Objective: To characterize amikacin pharmacokinetics in serum and in blister fluid of severe burn patients to guide optimal treatment timing. Methods: Patients (N = 32) were divided into four groups based on amikacin ...Objective: To characterize amikacin pharmacokinetics in serum and in blister fluid of severe burn patients to guide optimal treatment timing. Methods: Patients (N = 32) were divided into four groups based on amikacin administration timing and groups received drug minutes to hours after injury. In Groups A, B, C, and D, amikacin (400 mg, IV) was administered 3 - 4, 10, 20 and 30 h post burn injury, respectively (N = 8 for all groups). Next blister fluid and venous blood samples from 9 patients were obtained at 0, 0.25, 0.5, 1, 2, 3, 4, 5, 6, and 7 h after drug infusion. Amikacin concentrations were measured with a fluorescent polarization immunoassay and pharmacokinetics was deduced using DAS3.2.5. Statistical analyses performed with SPSS13.0. Results: Compared with normal values, t1/2z of amikacin from burn patients was shortened in serum but amikacin half-lives in blister fluid was significantly greater than serum half-life values (p < 0.05). Groups A and B had greater pharmacokinetic values at each time point, and Group D did not achieve antibacterial concentrations of amikacin. Conclusion: Early amikacin administration in severe burn patients offers greater concentrations of drug in serum and blister fluids.展开更多
Background:Red blood cell transfusions are critical in burn management.The subsequent iron overload that can occur from this treatment can lead to secondary hemochromatosis with multi-organ damage.Case Presentation:Wh...Background:Red blood cell transfusions are critical in burn management.The subsequent iron overload that can occur from this treatment can lead to secondary hemochromatosis with multi-organ damage.Case Presentation:While well recognized in patients receiving chronic transfusions,we present a case outlining the acute development of hemochromatosis secondary to multiple transfusions in a burn patient.Conclusions:Simple screening laboratory measures and treatment options exist which may significantly reduce morbidity;thus,we believe awareness of secondary hemochromatosis in those treating burn patients is critical.展开更多
BACKGROUND Body parts such as the face and hands are highly exposed during daily life and burns may accumulate in these areas.In addition,residual wounds,scar hyperplasia and contracture often exist in the late stage ...BACKGROUND Body parts such as the face and hands are highly exposed during daily life and burns may accumulate in these areas.In addition,residual wounds,scar hyperplasia and contracture often exist in the late stage of a deep burn in these areas,which may affect patients’appearance,movements,and mental health.However,inadequate attention has been paid to this issue which can result in problems,such as difficulty in healing,possibility of carcinoma,chronic pain and a heavy mental burden.AIM To investigate the long-term medical treatment of patients with severe burns at exposed sites following a mass burn casualty event.METHODS A retrospective analysis of 13 patients with severe burns at exposed sites was performed to determine their respective long-term medical treatment.A combined wound dressing scheme consisting of traditional Chinese and Western medicine was introduced to repair residual wounds.Active and passive functional exercises with massage,Chinese herbal baths and compression fixation were proposed to ameliorate the condition of the hands.A combination of physical,chemical and photoelectrical measures was adopted for anti-scar treatment.A psychological intervention and recovery guide was provided which corresponded to the patients’psychological status.RESULTS Compared to patients who did not simultaneously receive the same treatment,patients who underwent systematic treatment recovered with a lower woundinfection rate(P<0.05),a shorter healing time(13.6±3.2 d)compared with(19.1±3.5 d)and more bearable pain during wound dressing at three days,one week and two weeks after a Chinese herbal bath(P<0.05).Satisfactory results were achieved with regard to restored function of patients’joints and blood supply to nerve endings,closure of the eyelids and the size of mouth opening tended to be normal,and only 7.1%of patients were diagnosed with severe scar hyperplasia and contracture deformity compared with 30.7%in the control group.In addition,the color,thickness,vascular distribution and softness score of the scars improved(P<0.01),and the effects of the psychological intervention was remarkable as shown by the Self-Rating Anxiety Scale and Self-Rating Depression Scale.CONCLUSION A better prognosis can be achieved in patients in the late stage of a burn with active residual wound repair,limb functional exercise,anti-scar and psychological rehabilitation.展开更多
Burn wound infection delays wound healing, leading to varying degrees of morbidity and mortality. Various antibiotics are administered to burn patients in burn wound management. The emergence of antibiotic resistance ...Burn wound infection delays wound healing, leading to varying degrees of morbidity and mortality. Various antibiotics are administered to burn patients in burn wound management. The emergence of antibiotic resistance is a menace that costs families and the country. This review seeks to expound on infections related to burn wounds, common bacteria of burn wound infections and choice of antibiotics in burns treatment. Words such as burns, wound infection, burns injury and antibiotics were put into the Google search engine. Only articles related to the subject of burns, burn wound infection and antibiotics were used to write the review. Articles obtained included case reports on burns, research articles, review articles, short notes, briefs, literatures and other articles relating to burns. We found that the choice of antibiotics in the management of burns is an issue of major concern due to the evolution of pathogens causing these infections. The challenge of antibiotic resistance still persists in burns wound management. The commonly used topical antimicrobials included silver sulphadiazine, silver nitrate solution, silver impregnated dressings and mafenide acetate. Mafenide acetate has a wide antibacterial activity and also acts against the usual wound pathogens that were identified: Pseudomonas aeruginosa and Staphylococcus aureus. The role of antibiotic resistance is of major concern. Antibiotics must be administered after culture evidence in order to reduce the chance of increasing evolution of resistant strains of bacteria.展开更多
文摘Objective: To characterize amikacin pharmacokinetics in serum and in blister fluid of severe burn patients to guide optimal treatment timing. Methods: Patients (N = 32) were divided into four groups based on amikacin administration timing and groups received drug minutes to hours after injury. In Groups A, B, C, and D, amikacin (400 mg, IV) was administered 3 - 4, 10, 20 and 30 h post burn injury, respectively (N = 8 for all groups). Next blister fluid and venous blood samples from 9 patients were obtained at 0, 0.25, 0.5, 1, 2, 3, 4, 5, 6, and 7 h after drug infusion. Amikacin concentrations were measured with a fluorescent polarization immunoassay and pharmacokinetics was deduced using DAS3.2.5. Statistical analyses performed with SPSS13.0. Results: Compared with normal values, t1/2z of amikacin from burn patients was shortened in serum but amikacin half-lives in blister fluid was significantly greater than serum half-life values (p < 0.05). Groups A and B had greater pharmacokinetic values at each time point, and Group D did not achieve antibacterial concentrations of amikacin. Conclusion: Early amikacin administration in severe burn patients offers greater concentrations of drug in serum and blister fluids.
文摘Background:Red blood cell transfusions are critical in burn management.The subsequent iron overload that can occur from this treatment can lead to secondary hemochromatosis with multi-organ damage.Case Presentation:While well recognized in patients receiving chronic transfusions,we present a case outlining the acute development of hemochromatosis secondary to multiple transfusions in a burn patient.Conclusions:Simple screening laboratory measures and treatment options exist which may significantly reduce morbidity;thus,we believe awareness of secondary hemochromatosis in those treating burn patients is critical.
基金Supported by Key Research and Development Project of Jiangsu Province,No.BE2018626。
文摘BACKGROUND Body parts such as the face and hands are highly exposed during daily life and burns may accumulate in these areas.In addition,residual wounds,scar hyperplasia and contracture often exist in the late stage of a deep burn in these areas,which may affect patients’appearance,movements,and mental health.However,inadequate attention has been paid to this issue which can result in problems,such as difficulty in healing,possibility of carcinoma,chronic pain and a heavy mental burden.AIM To investigate the long-term medical treatment of patients with severe burns at exposed sites following a mass burn casualty event.METHODS A retrospective analysis of 13 patients with severe burns at exposed sites was performed to determine their respective long-term medical treatment.A combined wound dressing scheme consisting of traditional Chinese and Western medicine was introduced to repair residual wounds.Active and passive functional exercises with massage,Chinese herbal baths and compression fixation were proposed to ameliorate the condition of the hands.A combination of physical,chemical and photoelectrical measures was adopted for anti-scar treatment.A psychological intervention and recovery guide was provided which corresponded to the patients’psychological status.RESULTS Compared to patients who did not simultaneously receive the same treatment,patients who underwent systematic treatment recovered with a lower woundinfection rate(P<0.05),a shorter healing time(13.6±3.2 d)compared with(19.1±3.5 d)and more bearable pain during wound dressing at three days,one week and two weeks after a Chinese herbal bath(P<0.05).Satisfactory results were achieved with regard to restored function of patients’joints and blood supply to nerve endings,closure of the eyelids and the size of mouth opening tended to be normal,and only 7.1%of patients were diagnosed with severe scar hyperplasia and contracture deformity compared with 30.7%in the control group.In addition,the color,thickness,vascular distribution and softness score of the scars improved(P<0.01),and the effects of the psychological intervention was remarkable as shown by the Self-Rating Anxiety Scale and Self-Rating Depression Scale.CONCLUSION A better prognosis can be achieved in patients in the late stage of a burn with active residual wound repair,limb functional exercise,anti-scar and psychological rehabilitation.
文摘Burn wound infection delays wound healing, leading to varying degrees of morbidity and mortality. Various antibiotics are administered to burn patients in burn wound management. The emergence of antibiotic resistance is a menace that costs families and the country. This review seeks to expound on infections related to burn wounds, common bacteria of burn wound infections and choice of antibiotics in burns treatment. Words such as burns, wound infection, burns injury and antibiotics were put into the Google search engine. Only articles related to the subject of burns, burn wound infection and antibiotics were used to write the review. Articles obtained included case reports on burns, research articles, review articles, short notes, briefs, literatures and other articles relating to burns. We found that the choice of antibiotics in the management of burns is an issue of major concern due to the evolution of pathogens causing these infections. The challenge of antibiotic resistance still persists in burns wound management. The commonly used topical antimicrobials included silver sulphadiazine, silver nitrate solution, silver impregnated dressings and mafenide acetate. Mafenide acetate has a wide antibacterial activity and also acts against the usual wound pathogens that were identified: Pseudomonas aeruginosa and Staphylococcus aureus. The role of antibiotic resistance is of major concern. Antibiotics must be administered after culture evidence in order to reduce the chance of increasing evolution of resistant strains of bacteria.
