Eight burn wound sepsis patients, in which 6 cases were diagnosed as MODS and two as septic shock, were treated consecutively in our hospital from September 1997 to October 1998. The plasma concentration of IL-6, IL-8...Eight burn wound sepsis patients, in which 6 cases were diagnosed as MODS and two as septic shock, were treated consecutively in our hospital from September 1997 to October 1998. The plasma concentration of IL-6, IL-8, TNFα and LPS were assayed before and after surgical intervention, as well as when the patients vital signs became stable. The results showed: ①The patients' conditions abruptly deteriorated when the burn wound sepsis emerged.展开更多
To evaluate the effect of extensive excision of invasive burn wound infection on hypermeta-bolic response in burn patients with sepsis. Methods:Eight patients with major burn, complicated by invasive burn wound infect...To evaluate the effect of extensive excision of invasive burn wound infection on hypermeta-bolic response in burn patients with sepsis. Methods:Eight patients with major burn, complicated by invasive burn wound infection and sepsis were consecutively admitted to our hospital from September 1997 to October 1998. REEs were monitored by means of Cardiorespiratory Diagnostic System (Medical Graphics Corporation, USA) at patients bedside. Plasma concentration of IL-6、IL-8、TNF-α and LPS were assayed before an...展开更多
To investigate the clinical characteristics of invasive burn wound infection with sepsis in patients with major burns and to summarize the successful experiences in the treatment of such patients Methods Eight patie...To investigate the clinical characteristics of invasive burn wound infection with sepsis in patients with major burns and to summarize the successful experiences in the treatment of such patients Methods Eight patients with major burns, complicated by invasive burn wound infection and sepsis were consecutively admitted to our hospital from September 1997 to October 1998 Among them, 6 patients developed multiple organ dysfunction syndrome (MODS) and 2 developed septic shock The plasma concentrations of IL 6, IL 8, TNFα and lypopolysaccharide (LPS) were assayed before and after surgical intervention, as well as when the patient's vital signs became stable Results The patients' conditions usually deteriorated abruptly when extensive invasive burn wound infection emerged While multi microbial infection was usually found, Pseudomonas aeruginosa was the predominant bacteria isolated from the subeschar tissue The plasma concentrations of IL 6, IL 8, TNFα and LPS before surgical intervention were significantly higher than those after surgical intervention ( P <0 05) The lowest levels of the inflammatory mediators were observed when the patients' conditions became stable, and the values were significantly lower than those before surgical intervention ( P <0 001) Conclusion Since the main cause of burn wound sepsis is the presence of a large area of infected burn wound, they should be excised and covered as early as possible LPS and pro inflammatory mediators play an important role in the pathogenesis of burn sepsis Although favorable results should be attributed to comprehensive treatment, we believe that early, aggressive and thorough surgical excision of infected burn wounds, followed by sound and complete coverage of the area, play a crucial role展开更多
BACKGROUND Toxic epidermal necrolysis(TEN)is often associated with skin wounds affecting large areas.Healing of this type of wound is difficult because of pressure,infection and other factors.It can increase the lengt...BACKGROUND Toxic epidermal necrolysis(TEN)is often associated with skin wounds affecting large areas.Healing of this type of wound is difficult because of pressure,infection and other factors.It can increase the length of hospital stay and result in wound sepsis and even death.CASE SUMMARY A 49-year-old woman developed a skin lesion covering 80%of the total body surface area after using a kind of Chinese medicinal ointment on a burn wound on her back;she developed life-threatening wound sepsis and septic shock.Methicillin-resistant Staphylococcus aureus,carbapenem-resistant Acinetobacter baumannii,carbapenem-resistant Pseudomonas aeruginosa and other bacteria were cultured from wound tissue,deep venous catheter and blood samples.Imipenem cilastatin sodium,tigecycline and teicoplanin were used for anti-infection therapy.Finally,the patient was transferred to the burn department because of severe wound sepsis.In the burn intensive care unit,pain-free dressing changes and autologous scalp skin grafting were performed to heal the wound in addition to reasonable and effective antibacterial treatment according to microbial susceptibility test results.After three operations within 2 wk,the wound healed and sepsis resolved.CONCLUSION TEN patients with large areas of skin injury may develop wound infection and life-threatening wound sepsis.Autologous scalp skin grafting may be beneficial for rapid wound healing and reducing the risk of sepsis in TEN patients,and it leaves no scar at the donor site.展开更多
文摘Eight burn wound sepsis patients, in which 6 cases were diagnosed as MODS and two as septic shock, were treated consecutively in our hospital from September 1997 to October 1998. The plasma concentration of IL-6, IL-8, TNFα and LPS were assayed before and after surgical intervention, as well as when the patients vital signs became stable. The results showed: ①The patients' conditions abruptly deteriorated when the burn wound sepsis emerged.
文摘To evaluate the effect of extensive excision of invasive burn wound infection on hypermeta-bolic response in burn patients with sepsis. Methods:Eight patients with major burn, complicated by invasive burn wound infection and sepsis were consecutively admitted to our hospital from September 1997 to October 1998. REEs were monitored by means of Cardiorespiratory Diagnostic System (Medical Graphics Corporation, USA) at patients bedside. Plasma concentration of IL-6、IL-8、TNF-α and LPS were assayed before an...
基金This work was supported by the grant from the National Natural Science Foundation of China (No 39970716)the grant from the ResearchFounda
文摘To investigate the clinical characteristics of invasive burn wound infection with sepsis in patients with major burns and to summarize the successful experiences in the treatment of such patients Methods Eight patients with major burns, complicated by invasive burn wound infection and sepsis were consecutively admitted to our hospital from September 1997 to October 1998 Among them, 6 patients developed multiple organ dysfunction syndrome (MODS) and 2 developed septic shock The plasma concentrations of IL 6, IL 8, TNFα and lypopolysaccharide (LPS) were assayed before and after surgical intervention, as well as when the patient's vital signs became stable Results The patients' conditions usually deteriorated abruptly when extensive invasive burn wound infection emerged While multi microbial infection was usually found, Pseudomonas aeruginosa was the predominant bacteria isolated from the subeschar tissue The plasma concentrations of IL 6, IL 8, TNFα and LPS before surgical intervention were significantly higher than those after surgical intervention ( P <0 05) The lowest levels of the inflammatory mediators were observed when the patients' conditions became stable, and the values were significantly lower than those before surgical intervention ( P <0 001) Conclusion Since the main cause of burn wound sepsis is the presence of a large area of infected burn wound, they should be excised and covered as early as possible LPS and pro inflammatory mediators play an important role in the pathogenesis of burn sepsis Although favorable results should be attributed to comprehensive treatment, we believe that early, aggressive and thorough surgical excision of infected burn wounds, followed by sound and complete coverage of the area, play a crucial role
基金The State Key Laboratory of Trauma,Burns and Combined Injury,No.SKLJYJF18the First Affiliated Hospital,Army Medical University,No.SWH2019QNLC-04.
文摘BACKGROUND Toxic epidermal necrolysis(TEN)is often associated with skin wounds affecting large areas.Healing of this type of wound is difficult because of pressure,infection and other factors.It can increase the length of hospital stay and result in wound sepsis and even death.CASE SUMMARY A 49-year-old woman developed a skin lesion covering 80%of the total body surface area after using a kind of Chinese medicinal ointment on a burn wound on her back;she developed life-threatening wound sepsis and septic shock.Methicillin-resistant Staphylococcus aureus,carbapenem-resistant Acinetobacter baumannii,carbapenem-resistant Pseudomonas aeruginosa and other bacteria were cultured from wound tissue,deep venous catheter and blood samples.Imipenem cilastatin sodium,tigecycline and teicoplanin were used for anti-infection therapy.Finally,the patient was transferred to the burn department because of severe wound sepsis.In the burn intensive care unit,pain-free dressing changes and autologous scalp skin grafting were performed to heal the wound in addition to reasonable and effective antibacterial treatment according to microbial susceptibility test results.After three operations within 2 wk,the wound healed and sepsis resolved.CONCLUSION TEN patients with large areas of skin injury may develop wound infection and life-threatening wound sepsis.Autologous scalp skin grafting may be beneficial for rapid wound healing and reducing the risk of sepsis in TEN patients,and it leaves no scar at the donor site.
