| Development of a long-term ovine model of cutaneous burn and smoke inhalation injury and the effects of early excision and skin autografting. | |
| | |
MedLine Citation:
|
PMID: 22459154 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
|
Smoke inhalation injury frequently increases the risk of pneumonia and mortality in burn patients. The pathophysiology of acute lung injury secondary to burn and smoke inhalation is well studied, but long-term pulmonary function, especially the process of lung tissue healing following burn and smoke inhalation, has not been fully investigated. By contrast, early burn excision has become the standard of care in the management of major burn injury. While many clinical studies and small-animal experiments support the concept of early burn wound excision, and show improved survival and infectious outcomes, we have developed a new chronic ovine model of burn and smoke inhalation injury with early excision and skin grafting that can be used to investigate lung pathophysiology over a period of 3 weeks. MATERIALS AND METHODS: Eighteen female sheep were surgically prepared for this study under isoflurane anesthesia. The animals were divided into three groups: an Early Excision group (20% TBSA, third-degree cutaneous burn and 36 breaths of cotton smoke followed by early excision and skin autografting at 24h after injury, n=6), a Control group (20% TBSA, third-degree cutaneous burn and 36 breaths of cotton smoke without early excision, n=6) and a Sham group (no injury, no early excision, n=6). After induced injury, all sheep were placed on a ventilator and fluid-resuscitated with Lactated Ringers solution (4mL/% TBS/kg). At 24h post-injury, early excision was carried out to fascia, and skin grafting with meshed autografts (20/1000in., 1:4 ratio) was performed under isoflurane anesthesia. At 48h post-injury, weaning from ventilator was begun if PaO(2)/FiO(2) was above 250 and sheep were monitored for 3 weeks. RESULTS: At 96h post-injury, all animals were weaned from ventilator. There are no significant differences in PaO(2)/FiO(2) between Early Excision and Control groups at any points. All animals were survived for 3 weeks without infectious complication in Early Excision and Sham groups, whereas two out of six animals in the Control group had abscess in lung. The percentage of the wound healed surviving area (mean±SD) was 74.7±7.8% on 17 days post-surgery in the Early Excision group. Lung wet-to-dry weight ratio (mean±SD) was significantly increased in the Early Excision group vs. Sham group (p<0.05). The calculated net fluid balance significantly increased in the early excision compared to those seen in the Sham and Control groups. Plasma protein, oncotic pressure, hematocrit of % baseline, hemoglobin of % baseline, white blood cell and neutrophil were significantly decreased in the Early Excision group vs. Control group. CONCLUSIONS: The early excision model closely resembles practice in a clinical setting and allows long-term observations of pulmonary function following burn and smoke inhalation injury. Further studies are warranted to assess lung tissue scarring and measuring collagen deposition, lung compliance and diffusion capacity. |
| | |
Authors:
|
Yusuke Yamamoto; Perenlei Enkhbaatar; Hiroyuki Sakurai; Sebastian Rehberg; Sven Asmussen; Hiroshi Ito; Linda E Sousse; Robert A Cox; Donald J Deyo; Lillian D Traber; Maret G Traber; David N Herndon; Daniel L Traber |
Related Documents
:
|
23426814 - Higher dose of methimazole causes frequent adverse effects in the management of graves'... 11137414 - Continuous intravenous diclofenac does not induce opioid-sparing or improve analgesia i... 6352034 - A six-month parallel group comparison of fenbufen and naproxen in the treatment of rheu... 2525984 - Recent clinical experience with etodolac in the treatment of osteoarthritis of the knee. 21130044 - Midterm results for gastric banding as salvage procedure for patients with weight loss ... 22011274 - Is gastro-gastric fixation suture necessary ın laparoscopic adjustable gastric banding... |
Publication Detail:
|
Type: JOURNAL ARTICLE Date: 2012-3-27 |
Journal Detail:
|
Title: Burns : journal of the International Society for Burn Injuries Volume: - ISSN: 1879-1409 ISO Abbreviation: - Publication Date: 2012 Mar |
Date Detail:
|
Created Date: 2012-3-30 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8913178 Medline TA: Burns Country: - |
Other Details:
|
Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
|
Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved. |
Affiliation:
|
Department of Anesthesiology, Investigational Intensive Care Unit, The University of Texas Medical Branch, Shriners Burns Hospital for Children, 601 Harborside Drive, Galveston, TX 77555-1102, USA; Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, 8-1 Kawata-cho, Shinjuku-ku, Tokyo 162-8666, Japan. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: The Psen1-L166P-knock-in mutation leads to amyloid deposition in human wild-type amyloid precursor p...
Next Document: A burn center paradigm to fulfill deferred consent public disclosure and community consultation requ...