Burns : journal of the International Society for Burn Injuries
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Randomized Controlled Trial
Autologous fat grafting does not improve burn scar appearance: A prospective, randomized, double-blinded, placebo-controlled, pilot study.
It has been proposed that fat grafts can improve the appearance of mature burn scars. The pluripotent progenitor cells contained within autologous adipose tissue grafts are believed to induce skin repair and improve scar appearance. We conducted a prospective, randomized, double-blinded, placebo-controlled study to evaluate the effects of fat grafts on the appearance of mature burn scars. ⋯ Single treatment with autologous fat grafts did not improve mature pediatric burn scars when compared to normal saline injections.
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Review
Oxidative stress in sepsis: Pathophysiological implications justifying antioxidant co-therapy.
Sepsis is one of the main causes of death among critically ill patients. Sepsis pathogenesis includes infection by gram-negative and gram-positive bacteria, fungi, or both; exacerbated inflammatory response; hypotension, with potential to cause vasodilatory shock; and lesser delivery of oxygen to tissues due to impairment of oxygen utilization by cells. The participation of reactive species and/or free radicals such as nitric oxide (NO), peroxynitrite (ONOO-), superoxide (O2-), hydrogen peroxide (H2O2), and hydroxyl radical (OH) has been reported to underlie these effects. ⋯ In addition, overproduction of NO due to inducible nitric oxide synthase (iNOS) activity has been associated with harmful effects such as general vasodilatation and hypo-responsiveness to therapeutic vasoconstrictor agents. Considering that iNOS expression is regulated by nuclear factor-κB, which may be activated by ROS, antioxidants could inhibit the overexpression of iNOS in sepsis. In line with this, several antioxidants such as vitamins C and E, polyphenols, melatonin, β-glucan, N-acetylcysteine, mitochondrion-targeted antioxidants (MitoQ, MitoE, and peptides associated with dimethyltyrosine), selenium salts, and organoselenium compounds were effective in ameliorating oxidative stress in animal models of sepsis and in a number of clinical trials with septic patients.
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While the most obvious impact of burn is on the skin, systemic responses also occur after burn, including intestinal inflammation. The objective of this study was to assess if burns are associated with increased long-term admissions for gastrointestinal diseases. ⋯ Findings of increased hospital admission rates and prolonged length of hospital stay for gastrointestinal diseases in the burn cohort provide evidence to support that burns have effects that persist long after the initial injury.
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Comparative Study
A prospective intra-individual evaluation of silk combared to Biobrane for the treatment of superficial burns of the hand and face.
An ever-increasing number of commercially available dressings have been applied to treat superficial burns with the aim to reduce pain and inflammation and lead to a fast wound healing and scar reduction. Nevertheless the search for cheap and effective wound dressing proceeds. Dressilk(®) consisting of silkworm silk showed good results for wound healing in regards to scarring, biocompatibility and reduction of inflammation and pain. Therefore it seemed to be an interesting product for the treatment of superficial burns. ⋯ The "ideal" wound dressing maximizes patients' comfort while reducing pain and promoting wound healing. Dressilk(®) and Biobrane(®) both provided an effective and safe healing environment, showing low overall complication rates with respect to infection and exudation on superficial burns of the hand and face. Therefore Dressilk(®), being clearly superior to Biobrane(®) in cost efficiency is an interesting alternative especially for the treatment of superficial burns of faces.
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Many burn patients are needed to be referred to a tertiary burn hospital according to the American Burn Association (ABA) criteria. The purpose of this study was to verify the reasons for referring of the burn patients to the hospital. ⋯ A total of 45% of the referrals were by request of the family and patients. Tele-medicine may help to establish a direct contact between expert burn physicians and the patients and thus reduce unnecessary transfers. Approximately 9% of the referrals were because of lack of some diagnostic facilities.