Burns : journal of the International Society for Burn Injuries
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The occurrence of the adult respiratory distress syndrome (ARDS) and pneumonia was assessed in 482 patients with severe burns, but without evidence of inhalation injury. The patients were resuscitated during the burn shock period with a low-volume formula consisting mainly of plasma. ⋯ These incidences were compared with other studies, and a pathophysiological explanation has been offered to explain differences in the frequency of pulmonary complications. The present review indicates that resuscitation with a low-volume formula consisting mainly of colloids can act as prophylaxis for reducing the incidence of ARDS and pneumonia.
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Multicenter Study Clinical Trial
Multicentre experience in the treatment of burns with autologous and allogenic cultured epithelium, fresh or preserved in a frozen state.
This report describes the clinical results obtained from a multicentre experience of the use of autologous and allogenic cultured human epidermal cells in the treatment of partial and full skin thickness burns. A laboratory has been organized to supply cultured epithelium to Burns Units in different cities. ⋯ Graftable cultured epithelium can be frozen and remain viable if stored in a skin bank. Such grafts were used successfully to treat patients with partial and full skin thickness wounds.
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Forty-seven children under the age of 5 years admitted for contact burns into the Burns Unit of the Birmingham Accident Hospital during the period 1981-88 were reviewed. Contact burns formed only 3.93 per cent of all the thermal injuries seen in this age group for the same period. ⋯ Although the sizes of the burns were generally small, the potential scarring and disability were recognized and this influenced the management. The prevention of contact burns from hot electric irons has been discussed and the need to look out for non-accidental injuries emphasized.
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One hundred and seventy-two burn wound swabs obtained from 90 patients admitted to the Aljila Hospital Burn Unit, Benghazi over a 3-month period were processed to determine the microbial flora colonizing burns and their resistance patterns to selected locally available topical and systemic agents. Approximately 84.9 per cent of the swab specimens yielded growth of 11 bacterial species and Candida spp.; of these, Ps. aeruginosa, Staph. aureus and Klebsiella spp. predominated in order of prevalence, followed by Enterobacteria. ⋯ In studies in vitro using six topical agents, Ps. aeruginosa strains were most sensitive, in decreasing order, to mafenide acetate, silver sulphadiazine, acetic acid, silver nitrate and Eusol. Seventy-eight per cent of Staph. aureus isolates were resistant to methicillin and erythromycin and 93 per cent to tetracycline.
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The following report reviews 851 applications of Biobrane on partial skin thickness burn wounds awaiting epithelialization. After the patients had been evaluated and resuscitated as needed, the burn wounds were cleansed and debrided. Those evaluated as shallow were treated with Biobrane application. ⋯ Very deep wounds will not allow Biobrane adherence, neither will it occur if the wound has a high bacterial count. If joint surfaces are not splinted, the Biobrane will shear and not adhere to the wound. Convex and concave surfaces can be treated with Biobrane, which may need to be meshed.