Burns : journal of the International Society for Burn Injuries
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Randomized Controlled Trial
Effect of amniotic membrane on graft take in extremity burns.
Several studies have shown that the application of amniotic membrane as a biological dressing in the management of burns is accompanied by rapid re-epithelialisation and healing as it diminishes the oozing of plasma, bacterial count and fluid, protein and heat loss. This study evaluates the effect of amniotic membrane on graft take in split-thickness skin graft of extremity burns. ⋯ Our results show that although the amniotic membrane has no negative impact on graft take, it significantly reduces the duration of complete graft take, which is very important for both the patient and the health-care system.
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Randomized Controlled Trial
Oral ketamine and dexmedetomidine in adults' burns wound dressing--A randomized double blind cross over study.
Study was designed to compare analgesic efficacy and side effects of oral dexmedetomidine and ketamine in adults for burn wound dressing. Sixty healthy adults with thermal burns with burn area (20-50%) were randomly assigned into 2 groups. In Group K 5mg/kg ketamine and in Group D 4 mcg/kg dexmedetomidine was given orally. ⋯ More patients preferred ketamine (63.3%) than dexmedetomidine (36.7%), P<0.05. Oral ketamine and dexmedetomidine produced significant pain relief during burns wound dressing. Oral ketamine produced significantly better pain relief than dexmedetomidine but was associated with delirium and excessive salivation.
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Randomized Controlled Trial
Efficacy of debridement and wound cleansing with 2% hydrogen peroxide on graft take in the chronic-colonized burn wounds; a randomized controlled clinical trial.
Severe burns are associated with dramatic outcomes which are potentially detrimental. Nowadays the standard treatment for deep partial thickness and full-thickness burn is early excision and grafting, which is not always feasible this leads to chronicity and microbial colonization of burn wounds. Interesting properties of hydrogen peroxide 2% soaked gauze convinced us to use it in management of chronic burn wounds. ⋯ Our study showed that, administration of hydrogen peroxide intraoperatively appears to be safe and significantly increases the mean success rate graft take in chronic-colonized wounds. Therefore, it can be recommended in management of chronic burn wounds management.
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Randomized Controlled Trial
Gene expression profiling of negative-pressure-treated skin graft donor site wounds.
Negative-pressure wound therapy (NPWT) is widely used to improve skin wound healing. Although NPWT has been studied as a treatment for wound closure and healing, the molecular mechanisms explaining its therapeutic effects remain unclear. To investigate the effect of NPWT on gene expression, and to discover the genes most dominantly responding to this treatment during skin wound healing, we applied negative pressure on split-thickness skin graft donor sites from the first postoperative day (POD) to the seventh POD. ⋯ The genes most induced were associated with cell proliferation and inflammation, and the most down-regulated genes were linked to epidermal differentiation. Our results provide the first insight into the molecular mechanisms behind NPWT, and suggest that NPWT enhances specific inflammatory gene expression at the acute phase associated with epithelial migration and wound healing. However, its continued use may inhibit epithelial differentiation.
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Randomized Controlled Trial
Effects of puerarin on the inflammatory role of burn-related procedural pain mediated by P2X(7) receptors.
Burn injury can induce an inflammatory response in the blood and wound of patients. Procedural activities in burn patients are particularly problematic in burn care due to their high intensity and frequency; hence, procedural pain evoked by burn dressing changes is a common severe issue. Previous studies demonstrated that purinergic signalling is one of the major pathways involved in the initiation, progression and down-regulation of the inflammatory response. Adenosine 5'-triphosphate (ATP) contributes to inflammation, and increased extracellular ATP levels amplify inflammation in vivo via the P2X7 receptor. In the present study, the effect of puerarin, an active ingredient extracted from Chinese herbal medicine Ge Gen, on pain relief of burn patients during dressing change and the mechanism related to the regulation of the purinergic signalling pathway were investigated. ⋯ The inflammation and associated pain involved in dressing changes of burn patients were relieved by puerarin treatment. The effects were correlated with the decreased expression level of P2X7 receptor mRNA and protein in PBMCs of burn patients.