The Journal of burn care & rehabilitation
-
J Burn Care Rehabil · Sep 1994
Current trends in the use of allograft skin for patients with burns and reflections on the future of skin banking in the United States.
Cadaveric allograft skin can play a critical role in the care of patients with massive burns. It is difficult, however, to estimate current use and levels of enthusiasm for allograft skin in the United States. We report on a survey of 40 skin banks and 140 United States burn center medical directors as listed in the American Burn Association's Directory of Burn Care Resources for North America 1991-1992. ⋯ Overall, 12% of admitted patients were treated with allograft skin at the responding burn centers. Sixty-nine percent of burn center directors preferred to use fresh skin, although only 47% of skin banks were able to supply fresh cadaver skin. Tabulated survey results and a review and discussion of future directions in skin banking and replacement research are discussed in this paper and were presented to the Tissue Bank Special Interest group at the 1993 American Burn Association annual meeting.
-
J Burn Care Rehabil · Sep 1994
Simple method of applying pressure to skin grafts of neck with foam dressing and staples.
Pressure applied over a skin graft prevents formation of hematoma and shearing of the graft. Most of the methods used to obtain adequate pressure are often cumbersome to apply and time-consuming. This report describes a quick and simple method for fixing and applying pressure over skin graft with foam dressing and staples.
-
Between July 1, 1984, and December 31, 1991, 27 consecutive patients required admission to the Grady Memorial Hospital Burn Unit for care of hot tar burns. This group represented 1.4% of all admissions to this burn unit. Injuries occurred at the workplace and occurred mostly during the summer. ⋯ The survival rate was 92.6%. Both of the patients who died had large burns and/or preexisting medical problems. Hot tar burns occur under predictable circumstances, appear to be preventable, and have accounted for only a small fraction of all admissions to this burn unit.
-
J Burn Care Rehabil · Jul 1994
Investigation of the presence and role of calmodulin and other mitogens in human burn blister fluid.
It is unclear whether burn blister fluid is beneficial or deleterious to the healing of the underlying wound. We investigated the calcium binding protein calmodulin in human burn blister fluid and its role in the mitogenicity of this fluid in the culture of human keratinocytes, fibroblasts, and mouse 3T3 fibroblasts. Calmodulin levels in blister fluid were three times greater than in serum (p < 0.005), whereas epidermal growth factor and platelet-derived growth factor concentrations were significantly lower (p < 0.001). ⋯ Inhibiting calmodulin with either an antagonist or antibody to calmodulin reduced the mitogenic activity of blister fluid in three cell types by 26% to 80%. These in vitro studies suggest that burn blister fluid may promote wound healing, and locally released calmodulin contributes to this effect. In appropriate cases it may be beneficial to leave burn blisters intact.