British journal of plastic surgery
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Review Comparative Study Clinical Trial Controlled Clinical Trial
Silver sulphadiazine and the healing of partial thickness burns: a prospective clinical trial.
A clinical trial was devised to determine whether the healing of partial thickness burns was retarded by the use of silver sulphadiazine cream (SSD) compared with simple, non-bacteriocidal dressings. Biopsy-confirmed partial thickness burns of at least 2% confluent area were dressed according to a strict protocol to compare the rate of epithelialisation of the control dressing, tulle gras, with that obtained with the use of silver sulphadiazine. The same comparative dressing regimen was carried out on a series of split thickness graft donor sites. ⋯ The mean time to healing of SSD-treated burn areas was longer than that for tulle gras; the difference when analysed by paired t-test was statistically significant (p less than 0.05). There was very little difference in the compared healing rates of the donor sites, which implies that SSD does not retard epithelialisation of dermal depth injuries but rather that the delayed healing is a unique response of the partial thickness burn wound to the presence of SSD. A review of the relevant literature is included in the discussion.
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Traction on, or stretching of, any structure innervated by the trigeminal nerve can cause reflex slowing of the pulse, inappropriately known as the "oculocardiac reflex" because it is well-known to result from traction on the extra-ocular muscles. This phenomenon can cause problems in surgery of the face and cranium as well as the orbit. An awareness of its management can obviate morbidity and mortality. An account of the phenomenon, its treatment and illustrative case histories are presented.
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Recovery of cold, warmth and heat-pain sensations in skin grafts was studied psychophysically in 22 patients who had had split skin grafts transplanted over muscle fascia 1 to 4 years earlier. A thermal stimulator based on the Peltier principle and controlled by a microprocessor was used to measure the thermal sensitivity of the grafts. Control measurements were obtained from the corresponding opposite side of the body. ⋯ Heat-pain sensitivity was present in 8 grafts. If the warmth and heat-pain sensibility had recovered, the sensation threshold was closer to the normal value than that for cold. In 7 grafts (from 1-3 years) no recovery was obtained.