Early laminar excision: Improved control of burn wound sepsis by partial dermatome debridement

Lloyd, James R.; Hight, Donald W.

doi:10.1016/s0022-3468(78)80117-1

Cited by 17 publications

(18 citation statements)

References 7 publications

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“…Lloyd y cols. 19 informaron que la incidencia de sepsis descendió del 6% al 1% con la incisión temprana y constataron una reducción significativa en la mortalidad con la escarectomía precoz, en comparación con el tratamiento quirúrgico convencional. En esta serie de pacientes, la escarectomía fue un factor de riesgo no independiente de infección, tal vez explicado por el mayor número de procedimientos necesarios y la posibilidad de bacteriemia secundaria a la escarectomía, o porque en el grupo sin infección este procedimiento se realizó más temprano.…”

Section: Discussionunclassified

Infecciones en los niños quemados: análisis epidemiológico y de los factores de riesgo

2013

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Infecciones en los niños quemados: análisis epidemiológico y de los factores de riesgoResultados. En esta cohorte de 110 niños se documentaron 128 infecciones intrahospitalarias en 84 pacientes. Se produjeron 17 (15%) muertes; en 14 de 17 (82%) la causa estuvo relacionada con la infección. Los factores vinculados a la infección fueron el porcentaje de superficie quemada; el mayor puntaje de Garcés; la profundidad de la quemadura; la profilaxis antibiótica; el uso de antibióticos tópicos; la presencia de catéter venoso central, catéter arterial, sonda vesical, asistencia respiratoria, escarectomía y requerimiento de injerto. El análisis multivariado mostró mayor riesgo de infección con el uso de catéteres venosos centrales (RR 5,15; IC 95% 1,44 a 18,46), la profilaxis antibiótica (RR 5,22; IC 95% 1,26 a 21,63) y el requerimiento de injerto (RR 3,65; IC 95%; 1,08 a 12,37). Conclusiones. La presencia de catéteres, la profilaxis antibiótica y el requerimiento de injerto fueron factores independientes de riesgo de infección en los niños quemados. Palabras clave: quemados, infecciones, niños.

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Section: Discussionunclassified

Infecciones en los niños quemados: análisis epidemiológico y de los factores de riesgo

2013

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“…There was a substantial reduction in one burn center in 1978 in the incidence of both burn wound infection and sepsis after the advent of early excision therapy (253). During the study period, the incidence of burn wound sepsis fell from 6% to 1% and the mortality rate for burn-related complications decreased from 40% to 18%.…”

Section: Impact Of Changes In Burn Wound Carementioning

confidence: 99%

“…Early burn wound excision now occurs within the first few days after burn injury and has resulted in improved survival (30,127,170,185,196,200,253,334,390,429). Full-thickness and deep partial-thickness wounds are excised as soon after injury as possible once the patient has been hemodynamically stabilized.…”

Section: Early Excision and Burn Wound Closurementioning

confidence: 99%

“…Patients with areas of unexcised deep partial-thickness or full-thickness burn wound have an increased risk of developing an invasive infection (10,11,27,29,253). This complication may be heralded by a rapid associated change in burn wound appearance or character such as separation of the eschar or dark brown, black, or violaceous discoloration of the eschar.…”

Section: Types Of Burn Wound Infectionmentioning

confidence: 99%

“…Sepsis syndrome is clinically heralded by the onset of hypothermia or hyperthermia, hypotension, decreased urinary output, hyperglycemia, neutropenia or neutrophilia, and thrombocytopenia (20,47,86,140,177). Burn wound sepsis was predominantly due to invasive wound infection prior to the advent of early burn wound excision (30,127,170,185,253,296,334,429).…”

Section: Sepsis and Toxic Shock Syndromementioning

confidence: 99%

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Burn Wound Infections

Church

Elsayed

Reid³

et al. 2006

Clin Microbiol Rev

1,622

1,345

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SUMMARYBurns are one of the most common and devastating forms of trauma. Patients with serious thermal injury require immediate specialized care in order to minimize morbidity and mortality. Significant thermal injuries induce a state of immunosuppression that predisposes burn patients to infectious complications. A current summary of the classifications of burn wound infections, including their diagnosis, treatment, and prevention, is given. Early excision of the eschar has substantially decreased the incidence of invasive burn wound infection and secondary sepsis, but most deaths in severely burn-injured patients are still due to burn wound sepsis or complications due to inhalation injury. Burn patients are also at risk for developing sepsis secondary to pneumonia, catheter-related infections, and suppurative thrombophlebitis. The introduction of silver-impregnated devices (e.g., central lines and Foley urinary catheters) may reduce the incidence of nosocomial infections due to prolonged placement of these devices. Improved outcomes for severely burned patients have been attributed to medical advances in fluid resuscitation, nutritional support, pulmonary and burn wound care, and infection control practices.

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Preparation of antimicrobial poly(ϵ‐caprolactone) electrospun nanofibers containing silver‐loaded zirconium phosphate nanoparticles

Duan

Jia

Wang

et al. 2007

J of Applied Polymer Sci

105

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Antimicrobial nanofibers of poly(e-caprolactone) (PCL) were prepared by electrospinning of a PCL solution with small amounts of silver-loaded zirconium phosphate nanoparticles (nanoAgZ) for potential use in wound dressing applications. The electrospun nanoAgZcontaining PCL nanofibers were characterized using field emission scanning electron microscopy, energy dispersive X-ray spectrum (EDX), X-ray diffraction analysis (XRD), antimicrobial tests, and biocompatibility tests. The SEM, EDX, and XRD investigations of the electrospun fibers confirmed that silver-containing nanoparticles were incorporated and well dispersed in smooth and beadless PCL nanofibers. The results of the antimicrobial tests showed that these fibers have maintained the strong killing abilities of Ag 1 existed in the nanoAgZ against the tested bacteria strains and discoloration has not been observed for the nanofibers. To test the biocompatibility of nanofibers as potential wound dressings, primary human dermal fibroblasts (HDFs) were cultured on the nanofibrous mats. The cultured cells were evaluated in terms of cell proliferation and morphology. The results indicated that the cells attached and proliferated as continuous layers on the nanoAgZ-containing nanofibers and maintained the healthy morphology of HDFs. The earlier results suggested that nanoAgZ-containing fibers may be expected to be a novel material for potential wound dressing applications because of the significant bacteriostatic activities and good biocompatibility.

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Early laminar excision: Improved control of burn wound sepsis by partial dermatome debridement

Cited by 17 publications

References 7 publications

Infecciones en los niños quemados: análisis epidemiológico y de los factores de riesgo

Infecciones en los niños quemados: análisis epidemiológico y de los factores de riesgo

Burn Wound Infections

Preparation of antimicrobial poly(ϵ‐caprolactone) electrospun nanofibers containing silver‐loaded zirconium phosphate nanoparticles

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