Burns : journal of the International Society for Burn Injuries
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Cultured keratinocytes were used as allografts on burn wounds in two patients. In both patients successful covering of the wounds was obtained. DNA fingerprinting of the epidermis covering the wounds 21 days later showed that the cultured keratinocytes were replaced by the patients' cells.
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Over a 10-year period 110 patients over the age of 65 years were admitted to the Burn Center, Rui Jin Hospital and 36 (32.7 per cent) died. Significant differences between the survivors and non-survivors were related to the total burn surface area and full skin thickness burn size. Among the causes of death, pre-existing cardiopulmonary diseases and associated inhalation injury were particularly important since pneumonia was considered as a primary cause of death in 13 patients, myocardial disease in two, cor-pulmonale and heart failure in two. Care of the early fluid resuscitation, early excision of deep burn wounds and grafting, prevention or treatment of a variety of life-threatening complications, and nutritional supplementation appeared to decrease the mortality of aged burn patients.
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The occurrence of hypertrophic scarring in burn-injured children under the age of 5 years was studied by examining the records of patients admitted to the Wessex Regional Burns Unit in the years 1968 and 1984. In both years the pattern and nature of injury to the children was the same. The incidence of scar hypertrophy was at least 50 per cent in both years. The occurrence of hypertrophic scarring in these 2 years did not appear to have been influenced by changes in clinical practice.
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Expanding oral angle plasty using a subcutaneous pedicle flap to correct severe microstomia due to extensive facial scar contractures is described. This technique is especially suited for the elderly, who are unable to tolerate large skin grafting of the face, and for patients with insufficient normal donor skin to undertake extensive correction of scar contractures.
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Comparative Study
Wound contraction following transplantation of microskin autografts with overlaid skin allograft in experimental animals.
The wound contraction associated with a new grafting technique, transplantation of microskin autografts with overlaid skin allograft, was evaluated in a rat model. Male inbred Lewis rats were used as microskin autograft recipients while Buffalo rats were used as allogeneic skin graft donors providing a sheet allograft for overlay. ⋯ The results showed that the application of autologous microskin grafting with allograft overlay was associated with more scar contraction than was the use of a sheet isograft. Maximum contraction to 43 per cent of the original size appeared at 7 weeks postgrafting in the microskin grafting group, while in the sheet isografting group the greatest contraction occurred at 4 weeks postgrafting when it retained 72 per cent of the original size.