Burns : journal of the International Society for Burn Injuries
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This study was planned to design a mouse model for studying sulphur mustard (SM)-induced skin injury. SM was applied dermally at dose of 5 or 10 mg kg(-1) in polyethyleneglycol-300 (PEG-300) or dimethylsulphoxide (DMSO) or acetone once. The changes in body weight, organ body weight indices (OBWI) and haematological and oxidative stress parameters were investigated over a period of 3-7 days and supported by histopathological observations. ⋯ These biochemical changes were supported by the histological observations, which revealed pronounced toxic effect and damage to liver, kidney and spleen after dermal application of SM diluted in PEG-300 or DMSO. The skin showed similar microscopic changes after dermal application of SM in all the three diluents, however; the severity of lesions was found to be time and dose dependent. It can be concluded that dermal exposure of SM diluted in acetone can be used to mimic SM-induced skin toxicity without systemic toxicity in a mouse model.
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A severe burn will significantly alter haematologic parameters, and manifest as anaemia, which is commonly found in patients with greater than 10% total body surface area (TBSA) involvement. Maintaining haemoglobin and haematocrit levels with blood transfusion has been the gold standard for the treatment of anaemia for many years. While there is no consensus on when to transfuse, an increasing number of authors have expressed that less blood products should be transfused. ⋯ The quest for a universal transfusion trigger should be abandoned. All RBC transfusions should be tailored to the patient's blood volume status, acuity of blood loss and ongoing perfusion requirements. We also focus on the prevention of unnecessary transfusion as well as techniques to minimise blood loss, optimise red cell production and determine when transfusion is appropriate.
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Randomized Controlled Trial Comparative Study
Randomized controlled single center study comparing a polyhexanide containing bio-cellulose dressing with silver sulfadiazine cream in partial-thickness dermal burns.
A prospective, randomized, controlled single center study was designed to evaluate clinical efficacy of a polyhexanide containing bio-cellulose dressing (group B) compared to a silver-sulfadiazine cream (group A) in sixty partial-thickness burn patients. ⋯ Group B demonstrated a better and faster pain reduction in the treated partial-thickness burns, compared to group A. The results indicate the polyhexanide containing bio-cellulose dressing to be a safe and cost effective treatment for partial-thickness burns.
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Review
Solid organ procurement from donors with carbon monoxide poisoning and/or burn--a systematic review.
Traditionally, carbon monoxide poisoning and/or burn are considered contraindications to organ procurement. Previously reported cases have shown mixed results and many have been redundantly reported in the literature. ⋯ Burn, carbon monoxide poisoning, high peak carbon monoxide-levels, use of inotropes or vasopressors or cardiopulmonary resuscitation prior to procurement are not contraindications for organ procurement and transplantation. New guidelines for burn units defining the special requirements for organ procurement from donors with carbon monoxide poisoning and/or burn are needed to raise the awareness for potential organ donors and to ultimately increase the donor pool and save patients' lives.
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Allografts, cadaver skin and amnion membrane are considered the golden standard in the management of partial thickness burns. However, debate on whether the tissue needs to be viable is on-going, since many believe that viable grafts result in better healing. The objective of this literature survey was to analyse the evidence on the method of preservation of allografts (cadaver skin or amnion membrane, glycerol, cryopreservation, lyophilisation) having a clinical impact on the healing of partial thickness burns. ⋯ Most studies on allograft treatment of partial thickness burns are observational, with only one study of a (historical) comparative nature. A true meta-analysis was not performed and the results of this survey are observational in nature as well: they indicate that there is no evidence that viability of the graft influences healing outcomes. Thus, instead of viability, other aspects, such as intrinsic antimicrobial safety of the preservation method and cost should be the primary criteria for the choice of preservation method to be used for allografts.