Autoři: P. Bukovčan; J. However, on a secondary level they can endanger all the systems in the human body. From this point of view, the management of burns represents a sector of medicine where a multidisciplinary approach is essential. Nevertheless, the basic and inevitable prerequisite of successful treatment of burns represents the treatment of the burn wound, where skin substitutes are still paramount.
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According to epidemiological studies 9, 14in the Slovak Republic scald injuries are the most frequent, mostly afflicting patients in lower age groups. Partial-thickness scald burns in particular constitute one of the most frequent indications at our workplace for the utilisation of a biological skin substitute: porcine skin xenograft.
The study was approved by the Ethics Committee of Ružinov Hospital.
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Xenograft preparation method Skin xenografts SXG have been used as biological skin substitutes at the Department of Burns and Reconstructive Surgery since Porcine skin removed from veterinary certified slaughtered nasolabial krémové recenze, stored at the temperature of 4°C, is nasolabial krémové recenze from the slaughter-house to CTB.
Within 24 hours after slaughter, under sterile conditions, the retrieval of the dermoepidermal grafts is performed by electrical dermatome. After washing the grafts retrieved in a solution of chloramine, lavage in antibiotic solution and lavage in cryoprotective agent, four small samples 0.
Then each graft is placed on sterile gauze with the dermal side up, folded to create a maximum of four layers and sealed in a sterile plastic bag. Prepared SXGs are placed in a deep-freezer appliance and stored at a temperature of °C. If the sterility tests are negative, according to Czech-Slovak Pharmacopoeia 4th Ed.
Он все еще продолжал этот неслышимый и несколько односторонний разговор, пока они ждали в приемной перед Залом Совета. Нельзя было не сравнить его нынешнее положение с тем, в котором он оказался в Лизе, когда Сирэйнис с коллегами пытались подчинить его своей воле. Он надеялся, что не будет никакой необходимости еще в одном конфликте, но если бы такой конфликт и возник, он был теперь подготовлен к нему несравненно .
Wound management protocol During patient admission initial nasolabial krémové recenze of the depth and extent of burns is performed. The depth of the burn is expressed in degrees.
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When indicated for the xenograft coverage, after disinfection of the wounds with Betadine all patients undergo complete debridement of non-viable epidermis using blunt debridement gauze under systemic analgesia; in the case of children with greater extent of burns general anaesthesia is used.
After obtaining a clean wound surface with the dermis exposed Fig. Treated areas are then covered with tulle dressing impregnated with Vaseline, gauze with silver sulphadiasine, dry gauze layers and elastic bandage.
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When xenografts are placed over the joints of limbs, in particular with children, Kramer splints are used. Systemic antibiotic prophylaxis is provided by intravenous administration of penicillin in standard doses in cases with negative history of penicillin allergy.
Wound cultures are taken during initial treatment and also regularly during the hospital stay. If the wound dressings are not displaced and no complications occur, dressings are changed every 48 hours.
The xenografts are left to adhere to the wound surface until they are separated by means of transepithelial elimination Fig. The residual defects if present are treated by application of topical špičkové superfood proti stárnutí agents within the scope of the methods for the wound healing during the hospital stay or on an outpatient basis.
IIa degree scald burn suffered by a month-old child Fig. The same child after immediate coverage with skin xenografts Fig. All patients were discharged from hospital discharge if outpatient management could be performed safely and comfortably.
The mean age of the patients was 7. The majority of the patients were children 96 cases. All patients suffered burns caused by hot liquids water, tea, coffee, soup.
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This shows the correlation between the larger extents of burns and increased healing times in this group. Healing within 14 days serves as an nasolabial krémové recenze of the healing dynamics and as a parameter for comparison nasolabial krémové recenze other studies focused on alternative treatment options.
In all the cases the mean total healing time was Discharge time As the treatment of residual defects could have been performed, in many cases, on an outpatient basis, the mean values of discharge time in each group were lower than mean values of total healing time. Of the patients in total the mean discharge time was up to 10 days. Operations In four cases it was necessary to perform tangential excision of the deep parts of nejlepší maska proti vráskám wounds and coverage with split-thickness skin autografts or coverage of residual defects of a larger extent, the spontaneous healing of which would require much more time.
Because of the wound deepening nasolabial krémové recenze BSAB 3. Skin xenografts were replaced by split-thickness skin autografts in the second stage. The wound cultures at the day of admission were sterile, on day 4 postburn sterile — after multiplication Staphylococcus aureus.
In one case a two-year-old girl, BSAB: Of the patients four underwent surgery, which represents 3.
The mean surface operated on was 4. In Beverwijk, the Netherlands, a retrospective study of the treatment of scalds by glycerolised skin allografts was performed by Brans 3 and published in Over a period of four years 45 patients with a mean age of 23 months, mean BSAB The decisive factor may be the difference in the viability of these skin substitutes.
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The results of other studies indicate that it is necessary for a bioactive surface to be present, in order to accelerate re-epithelialisation through contact orientation and stimulation of cell proliferation nasolabial krémové recenze, 8. From this point of view, and with regard to the results achieved, the partially retained bioactivity of skin xenografts seems more advantageous.
It is also possible to preserve skin allografts by deep freezing, which retains their viability. However, utilisation is recommended in cases where integration of the dermal nasolabial krémové recenze as a part of permanent wound closure is desired 5because the glycerol preserved allograft provides no viable coverage material and lacks the beneficial effect of integration and vascularisation of viable allogeneic grafts 2.
In Copenhagen, Denmark, a prospective randomised study was performed by Leicht 10 based on a comparison of treatment of scalds by lyophilised alografts Nasolabial krémové recenze and by open technique. Of 50 patients with scalds, 25 — with the mean age of 1. The parameters compared are shown in Table 3. Comparison of the results For the coverage of partial-thickness burns amnion obtained from the placentas of selected donors is also being used.
In Singh 13 compared the burn wound healing rate between radiation sterilized amniotic membranes and glycerol preserved amniotic membranes. The wounds of each patient were divided into halves, one half treated with glycerol preserved membranes and the second half with irradiated membranes.
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There were no significant differences in the rate of healing between the gamma-irradiated amniotic membranes and glycerol preserved membranes, indicating that there is no adverse effect of gamma irradiation on the efficacy of the membranes.
According to the authors, in all the patients the membranes dessicated and separated in 10—14 days, leaving behind an epithelialized surface.
The exact results of the healing were not stated.