105 research outputs found
Laser Doppler imaging in a paediatric burns population
No full textObjectiveLaser Doppler imaging (LDI) was compared to wound outcomes in children's burns, to determine if the technology could be used to predict these outcomes.MethodsForty-eight patients with a total of 85 burns were included in the study. Patient median age was 4 years 10 months and scans were taken 0-186 h post-burn using the fast, low-resolution setting on the Moor LDI2 laser Doppler imager. Wounds were managed by standard practice, without taking into account the scan results. Time until complete re-epithelialisation and whether or not grafting and scar management were required were recorded for each wound. If wounds were treated with Silvazine or Acticoat prior to the scan, this was also recorded.ResultsThe predominant colour of the scan was found to be significantly related to the re-epithelialisation, grafting and scar management outcomes and could be used to predict those outcomes. The prior use of Acticoat did not affect the scan relationship to outcomes, however, the use of Silvazine did complicate the relationship for light blue and green scanned partial thickness wounds. Scans taken within the 24-h window after-burn also appeared to be accurate predictors of wound outcome.ConclusionLaser Doppler imaging is accurate and effective in a paediatric population with a low-resolution fast-scan.Julie Mill, Leila Cuttle, Damien G. Harkin, Olena Kravchuk and Roy M. Kimblehttp://www.elsevier.com/wps/find/journaldescription.cws_home/30394/description#descriptio
Burn healing is dependent on burn site: a quantitative analysis from a porcine burn model
No full textThis retrospective review examines healing in different sites on a porcine burn model; 24 pairs of burns on 18 pigs from other animal trials were selected for analysis. Each pair of burns was located on the either the cranial or the caudal part of the thoracic ribs region, on the same side of the animal. The burns were 40–50 cm2 in size and of uniform deep-dermal partial thickness. Caudal burns healed significantly better than cranial burns, demonstrated by earlier closure of wounds, less scar formation and better cosmesis. To our knowledge, this is the first detailed study reporting that burn healing is affected by location on a porcine burn model. We recommend that similar symmetrical burns should be used for future comparative assessments of burn healing.Xue-Qing Wang, Pei-Yun Liu, Margit Kempf, Leila Cuttle, Allen Hong-En Chang, Michael Wong, Olena Kravchuk, Julie Mill, Roy M. Kimbl
The optimal duration and delay of first aid treatment for deep partial thickness burn injuries
No full textUsing our porcine model of deep dermal partial thickness burn injury, various durations (10min, 20min, 30min or 1h) and delays (immediate, 10min, 1h, 3h) of 15 degrees C running water first aid were applied to burns and compared to untreated controls. The subdermal temperatures were monitored during the treatment and wounds observed weekly for 6 weeks, for re-epithelialisation, wound surface area and cosmetic appearance. At 6 weeks after the burn, tissue biopsies were taken of the scar for histological analysis. Results showed that immediate application of cold running water for 20min duration is associated with an improvement in re-epithelialisation over the first 2 weeks post-burn and decreased scar tissue at 6 weeks. First aid application of cold water for as little as 10min duration or up to 1h delay still provides benefit.Leila Cuttle, Margit Kempf, Pei-Yun Liu, Olena Kravchuk, Roy M. Kimbl
Conservative surgical debridement as a burn treatment: supporting evidence from a porcine burn model
No full textIn thermal deep-dermal burns, surgical debridement is normally used in conjunction with skin grafting or skin substitutes and debridement alone as a burn treatment is not usually practiced. The current study addresses whether or not debridement alone would enhance burn wound healing on small deep-dermal-partial thickness burns. This was a prospective and blinded experimental trial using a porcine deep-dermal-partial thickness burn model. Four burns, approximately 50 cm2 in size, were created on each of eight pigs. Two burns from each pig were immediately surgically debrided and the other two were not debrided as the internal control. Hydrate gel together with paraffin gauze were used to cover the burns for four pigs and silver dressings for the other four. Clinical assessment of wound healing was conducted over a 6-week period. Skin samples were collected at the end of the experiment and histopathological evaluation was performed. The results show thinner scar formation and lower scar height in the debrided compared with nondebrided wounds in the hydrate gel/paraffin gauze groups. There were no statistically significant differences in wound healing assessment between the debrided and nondebrided wounds dressed with silver dressings. This study provides supporting evidence that immediate debridement with an appropriate dressing and without skin grafting may promote wound healing, suggesting its potential benefit for clinical patients.Xue-Qing Wang, Margit Kempf, Pei-Yun Liu, Leila Cuttle, Hong-En Chang, Olena Kravchuk, Julie Mill, Gael E Phillips, Roy M. Kimbl
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
An audit of first aid treatment of paediatric burns patients and their clinical outcome
No full textThis study describes the first aid used and clinical outcomes of all patients who presented to the Royal Children’s Hospital, Brisbane, Australia in 2005 with an acute burn injury. A retrospective audit was performed with the charts of 459 patients and information concerning burn injury, first-aid treatment, and clinical outcomes was collected. First aid was used on 86.1% of patients, with 8.7% receiving no first aid and unknown treatment in 5.2% of cases. A majority of patients had cold water as first aid (80.2%), however, only 12.1% applied the cold water for the recommended 20 minutes or longer. Recommended first aid (cold water for >=20 minutes) was associated with significantly reduced reepithelialization time for children with contact injuries (P = .011). Superficial depth burns were significantly more likely to be associated with the use of recommended first aid (P = .03). Suboptimal treatment was more common for children younger than 3.5 years (P < .001) and for children with friction burns. This report is one of the few publications to relate first-aid treatment to clinical outcomes. Some positive clinical outcomes were associated with recommended first-aid use; however, wound outcomes were more strongly associated with burn depth and mechanism of injury. There is also a need for more public awareness of recommended first-aid treatment.Leila Cuttle, Olena Kravchuk, Belinda Wallis and Roy M. Kimbl
Silver deposits in cutaneous burn scar tissue is a common phenomenon following application of a silver dressing
No full textBackground: Silver dressings have been widely and successfully used to prevent cutaneous wounds, including burns, chronic ulcers, dermatitis and other cutaneous conditions, from infection. However, in a few cases, skin discolouration or argyria-like appearances have been reported. This study investigated the level of silver in scar tissue post-burn injury following application of Acticoat™, a silver dressing. Methods: A porcine deep dermal partial thickness burn model was used. Burn wounds were treated with this silver dressing until completion of re-epithelialization, and silver levels were measured in a total of 160 scars and normal tissues. Results: The mean level of silver in scar tissue covered with silver dressings was 136 μg/g, while the silver level in normal skin was less than 0.747 μg/g. A number of wounds had a slate-grey appearance, and dissection of the scars revealed brown-black pigment mostly in the middle and deep dermis within the scar. The level of silver and the severity of the slate-grey discolouration were correlated with the length of time of the silver dressing application. Conclusions: These results show that silver deposition in cutaneous scar tissue is a common phenomenon, and higher levels of silver deposits and severe skin discolouration are correlated with an increase in the duration of this silver dressing application.Xue-Qing Wang, Hong-En Chang, Rod Francis, Henry Olszowy, Pei-Yun Liu, Margit Kempf, Leila Cuttle, Olena Kravchuk, Gael E. Phillips and Roy M. Kimbl
Cuttle-fish oil and mackerel oil
No full text1953-09-15Cuttle-fish oil is obtained as a byproduct of the manufacture of dried cuttle-fish, for which the species Ommastrephes sloani pacificus Steenstrup is chiefly used. This oil is prepared from cuttle-fish viscera by rendering, but the resulting oil is derived mainly from livers. Production of this oil has so rapidly increased after the war with Hokkaido as the production center that this oil has recently replaced sardine and herring oils which were formerly the most important fish oils in Japan. Mackerel oil is prepared either from the offals or sometimes from the whole body of mackerel, Scomber japonicus Houttuyn. Production of this oil has also greatly increased after the war chiefly in Hokkaido. Cuttle-fish oil and mackerel oil were formerly studied by Tsujimoto and his co-workers, but literatures relating to the characteristics of these oils are very scanty up to the present. The cuttle-fish oil examined by Tsujimoto showed d4^15 0.9316, nD^20 1.4806, A.V. 3.9, S.V. 189.6 I.V. 177.0, Unsap. matter 1.14%, and polybromides of fatty acids 57.45% with Br content 70.91%. Unsaponifiable matter of another sample examined by the same author contained 48% of cholesterol together with cetyl, oleyl, batyl, chimyl, and selachyl alcohols. The oil reported by Tsujimoto and Kimura had d4^15 0.9300, nD^20 1.4833, A.V. 18.2, S.V. 176.9, I.V. (pyridine sulfate dibromide method) 179.5, Unsap. matter 4.20%, solid acids by lead salt alcohol method 22.6% with I.V. 14.1, and highly unsaturated acids by lithium salt acetone method 41.3% with I.V. 372.l. Saturated acids contained palmitic acid, and unsaponifiable matter contained 56% of cholesterol. The oil contained also vitamin A. Kitabayashi, Nakamura, and Shuto have recently reported 3 samples of cuttle-fish oil having d4^15 0.9365-0.9393, A.V. 10.0-15.8, S.V. 180.5-186.2, I.V. 175.0-182.6, and Unsap. matter 3.5-5.5%. One sample contained 25.4.% of solid acids with I.V. 8.8. Tsujimoto examined also an oil obtained from another kind of cuttle-fish, Watasenia scintillans (Berry). André and Canal reported the properties of European cuttle-fish oil. The mackerel oil reported by Tsujimoto showed d4^15 0.9301, nD^20 1.4811, A.V. 1.7, S.V. 191.6, I.V. 167.4, and brominated fatty acids insoluble in acetic acid 36.18% with Br content 69.38%. Spanish mackerel oils are reported to have S.V. 182.5-204.9 and I.V. 115.3-136.7. Characteristics of mackerel liver oils are recorded as Sp. Gr. 0.928-0.969, Refr. index 1.4810-1.4969, F.F.A. 24.3-36.8%, S.V. 166.8-177.6, I.V. 129.1-158.2, Upsap. matter 5.78-15.63%, vitamin A (U.S.P. units per g) 30,000-200,000, and vitamin D (I.U. per g) 1,400-5,400. The present paper records the more important properties of the cuttle-fish and mackerel oils which were produced in 1951 and examined by the authors.departmental bulletin pape
The evaluation of a clinical scar scale for porcine burn scars
No full textThis study describes the evaluation of a clinical scar scale for our porcine burn scars, which includes scar cosmetic outcome, colour, height and hair, supplemented with reference porcine scar photographs representing each scar outcome and scar colour scores. A total of 72 porcine burn scars at week 6 after burn were rated in vivo and/or on photographs. Good agreements were achieved for both intra-rater reliability (correlation is 0.86-0.98) and inter-rater reliability (ICC=80-85%). The results showed statistically significant correlations for each pair in this clinical scar scale (p<0.01), with the best correlation found between scar cosmetic outcome and scar colour. A multivariate principle components analysis revealed that this clinical scar assessment was highly correlated with scar histology, wound size, and re-epithelialisation data (p<0.001). More severe scars are clinically characterised by darker purple colouration, more elevation, no presence of hair, histologically by thicker scar tissue, thinner remaining normal dermis, are more likely to have worse contraction, and slower re-epithelialisation. This study demonstrates that our clinical scar scale is a reliable, independent and valuable tool for assessing porcine burn outcome and truthfully reflects scar appearance and function. To our knowledge, this is the first study demonstrating a high correlation between clinical scar assessment and scar histology, wound contraction and re-epithelialisation data on porcine burn scars. We believe that the successful use of porcine scar scales is invaluable for assessing potential human burn treatments.Xue-Qing Wang, Olena Kravchuk, Pei-Yun Liu, Margit Kempf, Carolina V.D. Boogaard, Peter Lau, Leila Cuttle, Julie Mill and Roy M. Kimblehttp://www.elsevier.com/wps/find/journaldescription.cws_home/30394/description#descriptio
Vitronectin: growth factor complexes hold potential as a wound therapy approach
No full textTopical administration of growth factors has displayed some potential in wound healing, but variable efficacy, high doses, and costs have hampered their implementation. Moreover, this approach ignores the fact that wound repair is driven by interactions between multiple growth factors and extracellular matrix (ECM) proteins. We report herein that complexes comprising IGF and IGF-binding proteins bound to the ECM protein vitronectin (VN) significantly enhance cellular functions relevant to wound repair in human skin keratinocytes in two- and three-dimensional in vitro cell models and are active, even in the presence of wound fluid. Moreover, these responses require activation of both the IGF receptor and the VN-binding av integrins. Further, we assessed the complexes as a topical agent in the treatment of deep dermal partial thickness burns in a porcine model. This pilot study revealed that the complexes may hold promise as a wound healing therapy. Critically, the significant responses observed in vitro and the encouraging preliminary data in vivo were obtained with nanogram doses of growth factors. This suggests that coupling delivery of growth factors to ECM proteins such as VN may ultimately prove to be a more effective strategy for developing a wound healing therapy.Zee Upton, Leila Cuttle, Anthony Noble, Margit Kempf, Gemma Topping, Jos Malda, Yan Xie, Julie Mill, Damien G Harkin, Olena Kravchuk, David I Leavesley and Roy M Kimbl
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