电烧伤动物模型的复制

采用一万伏高压电放电装置对家兔进行实验性电烧伤研究，并做局部病理学检查。实验结果表明使用该实验装置模拟了高压电烧伤，为高压电烧伤的实验研究创造了一定的条件。     

电烧伤动物模型的复制

采用一万伏高压电放电装置对家兔进行实验性电烧伤研究,并做局部病理学检查。实验结果表明使用该实验装置模拟了高压电烧伤,为高压电烧伤的实验研究创造了一定的条件。     

右单侧肢体高压电烧伤并发内脏损伤的实验研究

右单侧肢体高压电烧伤并发内脏损伤的实验研究邱海李敬录宋晓荣黄孝立唐凯森周金有陈凤超张海霞家兔实验性高压电烧伤后，早期肝脏超微结构研究已有报告［１］。我们通过制作家兔６千伏高压电烧伤模型，对其７天内部分内脏损伤状况作一动态观察，以了解电流经右单侧肢体致...     

高压电烧伤大鼠血清内皮素1与一氧化氮变化及乌司他丁的干预作用

微血管是电烧伤的主要靶组织之一,微血管损伤在电烧伤渐进性损伤过程中起重要作用[1].内皮素1和NO是重要的血管活性因子,在微血管功能调节方面发挥重要作用,因而探讨高压电烧伤后血清内皮素1和NO的变化规律,对于认识高压电流对机体微血管损伤,尤其是渐进性损伤机制有重要意义.乌司他丁 (UTI)作为一种广泛的酶活性抑制剂,已应用于烧伤感染的治疗,并取得了较好疗效.本实验通过复制高压电烧伤大鼠模型,进一步探讨内皮素1、NO在高压电对机体微血管损伤过程中的作用及UTI的疗效.     

家兔高压电烧伤后凝血机理改变的研究

采用高压电放电装置进行家兔凝血机理方面的实验研究。根据电烧伤后家兔抗凝和纤溶指标的结果分析表明：ＡＴ－Ⅲ和ＰＣ在伤后６ｈ或１２ｈ出现有意义的升高或下降，ＰＡＩ：Ａ和ｔ－ＰＡ：Ａ也同样在伤后６ｈ出现有意义的改变，而ＦＤＰ在伤后６ｈ持续升高至伤后５天。提示早期电烧伤后微血栓的形成倾向于伤后６ｈ至１２ｈ，致伤５天后有可能再次出现栓塞现象，应引起重视。     

高压电烧伤合并内毒素血症家兔血液流变学变化及己酮可可碱的干预作用

减少体内内毒素和减轻其对机体的损害,是电烧伤研究的重要课题之一.高压电对微血管的损害是其损伤机体组织和器官的重要机制之一[1-2],对血液流变学的影响也十分明显[3],两者共同作用造成组织和器官微循环障碍.本研究制作高压电烧伤合并内毒素血症动物模型,检测其血液流变学变化,并用己酮可可碱(pentoxifylline,PTX)治疗,分析PTX对高压电烧伤的疗效.     

高压电烧伤合并内毒素血症家兔血液流变学变化及己酮可可碱的干预作用

减少体内内毒素和减轻其对机体的损害,是电烧伤研究的重要课题之一.高压电对微血管的损害是其损伤机体组织和器官的重要机制之一[1-2],对血液流变学的影响也十分明显[3],两者共同作用造成组织和器官微循环障碍.本研究制作高压电烧伤合并内毒素血症动物模型,检测其血液流变学变化,并用己酮可可碱(pentoxifylline,PTX)治疗,分析PTX对高压电烧伤的疗效.     

高压电烧伤合并内毒素血症家兔血液流变学变化及己酮可可碱的干预作用

减少体内内毒素和减轻其对机体的损害,是电烧伤研究的重要课题之一.高压电对微血管的损害是其损伤机体组织和器官的重要机制之一[1-2],对血液流变学的影响也十分明显[3],两者共同作用造成组织和器官微循环障碍.本研究制作高压电烧伤合并内毒素血症动物模型,检测其血液流变学变化,并用己酮可可碱(pentoxifylline,PTX)治疗,分析PTX对高压电烧伤的疗效.     

家兔高压电烧伤后肝脏的病理变化

我们应用模拟高压电装置进行了家兔的触发试验。触电后按６、１２、２４、４８、７２、１２０、１６８、２４０小时８个时相点活杀取材，作光镜和电镜观察，发现家兔高压电严重烧伤后肝脏病变具有出现早、病变重、分布广和形态多样化的特点。肝细胞变性多以细胞肿胀、胞质疏松、浊肿、空泡变、脂肪变，进而出现肝实质坏死为其特点。我们根据家兔肝脏变化的多种因素进行了分析和探讨。     

阴茎高压电烧伤的修复

目的 探讨阴茎高压电烧伤的修复方法。方法 153例高压电烧伤患者伴阴茎烧伤6例，其中全阴茎坏死3例、部分阴茎坏死1例、阴茎皮肤部分坏死1例、阴茎皮肤全部坏死1例。采用阴茎坏死皮肤直接切除缝合修复1例、皮片移植2例、阴囊皮瓣转移3例。结果 除2例患者阴茎缺如外，其余3例患者阴茎及1例后期再造阴茎的外观、功能满意。结论 阴茎高压电烧伤后采用阴囊皮瓣修复阴茎皮肤坏死，全阴茎坏死后选用腹部皮瓣行阴茎再造，均为较好的修复方法。     

Discordance between histologic and visual assessment of tissue viability in excised burn wound tissue

The regenerative capacity of burn wounds, and the need for surgical intervention, depends on wound depth. Clinical visual assessment is considered the gold standard for burn depth assessment but it remains a subjective and inaccurate method for tissue evaluation. The purpose of this study was to compare visual assessment with microscopic and molecular techniques for human burn depth determination, and illustrate differences in the evaluation of tissue for potential regenerative capacity. Using intraoperative visual assessment, patients were identified as having deep partial thickness or full thickness burn wounds. Tangential excisions of burn tissue were processed with hematoxylin and eosin to visualize tissue morphology, lactate dehydrogenase assay to ascertain cellular viability, and Keratin‐15 and Ki67 to identify epidermal progenitor cells and proliferative capacity, respectively. RNA from deep partial and full thickness burn tissue as well as normal tissue controls were submitted for RNA sequencing. Lactate dehydrogenase, Keratin‐15, and Ki67 were found throughout the excised burn wound tissue in both deep partial thickness burn tissues and in the second tangential excision of full thickness burn tissues. RNA sequencing demonstrated regenerative capacity in both deep partial and full thickness burn tissue, however a greater capacity for regeneration was present in deep partial thickness compared with full thickness burn tissues. In this study, we highlight the discordance that exists between the intraoperative clinical identification of burn injury depth, and microscopic and molecular determination of viability and regenerative capacity. Current methods utilizing visual assessment for depth of injury are imprecise, and can lead to removal of viable tissue. Additionally, hematoxylin and eosin microscopic analysis should not be used as the sole method in research or clinical determination of depth, as there are no differences in staining between viable and nonviable tissue.     

我国烧伤免疫的研究

The electric burn is a kind of special injury, in which the injured areas are not big, but deep tissues and organs are often injured, resulting in higher rates of mortality and amputation than thermal injury. In the process of management, besides the treatment for systemic and pathologic changes, wound repair is also emphasized for restoration of function. In the past 50 years, ten thound patients with electric burn were cured in our country, including hundreds of severe electric burn patients with extensive injury. Lots of operative regimes for electric burn were developed, and the scope of experimental research was broadening. As aresult, six monographs concerning electric burns were published. However, clinical management of severe electric burn to give a satisfactory result is still difficult, therefore further indepth research is necessary, especially in the field of the use of artificial skin, vessels, nerves, muscular tendon, etc. from gene and tissue engineering to improve quality of wound repair.     

带蒂背阔肌肌皮瓣早期修复颈部电烧伤深度创面

目的 探讨早期应用带蒂背阔肌肌皮瓣修复颈部深度电烧伤的临床效果。方法 自2010年5月至2015年11月,共收治5例颈部深度电烧伤患者。烧伤面积2%~20%。给予颈部早期清创后,应用带蒂的背阔肌肌皮瓣转移修复创面。结果 所移植皮瓣均成活良好,无坏死或溃疡,皮瓣质地、色泽好。术后随访6~24个月,颈部外形满意,活动无明显受限。结论 颈部深度电烧伤创面应早期清创后进行肌皮瓣转移术;背阔肌肌皮瓣血管恒定,血供丰富,供瓣面积大,转移灵活,是临床上修复颈部电烧伤深度创面的较好方法。     

The degree of bacterial translocation is a determinant factor for mortality after burn injury and is improved by prostaglandin analogs.

Bacterial translocation and related mortality rates were examined in previously transfused BALB/c mice that were gavaged with 14C radioisotope-labeled Escherichia coli before inflicting a 20% full-thickness flame burn. Radionuclide counts were measured in blood obtained by retro-orbital puncture 4 hours postburn, and survival was recorded for 10 days. Radionuclide counts in the blood correlated well with both radionuclide counts and numbers of viable bacterial in the tissues. Survivors had significantly less bacterial translocation as evidenced by blood radionuclide counts compared with nonsurvivors, and there was a significant inverse correlation between the degree of translocation and the length of survival. In the next experiment, the prostaglandin E (PGE) analogs misoprostol, enisoprost, or 16,16-dimethyl PGE2 were administered to transfused animals for 3 days before burn. Prostaglandin E analogs significantly reduced bacterial translocation as measured by blood radionuclide counts 4 hours postburn and improved survival. The data demonstrate that the intensity of bacterial translocation after burn injury is significantly associated with subsequent death. Improvement of survival by PGE analogs is associated with decreased bacterial translocation.     

下腹部岛状皮瓣在阴囊毁损性电烧伤修复中的应用

目的探索阴囊毁损性电烧伤造成阴囊缺损的修复方法。方法应用下腹部岛状皮瓣再造毁损性电烧伤的缺损阴囊。结果2001年10月至2009年12月,共8例,均采用下腹部岛状皮瓣进行阴囊缺损的修复,切取皮瓣面积8 cm×11 cm至10 cm×12 cm,皮瓣全部成活。结论下腹部岛状皮瓣是阴囊毁损性电烧伤后阴囊再造的良好方法。     

Full-thickness burn of the foot: successful treatment with Apligraf. A case report

Burn wounds, although uncommon in the foot, present a uniquely challenging opportunity to physicians. The keys to successful management include a proper and specific initial evaluation of the burning agent, the location, the TBSA affected, and the depth. Ultimately, proper recognition and meticulous wound care with skin grafting, when necessary, bring about the desired results. A case report of a patient with a third-degree burn over the dorsum of the left foot is presented. This case is unique in that Apligraf, a human skin equivalent, was used to gain coverage and eventual resolution of the wound. It is the authors' opinion that the use of Apligraf in this application is a viable alternative to traditional methods of skin harvesting and grafting. To the authors' knowledge, there have been no other cases reported of Apligraf use in burn wound coverage of the foot.     

Utilization of skin flap for reconstruction of the genitalia after an electric burn

The objective of this article is to describe a case of an electric burn to the genitalia causing scrotal and testicular lesion, and the subsequent reconstruction using a skin graft. The patient was a 10-year-old boy who was victim of an electric burn that harmed the genitalia. There was extended skin loss, penile, scrotal and partial testicular lesion. The treatment consisted of plastic surgery to reconstruct the genitalia with skin flaps grafted on the left thigh, the scrotum and the base of the penis. The patient recovered well and was discharged after two weeks. We concluded that in severe cases of electric burns to the genitalia, skin graft offer a good therapeutic option.     

Topical silver treatment after escharectomy of infected full thickness burn wounds in rats

White male Sprague Dawley rats (200 g.) with 20% full thickness scald burns seeded with 10 Pseudomonas aeruginosa, strain 59-1244, were used as experimental animals. Studies including the following: (1). Control groups. (2). DC pretreatment groups. (3). Treatment groups. P. aeruginosa infected burn wounds were excised, and then treated with either autograft or silver-nylon dressings, with (SNDC) or without (SN) application direct current. Excision and treatment were initiated 1, 2, 3, 4 or 5 days after burning and inoculation. (4). Groups for antimicrobial barrier function study. Mortality of each group was recorded at 21 days PB.With burns alone, there was no mortality. Without treatment 19 of 20 burn inoculated controls died. In the pretreatment study, the mortality of the group pretreated with SN was 95% while that of the group pretreated with SNDC was only 30%. With excision and autografting, PB mortality rose from 5/20 at day 2 PB to 19/20 at day 3 PB. In the excision and SN groups, mortality rose from 5/20 at day 3 PB to 18/20 at day 4 PB. In the excision and SNDC groups, mortality rose from 5/20 at day 3 PB to 18/20 at day 4 PB. In the antimicrobial barrier function study, the 10% mortality in the SN dressing group was significantly less than that of 95% in the plain nylon dressed group.Histologic examination revealed progressively deepening colonization of non-viable wound tissue, progressing to invasion of underlying viable tissue by PB day 4. With wound excision, SN, SNDC, and autografting were equally protective for the first two days, but only SN and SNDC extended this effect to the third PB day.In conclusion, SN and SNDC have a strong local anti-microbial effect on the burn wound when applied within 72 hours of the time of bacterial inoculation, but little effect if applied after the bacteria have invaded unburned vessels and viable tissue adjacent to the burn.     

Fire caused by a spark of electric scalpel igniting alcoholic antiseptic containing chlorhexidine

Fire accident is one of the most severe complications that can occur in the perioperative period. We report a case of an episode of electrosurgical burn. An 80-year-old woman was scheduled for ascending colectomy due to ascending colon carcinoma. The skin of the surgical site was sterilized with alcoholic antiseptic containing chlorhexidine before the operation. On coagulating the bleeding point of the subcutaneous fatty tissue, a spark of the electric scalpel ignited the alcoholic antiseptic. She had burn on her right thorax, lower abdomen and femoral region. Two-degree burn occupied 2% of the body surface and three-degree burn 3%. She underwent dermatoplasty 14 days later. Postoperative course was uneventful and she left the hospital on the 58th postoperative day. An alcoholic antiseptic is the most useful and has an immediate effect for preoperative disinfection of the skin according to the CDC guideline. However, electric scalpel and alcoholic use are always accompanied with the risk of ignition and sufficient caution is required.