Burns : journal of the International Society for Burn Injuries
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Skin banking was set up in Sheffield in 1991 to provide a readily available source of allograft material to be used both for research purposes and also as a means of providing immediate wound cover for major burns patients. Once skin was available, however, clinical demand for it both within and outside Sheffield, outstripped the resources to run the bank. Logistical difficulties were encountered in the day to day running of the bank. ⋯ The decision was made to transfer the now established skin bank to the National Blood Service where it now operates with staff and resources dedicated specifically to this purpose. Experience leads to the suggestion that there is a clinical need for allograft skin in the UK which is not being met at the present time. There is a need for dedicated properly resourced skin banks and for the Department of Health to introduce regulation, monitoring and inspection of skin bank facilities in order to safeguard standards.
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Randomized Controlled Trial Clinical Trial
The safety of topical anaesthetic and analgesic agents in a gel when used to provide pain relief at split skin donor sites.
Post operative pain from split skin donor sites is a recognised problem. This study was carried out to assess the safety of a 'depot' preparation of bupivacaine and ketoprofen when applied to denuded dermis of a split donor site. Two groups of six patients each received either bupivacaine gel (2.5 mg/ml) or ketoprofen gel (1.6 mg/ml). ⋯ Ketoprofen levels also peaked at 120 min and the mean level obtained was 0.20 microgram/ml (range 0.12-0.27). The reported toxic serum level for bupivacaine was 4 micrograms/ml and for ketoprofen is 1128 micrograms/ml. In conclusion, these preparations, when applied to denuded dermis of a split skin donor site, are unlikely to result in toxic levels.
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Ninety-one patients with at least 5 per cent (median 10 per cent, maximum 50 per cent) total body surface area (TBSA) burns were clinically re-examined on average 17.3 yr after primary injury. The patients had sustained mostly superficial dermal scalds. The most common long-term functional sequelae were impaired tanning (n = 67; 77.7 per cent), diminished tactile sensibility (n = 50; 56.2 per cent) and increased reddening (n = 14; 15.6 per cent) either in the sun or the Finnish sauna. ⋯ In this series the harmful functional consequences were generally slight. The aetiological background (scalds) and the relatively small, superficially burned skin area probably explains the good late outcome. However, since nearly every burn-injured child will have some signs of the injury in adulthood, children present a constant challenge in the effort for better burn care and prevention.