ABSTRACT
PURPOSE: The aim of this study was to document the surgical and intensive care methods used in six extensively burned children (EBC), ie, total body surface area (TBSA) burned over 70% or TBSA with deep burns over 60%, treated with cultured epidermal autografts (CEA). METHODS: Six EBC, with a mean age of 7.5 years (range, 2.5 to 12) received CEA. Their mean TBSA burned was 82% (range, 70-94) with 74% (range, 60-90) of TBSA with deep burns. All sustained flame burns and inhalation injuries. RESULTS: The survival rate was six of six. The average initial and final engraftment rates of CEA were, respectively, 79% (range, 70 to 95) and 84% (range, 72 to 100). CEA definitively covered 45% (range, 18 to 57) of TBSA for a mean cost per child of $80,000 (range, 55,000 to 110,000). CONCLUSION: Even if CEA are expensive, such engraftment rates and survival ratio results make them an excellent alternative wound covering method for EBC when donor sites for widely meshed autografts are exhausted.
Subject(s)
Burns/surgery , Keratinocytes/cytology , Skin Transplantation , Animals , Cells, Cultured , Child , Culture Techniques/methods , Epidermal Cells , Female , Follow-Up Studies , Humans , Male , Mice , Skin Transplantation/methods , Time Factors , Transplantation, AutologousABSTRACT
There is a strong relationship between nutritional status and resistance to infection. This relationship must receive attention more especially as human being is young. Newborns and infants have some immunological immaturity in regard to systemic immunity as well as local (particularly intestinal), immune defense. Malnutrition is an aggravating factor vis a vis such an immunodeficiency. It modifies the regulating activities of the different lymphocyte populations, of the macrophages, of the complementary system. These disorders are bound to energy, proteins, vitamins and mineral deficiencies. But many metabolic phenomenons have still to be explored, as well as the effect of such a dysimmunity on immunization. Bowel epithelial cells, cross-roads between immunity and nutrition, seem to be the point we ought to select in order to dislocate the infection--malnutrition couple.