Burns : journal of the International Society for Burn Injuries
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Burn injuries may cause gastrointestinal dysfunction leading to intestinal barrier dysfunction, abdominal compartment syndrome, and acute mesenteric ischemia. In the absence of major vascular occlusion, non-occlusive mesenteric ischemia (NOMI) often occurs in critically ill intensive-care burn patients. ⋯ NOMI represents a potentially fatal condition for the burn patient. The current lack of sensitive biomarkers and accurate diagnostic tools for the early detection of NOMI onset is a major factor behind the overall poor prognosis. We propose the intra-arterial administration of alprostadil as a novel approach to targeted treatment for NOMI.
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The aim of this study was to explore the effect and mechanism of formononetin (FMNT) in thermal-injured fibroblast proliferation, apoptosis, and oxidative stress. After thermal injury, human skin fibroblast (HSF) cells showed inhibited proliferation, migration, extracellular matrix (ECM) synthesis; and increased apoptosis, reactive oxygen species (ROS) production, and inflammation. Specifically, after thermal injury, cell viability, migration distance, and protein levels of collagen I, collagen III, α-SMA, MMP1, and MMP3 were reduced; cell apoptosis rate and TUNEL-positive cell numbers were increased; the levels of Bax and cleaved caspase-3 were elevated, while Bcl-2 level was reduced. ⋯ Additionally, the levels of the P13K/AKT/mTOR signaling-related proteins (p-P13K, p-AKT, and p-mTOR) were reduced in thermally injured HSF cells, whereas FMNT could promote p-P13K, p-AKT, and p-mTOR levels. FMNT can partially alleviate the thermal injury-induced inhibition of fibroblast proliferation and migration; FMNT also inhibited the apoptosis, ROS level, and inflammation in thermal-injured cells. The effects of FMNT may be mediated by regulating the P13K/AKT/mTOR pathway.
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This meta-analysis aims to evaluate the efficacy and safety of triamcinolone acetonide (TCA) combined with botulinum toxin type A (BTA) for treating hypertrophic scars and keloids. ⋯ This meta-analysis showed that the combined use of BTA and TCA demonstrates high effectiveness in scar treatment, but its influence on scar thickness is limited. Future research should further explore the sources of heterogeneity and validate the long-term effects and safety of this therapy.
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Autologous fat grafting (AFG), mostly in combination with adhesiolysis, has become the workhorse for reconstructing a dysfunctional or absent subcutaneous layer. In a previous study we showed that fat grafts isolated by centrifuging led to more than 20 % improvement in scar pliability. Nevertheless, there is still debate on which technique should be used to process and purify fat grafts. ⋯ Objectively measured pliability and erythema and melanin showed no statistically significant differences at 12 months follow-up. Patient-reported outcomes revealed a significant improvement in scar quality, especially scar pliability, after AFG processed by filtration in patients with adherent scars. However, no scar quality improvement was found when assessed with objective tools.
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Disaster simulation exercises are important to test service processes, capabilities, and deficiencies; disaster response planning should encompass the entire multidisciplinary team over an extended period. Our service simulated a modest eight burn casualty scenario to test our service capabilities over a 10-week period across medical, nursing, and allied health professions. Requirements due to the mass burns casualty cohort were predicted in terms of theatre requirements, allied health treatment hours required, and nursing hours requirements. ⋯ This simulation clearly demonstrated the high and immediate increase in workload demands across all professions over a prolonged 10-week period and that high business-as-usual demand can greatly affect staff capacity to cope with a mass casualty surge in admissions. It was able to provide evidence, and awareness, for leadership and management on the need for resources and resource re-allocation in a mass burn casualty scenario. It also informed a review of our current triggers for activating our SA Health Multiple Burns Plan.