Pathophysiology of the burn wound and pharmacological treatment. The Rudi Hermans Lecture, 1995

https://cyberleninka.org/article/n/106406.pdf

Stem cell therapy for abrogating stroke-induced neuroinflammation and relevant secondary cell death mechanisms.

Negative pressure wound therapy (NPWT) has become widely adopted over the last 15 years and over 1000 peer reviewed publications are available describing its use. Despite this, there remains uncertainty regarding several aspects of usage. In order to respond to this gap a global expert panel was convened to develop evidence-based recommendations describing the use of NPWT. In this paper the results of the study of evidence in traumatic wounds (including soft tissue defects, open fractures and burns) and reconstructive procedures (including flaps and grafts) are reported. Evidence-based recommendations were obtained by a systematic review of the literature, grading of evidence, drafting of the recommendations by a global expert panel, followed by a formal consultative consensus development program in which 422 independent healthcare professionals were able to agree or disagree with the recommendations. The criteria for agreement were set at 80% approval. Evidence and recommendations were graded according to the SIGN (Scottish Intercollegiate Guidelines Network) classification system. Twelve recommendations were developed in total; 4 for soft tissue trauma and open fracture injuries, 1 for burn injuries, 3 for flaps and 4 for skin grafts. The present evidence base is strongest for the use of NPWT on skin grafts and weakest as a primary treatment for burns. In the consultative process, 11/12 of the proposed recommendations reached the 80% agreement threshold. The development of evidence-based recommendations for NPWT with direct validation from a large group of practicing clinicians offers a broader basis for consensus than work by an expert panel alone.

Evidence-based recommendations for the use of Negative Pressure Wound Therapy in traumatic wounds and reconstructive surgery: Steps towards an international consensus

Use of subatmospheric pressure therapy to prevent burn wound progression in human: first experiences.

Expedient primary excision of deep dermal and full-thickness burn wounds with subsequent skin grafting is the standard of care in most burn institutions, but differentiating full-thickness from partial-thickness burns is often difficult. Because accurate early assessment of burn depth may improve care, a variety of technical methods have attempted to measure burn depth but these methods have had limited success. We describe a new technique to determine burn depth that uses infrared (840- to 850-nm) fluorescence emission from intravenously administered indocyanine green following excitation with infrared (780 nm) and UV light (369 nm). Full-thickness and partial-thickness burns in hairless rat skin were distinguished based on the infrared-induced and UV-induced fluorescence intensity ratios relative to normal, unburned skin immediately after the burn and on post-burn days 1 through 3 and 7. Dual-wavelength excitation of indocyanine green infrared fluorescence can delineate full-thickness from partial-thickness burns at an early date, allowing prognosis, surgical planning, and early primary excision and grafting.

Burn depth estimation using indocyanine green fluorescence.

Permeability of blood vessels after thermal injury

Rheologic impairment of the microcirculation during decompression sickness

Pulmonary microcirculation following full-thickness burns

Changes in capillary blood flow induced by the extravascular application of hypertonic solutions: a possible mechanism for the control of renal medullary blood flow.

T.P. Bond

Papers

Permeability of blood vessels after thermal injury

Rheologic impairment of the microcirculation during decompression sickness

Pulmonary microcirculation following full-thickness burns

Changes in capillary blood flow induced by the extravascular application of hypertonic solutions: a possible mechanism for the control of renal medullary blood flow.

Effects of mannitol and nicotinic acid on renal papillary blood flow in burned hamsters