摘要:Microskin graft is a technique of skin defect closure using a minimum of STSG donors to cover the large defect. Some considerations were taken, which includes the general status of the patient, donor area morbidity, and patient refusal to act is one of the reasons for the use microskin graft. History STSG failure with previous defect closure and lack of donor area would to bene!t from microskin graft. Case of boy 12 years old with extensive defects in the forearm due to burns. Consideration of the lack of donor area made us deciding to use microskin graft as main option to close the defect. We did one-week post operative evaluation. Epithelialization occurs at day 7, while complete epithelialization occurred at 14th day. Three month during follow-up control, the scar are minimal. We conclude that microskin graft is one technic that can be used in skin defect closure with minimal donor.
摘要:目的:观察超脉冲CO2点阵激光Active FX、Deep FX治疗兔耳浅表性瘢痕的创面愈合情况并比较湿性创面护理技术和传统外科创面护理技术,创面愈合的差异性。研究CK19、P63在兔耳浅表性瘢痕点阵激光修复中的表达及不同创面护理技术对它们的影响,为临床采用超脉冲CO2点阵激光治疗瘢痕、寻找表皮干细胞参与瘢痕修复的证据。方法:选取新西兰大白兔20只,在兔耳腹侧面制作边长为1.5cm的正方形全层皮肤及软骨膜缺损创面,每只兔耳2个创面,共计80个创面,建立兔耳浅表性瘢痕模型。激光治疗分为两组: UltraPulse CO2Fractional(超脉冲CO2点阵)激光Active FX治疗组和UltraPulse CO2Fractional(超脉冲CO2点阵)激光Deep FX治疗组;激光治疗后创面修复分为两组:传统络合碘治疗方法组和湿润烧伤膏治疗方法组。每天观察创面愈合情况,记录每个创面的愈合时间;收集治疗前、治疗后即刻、1天、4天、7天、14天的瘢痕组织标本作病理组织切片,行HE染色镜下观察,并采用免疫组化检测皮肤干细胞标志分子角蛋白19(cytokeratinsCK19)、转录因子P63的表达,分析超脉冲CO2点阵激光两种不同模式和两种创面修复方法对CK19、P63的影响。结果:1、大体观察:络合碘组Active FX、Deep FX模式治疗后第2~3天创面开始干燥结痂、第9~10天痂皮开始脱落、第14天创面愈合,瘢痕较治疗前平整,颜色变浅;湿润烧伤膏组Active FX模式治疗后创面湿润,第2~3天创面可见散在点状结痂,第5~6天点状痂皮脱落,Deep FX模式治疗后创面未见明显结痂,治疗后第6~7天创面上皮化愈合。点阵激光Active FX模式治疗:络合碘组创面愈合时间为(13.7±0.65)天,湿润烧伤膏组创面愈合时间为(10.4±0.80)天,组间差异有统计学意义(P<0.05);点阵激光Deep FX模式治疗:络合碘组创面愈合时间为(9.4±0.28)天,湿润烧伤膏组创面愈合时间为(7.5±0.62)天,组间差异有统计学意义(P<0.05);Active FX模式和Deep FX模式治疗创面愈合时间对比,...
摘要:Burn injury is one of the most devastating injuries that may affect a patient. Even in economically deprived areas, burn care is largely driven by relatively plentiful resources equating quality of care with generous monitoring and clinical attention with little concern to management cost. Burn care costs have been the subject of very few investigations and are among the least studied by health services researchers. Nevertheless, it can be stated that local care of burn wounds accounts for a large proportion of the cost per day for treating patients. As economic times are changing and as market penetration of managed care contracts and stiff competition in the health care industry gains momentum, ways to reduce expenditures without adversely affecting the quality of care have become of primary importance. We report a randomized prospective comparative study analyzing the benefit-cost value of moist exposed burn ointment (MEBO) application, an exposed method for burn wound care without the need for a secondary covering dressing, as compared to conventional closed methods.
摘要:Objective: The goal of any topical formulation is efficient transdermal delivery of its active components. However, delivery of compounds can be problematic with penetration through tough layers of fibrotic dermal scar tissue.Approach: We propose a new approach combining high-performance liquid chromatography (HPLC) and Raman spectroscopy (RS) using a topical of unknown composition against a well-known antiscar topical (as control).Results: Positive detection of compounds within the treatment topical using both techniques was validated with mass spectrometry. RS detected conformational structural changes; the 1,655/1,446?cm?1 ratio estimating collagen content significantly decreased (p?<?0.05) over weeks 4, 12, and 16 compared with day 0. The amide I band, known to represent collagen and protein in skin, shifted from 1,667 to 1,656?cm?1, which may represent a change from β-sheets in elastin to α-helices in collagen. Confirmatory elastin immunohistochemistry decreased compared with day 0, conversely the collagen I/III ratio increased in the same samples by week 12 (p?<?0.05, and p?<?0.0001, respectively), in keeping with normal scar formation. Optical coherence tomography attenuation coefficient representing collagen deposition was significantly decreased at week 4 compared with day 0 and increased at week 16 (p?<?0.05).Innovation: This study provides a platform for further research on the simultaneous evaluation of the effects of compounds in cutaneous scarring by RS and HPLC, and identifies a role for RS in the therapeutic evaluation and theranostic management of skin scarring.Conclusions: RS can provide noninvasive information on the effects of topicals on scar pathogenesis and structural composition, validated by other analytical techniques.