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Biomedical subjects

R Reddy

Publications and source records attributed to R Reddy.

278 records · Page 16Linked to original sources

Sensory loss over grafted areas in patients with burns.

We studied loss of cutaneous sensibility after grafting in 60 patients with burns who had applied for impairment assessment. Fifty-eight patients (97%) demonstrated markedly diminished or absent responses to sharp/dull, hot/cold, and light touch stimuli over grafted areas. However, all but one patient had intact perception over donor areas and over areas of healed (ungrafted) partial-thickness burns. Deep touch sensation was intact over both grafted and ungrafted areas in all patients. Loss of sensation was not related to patient age, burn size, or type of burn; nor did sensory loss correlate with the impairment rating received. Depth of burn injury appears to be the best predictor of altered sensation, and some abnormalities in patients appear inevitable after skin grafting. Patients should be counseled about possible outcomes. However, the decrease in sensation that was observed rarely contributed significantly to the long-term impairment rating of these burn victims.

Adult↗

Grease burns at fast-food restaurants. Adolescents at risk.

Intermountain Burn Center and Utah State Insurance Fund industrial records were reviewed to determine the incidence and consequences of grease burns among teenagers employed at fast-food restaurants. Burn center records reveal that 10 patients were admitted between 1977 and 1985, and that nine patients required surgery with mean burn care costs of $7389 per patient. State Insurance Fund records demonstrate that 81 grease-burn injuries were reported from 1982 through 1985, at an average burn care cost of $660 per patient. Causes of burn wounds included adding, filtering, or removing hot grease, dropping objects into hot grease, slipping on the floor, cleaning the grill or fryer, and splashing hot grease during cooking. Those treated as outpatients were off from work for as long as 10 days. These data identify an adolescent population at risk for work-related burn injury in fast-food restaurants.

Accidents, Occupational↗

A technique for control of hypertrophic scarring in the central region of the face.

Various methods are available for applying pressure to the central portion of the face to reduce hypertrophic scarring after burn injury. Our center uses an elastomer insert with a thermoplastic backing, which is formed over a plaster mold of the patient's face. The insert is worn under a traditional anti-burn scar face mask. We reviewed the records of 26 patients with hypertrophic scarring to the central portion of the face to assess the effectiveness of the insert. Seventeen (65%) of these patients wore the insert until scar maturation. Three of these 17 patients later required reconstructive surgery of the central face. Our findings suggest that pressure to this part of the face may be effective in decreasing hypertrophic scar formation. The insert described in this article is inexpensive and relatively easy to fabricate.

Burns↗

Evaluation of topical therapeutic ultrasound to improve response to physical therapy and lessen scar contracture after burn injury.

This study compared results of patients who received standard burn physical therapy and topical ultrasound with patients who received standard care alone to investigate the effect of topical therapeutic ultrasound on range of motion and pain in patients with burns. Fourteen burned extremities were studied. Eight joints were randomized to treatment with ultrasound followed by 10 minutes of passive stretching. Six joints received placebo ultrasound treatments and stretching. All treatments were performed every other day throughout a 2-week study period. Joint range of motion was measured before and after each treatment, and patients estimated the pain of the procedure. Patients and therapists were blinded to the treatment group. Analysis of the data revealed no differences in range of motion or perceived pain between the two groups. The effect of ultrasound on range of motion and pain was not predictable. We conclude that patients are not likely to improve from ultrasound treatment at our protocol parameters.

Adult↗

Uses of Coban self-adherent wrap in management of postburn hand grafts: case reports.

Coban wrap is a durable, elastic, self-adherent gauze that applies snugly without loosening. Coban does not stick to underlying tissue, making it excellent for early postoperative management of split- and full-thickness hand grafts. The wrap protects new grafts and decreases postoperative edema, permitting earlier mobility and facilitating accurate measurements for fitting of pressure garments. Wounds are judged suitable for Coban when the grafts are largely adherent and vascularized. Coban can be wrapped (1) directly over the graft, (2) over an ointment/adaptic dressing, or (3) over gauze padding for extra protection, or use as a "soft splint." Because of its inherent elasticity, Coban can be used to passively encourage desirable joint positions. The wrap is changed daily, and family members readily learn its use. Coban appears to encourage early, protected, active range of motion and early use of custom-fit pressure garments.

Adult↗

Effect of 3M Coban Self-Adherent Wraps on edema and function of the burned hand: a case study.

Edema and limited function are common acute problems associated with hand burns. This case study examined the effects of 3M Coban Self-Adherent Wraps on edema and function in a 59-year-old male (46% TBSA flame injury) with newly skin grafted dorsally burned hands. At the time of each dressing change, circumferential measurements were taken of both hands and weekly active range of motion and grip strength measurements were recorded. The nine-hole peg test was used to appraise dexterity. During the 4-week study period, there was less edema, greater active range of motion and grip strength, and greater dexterity in the hand with 3M Coban Self-Adherent Wraps as compared with the control hand. This case study suggests that 3M Coban Self-Adherent Wraps were effective in reducing edema in the skin-grafted hand after skin grafting. It further appeared that the reduced edema may have contributed to improved hand function and that 3M Coban Self-Adherent Wraps as a compressive dressing do not impede hand function

Burns↗

Acute upper airway obstruction in infants and children. Evaluation by the fiberoptic bronchoscope.

All infants and children seen by the pediatric pulmonary service who display symptoms of upper airway obstruction undergo transnasal fiberoptic evaluation with the 3.2 mm flexible instrument. The procedure enables the observer to immediately visualize the nasopharynx, supraglottic, glottic and subglottic structures. Instrumentation is done in the sitting upright position and takes the skilled observer about 20 seconds to perform. The differentiation of epiglottitis from subglottic croup, foreign body aspiration and other less common causes of airway obstruction is easily performed and well tolerated. The fiberoptic instrument is often utilized both as a diagnostic and therapeutic tool. It can be utilized to intubate cases of epiglottitis and to evaluate the epiglottis to determine the appropriate time for extubation. This procedure is superior to oral airway examination because it does not distort airway anatomy, can be performed in the upright position, and does not further exacerbate airway obstruction.

Adolescent↗

Cancer mortality and the method of chlorination of public drinking water: St. Louis City and St. Louis County, Missouri.

St. Louis City and St. Louis County, Missouri share the same public drinking water source, namely the Missouri River. The 'all cancer' and most organ specific cancer mortality rates have been consistently and considerably higher for St. Louis City than for St. Louis County for the period 1960 through 1972. A change in the St. Louis County water treatment process, which included increasing the chlorine dosage and delaying the addition of ammonia to form chloramines until just prior to distribution, was instituted in 1955. St. Louis City has, by contrast, continued the lower chlorine level and early ammoniation. Trend analysis using the period 1960-67 and 1972-76 showed higher percentage as well as net cancer mortality rate per million increases for large bowel, liver and bladder cancers for St. Louis County. An apparent association between a probable increase in trihalomethane production in the St. Louis County water since 1955 and an increase in these specific cancer rates which exceed the increases in the St. Louis City rates appears to have been shown. This does not imply causality but is in general agreement with other studies which have examined water chlorination and cancer mortality.

Adult↗