Background: Burn injuries are associated with significant mortality and morbidity around the world. The care of burn wounds requires a great amount of medical resources therefore it is important to find a wound dressing that accelerates wound healing and is readily available. Objectives: This review article will provide an overview of the literature and background of the usage of amniotic membranes in burn patients. We will also discuss its properties of preventing infections, relieving pain, how it promotes and accelerates wound healing. Discussion: Human amniotic membrane is now used around the world as a relatively cheap temporary dressing for burn wounds. It has been shown to promote wound healing, create a moist environment, reduce pain intensity, reduce scar formation, prevent water and electrolyte disturbances and also reduce the risk of infections. Research has also shown that it contains antimicrobial properties that could be of great benefit in burn patients and is compatible to use in developing countries because it is readily available, easy to obtain and sterilize, able to cover wounds of large size, protects the wound from excessive water and electrolyte loss, reduces pain intensity, requires fewer dressing changes and is also more cost effective than conventional dressings. Conclusion: Amniotic membrane is a biological dressing that can be useful in the treatment of burn wounds. Further research should be conducted to investigate and understand the mechanisms of amniotic membrane for burn and wound care.
Background: Deep sternal wound infection (DSWI) or mediastinitis is a severe and life-threatening infection with high morbidity and mortality rates. Vacuum-assisted closure (VAC) provides good results and is very useful in wound closure. VAC therapy is a safe and affordable method for managing complex sternal and thoracic injuries. The use of VAC has been shown to increase parasternal blood flow by dilating arterioles, reducing bacterial load, and accelerating granulation tissue formation. It also helps with facilitating wound edge closure. Case and Operation Technique: A 6-month-old baby presented with an ulcer 2 cm deep in the thorax region. The wound had an exposed bone surrounded by slough and hyperemic edges. Bone destruction was seen to have reached the costochondral joint with a gross visible appearance of the pleura. Management of this patient included debridement, sternotomy, internal fixation of the sternum using the Robiscek technique, and application of the Water Shield Drainage (WSD) and VAC. The tobacco-sack technique was used to close the open wound. The Robiscek technique was used in this patient because of the bone destruction to the costochondral joints causing the sternum to become unstable. The VAC dressing was then connected to a suction with an intermittent negative pressure of 75mmHg. After a significant decrease in the wound surface area, a local rotational flap was used to close the wound. Conclusion: The use of modified VAC for deep sternal wound infection (DSWI) is effective, simple, and affordable with minimal complications.
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