Burns : journal of the International Society for Burn Injuries
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Infection is an important cause of mortality in patients with burns. Rapid emergence of hospital pathogens and antibiotic-resistant organisms necessitate periodic evaluation of bacterial colonisation patterns and antibiogram sensitivity in burn wards. ⋯ This study showed a high rate of resistance to the administered antibiotics. The prevalent Gram-negative organisms in our ward were resistant to ceftazidime and imipenem in nearly 90% and 20% of cases, respectively.
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Approximately 70% of all people with severe burns die from related infections despite advances in treatment regimens and the best efforts of nurses and doctors. Silver ion-eluting wound dressings are available for overcoming this problem. However, there are reports of deleterious effects of such dressings due to cellular toxicity that delays the healing process, and the dressing changes needed 1-2 times a day are uncomfortable for the patient and time consuming for the stuff. ⋯ In vivo evaluation of the dressing material in contaminated deep second degree burn wounds in guinea pigs (n=20) demonstrated its ability to accelerate epithelialization by 40% compared to an unloaded format of the material and a conventional dressing material. Wound contraction was reduced significantly, and a better quality scar tissue was formed. The current dressing material exhibits promising results, does not require frequent bandage changes, and offers a potentially valuable and economic approach to treating the life-threatening complication of burn-related infections.
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Here we report an outbreak among 17 patients caused by a single strain of a multiresistant methicillin-susceptible Staphylococcus aureus (MR-MSSA) in a burn centre. The MR-MSSA strains were resistant to penicillin, ciprofloxacin, erythromycin, clindamycin and co-trimoxazole. Further analysis showed an increased prevalence of MR-MSSA carriership in S. aureus colonized patients admitted to the burn centre, from 0% in 2005 (0/118), 3.3% in 2006 (4/121), 6.1% in 2007 (6/99), to 7.8% in 2008 (7/90). ⋯ One HCW tested positive for a genotype of MR-MSSA that was indistinguishable from the genotype found in samples of the burned patients. No new cases of MR-MSSA colonization or infection were identified after the colonized HCW stopped working at the burn centre. The routine practice of molecular typing of collected S. aureus strains from both patients and HCWs will help to detect nosocomial spread in a burn centre, and opens the possibility of a rapid, almost pre-emptive response.
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Keloids are common abnormal raised fibroproliferative lesions that can occur following even minor cutaneous trauma. Human leukocyte antigen (HLA) polymorphisms have shown strong association with susceptibility to keloids with different ethnic backgrounds. In this study, the polymerase chain reaction sequence-specific primer method was used to analyze the distribution of HLA haplotype in 192 patients with keloids and 252 healthy control individuals. ⋯ This is the first detailed report to elucidate HLA haplotypes associated with keloids. Our results provide some information for future research on predisposing genes in major histocompatibility complex (MHC) regions in Chinese patients with keloids. In addition, the association of certain HLA haplotypes with susceptibility to keloids would provide clues in choosing proper preventive strategies.
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The red-yellow-black-scheme (RYB) is a well-known and validated scheme to classify chronic and acute wounds, based on wound color and moistness. We investigated whether this RYB-scheme is also useful to classify donor site wounds uniformly (DSW). ⋯ Clinicians and scientists have difficulty with classifying DSWs by means of the RYB-scheme. Therefore, this scheme does not appear useful to classify donor site wounds in a uniform manner.