The Journal of burn care & rehabilitation
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J Burn Care Rehabil · Jan 1988
The Everett Idris Evans memorial lecture--1987: twenty-five years' experience treating burns.
For this presentation, the author selected a few highlights and summarized some of his main interests drawn from 25 years' experience as a surgeon in the Department of Plastic Surgery at Hokkaido University. The four major topics addressed are (1) kinetics and the effect of antibacterial agents and other drugs on the burn wound; (2) study of inhalation injuries and anticoagulant therapy in severe burns; (3) wound healing and the effects of artificial skin substitutes; and (4) reconstructive surgery in burned patients.
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J Burn Care Rehabil · Jan 1988
Short-term skin preservation at 4 degrees C: skin storage configuration and tissue-to-volume medium ratio.
This study was designed to examine the effect of the storage configuration of skin and the ratio of tissue-to-storage medium on the viability of skin stored under refrigeration. Human skin specimens were stored in four physical configurations in RPMI 1640 tissue culture media at 4 degrees C. Skin was transferred to surgically created defects on nude mice after specific storage intervals. ⋯ The graft viability of the outside of the skin rolls was similar for both tissue-to-media ratios as well as for both free-floating configurations (P = 0.27). These findings suggest the optimum cold storage configuration is free floating, and 300 cm2/100 mL is an appropriate skin surface area to volume media ratio. This proportion of tissue to media is in agreement with the minimum ratio currently recommended by the Skin Council of the American Association of Tissue Banks.
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J Burn Care Rehabil · Jan 1988
Laser Doppler monitoring of microcirculatory changes in acute burn wounds.
Because burns are dynamic wounds that can change in apparent depth during the first 72 hours, we asked whether measuring changes in cutaneous blood flow might help predict the ultimate fate of burns that were not obviously shallow or deep. A laser Doppler flowmeter was used to study cutaneous perfusion for at least 72 hours in partial-thickness wounds on patients with burns of less than 15% TBSA and in experimental wounds of similar size on rats. ⋯ Differences between average flow levels for healing and nonhealing burns were statistically significant throughout the study period. Perfusion levels in experimental wounds were stratified according to burn severity, with shallower wounds showing a pattern of increase similar to the clinical wounds.
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J Burn Care Rehabil · Nov 1987
Cyclosporine-induced long-term allograft survival and its potential in posttrauma tissue replacement.
This report is a partial review of our work to date concerning the use of cyclosporine and integumentary/musculoskeletal allografts for posttrauma tissue replacement. Our ultimate goals for such allografts are their lifesaving capabilities in addition to their utilization in functional and aesthetic surgical reconstructions. ⋯ Permanent host-accepted integumentary/musculoskeletal allografts would appear to offer much greater promise in comparison with recent synthetic and cultured tissue replacements. Summarized topics covered in this review include short- and long-term use of cyclosporine in a 30% body surface area rat burn model; bacterial studies in this model; primary wound excision and use of cyclosporine in a massive 80% body surface area rat burn model; pathological skin alterations in cyclosporine-treated rats; the synergistic immunosuppressive effects of prior blood transfusions and cyclosporine; long-term residual cyclosporine levels assayed in various long-term surviving allograft-recipients; and the use of cyclosporine and cadaver skin allografts to treat massive full-thickness burns in patients.