The results of ATIII treatment in this population of patients suggests that replacement therapy reduces mortality in the subgroup of septic shock patients only.

Full-thickness burns of the face are notoriously difficult to repair and their management poses a series of problems to the surgeon. We present the case of a 49-year-old man (only survivor of a catastrophic airport accident) with third-degree flame burns to >80% of total body surface area and extensive face damage who achieved a fully satisfactory outcome after a treatment plan based on gradual escharectomy followed by application of artificial dermis and, later, grafting with sheets of cultured keratinocytes. Re-epithelialisation was already visible at day 16 after admission and all facial wounds were closed by day 56, the treatment continuing on the scalp. Within 6 months of the accident, the patient had recovered functional and cosmetic features (including re-growth of skin appendages) that were beyond expectations. The use of nanocrystalline silver-coated dressings during the escharectomy and resurfacing phases was important, as part of a multifaceted strategy, in ensuring excellent antimicrobial control, thus avoiding the need for autologous grafting and contributing to a rapid healing and complete restoration of the face and head skin.

No abstract

SAPS II offers a real improvement compared with SAPS in its ability to explain hospital mortality, but its standard parameters do not fit our data from Italy. The role and impact of potential determinants of this lack of fit, such as random errors and confounders related to casemix and/or quality of care should be clarified before this scoring system be used outside formal research projects. Special caution is suggested when SAPS II is adopted to predict mortality to compare intensive care unit performance across different countries and systems of care.

No abstract