It is in urgent need clinically to look for an ideal substance for the coverage of burn wounds owing to shortage of autografts or allografts. After the cadaveric skin was extracted with acetic acid, salted out with NaCl and freeze-dried to prepare a porous collagen membrane. The membrane was seeded with allo-epidermal cells and allo-fibroblasts on its two sides, respectively, and then was cultured to achieve an artificial composite allograft. The artificial composite allograft was then transplanted onto ten severly burned wounds. One-year follow-up showed satisfactory results and the histological examination confirmed that the composite allograft could improve the adherence and growth of the epidermal cells and was helpful for blood vessels and healing of non-inflammatory connective tissues in the wounds.
OBJECTIVE: To investigate the efficiency of recombinant human epidermal growth factor (rhEGF) on burn wound healing and to explore the effective density of the ointments. METHODS: A total of 120 cases of burn in superficial II degree and profound II degree were randomly divided into 2 groups. In the first group of 15 cases of superficial II degree, the wounds were treated by rhEGF ointments of different density, 0.5 microgram/g, 10 micrograms/g and 50 micrograms/g, to screen out the effective density. And in the other 105 cases of the second group, optimal density of the ointments based on the result of the first group were employed to treat the burn wound in superficial II degree and profound II degree, with the self-corresponding wounds of the same degree as control, to study the efficiency of rhEGF on wound healing, according to the wound healing time, and adverse reaction of the ointment. RESULTS: In the first group, the average healing time of superficial II wound treated by ointments of 10 micrograms/g and 50 micrograms/g significantly shortened when compared with that treated by ointments of 0.5 microgram/g(P lt; 0.01), but there was no obvious difference between the cases treated by ointments of 10 micrograms/g and 50 micrograms/g. In the second group, the healing time of superficial II wound treated by ointments of 10 micrograms/g was (8.39 +/- 2.25) days, (9.52 +/- 2.56) days in the control (P lt; 0.01); and healing time of profound II burn treated by ointments of 10 micrograms/g was (16.80 +/- 2.99) days, (18.27 +/- 3.17) days in the control (P lt; 0.01). And healing rates of burn wound at different periods were higher than those of the control. CONCLUSION: The above results indicate that rhEGF ointments can enhance burn wound healing significantly, and the ointment of 10 micrograms/g is a good choice for clinical application.
Objective To assess the effectiveness and the safety of clinical use of growth hormone (GH) in burn patients. Method Search were applied to the following electronic databases: Chinese Bio-medicine Database (CBM), MEDLINE, EMBASE and Cochrane Library. Language was restricted in Chinese and English. Data were extracted and evaluated by the two reviewers independently of each other. Applied RevMan 4.1 for statistical analyse. Results Nine trials involving 732 patients were included. The combined results showed that GH can shorten wound healing time [weighted mean difference (WMD) = -11.25, 95%CI (-14.84 to -7.66), Plt;0.000 01], donor site healing times [WMD= -1.87, 95%CI (-2.28 to -1.47), P＜0.000 01), and length of hospital stay [WMD= -8.10, 95%CI (-10.40 to -5.79), P＜0.000 01]. There was no statistical significance on resting energy expenditure [WMD= -0.04, 95%CI ( -0.08 to 0.00), P=0.06], mortality [odds ratio (OR) =1.15, 95%CI (0.15 to 8.53), P=0.9], sepsis [OR=1.08, 95%CI (0.50 to 2.34), P=0.8] and ventilatory support required [OR=1.51, 95%CI (0.72 to 3.16), P=0.3]. Nevertheless, the plasma levels of glucose [standardized mean difference (SMD) =0.98, 95%CI (0.54 to1.42), P＜0.000 01] and insulin [SMD=0.86, 95%CI (0.43 to1.30), P=0.000 1] were increased in GH groups. Conclusions GH for burn patients is effective and safe if blood glucose can be controlled well.
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...
Compound Huangbai liquid coating agent is a preparation that combines multiple traditional Chinese medicinal herbs and has shown significant efficacy in burn treatment. In recent years, the application of this coating agent in burn treatment has received widespread attention, and it plays a role in promoting wound healing, preventing infection, and reducing patient pain. This article reviews the research progress of compound Huangbai liquid coating agent in burn treatment, explores its mechanism of promoting wound healing, evaluates its current advantages and limitations in burn treatment, and provides scientific basis and theoretical support for its better use in burn treatment.
OBJECTIVE L-arginine is a semiessential dibasic amino acid for humans and animals. This paper aims to investigate the therapeutic effect of L-arginine supplementation on partial-thickness burned patients. METHODS A randomized controlled clinical trial was designed to evaluate the cellular immune function (T cell count, ratio of CD4/CD8, natural killer cell activity and IL-2 level) and protein metabolism (transferrin, prealbium and nitrogen balance) of patients in the experimental group which daily given 15 g arginine and the control group which daily given 25 g glycine. RESULTS The natural killer cell activity and IL-2 production in the experimental group were higher than that of the control group. The suppression of transferrin and prealbium was alleviated and the nitrogen balance was improved in the experimental group. CONCLUSION It suggests that exogenous arginine supplementation is beneficial for recovery of cellular immunity function and protein anabolism in partial-thickness burned patients.
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.
Objective To observe clinical effects of burn wounds treatment with bovine amnion and to screen the best method of preparing and storing of bovine amnion. Methods From January 2004 to January 2005,We selected randomly 58 patients with superficial Ⅱ° wound, deepⅡ° wound, autografting area for removal of eschars and tangential excision, fetching skin area or residual burn wound . Using auto-control, every burn wound was divided into 3 parts and was treated with 3 dressings: bovine amnion dealt with by 0.1% chlorhexidine（group A）, bovine amnion dealt with by 0.4% glutaraldehyde（group B） and vaseline gauze dressing（group C as control）. The clinical effects were compared between different groupsand the method of preparing and storing bovine amnion was evaluated. Results The dressing texture of group A was softer than that of group B, and its flexibility was fine. The pretreatment was not necessary for dressing in group A. When the dressing was used on burn wounds in groups A and B, painwas slight, but pain was obvious in group C; healing time in groups A and B was much less than that in group C, showing statistically significant difference(P＜0.01). There was no statistically significant difference in healing time between groups A and B (P＞0.05). The infection ratio of burn wound in deepⅡ° wound and residual burn wound of groups A and B is much lower than that of group C, showing statistically significant difference (P＜0.05); in theother burn wounds there was no significant difference (P＞0.05). There was no statistically significant difference between groups A and B (P＞0.05). Conclusion Bovine amnion could make benefit on burn wounds healing, reduce infection ratio of burn wounds, could be used on different kinds of burn wounds. The clinical effect between bovine amnion dealt with by glutaraldehyde and by chlorhexidine is similar. Whereas the latter is more easy to be popularized.
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 explore the appl ication of damage control surgery (DCS) strategy in the treatment of severe burn-trauma combined injury. Methods From January 2004 to December 2009, 28 patients with severe burn-trauma combined injury received salvage treatment according to DCS, including 12 cases of burn combining injury at 2 sites, 6 cases ofburn combining injury at 3 sites, and 10 cases of burn combining injury at 4 sites or above. There were 18 males and 10 females with a median age of 39.5 years (range, 8-56 years). The burn area was 15% to 56% of total body surface area. The injury severity score a (ISS) was 25 to 56, and the traumatic index was 17 to 24. Lethal triad syndrome occurred in all patients. Of them, 16 cases were on admission immediatly after first-aid, and 12 cases were thansferred from other hospitals. The time from injury to hospital ization was 20 minutes to 36 hours. All patients were treated by immediate fluid resuscitation and emergent operation to control hemorrhage and contaminations. Biological dressings were used to seal the wounds provisionally. The systemic therapy was carried out as soon as the vital signs of the patients became stable. Results In 26 survivors, 23 achieved wound heal ing by first intention, 3 had a l ittle residual wound at discharge. The hospital ization days were 31 to 398 days (62 days on average). However, 1 patient died of multiple organ failure, another 1 patient died of severe cerebral trauma with refractory shock. Conclusion The DCS strategy is effective in reducing mortal ity of patients with severe burn-trauma combined injury.