Efficacy of combination of localized closure,ethacridine lactate dressing,and phototherapy in treatment of severe extravasation injuries:A case series

BACKGROUND The management of severe extravasation injuries is still controversial.Extravasation injuries can be treated in many ways.AIM To present a series of patients with severe extravasation injuries due to infusion who were managed with ethacridine lactate dressing combined with localized closure and phototherapy.METHODS In this study,we evaluated the data of eight patients,including six from the Department of Burn,one(with colorectal carcinoma)from the Veteran Cadre Department,and one(with leukemia)from the Hematology Department.Of these,three patients were male and five were female.Age of the patients ranged from 10 mo to 72 years,including two children(10 and 19 mo of age).In this study,the infusion was stopped immediately when the extravasation was identified.The extravasation event was managed routinely using a blocking solution.A ring-shaped localized closure was performed using the blocking agents.Moreover,ethacridine lactate dressing and phototherapy were applied for 3-5 d.RESULTS In this study,the drugs contained in the infusates were iodixanol,norepinephrine,alprostadil,amino acids,fat emulsion,cefoselis,cefoxitin,and potassium chloride+concentrated sodium chloride.All of the patients achieved complete healing after treatment and no obvious adverse reactions were observed.CONCLUSION The treatment of severe extravasation injuries using a combination of localized closure,ethacridine lactate dressing,and phototherapy resulted in satisfactory outcomes in patients.

Epidemiologic and clinical characteristics of severe burn patients: results of a retrospective multicenter study in China, 2011–2015

Background: Severe burns injury is a serious pathology, leading to teratogenicity and significant mortality, and it also has a long-term social impact. The aim of this article is to describe the hospitalized population with severe burns injuries in eight burn centers in China between 2011 and 2015 and to suggest future preventive strategies. Methods: This 5-year retrospective review included all patients with severe burns in a database at eight institutions. The data collected included gender, age, month distribution, etiology, location, presence of inhalation injury, total burn surface area, depth of the burn, the length of hospitalization, and mortality. SPSS 19.0 software was used to analyze the data. Results: A total of 1126 patients were included: 803 (71.3%) male patients and 323 (28.7%) female patients. Scalds were the most common cause of burns (476, 42.27%), followed by fire (457, 40.59%). The extremities were the most frequently affected areas, followed by the trunk. The median length of hospitalization was 30 (15, 52) days. The overall mortality rate was 14.21%. Conclusions: Although medical centers have devoted intensive resources to improving the survival rates of burn patients, expenditures for prevention and education programs are minimal. Our findings suggest that more attention should be paid to the importance of prevention and the reduction of injury severity. This study may contribute to the establishment of a nationwide burn database and the elaboration of strategies to prevent severe burns injury.

Ultrasonographic findings of re-epithelialized skin after partial-thickness burns

Background:This study aimed to investigate the difference between ultrasonographic findings of normal skin and those of re-epithelialized skin after partial-thickness burns and to evaluate the relationship between these findings and clinical outcomes. Methods:This study retrospectively analysed the ultrasound images of re-epithelialized skin after partial-thickness burns and contralateral normal skin from January 2016 to December 2016. A total of 155 lesions from 148 patients were analysed with ultrasound images, and healing time was documented. The scar status of each lesion was evaluated through medical records and photographs. We analysed the difference in ultrasonographic findings between normal skin and re-epithelialized skin after partial-thickness burns and statistically analysed the relationship between healing time, scar status and ultrasonographic findings. Results: The re-epithelialized skin after partial-thickness burns was significantly thicker than the contralateral normal skin, and the echogenicity was significantly lower. The ultrasound images of the re-epithelialized skin after partial-thickness burns showed the characteristic findings of low-echogenic bands (LEB), and the proportion of LEB thickness is strongly correlated with healing time. In the multivariate analysis of scar status, only the proportion of LEB thickness was statistical y significant. Conclusion:In this study, we found that there were ultrasonographic differences between re-epithelialized skin after partial-thickness burns and normal skin and that an LEB of varying thickness was formed after re-epithelialization. The thickness of the LEB in re-epithelialized skin after partial-thickness burns increased with healing time and was related to scar status.

The molecular basis of hypertrophic scars

Hypertrophic scars(HTS)are caused by dermal injuries such as trauma and burns to the deep dermis,which are red,raised,itchy and painful.They can cause cosmetic disfigurement or contractures if craniofacial areas or mobile region of the skin are affected.Abnormal wound healing with more extracellular matrix deposition than degradation will result in HTS formation.This review will introduce the physiology of wound healing,dermal HTS formation,treatment and difference with keloids in the skin,and it also review the current advance of molecular basis of HTS including the involvement of cytokines,growth factors,and macrophages via chemokine pathway,to bring insights for future prevention and treatment of HTS.

A Modified Surgical Technique Using Levator Aponeurosis-MiJller Muscle Complex to Correct Mild-to-Moderate Blepharoptosis

To the Editor： Blepharoptosis is a disease commonly seen in the Asian population, defined as an abnormal lower upper eyelid margin that is 〈2.0 mm above the midpoint of the pupil when a person looks straightforward.