Meek植皮术和微粒皮移植术治疗特大面积深度烧伤患者的效果比较

目的:比较Meek植皮术和微粒皮移植术治疗特大面积深度烧伤患者的效果。方法:回顾性分析2018年6月至2020年6月该院烧伤科收治的100例特大面积深度烧伤患者的临床资料,按手术方法不同分为对照组和研究组各50例。对照组采用微粒皮移植术,研究组采用Meek植皮术。比较两组植皮效果、手术相关指标(手术时间、创面愈合时间、住院时间和治疗费用)、患者满意度和并发症发生率。结果:研究组植皮优良率为90.00%(45/50),显著高于对照组的56.00%(28/50),植皮达优率为60.00%(30/50),显著高于对照组的20.00%(10/50),差异均有统计学意义(P<0.05);研究组手术时间、住院时间、创面愈合时间均显著短于对照组,治疗费用和并发症发生率均低于对照组,差异有统计学意义(P<0.05);研究组满意度为96.00%(48/50),显著高于对照组的76.00%(38/50)。结论:Meek植皮术治疗特大面积深度烧伤患者的效果优于微粒皮移植术,能缩短手术时间、创面愈合时间和住院时间,降低并发症发生率和治疗费用,且患者满意度较好。     

早期卧位踏车训练对下肢重度烧伤患者的效果

目的探讨早期卧位踏车训练在下肢重度烧伤患者功能康复中的临床效果。方法2016年10月至2017年12月,下肢重度烧伤患者30例分为对照组和观察组,各15例。对照组采用常规综合康复,观察组此基础上增加早期卧位踏车训练。入院时和住院治疗6周后,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、疼痛数字评分法(NRS)、Berg平衡量表(BBS)和6分钟步行测试进行评定。结果治疗后,两组SAS、SDS、NRS评分均明显降低(t>3.636,P<0.01),观察组低于对照组(t>2.319,P<0.05);观察组BBS评分和6分钟步行距离高于对照组(t>2.541,P<0.05)。结论早期卧位踏车训练对下肢重度烧伤患者功能恢复有一定促进作用。     

Protective effect of bromelain on corrosive burn in rats

IntroductionIn some cases, the tongue and oesophagus tissues are damaged by the corrosive burn. Surgical interventions may cause scar formation, and severe burns treatment methods are limited. This study aims to investigate bromelain, a phytotherapeutic product, on the corrosive burn as a non-surgical option and as an adjunctive therapy, insofar as the treatment of corrosive wounds is not limited only to the treatment of oxidative stress and inflammatory reactions.MethodsOn the tongues of Wistar albino rats, chemically produced oral ulcers were created by topical application of NaOH (40%) solution, and in the distal oesophagus same mixture was applied to produce a corrosive oesophageal burn. For a week, they were treated orally by bromelain (100 mg/kg/day) or saline solution. At the end of seven days, animals were decapitated to remove the tongue and oesophagus, and blood samples were collected to obtain serum. Myeloperoxidase (MPO) activity, malondialdehyde (MDA), glutathione (GSH), interleukin-1 beta (IL-1β) and tumour necrosis factor-alpha (TNF-α) concentrations were measured in serum, and luminol and lucigenin chemiluminescence (CL) were measured in tissue samples.ResultsMDA and CL values were significantly increased, and GSH levels in tissue significantly decreased due to the corrosive burns. Saline treated corrosive burn group measured higher in the serum cytokines in according to the control group.ConclusionsBromelain administration decreased oxidant and inflammatory parameters and increased antioxidant levels in NaOH-induced corrosive burns. Thus, we concluded that bromelain may protect the tongue and oesophagus tissues with its anti-inflammatory and antioxidant effects.     

重症烧伤患者急救期输液及营养的路径护理

目的讨论研究对重症烧伤患者实行急救期输液及营养的路径护理的临床疗效与意义。方法选择医院烧伤科重症烧伤患者100例随机分组委观察组与对照组各50例。对照组给予急救期输液及营养常规护理。观察组提供急救期营养及输液路径护理。比较两组患者不同护理方式后营养状况、不良反应人数及护理满意度。结果治疗后观察组各项营养指标均显著优于对照组(P<0.05);观察组不良反应发生人数较少,护理服务满意程度较高。结论为重症烧伤患者提供急救期输液与营养路径护理可降低不良反应发生率并为患者加强营养支持,增强免疫力,有助于帮助其有效度过危险期,可促进患者后期治疗与恢复,更有助于拉近护患距离,提升医疗护理服务满意度。     

Global burn care and the ideal burn dressing reloaded — A survey of global experts

PurposeBurn care is a highly relevant medical specialty in every part of the world. Different infrastructure, healthcare systems and access to medical supplies lead to different needs, treatment strategies and outcomes. A fundamental tool in a burn care provider’s armamentarium is the use of different dressings. Several studies have investigated the question of the ideal burn dressing, but none could achieve a proper global perspective. With advanced dressings being on the rise, we conducted this study to get a global understanding of the actual use and idea of the ideal burn dressing.ObjectiveThe objective of this study was to investigate the understanding of an ‘ideal burn dressing’ on a global scale.Materials and methodsA questionnaire about burn care and the ideal burn dressing has been created and translated to five of the most spoken languages world-wide (English, Spanish, French, Chinese, Indonesian). It has been uploaded to an online survey platform and sent out to burn experts worldwide. The voluntary participation was possible for a period of four weeks.ResultsIn total, 196 respondents from 49 countries participated in the study, yielding a response rate of 24.5%. The most important burn dressing characteristics in a cumulative ranking were (1) lack of adhesion (80.54%), (2) pain-free dressing change (79.87%), (3) requirement of fewer dressing changes, while in a linear ranking they were (1) anti-infective (35.14% 1st), pain-reduction (24.14% 2nd), and high absorbency (23.49% 3rd). Silver-based dressings are the most used dressings for superficial (45.21%) and deep (52.78%). 94.81% believe that the choice of burn dressing affects the outcome.ConclusionThis investigation has delivered valuable insights into the global perspective of the ideal burn dressing. Yet, the question of the ideal burn dressing is still inconclusive. Wound dressing research is of fundamental interest for patients, healthcare providers and healthcare systems.     

Effects of a projector-based hybrid virtual reality on pain in young children with burn injuries during hydrotherapy sessions: A within-subject randomized crossover trial

AimThe aim of this study was to examine the effect of a water-friendly Projector-Based Hybrid Virtual Reality (VR) dome environment combined with standard pharmacological treatment on pain in young children undergoing burn wound care in hydrotherapy.MethodsThis study was a prospective, within-subject crossover trial of 38 children aged 6 months to 7 years old (mean age = 1.8 years old). Each hydrotherapy procedure was divided into two equivalent wound care segments (No hybrid VR during one segment vs. Hybrid VR during the other segment, treatment order was randomized). Pain was measured using the 0–10 FLACC (Face, Legs, Activity, Cry Consolability scale) and the 0–10 NRS-obs (Numerical Rating Scale-obs).ResultsProjector-Based Hybrid VR significantly reduced procedural pain levels measured by the FLACC (p = 0.026) and significantly increased patients' comfort levels (p = 0.002). Patients' pain levels rated by the nurses using the NRS-obs were non-significant between both groups (p = 0.135). No side effects were reported.ConclusionProjector-Based Hybrid VR helped in reducing the pain related to hydrotherapy procedures in young children with burn wound injuries. This is the first study using virtual reality distraction with young children, and our findings are especially important because a large percentage of pediatric burn patients are very young. Additional research and development are recommended.Trial registrationClinicalTrials.gov, NCT02986464, registered on June 12, 2016.     

iPhone charger-induced chemical burn from overnight contact with sweat: Two cases

Smartphones have become essential devices in modern society. The coverage rate of smartphones in 2017 in Japan was 75% according to the Ministry of Internal Affairs and Communications. The iPhone is one of the most well-known smartphone brands. According to the manufacturer of iPhones (Apple), more than 200 million iPhones had been sold worldwide by 2017. These devices are often charged at night-time, especially while being used in bed. There are only three reports of smartphone charger-induced skin damage. We present two new cases of skin ulcers induced by an iPhone charger. The iPhone’s “lightning cable” has electrodes outside, and we found that this can present a higher risk of causing a skin injury compared with other types of phone chargers. We also investigated the mechanism of the skin ulcers caused by the iPhone charger. The results indicated that these ulcers were chemical burns rather than an electrical injury or heat-induced burn.     

Biosynthetic cellulose compared to porcine xenograft in the treatment of partial-thickness burns: A randomised clinical trial

AimThe aim was to compare two dressing treatments for partial-thickness burns: biosynthetic cellulose dressing (BsC) (Epiprotect® S2Medical AB, Linköping, Sweden) and porcine xenograft (EZ Derm®, Mölnlycke Health Care, Gothenburg, Sweden).MethodsTwenty-four adults with partial-thickness burns were included in this randomized clinical trial conducted at The Burn Centers in Linköping and Uppsala, Sweden between June 2016 and November 2018. Time to healing was the primary outcome. Secondary outcomes were wound infection, pain, impact on everyday life, length of hospital stay, cost, and burn scar outcome (evaluated with POSAS).ResultsWe found no significant differences between the two dressing groups regarding time to healing, wound infection, pain, impact on everyday life, duration of hospital stay, cost, or burn scar outcome at the first follow up. Burn scar outcome at the 12-month follow up showed that the porcine xenograft group patients scored their scars higher on the POSAS items thickness (p = 0.048) and relief (p = 0.050). This difference was, however, not confirmed by the observer.ConclusionsThe results showed the dressings performed similarly when used in adults with burns evaluated as partial thickness.