Cytotoxic and Antibacteriial Actiivity of the Mixture of Olive Oil and Lime Cream in Vitro Conditions

The mixture of olive oil and lime cream has been traditionally used to treat external burns in the region of Hatay/Antakya and middle Anatolia. Olive oil and lime cream have been employed by many physicians to treat many ailments in the past. A limited number of studies have shown the antibacterial effect of olive oil and that it does not have any toxic effect on the skin. But we did not find any reported studies on the mixture of olive oil and lime cream. The aim of this paper is to investigate the cytotoxic and antibacterial activity of olive oil and lime cream individually or/and in combination in vitro conditions, by using disk-diffusion method and in cell culture. The main purpose in using this mixture is usually to clear burns without a trace. Agar overlay, MTT (Cytotoxicity assay) and antibacterial susceptibility tests were used to investigate the cytotoxic and antibacterial activity of olive oil and lime cream. We found that lime cream has an antibacterial activity but also cytotoxic on the fibroblasts. On the other hand olive oil has limited or no antibacterial effect and it has little or no cytotoxic on the fibroblasts. When we combined lime cream and olive oil, olive oil reduced its cytotoxic impact. These results suggest that mixture of olive oil and lime cream is not cytotoxic and has antimicrobial activity.     

CICARE需求评估联合支持性照护对手部烧伤病人瘢痕整形术后应对方式及心理弹性的影响

目的:探讨CICARE需求评估联合支持性照护对手部烧伤病人瘢痕整形术后应对方式及心理弹性的影响。方法:将2016年3月—2019年3月收治的94例手部烧伤瘢痕整形术病人随机分为对照组、观察组各47例,对照组采用常规护理,观察组在常规护理基础上给予CICARE需求评估联合支持性照护。干预1周后采用简易应对方式量表、中文版心理弹性水平量表(CD-RISC)评价病人应对方式、心理弹性。结果:观察组病人积极应对评分高于对照组,消极应对评分低于对照组(P<0.05);观察组病人CD-RISC量表中坚韧控制、力量、乐观维度评分高于对照组(P<0.05)。结论:CICARE需求评估联合支持性照护在手部烧伤瘢痕整形术病人中的应用,能转变其术后应对方式,提升心理弹性水平。     

MEBT/MEBO联合微粒皮种植治疗Ⅲ度深型烧伤的疗效观察

目的探讨烧伤湿性医疗技术(Moist Exposed Burn Therapy/Moist Exposed Burn Ointment,MEBT/MEBO)联合微粒皮种植治疗Ⅲ度深型烧伤的临床疗效。方法 10例Ⅲ度深型烧伤患者在全身治疗的基础上,采用MEBT/MEBO联合微粒皮种植治疗,观察创面愈合率、愈合时间及愈合质量。结果 10例患者创面均愈合,愈合率为100%,愈合时间为45~140 d,平均愈合时间为78 d,愈后皮肤有轻度瘢痕形成,但无功能障碍和畸形。结论 MEBT/MEBO联合微粒皮种植治疗Ⅲ度深型烧伤创面,操作简便,能有效缩短Ⅲ度深型烧伤创面的愈合时间,提高创面愈合率及愈合质量,疗效显著,值的临床推广应用。     

腹部带蒂皮瓣修复手部深度烧伤患者的护理

目的 探讨腹部带蒂皮瓣修复手部深度烧伤患者的有效护理方法.方法 将60例采用腹部带蒂皮瓣修复手部深度烧伤的患者随机分为观察组和对照组,对照组采用常规护理,观察组在对照组的基础上采用综合护理,比较2组的术后康复情况及生活质量.结果 2组的创面Ⅰ期愈合率无统计学意义(P＞0.05);观察组的创面愈合时间、断蒂时间及住院时间少于对照组,疼痛评分低于对照组,手功能恢复好于对照组,差异具有统计学意义(P＜0.05);观察组在躯体功能、心理功能、社会功能等生活质量方面均高于对照组,差异具有统计学意义(P＜0.05).结论 对腹部带蒂皮瓣修复手部深度烧伤的患者实施综合护理,能够缩短其术后康复的时间,改善生活质量和手功能.     

血清降钙素原在烧伤患者细菌性感染诊断中的价值

目的探讨血清降钙素原(PCT)在烧伤患者细菌性感染诊断中的临床价值。方法 169例烧伤患者经血培养、分泌物和穿刺液培养等病原学检查确认细菌性感染96例,非细菌性感染73例,2组患者同时进行PCT、WBC和超敏C反应蛋白(hsCRP)检查,比较这3项指标在细菌性感染诊断中的价值,并进一步研究PCT浓度水平与烧伤程度的关系。结果细菌性感染组烧伤患者血清PCT、WBC和hs-CRP浓度水平明显高于非细菌性感染组(P0.05)。PCT诊断细菌性感染敏感性为90.63%,特异性为89.04%,阳性预测值为91.58%,阴性预测值为87.84%,PCT对细菌性感染的诊断效能明显高于其他两项炎症指标,PCT的浓度水平与烧伤患者的烧伤程度成正相关。结论细菌性感染的烧伤患者血清PCT、WBC和hs-CRP水平明显升高,PCT作为诊断细菌性感染标志物具有更好的敏感性及特异性,优于WBC和hs-CRP两项炎症指标。     

不同剂量氯胺酮对兔严重烧伤早期全身炎症反应的影响

目的：比较不同剂量氯胺酮对严重烧伤兔早期炎性细胞因子的影响,初步探讨其对创伤应激早期炎症反应的调节作用。方法选择健康雄性新西兰兔40只,按随机数字表法分正常对照组、烫伤模型组、氯胺酮镇痛组和氯胺酮麻醉组。烫伤前用戊巴比妥钠麻醉后分别经颈内静脉和颈内动脉置管备用,24 h后制备兔背部和臀部30%Ⅲ度烫伤模型,氯胺酮镇痛组于伤后0.5 h静脉注射（静注）氯胺酮负荷量0.5 mg/kg,然后持续静脉泵注氯胺酮9μg·kg-1·min-1共24 h;氯胺酮麻醉组伤后0.5 h静注氯胺酮1.5 mg/kg,然后持续静脉泵注氯胺酮45μg·kg-1·min-1共4 h维持全身麻醉;正常对照组和模型组仅给予静脉输液处理。记录各组补液量及氯胺酮镇痛组和麻醉组的氯胺酮总用量。分别于烫伤前和烫伤后0.5、6、12、24 h进行动脉血气分析,并检测血清白细胞介素（IL-1、IL-6）及肿瘤坏死因子-α（TNF-α）水平。结果4组血气分析指标虽然有所变化,但均在正常范围,说明呼吸功能在正常范围,间接反映循环功能也在正常范围,排除了呼吸和循环功能因素的影响对细胞因子的评判。4组烫伤前IL-1、IL-6及TNF-α水平比较差异均无统计学意义（均P＞0.05）。伤后0.5 h起,烫伤模型组IL-1（ng/L：30.27±0.93比13.79±1.11）、IL-6（ng/L：47.22±1.49比46.31±4.12）及TNF-α（ng/L：243.39±20.85比190.95±14.97）水平即均显著高于正常对照组（均P＜0.05）,并持续到伤后24 h;伤后6 h起氯胺酮镇痛组和麻醉组上述指标均较烫伤模型组明显降低,于伤后12 h起氯胺酮镇痛组上述指标的降低程度较氯胺酮麻醉组更显著〔IL-1（ng/L）：19.28±2.51比40.12±10.31,IL-6（ng/L）：52.10±4.23比72.20±10.11, TNF-α（ng/L）：246.03±20.74比313.71±27.34,均P＜0.05〕。结论小剂量氯胺酮镇痛和氯胺酮麻醉对兔严重烧伤后早期炎性细胞因子的表达和释放有一定抑制作用,且长时间小剂量氯胺酮镇痛效果更明显。     

Viral Infections in Burn Patients: A State-Of-The-Art Review

Infections that are triggered by the accompanying immunosuppression in patients with burn wounds are very common regardless of age. Among burn patients, the most frequently diagnosed infections include the bacterial ones primarily caused by Pseudomonas aeruginosa or Klebsiella pneumonia, as well as fungal infections with the etiology of Candida spp. or Aspergillus spp. Besides, burn wounds are highly susceptible to viral infections mainly due to the impaired immune responses and defective functions of the immune cells within the wound microenvironment. The most prevalent viruses that invade burn wounds include herpes simplex virus (HSV), cytomegalovirus (CMV), human papilloma virus (HPV), and varicella zoster virus (VZV). Likewise, less prevalent infections such as those caused by the orf virus or Epstein–Barr Virus (EBV) might also occur in immunosuppressed burn patients. Viral infections result in increased morbidity and mortality rates in severely burned patients. Additionally, a positive correlation between the hospitalization duration and the severity of the viral infection has been demonstrated. Viral infections trigger the occurrence of various complications, ranging from mild symptoms to even fatal incidents. Accurate detection of viral infection is of great clinical importance because of the possibility for a quicker introduction of proper treatment therapy and shortening of hospitalization time. The aim of this paper is to provide a comprehensive review of the literature and summarize the findings regarding the most common viral infections in immunosuppressed burn patients.     

12-Month generic health status and psychological distress outcomes following an Australian natural disaster experience: 2009 Black Saturday Wildfires

Objective

To describe the generic health status, health-related quality of life and psychological distress over a 12-month period of burns patients affected by the 2009 Black Saturday Wildfires.

Design setting and participants

Cohort study with retrospective assessment of pre-injury status and prospective assessment of physical and psychosocial functioning in the Black Saturday Wildfires burns patients across time. Generic health status and burn specific quality of life using the 36-item Short Form Health Survey (SF-36) and Burn Specific Health Scale (BSHS) were collected at three, six and twelve months post-burn injury. In addition, similar time points were used to measure level of psychological distress and the presence of pain using the Kessler-10 questionnaire (K-10) and the McGill Pain Questionnaire.

Results

At 12 months post-injury, patients reported a mean 16.4 (standard error, SE: 3.2) reduction in physical health and a 5.3 (SE 2.5) reduction in mental health scores of the SF-36 as compared to their pre-injury scores, with significant decreases observed in the “bodily pain”, “physical functioning”, “role physical” and “vitality” subscales. High levels of psychological distress and persistent pain were experienced, with no significant changes during the study period to the overall burns specific quality of life.

Conclusions

Even 12 months post-burn injury, patients affected by the 2009 Victorian Wildfires still experienced a significant reduction in generic health, increased psychological distress and persistent pain. The need for early and ongoing identification of physical and psychosocial impairments during hospital admission and upon discharge could be helpful to establish systematic interdisciplinary goals for long-term rehabilitation after severe burn injury.     

自体表皮细胞-纤维蛋白膜创面移植治疗大鼠烧伤

目的：观察自体表皮细胞-纤维蛋白膜移植到大鼠烧伤创面治疗皮肤缺损的效果。方法：健康Wistar大鼠20只,随机分成烧伤皮肤缺损造模组和自体表皮细胞-纤维蛋白膜移植治疗组,治疗后计算表皮细胞在纤维蛋白膜上最佳接种密度,观察移植后的各组创面愈合情况、创面伤口的收缩比例等。结果：在纤维蛋白膜上接种表皮细胞的最佳密度为5×10^4／cm2,烧伤皮肤缺损造模组创面完全愈合时间平均22．3d,自体表皮细胞-纤维蛋白膜移植治疗组为18．1d,造模组创面收缩率为（70±5）％,移植组为（20±5）％（均P〈0．05）。结论：自体表皮细胞-纤维蛋白膜可用于覆盖大面积烧伤造成的皮肤缺损,预防创面伤口瘢痕化的形成,减轻创面收缩率,加速皮肤缺损创面的愈合速度。