Burns : journal of the International Society for Burn Injuries
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Case Reports
Surgical treatment of extensive skin necrosis secondary to purpura fulminans in a patient with meningococcal sepsis.
Meningococcal sepsis is associated with a high mortality rate. These patients may show severe disseminated intravascular coagulation (DIC) and skin necrosis. ⋯ We report the surgical treatment of extensive skin necrosis in a patient with meningococcal sepsis and DIC. This treatment is similar to that used in full thickness burns, including excision of necrotic tissue and coverage with autografts, as well as amputation of extremities if distal coverage is not possible.
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Comparative Study
An ultra-weak chemiluminescence study on oxidative stress in rabbits following acute thermal injury.
It is not easy to detect oxygen free radicals directly because of their very short half-life. In the present study, a sensitive ultra-weak chemiluminescence detector was used to detect the generation of oxygen free radicals following thermal injury. Twelve New Zealand white rabbits were used in this study. ⋯ The results for TBHP-initiated chemiluminescence from visceral organs following acute thermal injury were much higher than that of the control rabbits. The effects of lucigenin-initiated tissue chemiluminescence following acute thermal injury were not statistically significant. It is suggested that the decreased vascular antioxidant activity following local thermal injury is partially contributed by the superoxide pathway; while, the remote pathophysiologic events are mediated by the defective scavenging defenses.
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Two non-invasive methods (the bioimpedance technique, BIA, and the impression method, IM) were studied, to find out whether they are sensitive enough to detect and chronicle the development of the oedema and fluid resuscitation effects (Parkland formula) that occur secondary to a major burn. Ten patients with a total burned body surface area (TBSA) of more than 10% were included in this prospective study. Total body water (TBW), as measured by the resistance (BIA) or F(0) variable (IM), reached a maximum on day 2. ⋯ The phase angle (BIA) indicative of cellular membrane effects of burn and sepsis had its lowest values at day 1.5, and stayed significantly low until day 4. Interestingly, the phase angle was lowest in the two cases that died subsequently. The different time course of the INT value (IM), which reflected the translocatable interstitial fluid volume in skin, may be the result of resuscitation fluid remaining in this compartment, due to the excess sodium content together with a possible change in tissue compliance secondary to the early total water peak on day 2.
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Comparative Study
A longitudinal study of C3, C3d and factor Ba in burn patients in Hong Kong Chinese.
A longitudinal study of serum C3, C3d and fragment Ba was carried out in 53 burn patients of Chinese origin whose total burn surface area ranged from I to 45%. Complement C3 was found to be activated on or before day 7 post-burn. ⋯ In addition factor Ba was increased in these patients, suggesting that the alternative pathway was also activated following thermal injuries. The fluctuations of C3, C3d and Factor Ba observed about 1 year after injury suggested chronic inflammation associated with long term of outcome of healing in the burn sites.