An Introduction to Burn Care: The Sequel.

General Purpose: To review burn care, with an emphasis on burn-specific issues and treatment.

Target Audience: This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

Learning Objectives/outcomes: After participating in this educational activity, the participant will:1.

Neodermis Formation in Full Thickness Wounds Using an Esterified Hyaluronic Acid Matrix.

The role of the dermis is essential for the proper orchestration of all phases of the normal wound healing process. Wounds with seriously damaged or even absent dermis consistently show seriously impaired wound healing and/or long-term complications such as hypertrophic scarring. Replacing a damaged dermis requires a dermal matrix that is compatible with, or even stimulates, the process of wound healing.

Managing Wounds with Exposed Bone and Tendon with an Esterified Hyaluronic Acid Matrix (eHAM): A Literature Review and Personal Experience.

The loss of extracellular matrix in combination with the exposure of structures such as bone and tendon pose a major challenge; the development of granulation tissue and subsequent reepithelialization over these structures is extremely slow and often may not happen at all. Replacement of the matrix has been shown to significantly increase the chances of healing since, with revascularization of the matrix, a wound bed is created that may either heal by secondary intention or via the application of a skin graft. A literature search on an esterified hyaluronic acid-based matrix (eHAM) returned five articles on the treatment of wounds with tendon and bone loss in which the eHAM was used.

Necrotizing Fasciitis: An Overview and 2 Illustrative Cases.

Necrotizing fasciitis is the generic term for a series of progressive gangrenous infections of the skin and subcutaneous tissues. Typically, necrotizing fasciitis start with an, often small, infected lesion with atypical symptoms, which then quickly develops into a rapidly spreading, massive infection. The primary therapy is excision of all necrotic tissue in combination with treatment of systemic symptoms such as shock.

Failure to Reposition After Sliding Down in Bed Increases Pressure at the Sacrum and Heels.

Unlabelled: The head of the bed (HOB) for a patient is often elevated since it improves comfort and facilitates respiratory functions. However, elevating the HOB essentially causes the patient support surface to turn into a ramp, forcing the patient's body to slide down. As the patient slides down, weight pressing on the pelvis, the coccyx, and the ischial tuberosities increases, resulting in associated increases in interface pressures.

Results of a retrospective comparative study: material cost for managing a series of large wounds in subjects with serious morbidity with a hydrokinetic fiber dressing or negative pressure wound therapy.

Unlabelled: This retrospective observational study analyzed lesions with regard to healing trends and cost of materials.

Materials And Methods: The observed lesions were mostly postsurgical or stage IV pressure ulcers in patients with serious morbidity. The wounds were treated with a hydrokinetic fiber dressing (sorbion Sachet S, sorbion Gmbh & Co, a BSN medical company, Senden, Germany) (n = 26) or negative pressure wound therapy (NPWT) (n = 16).

Porcine xenografts vs. (cryopreserved) allografts in the management of partial thickness burns: is there a clinical difference?

Porcine xenografts and cryopreserved allografts are used for the management of partial thickness burns and both biological materials have strong advocates with regard to clinical performance, the possibility of disease transfer from donor to recipient and other clinical aspects. A literature analysis was performed in an attempt to investigate whether true (statistically significant) differences exist on clinical performance and on other determinants for use. Comparing the results of this study with a similar, previously published study performed on possible differences amongst different types of allograft in the management of partial thickness burns, both allografts and porcine xenograft seem to perform equally well clinically with regard to healing related outcomes.

Adhesion prevention in an intraperitoneal wound model: performance of two resorbable hemostats in a controlled study in rabbits.

Adhesions, particularly in the abdominal and pelvic cavities, represent a significant clinical problem. Among other complications, they are considered the most common cause of intestinal obstructions in the Western world. The purpose of this study was to evaluate two commercially available hemostats for their ability to prevent adhesion formation in an abdominal wound model.

Preservation methods of allografts and their (lack of) influence on clinical results in partial thickness burns.

Allografts, cadaver skin and amnion membrane are considered the golden standard in the management of partial thickness burns. However, debate on whether the tissue needs to be viable is on-going, since many believe that viable grafts result in better healing. The objective of this literature survey was to analyse the evidence on the method of preservation of allografts (cadaver skin or amnion membrane, glycerol, cryopreservation, lyophilisation) having a clinical impact on the healing of partial thickness burns.

Evaluation of Vashe Wound Therapy in the clinical management of patients with chronic wounds.

Objective: To analyze if Vashe Wound Therapy (PuriCore, Malvern, Pennsylvania) is a valuable contribution to standard protocols of wound care.

Design: Open, noncomparative study.

Setting: Outpatient clinic.

Results of an internet survey on the treatment of partial thickness burns, full thickness burns, and donor sites.

The objective of this study was to analyze which materials and methods are used for the management of partial and full thickness burns, as well as donor sites. An Internet survey was used to poll directors of burn centers around the world on their preferences for local treatment of different types of burns and donor sites. Results were tabulated and expressed as a percentage of the total number of answers for a given indication.

A general overview of burn care.

The majority of burn victims do not need to be treated in a burn centre. Adequate care can be given by non specialised medical personnel, provided that proper guidelines are followed. The article outlines and reviews these guidelines.

Aquacel Ag in the management of partial-thickness burns: results of a clinical trial.

Aquacel Hydrofiber is a moisture retentive topical dressing that has been demonstrated to be safe and efficacious for the management of partial-thickness burns, showing parity for most dressing related aspects to cadaver skin for this indication. Recently, 1.2% w/w silver has been added to the Aquacel Hydrofiber, to create Aquacel Ag.

Letters.

ABPI: CORRECT TECHNIQUE ESSENTIAL MANAGING EPIDERMOLYSIS BULLOSA OCCLUSIVE DRESSINGS GIVE PAIN RELIEF CYCLE TIMES OF PRODUCTS USED FOR INTERMITTENT COMPRESSION TREATMENT.