Backgrounds: Burn patients, due to the immune compromise effects of their injury have a high risk for infections. The major cause of infection is the hospital environment contamination. This study was conducted to detect and identify isolated bacteria from patients and hospital environment in the Burn Unit and determine their antibiotics pattern in response to commonly used antimicrobial agents; in order to give recommendations for management of bacterial infections and drug-resistance. Patients and Methods: Retrospective observational study was conducted reviewing the database of Burn Unit in RSCM from January until December 2010. The characteristics of microorganisms found on the burn wound were compared to those obtained from the environments such as from the air, bathing water, and medical instruments. The pattern of microorganisms and their sensitivity-resistance characteristics were noted.Result: The pattern shows that nosocomial infection in the Burn Unit of RSCM was high. Klebsiella pneumoniae found on the burn wound eschars mimics those obtained from the air within the Burn Unit. Strains of MRSA were also found on screening.Conclusion: Our findings emphasize the need for careful disinfection and more strict infection control procedures in areas that serve immune suppression individual, such as burn patients.
Considering the advantages of wound treatment in moist-state, many practitioners always keep the wound in the moist condition. One of the alternatives is by using aloe vera. It has moisturizing effect, anti inflammatory and can stimulate growth factor and fibroblast. In this study, the authors aim to compare the effect of the wound dressing with the dry gauze, moist gauze and aloe vera toward the tensile strength. Thirty Rattus Novergicus were divided into two experimental groups and 1 control group. We performed full thickness skin incision on the back of the rats, and then we sutured and nursed them by using moist gauze and Aloe Vera while the dry gauze group treated as the control. On the 10th day, we decapitated the rats and we took the trace of incisional skin for the tensile strength test. At last, the samples were measured by Zwick universal tensile strength testing machine. This research show that the group treated by dry gauze had tensile strength (35 ± 7 N/cm2) , with moist gauze (41 ± 7 N/cm2), and with Aloe Vera (68 ±17 N/cm2). There was a significant difference between the three groups regarding the tensile strength (p<0.001). Treatment of wound by using Aloe Vera is proven to be more effective than the dry gauze and moist gauze to increase the tensile strength.
Among the current adjunctive treatment modalities available for the treatment of chronic wounds, vacuum-assisted closure therapy showed promising results. However, the VAC Therapy system is expensive, requires extensive amounts of product and needs a power source at all times. In this article, the authors introduce and review their experience with simplest modified vacuum assisted closure (smVAC) for treatment of chronic wound. Three patients with chronic wound came to the plastic surgery division at Sardjito hospital in early 2010 and were treated using simplest modified vacuum assisted closure (smVAC). After the wound bed was ready, split thickness skin graft (STSG) were performed to close the wound and smVAC was used to assist the graft placement. All patients underwent successful healing and reported satisfaction with their results. There were no side effects from using this device, such as maceration, necrosis and bleeding. Through the serial cases, the smVAC had shown to serve its function in providing adequate vacuum pressure for wounds. It is an alternative to the original vacuum assisted closure.
According to our experience in Ciptomangunkusumo hospital, most cleft palate patients has wide gap. It makes the epithelialization of the lateral defect takes longer time ( 3- 4 weeks). In this study, the authors propose a modified technique to the two-flap palatoplasty by not elevating the lateral part of the periosteum with the flap, and then apply honey packs to cover the lateral defects. The technique modification and additional honey-soaked dressing are expected to hasten the epithelialization rate. Twelve consecutive patients with non-syndromic cleft palate (with or without cleft lip) are included in the study. They undergo the modified two-flap palatoplasty with the lateral periosteum left behind, covering the palatal bone and the utilization of Honey pack. The rate of epithelialization is then observed every 2 days after operation until full healing is achieved. Complete epithelialization was attained within 5 days in one patient ( 2,8 mm/day), within 7 days in 8 patients (2-2,5mm/day), and within 9 days in 3 patients (2,2-2,7mm/day). There were no surgical complications, such as hemorrhage or wound infection. The fistula of the palate was not found until the defect closed. Our technique hasten the rate of epithelialization. It may prevent the maxillary growth disturbances in the future because faster healing reduces scar formation and wound contraction.
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