Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns
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Zhonghua Shao Shang Za Zhi · Oct 2020
[National expert consensus on the application of natural dermal matrix in wound repair (2020 version)].
Natural dermal matrix has good biocompatibility and can serve as " biological template" in wound repair. According to the source of material, natural dermal matrix can be divided into acellular dermal matrix (ADM), denatured dermal matrix, and scar dermal matrix. ADM is a biological material prepared by removing cellular components from the skin and retaining extracellular matrix (ECM) of the dermis. ⋯ Scar dermal matrix is a kind of dermal scaffold made of autologous split-thickness scar tissue, possessing the characteristics of high survival rate, good texture, and slight scar reaction. Scar dermal matrix can effectively reduce secondary damage to the donor site when repairing scar contracture deformity. Based on the research progress at home and abroad and the opinions of domestic experts, this paper summarizes the indications, application methods, contraindications, and considerations of different types of natural dermal matrix in application of wound repair.
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Zhonghua Shao Shang Za Zhi · Sep 2020
[Retrospective analysis of 2 997 inpatients with skin and soft tissue injuries].
Objective: To analyze the epidemiological characteristics and the related information on the diagnosis and treatment of inpatients with skin and soft tissue injuries. Methods: The medical records of inpatients with skin and soft tissue injuries who were admitted to the Fourth Medical Center of PLA General Hospital (hereinafter referred to as the author's unit) from January 1, 2014 to December 31, 2018, conforming to the study criteria, were retrospectively analyzed. The indexes included inpatients'gender, age, wound course, underlying disease, wound type, wound site, and wound microbiological culture result, methods and outcome of treatment, type of medical payment, hospital day, and hospitalization cost. ⋯ Patients with chronic wounds are often complicated with various underlying diseases, and the course of disease is long, so the constituent ratio of cured patients is lower than that of patients with acute wounds. Patients with skin and soft tissue injuries have long hospital days and high proportion of material cost, which are directly related to the clinical characteristics and long treatment cycle of chronic wounds. Therefore, it is suggested that the medical insurance administration department should adjust the consumption ratio and other management indicators according to the actual clinical needs of elderly patients with chronic wounds.
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Zhonghua Shao Shang Za Zhi · Sep 2020
[Establishment of nomogram predicting model for the death risk of extremely severe burn patients and the predictive value].
Objective: To explore the death risk factors of extremely severe burn patients, establish a death risk nomogram predicting model, and investigate the predictive value for death risk of extremely severe burn patients. Methods: The medical records of 231 extremely severe burn patients (190 males and 41 females, aged 18-60 years) who were admitted to the Institute of Burn Research of the First Affiliated Hospital of Army Medical University from January 2010 to October 2018 and met the inclusion criteria were analyzed retrospectively. According to the final outcome, the patients were divided into survival group of 173 patients and death group of 58 patients. ⋯ The optimum threshold of ROC curve was 0.23, the sensitivity and specificity of optimum threshold were 86.0% and 80.0%, respectively, and the area under ROC curve was 0.90 (95% confidence interval=0.86-0.94, P<0.01). Conclusions: Severe burns and damage and/or failure of organ are the main death causes of extremely severe burn patients. The death risk nomogram predicting model established on the basis of use of ventilator, use of CRRT, and burn index have good predictive ability for death of extremely severe burn patients.
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Zhonghua Shao Shang Za Zhi · Aug 2020
Meta Analysis[Meta-analysis of the effects of supplemental parenteral nutrition on prognosis of critically ill patients].
Objective: To compare the effects of supplemental parenteral nutrition (SPN) and enteral nutrition (EN) on prognosis of critically ill patients in intensive care unit (ICU) using meta-analysis. Methods: Foreign language databases including PubMed, Embase, Cochrane Library, and Cochrane Central Register of Controlled Trials were retrieved with the search terms of " supplemental parenteral nutrition, parenteral nutrition, enteral nutrition, critically ill" , and Chinese database SinoMed database was retrieved with the search terms of ",,," to obtain the publicly published randomized controlled trials about the effects of SPN and EN supportive treatment on prognosis of critically ill patients in ICU from the establishment of each database to December 2018. The Google Scholar was retrieved for supplement. ⋯ The subgroup analysis showed that the risks of bias of studies and follow-up time might be sources of the heterogeneity of mechanical ventilation time. There was publication bias in ICU overall mortality (P<0.05), while no publication bias in the other outcome indexes (P>0.05). Conclusions: SPN supportive treatment can decrease the infection rate of critically ill patients in ICU, but it has no obvious influences on overall mortality, mechanical ventilation time, and length of hospital stay.
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Zhonghua Shao Shang Za Zhi · Aug 2020
[Research advances in the mechanism of pulmonary fibrosis induced by coronavirus disease 2019 and the corresponding therapeutic measures].
Coronavirus disease 2019 (COVID-19) outbroke in Wuhan, China in December 2019 and the severe acute respiratory syndrome (SARS) outbroke in Guangzhou, China in 2003 were caused by highly pathogenic coronaviruses with high homology. Since the 2019 novel coronavirus is highly contagious and spreads rapidly. It has caused negative social effects and massive economic loss globaly. ⋯ Extensive epidemiological, viral immunological and current clinical evidences support the possibility that pulmonary fibrosis may be one of the major complications in COVID-19 patients. At present there is no report on the mechanism by which COVID-19 induces pulmonary fibrosis. With the existing theoretical basis, this article focuses on discussing the possible mechanism of COVID-19 sustained lung damaging, the key role of abnormal immune mechanism in the initiation and promotion of pulmonary fibrosis, and the corresponding therapeutic measures.