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Biomedical subjects

C G Ward

Publications and source records attributed to C G Ward.

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

Biodebridement: a case report of maggot therapy for limb salvage after fourth-degree burns.

The wound healing and antimicrobial properties of maggots are well known. Maggot debridement therapy has been used for the treatment of various conditions. For maggot debridement therapy, the larvae of the blowfly are applied over necrotic or nonhealing wounds. We used maggot debridement therapy with the larvae of Phaenicia sericata for limb salvage after bilateral lower extremity fourth-degree burns.

Adult↗
PubMedDate not supplied

Burns in school-age children: demographics and burn prevention.

Epidemiologic and demographic study of burn center patients and admission patterns can be useful in tailoring burn prevention programs. Such studies can pinpoint specific high-risk areas and seasons, thus allowing more efficient expenditure of resources.

Adolescent↗
PubMedDate not supplied

Self-inflicted burns.

Suicide by self-inflicted burns is uncommon in Western cultures. The majority of patients who attempt suicide in this manner have preexisting psychiatric illness, including a history of prior suicide attempts. A history of previous self-inflicted burn is rare, however, as are further suicide attempts in survivors. In this series of 33 patients, a cultural trend can be identified, with an increased incidence among Latin women.

Adolescent↗
PubMedDate not supplied

The occurrence of acquired immunodeficiency syndrome and unsuspected human immunodeficiency virus in burn patients.

Although the risk of nosocomial transmission of human immunodeficiency virus remains low, burn center personnel may be at greater risk. Approximately 10% of burn patients admitted to an urban center were found to be positive to the human immunodeficiency virus, consistent with other findings of increased prevalence in trauma patients. "Universal" precautions adequate for other health care settings may not be sufficient in the burn center. Knowledge of a patient's human immunodeficiency virus status has important treatment implications.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

The bactericidal power of the blood and plasma of patients with burns.

Patients with burns are unusually susceptible to bacterial infections, but so far there is no satisfactory explanation for this lack of resistance. Since resistance to infection involves many different mechanisms, examination of individual components of the immune system may not sufficiently explain the underlying reasons for increased susceptibility. The use of whole blood for antibacterial tests has the advantage that all the immune systems present in that fluid compartment can take part in the bactericidal effect. Tests with Klebsiella pneumoniae and Staphylococcus aureus showed no evidence that the bactericidal power of the blood and plasma of patients with burns was less than that of normal control plasma. This suggests that the solution to the problem of increased susceptibility to infection in patients with burns does not lie with the blood but must be looked for elsewhere.

Blood Bactericidal Activity↗
PubMedDate not supplied

Bacterial virulence and host selection: bacteria "select" patients to infect.

A clinically lethal strain of Pseudomonas aeruginosa was tested and its growth patterns in normal plasma and in normal whole blood clotted with thrombin were compared. Two stock cultures were used; one was maintained in liquid nitrogen and one was passed from plate to plate 24 times on blood agar plates at room temperature. The results showed that plasma alone and whole blood controlled the growth of a clinically pathogenic strain of P. aeruginosa consistently and uniquely for each donor, dependent on size of inoculum, length of incubation, and means by which the culture was maintained. The changing virulence of an organism and its unique growth patterns in different individuals' plasma and whole blood may explain why patients exposed to the same organisms within the same environment vary in susceptibility to clinical infection.

Burns↗
PubMedDate not supplied

The relationship of burn wound fluid to serum creatinine and creatinine clearance.

A case is presented with emphasis on creatinine clearance and burn wound closure. It suggests that the burn wound acts as an extrarenal site for creatinine loss. As a result, renal creatinine clearance may be falsely elevated while the burn wound is open, and closure of the burn wound may affect creatinine clearance.

Adult↗
PubMedDate not supplied

Comparison of length of hospital stay to mortality rate in a regional burn center.

Data were collected prospectively from 196 patients admitted to our regional burn center during a 10-month period. Fifteen patients died during hospitalization, for a mortality rate of 7.7%. The mean hospital stay of the 181 patients who survived was 13.9 days (+/- 13.7 SD), ranging from 2 to 89 days. The mean burn size was 9.2% (+/- 11% SD), ranging from 0.5% to 60% total body surface area. One hundred ten patients received at least 1 day of antibiotic treatment, and 22 patients required ventilatory support during hospitalization. Hospital stay was longer for those requiring antibiotics (18.6 days vs 7 days) or ventilatory support (34.4 days vs 11.2 days). When these and other variables were entered into a linear regression model, the most powerful predictors of hospital stay were burn size and duration of antibiotic use (p = 0.0001), followed next by the presence of other traumatic injuries (p = 0.047).

Adolescent↗
PubMedDate not supplied

"The die is cast": telling patients they are going to die.

The decision not to resuscitate a patient with burns is an issue of concern, with advocates both for and against. Most patients have not had previous experience with major burn injuries. It is therefore unreasonable to expect them or their families to act from a position of knowledge. There is a subset of patients considered for "do not resuscitate" orders who are nonsurvivors. If the outcome is predictable, the responsibility of the burn team is to inform patients and their families. Such discussion should come within the first few hours of admission, when the patient is fully awake and able to understand, to respond, and to make plans.

Attitude to Death↗
PubMedDate not supplied

Iron and immunologic function.

This short review focuses on the immunological functions of iron-containing compounds. Five such compounds--transferrin, haptoglobin, hemopexin, albumin, and lactoferrin--are thought to contribute to normal infection resistance. Experimental results that demonstrate the ability of these compounds to inhibit the growth of an important pathogen, Klebsiella pneumoniae, are discussed.

Albumins↗