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  • 1
    Online Resource
    Online Resource
    Implementierung der Behandlung durch enzymatisches Debridement bei Verbrennungen – Ergebnisse eines interprofessionellen, deutschsprachigen Expertenworkshops
    Georg Thieme Verlag KG ; 2020
    In:  Handchirurgie · Mikrochirurgie · Plastische Chirurgie
    Details
    In: Handchirurgie · Mikrochirurgie · Plastische Chirurgie, Georg Thieme Verlag KG
    Abstract: Einleitung Das enzymatische Debridement (ED) auf Bromelain-Basis (Nexobrid®) wird seit seiner Markteinführung 2013 zunehmend in Verbrennungszentren eingesetzt. Die Literatur belegt die Effizienz der Escharentfernung sowie eine Überlegenheit im Vergleich zum Standard-of-Care in Bezug auf periprozeduralem Blutverlust und Notwendigkeit operativer Maßnahmen. Während ausreichende Erfahrung eine zuverlässige Anwendung ermöglicht, müssen zur Implementierung der Technik einige praktische und logistische Hürden überwunden werden, die weder in den Herstellerangaben noch in der verfügbaren Literatur ausreichend beschrieben sind. Methode Ein multiprofessionelles Panel, bestehend aus erfahrenen Anwendern aus deutschsprachigen Brandverletztenzentren, wurde zu einem Expertenworkshop eingeladen. Vorab wurden mit den Teilnehmern Themenkomplexe aus den Bereichen Indikationsstellung, Definition von Behandlungspfaden, praktische Durchführung des enzymatischen Debridements, Nachbehandlung sowie Komplikationen abgestimmt, um diese im Rahmen des Expertenworkshops zu erörtern. Ergebnisse Zu den vordefinierten Themenkomplexen wurden konkrete Handlungsempfehlungen im Expertenpanel erarbeitet und konsentiert. Zusammenfassende Kernaussagen wurden zusätzlich herausgestellt. Sie richten sich sowohl an Einsteiger als auch an erfahrenere Anwender und bieten Unterstützung, um möglichst optimale Ergebnisse durch ED zu erzielen. So entstanden unter anderem Hinweise für den Einsatz von ED über klassische Indikationen hinaus, unterschiedliche Behandlungspfade je nach Verbrennungstiefe und Verlauf des ED mit jeweils angepasster Nachbehandlung, Management von Therapieversagen sowie Empfehlungen hinsichtlich infrastruktureller Rahmenbedingungen zur Implementierung von ED. Diskussion Obwohl die Wirksamkeit von ED durch die vorhandene Literatur belegt und eine Überlegenheit hinsichtlich mehrerer Aspekte der Behandlung von Verbrennungswunden gezeigt werden konnte, sind bislang nur wenige anwenderorientierte Empfehlungen zur praktischen Implementierung von ED verfügbar. Wenngleich die hier publizierten Handlungsempfehlungen und Expertenaussagen nur zum Teil durch Evidenz aus eindeutigen Studien zu untermauern sind, basieren sie dennoch auf der gebündelten Erfahrung des Expertenpanels, die die Anzahl der bisher publizierten Fälle um ein Vielfaches übertrifft und dadurch erlaubt, wertvolle Unterstützung bei der erfolgreichen Implementierung der Technik bereitzustellen.
    Type of Medium: Online Resource
    ISSN: 0722-1819 , 1439-3980
    URL: Article
    DOI: 10.1055/a-1319-7566
    Language: German
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2020
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  • 2
    Online Resource
    Online Resource
    Growth Differentiation Factor 5 Accelerates Wound Closure and Improves Skin Quality During Repair of Full-Thickness Skin Defects
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Advances in Skin & Wound Care Vol. 30, No. 5 ( 2017-5), p. 223-229
    Details
    In: Advances in Skin & Wound Care, Ovid Technologies (Wolters Kluwer Health), Vol. 30, No. 5 ( 2017-5), p. 223-229
    Abstract: A fast and stable wound closure is important, especially for extended and unstable wounds found after burn injuries. Growth can regulate a variety of cellular processes, including those involved in wound healing. Growth differentiation factor 5 (GDF-5) can accelerate fibroblast cell migration, cell proliferation, and collagen synthesis, which are essential for wound healing. Nevertheless, no standardized evaluation of the effect of GDF-5 on the healing of full-thickness wounds has been published to date. METHODS: Five full-thickness skin defects were created on the backs of 6 minipigs. Three wounds were treated with GDF-5 in different concentrations with the help of a gelatin-collagen carrier, and 2 wounds served as control group. The first was treated with the gelatin carrier and an Opsite film (Smith & Nephew, Fort Worth, Texas), and the other was treated solely with an Opsite film that was placed above all wounds and renewed every second day. RESULTS: Growth differentiation factor 5 accelerates wound closure (10.91 [SD, 0.99] days) compared with treatment with the carrier alone (11.3 [SD, 1.49] days) and control wounds (13.3 [SD, 0.94] days). Epidermal cell count of wounds treated with GDF-5 revealed a higher number of cells compared with the control group. In addition, mean epidermal thickness was significantly increased in GDF-5–treated wounds compared with the control wounds. CONCLUSIONS: Because of its ability to improve skin quality, GDF-5 should be considered when developing composite biomaterials for wound healing.
    Type of Medium: Online Resource
    ISSN: 1538-8654 , 1527-7941
    URL: Article
    DOI: 10.1097/01.ASW.0000515078.69041.3c
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 2053383-4
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  • 3
    Online Resource
    Online Resource
    Evaluation of Scar Quality after Treatment of Superficial Burns with Dressilk® and Suprathel®—In an Intraindividual Clinical Setting
    MDPI AG ; 2022
    In:  Journal of Clinical Medicine Vol. 11, No. 10 ( 2022-05-18), p. 2857-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 11, No. 10 ( 2022-05-18), p. 2857-
    Abstract: Background: Various synthetic and biological wound dressings are available for the treatment of superficial burns, and standard care differs among hospitals. Nevertheless, the search for an ideal wound dressing offering a safe healing environment as well as optimal scar quality while being economically attractive is a continuing process. In recent years, Dressilk®, which consists of pure silk, has become the standard of care for the treatment of superficial burns in our hospital. However, no long-term scar-evaluation studies have been performed to compare Dressilk® with the often-used and more expensive Suprathel® in the treatment of superficial burns. Methods: Subjective and objective scar evaluations were performed three, six, and twelve months after treatment in patients who received simultaneous treatment of 20 superficial burn wounds with both Suprathel® and Dressilk®. The evaluations were performed using the Vancouver Scar Scale, the Cutometer®, Mexameter®, Tewameter®, and the O2C®. Results: Both dressings showed mostly equivalent results in subjective scar evaluations. In the objective scar evaluations, the wounds treated with Dressilk® showed a faster return to the qualities of non-injured skin. Wound areas treated with the two dressings showed no significant differences in elasticity and transepidermal water loss after 12 months. Only oxygen saturation was significantly lower in wound areas treated with Suprathel® (p = 0.008). Subjectively, wound areas treated with Dressilk® showed significantly higher pigmentation after six months, which was not apparent after 12 months. Conclusion: Both wound dressings led to esthetically satisfying scar recovery without significant differences from normal uninjured skin after 12 months. Therefore, Dressilk® remains an economically and clinically interesting alternative to Suprathel® for the treatment of superficial burns.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm11102857
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2662592-1
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  • 4
    Online Resource
    Online Resource
    The performance of clinical risk scores in the diagnosis of necrotising fasciitis
    Mark Allen Group ; 2023
    In:  Journal of Wound Care Vol. 32, No. 5 ( 2023-05-02), p. 284-290
    Details
    In: Journal of Wound Care, Mark Allen Group, Vol. 32, No. 5 ( 2023-05-02), p. 284-290
    Abstract: Necrotising fasciitis (NF) is a quickly progressing and potentially life-threatening infection, involving the fascia and subcutaneous tissues. The diagnosis of this disease is challenging, especially due to a lack of specific clinical signs. In order to ensure a better and quicker identification of NF patients, a laboratory risk indicator score has been developed for NF (LRINEC). A variant has widened this score by adding clinical parameters (modified LRINEC). This study shows current outcomes of NF and compares the two scoring systems. Methods: This study was conducted between 2011 and 2018, and included patient demographics, clinical presentations, sites of infection, comorbidities, microbiological and laboratory findings, antibiotic therapies and LRINEC as well as modified LRINEC scores. The primary outcome was in-hospital mortality. Results: A cohort of 36 patients, diagnosed with NF, were included in this study. The mean hospital stay was 56 days (±38.2 days). The mortality rate in the cohort was 25%. The sensitivity of the LRINEC score was 86%. Calculation of the modified LRINEC score showed an improvement of the sensitivity to 97%. The average LRINEC score and modified LRINEC score for patients who died and who survived were equal (7.4 versus 7.9 and 10.4 versus 10.0, respectively). Conclusion: The mortality rate of NF remains high. The modified LRINEC score increased the sensitivity in our cohort to 97%, and this scoring system could be supportive in the diagnosis of NF for early surgical debridement.
    Type of Medium: Online Resource
    ISSN: 0969-0700 , 2052-2916
    URL: Article
    DOI: 10.12968/jowc.2023.32.5.284
    Language: English
    Publisher: Mark Allen Group
    Publication Date: 2023
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  • 5
    Online Resource
    Online Resource
    Utilization of laser D oppler flowmetry and tissue spectrophotometry for burn depth assessment using a miniature swine model
    Wiley ; 2015
    In:  Wound Repair and Regeneration Vol. 23, No. 1 ( 2015-01), p. 132-136
    Details
    In: Wound Repair and Regeneration, Wiley, Vol. 23, No. 1 ( 2015-01), p. 132-136
    Abstract: Currently, the diagnosis of burn depth is primarily based on a visual assessment and can be dependent on the surgeons' experience. The goal of this study was to determine the ability of laser D oppler flowmeter combined with a tissue spectrophotometer to discriminate burn depth in a miniature swine burn model. Burn injuries of varying depth, including superficial‐partial, deep‐partial, and full thickness, were created in seven G öttingen minipigs using an aluminium bar (100 ° C ), which was applied to the abdominal skin for periods of 1, 3, 6, 12, 30, and 60 seconds with gravity alone. The depth of injury was evaluated histologically using hematoxylin and eosin staining. All burns were assessed 3 hours after injury using a device that combines a laser light and a white light to determine blood flow, hemoglobin oxygenation, and relative amount of hemoglobin. The blood flow (41 vs. 124 arbitrary units [ AU ]) and relative amount of hemoglobin (32 vs. 52 AU ) were significantly lower in full thickness compared with superficial‐partial thickness burns. However, no significant differences in hemoglobin oxygenation were observed between these depths of burns (61 vs. 60%). These results show the ability of laser D oppler flowmeter and tissue spectrophotometer in combination to discriminate between various depths of injury in the minipig model, suggesting that this device may offer a valuable tool for burn depth assessment influencing burn management.
    Type of Medium: Online Resource
    ISSN: 1067-1927 , 1524-475X
    URL: Issue
    URL: Article
    DOI: 10.1111/wrr.v23.1
    DOI: 10.1111/wrr.12246
    Language: English
    Publisher: Wiley
    Publication Date: 2015
    detail.hit.zdb_id: 2011990-2
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  • 6
    Online Resource
    Online Resource
    Low-Dose Blue Light (420 nm) Reduces Metabolic Activity and Inhibits Proliferation of Human Dermal Fibroblasts
    MDPI AG ; 2023
    In:  Life Vol. 13, No. 2 ( 2023-01-25), p. 331-
    Details
    In: Life, MDPI AG, Vol. 13, No. 2 ( 2023-01-25), p. 331-
    Abstract: Hypertrophic scarring in burn wounds is caused by overactive fibroblasts and myofibroblasts. Blue light reveals wavelength- and dose-dependent antibacterial and antiproliferative effects and may serve as a therapeutic option against wound infection and fibrotic conditions. Therefore, we evaluated in this study the effects of single and multiple irradiations with blue light at 420 nm (BL420) on the intracellular ATP concentration, and on the viability and proliferation of the human skin fibroblast (HDFs). In addition, possible BL420-induced effects on the catalase expression and differentiation were assessed by immunocytochemical staining and western blot analyses. Furthermore, we used RNA-seq analyses to identify BL420-affected genes. We found that BL420 induced toxicity in HDFs (up to 83%; 180 J/cm2). A low dose of 20 J/cm2 reduced the ATP concentration by ~50%. Multiple irradiations (4 × 20 J/cm2) inhibited proliferation without visible toxicity and reduced catalase protein expression by ~37% without affecting differentiation. The expression of about 300 genes was significantly altered. Many downregulated genes have functions in cell division/mitosis. BL420 can strongly influence the fibroblast physiology and has potential in wound therapy. However, it is important to consider the possible toxic and antiproliferative effects, which could potentially lead to impaired wound healing and reduced scar breaking strength.
    Type of Medium: Online Resource
    ISSN: 2075-1729
    URL: Article
    DOI: 10.3390/life13020331
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2662250-6
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  • 7
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    Online Resource
    Can Cold Atmospheric Plasma Be Used for Infection Control in Burns? A Preclinical Evaluation
    MDPI AG ; 2023
    In:  Biomedicines Vol. 11, No. 5 ( 2023-04-22), p. 1239-
    Details
    In: Biomedicines, MDPI AG, Vol. 11, No. 5 ( 2023-04-22), p. 1239-
    Abstract: Wound infection with Pseudomonas aeruginosa (PA) is a serious complication and is responsible for higher rates of mortality in burn patients. Because of the resistance of PA to many antibiotics and antiseptics, an effective treatment is difficult. As a possible alternative, cold atmospheric plasma (CAP) can be considered for treatment, as antibacterial effects are known from some types of CAP. Hence, we preclinically tested the CAP device PlasmaOne and found that CAP was effective against PA in various test systems. CAP induced an accumulation of nitrite, nitrate, and hydrogen peroxide, combined with a decrease in pH in agar and solutions, which could be responsible for the antibacterial effects. In an ex vivo contamination wound model using human skin, a reduction in microbial load of about 1 log10 level was observed after 5 min of CAP treatment as well as an inhibition of biofilm formation. However, the efficacy of CAP was significantly lower when compared with commonly used antibacterial wound irrigation solutions. Nevertheless, a clinical use of CAP in the treatment of burn wounds is conceivable on account of the potential resistance of PA to common wound irrigation solutions and the possible wound healing-promoting effects of CAP.
    Type of Medium: Online Resource
    ISSN: 2227-9059
    URL: Article
    DOI: 10.3390/biomedicines11051239
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2720867-9
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  • 8
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    Online Resource
    Erziehungsunfähigkeit Als Mietmangel
    Walter de Gruyter GmbH ; 2018
    In:  Familie und Recht Vol. 29, No. 8 ( 2018-08-01), p. 396-399
    Details
    In: Familie und Recht, Walter de Gruyter GmbH, Vol. 29, No. 8 ( 2018-08-01), p. 396-399
    Type of Medium: Online Resource
    ISSN: 2366-2018 , 0937-2180
    URL: Article
    DOI: 10.1515/fur-2018-290805
    RVK:
    PA 1000
    Language: Unknown
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2018
    detail.hit.zdb_id: 1016455-8
    detail.hit.zdb_id: 2652187-8
    SSG: 2
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  • 9
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    COVID-19 and burns: Lessons learned?
    Elsevier BV ; 2020
    In:  Burns Vol. 46, No. 6 ( 2020-09), p. 1467-1468
    Details
    In: Burns, Elsevier BV, Vol. 46, No. 6 ( 2020-09), p. 1467-1468
    Type of Medium: Online Resource
    ISSN: 0305-4179
    URL: Article
    DOI: 10.1016/j.burns.2020.05.015
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
    detail.hit.zdb_id: 2025040-X
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  • 10
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    A prospective intra-individual evaluation of silk compared to Biobrane for the treatment of superficial burns of the hand and face
    Elsevier BV ; 2017
    In:  Burns Vol. 43, No. 3 ( 2017-05), p. 539-548
    Details
    In: Burns, Elsevier BV, Vol. 43, No. 3 ( 2017-05), p. 539-548
    Type of Medium: Online Resource
    ISSN: 0305-4179
    URL: Article
    DOI: 10.1016/j.burns.2016.09.005
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2017
    detail.hit.zdb_id: 2025040-X
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