Burns : journal of the International Society for Burn Injuries
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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.
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Comparative Study
Clinical experience of postage stamp autograft with porcine skin onlay dressing in extensive burns.
Fifteen patients with extensive burns (deep second-degree burn > 50%, or third-degree burn > 30% of total body surface area) were treated with postage stamp autograft and meshed porcine skin onlay dressing from 1992 to 1996. All patients received the procedure within 10 days of sustaining the burn, with an average of 6.3 days. The areas chosen for postage stamp autograft were the anterior chest, abdomen, back, buttocks and the proximal part of the extremities. ⋯ The success rate of the skin grafts was nearly 100% in 14 patients. One patient had a 40% loss due to contamination from adjacent wounds. In conclusion, the postage stamp autograft with porcine skin overlay is an effective way to treat extensive burn wounds in the early stages.
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Case Reports Comparative Study
Intrabronchial surfactant application in cases of inhalation injury: first results from patients with severe burns and ARDS.
Damage to the respiratory tract caused by inhalation of toxic products of combustion with subsequent development of an acute respiratory distress syndrome (ARDS) is one of the main causes of death in burn patients. Treatment with an exogenous surfactant is a therapeutic option for which there has previously been no empirical data. We report on four severely burned patients with deep partial thickness and full thickness burns of between 40 and 70 per cent body surface area (BSA), and with inhalation injury complicated by ARDS. ⋯ After the limits of mechanical ventilation had been reached, bronchoscopic intrabronchial administration of surfactant was followed by temporarily improved gas exchange with an increase in arterial O2 partial pressure (PaO2), accompanied by a reduction in inspiratory O2 concentration (FiO2), and also improved lung compliance. All the patients survived in spite of an initially unfavourable prognosis. Replacement of exogenous surfactant in the treatment of inhalation traumatized severe burn patients with ARDS appears to show considerable promise as an approach to improving the survival chances of these high-risk patients.
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Two elderly patients with 6 and 4 per cent total body surface area (TBSA) full thickness burns were entirely skin grafted solely under topical anaesthesia with EMLA cream. Both patients had several concurrent illnesses. ⋯ The taking of the skin grafts and the healing of the donor sites were uneventful. It seems that the late skin grafting of full thickness burns up to 10 per cent TBSA may be accomplished solely under the topical anaesthesia with EMLA cream and thus avoiding the general or spinal anaesthesia in a high risk group of thermally injured patients.
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Comparative Study
Lung function following thermal injury in children--an 8-year follow up.
despite the frequency of pulmonary complications and the reports of abnormal lung function as a sequela of severe thermal injury, most of the lung function studies following thermal injury have been directed at the immediate post-burn period. This investigation is designed to evaluate late residual respiratory impairment in patients with severe thermal injury. ⋯ the data indicate that children who survive severe thermal injury may not regain normal lung function.