scholarly journals Paradigm Shift in Treatment Strategies for Second-Degree Burns Using a Caprolactone Dressing (Suprathel®)? A 15-Year Pediatric Burn Center Experience in 2084 Patients

2021 ◽  
Vol 3 (1) ◽  
pp. 1-9
Author(s):  
Katharina Schriek ◽  
Hagen Ott ◽  
Mechthild Sinnig
Keyword(s):  
Retrospective Study ◽  
General Anesthesia ◽  
Skin Grafting ◽  
Treatment Modalities ◽  
Control Group ◽  
Study Group ◽  
Pediatric Hospital ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Second Degree

Background: Thermal injuries represent a highly relevant epidemiologic problem with 11 million individuals affected globally each year, of which around 2.75 million are children. Different approaches to the conservative treatment of second-degree burns have been widely discussed in the existing literature. One method that has attracted increasing attention is the use of caprolactone dressings. This paper describes a study involving the therapeutic management of 2084 pediatric patients suffering from mixed superficial and deep dermal second-degree burns who received comprehensive expert treatment using caprolactone membranes at the pediatric hospital AUF DER BULT. Methods: A retrospective study was conducted to evaluate the frequency and effect of caprolactone membrane usage on children who were admitted to the pediatric hospital between 2002 and 2016 with mixed second-degree burns. The number of dressing changes under general anesthesia and the requirement for split thickness skin grafting were monitored and recorded. In addition, a cost comparison analysis of different treatment modalities was performed. Results: This retrospective study involved 2084 children who had been treated for mixed superficial and deep dermal burns between 2002 and 2016 using either caprolactone dressing (Suprathel®) (study group; n = 1154) or an alternative dressing material (control group; n = 930). Of the patients in the study group, 91.74% (n = 1053) were treated conservatively compared to 76.05% of the control group patients, meaning that 8.26% (n = 101) of the study group patients required skin grafting, compared to 23.95% (n = 223) in the control group. Additionally, the number of procedures under general anesthesia per patient was found to be 54.3% lower among all patients treated with caprolactone dressing (1.75 procedures per patient) compared to the entire control group (3.22 procedures per patient). In the subgroups, patients treated conservatively with caprolactone dressing required 1.42 procedures per patient compared to 2.25 procedures per patient in patients with alternative wound treatment. When split thickness skin grafting was necessary, 1.2 times as many procedures were performed on patients with alternative dressing compared to those treated with caprolactone dressing. Finally, the cost per patient was considerably lower in the conservative therapy group in comparison to the group that consisted of patients undergoing operative therapy with split thickness skin grafting. Conclusions: Caprolactone dressings were found to be beneficial for children who reported with mixed superficial and deep dermal burns. Specifically, they reduced the need for skin transplantation, the number of dressing changes under general anesthesia, and the treatment costs.

scholarly journals TO STUDY THE EFFICACY OF AUTOLOGOUS PLATELET RICH PLASMA OVER CONVENTIONAL MECHANICAL FIXATION METHODS IN SPLIT THICKNESS SKIN GRAFTING

2021 ◽  
pp. 1-4
Author(s):  
Ankur Deshwali ◽  
Peeyush Kesharwani ◽  
Rohan Gupta
Keyword(s):  
Skin Graft ◽  
Platelet Rich Plasma ◽  
Skin Grafting ◽  
Controlled Study ◽  
Study Group ◽  
Fixation Methods ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Autologous Platelet Rich Plasma ◽  
Autologous Platelet

TITLE Efficacy of autologous platelet rich plasma over conventional mechanical fixation methods in split thickness skin grafting . AIMS AND OBJECTIVES to determine the efficacy of autologous platelet rich plasma over conventional mechanical fixation methods in split thickness skin grafting. METHODS  This a prospective randomized controlled study, conducted in the Department of surgery, SAIMS Medical College and P.G Institute, Indore for a period of two years from September 2016 to September 2018. A total of 20 patients were included in the study, and divided into two groups of 10 each randomly. The study was approved by the local ethical committee of our hospital. An informed written consent was obtained from all patients.  Total of 20 patients were studied; 10 cases were randomly chosen for study with autologous platelet rich plasma and 10 cases received conventional methods like staples/sutures used to anchor the skin grafts in a control group. RESULTS Autologous PRP showed faster and better healing rates. With PRP study group instant graft adherence was seen in all cases. Hematoma, graft edema, discharge from graft site, frequency of dressings and duration of stay in hospital were significantly less in the PRP. There were no adverse effects or reactions seen with the use of autologous PRP among the study group. CONCLUSION  The combination of PRP with Split Thickness Skin Graft (STSG) significantly improved clinical outcomes and shortened the wound healing time. Therefore, this treatment combination could provide a way to heal skin after skin graft reconstruction with minimal recovery time. It is found to be highly beneficial in many aspects both to the patient and surgeon based on our results.

scholarly journals Comparative study of Collagen vs. Silver foam dressing in second degree superficial burns: An institutional study

2020 ◽  
pp. 1-3
Author(s):  
HEMANG SANGHVI ◽  
SMITHA SEGU ◽  
SHIKHA SANGHVI
Keyword(s):  
Skin Grafting ◽  
Pain Tolerance ◽  
Split Thickness Skin Graft ◽  
Chi Square ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Significant Difference ◽  
Chi Square Test ◽  
A Prospective Study ◽  
Second Degree

Aim: To compare the efficacy of collagen dressing with that of Silver foam in the management of Second Degree superficial burns. Material and methods: A prospective study was done at our Department of burns and plastic surgery from a period January 2016 to December 2016. Patients with less than 40% second degree superficial burns who consented were included in the study. Collagen dressing was done on one hand or leg and on other hand or leg we did silver foam dressing. Wound epithelisation, exudates of wound, patient tolerance to pain while change of dressing and requirement of Split thickness skin graft in non healed wound were noted and analysed using ‘Pearson Chi-Square test’ . Results: A total of 30 patients were included in our study. 16 were males and 14 were females.21 out of 30 patients in whom collagen was applied had complete epithelisation in 10 days whereas 19 out of 30 patients in whom silver foam dressing was done had epithelisation in 10 days. 26 out of 30 patients in whom collagen was applied had complete epithelisation in 14 days whereas 24 out of 30 patients in whom silver foam dressing was done had epithelisation in 14 days. There was no statistically significant difference in the completeness of healing of wounds in 2 weeks. 4 patients treated with collagen dressing and 6 patients having silver foam application required split thickness skin grafting. Pain was significantly less statistically on application of silver foam dressing compared to collagen treated wounds. Conclusions: Collagen dressing does not offer significant better results over Silver foam dressings in terms of completeness of healing of burns. Pain tolerance is better in silver foam dressing. Silver foam dressing works better in exudative wounds.

Outcomes of Split Thickness Skin Grafting on Lower Extremity Wounds in Diabetics

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 111-OR
Author(s):  
ELLIOT WALTERS ◽  
GREG STIMAC ◽  
NEHA RAJPAL ◽  
IRAM NAZ ◽  
TAMMER ELMARSAFI ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Skin Grafting ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting

scholarly journals Radiological Parameters Review for Choanal Atresia

2021 ◽  
Vol 13 (2) ◽  
pp. 302-311
Author(s):  
Daniela Messineo ◽  
Maryia Chernikava ◽  
Valeria Pasquali ◽  
Serena Bertin ◽  
Mario Ciotti ◽  
...  
Keyword(s):  
Retrospective Study ◽  
High Resolution ◽  
Surgical Approach ◽  
Choanal Atresia ◽  
Point Of View ◽  
Control Group ◽  
Study Group ◽  
Control Groups ◽  
Imaging Parameters ◽  
Multiplanar Imaging

(1) Background: The study aims to identify which imaging parameters are necessary for a new correct surgical approach in the study of choanal atresia, and which anatomical findings are essential for correct planning of endoscopic treatment in choanal atresia. (2) Methods: In this retrospective study, 19 patients with choanal atresia had high-resolution multiplanar imaging (14 cases aged ≤1 year and 5 cases aged 1 to 3 years) and 35 patients in the control group similarly distributed by age. Fourteen variables, the most relevant from a surgical point of view, were selected and measured. A comparison was made between the averages of the study group and the different control groups, either directly observed or selected from the literature, using Pearson’s correlation. (3) Results: In 14 out of 26 cases, the differences were statistically significant. There was a correlation between the structures assessed, such as choanal height, rostrum height, and age. (4) Conclusions: Thanks to volumetric reformatting, this work identified and provided the clinician with useful information that helped choose the correct surgical approach. Furthermore, it focused on which imaging parameters are necessary to improve the planning of the surgical correction of choanal atresia.

668 Fixation of Split-Thickness Skin Grafts with Liquid Adhesive and Fibrin Glue in Place of Staples

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S190-S191
Author(s):  
Joshua Frost ◽  
Nathan Hallier ◽  
Tanir Moreno ◽  
Jared Covell ◽  
Ryan Keck ◽  
...  
Keyword(s):  
Fibrin Glue ◽  
Skin Grafting ◽  
Skin Grafts ◽  
Inclusion Criteria ◽  
Intact Skin ◽  
Body Area ◽  
Wound Site ◽  
Graft Take ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting

Abstract Introduction A critical component of split-thickness skin grafting is the fixation of the skin graft to the wound site. Graft displacement can result in graft failure, especially during the initial 48–72 hours following application. The most common method of securing grafts is with the use of staples, sometimes with the addition of fibrin glue in order to aid both graft adhesion and homeostasis. The use of staples, however, is associated with significant levels of patient discomfort, especially during staple removal. A possible alternative to staples is the use of liquid adhesives, in combination with steri-strips, to anchor the edges of skin grafts to intact skin. Certain liquid adhesives, such as gum-based resins, are cheaper to use than staples and offer the potential to secure small split-thickness skin grafts without the associated pain of staples. In this pilot study, we examined the effectiveness of using a combination of gum-based resin (Gum Mastic-Storax-Msal-Alcohol), fibrin glue, and steri-strips to secure partial-thickness grafts in 8 patients without the use of staples or sutures. Methods Patients were included in the study who required split-thickness skin grafts to treat wounds involving less than or equal to 15% total surface body area and whose wounds were not located in areas prone to graft displacement, such as the axilla and groin. For each patient, skin grafts were secured using fibrin glue (sprayed over the entire wound), and a combination of liquid adhesive and steri-strips applied around the wound perimeter. The success of each graft was determined by the percentage of graft take. Results From January 1st, 2020 to April 30th, 2020, 8 patients were identified who fit the inclusion criteria. Five of the patients received grafts to their lower extremities, two patients received grafts to their upper extremities, and one of the patients received a graft to the torso. The average wound site that was grafted was 116.7 cm2. Average graft take among the 8 patients was 96.9%, with a range of 90%-100%. No complications at the graft site were noted, such as hematomas or any other event that resulted in graft displacement or failure. Conclusions The results of the study demonstrate that a combination of liquid adhesive, fibrin glue, and steri-strips, can be used as an effective alternative to staples in small split-thickness skin grafts. The use of liquid adhesive in place of staples was advantageous because it eliminated to need for staple removal, which resulted in less discomfort for the patient and less work for the nursing staff.

scholarly journals Sonographic Signs of Adenomyosis in Women with Endometriosis Are Associated with Infertility

2021 ◽  
Vol 10 (11) ◽  
pp. 2355
Author(s):  
Dean Decter ◽  
Nissim Arbib ◽  
Hila Markovitz ◽  
Daniel S. Seidman ◽  
Vered H. Eisenberg
Keyword(s):  
Laparoscopic Surgery ◽  
Retrospective Study ◽  
Statistical Analysis ◽  
Conservative Management ◽  
Transvaginal Ultrasound ◽  
Control Group ◽  
Study Group ◽  
Control Groups ◽  
Increased Risk ◽  
And Control

We compared the prevalence of ultrasound signs of adenomyosis in women with endometriosis who underwent surgery to those who were managed conservatively. This was a retrospective study of women evaluated at a tertiary endometriosis referral center who underwent 2D/3D transvaginal ultrasound. Adenomyosis diagnosis was based on the presence of at least three sonographic signs. The study group subsequently underwent laparoscopic surgery while the control group continued conservative management. Statistical analysis compared the two groups for demographics, symptoms, clinical data, and sonographic findings. The study and control groups included 244 and 158 women, respectively. The presence of any, 3+, or 5+ sonographic signs of adenomyosis was significantly more prevalent in the study group (OR = 1.93–2.7, p < 0.004, 95% CI; 1.24–4.09). After controlling for age, for all findings but linear striations, the OR for having a specific feature was higher in the study group. Women in the study group with ≥ 5 sonographic signs of adenomyosis had more than twice the risk of experiencing infertility (OR = 2.31, p = 0.012, 95% CI; 1.20–4.45). Sonographic signs of adenomyosis are more prevalent in women with symptomatic endometriosis who underwent surgery compared with those who continued conservative management. Women with 5+ findings have a significantly increased risk of infertility. Adenomyosis on ultrasound should be considered in the management decisions regarding these patients.

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