1,721,026 research outputs found
First aid treatment of burn injuries
No full textThe recommendations for the first aid treatment of burn injuries have previously been based upon conflicting published studies and as a result the recommendations have been vague with respect to optimal first aid treatment modality, temperature, duration and delay after which treatment is still effective. The public have also continued to use treatments such as ice and alternative therapies, however there is little evidence to support their use. Recently there have been several studies conducted by burn researchers in Australia which have enabled the recommendations to be clarified. First aid should consist of cool running water (2-15°C), applied for 20 minutes duration, as soon as possible but for up to 3 hours after the burn injury has occurred. Ice should not be used and alternative therapies should only be used to relieve pain as an adjunct to cold water treatment. Optimal first aid treatment significantly reduces tissue damage, hastens wound re-epithelialisation and reduces scarring and should be promoted widely to the public
Cytotoxicity testing of silver-containing burn treatments using primary and immortal skin cells
No full textA novel burn wound hydrogel dressing has been previously developed which is composed of 2-acrylamido-2-methylpropane sulfonic acid sodium salt with silver nanoparticles (silver AMPS). This study compared the cytotoxicity of this dressing to the commercially available silver products; Acticoat™, PolyMem Silver® and Flamazine™ cream. Human keratinocytes (HaCaT and primary HEK) and normal human fibroblasts (NHF) were exposed to dressings incubated on Nunc™ polycarbonate inserts for 24, 48 and 72h. Four different cytotoxicity assays were performed including; Trypan Blue cell count, MTT, Celltiter-Blue™ and Toluidine Blue surface area assays. The results were expressed as relative cell viability compared to an untreated control. The cytotoxic effects of Acticoat™ and Flamazine™ cream were dependent on exposure time and cell type. After 24h exposure, Acticoat™ and Flamazine™ cream were toxic to all tested cell lines. Surprisingly, HaCaTs treated with Acticoat™ and Flamazine™ had an improved ability to survive at 48 and 72h while HEKs and NHFs had no improvement in survival with any treatment. The novel silver hydrogel and PolyMem Silver® showed low cytotoxicity to all tested cell lines at every time interval and these results support the possibility of using the novel silver hydrogel as a burn wound dressing. Researchers who rely on HaCaT cells as an accurate keratinocyte model should be aware that they can respond differently to primary skin cells
Acticoat (TM): A cost-effective and evidence-based dressing strategy
No full textWe thank Dr. Burd et al. for taking an interest in our paper [1]. The retrospective cohort study was performed and published for two reasons. Firstly, we wished to compare and contrast the use of Acticoat™ and Silvazine™, and secondly we wished to demonstrate how one's practice can be dramatically altered by a change in dressing used. We found that Acticoat™ was safe and easy to use, caused less trauma to patients, required less frequent dressing changes and enabled treatment to be conducted on an outpatient, rather than an inpatient basis. During the period of Acticoat™ treatment we also saw a dramatic reduction in grafting requirements and also in the need for long-term scar management. Burd et al. correctly state that silver-based dressings are now more widely available, however many burn centres in the world continue to use silver sulphadiazine with daily baths. We therefore feel that a comparison is very relevant and useful. Prospective, randomised clinical trials of a range of silver-based dressings would indeed be useful, and hopefully Dr. Burd and colleagues will take up their own suggestion and perform these studies..
Quantifying the role of burn temperature, burn duration and skin thickness in an in vivo animal skin model of heat conduction
No full textTo determine the extent to which heat conduction through skin is affected by skin thickness, burn temperature, and burn duration, we perform a suite of experiments using an in vivo porcine (pig) model. Fourteen different burn conditions are considered, and each burn condition is replicated at least four times, giving a total of sixty four individual experimental burns. The subdermal temperature within the skin is recorded as a function of time during each experiment. To quantitatively interpret the experimental data, we develop an exact solution of a simplified, depth-averaged, heat equation. Calibrating this solution to the experimental data provide estimates of the effective thermal diffusivity of the skin, α and the effective thermal loss rate, k. Estimates of α and k are obtained for the fourteen different, clinically relevant, burn conditions. Overall, we find α = 0.03 ± 0.02 mm/s (to one significant figure), and is approximately independent of the burn duration, burn temperature, and skin thickness (H). This estimate implies that the time required for thermal energy to diffuse vertically down, through the skin of thicker (H = 2.27 mm) and thinner (H = 1.40 mm) skinned animals is approximately 170 and 70 s, respectively. We find that k = 0.002 ± 0.002/s (to one significant figure). In summary, our results provide contemporary estimates for the thermal properties of in vivo porcine skin, which has broad application to heat transfer modelling investigations of thermal injury prevention and thermal therapy studies
Predictors of re-epithelialization in pediatric burn
No full textIntroduction An important treatment goal for burn wounds is to promote early wound closure. This study identifies factors associated with delayed re-epithelialization following pediatric burn. Methods Data were collected from August 2011 to August 2012, at a pediatric tertiary burn center. A total of 106 burn wounds were analyzed from 77 participants aged 4-12 years. Percentage of wound re-epithelialization at each dressing change was calculated using Visitrak™. Mixed effect regression analysis was performed to identify the demographic factors, wound and clinical characteristics associated with delayed re-epithelialization. Results Burn depth determined by laser Doppler imaging, ethnicity, pain scores, total body surface area (TBSA), mechanism of injury and days taken to present to the burn center were significant predictors of delayed re-epithelialization, accounting for 69% of variance. Flame burns delayed re-epithelialization by 39% compared to all other mechanisms (p = 0.003). When initial presentation to the burn center was on day 5, burns took an average of 42% longer to re-epithelialize, compared to those who presented on day 2 post burn (p < 0.000). Re-epithelialization was delayed by 14% when pain scores were reported as 10 (on the FPS-R), compared to 4 on the first dressing change (p = 0.015) for children who did not receive specialized preparation/distraction intervention. A larger TBSA was also a predictor of delayed re-epithelialization (p = 0.030). Darker skin complexion re-epithelialized 25% faster than lighter skin complexion (p = 0.001). Conclusions Burn depth, mechanism of injury and TBSA are always considered when developing the treatment and surgical management plan for patients with burns. This study identifies other factors influencing re-epithelialization, which can be controlled by the treating team, such as effective pain management and rapid referral to a specialized burn center, to achieve optimal outcomes
The blister fluid proteome of paediatric burns
No full text<b>Highlights</b>\ud
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- Paediatric burn blister fluid proteome\ud
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- Over 800 proteins were identified including unique proteins in superficial, deep, and full thickness burns\ud
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- GO analysis reveal the underlying biological processes respond to burn injury\ud
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- Increased knowledge of burn blister fluid biochemistry provides valuable insight for clinical practice of paediatric burns\ud
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<b>Abstract</b>\ud
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Burn injury is highly traumatic for paediatric patients, with the severity of the burn often dictating the extent of\ud
scar formation. The diagnosis of burn wound severity is largely determined by the attending clinician's experience.\ud
Thus, a greater understanding of the biochemistry at burn wound site environment and the biology of burns of different severities at an earlier stage may reduce the reliance on subjective diagnoses. In this study, blister\ud
fluid was collected from superficial thickness, deep-partial thickness, and full-thickness paediatric burn\ud
wounds. Samples were combined together based on burn depth classification and then subjected to four different fractionation methods followed by trypsin digestion. Peptides were analysed by liquid chromatography tandem\ud
mass spectrometry in order to measure the proteomeof each fraction. In total, 811 individual proteinswere identified,\ud
including 107, 84, and 146 proteins unique to superficial, deep-partial thickness and full-thickness burn wounds, respectively. The differences in the protein inventory and the associated gene ontologies represented within each burn depth category demonstrated that there are subtle, yet significant, variations in the biochemistry of burn wounds according to severity. Importantly, this study has produced the most comprehensive catalogue of proteins from the paediatric burn wound microenvironment to date.\ud
Significance: To our knowledge, this study has been the first to comprehensivelymeasure the paediatric burn blister\ud
fluid proteome and has provided insight into the proteomic response to burn injury. The study contributes to\ud
the knowledge of blister fluid biochemistry of burn injury and provides clinically relevant knowledge through the\ud
qualitative evaluation of biochemical differences between burns of different depths. A better understanding of\ud
the burn wound environment will ultimately assist with more accurate clinical decision making and improved\ud
wound healing and scar reduction procedures
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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