Wounds
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Autologous skin transplantation is a common treatment for patients with full-thickness burns. Postoperative wound care is essential for skin graft donor and recipient sites, but traditional wound dressings such as cotton and gauze do not form an effective barrier to bacteria, and patients can feel uncomfortable when replacing dressings. ⋯ This antimicrobial spray could potentially be used in wound dressing applications.
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Review Case Reports
Deep Frostbite Treated With Hyperbaric Oxygen and Thrombolytic Therapies.
The authors present a case of deep frostbite treated with both hyperbaric oxygen and thrombolytic therapies. Both of these therapies are experimental and have not yet achieved widespread clinical use. ⋯ Of his 6 digits with extensive, deep frostbite, 1 digit eventually required partial amputation, and another had protracted osteomyelitis treated with intravenous antibiotics. The authors present a case history in the context of current research and provide a listing of previous case reports of hyperbaric oxygen therapy for frostbite.
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The incidence of partial-thickness wounds is high and, until recently, little was known about the alteration of the biomechanical properties of the skin in these wounds during the course of healing. The aim of this study was to demonstrate the biomechanical changes in skin elasticity. ⋯ The alteration of biomechanical properties of skin is a function of tissue structure. The presented results demonstrate the complex changes of skin biomechanical properties in the course of healing of partial-thickness wounds. This study could serve as a model to compare the effectiveness of different wound dressings in regard to skin elasticity.
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Randomized Controlled Trial Comparative Study
A comparative study of spray keratinocytes and autologous meshed split-thickness skin graft in the treatment of acute burn injuries.
ReCell (Avita Medical, Northridge, CA) is an autologous cell harvesting (ACH) device that enables a thin split-thickness skin biopsy to be processed to produce a cell population that includes a mixed population of keratinocytes, melanocytes, Langerhans cells, and papillary dermal fibroblasts for immediate delivery via a spray applicator onto a prepared skin surface. ⋯ This preliminary report describes an early experience with the ACH device and the treatment of partial-thickness burn injuries. In this 10-patient series, patients benefitted from having a decreased donor site size and comparable outcomes with MSTSG treatment. While this preliminary underpowered study has provided positive results, there is a learning curve with choosing the proper wound for treatment with the ACH device, as well as with using the device.
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Review
The increasing role of epidermal grafting utilizing a novel harvesting system in chronic wounds.
Skin grafting techniques range from harvesting full-thickness to split-thickness grafts to grafts containing only epidermis. All of these autologous tissues have their place on the reconstructive ladder. However, the use of full-thickness and split-thickness grafts as coverage over chronic wounds remains limited by a number of factors, including the need for anesthesia, a surgically trained physician, and an operating room in which to perform the procedure; pain and damage associated with the donor site; and severe patient comorbidities. ⋯ An automated epidermal harvesting system is now commercially available and involves a tool that applies both heat and suction concurrently to normal skin to induce epidermal micrograft formation. The new tool allows quick harvest and transfer of the epidermal micrografts at the bedside without anesthesia, with minimal donor site healing time and patient discomfort. The use of epidermal grafts in chronic wounds and the harvesting technique are reviewed here.