Moderate and deep sedation can effectively relieve or eliminate the pain and body discomfort during wound dressing change in pediatric burn patients, relieve anxiety, agitation, and even delirium of the children, reduce the metabolic rate of the children, make them in a quiet, comfortable, and cooperative state, which is conducive to the smooth completion of dressing change. This paper summarized the three aspects of moderate and deep sedation in pediatric burn patients, including the overview, main points of implementation, and effects, and further introduced the moderate and deep sedation medication regimens for different routes of administration, as well as the content of evaluation and monitoring. Suggestions on the prevention and management of related complications and the management of moderate and deep sedation implementation procedures were put forward, in order to provide references for the development of moderate and deep sedation for wound dressing change in pediatric burn patients in China.
Child ; Humans ; Bandages/adverse effects* ; Burns/therapy* ; Deep Sedation ; Pain/complications* ; Pain Management/methods*

OBJECTIVETo investigate the therapeutic effect of nanometer silver impregnated dressing on gunshot wounds after being immersed in brine and tapwater in rabbits.

METHODSRabbits were randomly divided into two groups after receiving gunshot wounds in both lower limbs. In group 1, the wounded limbs on the experimental side were immersed in brine for 5 h; in group 2, the wounded limbs on experimental side were immersed in tapwater for 5 h. All the wounds were treated with nanometer silver impregnated dressing on the experimental sides, while those of the control sides were treated with vaseline dressing. Biopsy was done after 30 min and 1, 2, 3, 4, 5 h, respectively.

RESULTSIn group 1, the onset of inflammation around the wounds of the experimental sides was delayed, the inflammatory response was less serious, and the wounds were dry with less exudation compared to the controls. The mean healing time of the entry wounds on experimental and control sides was (29.4 +/- 6.6) d and (36.3 +/- 6.0) d (P < 0.01), respectively, and that of the exit wounds on experimental and control sides was (20.1 +/- 6.0) d and (27.3 +/- 5.7) d (P < 0.01), respectively. In group 2, only one of the experimental wounds showed mild inflammation, while all of the control wounds showed serious inflammation with much exudation. The mean healing time of the entry wounds on experimentsides was (13.0 +/- 1.52) d, while that on control sides was (16.0 +/- 3.10) d (P < 0.01). The mean healing time of exit wounds on experimental sides was (11.0 +/- 2.75) d, and those of the control sides was (15.6 +/- 2.85) d (P < 0.01).

CONCLUSIONThe nanometer silver impregnated dressing can control infection and accelerate healing in gunshot wounds in rabbits.

Animals ; Bacterial Infections ; etiology ; prevention & control ; Bandages ; Female ; Immersion ; Male ; Models, Animal ; Nanotechnology ; Rabbits ; Random Allocation ; Salts ; adverse effects ; Seawater ; adverse effects ; Silver ; pharmacology ; therapeutic use ; Treatment Outcome ; Water ; adverse effects ; Wound Healing ; drug effects ; Wounds, Gunshot ; microbiology ; pathology ; therapy

BACKGROUNDThe methods for the treatment of postcatheterization femoral arteriovenous fistulas (AVF-s) - simple observation, ultrasound guided compression, covered stents implantation and coil embolization have poor outcome. Surgery is the standard method for treatment of femoral AVFs, but it is a traumatic operation. In this study, we report the results of the treatment of postcatheterization femoral AVFs by simple prolonged compressing bandage.

METHODSTo treat iatrogenic femoral AVFs caused by transfemoral catheterization, prolonged binding with elastic or common bandage was applied in 16 cases. Catheterization was performed in 7 cases for radiofrequency current catheter ablation, in 4 for occlusion of congenital heart disease, in 3 for percutaneous coronary intervention, in 1 for coronary angiography and in 1 for right heart catheterization.

RESULTSAll iatrogenic femoral AVFs were healed after simple binding with elastic or common bandage for 4 - 46 days (mean (15 +/- 10) days). During the period of binding, local skins ulceration occurred at puncture site in two cases and femoral vein thrombus was found in one patient. During 6 - 24 months (mean (11.8 +/- 3.6) months) followup with colour Doppler ultrasonography, no recurrent arteriovenous shunting or other complications were observed.

CONCLUSIONThe results suggest that simple prolonged bandaging for postcatheterization femoral AVFs is an effective and economical procedure.

Adolescent ; Adult ; Aged ; Arteriovenous Fistula ; etiology ; therapy ; Bandages ; Catheterization, Peripheral ; adverse effects ; Female ; Femoral Artery ; pathology ; Femoral Vein ; pathology ; Humans ; Male ; Middle Aged

OBJECTIVETo compare the influence on the postoperative wound healing between inflatable pressure applicator and traditional pressure dressing.

METHODSFrom May 2009 to February 2010, 50 patients with closed femoral shaft fractures were randomly divided into group A and group B, with 25 patients in each group. There were 13 males and 12 females in group A, ranging in age from 38 to 60 years, with an average of (55.1 +/- 9.5) years; of them, road accident was in 18 cases, fall from heigh was in 6 cases, accidental falling injury was in 1 case. There were 15 males and 10 females in group B, ranging in age from 40 to 65 years, with an average of (56.5 +/- 9.2) years; of them, road accident was in 13 cases, fall from heigh was in 6 cases, accidental falling injury was in 6 cases. There was no significant difference between two groups in clinical data. The postoperative wounds of group A were binded with dressing of inflatable pressure applicator; and of group B with traditional pressure dressing. Volume of drainage at 12 h after operation, saturation of blood oxygen at 12, 24 h after operation, satisfactory rate of patients were compared between two groups.

RESULTSPostoperative volume of drainage in group A was lower than that of group B, respectively was (77.5 +/- 4.6), (94.3 +/- 3.8) ml. Saturation of blood oxygen at 12, 24 h after operation in A group was respectively (98.3 +/- 1.1)%, (98.9 +/- 0.8)%, and in group B was respectively (96.5 +/- 0.4)%, ( 97.0 +/- 0.3)%; there was significant difference between two groups at the same time. Satisfactory rate of patients in A group was better than that of group B.

CONCLUSIONInflatable pressure applicator can obviously pressurize and stop bleeding for postoperative wounds, but no affect on peripheral blood supply and can improve discomfort of patients.

Adult ; Case-Control Studies ; Compression Bandages ; adverse effects ; Equipment Design ; Female ; Femoral Fractures ; surgery ; Humans ; Male ; Middle Aged ; Patient Satisfaction ; Postoperative Complications ; prevention & control ; Retrospective Studies