RESUMEN
We present here two cases of purpura fulminans (PF), a rare complication of septicemia. Its fulminant course usually prompt the surgeon into quick and aggressive action. Although sometimes it may lead to mutilation of a patient, nevertheless it is a life-saving procedure. A decision to amputate all four extremities is very difficult, both for the parents and for the surgeon. Therefore one must be absolutely sure that this management strategy is the only way to save the patient's life. Two cases of meningococcal and staphylococcal sepsis treatment are described in this paper. The surgical approach is discussed together with a review of the literature.
Asunto(s)
Bacteriemia/microbiología , Infecciones Meningocócicas/complicaciones , Choque Séptico/microbiología , Infecciones Estafilocócicas/complicaciones , Síndrome de Waterhouse-Friderichsen/microbiología , Amputación Quirúrgica/métodos , Preescolar , Desbridamiento/métodos , Femenino , Humanos , Lactante , MasculinoRESUMEN
The purpose of the study was to select the parameters of an experimental model of burn and to determine the effects of the recombinant human growth hormone drug biosome ("BIOTECHNA" CJSC, Lithuania) burn wound healing. Wistar rats were randomly divided into 2 groups: 1) those receiving placebo injections and 2) those given daily injections of Biosome in a dose of 2.0 mg/kg. A model of contact burn was used to reproduce a burn wound. The depth of the wound was determined, by morphologically assessing a burn wound tissue specimen on day Ð of burn application. The process of wound healing was associated with the change in the skin granulation defect area expressed as cm2. A statistically significant difference in the area of wounds in 2 animal groups was observed on healing day 10. On experimental day 22, the rat wound area in Group 2 decreased to an average of 0.26±O.I9 cm2, it was covered by crusts and regarded as healed. In Group I, the wound area achieved the similar one only on healing day 28. The difference in the duration of wound healing between the two groups was 9 days. The copper plate heated up to 240°C and pressed by a force of 1.56 n for 14 sec causes a deep rat skin bum of grade III B. The injections of Biosome reduced the healing of a deep skin burn in Group 2 rats by 27% as compared with Group I ones.
RESUMEN
Three cases of deep high-energy electrical burns of the calvarium are presented. Surgical aspects such as the timing of osteonecrectomy, reconstruction and the choice of methods for covering of extensively denuded brain are discussed.