Burns : journal of the International Society for Burn Injuries
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Randomized Controlled Trial
A prospective randomized clinical trial to investigate the effect of silicone gel sheeting (Cica-Care) on post-traumatic hypertrophic scar among the Chinese population.
This study aimed to determine the efficacy of silicone gel (Cica-Care) on severe post-traumatic hypertophic scars among the Chinese population. ⋯ This study indicated that silicone gel sheeting (Cica-Care) was effective to reduce thickness, pain, itchiness and pliability of the severe hypertrophic scar among the Chinese population. The moisturization effect of the tough and hard scar might contribute to the reduction of the skin thickness after 6 month's intervention.
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Burn contractures of the extremities present a clinical challenge. Flexion contractures are more common than extension contractures. ⋯ A number of different methods are available for resurfacing the wound and these are reviewed. An algorithm is presented which permits a simple approach to managing burn scar contracture of the extremities.
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Randomized Controlled Trial
PVP-iodine in hydrosomes and hydrogel--a novel concept in wound therapy leads to enhanced epithelialization and reduced loss of skin grafts.
Moist wound treatment improves healing at a possibly increased risk of bacterial infection and many local antiseptics impair healing. A moist treatment modality with efficient antimicrobial activity would be desirable. ⋯ The results demonstrate significant clinical advantages of Repithel. This new local wound healing drug combines antisepsis and wound moisture efficiently resulting in significantly enhanced epithelialization, decreased transplant losses, and significantly improved healing especially in smokers.
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Case Reports
Dermal preservation using the Versajet hydrosurgery system for debridement of paediatric burns.
Loss of dermis is one of the principal factors that contributes to poor scar outcome after severe burn. Dermal loss may be due to the primary injury, surgical management or as a result of infection. Strategies for dermal preservation are therefore important to improve scar quality. ⋯ In deep partial thickness burns softer necrotic dermis can be removed with the Versajet sparing the underlying tougher viable dermis. In superficial burns the Versajet cleans and removes loose epidermal elements providing an optimal wound surface for the application of biological dressings, even a number of days after injury. Versajet is most useful when the tissue to be removed is softer than that to be left behind.
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The assessment of surface area of the body affected by a burn (TBSA) has long been estimated with manual charts. Initial assessment of burned patients is made frequently by clinicians with limited experience producing significant errors. Paper copies of burn charts are unwieldy, subject to loss and tend towards overestimation. ⋯ This initial pilot study compared figures from 50 paper charts with those from Burn Calculator to determine its accuracy and reproducibility. Previously reported variations in TBSA estimation were confirmed, as was the tendency towards TBSA underestimation resulting from transcription of a three-dimensional clinical situation to a two-dimensional representation. Burn Calculator showed high correlation (r=0.9850; p<0.0001) and reproducibility (R=0.9957) that would simplify assessment and referral plus facilitate data collection, interpretation and research.