Articles: burns.
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Randomized Controlled Trial Comparative Study Clinical Trial
Failure of therapeutic ultrasound in healing burn injuries.
Experimental observations suggest that therapeutic ultrasound stimulates wound healing. Despite the controversy concerning its efficiency, this procedure is commonly implemented. ⋯ No stimulating effect of ultrasound could be demonstrated in these two groups, monitored by histological examination and a size index. These results discourage the clinical administration of therapeutic ultrasound to enhance the healing of burns.
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J Burn Care Rehabil · Jan 1997
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialA multicenter clinical trial of a biosynthetic skin replacement, Dermagraft-TC, compared with cryopreserved human cadaver skin for temporary coverage of excised burn wounds.
This multicenter study compared the use of a biosynthetic human skin substitute with frozen human cadaver allograft for the temporary closure of excised burn wounds. Dermagraft-TC (Advanced Tissue Sciences, Inc.) (DG-TC) consists of a synthetic material onto which human neonatal fibroblasts are cultured. Burn wounds in 66 patients with a mean age of 36 years and a mean burn size of 44% total body surface area (28% total body surface area full-thickness) were surgically excised. ⋯ DG-TC was equivalent or superior to allograft with regard to autograft take at postautograft day 14. DG-TC was also easier to remove, had no epidermal slough, and resulted in less bleeding than did allograft while maintaining an adequate wound bed. Overall satisfaction was better with DG-TC.
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J Burn Care Rehabil · Jan 1997
Randomized Controlled Trial Clinical TrialSuperiority of oral ketamine as an analgesic and sedative for wound care procedures in the pediatric patient with burns.
The management of pain and anxiety in pediatric patients with burns includes the challenge of striking a balance between inadequate versus excessive medication. Ketamine provides effective sedative, analgesic, and amnestic properties for children and has been used intravenously with good results. With its recent availability as an elixir, we speculated that ketamine given orally may provide effective analgesia and sedation during wound care procedures with a wide safety margin. ⋯ The Ramsey scale was used to quantitate sedation and demonstrated that ketamine improved sedation by 360% (p < 0.05). These results substantiate improved analgesia and sedation with oral ketamine as compared to a commonly used narcotic and sedative in facilitating wound care procedures in pediatric patients with burns. These findings suggest that expanded use of ketamine oral suspension may be.
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Randomized Controlled Trial Clinical Trial
A comparative study of silicone net dressing and paraffin gauze dressing in skin-grafted sites.
This prospective randomized study has compared paraffin gauze dressing (n = 19) with silicone net dressing (Mepitel, n = 19) applied as the first layer to newly grafted burn wounds. At the first postoperative dressing visual analogue pain scores were greater in the paraffin gauze group (mean 4.4) than in the silicone net group (mean 1.4, P < 0.01). ⋯ Dressings were harder to remove in the paraffin gauze group as assessed by a simple scoring system (P < 0.001). In conclusion silicone net dressing confers advantages over conventional paraffin gauze, especially in reducing patient discomfort during dressing changes.
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Plast. Reconstr. Surg. · Aug 1996
Randomized Controlled Trial Comparative Study Clinical TrialControlled clinical study of skin donor sites and deep partial-thickness burns treated with cultured epidermal allografts.
Two clinical studies in donor sites and deep partial-thickness burns treated with banked cultured human epidermal allografts are described. Ten burn patients were subjected to donor split-thickness skin harvesting. The study was controlled, side-by-side comparative, blind, and randomized. ⋯ Wounds treated with cultured allografts showed complete reepithelialization in about 3 to 6 days. The two clinical studies showed that banked cultured epidermal allograft promotes a significantly faster epithelialization of donor sites and deep partial-thickness wounds. These results support the idea that cultured allografts should be used routinely to improve treatment of burn patients and reduce their therapy time.