Burns : journal of the International Society for Burn Injuries
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In the field of burns repairs, many problems exist in the shortage of donor skin, the expense of allograft or xenograft skin, temporary substitution and unsatisfactory extremity function after wound healing. Previous studies showed that burn-denatured skin could return to normal dermis formation and function. This study investigates the application of laser micro-pore burn-denatured acellular dermis matrix (DADM) from an escharotomy in the repair of burn wounds and evaluates the biological properties and wound repair effects of DADM in implantation experiments in Kunming mice. ⋯ There was better bio-performance, low immunogenicity and better dermal incorporation after treated by laser micro-pore drilling and decellularized deep II° burn-DADM, which may be considered as a better substitute for dermal matrix. Furthermore, the earlier harvested DADM after burn (24h) shows the better transplantation effect.
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The Renin Angiotensin System is involved in fibrotic pathologies in various organs such as heart, kidney and liver. Inhibition of this system by angiotensin converting enzyme antagonists, such as Captopril, has been shown beneficial effects on these pathologies. Captopril reduced the inflammatory reaction but also directly influenced the fibrotic process. ⋯ The local treatment showed reduced wound closure in comparison to the systemic treatment and the control group. Early Captopril treatment of burn wounds did not show the beneficial effects that were reported for fibrotic disorders in other tissues. To influence the fibrotic response Captopril treatment at a later time point, e.g. during the remodeling phase, might still have beneficial effects.
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Early ambulation of lower extremity burns that undergo a skin graft may help to avoid some of the complications associated with immobilization. Despite recent evidence supporting early ambulation, post-operative immobilization following lower extremity skin grafting is still a common practice. The purpose of this study was to retrospectively assess the outcomes of lower extremity skin graft cases dressed with a multi-layer compression bandage who were ambulated in the immediate post-operative period. ⋯ This study demonstrates the excellent graft take rates that can be achieved with immediate ambulation following lower extremity skin grafting and challenges the conventional teaching of post-operative bed rest following lower extremity skin grafting procedures.
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Scar massage is used in burn units globally to improve functional and cosmetic outcomes of hypertrophic scarring following a burn, however, the evidence to support this therapy is unknown. ⋯ It appears that there is preliminary evidence to suggest that scar massage may be effective to decrease scar height, vascularity, pliability, pain, pruritus and depression in hypertrophic burns scaring. This review reflects the poor quality of evidence and lack of consistent and valid scar assessment tools. Controlled, clinical trials are needed to develop evidence-based guidelines for scar massage in hypertrophic burns scarring.
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This study developed a predictive model for fires and burns among parents and children in Jefferson County, Kentucky. Eight risk factors for pediatric burns with census tract level data available were identified. Risk factors were synthesized to develop a cartographic model with risk levels low, medium, high, and severe. ⋯ Risk was correlated with fire incidence rate (ρ=0.67, p<0.001). Significant risk factors were race (β=0.54, p<0.001), education (β=0.38, p<0.001), and year home built (β=-0.17, p=0.005). Cartographic modeling is a underutilized tool to identify at-risk areas.