No abstract
Topical negative pressure has been demonstrated to improve graft take in a number of noncomparative studies. This study aimed to assess whether split-thickness skin graft take is improved qualitatively or quantitatively with topical negative pressure therapy compared with standard bolster dressings. A blinded, prospective, randomized trial was conducted of 22 adult inpatients of Liverpool Hospital between July of 2001 and July of 2002 who had wounds requiring skin grafting. After grafting, each wound half was randomized to receive either a standard bolster dressing or a topical negative pressure dressing. Skin graft assessment was performed at 2 weeks by a single observer blinded to the randomization. Two patients were lost to follow-up and were excluded from the study. There were 20 patients (12 men and eightwomen) in the study group. The median patient age was 64 years (range, 27 to 88 years), and the mean wound size was 128 cm2 (range, 35 to 450 cm2). The wound exposed subcutaneous fat in eight patients, muscle in six patients, paratenon in four patients, and deep fascia in two patients. At 2 weeks, wounds that received a topical negative pressure dressing had a greater degree of epithelialization in six cases (30 percent), the same degree of epithelialization in nine cases (45 percent), and less epithelialization in five cases (25 percent) compared with their respective control wounds. Graft quality following topical negative pressure therapy was subjectively determined to be better in 10 cases (50 percent), equivalent in seven cases (35 percent), and worse in three cases (15 percent). Although the quantitative graft take was not significant, the qualitative graft take was found to be significantly better with the use of topical negative pressure therapy (p < 0.05). Topical negative pressure significantly improved the qualitative appearance of split-thickness skin grafts as compared with standard bolster dressings.
This research tackles the intermediate spaces between buildings and the street, by examining the definition and importance of spatial configuration in relation to urban morphology and social relations. It also analyses how the organisation of in-between space affects social interaction in different urban forms. To understand the complex relations and socio-spatial structure of the city, it is important to use mixed methods. This research utilises various methods to focus on three dissimilar urban morphologies in Izmir, Turkey. Two inner city quarters and one modern housing estate of middle-and high-income groups are compared using space syntax analysis and snapshot observations. These neighbourhoods are selected according to their syntax measures from more integrated to segregated neighbourhoods in the axial analysis. And for a detailed zoomed-in analysis, similar diameter areas are covered for observations. Subsequently, activity patterns are observed at different times of the day, one weekday and one Sunday in three cases. In each neighbourhood, syntactic measures of all selected streets are correlated with these recorded activities. This study reveals that connectivity of streets is important for supplying niches that trigger long-duration activities and social interaction. In modern estates, stationary activities are not correlated strong enough with movement as it is in inner city neighbourhoods. Additionally, in-between spaces increase the frequency of social interaction and co-presence of people particularly in more integrated areas. However, this is only one element in developing sense of community. Further research is needed especially in correlating space syntax with environmental issues, as well as people's behaviour.
At the end of the twentieth century our cities face a multitude of problems both of a spatial and functional nature. One of the key issues to be addressed is the limited time-9 a.m. to 5 p.m.-during which we utilize the facilities and opportunities that the city centre has to offer. The Twenty-four Hour City concept is a relatively recent approach of combining a series of wide-ranging initiatives to tackle this problem by revitalizing and creating safer city centres. The main aim of this approach is to attract a wide range of groups back into the city both to use the services and facilities that it has to offer and as residents.
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