Skin substitute may permit more 'natural' burn healing.
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Sixty general surgical cases in a district hospital had skin closure accomplished with an adhesive membrance device (Op-site, Smith and Nephew). The technique of application is described. Thirteen cases had minor wound complications. It was found that the device was not applicable to all skin wounds, had some limitations in vertical wound closure, was comparable in price with skin sutures, usually gave good cosmetic results especially in transverse wounds, and as it could be removed by the patient, avoided problems of suture removal after discharge from hospital.
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Cutaneous ulcers associated with Hansen's disease have long been recognized as among the most indolent of all ulcers. We have successfully treated such ulcers with porcine xenograft, achieving healing in ulcers which had been present for as much as three decades. These results suggest that this regimen may be applicable to other cutaneous ulcers wherever skin is missing. The newly available antibacterial effects of silver-impregnated porcine xenografts should have the result of increasing the effectiveness of the treatment still further.
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The United States leads industrialized nations in per capita fire deaths. The most recent U.S. statistics are from 1978. Two hundred thousand burn and inhalation injuries, 70,000 hospitalizations, and 12,000 deaths occurred that year [56]. Burn care has traditionally been the general surgeon's responsibility. However, the interest and commitment of plastic and reconstructive surgeons has increased considerably over the past fifteen years. During this time, major advancements have occurred in five areas: assessment, resuscitation, control of burn wound sepsis, wound closure, and burn team management.
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