Scand J Plast Recons
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Scand J Plast Recons · Dec 1998
Case ReportsEarly dermabrasion of deep dermal burns with sandpaper. Case reports.
Deep dermal burns are initially difficult to evaluate, and they sometimes heal spontaneously. We present our experience of dermabrasion with sandpaper in four patients. ⋯ Skin grafts are not always required and the aesthetic results are excellent. Dermabrasion should be considered routinely for all deep dermal burns and particularly for facial burns and those caused by scalds.
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Scand J Plast Recons · Mar 1998
The effects of L-arginine and iloprost on the viability of random skin flaps in rats.
The effects of an intravenous infusion of L-arginine as a physiological precursor of endothelium-derived relaxing factor/nitric oxide (EDRF/NO), iloprost (a stable prostacyclin (PGI2) analogue), and L-arginine combined with iloprost on skin viability were studied in 9 x 3 cm random pattern skin flaps in rats. Intravenous infusion of all drugs was started at the beginning of the operation and continued for 60 minutes. ⋯ There was a significant reduction in distal necrosis of random skin flaps after intravenous infusion of L-arginine, iloprost, and L-arginine combined with iloprost (p < 0.01). Possible mechanisms that may be responsible for impairment of endothelium-dependent vasodilation and vasospasm in the microvasculature of random skin flap and their prevention with L-arginine and iloprost include restoration of the depleted stores of NO which in turn causes vasodilatation and has an antithrombotic effect.
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The late appearance of scars in children who had been burned, mainly scalded (n = 82, 90%) were analysed retrospectively from patient records and by clinical reassessment. All 91 patients who were re-examined had primarily sustained a burn of at least 5% of their total body surface area (TBSA). Only five patients showed no visible scars. ⋯ The mean area of scars varied from 0.47% (on the neck) to 3.73% (on the left lower limb). There was no significant association between the appearance of the scar and any given method of treatment. The late cosmetic results were better than anticipated.
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Scand J Plast Recons · Sep 1997
Intraoperative blood loss after tangential excision of burn wounds treated by subeschar infiltration of epinephrine.
To assess the operative blood loss after tangential excision of burn wounds treated by subeschar infiltration of epinephrine solution, the medical records of 85 consecutive patients were analysed retrospectively. All patients were given epinephrine. The median (range) blood loss was 0.9 (0.3 - 4%) of the blood volume of each patient of the body surface excised and grafted (blood loss from donor sites included). ⋯ The correlation between age and blood loss was significant (p < 0.05). Neither the weight of the patients nor the amount of epinephrine injected significantly influenced the amount of blood lost. Operative blood loss was accurately predicted by multiple regression analysis in 62% of cases.
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Toxic shock syndrome is a life-threatening exotoxin mediated disease caused by Staphylococcus aureus, which was originally described as affecting menstruating women, but has lately been reported after surgical procedures and burns. The high mortality emphasises the importance of early diagnosis. In most cases there is a prodromal period with fever (> 38.9 degrees C), myalgia, headache, and vomiting before the onset of hypotension and multiorgan failure. We present two cases in children with minor burns, and review current recommendations for treatment.