RESUMO
The color of restored skin (RS) resulting from healing of partial skin thickness burns was analyzed. Comparisons within symmetric skin areas were performed between RS and healthy undamaged skin (HS), using spectrophotometry, in 118 subjects, 64 males, 54 females with an age range of 1-70 years. A total of 379 samples were analyzed. The CIE-1976 color system was adopted where L*, a* and b*, characterizes the sample color. L*, a* and b* values from restored and healthy skin were obtained and differences between them calculated. Age, sex, sun exposure and time span after burn were taken into account and the data was submitted to statistical analysis: Wilcoxon test for age and chi 2 for other variables. RS became darker: one year after the original burn; in subjects with sun exposure and in older subjects. Sex did not show any influence on brightness index. RS became more red in subjects with sun exposure; in older subjects; within the first six months after the burn. Sex did not show any influence on a* chromaticity axis. RS became more blue: in male subjects and within one year after the burn. Age and sun exposure did not yield any influence on b* chromaticity axis.
Assuntos
Queimaduras/patologia , Pele/patologia , Cicatrização , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , Cor , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Pigmentação da Pele , Espectrofotometria , Fatores de TempoRESUMO
Myofibroblasts and the contraction of split skin-graft donor sites were studied in 18 patients. For each patient five samples were studied, taken on days 0, 14, 21, 28, and 35. On each occasion the extensions and densities of myofibroblasts were calculated. After the initial measurement, the subsequent extensions were expressed in percentages of the first, resulting in mean measurements of 100, 95, 97, 99, and 99%, respectively. The myofibroblasts in 10 dermic fields were counted under light microscopy at a magnification of 1000 marked with anti-alpha-smooth muscle actin antibodies using immunoperoxidase, resulting in the means of 0.2, 3.8, 1.3, 1.3, and 0.4, respectively. The contraction and the increase in density of myofibroblasts were transitory and significant in the samples measured on day 14, but in sample 35 neither of the variables was significantly different from the initial sample. These variables evolved concurrently, corroborating the hypothesis that myofibroblasts are responsible for the contraction.
Assuntos
Transplante de Pele/patologia , Pele/patologia , Cicatrização , Contagem de Células , Fibroblastos/patologia , HumanosRESUMO
First the authors conceptualized healed burns, the tegument resulting from the healing of burns (TRH), and the 4 main species of teguments: 1--Regenerated skin; 2--Restored skin; 3--Grafts and 4--Scars. One hundred patients at the Unit Burn from the Division of Plastic Surgery, Faculty of Medicine, University of São Paulo, Brazil, were then studied prospectively, and the respective teguments which resulted from the healing of the burns were analyzed in their qualitative and quantitative aspects. From the qualitative point of view, TRHs were classified into 7 types. The extensions of the species which comprised each type were calculated as a % of the TRH. From this analysis it was seen that restored skin was present in all patients and that pos-burn restored skin was the most frequent and most extensive species. It also became evident that restored skin has not been considered as such, since it has been incorrectly referred to as scar. From this qualitative and quantitative analysis a Quality Index was drawn up to objectively evaluate healed burns and, indirectly the caliber of the treatment carried out. It also become clear how heterogeneous are the teguments that make up healed burns and the importance of this fact for treating patients.
Assuntos
Queimaduras/patologia , Cicatriz/patologia , Pele/patologia , Cicatrização/fisiologia , Adolescente , Adulto , Fatores Etários , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores SexuaisRESUMO
The authors studied the local treatment of burns in 11045 cases: 6063 (54.9%) were treated without topical antibacterials and 4985 (45.1%) with antibacterial agents. In 62.1% of cases the topical antibacterial treatment was done mainly in the hospital ward (69.5%) while the treatment without topical medication was mostly performed in the operating room. The use of topical antibacterials was studied during eight years, from 1985 to 1992. In the earlier periods the justifications were not related to burn wound sepsis. In the recent years the topical antibacterials were used chiefly for the treatment and prophylaxis of wound infection (96.8% of cases).
Assuntos
Anti-Infecciosos Locais/uso terapêutico , Queimaduras/tratamento farmacológico , Infecção dos Ferimentos/prevenção & controle , Humanos , Estudos Retrospectivos , Fatores de TempoRESUMO
Classification of skin grafting in use at the Division of Plastic Surgery and Burns of the São Paulo University for 16 years is presented. It is based on the type and way of the wound coverage from which the esthetic results essentially depend. This classification takes in consideration whether the healing at the receptor site should be or not by second intention or by the limitation of the healing through the reduction of the epithelialization time.
Assuntos
Transplante de Pele/classificação , Brasil , Humanos , Terminologia como AssuntoRESUMO
Os autores estudaram a retracao primaria dos enxertos de pele relacionando-a com a espessura dos mesmos e a distencao da area doadora, apos a excisao dos enxertos, relacionando-a com a espessura da derme residual. Foram estudados dez areas doadoras e os respectivos enxertos. A espessura media dos enxertos estudados foi 318,0 micra que corresponde a 20,0 por cento da pele doadora. A retracao primaria desses enxertos foi 17,6 por cento da area doadora. Os autores compararam os resultados com aqueles obtidos por Davis e Ketowsk, salientando as diferencas entre os metodos utilizados nos dois trabalhos. A espessura media da derme residual das areas doadoras logo apos a excisao dos enxertos foi 1.287,0 micra que corresponde a 85,2 por cento da espessura media da derme reticular da pele doadora. A distencao da area doadora apos a retirada do enxerto foi de 2,1 por cento da original.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Transplante de Pele/métodos , Epiderme/cirurgia , Epiderme/transplanteRESUMO
In ten patients a study of skin grafts and of the changes that occurred in the donor area was carried out: the primary retraction of the grafts in relation to their thickness was determined as well as the distension of the donor area of the graft after the excision of the same and comparison of it's thickness with that of the residual skin. The average thickness of the grafts was 318.0 micra, which corresponded to 20% of the donor skin. The primary retraction was 17.6%. The mean thickness of the residual skin at the donor area was 1,287.0 micra or 85.2% of the mean thickness of the reticular derma: the distension of the donor skin area after the removal of the graft corresponded to 2.1% of the original size.