The Journal of burn care & rehabilitation
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J Burn Care Rehabil · Nov 1988
Use of 5% sulfamylon (mafenide) solution after excision and grafting of burns.
In previous reports, 5% sulfamylon solution has been utilized on unexcised burns and granulation tissue. We prospectively evaluated 67 burn patients to determine graft take and the incidence of side effects with use of sulfamylon solution dressings after excision and grafting. Of patients excised and grafted, the mean graft take for a total of 100 procedures was 86%. ⋯ Pain intensity was rated on a Visual Analog Scale with a mean score of 2.4; in no case was the pain considered severe enough by the patient to terminate treatment. Acidosis was present in 3% of patients but felt to be unrelated to the sulfamylon treatment. As an antimicrobial agent, 5% sulfamylon solution is a viable alternative for fresh autografts with excellent graft take and acceptable side effects.
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J Burn Care Rehabil · Nov 1988
A new instrument for serial measurements of elasticity in hypertrophic scar.
The "elastometer," a hand-held device, was designed and constructed to permit noninvasive quantification of the elastic properties of normal skin or hypertrophic scar. The instrument utilizes a constant-tension spring and a sensitive strain gauge to distract two loci of skin. Normal skin from 15 dogs was measured in vivo with the elastometer and in vitro using standard tensometry. ⋯ There was a trend towards higher values in older scars. Elastometric measurements have increased appreciably in some burn scars undergoing treatment. The elastometer should be useful in documenting objectively the spontaneous maturation of burn scars and/or their response to treatment.
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J Burn Care Rehabil · Nov 1988
The role of oxygen-derived free radicals in burn-induced myocardial contractile depression.
The release of oxygen free radicals from ischemic myocardium has been implicated as a causative factor of cardiac dysfunction after thermal injury. In this study, isolated coronary perfused guinea pig hearts were used to determine if free radical scavengers improve left ventricular (LV) intrinsic contractile response to burn shock. Parameters measured included peak isovolumic LV pressure (LVP) and maximal rate of LVP rise (+dP/dtmax) and fall (-dP/dtmax) at a constant preload. ⋯ There was no significant difference in heart rate or time to peak pressure or time to maximal contraction or relaxation among the groups. Left ventricular function curves for burned hearts were shifted downward and to the right of curves obtained from control hearts (P less than 0.01), regardless of scavenger treatment. PEG-SOD, 6,000 U, improved left ventricular contractility (+dP/dt) at maximal levels of end-diastolic pressure but deficits in left ventricular pressure and relaxation persisted.(ABSTRACT TRUNCATED AT 400 WORDS)
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Patients with neurologic disorders are frequently burned in mishaps related directly to their diseases. Once burned, these patients face a mortality rate significantly greater than that of the burn population as a whole. To assess the impact of neurologic disease on burn care, we reviewed the records of 37 patients admitted to our burn center with burns and neurologic illness. ⋯ This comparison revealed significantly longer length of stay for the neurologically impaired sample. We presume that costs of care are also increased for this sample. The high frequency of burn injury among neurologically impaired persons, coupled with the greater difficulty in caring for them, suggests that this group should receive intensive burn prevention educational efforts.
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A study conducted by the University of Colorado Health Sciences Center Burn Center of 42 burned pregnant patients indicates that the mortality of both the fetus and mother is dependent upon the percent body burn of the mother. Aggressive surgical therapy, including debridement with eschar excision and skin grafting, increases maternal survival. Chances of successful pregnancy were greatest when the mother was in her first or third trimester at the time of injury; however, no differences were noted in maternal or fetal mortality at different gestational months.