Permeability of blood vessels after thermal injury

Nozaki, Manabu; Guest, M. Mason; Bond, Ted P.; Larson, Duane L.

doi:10.1016/s0305-4179(80)80001-5

Cited by 14 publications

(3 citation statements)

References 25 publications

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“…The impairment of blood flow within the zone of stasis is due to the impairment of the vascular patency at the microvascular level [12]. This progression is closely correlated to the degree of edema formation, because odema precedes capillary stasis, which in turn provokes capillary thrombosis [13][14][15]. The progress of the burn wound usually begins within 3 h and proceeds for up to 48 h postburn [16].…”

Section: Burn Wound Evaluationmentioning

confidence: 99%

The surgical treatment of acute burns

et al. 2006

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Zusammenfassung. Grundlagen: Infolge der optimierten Behandlungsstrategien richtet sich das Augenmerk bei der Verbrennungsbehandlung nicht mehr auf das Überleben allein; auch die wiederzuerlangende Lebensqualität spielt hier eine entscheidende Rolle. Ziel dieser Arbeit war es, einen aktuellen Behandlungsplan zu erheben und zu evaluieren.Methodik: Der Inhalt dieser Arbeit beruht großteils auf unserer langjährigen Erfahrung bei der Verbrennungsbehandlung.Ergebnisse: Entscheidend für die Behandlung von Verbrennungen ist die exakte Tiefenbestimmung; auf ihr beruht die Entscheidung für ein konservatives oder operatives Vorgehen. Bei tiefen Verbrennungen (Grad 2b, Grad 3) ist eine frühzeitige Nekrosektomie und tiefenspezifische Deckung der Wunde anzustreben. Weiters kommt der richtigen Ernährung bei der Behandlung eine entscheidende Bedeutung zu.Schlussfolgerungen: Diese Arbeit soll all jenen dienen, die lediglich geringe Erfahrung bei der Behandlung von Brandverletzen haben. Außerdem sollte sie dazu verwendet werden, Patienten herauszufiltern die nach einer adequaten Erstversorgung von dem Transfer und der Behandlung an einem Verbrennungszentrum profitieren.Schlüsselwörter: Verbrennungen, Management, Chirurgie. Summary.Background: In the last decades, burn care has improved, so the trend in the current treatment extends beyond the preservation of life; the ultimate goal is the return of burn victims, as full members, back into their families and communities. This paper was prepared to consider the complex treatment of burns.Methods: This paper is mainly based on our experience in treating patients suffering from burn injuries.Results: One of the major problems that face any burn surgeon is the decision on the nature of treatment (conservative versus operative), so the key decision in the treatment is based on the exact determination of burn wound depth. In case of deep lesions early excision and suitable grafting and coverage should be performed whenever possible. Moreover, the adequate nutritional support is of utmost importance for the surgical treatment of burns.Conclusions: This paper is designed as a guideline and instruction manual to guide those with less experience through difficult situations in surgical burn care. Moreover it should be used as a guide to detect patients that require a referral to a burn centre after initial assessment.

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Section: Burn Wound Evaluationmentioning

confidence: 99%

The surgical treatment of acute burns

et al. 2006

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“…Should fluores¬ cence staining with dye persist, despite lowered initial concentrations, digital subtraction techniques might be utilized to reduce the effect of the residual fluorescing dye before reinjection of more dye.71 Video image pro¬ cessing may also allow for the identification and subse¬ quent removal of the fluorescing stained necrotic burn tissue before reinjection of dye.41 If burned-skin stain¬ ing still interferes with the ability to distinguish and treat full-thickness and partial-thickness burns at 24 hours despite the use of lower concentrations of IG dye, future studies may need to examine the use of highmolecular-weight dye-dextran congeners to decrease cutaneous vascular leakage and tissue staining. 69 The ideal technology for detecting burn depth would produce an image ofthe depth, perfusion, and structure of the viable dermis and subcutis. The instrument should also be capable of rapid imaging with sufficient resolution to quantify burn surface area, identify viable tissue, and monitor healing.72"74 The technique should incorporate the accuracy of cutaneous blood flow quan¬ tification, similar in spirit to that provided by laser Doppler.22 With these capabilities, a physician could investigate burn depth and differentiate necrotic from viable skin.…”

Section: Histologie Burn Depth Measurementsmentioning

confidence: 99%

Burn Depth Estimation Using Indocyanine Green Fluorescence

Green

Bua²,

Anderson³

et al. 1992

Arch Dermatol

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Expedient primary excision of deep dermal and full-thickness burn wounds with subsequent skin grafting is the standard of care in most burn institutions, but differentiating full-thickness from partial-thickness burns is often difficult. Because accurate early assessment of burn depth may improve care, a variety of technical methods have attempted to measure burn depth but these methods have had limited success. We describe a new technique to determine burn depth that uses infrared (840- to 850-nm) fluorescence emission from intravenously administered indocyanine green following excitation with infrared (780 nm) and UV light (369 nm). Full-thickness and partial-thickness burns in hairless rat skin were distinguished based on the infrared-induced and UV-induced fluorescence intensity ratios relative to normal, unburned skin immediately after the burn and on post-burn days 1 through 3 and 7. Dual-wavelength excitation of indocyanine green infrared fluorescence can delineate full-thickness from partial-thickness burns at an early date, allowing prognosis, surgical planning, and early primary excision and grafting.

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“…When the body is in a warm environment, the veins and capillaries are more dilated than when it is in a cold environment, and blood flow is higher in warm than in cold environments (Peiffer et al, 2009). Drug permeability through the endothelial membranes of blood vessels and capillaries is also higher in warm than in cold environments (Schimmelb et al, 1964;Nozaki et al, 1980). In addition, the tight junctions in the endothelial membranes of blood vessels and capillaries are opened in inflamed conditions, and so drug molecules can easily permeate across the skin and reach the systemic blood circulation after their topical application to skin (Stewart et al, 1944;Arndt and Lipfert, 1993).…”

Section: Introductionmentioning

confidence: 99%

Pretreatment effects of moxibustion on the skin permeation and skin and muscle concentrations of salicylate in rats

Cao

Tazawa

Ishii

et al. 2011

International Journal of Pharmaceutics

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The effect of moxibustion on the in vitro and in vivo skin permeation of salicylate was evaluated in rats. First, the effect of moxibustion pretreatment on the elimination pharmacokinetics of salicylate after i.v. injection in rats was determined: no clear difference was observed in the plasma profiles of salicylate (SA) with or without moxibustion pretreatment. However, much higher skin and muscle concentrations of salicylate were observed after its i.v. injection. Next, an in vitro skin permeation study of SA was performed after moxibustion pretreatment. Moxibustion pretreatment increased the skin permeation of SA, and the extent of the increase in SA skin permeation was related to the strength of moxibustion ignition. More intense treatments produced higher skin permeation. A similar enhancement effect on the skin permeation of SA was observed in in vivo studies. Interestingly, the skin/plasma and muscle/plasma ratios of SA were markedly increased by moxibustion pretreatment. These results were due to the induction of enhanced skin permeation and lower clearance into the cutaneous vessels by moxibustion ignition. Combination treatment involving moxibustion and the topical application of drugs such as NSAID may be useful for increasing local pharmaceutical effects by enhancing the drug concentration in the skin and muscle underneath the topical application site.

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Permeability of blood vessels after thermal injury

Cited by 14 publications

References 25 publications

The surgical treatment of acute burns

The surgical treatment of acute burns

Burn Depth Estimation Using Indocyanine Green Fluorescence

Pretreatment effects of moxibustion on the skin permeation and skin and muscle concentrations of salicylate in rats

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