Validation of a Taiwanese Version of the Burn-Specific Health Scale-Brief.

The purposes of this study were to translate the brief version of the Burn-Specific Health Scale (BSHS-B) into traditional Chinese (Taiwanese) and to evaluate its psychometric properties to measure quality of life of burn patients in Taiwan. The BSHS-B-Taiwanese was translated and reviewed by an expert committee. Patients were invited to participate in this study while they visited the outpatient burn clinic. One hundred and eight burn patients participated in this study by filling out the BSHS-B-Taiwanese and SF-36 Taiwanese version. Forty-one of 108 patients completed a retest on the BSHS-B-Taiwanese. A ceiling effect was found for psychosocial functioning and all domains of the BSHS-B-Taiwanese. Internal consistency shown by Cronbach's alpha was all above 0.70 except for the interpersonal relationships domain. Of these, Cronbach's alpha ≥0.9 was found in the work, heat sensitivity, and body image domains. Test-retest reliabilities ranged from 0.74 to 0.93 except for the simple activity domain. As for the criterion validity, most of the BSHS-B-Taiwanese version was shown to have fair to moderate correlations with the SF-36-Taiwanese in corresponding domains. The discriminant validity of the BSHS-B-Taiwanese was demonstrated by significant score differences in several domains between subgroups of different severity regarding length of hospital stay and TBSA. Our finding suggests that the BSHS-Taiwanese is generally reliable and valid. A shorter version of BSHS-B-Taiwanese together with a generic instrument, such as SF-36, can be used to measure the quality of life of burn patients in Taiwan.

Five years' experience of the modified Meek technique in the management of extensive burns.

BACKGROUND: The Meek technique of skin expansion is useful for covering a large open wound with a small piece of skin graft, but requires a carefully followed protocol. METHODS: Over the past 5 years, a skin graft expansion technique following the Meek principle was used to treat 37 individuals who had sustained third degree burns involving more than 40% of the body surface. A scheme was devised whereby the body was divided into six areas, in order to clarify the optimal order of wound debridements and skin grafting procedures as well as the regimen of aftercare. RESULTS: The mean body surface involvement was 72.9% and the mean area of third degree burns was 41%. The average number of operations required was 1.84. There were four deaths among in this group of patients. CONCLUSIONS: The Meek technique of skin expansion and the suggested protocol are together efficient and effective in covering an open wound, particularly where there is a paucity of skin graft donor sites.

Bacterial artificial chromosome-based physical map of Gibberella zeae (Fusarium graminearum).

Fusarium graminearum is the primary causal pathogen of Fusarium head blight of wheat and barley. To accelerate genomic analysis of F. graminearum, we developed a bacterial artificial chromosome (BAC)-based physical map and integrated it with the genome sequence and genetic map. One BAC library, developed in the HindIII restriction enzyme site, consists of 4608 clones with an insert size of approximately 107 kb and covers about 13.5 genome equivalents. The other library, developed in the BamHI restriction enzyme site, consists of 3072 clones with an insert size of approximately 95 kb and covers about 8.0 genome equivalents. We fingerprinted 2688 clones from the HindIII library and 1536 clones from the BamHI library and developed a physical map of F. graminearum consisting of 26 contigs covering 39.2 Mb. Comparison of our map with the F. graminearum genome sequence showed that the size of our physical map is equivalent to the 36.1 Mb of the genome sequence. We used 31 sequence-based genetic markers, randomly spaced throughout the genome, to integrate the physical map with the genetic map. We also end-sequenced 17 BamHI BAC clones and identified 4 clones that spanned gaps in the genome sequence. Our new integrated map is highly reliable and useful for a variety of genomics studies.

Use of vacuum-assisted wound closure to manage limb wounds in patients suffering from acute necrotizing fasciitis.

BACKGROUND: An effective regimen to treat patients suffering from acute necrotizing fasciitis requires surgical removal of devitalized tissues, systemic administration of broad antimicrobials and ameliorating underlying systemic disease processes. The task of managing wounds consequential to surgical debridement, on the other hand, can be difficult. We had the opportunity of using a vacuum-assisted wound closure (VAC) technique in 12 patients with non-healing wounds in either the upper or the lower limb because of acute necrotizing fasciitis. The usefulness of the device was assessed by comparing with the conventional approach of wet dressing technique of wound care. METHODS: A vacuum-assisted wound closing device was used in 12 patients with open wounds. For comparison, the conventional technique of wound care, i.e., the wet dressing technique, was used in 12 patients. The change in wound size, amount of drainage and the mortality rate were recorded in each group. RESULTS: The extent of wound size reduction noted in the VAC group was 47%, while in the conventional wet-to-dry dressing (CWD) group, it was 41%. The amount of drainage reduction noted was 49% in the VAC group and 39% in the CWD group. The cost of supplies for the CWD group was about one-seventh that of the VAC group. On the other hand, time required for the care was decreased by 3.7-fold with the use of the VAC technique. CONCLUSION: The VAC technique of wound closure was found to be effective in managing non-healing limb wounds consequential to surgical treatment for patients suffering from acute necrotizing fasciitis. Although the cost of the VAC device was high, morbidity was much lower when compared to the CWD technique.