ABSTRACT
In this article the authors discuss the problem faced by physicians when trying to use moisture-retentive dressing in pressure sores (decubitus ulcers). First, they report the results of an in vitro study using a new model of experimental wound (radio-isotopic investigation) that assesses the release of Ringer's solution from interactive dressings continually during fourteen hours. Second, they perform an animal experiment that assesses the incidence of wound infection in defects treated conventionally or using interactive dressings. The defects treated with interactive pads had lower incidence of wound infection, and the process of wound healing was rapid. Finally, the authors discuss their experience in four paraplegic patients with decubitus ulcers where they used moisture-retentive dressing on ulcers and on the surrounding intact skin before surgical procedure to detect the possibility of maceration of healthy skin. Histological evaluation was performed in order to find microscopically changes after moisture healing. The changes of healthy skin were not significant after treatment of moisture-retentive dressings.
Subject(s)
Bacterial Infections/prevention & control , Occlusive Dressings , Pressure Ulcer/therapy , Wound Healing , Wound Infection/prevention & control , Aged , Animals , Female , Humans , In Vitro Techniques , Incidence , Isotonic Solutions , Pressure Ulcer/pathology , Pressure Ulcer/surgery , Prospective Studies , Ringer's Solution , SwineABSTRACT
This study summarizes the Brno Burn Centre experience with the application of cultured epidermal allografts (CEAl) in the treatment of deep dermal burns. In a prospective randomised trial on 30 patients with deep dermal burns CEAl obtained from young healthy and examined donors and fixed on tulle grass carrier (Grasolind) were compared with empty Grasolind as the lowest layer of dressing. All the other layers were identical.Both kinds of dressing were applied simultaneously on the same deep dermal burn wound between 6th and 10th day after burn. Six days later the non-healed wound areas were recorded through painting on cellophane membrane and scanned in the computer. The percentage of wound reduction was calculated and statistically evaluated.The reduction of the non-epithelialized wound area was 86.5% when covered through CEAl and only 71.2% when covered with tulle grass (Grasolind) only. This difference is statistically significant.In conclusion it can be stated that cultured epidermal allografts strongly stimulate reepithelialisation in deep dermal burns.
ABSTRACT
Types of burns and other aspects of burn injuries and case outcomes were assessed in a group of geriatric patients (> 60 years) and a younger group of patients (40-59 years). Between 1990 and 1999, 137 geriatric patients (47 [34%] males and 90 [66%] females) were admitted to the Burn Centre and Reconstructive Surgery Centre at University Hospital in Brno. We compared findings in this elderly group to those in 176 younger burn patients (126 [72%] males and 50 [28%] females) who were treated at the centre during the same time period. Age and concomitant chronic disease contribute to the high mortality and a higher frequency of complications in geriatric patients who suffer burn injuries. In this study, the complication rates for geriatrics during hospitalization (44% in males and 32% in females) and the elderly patients' mortality rates (26% in males and 17% in females) differed statistically from the corresponding rates in the younger patient group. It is important to know the special needs of elderly burn patients because this patient group is expected to grow in parallel with the rising average age of the Czech Republic's population.
Subject(s)
Burns/therapy , Adult , Age Factors , Aged , Burns/complications , Burns/mortality , Case-Control Studies , Czech Republic/epidemiology , Female , Humans , Length of Stay , Male , Middle Aged , Rural Population , Trauma Severity Indices , Treatment Outcome , Urban PopulationABSTRACT
We compared two types of moisture-retentive dressings (dressings that are capable of maintaining a moist environment) in wound healing. The conventional method of using an impregnated gauze in combination with a moist wound dressing was compared with TenderWet. First, we report results from an in vitro study and an animal experiment that included assessment of reepithelization and incidence of wound infection. Secondly, we discuss our experience using TenderWet in a clinical setting. Two cases of deep dermal burns are described and documented in detail. The results of our work suggest that a moist wound environment is more effective in facilitating wound healing than conventional methods.
Subject(s)
Bandages , Burns/therapy , Wound Healing , Animals , Bacteria/growth & development , Female , Humans , Microbial Sensitivity Tests , Middle Aged , SwineABSTRACT
The study concerns a clinical experiment in two patients with a dermal substitute based on atelocollagen and hyaluronic acid, and allogeneic acellular dermis. In both cases two-step grafting was performed. At the first step the dermal substitute was implanted into the wound and it was grafted at the second step with thin dermoepidermal autograft. Large hypertrophic scars after burn injury were treated. In both patients the quality of skin cover was significantly improved.
Subject(s)
Burns/complications , Cell Transplantation , Cicatrix, Hypertrophic/surgery , Skin, Artificial , Skin/cytology , Adult , Child , Cicatrix, Hypertrophic/etiology , Humans , MaleABSTRACT
INTRODUCTION: Transconjunctival lower blepharoplasty has become more popular in the last decade with the introduction of the CO2 laser as a cutting and resurfacing tool. The authors have 4 years experience with this procedure. METHOD: Patient selection, preoperative evaluation and the surgical technique are described in detail. The operation itself is divided into two parts: 1. Laser-assisted transconjunctival exposure and resection of prolapsed fat pads, 2. Laser resurfacing of the lower eyelid skin. RESULTS: 36 patients underwent transconjunctival, laser-assisted lower blepharoplasty in the author's department in the period 1997-2000. Transitional hyperpigmentations were treated in 4 patients (11.1%). No severe complications were noted. All patients except one were satisfied or very satisfied. DISCUSSION: Transconjunctival and transcutaneous lower blepharoplasties are compared: 1. Transcutaneous blepharoplasty is simpler to perform, some skin resection is possible and no laser device is needed. 2. The danger of ectropion is relatively high in transcutaneous blepharoplasty, and the scar may not be fully acceptable for the patient. 3. Aged and sun-damaged skin is not influenced with the transcutaneous approach except for some improvement of rhytides. 4. Transconjunctival lower blepharoplasty is a relatively safe procedure with very good cosmetic results avoiding an incision and scar of the lower eyelid. 5. There is much less risk of ectropion and other complications in transconjunctival blepharoplasty than in the transcutaneous one. 6. An unpleasant side effect in transconjunctival blepharoplasty is erythema of the lower eyelids persisting for about 2-3 months. CONCLUSION: Laser-assisted transconjunctival lower blepharoplasty requires a shorter operating time and causes less bleeding and less patient discomfort. This is full-value alternative to the conventional transcutaneous lower blepharoplasty.
Subject(s)
Blepharoplasty/methods , Laser Therapy/methods , Adipose Tissue/surgery , Adult , Conjunctiva/surgery , Humans , Middle Aged , Postoperative CareABSTRACT
Antimicrobial effects of several composite fillers are monitored in response to a mixed aerobic and anaerobic microbial flora of the oral cavity. None of observed both self-polymerizing and photopolymerizing composites showed antimicrobial effects.
