scholarly journals Use Of Synthetic Skin Substitute (Biobrane) For Plantar Foot Burn

2018 ◽  
Vol 4 (2) ◽  
pp. 101-104
Author(s):  
Johandi F ◽  
Feng J ◽  
Ruth Lumbun ◽  
Chong J ◽  
Tan B K ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Small Sample Size ◽  
Case Series ◽  
Small Sample ◽  
Skin Substitute ◽  
Repeat Surgery ◽  
Partial Thickness ◽  
Partial Thickness Burn ◽  
Singapore General Hospital ◽  
Partial Thickness Burns

Background : In Singapore, we experience a unique annual surge of burn cases involving sole of foot during the Hindu fire walking festival. Traditionally, superficial partial-thickness burns of the soles were managed expectantly with regular dressings. We conducted a study to evaluate the effectiveness of an alternative approach of using synthetic skin substitute (Biobrane®). Method : A case series of foot burns admitted October 2016 to the Singapore General Hospital Burns Centre. Burn cases with superficial partial-thickness burn of bilateral sole of foot were included in the study. Exclusion criteria included deep dermal burns and burns that required excision and closure with skin grafting. The patient demographics, time to presentation, medical co-morbidities were analyzed. Outcomes such as length of hospital stay, incidence of infection, need for further surgery, return to pre-injury ambulation status and occupation and cost were studied. Result : A total of 6 partial thickness burns of sole of foot in 3 patients with bilateral foot burns which were treated with Biobrane® were included in the study. Patients were able to return pre-injury functional status- return to work and pre-morbid ambulation status. Neither incidence of wound infections nor any needs for repeat surgery were recorded. However, this group required an increased length of stay and incurred high treatment cost. Conclusion: Biobrane® is a viable adjunct in the management of sole of foot burns. The authors believe there is potential for an improved rate of recovery with Biobrane®. However, the higher cost and length of stay are among its drawbacks. In view of the limitations of our study- case series and small sample size, a prospective and double arm assessment will be required to present definite evidence for synthetic skin substitute in these cases

scholarly journals The use of a non-medicated dressing for superficial-partial thickness burns in children: a case series and review

2019 ◽  
Vol 5 ◽  
pp. 205951311989695
Author(s):  
Ter-Er Kusu-Orkar ◽  
Umar Islam ◽  
Benjamin Hall ◽  
Evan Araia ◽  
Nikki Allorto
Keyword(s):  
Antimicrobial Properties ◽  
Case Series ◽  
Length Of Hospital Stay ◽  
Hot Water ◽  
Secondary Outcome ◽  
Wound Complications ◽  
Burn Wounds ◽  
Partial Thickness ◽  
Partial Thickness Burn ◽  
Partial Thickness Burns

Background: Cutimed® Sorbact® is a dressing marketed as having antimicrobial properties and easy application without the threat of antibiotic resistance and difficult accessibility. There is little evidence on the clinical outcomes of the use of Cutimed® Sorbact® in adults and currently no evidence of use of Cutimed® Sorbact® on superficial-partial thickness burn injuries in children. Objective: To summarise the clinical outcome of burn wounds in children with superficial-partial thickness burns in which Cutimed® Sorbact® was used. Method: An observational case series was conducted in Edendale Hospital, Pietermaritzburg, South Africa over the course of four weeks. Patients where included if they were aged < 10 years and had a ⩽ 15% superficial-partial burn. The primary outcome measure was time to 95% re-epithelialisation. Secondary outcome measures included wound complications, adverse healing and number of dressing changes. Results: Ten patients (five girls, five boys; age range = 11 months–8 years) were included in this case series. All participants had a type VI Fitzpatrick skin type and 80% of burns were hot water burns. Of all patients treated with Cutimed® Sorbact®, 50% healed within seven days, 70% within 14 days and 100% within 21 days. There was only one wound complication noted in this study and there was no adverse healing in any burn wounds. The mean number of dressing changes was 1.4 (range = 1–2) and length of hospital stay was in the range of 0–11 days (mean = 5.1 days). Conclusion: Cutimed® Sorbact® is a safe, useful and cost-effective dressing that should be used as an alternative for superficial-partial burns in children.

scholarly journals Porcine Xenograft and Epidermal Fully Synthetic Skin Substitutes in the Treatment of Partial-Thickness Burns: A Literature Review

Medicina ◽  
2021 ◽  
Vol 57 (5) ◽  
pp. 432
Author(s):  
Herbert L. Haller ◽  
Sigrid E. Blome-Eberwein ◽  
Ludwik K. Branski ◽  
Joshua S. Carson ◽  
Roselle E. Crombie ◽  
...  
Keyword(s):  
Healing Time ◽  
Subsequent Treatment ◽  
Skin Substitute ◽  
Skin Substitutes ◽  
Burn Treatment ◽  
Advantages And Disadvantages ◽  
Partial Thickness ◽  
Partial Thickness Burn ◽  
Partial Thickness Burns ◽  
Porcine Xenograft

Background and Objectives: Porcine xenografts have been used successfully in partial thickness burn treatment for many years. Their disappearance from the market led to the search for effective and efficient alternatives. In this article, we examine the synthetic epidermal skin substitute Suprathel® as a substitute in the treatment of partial thickness burns. Materials and Methods: A systematic review following the PRISMA guidelines has been performed. Sixteen Suprathel® and 12 porcine xenograft studies could be included. Advantages and disadvantages between the treatments and the studies’ primary endpoints have been investigated qualitatively and quantitatively. Results: Although Suprathel had a nearly six times larger TBSA in their studies (p < 0.001), it showed a significantly lower necessity for skin grafts (p < 0.001), and we found a significantly lower infection rate (p < 0.001) than in Porcine Xenografts. Nonetheless, no significant differences in the healing time (p = 0.67) and the number of dressing changes until complete wound healing (p = 0.139) could be found. Both products reduced pain to various degrees with the impression of a better performance of Suprathel® on a qualitative level. Porcine xenograft was not recommended for donor sites or coverage of sheet-transplanted keratinocytes, while Suprathel® was used successfully in both indications. Conclusion: The investigated parameters indicate that Suprathel® to be an effective replacement for porcine xenografts with even lower subsequent treatment rates. Suprathel® appears to be usable in an extended range of indications compared to porcine xenograft. Data heterogeneity limited conclusions from the results.

scholarly journals Questioning COVID-19 Surface Stability and Fomite Spreading in Three Aeromedical Cases: A Case Series

2020 ◽  
Author(s):  
Sean Horoho ◽  
Stephen Musik ◽  
David Bryant ◽  
William Brooks ◽  
Ian M Porter
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Close Contact ◽  
Small Sample Size ◽  
Case Series ◽  
Small Sample ◽  
Posture Analysis ◽  
Surface Stability ◽  
Single Positive ◽  
Means Of Transmission ◽  
Respiratory Droplets

ABSTRACT It is well established that coronavirus disease 2019 is primarily transmitted through respiratory droplets, and there is mounting research speculation that it may also be transmitted via fomites. Several studies have shown that the virus can persist on both porous and nonporous surfaces for hours to days, depending upon the material. This article examines three cases of polymerase chain reaction–proven severe acute respiratory syndrome coronavirus 2 infection with several additional individuals meeting CDC close contact criteria. In 1 case, 195 downstream contacts were all tested to prevent a mass outbreak in a deployment posture. Analysis of these contacts yielded only a single positive test, which could be reasonably ascribed to respiratory droplet transmission. While these cases and their contacts ultimately represent a small sample size, we suggest fomite spread may not be a significant means of transmission for severe acute respiratory syndrome coronavirus 2 in real-world operational scenarios.

Case series: COVID-19 infection causing new-onset diabetes mellitus?

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Rujuta Katkar ◽  
Narasa Raju Madam
Keyword(s):  
Diabetes Mellitus ◽  
Severe Acute Respiratory Syndrome ◽  
Cell Damage ◽  
Small Sample Size ◽  
Case Series ◽  
Small Sample ◽  
Onset Diabetes ◽  
History Of ◽  
New Onset Diabetes Mellitus ◽  
New Onset

Objectives: This paper seeks to explore the hypothesis of the potential diabetogenic effect of SARS-COV-2 (Severe Acute respiratory syndrome coronavirus). Case series presentation: We present a case series of observation among 8 patients of age group ranging from 34 to 74 years with a BMI range of 26.61 to 53.21 Kilogram/square meters that developed new-onset diabetes after COVID-19 infection. Severe Acute Respiratory Syndrome Coronavirus (SARS-COV-2), commonly known as Coronavirus or COVID-19(Coronavirus infectious disease), gains entry into the cells by binding to the Angiotensin-converting enzyme-2(ACE-2) receptors located in essential metabolic tissues including the pancreas, adipose tissue, small intestine, and kidneys. The evidence reviewed from the scientific literature describes how ACE 2 receptors play a role in the pathogenesis of diabetes and the plausible interaction of SARS-COV-2 with ACE 2 receptors in metabolic organs and tissues. Conclusion: The 8 patients without a past medical history of diabetes admitted with COVID-19 infection developed new-onset diabetes mellitus due to plausible interaction of SARS-COV-2 with ACE 2 receptors. The resulting downregulation of ACE-2 and ACE-2 receptors expression caused islet-cell damage resulting into diabetes. The resulting observation has the potential to adversely impact significant number of the globally affected population. Screening patients with COVID-19 for diabetes routinely can help in early detection, significantly reducing morbidity and mortality associated with diabetes. Due to limitations of observational study with a small sample size will require further investigation in the form of Clinical trial.

scholarly journals Hodgkin lymphoma arising in patients with chronic lymphocytic leukemia: outcomes from a large multi-center collaboration

Haematologica ◽  
2020 ◽  
pp. 0-0
Author(s):  
Deborah M. Stephens ◽  
Ken Boucher ◽  
Elizabeth Kander ◽  
Sameer A. Parikh ◽  
Erin M. Parry ◽  
...  
Keyword(s):  
Chronic Lymphocytic Leukemia ◽  
Hodgkin Lymphoma ◽  
Hematopoietic Cell Transplantation ◽  
Small Sample Size ◽  
Case Series ◽  
Standard Of Care ◽  
Median Number ◽  
Small Sample ◽  
Lymphocytic Leukemia ◽  
Treatment Type

Chronic lymphocytic leukemia (CLL) patients who develop Hodgkin lymphoma (HL) have limited survival. No current therapeutic standard of care exists. We conducted a multi-center retrospective study of patients with Hodgkin Transformation (HT) of CLL. Clinicobiologic characteristics, treatment type, and survival outcomes were analyzed and compared with historic case series. Ninety-four patients were identified. Median age at HT was 67 years (range, 38-85). Median time from CLL diagnosis to HT was 5.5 years (range, 0-20.2). Prior to HT, patients received a median of 2 therapies for CLL (range, 0-12). As initial therapy for HT, 61% (n=62) received ABVD-based regimens (adriamycin, bleomycin, vinblastine, and dacarbazine). Seven (7%) patients received hematopoietic cell transplantation (HCT) while in first complete remission (CR1). The median number of treatments for HT per patient was 1 (range, 0-5) with 59 (61%) patients only receiving one line of therapy. After HT, patients had a median follow-up of 1.6 years (range, 0-15.1). Two-year overall survival (OS) after HT diagnosis was 72% (95%CI 62-83%). The patients who received standard ABVD-based therapy had a median OS of 13.2 years. Although limited by small sample size, the patients who underwent HCT for HT in CR1 had a similar 2-year OS (n=7; 67%) compared to patients who did not undergo HCT for HT in CR1 (n=87; 72%; p=0.46). In this multi-center study, HT patients treated with ABVD-based regimens had prolonged survival supporting the use of these regimens as standard of care for these patients.

The Role of Autologous PRP on Deep Partial-Thickness Burn Wound Healing in Bama Pigs

2020 ◽  
Vol 41 (3) ◽  
pp. 657-662 ◽  
Author(s):  
Yanwei Sun ◽  
Yongqian Cao ◽  
Ran Zhao ◽  
Famei Xu ◽  
Dan Wu ◽  
...  
Keyword(s):  
Wound Healing ◽  
Growth Factors ◽  
Growth Factor ◽  
Healing Process ◽  
Control Group ◽  
Therapeutic Effects ◽  
Partial Thickness ◽  
Partial Thickness Burn ◽  
The Mean ◽  
Partial Thickness Burns

Abstract In this study, we aimed to evaluate the therapeutic effects of autologous platelet-rich plasma (PRP) on deep partial-thickness burns in Bama pigs. Deep partial-thickness burn wounds were created on the back of Bama pigs. The reepithelialization time was compared between the PRP and control groups. The mean score of Ki67 (+) cells and α-SMA (+) vessels, the mean thickness of epidermis and dermis of the healing wounds were determined via H&E staining and immunohistochemical assay. The levels of the growth factors epidermal growth factor (EGF), basic fibroblast growth factor (bFGF), and vascular endothelial growth factor (VEGF) were examined by ELISA. Our data showed that the time to wound reepithelialization was shorter in the PRP group compared with the control group. The thickness of the epidermis was larger in the PRP group compared with the control group. On the 7th and 14th days after the treatment, the mean score of Ki67 (+) cells and α-SMA (+) vessels were higher in the PRP group compared with the control group. The PRP group showed higher levels of growth factors (EGF, bFGF, and VEGF) compared with the control group by ELISA. The results indicated that PRP could improve wound healing process of deep partial-thickness burns in Bama pigs. The PRP increased the thickness of epidermis of the healed wounds, cell proliferation, and angiogenesis. We demonstrated that applying PRP had a greater potential for the treatment of deep partial-thickness burns.

Aortic Valve Intervention During Aortic Root Surgery in Children: A Systematic Review

2020 ◽  
Vol 11 (5) ◽  
pp. 611-618
Author(s):  
Maria Rodriguez ◽  
Anahita Malvea ◽  
Dayre McNally ◽  
Vid Bijelic ◽  
Ming Guo ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Root ◽  
Small Sample Size ◽  
Case Series ◽  
Small Sample ◽  
Aortic Root Surgery ◽  
Valve Sparing ◽  
One Year

Background: Pediatric aortic root dilatation is a life-threatening condition that lacks guidelines for surgical management. We aimed to analyze the data on aortic valve interventions during root surgery to guide decision-making. Methods: A search was performed of MEDLINE, Embase, CENTRAL, ClinicalTrials.gov , and WHO ICTRP. Citations were screened in duplicate and independently to identify randomized controlled trials, cohorts, and case series involving populations aged 0 to 18 years, who received valve-sparing and valve-replacing aortic root surgeries between 1999 and 2019. Outcomes considered included mortality (perioperative, one year, five year), reintervention rates. Results: After duplicate removal, 689 citations were screened through abstract and full text review, identifying five eligible studies. All five were observational studies evaluating valve-sparing procedures. There were 81 patients with a mean study age range of 9.9 to 13.9 years. Both reimplantation (74%) and remodeling (26%) subtypes were done. Range of mean duration of follow-up was 1.2 to 4.4 years. There was no mortality reported until the one-year follow-up period. The long-term mortality rate was calculated as 0.02 per patient-year (95% CI: 0.01-0.05). The long-term reintervention rate was 0.08 per patient-year (95% CI: 0.05-0.13). Conclusions: There is limited experience on aortic valve intervention during aortic root surgery in children. Single-arm studies on valve-sparing surgeries show excellent survival up to one year. Mortality and reintervention rates increase in the longer term. The small sample size and lack of controlled studies do not allow for direct comparisons between procedure types.

P112 CORRELATION OF FECAL CALPROTECTIN TO COLONOSCOPIC FINDINGS FOR DETECTION OF RECURRENCE OF CROHN’S DISEASE IN THE POST-OPERATIVE SETTING AT A SINGLE ACADEMIC CENTER

2020 ◽  
Vol 26 (Supplement_1) ◽  
pp. S17-S17
Author(s):  
Anil Sharma ◽  
Georgia Morrison ◽  
Kian Keyashian ◽  
Rebecca Matro
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Small Sample Size ◽  
Rank Correlation ◽  
Fecal Calprotectin ◽  
Small Sample ◽  
Operating Characteristics ◽  
Repeat Surgery ◽  
Endoscopic Recurrence ◽  
Noninvasive Biomarkers

Abstract Introduction Patients with Crohn’s disease (CD) who undergo a first surgery are at higher risk of having a subsequent surgery in light of recurrence of disease. Significant evidence suggests that a postoperative colonoscopy evaluating recurrence at the anastomosis using the Rugeerts score (RS) can predict risk of repeat surgery. Given the invasive nature of colonoscopy, there has been increasing interest in using noninvasive biomarkers to predict disease recurrence. Studies have shown variability in the operating characteristics of the fecal calprotectin (FC) assay with sensitivities and specificities for detecting recurrence ranging widely from 48–95 and 58–79%, respectively. A recent meta-analysis demonstrated a pooled sensitivity of 70% when using an optimal FC cut-off of 150 ug/g. We sought to delineate how FC correlates with RS at our institution and to identify a cutoff for significant recurrence. Methods We performed a retrospective review of adult patients with CD who underwent ileocecectomy followed by a colonoscopy within 18 months of surgery, with the additional inclusion of FC testing within 2 weeks of the colonoscopy. Patients were identified at our institution via ICD 9 and 10 codes and the electronic medical record. The primary outcome of interest was a comparison of mean FC for those without endoscopic recurrence (defined as RS i0-i1) to those with significant endoscopic recurrence (defined as RS i2-i4). Other variables assessed included gender, disease location and phenotype, and extent of surgery (Table 1). Results A total of 12 patients met the inclusion criteria. 7 patients (58.3%) were female. Age at time of surgery ranged from 21 to 73 years (mean 37.9). Only 1 patient (8.3%) had a nonstricturing, nonpenetrating phenotype. After surgery, 11 patients were on biologic or combination therapy and 1 patient was not on any medical therapy. 5 patients (42%) demonstrated endoscopic recurrence by RS with mean FC of 883.7 ug/g, as compared to mean FC of 83.6 ug/g for those without recurrence. There was a positive correlation between FC and RS with a Spearman’s rank correlation coefficient of 0.86 (p = 0.0004). Conclusions Our results demonstrate a strong correlation between FC and RS. Using a cutoff for FC of 150 ug/g, we demonstrate sensitivity and specificity of 100%. This further supports the possibility of using FC as a surrogate to possibly defer colonoscopy in those post-operative CD patients with low FC. Study limitations include the retrospective nature and small sample size, recognizing that in years past FC was not as readily available or used in this setting. Future considerations include larger, prospective studies looking at FC and other noninvasive biomarkers in this post-operative setting.

scholarly journals Histologic and Tomographic Findings of Bone Block Allografts in a 4 Years Follow-up: A Case Series

2016 ◽  
Vol 27 (6) ◽  
pp. 775-780 ◽  
Author(s):  
Daniel Deluiz ◽  
Luciano Santos Oliveira ◽  
Paul Fletcher ◽  
Fábio Ramôa Pires ◽  
Justine Monnerat Tinoco ◽  
...  
Keyword(s):  
Small Sample Size ◽  
Case Series ◽  
Small Sample ◽  
Histological Evaluation ◽  
Bone Block ◽  
Mucogingival Surgery ◽  
Native Bone ◽  
Implant Placement

Abstract The aim of this paper is to report histologic and tomographic findings of fresh frozen bone block allografts bearing dental implants in functional occlusion in a long-term follow-up. Four patients with implants functionally loaded for 4 years on augmented ridges requiring additional mucogingival surgery or implant placement were included in this case series. Cone-beam tomography scans were compared volumetrically between the baseline (first implant placement) and current images. Biopsies of the grafts were retrieved and sent to histological analysis. Volumetric reduction of the grafts varied from 2.1 to 7.7%. Histological evaluation demonstrated well-incorporated grafts with different degrees of remodeling. While data presented in this report are from a small sample size and do not allow definitive conclusions, the biopsies of the grafted sites were very similar to the host's native bone. Remodeling of the cortical portion of the allografts seems to take longer than the cancellous portion. The presence of unincorporated graft remains did not impair the implant success or the health of the surrounding tissues. This is the first time histologic and tomographic long term data of bone allograft have been made available in dentistry.

scholarly journals Commonly Used Severity Scores Are Not Good Predictors of Mortality in Sepsis from Severe Leptospirosis: A Series of Ten Patients

2012 ◽  
Vol 2012 ◽  
pp. 1-6
Author(s):  
Dimitrios Velissaris ◽  
Menelaos Karanikolas ◽  
Nikolaos Flaris ◽  
Fotini Fligou ◽  
Markos Marangos ◽  
...  
Keyword(s):  
Small Sample Size ◽  
Multiorgan Failure ◽  
Good Condition ◽  
Case Series ◽  
Scoring Systems ◽  
Small Sample ◽  
University Hospital ◽  
Severity Scores ◽  
Retrospective Data Collection ◽  
Severe Leptospirosis

Introduction. Severe leptospirosis, also known as Weil's disease, can cause multiorgan failure with high mortality. Scoring systems for disease severity have not been validated for leptospirosis, and there is no documented method to predict mortality.Methods. This is a case series on 10 patients admitted to ICU for multiorgan failure from severe leptospirosis. Data were collected retrospectively, with approval from the Institution Ethics Committee.Results. Ten patients with severe leptospirosis were admitted in the Patras University Hospital ICU in a four-year period. Although, based on SOFA scores, predicted mortality was over 80%, seven of 10 patients survived and were discharged from the hospital in good condition. There was no association between SAPS II or SOFA scores and mortality, but survivors had significantly lower APACHE II scores compared to nonsurvivors.Conclusion. Commonly used severity scores do not seem to be useful in predicting mortality in severe leptospirosis. Early ICU admission and resuscitation based on a goal-directed therapy protocol are recommended and may reduce mortality. However, this study is limited by retrospective data collection and small sample size. Data from large prospective studies are needed to validate our findings.

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