Nanofibrillar cellulose wound dressing in skin graft donor site treatment.

BACKGROUND: Although new therapeutic approaches for burn treatment have made progress, there is still need for better methods to enhance wound healing and recovery especially in severely burned patients. Nanofibrillar cellulose (NFC) has gained attention due to its renewable nature, good biocompatibility and excellent physical properties that are of importance for a range of applications in pharmaceutical and biomedical fields. In the present study, we investigated the potential of a wood based NFC wound dressing in a clinical trial on burn patients. Previously, we have investigated NFC as a topical functionalized wound dressing that contributes to improve wound healing in mice. METHODS: Wood based NFC wound dressing was tested in split-thickness skin graft donor site treatment for nine burn patients in clinical trials at Helsinki Burn Centre. NFC dressing was applied to split thickness skin graft donor sites. The dressing gradually dehydrated and attached to donor site during the first days. During the clinical trials, physical and mechanical properties of NFC wound dressing were optimized by changing its composition. From patient 5 forward, NFC dressing was compared to commercial lactocapromer dressing, Suprathel® (PMI Polymedics, Germany). RESULTS: Epithelialization of the NFC dressing-covered donor site was faster in comparison to Suprathel®. Healthy epithelialized skin was revealed under the detached NFC dressing. NFC dressing self-detached after 11-21days for patients 1-9, while Suprathel® self-detached after 16-28days for patients 5-9. In comparison studies with patients 5-9, NFC dressing self-detached on average 4days earlier compared with Suprathel®. Lower NFC content in the material was evaluated to influence the enhanced pliability of the dressing and attachment to the wound bed. No allergic reaction or inflammatory response to NFC was observed. NFC dressing did not cause more pain for patients than the traditional methods to treat the skin graft donor sites. CONCLUSION: Based on the preliminary clinical data, NFC dressing seems to be promising for skin graft donor site treatment since it is biocompatible, attaches easily to wound bed, and remains in place until donor site has renewed. It also detaches from the epithelialized skin by itself.

Radiological image data migration. Practical experience and comparison of the costs of work.

PURPOSE: To identify costs deriving from data migration of obsolete digital archives by measuring the workload, and to analyse migration-associated problems. MATERIAL AND METHODS: Two digital archives were used (DTL and MOD) and the capacity of these archives could no longer support the needs of the Medical Imaging Centre. The entire content of the DLT archive and selected data from the MOD archive were transferred to the current higher capacity (17 TB) tape archive. The running time of work processes was measured by self-reporting, and the cost of work was calculated. RESULTS: The transfer of 43,096 studies required 314 working hours over the course of 15 months in total. The work was partly manual, partly automatic. The percentage of non-retrievable MOD images was 35. Less than 0.2% of the DLT image transfers failed due to incorrect patient or image data. The MOD - DLT transfer cost was six times higher per study than the DLT - DLT transmission cost. CONCLUSION: At present, data migration may be inevitable as the amount of data increases and technology advances. The data transfer proved to be labour intensive, with high fault sensitivity regarding the MOD archive. The cost of work of data migration was 0.4% of estimated digital archiving total yearly cost. Automated data migration is preferable.

Cost analysis of Turku University Central Hospital PACS in 1998.

Introduction of a picture archiving and communication system (PACS) into an old hospital poses several problems since the system cannot be implemented instantaneously. We analysed the costs of a halfway implemented PACS in Turku University Central Hospital (TUCH) during 1998. Manual and digital archiving in 1998 continued parallel so that only 10% reduction of film usage was achieved. A 21% increase in image manipulation and storage expenses occurred. A calculation based on potential 90% reduction of film usage and changes in the amount of personnel suggest some direct savings. Also, indirect savings due to more efficient patient treatment and the reduction of time spent in the hospital, and overhead costs of information handling are expected to lead to savings. However, these savings were not included in our calculations. When full-scale PACS is installed, equipment investments, network and digital ware maintenance costs will drop from 121 to 116% compared with traditional film archiving activity costs.

Transportation savings and medical benefits of a teleneuroradiological network.

Since 1996, Turku University Central Hospital has offered teleradiology consultations regarding computerized tomography examinations of the brain to three regional hospitals in Finland, in which neurosurgical or neuroradiological specialist services are not available, in order to avoid unnecessary patient transportation. We performed a retrospective survey of the teleconsultations performed in 1998. Medical records and the relevant radiology images were obtained. During the study period, teleconsultations were carried out for a total of 83 patients, of whom 16 were transported to the university hospital (i.e. 81% of these patients had avoided unnecessary transportation). The total savings amounted to 42,100 ECU. Of the 16 transported patients, 12 were immediately operated on in the university hospital. It was judged that, because of the consultation service, the patients undergoing an operation had benefited from a more rapid and a more complete recovery. In 1998 the teleradiology consultation service was established as part of the routine work of the Medical Imaging Centre and a fee for its services was adopted.