The Journal of burn care & rehabilitation
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J Burn Care Rehabil · Nov 1997
Randomized Controlled Trial Comparative Study Clinical TrialCultured allogeneic keratinocyte sheets accelerate healing compared to Op-site treatment of donor sites in burns.
Donor site treatment is a crucial issue in the treatment of extensive burns. In this single-blind, randomized study treatment of donor sites with a polyurethane dressing, Op-Site (Smith & Nephew, York, U. ⋯ Results show a mean healing time of 6.7 days with use of cultured keratinocyte sheets compared to mean healing time of 13.6 days with Op-Site treatment. Also, improvement in the comfort of patients as the result of less exudate formation and pain attenuation was noted.
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J Burn Care Rehabil · Jul 1997
Randomized Controlled Trial Clinical TrialStudy of antibiotic prophylaxis during burn wound debridement in children.
Twenty-three children completed a randomized, prospective, partially blinded study performed to assess the need and effectiveness of antibiotic prophylaxis at the time of burn wound debridement and grafting. Patients with a total body surface area (TBSA) burn less than 35% were randomized to receive cefazolin or placebo. Patients with burns of 35% or more TBSA were randomized to receive cefazolin or targeted antibiotics based on surveillance cultures. ⋯ All receiving cefazolin developed burn wound infection. Quantitative tissue culture was more than 10(5) colony-forming units per gram in all, whereas histologic examination was positive in one. In our patients with less than 35% burn, cefazolin was not necessary, and in those with 35% or more burn, it was not effective.
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J Burn Care Rehabil · Jan 1997
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialA multicenter clinical trial of a biosynthetic skin replacement, Dermagraft-TC, compared with cryopreserved human cadaver skin for temporary coverage of excised burn wounds.
This multicenter study compared the use of a biosynthetic human skin substitute with frozen human cadaver allograft for the temporary closure of excised burn wounds. Dermagraft-TC (Advanced Tissue Sciences, Inc.) (DG-TC) consists of a synthetic material onto which human neonatal fibroblasts are cultured. Burn wounds in 66 patients with a mean age of 36 years and a mean burn size of 44% total body surface area (28% total body surface area full-thickness) were surgically excised. ⋯ DG-TC was equivalent or superior to allograft with regard to autograft take at postautograft day 14. DG-TC was also easier to remove, had no epidermal slough, and resulted in less bleeding than did allograft while maintaining an adequate wound bed. Overall satisfaction was better with DG-TC.
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J Burn Care Rehabil · Jan 1997
Randomized Controlled Trial Clinical TrialSuperiority of oral ketamine as an analgesic and sedative for wound care procedures in the pediatric patient with burns.
The management of pain and anxiety in pediatric patients with burns includes the challenge of striking a balance between inadequate versus excessive medication. Ketamine provides effective sedative, analgesic, and amnestic properties for children and has been used intravenously with good results. With its recent availability as an elixir, we speculated that ketamine given orally may provide effective analgesia and sedation during wound care procedures with a wide safety margin. ⋯ The Ramsey scale was used to quantitate sedation and demonstrated that ketamine improved sedation by 360% (p < 0.05). These results substantiate improved analgesia and sedation with oral ketamine as compared to a commonly used narcotic and sedative in facilitating wound care procedures in pediatric patients with burns. These findings suggest that expanded use of ketamine oral suspension may be.
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J Burn Care Rehabil · May 1996
Randomized Controlled Trial Comparative Study Clinical TrialDermasorb versus Jelonet in patients with burns skin graft donor sites.
A prospective and randomized trial that compares Jelonet (Smith & Nephew PLC, London, England) with a new hydrocolloid dressing, Dermasorb (Convatec Ltd., Clwyd, United Kingdom), is presented. The dressings were applied on contiguous donor sites in 21 patients that required skin grafting for burn wounds. Pain experienced with the dressing in situ was assessed on days 2, 4, 7, and on two subsequent occasions. ⋯ No clinical or laboratory evidence of any differences of colonization or infection were found. All results were statistically significant. We would strongly recommend the use of Dermasorb as a split-thickness skin graft donor site dressing for a patient with burns.