Managing burn wounds with SMARTPORE Technology polyurethane foam: two case reports
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Abstract:
Successful wound healing depends on various factors, including exudate control, prevention of microbial contaminants, and moisture balance. We report two cases of managing burn wounds with SMARTPORE Technology polyurethane foam dressing.In Case 1, a 2-year-old Asian girl presented with a delayed (11 days) wound on her right leg. She sustained a thermal injury from a hot iron that was left idle on the floor. Clinical inspection revealed an infected wound with overlying eschar that traversed her knee joint. As her parents refused surgical debridement under general anesthesia, hydrotherapy and wound dressing using SMARTPORE Technology Polyurethane foam were used. Despite the delay in presentation of this linear thermal pediatric burn injury that crossed the knee joint, the patient's response to treatment and its outcome were highly encouraging. She was cooperative and tolerated each dressing change without the need of supplemental analgesia. Her wound was healed by 24 days post-admission. In Case 2, a 25-year-old Asian man presented with a mixed thickness thermal flame burn on his left leg. On examination, the injury was a mix of deep and superficial partial thickness burn, comprising approximately 3% of his total body surface area. SMARTPORE Technology polyurethane foam was used on his wound; his response to the treatment was very encouraging as the dressing facilitated physiotherapy and mobility. The patient rated the pain during dressing change as 2 on a scale of 10 and his pain score remained the same in every subsequent change. His wound showed evidence of epithelialization by day 7 post-burn. There were no adverse events reported.Managing burn wounds with SMARTPORE Technology polyurethane foam resulted in reduced pain during dressing changes and the successful healing of partial and mixed thickness wounds. The use of SMARTPORE Technology polyurethane foam dressings showed encouraging results and requires further research as a desirable management option in burn wounds.Keywords:
Eschar
Hydrotherapy
Successful wound healing depends on various factors, including exudate control, prevention of microbial contaminants, and moisture balance. We report two cases of managing burn wounds with SMARTPORE Technology polyurethane foam dressing.In Case 1, a 2-year-old Asian girl presented with a delayed (11 days) wound on her right leg. She sustained a thermal injury from a hot iron that was left idle on the floor. Clinical inspection revealed an infected wound with overlying eschar that traversed her knee joint. As her parents refused surgical debridement under general anesthesia, hydrotherapy and wound dressing using SMARTPORE Technology Polyurethane foam were used. Despite the delay in presentation of this linear thermal pediatric burn injury that crossed the knee joint, the patient's response to treatment and its outcome were highly encouraging. She was cooperative and tolerated each dressing change without the need of supplemental analgesia. Her wound was healed by 24 days post-admission. In Case 2, a 25-year-old Asian man presented with a mixed thickness thermal flame burn on his left leg. On examination, the injury was a mix of deep and superficial partial thickness burn, comprising approximately 3% of his total body surface area. SMARTPORE Technology polyurethane foam was used on his wound; his response to the treatment was very encouraging as the dressing facilitated physiotherapy and mobility. The patient rated the pain during dressing change as 2 on a scale of 10 and his pain score remained the same in every subsequent change. His wound showed evidence of epithelialization by day 7 post-burn. There were no adverse events reported.Managing burn wounds with SMARTPORE Technology polyurethane foam resulted in reduced pain during dressing changes and the successful healing of partial and mixed thickness wounds. The use of SMARTPORE Technology polyurethane foam dressings showed encouraging results and requires further research as a desirable management option in burn wounds.
Eschar
Hydrotherapy
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Infection remains a common cause of death in burn patients and is responsible for 75% of all deaths in patients with burns exceeding 40% total body surface area (TBSA). Current techniques of burn wound care and infection control measures have significantly reduced the incidence and mortality resulting from burn wound infection (BWI), changed the bacterial profile, and increased the time interval from injury to the onset of infection. Additional factors associated with improved outcome of infection include early burn eschar excision and grafting.
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Wound infection
Wound care
Skin grafting
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Objective To observe the therapeutical effects of carbon fiber wound dressing named Shangansu on large area deep burn wounds covered with xenoskin after microskin graft.Methods 76 patients with more than 50% TBSA were selected and randomly divided into control group(wound application dressing with iodophors carbasus and cotton mat) and treatment group(wound application dressing with Shangansu) until wound healing.The wound depth were III°and with excision of eschar,the areas were 30-51%.The operated wound surfaces were dressed by 0.5% iodophors carbasus within 24h,and changed the covering once a day.The wound excision of eschar was 5-7d after operation in both treatment group and control group,the wounds without operation were exposed with SD-Ag,and the eschars were promoted by grill.Then the exudate absorption,exclusion time of xenoskin,residue wound inflammation,wound healing time and wound healing quality were observed.Results Compared with the control group,the treatment group patients showed higher volume of exudate absorption,and exclusion time of xenoskin was extended by 4.76 days on average when compared with the control group.On the other hand,the treatment group patients showed a light residue wound inflammation,and the wound healing time was reduced by 5.8 days when compared with the control group.Conclusion Wound dressing with Shangansu has an advantage of adding exudate absorption;release inflammation reaction;extending exclusion time of xenoskin,promoting wound healing and reducing the formation of cicatrix.
Eschar
Exudate
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All charts of burn patients admitted to the US Army Institute of Surgical Research over a four-year period were reviewed to determine the efficacy of excision of the burn wound to fascia as a therapeutic modality. Of 1,013 burn patients, 72 underwent this procedure. The patients who had excisions had a mean total burn size of 52% of body surface area (BSA) and a mean third-degree burn of 33%. We correlated survival with burn size, associated injuries, day of excision, wound coverage, and sepsis. Survival in the group who had excisions (57%) did not differ substantially from that of the other patients (38%) when broken down by burn size. Careful selection of patients for this procedure and criteria for selection are stressed.
Body surface area
Deep fascia
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Promoting wound healing is an essential purpose of burn manegement. The problematic burn wound healing frequently occurs in clinical practice, such as; surgical wound closure in extensive full-thickness burn patients; the presence of burn eschar or necrotic tissue and its induced pathological events; the wound progressive injury occuring as well as the impaired wound healing resulting from various pathophysiological factors. During the past decades, Chinese burn surgeons have succesfully established a series of methods and obtained marked achievements in basic research on the problematic aspects of burn wound healing.
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Wound Closure
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Low molecular weight heparin (LMWH) appears to be a promising solution for reducing inflammatory post-burn episodes and results in improved healing. The clinical examination presented here includes patients with burn wounds ranging from 20 to 35% total body surface area (TBSA) who were categorized into two groups, of which one received subcutaneous LMWH treatment (10,000 units/day) and the other acted as control. The process of healing was assessed through regular examination of clinical features such as regression of erythema and oedema, eschar formation, and rate of re-epithelialization. Various studies have demonstrated an increase in levels of serum IL-6 indicating the severity of the morbid condition. In the present investigation, LMWH-treated patients exhibited a faster decline in levels of serum IL-6 (within 12 days) than control. Infiltration of inflammatory cells at the local wound site was assessed through a histological analysis of tissue samples taken on various days during the healing process. The LMWH-treated groups exhibited an organized healing pattern with better remodelling in a shorter duration (28 days), while control patients took more than 28 days for complete healing. A slight correlation was observed with TBSA to the inflammatory process, which subsided in patients treated with LMWH, favourably modulating the events involved in the inflammatory process of burn wound healing.
Eschar
Erythema
Infiltration (HVAC)
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Silver sulfadiazine
Eschar
Body surface area
Limiting
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Skin grafting
Immunosuppression
Wound Closure
Third-Degree Burn
Thermal burn
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Debridement (dental)
Burn center
Wound care
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Electrolyte imbalance
Silver sulfadiazine
Severe burn
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