Burns : journal of the International Society for Burn Injuries
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Aloe vera has been traditionally used for burn healing but clinical evidence remains unclear. We conducted a systematic review to determine the efficacy of topical aloe vera for the treatment of burn wounds. We electronically searched relevant studies in MEDLINE, CINAHL, Cochrane Library, HealthSTAR, DARE, South-East Asia Database, Chinese Databases, and several Thai local Databases (1918-June 2004). ⋯ Due to the differences of products and outcome measures, there is paucity to draw a specific conclusion regarding the effect of aloe vera for burn wound healing. However, cumulative evidence tends to support that aloe vera might be an effective interventions used in burn wound healing for first to second degree burns. Further, well-designed trials with sufficient details of the contents of aloe vera products should be carried out to determine the effectiveness of aloe vera.
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Case Reports
Reconstruction of the face and neck scar contractures using staged transfer of expanded "Super-thin flaps".
The authors introduced the "Super-thin flap" concept, which is sometimes called the subdermal vascular network (SVN) flap, in 1994. Since 1994, we have reconstructed face and neck scar contractures using various types of "Super-thin flaps." In this report, we introduce expanded "Super-thin flaps" for reconstruction of the face and neck for the first time in a patient. ⋯ Advantages of the expanded flaps are presented: (1) Large flaps can be harvested because of the expander; (2) Extremely thin flaps can be safely employed; (3) Texture and color match are good; (4) Donor site can be closed primarily; and (5) Microsurgery is not required. However, the disadvantage of the method is the requirement for two or three operations.
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Case Reports
A different and safe method of split thickness skin graft fixation: medical honey application.
Honey has been used for medicinal purposes since ancient times. Its antibacterial effects have been established during the past few decades. Still, modern medical practitioners hesitate to apply honey for local treatment of wounds. ⋯ No graft loss was seen during both the first dressing and the last view of the grafted areas. As a result, it has been shown that honey is also a very effective agent for split thickness skin graft fixations. Because it is a natural agent, it can be easily used in all skin graft operation for the fixation of the split thickness skin grafts.
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In our previous study, we used composite grafts consisting of meshed porcine acellular dermal matrix (PADM) and thin split-thickness autologous epidermis to cover full thickness burn wounds in clinical practice. However, a certain degree of contraction might occur because the distribution of dermal matrix was not uniform in burn wound. In this study, we prepare a composite skin graft consisting of PADM with the aid of laser to improve the quality of healing of burn wound. ⋯ Laser micropore PADM (0.8 or 1.0mm in distance) grafting in combination with split-thickness autografting can improve wound healing. The PADM with laser micropores in 1.0mm distance is the better choice.
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Randomized Controlled Trial Comparative Study
A comparison study between early enteral nutrition and parenteral nutrition in severe burn patients.
This clinical study compares effects between enteral nutrition and parenteral nutrition in the early stage of severe burns. Nineteen cases of severe burn patients were divided randomly into total enteral nutrition group (TEN) and total parenteral nutrition group (TPN). Plasma motilin, malondialdehyde (MDA), superoxide dismutase (SOD), endotoxin, tumor necrosis factor (TNF), serum gastrin, diamine oxidase (DAO), and urine lactulose/mannitol ratio (L/M) was determined on post burn day (PBD) 1, 4, 8, 14, respectively. ⋯ A positive correlation between L/M and DAO, MDA, TNF (r=0.5822-0.7598, p<0.05-0.01), and a negative correlation between L/M and SOD (r=-0.7771, p<0.01), and a positive correlation between plasma endotoxin and TNF, MDA (r=0.9038 and 0.6705, p<0.05-0.01) were found. These results indicate that enteral nutrition was a more effective route to preserve gastrin secretion and motility of gastrointestinal tract, lower intestinal ischemia and reperfusion injury, reduce intestinal permeability, decrease plasma endotoxin and inflammatory mediators, and maintain mucosa barrier function. Whenever gastrointestinal function permits, enteral nutrition was superior to parenteral nutrition early after burn.