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Gaoxing Luo,
Hua Fan,
Wei Sun,
Yizhi Peng,
Lang Chen,
Junsheng Tao,
Jun Li,
Sisi Yang,
Xianchang Li, Mark Fitzgerald,
Jun Wu
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ABSTRACT: To improve the accuracy of blood loss estimation during extensive escharectomy and auto-microskin grafting on extremities in adult male major burn patients.
All adult male major burn patients admitted to our center who underwent extensive escharectomy and auto-microskin graft on extremities for more than 10% TBSA during the period 1 January 2008 to 31 December 2009 were involved in this study. The blood loss during the operation was estimated by the surgeons or calculated according to the changes in hemoglobin levels.
The average burn and escharectomy areas for the 64 burn patients included in the study were 74.16 ± 16.96% and 30.27 ± 15.63% TBSA respectively. The auto-microskin donor area was 3.81% TBSA. The volumes of intra-operative calculated and estimated blood losses and transfused blood during the operation were 0.47 ml/cm2, 0.13 ml/cm2 and 0.20 ml/cm2 surgical area 77.29 ml, 20.51 ml and 32.83 ml per 1% TBSA), respectively. Within two weeks after injury surgical blood loss appeared to be greater the later the operation was carried out. Within the first week after injury the mean proportional blood loss was increased with area excised.
In this study the average calculated blood loss for the operation of extensive escharectomy and microskin graft in adult male major burn patient was 0.47 ml/cm2 (77.29 ml per 1% TBSA). This result will help us to predict expected blood loss more accurately.
Burns: journal of the International Society for Burn Injuries 02/2011; 37(5):790-93. · 1.95 Impact Factor
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ABSTRACT: This study presents fungi and their characteristics identified from burn patients at a major Chinese burn centre.
All burns patients admitted to our Burn Research Institute from 2003 to 2006 inclusive were included in this study. Once fungal infection was suspected clinically, samples including wound tissue, blood, urine, stool and sputum were harvested for the culture of yeast. The sensitivities of the identified yeast were determined and the positive samples and cases were analysed.
Out of a total of 3909 cases, 467 patients were clinically suspected of fungal infection, of which 1970 samples were taken for yeast culture. A total of 38 samples and 36 patients tested positive. The three most positive samples were urine, blood and catheter. Candida tropicalis was identified as the most common yeast type (42.1%), followed by Candida albicans (31.6%), Candida famata (T. Famata) (10.5%) and Candida glabrata (T. Glabrata) (7.9%). Except for C. galbrata, most of the yeast strains found in the study were sensitive to the routine antimycotic agents. There were eight deaths in the 36 positive patients. As much as 83.3% of the positive cases suffered burns of more than 50% total body surface area (TBSA) and half of the positive cases were greater than 80% TBSA. A total of 78.95% of the positive samples were taken from patients after 2 weeks post-burn injury.
A profile of the fungi isolated from burn patients in a major Chinese burn centre is presented.
Burns: journal of the International Society for Burn Injuries 04/2010; 37(2):299-303. · 1.95 Impact Factor
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ABSTRACT: This study aims to review the changes in management of inhalation injury and the associated reduction in mortality over the past 2 decades.
The records of burn patients with inhalation injury hospitalised in our institute from 1986 to 2005 were retrospectively analysed. The incidence of inhalation injury and the associated mortality were analysed. Meanwhile, the relationship of inhalation injury with age, total burn area, tracheostomy intubation and mechanical ventilation were studied.
The incidence of inhalation injury was 8.01% in the total 10 608 hospitalised burn patients during the 20 years surveyed. Inhalation injury was always associated with large-sized burn and was more common in adults. The incidence of tracheostomy and mechanical ventilation increased from 39.46 and 30.28% in the period from 1986 to 1995 to 70.12 and 39.74% from 1996 to 2005, respectively. The overall mortality of inhalation-injured burn patients was 15.88% compared with 0.82% of the non-inhalation group. The mortality of the burn patients with inhalation injury dropped from 25.29% during the first 10 years to 11.71% during the second decade (p<0.01). Mortality secondary to inhalation injury as the lead cause decreased from 14.56 to 6.29% (p<0.01).
The care of inhalation injury has made significant progress over the past 2 decades. The early diagnosis of inhalation injury, early airway control and pulmonary function assistance with mechanical ventilation contribute to the reduction of mortality.
Burns: journal of the International Society for Burn Injuries 10/2009; 36(4):506-10. · 1.95 Impact Factor
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ABSTRACT: Fluid resuscitation is one of the critical treatments for the major burn patient in the early phases after injury. We evaluated the practice of fluid resuscitation for severely burned patients with the Third Military Medical University (TMMU) protocol, which is most widely used in many regions of China.
Patients with major burns (>30% total body surface area (TBSA)) presenting to Southwest Hospital, Third Military Medical University, between January 2005 and October 2007, were included in this study. Fluid resuscitation was initiated by the TMMU protocol.
A total of 71 patients were (46 adults and 25 children) included in this study. All patients survived the first 48 h after injury smoothly and none developed abdominal compartment syndrome or other recognised complications associated with fluid resuscitation. The average quantity of fluid infused was 3.3-61.33% more than that calculated based on the TMMU protocol in both adult and paediatric groups. The average urine output during the first 24h after injury was about 1.2 ml per kg body weight per hour in the two groups, but reached 1.2 ml and 1.7 ml during the second 24h in adult and pediatric groups, respectively.
This study indicates that the TMMU protocol for fluid resuscitation is a feasible option for burn patients. Individualised resuscitation - guided by the physiological response to fluid administration - is still important as in other protocols.
Burns: journal of the International Society for Burn Injuries 06/2009; 35(8):1118-23. · 1.95 Impact Factor
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Gaoxing Luo,
Jin Tang,
Weifeng He,
Jun Wu,
Bing Ma,
Xihua Wang,
Xiwei Chen,
Shaoxuan Yi,
Xiaorong Zhang,
Xianchang Li, Mark Fitzgerald
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ABSTRACT: To evaluate the antibacterial effect of multivalent silver ion carried by zirconium phosphate (ZP-Ag) both in vitro and in an experimental rat burn wound compared with that of sulfadiazine silver (SD-Ag). Firstly, the minimal inhibition concentration and the minimal bactericidal concentration of ZP-Ag to three different strains of bacteria (Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli) were compared with those of SD-Ag in vitro. Following this dressings containing the same mass of ZP-Ag or SD-Ag were applied to wounds in a rat burn model and their antimicrobial activity assayed. The inflammatory response of the wounds managed with the two kinds of dressings was compared. Both the minimal inhibition concentration and minimal bactericidal concentration of ZP-Ag to S. aureus, P. aeruginosa, and E. coli were two to four times lower than those of SD-Ag. In vivo ZP-Ag had a more effective antibacterial action inhibiting the growth of the above three bacterial strains under burn scar, compared with dressings made from the same mass of SD-Ag. Moreover, the antibacterial effect was unchanged after the ZP-Ag dressings were washed 20 times, while it dramatically decreased after the dressings with SD-Ag were washed 20 times. When covered by either regular or washed ZP-Ag dressings, the wounds showed integrity with no visible inflammatory reaction. However, various extents of inflammatory reactions on or around the wounds covered with regular SD-Ag dressing were observed. This study showed that dressings with ZP-Ag had a prominent and relative long-term antibacterial effect. ZP-Ag dressings could be an effective, low-cost management option for burn wounds.
Wound Repair and Regeneration 16(6):800-4. · 2.91 Impact Factor
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ABSTRACT: This study aimed to determine whether mesenchymal stem cells (MSCs) derived from umbilical cord blood (UCB) would promote cutaneous wound healing. MSCs from human UCB were isolated and identified. The characteristics of the isolated MSCs' growth and proliferation were assayed in vitro. The MSCs labeled with 5-bromodeoxyuridine (BrdU) were applied on fresh cutaneous mice wounds. The healing rates were surveyed. The distribution and the differentiation into keratinocytes of the labeled MSCs in the wound tissue were checked by immunohistochemistry staining. The isolated MSCs could grow and proliferate well in vitro. The isolated MSCs from UCB could be labeled by 5-bromodeoxyuridine successfully. The MSCs derived from UCB could enhance the healing of mice skin defect wounds, and it was found that the implanted MSCs could differentiate into keratinocyte in the wound tissue. It was demonstrated that MSCs from UCB can be isolated and proliferated successfully. The local administration of MSCs derived from UCB improves skin defect wound healing in mice.
Wound Repair and Regeneration 18(5):506-13. · 2.91 Impact Factor
