Oral administration of pectins for prophylaxis and treatment of purulent septic complications in patients with burns]

Clinical and laboratory evaluation of pectins application efficacy demonstrated that the patients treated with pectines has lower frequency of bacteriemia, intoxication, infectious complications and lethality. Pectins use per os resulted by acceleration of burns wounds healing and by lower microbial dissemination. Frequency of coagulase-positive staphylococci, streptococci and enterococci isolation was also lower in the treated group of patients when compared to the control group. Feces microbial profile also demonstrated positive trend--normal microflora (bifidobacteria and lactobacilli) enhanced, opportunistic bacteria diminished. Pectins application provided normalization of leucocytes, lymphocytes, B-lymphocytes, immunoglobulins A and G. The results of investigation demonstrated pectins efficacy at the complex treatment regimes of the patients with burns.     

Morphological characteristics of the healing of burn wounds covered by an activated-charcoal tissue dressing

Activated-charcoal cloth and dressings product based upon this material were applied for covering burn wounds. As a control served a gauze dressings with greases and solution topical drugs. The healing of deep thermal burns of 3rd degree on rabbits studied by a histological method was differed by a rapid decreasing of inflammation reaction, active epithelialization and soft scar formation. A clinical use in 15 burned patients was shown that in combination with enzymatic and antimicrobial drug solutions these materials accelerate healing and epithelialization of superficial burn wounds and improve treatment of deep burn wounds before autodermoplasty.     

Graft survival and effectiveness of dermal substitution in burns and reconstructive surgery in a one-stage grafting model

Survival of the autograft and objective parameters for scar elasticity were evaluated after dermal substitution for acute burns and reconstructive surgery. The dermal substitute, which was based on bovine type I collagen and elastin-hydrolysate, was evaluated by intraindividual comparison in a clinical trial. The substitute was applied in a one-step procedure in combination with a split-thickness autograft. This treatment was compared with the conventional treatment, the split-thickness antograft. After 1 week, the percentage of autograft survival was assessed. The Cutometer SEM 474 was used to obtain objective measurements of skin elasticity parameters 3 to 4 months postoperatively. Forty-two pairs of wounds (31 patients, age 32.9 +/- 19.3 years; burned surface area, 19.8 +/- 14.5 percent) were treated because of acute burns. Reconstructive surgery was performed on 44 pairs of wounds (31 patients, age 33.9 +/- 17.5 years). Autograft survival was not altered by the substitute for reconstructive wounds, although a slight but significant reduction (p = 0.015) was established in the burn category for substituted compared with nonsubstituted wounds. However, the necessity for regrafting was not increased by substitution. Cutometer measurements of reconstructive wounds with a dermal substitute demonstrated a significant increase of pliability (50 percent, p < 0.001), elasticity (defined as immediate extension, 33 percent, p = 0.04), maximal extension (33 percent, p = 0.002), and immediate retraction (31 percent, p = 0.01), as compared with nonsubstituted wounds. After burn surgery, no improvement was found for the different elasticity parameters. Dermal substitution in a one-stage grafting model seems feasible with respect to graft survival. Skin elasticity was considerably improved by the collagen/elastin dermal substitute after reconstructive surgery.     

Healing of burns after treatment with 670-nanometer low-power laser light

Recent investigations have reported contradictory results on the influence of low-power laser light on wound healing. Low-power laser with a power output of 250 mW and an emitted laser light of 670 nm have been insufficiently investigated to date. The effect of a 250-mW/670-nm laser light on the healing of burning wounds in rats was investigated. Thirty rats were burned on both flanks. One wound was irradiated with 670-nm laser light (2 J/cm2), whereas the other side remained untreated. Macroscopic evaluation of the wounds was performed daily; 10, 20, and 30 days after burning, 10 rats were killed and the wounds histologically evaluated. Neither macroscopic nor histologic examination of the irradiated wound showed accelerated wound healing when compared with control wounds. In the present study, irradiation of burns with a 250-mW/670-nm laser light produced no beneficial effects on wound-healing processes.     

EVALUATION OF EXPOSURE TREATMENT OF BURNS

For purposes of comparison with the occlusive dressing method of treating burns, the exposure method was used in 30 cases—16 of first and second degree and 14 of third degree. Attempt was made to simulate the conditions which might be expected to prevail in mass treatment of burned patients—inadequate personnel and materials. Elaborate measures to immobilize burned areas were not employed.Healing of first and second degree burns was natural and the results satisfactory without further treatment. In third degree burns, skin grafting was necessary after the eschar was removed. Cracking of the eschar several days before time to remove it in some cases of third degree burns necessitated use of occlusive dressings in the last few days before skin grafting was done.The exposure method is considered valuable in circumstances in which saving of time, material and personnel is indicated. Generally it is not suitable for treatment of encircling burns of the trunk or extremities, since maintaining the integrity of the eschar is extremely difficult in such situations.     

Results of using polyvalent Pseudomonas aeruginosa vaccine in children with burns by various medical centers

Polyvalent Pseudomonas aeruginosa vaccine, prepared at the Institute of Hematology from 10 hospital strains isolated from burn wounds, was administered to 32 children with extensive and deep burns. The vaccine was well tolerated. The vaccine produced a high degree of the immunity against Pseudomonas aeruginosa infection. Agglutinin serum titre increased significantly. Vaccination either prevented or inhibited the infection of burn wounds with Pseudomonas aeruginosa in all immunized children. The symptoms of Pseudomonas aeruginosa infection usually disappeared following one or two vaccinations. Bacteriemia caused by P. aeruginosa was not observed in 31 out of 32 children. In the remaining child transient bacteriemia was noted. No septicemia caused by P. aeruginosa was seen. Due to the high efficiency of the polyvalent P. aeruginosa vaccine all burned children with burns exceeding 10% of the total body surface should by vaccinated to prevent the life-threatening infections with Pseudomonas aeruginosa.     

烧伤病区感染常见病原菌及抗生素的选择

目的探讨内江市第一人民医院烧伤病区感染的常见病原菌及其对常用抗生素的耐药性．以指导临床抗生素的选择,提出防治措施。方法对1999年1月～2003年12月该院烧伤病区患者因感染而分离出的658株病原菌进行回顾性分析。结果分离出的658株病原菌中．革兰阴性菌425株(64．6％),革兰阳性菌209株(31．8％)．真菌24株(3．6％)。主要病原菌分别为铜绿假单胞菌、金黄色葡萄球菌、大肠埃希菌、凝固酶阴性葡萄球菌和阴沟肠杆菌。药敏提示除真菌外的大多数病原菌出现多重耐药性。革兰阴性菌对亚胺培南、头孢哌酮-舒巴坦、头孢西丁和妥布霉素较为敏感。革兰阳性球菌对替考拉丁和万古霉素高度敏感。结论烧伤感染中以铜绿假单胞菌为主．其次为金黄色葡萄球菌、大肠埃希菌和凝固酶阴性葡萄球菌。了解病原菌的结构及其变化趋势．对于加强抗感染治疗的针对性和主动性,取得最佳的感染防治效果具有重要意义。     

Efficacy of bacteriophages in complex treatment of patients with burn wounds]

Results of clinical and laboratory evaluation of the treatment with pyobacteriophage in tablets of the patients with burn wounds are presented. It was shown that phagotherapy provided more rapid cure of pyoseptic complications, temperature normalization, wounds purification and lower lethality Bacteriological analysis of wound secretions revealed that after the treatment staphylococci and streptococci were cultured 2 times rarely, Proteus spp. Were isolated 1.5 times rarely, E. coli was not isolated. The amount of positive haemocultures also diminished. Investigation of immunologic status demonstrated statistically significant normalization of immunity on cell level. Phagocytosis level didn't change while in control group (without bacteriophage use) it became lower. Antibody level enhanced but less extensively than in control group. The results of trial demonstrates positive effect of phagotherapy use at the patients with burns.     

The use of allogeneic cultivated keratinocytes for the early coverage of deep dermal burns – indications, results and problems

Since 1995, keratinocytes are grown into cultures and used as allografts for the coverage of deep dermal defects in our burn unit. Donor skin samples are mostly acquired from other burn patients. In addition, special methods of skin preservation allow us the use of skin, which has been taken in redundancy for split thickness skin grafting from nonburned patients.Thirty five patients with deep partial thickness burns in the face were treated since 1996 according to the following concept: Dermabrasion or tangential excision was performed before the 5(th) day following trauma. If viable dermis was present, the wounds were covered with sheets of allogeneic cultivated keratinocytes. In cases of deeper defects, autologous skin grafts were applied. In 23 cases, epithelialisation was achieved within 10 days, in 8 patients, a prolonged duration until complete healing was observed. In 5 faces, coverage of residual defects with skin grafts was necessary. The mentioned problems of wound healing occurred from infection, incomplete excision of burn eschar and a depth of the wound which was retrospectively seen too deep for the treatment with keratinocytes. At follow up, patients were examined clinically and functionally with Frey's faciometer(R), which is an instrument for quantification of mimic movements. In cases of uncomplicated healing, a nearly complete restitution was found.Other indications include deep dermal burns in children and the coverage of early excised wounds in adults, with a reasonable amount of viable dermis remaining, both resulting in a significant reduction of donor-site morbidity. In severely burned adults with limited donor sites, it offers the possibility of immediate definite coverage of large areas.     

The effects of fire on grassland bird communities of Barberspan,North West Province,South Africa

Considering the frequent nature of fires and resultant drastic change in habitat following fire, research on the effects of fire on birds in the grasslands of South Africa is surprisingly scarce. For at least five months after burns we followed the changes in bird species composition, species richness and densities of two controlled burns and one accidental fire at the Barberspan Nature Reserve in grasslands that had not been burned or grazed in 10 years. Compared with the control areas, species richness and densities increased in the burned areas immediately following the burns, with more species and birds recruited to the burned areas than were lost. Immediate post-burn opportunists tended to be larger species, and the biomass increase mirrored the increases in species richness and densities in burned areas. Avian species richness, densities and biomass tended to return to the initial conditions after a number of months. Although the bird communities from two controlled-burns differed before the burns, they converged to a characteristic immediate post-burn composition. Five months after the burns however, the bird communities reflected a pre-burn composition. Indications were that birds in an area larger than that burned were affected. Mosaic burning, with shifting large and small patches, should be considered on a landscape scale.     

Wound fluid bacterial levels exceed tissue bacterial counts in controlled porcine partial-thickness burn infections

In the present study, an established controlled burn wound model was used to test the hypothesis that controlled surface contamination with is capable of generating a noninvasive method for the creation of a reproducible deep tissue burn wound infection. Using a liquid tight-wound chamber in Yorkshire pigs, partial-thickness burns were inoculated with saline-immersed for 24 hours. Noninoculated burns and unwounded skin immersed in normal saline served as controls. Bacterial cultures of wound fluid were performed daily, and tissue biopsies for bacteriological and histological evaluations were performed on days 1, 3, and 5. was only recovered from -inoculated wounds (tissue and fluid), whereas all controls contained endogenous only. The number of colony-forming units per gram of wound tissue did not correlate with the bacterial counts found in the overlying wound fluid for any wounds. Fluid counts were consistently higher than tissue counts by two logs. -inoculated wounds showed three times deeper tissue destruction than control wounds. Obtaining consistently deep tissue colonization without cross-contamination among wounds, this study introduces a noninvasive model for controlled burn wound infection suitable for future investigations regarding the efficacy of topical antibiotic wound treatment in experimental burns.     

表皮生长因子治疗兔角膜碱烧伤研究

本试验制成兔角膜碱烧伤模型,应用重组表皮生长因子（ｒｈＥＧＦ）滴眼剂对碱烧伤后的兔角膜溃疡创面进行治疗。６３只纯种新西兰白兔分为７组,每组９只,其中５组为治疗组,另２组为对照组,治疗组分别用每毫升０．５,５,２０,５０和１００μｇ表皮生长因子滴眼剂滴眼,对照组分别用纤维结合蛋白和氯霉素滴眼。伤后２４,４８,７２,９６及１２０ｈ裂隙灯荧光素染色,照像观察溃疡面积,经计算机图像处理,计算。结果显示５组治疗组创面愈合时间明显短于对照组,（Ｐ＜０．０５）。提示ＥＧＦ对角膜碱烧伤后的溃疡面愈合有促进作用。     

Home range and survival characteristics of male Bachman's Sparrows in an old-growth forest managed with breeding season burns

ABSTRACT.   Prescribed burning is essential for maintaining suitable habitat for Bachman's Sparrows ( Aimophila aestivalis ), but burns conducted during the breeding season may lead to site abandonment and low survival or productivity. We monitored a color-banded population of Bachman's Sparrow in Georgia for four breeding seasons to assess home range size, site fidelity, and survival in an area managed primarily using breeding season burns. Our study area was one of the last remaining tracts of old-growth longleaf pine ( Pinus palustris ), and alternating halves of the tract were burned during the breeding season during each year of our study. Mean home range size for males ( N = 46) during the breeding season was 3.1 ha based on 95% fixed kernel analysis and 1.8 ha based on minimum convex polygons. Breeding season burning had no effect on male site fidelity and home range characteristics. The proportion of males remaining on burned areas was similar to the proportion remaining on unburned areas. Shifts in home range centroids pre- and postburn were also similar for males on unburned (median = 49.7 m) and burned (median = 65.6 m) areas. In addition, the size of home ranges that were burned ( ha) was similar to that of home ranges that were not burned ( ha). Estimated annual survival for males was 0.59. The median shift in annual home range centers calculated for 38 males observed during multiple breeding seasons was 63 m and, coupled with our survival estimates, suggest greater site fidelity than previously reported. These results suggest that breeding season burns were not as detrimental to Bachman's Sparrows as reported at other locations, and such burns may be helpful in maintaining suitable habitat.     

Use of cultured fibroblasts in the treatment of burn wounds

This paper deals with the possibility of closing of burn surfaces of skin wounds with cultivation of patients' fibroblasts. Transplantation of cultured fibroblasts was performed in 11 patients with 30-75% of a body surface burned. The results obtained indicate a prospect of this method of burn treatment.     

Our Clinical Experience using Cryopreserved Cadaveric Allograft for the Management of Severe Burns

Human cadaveric allograft is the most commonly used alternative wound closure material for excised burn wounds when limited donor sites or the overall patient condition does not permit immediate grafting with autologous skin. The Skin Bank in Singapore has supplied a total of 33,000 cm² of cryopreserved cadaveric allograft to the Burns Centre in Singapore for the early post-burn treatment of 17 severely burned patients with body surface area (BSA) burn wounds averaging 58% (range 33–90). An average of 13% (range 3–30%) cadaveric allograft was transplanted on 17 patients. Seven patients had recovered from their burn injuries and ten patients died of multiple complications related to their burn injuries. Our clinical observation has shown good adherence of cadaveric allograft when applied on clean and debrided wound bed after 4–7 days of post-operation. The availability of cadaveric allograft permits early excision and wound coverage before the patients' condition is further compromised. Our clinical experience using cryopreserved cadaveric allograft is proving to be indispensable in the management of patients with severe burns. This revised version was published online in July 2006 with corrections to the Cover Date.     

Towards quantitative assessment of burn based on photoacoustic and optical coherence tomography

Accurate and timely assessment of the severity of burn is essential for the treatment of burns. Currently, although most first‐degree and third‐degree burns are easily diagnosed through visual inspection or auxiliary diagnostic methods, the second‐degree burn is still difficult to distinguish due to the ambiguity boundaries of second‐degree with first‐degree and third‐degree burns. In this study, we proposed a non‐invasive technique by combing photoacoustic imaging (PAI) and optical coherence tomography (OCT) to multi‐parameter quantitatively assess the burns. The feasibility and capacity of the dual‐mode PAT/OCT for assessing the burns was first testified by tissue‐mimicking phantom and burn wounds in mouse pinna in vivo. The further experiments conducted on the back of rats showed that the changes in skin scattering structure, vascular morphology and blood flow provided by the dual‐mode PAI/OCT system can determine distinct boundaries and depth of the burns. The experimental results prove that combined PAI/OCT as a novel method can be used to assess the severity of burn, which has the potential to diagnose the burns in clinic.     

Inhibition of neutrophil adhesion by pectic galacturonans

The inhibition of the adhesion of neutrophils to fibronectin by the fragments of the main galacturonan chain of the following pectins was demonstrated: comaruman from the marsh cinquefoil Comarum polustre, bergenan from the Siberian tea Bergenia crassifolia), lemnan from the duckweed Lemna minor), zosteran from the eelgrass Zostera marina), and citrus pectin. The parent pectins, except for comaruman, did not affect the cell adhesion. Galacturonans prepared from the starting pectins by acidic hydrolysis were shown to reduce the neutrophil adhesion stimulated by phorbol 12-myristate 13-acetate (1.625 μM) and dithiothreitol (0.5 mM) at a concentration of 50–200 μg/ml. The presence of carbohydrate chains with molecular masses higher than 300, from 100 to 300, and from 50 to 100 kDa in the galacturonan fractions was proved by membrane ultrafiltration.     

仙人掌提取物对浅Ⅱ度烫伤小鼠VEGF及FGF-2表达的影响

为探讨野生仙人掌和食用仙人掌提取物对浅Ⅱ度烫伤小鼠内源性血管内皮生长因子(VEGF)及碱性成纤维细胞生长因子(FGF-2)表达的影响,建立小鼠浅Ⅱ度烫伤模型。野生、食用仙人掌提取物组(浓度均为12.5 mg/mL),药物组(京万红),烫伤组(生理盐水),每天2次涂药并观察创面,分别在3 d和7 d各组取5只小鼠处死,取烫伤组织提取蛋白并检测VEGF、FGF-2的表达状况。仙人掌组中VEGF及FGF-2的表达量均高于烫伤组,且两种仙人掌组VEGF及FGF-2的表达量有差异。即仙人掌提取物能提高VEGF及FGF-2的表达量并能促进创面的修复。     

Full-thickness grafting of acute eyelid burns should not be considered taboo.

Split-thickness skin grafts are commonly used for the treatment of acute eyelid burns; in fact, this is dogma for the upper lid. Ectropion, corneal exposure, and repeated grafting are common sequelae, almost the rule. It was hypothesized that for acute eyelid burns, the use of full-thickness skin grafts, which contract less than split-thickness skin grafts, would result in a lower incidence of ectropion with less corneal exposure and fewer recurrences. The records of all patients (n = 18) who underwent primary skin grafting of acutely burned eyelids (n = 50) between 1985 and 1995 were analyzed retrospectively. There were 10 patients who received full-thickness skin grafts (12 upper lids, 8 lower lids) and 8 patients who received split-thickness skin grafts (15 upper lids, 15 lower lids). Three of 10 patients (30 percent) who received full-thickness skin grafts and 7 of 8 patients (88 percent) who received split-thickness skin grafts developed ectropion and required reconstruction of the lids (p = 0.02). No articles were found substantiating the concept that only split-thickness grafts be used for acute eyelid burns. The treatment of acute eyelid burns with full-thickness rather than split-thickness skin grafts results in less ectropion and fewer reconstructive procedures. It should no longer be considered taboo and should be carried out whenever possible and appropriate.     

Effects of Prescribed Burning on Herbaceous and Woody Vegetation in Northern Lowland Meadows

Abstract Spring burning of sedge‐grass meadows in the Slave River Lowlands (SRL), Northwest Territories, Canada was applied between 1992 and 1998 to reduce shrub encroachment and enhance Bison bison (bison) habitat, although the impact of fire on preferred bison forage was unknown before management. In the summer of 1998 we conducted a study in the Hook Lake area of the SRL to test the effect of burn frequency (unburned, burned once, or burned three times since 1992) on herbaceous plant community composition and Salix spp. L. (willow) shrub vigor. Plant species abundance, litter biomass, soil pH, and depth of the organic soil horizon were measured in 300 1‐m² quadrats nested within 30 1,000‐m² plots in both burned and unburned dry meadows. To test the relationship between frequency and willow vigor, all willow shrubs within the plots were assigned a vigor score from I (dead) to IV (flourishing). The spring burns appear to have reduced willow vigor; however, shrub survival remained high (76%) on the most frequently burned meadows. Ordination plots resulting from canonical correspondence analysis suggest that multiple spring burns influenced plant community composition in dry meadow areas and that less palatable bison forage species (e.g., Carex aenea Fern. and Juncus balticus L.) were correlated with a regime of three spring burns. Our results suggest that frequent spring fires in the Hook Lake area have only a small negative effect on willow cover but may reduce the abundance of primary bison forage plants compared with less frequently burned meadows.