ewma 2014 - ep386 wound coverage in patients with dermal burns

WOUND COVERAGE IN PATIENTS WITH DERMAL BURNS

Kovalenko O.M., Kovalenko A.O., Osadcha O.I.

Aim: to study effectiveness of treatment dermal burn wounds under the covers.

Methods: 95 patients with superficial dermal burn 5-30% TBSA aged 5-55 years were examined during 2009-2013. 60 patients were selected for study group. Their wounds were treated under wound covers in humid environment (hydrogel coating, spongy polyurethane, film coating). The control group consisted of 35 patients. Treatment of them wounds was conducted with wet antiseptic solution bandages or hyperosmolar antibacterial ointments. Were used the clinical, immunological, cytological and bacteriological methods of research.

National Medical University by O.O.Bogomolets, Ukraine, Kyiv

EP386Acute Wounds

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Hydrocolloid, sponge dressings allows removing dermal necrosis in a large area due to the active sorption wound allocation. Bacteriological control showed high antibacterial activity in the study group to pathogenic bacteria. Level bacterial contamination of wounds patients study group decreased from 104 CFU/g to 102-103 CFU/g.


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Indicators cytolytic activity of serum and its fractions in patients with burn wounds

in a wet environment on 8-10 days after injury

Most of the surface of the necrotic tissue was removed and melted with hydrogel coating after 7 days of dressing. Autolizys superficial necrosis occurred in wounds in a wet environment.


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Cytolytic activity of blood serum decreased by 15%, and performance albumin fraction by 18%. It reduces the level of endogenous intoxication.

Changes of inflammatory response wounds in a wet environment

Type of inflammatory

reaction

Time after injury

3-5 day 7-9 day 13-15 day 17-21 day

main group

compar.group

main group

compar.group

main group

compar.group

main group

compar.group

Degenerative-inflammatory

11,11% 58,82% – 17,64% – 11,76% – –

Inflammatory 38,89% 41,18% 11,11% 58,84% – 29,42% _ 5,88%

Inflammatory- regenerative

44,44% – 22,22% 11,76% 11,11% 41,17% 5,56% 41,18%

Regenerative 5,56% – 66,66% 11,76% 88,89% 17,65% 94,44% 52,94%66,66

44,44

Cytological studies has shown quick changing phases of wound healing in patients of basic group took place. Degenerative and degenerative-inflammatory types of wound healing have changed rapidly in the most favourable inflammatory and regenerative-inflammatory type.

88,89


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Conclusion:

1. Wound cover that keep the wound moist is an effective way to influence the wound process, which may be adjusted.2. Maintain a moist wound in a closed chamber changes the qualitative and quantitative composition of microflora of wounds, reduces microbial contamination of burn wounds, prevents re-infection, replaces strains pathogenic to opportunistic.3. Moist environment for wound does not enhances the level of endogenous intoxication, but rather improves the course of burn disease.


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