ABSTRACT
Early post-burn ischemic necrosis of the skin is of particular interest in modern burn research. The purpose of this study was to test the hypothesis that blood perfusion could be improved by the topical application of vasoactive substances. A sample of 55 wistar rats was used to investigate the effect of 0,4% nitroglycerin ointment (Rectogesic(®)) comparatively to no application and placebo. The beneficiary action of 5% prilocaine/lidocaine cream (EMLA(®)) in burn blood perfusion was also tested comparatively to Rectogesic(®). Both preparations were tested respectively to non burned controls. Laser Doppler assessment of blood flow at 15, 30, 45, 60, 120 and 180 minutes after preparation application, demonstrated that the use of Rectogesic(®) improved perfusion at all measurements compared to placebo and to no preparation application (p&0,05). There was no statistical significant difference in the effect of the two preparations.
La nécrose ischémique précoce de la peau brûlée est d'un grand intérêt dans la recherche actuelle en brûlologie. Le but de cette étude était de vérifier l'hypothèse que la vascularisation peut être améliorée par l'application topique de substances vaso-actives. Un échantillon de 55 rats Wistar a été utilisé pour étudier l'effet de 0,4% onguent à la nitroglycérine (Rectogesic®) comparativement à aucune application d'onguent et un placebo. L'action bénéfique de la crème lidocaïne (EMLA®)( 5% prilocaïne) sur la vascularisation cutanée a également été testé comparativement àvec le Rectogesic®. Les deux préparations ont été testées respectivement sur des témoins non brûlés. Une évaluation Laser Doppler du flux sanguin à 15, 30, 45, 60, 120 et 180 minutes après l'application de la préparation, a démontré que l'utilisation de Rectogesic® améliore la circulation à chaque mesure par rapport au placebo et par rapport à la non application d'onguent (p&0,05). Il n'y avait aucune différence statistiquement significative dans l'incidence des deux préparations.
ABSTRACT
The quality of life of burn-injured patients can be impaired physically and psychologically. Burn patients who experience facial disfigurement have psychological, social, and economic difficulties living with their appearance in addition to difficulties associated with their medical treatment. The aim of this review was to investigate, within a cognitive behavioural framework, the effect of facial disfigurement on body image and social integration in burn patients. Body image is a complex concept used to express the mental image of a person's physical self. Newell offered a cognitive-behavioural model which drew on clinical studies of phobic disorders, assuming that many of the psychological difficulties in patients who have suffered a threat to their body image are mediated primarily by fear and avoidance. The model proposes two ends of a continuum for disturbed body image: confrontation leading to social integration, and avoidance leading to social isolation. The literature suggests that many of the confrontational and adaptive processes described in the model are likely to be important in addressing facial disfigurement issues in burn patients. However, the conclusions drawn may be entirely speculative until they are confirmed by sufficient robust research evidence.