OBJECTIVE: To study the therapeutic effect of Suyuping in which liposome is the main constituent on II degree burn wound. METHODS: From October 1998 to October 1999, 42 cases with II degree burn wound were adopted in this study. Among them, there were 30 males and 12 females, the average wound area was (23.4 +/- 9.7)%. The wounds on the left side of body were managed with sulfadiazine argentum(SD-Ag) while that on the right side with Suyuping. Healing and other situation about the burn wounds were observed and recorded at times. RESULTS: Forty-two patients completely healed when discharged from hospital. The average wound area managed with Suyuping was (11.2 +/- 7.3)% and the area with SD-Ag was (9.4 +/- 5.8)%. The mean healing time of Suyuping group was(18.4 +/- 4.7) days while that of SD-Ag was (23.5 +/- 7.9) days, there was significant difference(P lt; 0.05). Suyuping group presented few wound pain, allergy, bleeding and the side effect was less. CONCLUSION: Suyuping can accelerate wound healing and attenuate wound pain, allergy and bleeding, it is a potential and specific topical agent for treating II degree burn wound.
ObjectivesTo investigate the occupational stress and career burnout of postgraduates in professional degree of clinical medicine.Methods70% of postgraduates with professional degree of clinical medicine from grade 2016 to 2018 in West China Hospital of Sichuan University were sampled. The individual characteristics and occupational stress were investigated by a questionnaire, and Maslach Burnout Inventory (MBI) was used to investigate the individual career burnout. ResultsA total of 600 questionnaires were distributed and 520 valid questionnaires were retrieved, with an effective rate of 86.7%. According to the stress results, 17.5% of the students were under severe stress, 44.81% were under moderate stress, and only 1.54% were without stress. Regarding the sources of stress, 63.46% were originated from scientific research while 27.88% were originated from clinical practice. For burnout, the mean score of MBI was 40.56 with 15.00 standard deviation suggesting most of the students were in good working condition. However, a small number of students had career burnout to a certain degree and required adjustment. ConclusionsPostgraduates in professional degree of clinical medicine face the dual pressure of scientific research and clinical work. Improving the existing medical master's training system, relieving postgraduates’ stress, maintaining postgraduates’ physical and mental health are necessary and urgent. In light of this, the teaching quality of postgraduates in professional degree of clinical medicine may require improvement.
OBJECTIVE: To evaluate the clinical efficacy of fasciocutaneous flap in the repair of the III degree burn wound in the facio-cervical region. METHODS: From January 1997 to October 2001, 11 cases of III degree burn wounds in the facio-cervical region were repaired with the cervical-thoracic fasciocutaneous flap ranging from 18 cm x 8 cm to 13 cm x 5 cm. Donor sites were covered with "Z" plasty or skin grafting. RESULTS: Except for partial necrosis of distal end of the flap in 1 case, the flaps in the other 10 cases all survived and presented satisfactory appearance and function during the following up. CONCLUSION: The fasciocutaneous flap in the cervical-thoracic region may provide a large area of flap, and can be easily transferred. It’s an ideal flap for the repair of skin defect in the facio-cervical region, especially for the repair of the wounds with infection or exposure of vessel, nerve and tendon.
Objective
To review the research progress of mesenchymal stem cells (MSCs) in burn wound repair.
Methods
The recent literature about MSCs involved in burn wound repair and mechanism was extensively reviewed and analyzed.
Results
MSCs have the capacity of self-renew, rapid proliferation, differentiation and paracrine, and promote burn wound repair through differentiating into a series of skin wound cells and regulating wound microenvironment.
Conclusion
MSCs have great potentials in the burn field. However, the cell survival and outcome are also facing challenges from poor microenvironment of the burn wound.
Objective To explore the mechanism of full-thickness burn wound healing with autoskin grafting in fault hypodermis wound of granulation excision and to evaluate its effect.Methods By the techniques of clinical observation, histopathology, immunohistochemistry,TEM and FCM,we observed changes of the activity andstructure of grafted skin and the granulation tissue,collagnous fiber,microvessels,the ultramicrostructure of fibroblasts and the expression of basic fibroblast growth factor(bFGF) in the base of autoskin grafting in fault hypodermis wound in burned adult minipigs(Group A), and compared with traditional method of autoskingrafting on the basilar fibrous tissue wound of scraped partly granulation being(Group B) and control group (Group C, without treatment except de-fur).Results The grafted skin survived after 3 days of operation, and it had less injury and higher proliferative index(PI) in group A than in group B. The hyperplasiaof granulation tissue and vascular endothelial and the expression of bFGF were more evident in group A. After 5 days, the proliferation of endothelial cells and granulation and the protein synthesis of fibroblasts were more active in groupA, and at this moment, fresh collagen appeared and proliferated more actively in group B. After 7-14 days, epidermic structure and dermic microvascular density became normal gradually, the granulation on grafting base matured and transformed into fibrous connective tissue in group A. The same change deferred about 2 days in group B. After 21 days, the above pathologic change in group A was less than that in group B. After 3060 days of operation, Group A achieved much less contraction and transfiguration than Group B, and the grafted skin was tender and movable. Conclusion Autoskin grafting in fault hypodermis wound of granulation excision has a better effect than traditional operation.
Objective To develop a new kind of skin substitute, selective acellular porcine skin, to cover excised wounds in treatment of extensivedeep burns on the basis of controlled de-cell technique. Methods Partial thickness porcine skin was treated with 0.25% trypsin for 2 hours at 37℃ after crosslinked with glutaraldehyde, and then it was glued to a container with the edge embedded with glue. The skin was shaken in 0.5% SDS for 24 hours, and then washed before use. The selective acellular skin was used with micro-autografts on the dermal side to cover 2 surgically excised burn wounds in a patient. The recoveries of function and appearance were observed. Results Morphological observation showed that the treated porcine skin had an intact epithelial layer and an acellular dermis. After being used to cover burn wounds, its acellular dermis could serve as host dermal matrix, and its devitalized epithelial layer could prevent the dermis from drying. The devitalized epithelium wasfinally replaced by host epithelial cells, and the healed wounds could achieve good cosmetic and functional results. Conclusion Selective acellular porcine skin can be used as promising skin substitute to cover excised wounds.
Abstract From March, 1987 through May, 1996, a total of 13 cases of severe deep burn and bone defect of hand and wrist were treated by groin skin and iliac bone composite graft with vascular pedicle and had resulted in satisfactory result. The operation was relatively simple. Because thecomposite graft carried its own blood supply in the pedicle, it was not necessary to revascularize the composite graft by anastomosis of blood vessel during operation. Owing to the presence of abundant vascular supply of the iliac bone, the antiinfection potency was high, so its application was suitable for those conditions such as fresh severe deep burn with infection and bone defect. As a result, this technique gave the best chance to save the limb from amputation, and the duration required for treatment could be markedly shortened. This method provided the possibility to solve effectively the difficult problem dealing with the treatment of severe deep burn with infection and bone defect of the hand and wrist.
hrbondioxide laser knife was ued to excise 40 cases of burn crusts and late cicatrices and the resuIts were compored with that from the ordinary surgieal knife. The extent of tiSsue damage,the operative successful rate and the amount of bleeding were obsered in both groupe. It was proved that by using,earbondioxide laser knife to excIse the tissue resulted in very limited damage of tissue,it did not influence the tissue healing and the amount of bleeding was far less than that fro...
Objective To explore the effectiveness and safety of topical phenytoin for wound healing. Methods We searched MEDLINE (1966 to Oct. 2002), EMBASE (1984 to 2002), The Cochrane Library (Issue 4, 2002), Biological Abstracts (1993 to 1996), Cancerlit (1997 to Sept. 2002), Life Science Collection (1982 to Mar. 1995), International Pharmaceutical Abstracts (1970 to 2002), and CBMdisc (1978 to Jan. 2003). Controlled trials on topical phenytoin for wound healing were identified. The methodological quality of included studies was assessed, and a descriptive analysis was performed. Results Nine studies (507 cases) including 1 randomized controlled trials (RCT) and 8 non-randomized controlled trials were included. These studies were of poor methodological quality. Because there were a variety of etiology of ulcers, differnet interventions in control groups, and different outcome measures, for which meta-analysis was difficult to perform, a descriptive analysis of the results was presented. Most studies showed that topical phenytoin had better effects on improving healthy granulation appearance, increasing complete recovery rate, reducing time for complete recovery, and positive cases of bacterial culture than those of control groups. Mild side effects were observed in only one study.Conclusions The reviewers think that the inclusion studies less rigorous than randomized controlled trials could result in misleading findings.Some well designed randomized controlled trials of topical phenytoin for wound healing are warranted.
OBJECTIVE: To evaluate the application of skin and soft tissue expansion in the treatment of deformity due to extensive severe burn injury and repair of severe deep electrical burned scalp and skull with fresh wound. METHODS: From 1988, 83 cases of application of skin and soft tissue expansion were reported. In those patients with deformity due to severe burn of large area and with whole nasal defect, soft tissue expander was used under the forehead skin graft and venter frontalis, followed by reconstruction of nose with the expanded vascularized skin flap and carved cartilago costalis as nasal frame. In patients of severe deep electrical burned scalp and skull with fresh wound, skin and soft tissue expansion were used to repair the wound simultaneously with scalp burn alopecia, anesthetics and antibiotics injected into the extracapsular space of the expander in case of pain and infection. RESULTS: All of the cases were successfully treated with little pain and minimized infection. CONCLUSION: Skin and soft tissue expansion in a safe and reliable measure in the treatment of deformity due to extensive severe burn injury and repair of severe deep electrical burned scalp and skull with fresh wound.