Burns : journal of the International Society for Burn Injuries
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Survival following a major burn is highly dependent on the availability of scare and expensive resources such as critical care services, modern dressings and access to operating theatres. Scoring systems, which predict mortality have been developed and can be used to identify patients in whom the outlay of these resources is futile. The aim of this study was to analyse the mortality at a regional South African burn service and to see if these scoring models developed in a resource rich environment were applicable to our setting. ⋯ Our data has shown that in our environment a significant number of fatalities occur in patients with potentially salvageable burns, and the breakpoints for the mortality prediction scores such as, the Modified Baux score, Coste et al. score, BOBI and ABSI scores are much lower than high-income countries. However these mortality predictive scores can be used in a resource scarce South African setting to triage patients into risk categories by lowering the breakpoints. This may facilitate early and more aggressive management of high-risk burn patients, improving survival rates, as well as efficient and judicious use of critical care and other resources.
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Current treatment options for severe burn wounds are often insufficient in reconstructing skin and soft tissue defects. Adipose-derived stem cells (ASCs), a readily available source of multipotent stem cells, represent a promising therapy for the treatment of full-thickness burn wounds. Full-thickness burn wounds were created on the paraspinal region of athymic mice. ⋯ Molecular studies showed enhanced adipogenesis, as well as type III and type I collagen deposition in the ASC treated group (p<0.05). An increase in the mRNA expression ratio of type III to type I collagen was also observed following ASC treatment (p<0.05). By enhancing vascularity, collagen deposition, and adipogenesis, ASCs show promise as an adjunctive therapy for the current treatment of full thickness burn wounds.
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Burns are major cause of morbidity and mortality in developing countries. Better understanding of the nature and extent of injury remains the major and only available way to halt the occurrence of the event. The present study was conducted to determine the prevalence of by self and by other unintentional burn, their comparison and the possible mode of acquisition by obtaining the history of exposure to known risk factors. ⋯ The burden of unintentional burn by self was considerably higher. Male gender and no schooling were found more at risk to have unintentional burn by self.
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There have been concerns that fire-derived acid gases could aggravate thermal burns for individuals wearing synthetic flame retardant garments. A comparative risk assessment was performed on three commercial flame retardant materials with regard to relative hazards associated with acidic combustion gases to skin during a full engulfment flash fire event. The tests were performed in accordance with ASTM F1930 and ISO 13506: Standard Test Method for Evaluation of Flame Resistant Clothing for Protection against Fire Simulations Using an Instrumented Manikin. ⋯ Discoloration was inversely proportional to the amount of acid collected on the traps. A risk assessment was performed on the potential adverse impact of acid gases on both the skin and open wounds. The results indicated that the deposition and dissolution of the acid gases in surficial fluid media (perspiration and blood plasma) resulted in an increase in acidity, but not sufficient to induce irritation/skin corrosion or to cause necrosis in open third degree burns.
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Chronic and complex full-thickness wounds have become increasingly prevalent. Besides autologous skin transplantation, innovative wound dressing products have gained interest, as the functional and esthetic outcome is still limited. In this respect, the effect of a novel modifiable collagen-gelatin fleece on the healing of deep dermal wounds was examined and compared with untreated controls and Matriderm(®). ⋯ Overall, the best results for the novel collagen-gelatin fleece were achieved for multiple applications with a thickness of 150g/m(2). The novel biomaterial shows accelerated and improved dermal wound repair in a minipig model. As the manufacturing process of the scaffold allows the integration of bioactive substances such as antibiotics and growth factors, we intend to design a composite biomaterial using this scaffold as a carrier matrix.