Search PubMed⌕ Search

Biomedical subjects

C B Cuono

Publications and source records attributed to C B Cuono.

46 records · Page 3Linked to original sources
PubMedDate not supplied

Myocutaneous flaps for head and neck reconstruction.

The recent development of myocutaneous flaps has ushered in an era of one-stage reconstructions, which have changed the patterns of surgery for head and neck cancer. This article reviews the development of these flaps and the clinical applications at various sites of the head and neck. Personal experience with 31 consecutive myocutaneous flaps confirms the versatility and reliability of these new techniques.

Head and Neck Neoplasms↗
PubMedDate not supplied

The role of topical treatment as a determinant of infection in outpatient burns.

Up to 95% of all burned patients are treated as outpatients. While uniform guidelines exist to evaluate the severity of an outpatient's burn, treatment forms vary greatly. Furthermore, the relative merits of one treatment modality over another have not been demonstrated. This study reviews 262 patients with uncomplicated, thermal partial-thickness burns. All of these patients were treated with either a petrolatum fine-mesh gauze (FMG = 102), a topical penetrating antibacterial agent (TPA = 58), or a topical nonpenetrating antibacterial agent (TNA = 102). The size of the injury along with its location and etiology, the age of the patient, the time from injury to treatment, and comorbid factors were comparable among the major treatment groups. On follow-up, a wound was classified as infected if it exhibited erythema, tenderness, increased warmth, and edema (cellulitis). Infection rates were 2.0% (2/102) in the FMG group, 5.2% (3/58) in the TPA group, and 2.0% (2/102) in the TNA group. The differences among the rates did not reach statistical significance (P = 0.41). Given the cost of treatment, frequency of dressing changes and overall patient comfort, we advocate FMG as the optimal method for the care of uncomplicated partial-thickness outpatient burns.

Administration, Topical↗
PubMedDate not supplied

Immunologic alterations following excisional wounding and immediate repair with syngeneic or allogeneic skin grafts.

Immunosuppression and its associated infectious complications have long been recognized as consequences of major thermal trauma, though the factors that mediate this suppression remain unclear. A murine split-thickness skin graft model was developed to investigate the role of a large surface area wound in the initiation of immunosuppression in the absence of burn injury. Significant T cell-mediated immunosuppression was demonstrated following wounding and immediate repair with either syngeneic or allogeneic split-thickness skin grafts. These results are consistent with previous experiments in a murine burn model treated by escharectomy and resurfacing with syngeneic composite full-thickness skin. Data also supports the concept that mediators of inflammation at the wound site play an important role in postburn immunosuppression. Furthermore, these results suggest that the use of skin allografts during the early postburn period does not adversely affect cell-mediated immunity in any way that could be abrogated by primary autografting.

Animals↗
PubMedDate not supplied

A reliable and cost-effective in vitro assay of skin viability for skin banks and burn centers.

The tetrazolium salt, MTT (3-[4,5-Dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide), was used to evaluate the viability of fresh native human skin and cryopreserved human skin under a wide variety of conditions. Viability of fresh and cryopreserved skin was determined with our modification of the MTT assay, and compared with the well-described tetrazolium reductase assay. The MTT assay provides a precise and reproducible index of viability for both fresh and cryopreserved skin. In comparison, the tetrazolium reductase assay (1) is subject to higher levels of variability and, (2) underestimates the viability of fresh native skin. The precision, simplicity, and economy of the MTT assay support its utility in the routine assessment of skin viability in skin banks, burn centers, and skin biology research units.

Burn Units↗
PubMedDate not supplied

Effects of cryopreservation and deconstruction on the dermal glycosaminoglycan content of human skin.

Since the concept of a fabricated skin replacement was first proposed, it has been recognized that a permanent skin replacement must contain a functional complex structure consisting of epidermis integrated with dermis. Although a practical solution for the replacement of missing epidermis exists through the culture expansion of the autologous epidermis, a practical solution for permanently replacing missing dermis has not been achieved. While it is generally recognized that the insoluble matrix components--largely collagen and elastin--are essential, the role of other matrix components such as glycosaminoglycans (GAGs) and proteoglycans remains undefined. This article describes both the qualitative and quantitative GAG composition of fresh and cryopreserved human dermis. Through the use of 2 different colorimetric assays and cellulose acetate electrophoresis, we found the following: 1) the principal dermal GAGs are those of the heparin family; 2) dermatan sulfate is the second most predominant GAG component; 3) chondroitin-6-sulfate is found at concentrations of 2 orders of magnitude less than the heparins; and 4) hyaluronan and keratan sulfate were both found as only minor constituents. When the GAG composition of fresh skin was compared with that of cryopreserved skin, no significant differences were observed. This study also examined the time course of GAG leaching during the preparation of deconstructed human dermis, which is human dermis reduced to the native insoluble matrix components by exhaustive saline soaking. We found that GAG leaching was readily detectable even within the first day. Sixty percent of total GAG leaching occurred by day 7. These investigations establish a benchmark for the reproduction of GAGs in synthetic dermal constructs. Further, the results of the leaching study generate important considerations for short-term skin storage and long-term skin banking. Because GAG leaching commences immediately, appropriate precautions must be taken to minimize the potential functional compromise of cryopreserved human dermis.

Cadaver↗
PubMedDate not supplied

The burn camp experience: variables that influence the enhancement of self-esteem.

Since 1982, there have been summer camps for children and adolescent burn survivors. Although the primary focus of camp is to have "fun," the principal goal is psychosocial readjustment through peer interactions and the resulting enhancement of self-esteem (SE). This study was initiated to test the hypothesis that the burn camp experience enhances the SE of campers. Forty-three campers at the Connecticut Burns Care Foundation Summer Camp were invited to participate in this study with the Rosenberg Self-Esteem Scale. The age range was 8 to 18 years (mean 12 years). The extent of previous burn injury ranged from 10% to 98% total body surface area (mean 40%). The interval between hospital discharge and camp experience was 4 to 144 months (mean 54 months). Thirty-seven percent of the children demonstrated an increase in SE to varying degrees, whereas 30% showed no change, and 3% exhibited a decrease in SE. This study failed to support the working hypothesis.

Adolescent↗