Burns : journal of the International Society for Burn Injuries
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The nanocrystalline silver (NCS) dressing Acticoat is commonly used in clinical practice for the treatment of burns and other open wounds as a topical antimicrobial. The dressing may dry resulting in traumatic dressing changes; hence the variety of contact layer dressings used in conjunction with it. Dressing combinations that do not permit NCS penetration are not cost effective and deprives the wound of the needed anti-microbial. ⋯ Our results illustrate that we should perhaps reconsider dressing combination choices with Acticoat in view of their redundancy or synergistic effect.
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Cell-spray autografting is an innovative early treatment option for deep partial-thickness burn wounds. As an alternative to non-operative management, cell-spray autografting can achieve rapid wound re-epithelialization, particularly in large wounds. When compared to traditional mesh autografting for deep partial-thickness burn wounds, cell-spray autografting can accomplish re-epithelialization with a much smaller donor site. ⋯ Over the time period, the donor-site to burn-wound surface area ratio was enhanced from 1:80 to 1:100. A detailed analysis of all process-related biotechnology and operative problems, pitfalls, and solutions was performed and is reported herein. Strategies for future clinical studies are discussed.
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Recent evidence indicates that early removal of eschar by tangential debridement can promote healing. Laser debridement can be used for debridement of areas that prove challenging for debridement using tangential excision. In particular, irradiation with an ArF excimer laser ablates desiccated eschar and is self-terminating, preserving hydrated or viable tissue. ⋯ Data from a pilot study demonstrates that ArF excimer laser irradiation removes burn eschar and promotes healing at 10days after burn. ArF excimer laser debridement is self-terminating and preserves underlying and adjacent perfused tissue. Potentially, this modality would be ideal for the complex curvilinear structures of the body.