The introduction of intermingled allograft/autograft skin grafting in western countries has long been hampered by high costs, due to the personnel requirements to produce this special form of graft. We have solved this problem by designing and constructing a computer-controlled machine, which in one operation punches holes out of strips of allogeneic donor skin and in another cuts fitting islets out of autogenous skin and transfers them into these holes. In comparison to manual preparation, this machine not only accelerates the production of intermingled skin grafts, but it also inserts the islets with superior accuracy, which is very important for the final functional and cosmetic result.

Adult↗

PubMedDate not supplied

Use of Pseudomonas hyperimmunoglobulin to treat septic shock in burn cases.

The progress of 18 episodes of septic shock in nine patients with burn injuries after administration of a Pseudomonas immunoglobulin is presented. In nine instances the septic shock was treated successfully. The mean burn index of these nine patients was 96. In six of the nine patients the septic shock was accompanied by simultaneous inhalation trauma and in six by acute kidney failure. In four cases the sepsis was caused by P. aeruginosa and in five by staphylococci. Despite the different causative agents, successful treatment was possible in these cases. The mean burn index for the four patients who eventually died was 119; all patients in this group were suffering from an inhalation trauma and acute kidney failure requiring dialysis. In these cases even the use of Pseudomonas immunoglobulin had no decisive effect.

Adult↗

PubMedDate not supplied

Influence of severe burn injury on the expression of RM 3/1 and HLA-DR antigens in human blood monocytes.

The effect of severe burns on the expression of the glucocorticoid-inducible RM 3/1 and HLA-DR antigens in blood monocytes was studied in patients with less than or more than 50% total body surface area (TBSA) burned. All patients showed a strong increase in the portion of RM 3/1+ monocytes within 1 day after injury. In patients with more than 50% TBSA, RM 3/1+ cells decreased after 2 days; in those with less than 50% TBSA, cells decreased after 3 days HLA-DR+ monocytes decreased within 4 days in both groups. In patients with less than 50% TBSA, HLA-DR+ monocytes slowly increased thereafter to basic levels. In patients with more than 50% TBSA, HLA-DR+ monocytes further decreased, then slowly increased, however, did not reach basic levels. This long-lasting decrease was evidence in the nonsurvivors. These results show that severe burns differently affect monocyte antigens. The induction of the anti-inflammatory subtype RM 3/1 and the decrease of the immunoregulatory HLA-DR antigens may contribute to the immunosuppression observed after burn injury.

Adolescent↗

PubMedDate not supplied

[In-house radio-assisted emergency call system in continuous monitoring of microcirculation using laser doppler flowmetry].

Instrumental monitoring is being increasingly employed in the postoperative phase after microsurgery. For this purpose, laser Doppler flowmetry has proven to be very useful. Monitoring of the perfusion of tissue with blood is mainly by clinical examination, which, however, requires the physical presence of the observer, and this is generally not possible on a continuous basis. By connecting up a laser Doppler unit with a computer and telephone modem and making use of the in-house radio system, it proved possible to produce an automatic emergency call system that responds to a worsening of perfusion and alerts the responsible doctor. For this purpose, the software program "call-doc" was developed, which provides the necessary monitoring and control functions. A general perfusion-independent emergency call can also be triggered at the touch of a button.

Emergency Medical Service Communication Systems↗

PubMedDate not supplied

[Multilayer myoperitoneal epigastric flap for the repair of oral and maxillofacial defects].

The multilayer myoperitoneal epigastric flap is a modification of the myocutaneous rectus abdominis flap commonly used in reconstructive surgery. By means of the microsurgical transplantation of this graft, which is supplied via the caudal epigastric vessels, it is possible to simultaneously replace oral mucosa, subcutaneous soft tissue and skin in extensive and deep cheek defects. The present article describes both the basic results of experimental animal studies and the possible clinical applications. The author's experience is based on 8 grafts for large cheek defects.

Adult↗