Acta chirurgiae plasticae
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Acta chirurgiae plasticae · Jan 1997
Rationale for early tangential excision and grafting in burn patients.
Early excision and grafting of the burn wound in the first 9 days remain the keys to survival for patients with major burn injuries. In the last 7-year-period, 54 major burn cases were treated in our burn facility, the only Burn Center in Istanbul. ⋯ Their follow-up results in terms of mortality and morbidity rates were compared. In addition to improvement in the prognosis, early excision and grafting procedures decreased the duration of hospitalization and cost of burn treatment.
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Acta chirurgiae plasticae · Jan 1997
Randomized Controlled Trial Comparative Study Clinical TrialCalcium alginate dressings promote healing of split skin graft donor sites.
A prospective controlled trial was carried out to assess the healing efficacy of calcium alginate and paraffin gauze on split skin graft donor sites. Thirty patients were randomised to the calcium alginate group and 21 to the paraffin gauze group. ⋯ There were two infections in the study, both occurring in the alginate group while there was no difference in dressing slippage between the two groups. Calcium alginate dressings provide a significant improvement in healing split skin graft donor sites.
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Acta chirurgiae plasticae · Jan 1997
Comparative StudyFluid resuscitation in thermally injured pediatric patients.
More than two-thirds of critical burns in special burn units are children. The burned child continues to represent a special challenge, since resuscitation therapy must be more precise than that for an adult with a similar burn. Children have a limited physiologic reserve and the pediatric fluid replacement therapy is based on the principle of separate calculation of physiological and pathological losses. ⋯ However, the 2 ml/kg/% BSAB formulas are more practical as a guideline for resuscitation of pediatric patients because of greater therapeutical range and better clinical response of children threatened by burn shock. It is important to remember that all formulas are only guides to fluid therapy, they should be modified according to individual needs and clinical status of the patient. Only successful restoring and maintaining perfusion pressures leads to optimal oxygenation of injured and noninjured tissues, which promotes spontaneous healing, prevents wound conversion, minimise bacterial colonisation, and prepares the injured areas for early grafting.
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The cosmetic and functional result in postburn scar deformities is influenced by following factors: 1. The type of patient's central nervous system and his response to burn injury. 2. Depth and site of burn areas. 3. ⋯ Fixation of dressings should be done using elastic materials and applied for so long until stabilisation of scars is completed. Elastic materials should be combined with rigid pressure and pressure massage. 6. Congenital predisposition of the patient to hypertrophic scarring.