proliferation. In addition, PRP functions as haemostatic by forming a fibrin clot. Also application of PRP enhances wound-healing in both soft and hard tissue. ⋯ The value of PRP application in burns remains unclear. A definitive assessment as to the application of PRP in burn treatment will require further studies. Theoretically the effects of PRP in burn wounds could be beneficial, however the interaction in tissue repair and regeneration must be better understood.
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This prospective study examined the extent to which the personality traits neuroticism, extraversion and agreeableness and coping styles approach, avoidant and ambivalent contribute to the development of depressive symptoms in adult burns survivors at three months post-injury. Participants were 70 adult burns survivors admitted to Royal Perth Hospital in Western Australia between June 2007 and February 2008. Personality was assessed using the NEO Personality Inventory-Revised (NEO-PI-R), coping was evaluated with the Coping with Burns Questionnaire (CBQ) and depressive symptoms were measured using The Centre for Epidemiologic Studies Depression Scale (CES-D). ⋯ Neuroticism significantly predicted depressive symptoms at three-month follow-up and this relationship was significantly mediated by avoidant coping. In addition, extraversion, avoidant coping and approach coping were all significant and independent predictors of depressive symptoms at three months. These findings suggest that burns patients at greatest risk of developing clinically significant depressive symptoms may be identifiable in the acute recovery phase.