456 Bums (1993) 19, (5), 456-457 Printed in Great Brituin

Abstracts

CLINICAL STUDIES

Cultured keratinocyte allografts induce more rapid healing of skin graft donor sites Half of the area of each human skin graft donor site in 10 patients was covered with cultured human allogeneic keratinocytes and then the whole donor site was covered with Biobrane. Wound inspections were carried out at 5, 7, 9, 11, 14, 17, 20 and 23 days after the ‘dressings’ had been applied. Biopsies of both halves of the healing wounds were taken at 7 days for light and electron microscopy.

The average time to healing for the sites that had been covered with keratinocytes was 6.6 f 1.96 days which should be compared with the healing time beneath the Biobrane of 12.6 f 4.32 days (PC 0.002). By 7 days most of the keratinocyte-covered sites showed complete epithelial cell cover with the formation of a basement membrane and hemidesmosomes at the epidermal- dermal junction; in contrast the Biobrane-covered areas were unhealed without epithelial cell cover.

The re-epithelialized donor sites, which had received keratino- cyte cover, were reharvested and formed successful grafts which ‘took as effectively as grafts taken from donor sites that had not been harvested before.

Fratianne R., Papay F., Housini I. et al. (1993) Keratinocyte allografts accelerate healing of split thickness donor sites: applica- tions for improved treatment of bums. 1. Burn Care Rehbil. 14, (2), 148-154.

Brain and auditory damage after electrical injury Comparisons were made between 48 patients with electric current injuries and 53 patients who were injured by flash, arcing or contact electrical injuries that did not involve the passage of electricity through the body.

Three-quarters of the patients with electric current injuries showed neurobehavioural (organic) dysfunction 1 year after injury implying brain damage and half showed persistent auditory changes. In contrast none of the patients whose electrical injuries did not involve the passage of electric current through the body showed neurobehavioural or auditory dysfunction.

Grossman A. R., Tempereau C. E., Brones M. F. et al. (1993) Auditory and neuropsychiatric behaviour patterns after electrical injury. 1, Btim Care Rehdd. 14, (2) 169-175.

Heat production by fatal and non-fatal burns Sixteen patients with moderately extensive bums developed hypothermia ( < 35°C) during an extensive series of operations. Eight patients survived, eight patients died. Postoperatively the rate of rise of body temperature was significantly lower in the non-survivors, primarily as a result of a decreased rate of heat production rather than increased heat losses. The measured energy production was only 1.7 times basal in the non-survivors

0 1993 Butterworth-Heinemann Ltd 0305-4179/93/05045&02

compared with 2.7 times basal in the survivors. In the non- survivors the lower heat production persisted until death.

Shiozaki T., Kishikawa M., Hiraide A. et al. (1993) Recovery from post operative hypothermia predicts survival in extensively burned patients. Am. 1. Surg. 165, (3), 326331.

Benefits of 5 per cent mafenide acetate solution Mafenide acetate solution (5 per cent) was used as a topical antibacterial application for bum wounds. With this solution (in contrast to the 10 per cent cream) acid base derangements did not occur. Discontinuation of therapy because of pain was necessary in only 2.5 per cent of patients (17/669). The incidence of rashes and pruritis was extremely low. Effective antibacterial activity was achieved.

Kucan J. 0. and Smoot E. C. (1993) Five per cent mafenide acetate solution in the treatment of thermal injuries. 1. Bwn Care Rekabil. 14, (2), 158-163.

ANIMAL STUDIES

Immunological benefits of giving dehydroepiandro- sterone Mice with deep bums covering 20 per cent TBSA were treated with 100 pg of dehydroepiandrosterone 1 h after injury and showed a completely normal capacity to produce T-cell-derived lymphokines and to generate cellular immune responses. Such treatment also induced an above normal ability to resist an induced infection with Lisferiu monocyfogenes and prevented the development of sustained plasma levels of interleukin-6 that normally accompany thermal injury and infection.

Araneo B. A., Shelby J., Li G. Z. et al. (1993) Administration of dehydroepiandrosterone to burned mice preserves normal immunologic competence. Arch. Surg. 128, (3) 318-325.

New fibroblast proliferation inhibitor A monokine has been isolated from rabbit macrophages that, in vitro, inhibited rabbit conjunctival fibroblast proliferation by 85 per cent; it inhibited human conjunctival fibroblast proliferation by 88 per cent, it inhibited human hypertrophic scar fibroblast proliferation by 85 per cent and inhibited human keloid fibroblast proliferation by 79 per cent. In vivo injection of this monokne into healing rabbit wounds inhibited fibroblast proliferation by 33 per cent after 7 days and by 27 per cent after 2 weeks. This monokine was produced by macrophages largely during the first 2 days of culture and was not species specific. It has a molecular weight of 3000 Da, is resistant to degradation by trypsin and carboxypep- tidase A and is heat stable.

Concannon M. J., Barrett B. B., Adelstein E. H. et al. (1993) The