Using negative pressure wound therapy on microskin autograft wounds.

BACKGROUND: Microskin autografts with conventional wrap and compression are used extensively in the treatment of skin and tissue defects. This comparative study aimed at investigation of the clinical application of negative pressure wound therapy (NPWT) in combination with microskin autografts for repair of acute and chronic wounds. METHODS: A prospective case-control study was performed from December 1, 2010-December 31, 2013 in Changhai Hospital, Shanghai. We compared a study group of patients received microskin autografting covered by NPWT with that of a control group of patients received microskin autografting covered by a conventional gauze. RESULTS: A total of 81 patients were in this study, 27 patients were allocated to the study group and 54 patients to the control group. The study group exhibited significant low infection rate and pain score during removal of inner layer at first dressing change after skin grafting compared with those of the control group (P < 0.05). The time interval between skin grafting and first postoperative change was longer in the study group than that in the control group (P < 0.01), the study group showed a significant shorter 95% wound healing time (P < 0.05), and survival rate of microskin autografts in the study group was higher than that in the control group (P < 0.05). CONCLUSIONS: NPWT is beneficial for wound closure after microskin autografts, which prolongs the interval between skin transplantation and first postoperative dressing change, reduces pain during removal of inner layer dressing, increases skin graft survival rate, and shortens wound healing time. Therefore, NPWT can be recommended for repair of acute and chronic wounds with microskin autografts.

Burn-Related Dysregulation of Inflammation and Immunity in Experimental and Clinical Studies.

The purpose of this study was to evaluate burn-related variations of inflammation and immunity. Fifty-five mice were divided randomly into sham burn and burn groups. Eighty-seven hospitalized burn patients were also reviewed. In mice, neutrophils and monocytes were elevated significantly on post burn day (PBD 1). Lymphocytes were reduced on PBDs 1 and 3. Levels of serum tumor necrosis factor-α and interleukin-6 were highest on PBD 1. Interleukin-1ß levels were the highest on PBD 3. On PBD 3, CD4CD25T regulatory cells/CD4 cells in spleen were higher. On PBDs 1, 3, 7, and 14, percentage of splenic dendritic cells were significantly lower than the sham burn group. In patients, neutrophils and monocytes were significantly elevated on PBD 1. Levels declined but remained elevated at most days to PBD 7. Lymphocytes in burn groups 1 and 2 were reduced on PBDs 1 and 3, respectively. Our results exhibited that severe burn injury initiated a hyperinflammatory response and immunosuppression. PBDs 1 to 3 were important for changes in inflammation and immunosuppression.

[Effect of hydrogen-rich saline on blood pressure and antioxidant ability of lung tissue in scalded rats following delayed resuscitation].

OBJECTIVE: To study the effect of hydrogen-rich saline on blood pressure and antioxidant ability of lung tissue in scalded rats following delayed resuscitation. METHODS: The hydrogen-rich saline was prepared (hydrogen-saturated normal saline with hydrogen concentration of 0.6 mmol/L). Twenty SD rats were divided into hydrogen-rich saline group (HS) and normal saline group (NS) according to the random number table, with 10 rats in each group. All the rats were subjected to 30% total body surface area (TBSA) full-thickness scald. Rats in HS and NS groups were infused with hydrogen-rich saline or normal saline with one half of the total fluid replacement volume as calculated according to the Parkland formula (4 mL×kg(-1)×%TBSA(-1)) at post scald hour (PSH) 7 and one-quarter of the volume at PSH 9 and 17 respectively. The general condition of rats during the experiment was observed. The systolic pressure of rats was measured at PSH 6 and 24. All rats were sacrificed at PSH 24 to collect lung tissue for detecting superoxide dismutase (SOD) inhibition ratio and malondialdehyde (MDA) level. Data were processed with t test. RESULTS: All rats survived through the experiment. The systolic pressure of rats in HS group and NS group was respectively (87 ± 4) mm Hg (1 mm Hg = 0.133 kPa) and (86 ± 5) mm Hg at PSH 6, and the values were close (t = 0.213, P = 0.834); however the systolic pressure at 24 h was higher in HS group than in NS group [(124 ± 7) mm Hg vs. (115 ± 6) mm Hg, t = 2.958, P = 0.008]. SOD inhibition ratio of lung tissue in HS group [(0.465 ± 0.014)%] was higher than that in NS group [(0.358 ± 0.021)%, t = 11.767, P = 0.000]. MDA level of lung tissue in HS group [(922 ± 196) pmol/mg] was lower than that in NS group [(1118 ± 212) pmol/mg, t = -2.142, P = 0.046]. CONCLUSIONS: Delayed resuscitation for scalded rats with hydrogen-rich saline is helpful in the recovery of systolic pressure, and it can ameliorate lung tissue injury caused by reperfusion through enhancing the effect of antioxidase.