Document Detail


Modulation of inflammatory and catabolic responses in severely burned children by early burn wound excision in the first 24 hours.
MedLine Citation:
PMID:  12578404     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
HYPOTHESIS: Early burn wound excision modulates the hypermetabolic response in severe pediatric burn injuries. DESIGN: Before-after trial. SETTING: A 30-bed burn referral center in a private, university-affiliated hospital. METHODS: We studied 35 severely burned children who were divided into 2 groups. One group (n = 20) was treated with early burn wound excision within 24 hours after the injury. The second group (n = 15) was treated conservatively with silver sulfadiazine in other burn facilities for 5 days, and burn wounds were surgically excised when patients were admitted to our burn center on day 6 after the injury. Data compiled included oxygen consumption and acute-phase protein, interleukin 1beta; interleukin 6, interleukin 10, tumor necrosis factor alpha, and anabolic hormone (growth hormone, insulinlike growth factor type 1) levels preoperatively and 24 hours and 5 days postoperatively. MAIN OUTCOME MEASURES: Acute-phase and hypermetabolic responses. RESULTS: Early burn wound excision abrogated the hypermetabolic response in pediatric burn patients. Patients who underwent conservative treatment had a significantly more severe inflammatory and hypermetabolic response at the same time interval and significantly lower levels of anabolic hormones. CONCLUSIONS: Early burn wound excision is a safe therapeutic approach that modulates the hypermetabolic response after burn injury. It was superior to the conservative treatment of silver sulfadiazine and delayed excision, and it should be considered when treating all severe full-thickness burns.
Authors:
Juan P Barret; David N Herndon
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Archives of surgery (Chicago, Ill. : 1960)     Volume:  138     ISSN:  0004-0010     ISO Abbreviation:  Arch Surg     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-02-11     Completed Date:  2003-04-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9716528     Medline TA:  Arch Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  127-32     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, University of Texas Medical Branch, and Galveston Shriners Hospital, Galveston, USA. bconsjb@meht.nhs.uk
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MeSH Terms
Descriptor/Qualifier:
Acute-Phase Reaction
Burn Units
Burns / metabolism,  surgery*,  therapy
Case-Control Studies
Child
Cytokines / blood
Female
Growth Hormone / blood
Humans
Insulin-Like Growth Factor Binding Protein 3 / blood
Insulin-Like Growth Factor I / metabolism
Male
Oxygen Consumption
Silver Sulfadiazine / administration & dosage
Time Factors
Chemical
Reg. No./Substance:
0/Cytokines; 0/Insulin-Like Growth Factor Binding Protein 3; 22199-08-2/Silver Sulfadiazine; 67763-96-6/Insulin-Like Growth Factor I; 9002-72-6/Growth Hormone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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