Burns : journal of the International Society for Burn Injuries
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Cultured epithelial autografts (CEAs) have long been used to tackle limited donor site availability and difficulty of permanent skin coverage in massive burns, but this approach still has limited documentation. ⋯ Although complex and costly, CEAs can be used with reasonable success and satisfying survival results for the treatment of massive burns. In this study, favorable outcome was principally associated with young age and low number of infectious complications.
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Institutional data shows a high burden of burn injury, which is managed by a conservative delayed approach. This is daily dressing until spontaneous eschar separation occurs followed by delayed skin grafting. Early excision and grafting is considered active management and is shown to be more cost effective in first world situations. We developed a costing model for both approaches to analyse financial costs in a developing country burns unit. ⋯ This simple cost model suggests considerable savings could be made with active burn wound management implementation. Accurate costing of a larger cohort should define these savings more accurately.
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High-resolution, high-contrast, three-dimensional images of live cell and tissue architecture can be obtained using second harmonic generation (SHG), which comprises non-absorptive frequency changes in an excitation laser line. SHG does not require any exogenous antibody or fluorophore labeling, and can generate images from unstained sections of several key endogenous biomolecules, in a wide variety of species and from different types of processed tissue. Here, we examined normal control human skin sections and human burn scar tissues using SHG on a multi-photon microscope (MPM). ⋯ Furthermore, we were able to detect collagen MPM-SHG signal in human frozen sections as well as in unstained paraffin embedded tissue sections that were then compared with hematoxylin and eosin staining in the identical sections. This same approach was also successful in localizing collagen in porcine and ovine skin samples, and may be particularly important when species-specific antibodies may not be available. Collectively, our results demonstrate that MPM SHG-detection is a useful tool for high resolution examination of collagen architecture in both normal and wounded human, porcine and ovine dermal tissue.