PURPOSE: When choosing dressing method to treat skin defect by second degree or higher burn, we have to consider method of rapid epithelization and minimization of pain during the treatment. In this study, we used biologic dressing with cultured allogenic keratinocytes for skin defect due to burn. We followed up the degree of epithelization, the degree of pain, and patient satisfaction. METHODS: From June 2003 to June 2006, among the patients with skin defect due to burn, 31 cases with second degree burn(moderate to severe) were selected and biological dressing with cultured allogenic keratinocytes were done. 21 cases did not use cultured allogenic keratinocytes. Most of the patients had second degree burn. We applied cultured allogenic keratinocyte by Kaloderm. For wounds that were not deep enough to effect the dermis, escharectomy was done before applying Kaloderm. After the operation, moist wound site was maintained by dressing with saline gauze for 5-7 days. We compared the condition of the wound site before and after applying Keloderm by grading epithelization by standardized percentage scoring scale(1-5), and degree of pain and patient satisfaction by visual analogue scale(0-10). RESULTS: When cultured allogenic keratinocytes were applied for the same period of time, the mean score of epithelization were 3.29+/-0.529(mean+/-S.D.). Without the application, the mean score of epithelization were 2.86+/-0.655(mean+/-S.D.). The degree of pain was 7.71+/-1.419(mean+/-S.D.) and 2.35+/-0.950(mean+/-S.D.) before and after the application, respectively. The patients' satisfaction score was 6.45+/-0.850(mean+/-S.D.) and 8.45+/-0.961(mean+/-S.D.) before and after the application, respectively. CONCLUSION: Applying biological dressing with cultured allogenic keratinocyte to skin defect due to second degree burn showed satisfactory results in the degree of the epithelization, degree of pain and patients' satisfaction.
Bandages ; Biological Dressings ; Burns ; Dermis ; Humans ; Keratinocytes ; Patient Satisfaction ; Skin

OBJECTIVE: To explore the design points of a three-dimensional (3D) printed customized cementless intercalary endoprosthesis with an intra-neck curved stem and to evaluate the key points and mid-term effectiveness of its application in the reconstruction of ultrashort bone segments in the proximal femur. METHODS: Between October 2015 and January 2021, 17 patients underwent reconstruction with a 3D printed-customized cementless intercalary endoprosthesis with an intra-neck curved stem. There were 11 males and 6 females, the age ranged from 10 to 76 years, with an average of 30.1 years. There were 9 cases of osteosarcoma, 4 cases of Ewing sarcoma, 2 cases of chondrosarcoma, 1 case of liposarcoma, and 1 case of myofibroblastoma. The disease duration was 5-14 months, with an average of 9.5 months. Enneking staging included 16 cases of stage ⅡB and 1 case of stage ⅢB. The distances from the center of the femoral head to the body midline and the acetabular apex were measured preoperatively on X-ray images. Additionally, the distances from the tip of the intra-neck curved stem to the body midline and the acetabular apex were measured at immediate postoperatively and last follow-up. The neck-shaft angle was also measured preoperatively, at immediate postoperatively, and at last follow-up. The status of osseointegration at the bone-prosthesis interface and bone growth into the prosthesis surface were assessed by X-ray films, CT, and Tomosynthesis-Shimadzu metal artefact reduction technology (T-SMART). The survival status of the patients, presence of local recurrence or distant metastasis, and occurrence of postoperative complications were assessed. The recovery of lower limb function was evaluated pre- and post-operatively using the Musculoskeletal Tumor Society (MSTS) scoring system, and pain relief was evaluated using the visual analogue scale (VAS) scores. RESULTS: The patient's femoral resection length was (163.1±57.5) mm, the remaining proximal femoral length was (69.6±9.3) mm, and the percentage of femoral resection length/total femoral length was 38.7%±14.6%. All 17 patients were followed up 25-86 months with an average of 58.1 months. During the follow-up, 1 patient died of lung metastasis at 46 months postoperatively, and the remaining 16 patients survived tumor-free. There was no complication such as periprosthetic infection, delayed incision healing, aseptic loosening, prosthesis fracture, or periprosthetic fracture. No evidence of micromotion or wear around the implanted stem of the prosthesis was detected in X-ray and T-SMART evaluations. There was no significant radiolucent lines, and radiographic evidence of bone ingrowth into the bone-prosthesis interface was observed in all stems. There was no significant difference in the distance from the tip of the curved stem to the body midline and the apex of the acetabulum at immediate postoperatively and last follow-up compared with the distance from the center of the femoral head to the body midline and the apex of the acetabulum before operation, respectively (P>0.05), and there was no significant difference in the above indexes between immediate postoperatively and last follow-up (P>0.05). The differences in the neck-shaft angle at various time points before and after operation were also not significant (P>0.05). At last follow-up, the MSTS score was 26.1±1.2 and the VAS score was 0.1±0.5, which were significantly improved when compared with those before operation [19.4±2.1 and 5.7±1.0, respectively] (t=14.735, P<0.001; t=21.301, P<0.001). At last follow-up, none of the patients walked with the aid of crutches or other walkers. CONCLUSION The 3D printed customized cementless intercalary endoprosthesis with an intra-neck curved stem is an effective method for reconstructing ultrashort bone segments in the proximal femur following malignant tumor resection. The operation is reliable, the postoperative lower limb function is satisfactory, and the incidence of complications is low.
Female ; Male ; Humans ; Child ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged ; Femur/surgery* ; Lower Extremity ; Bone-Implant Interface ; Femur Head ; Artificial Limbs

Background: In a low resource setting, strategies to optimize Personal Protective Equipment (PPE) supplies are being observed. Alternative protective measures were identified to protect health care personnel during delivery of care Objective: To provide list of recommendations on alternative protective equipment during this Coronavirus Disease 2019 (COVID-19) pandemic Methodology: Articles available on the various research databases were reviewed, appraised and evaluated for its quality and relevance. Discrepancies were rechecked and consensus was achieved by discussion. Recommendations: The use of engineering control such as barriers in the reception areas minimize the risk of healthcare personnel. Personal protective equipment needed are face shields or googles, N95 respirators, impermeable gown and gloves. If supplies are limited, the use of N95 respirators are prioritized in performing aerosol-generating procedures, otherwise, surgical masks are acceptable alternative. Cloth masks do not give adequate protection, but can be considered if it is used with face shield. Fluid-resistance, impermeable gown and non-sterile disposable gloves are recommended when attending to patients suspected or confirmed COVID-19. Used, soiled or damaged PPE should be carefully removed and properly discarded. Extended use of PPE can be considered, while re-use is only an option if supplies run low. Reusable equipment should be cleaned and disinfected every after use Conclusion In supplies shortage, personal protective equipment was optimized by extended use and reuse following observance of standard respiratory infection control procedures such as avoid touching the face and handwashing. The addition of physical barriers in ambulatory and triage areas add another layer of protection
Personal Protective Equipment ; Triage

PURPOSE: With the advances of knowledge in wound healing process and technology in various fields, dressing material of the split thickness skin graft (STSG) donor site was improved. Recently, biologic dressing materials attracted attention and these are used for wound management. The aim of the study was to compare the efficacy of Xe-derma® (porcine acellular dermal matrix) with Kaloderm® (cultured epithelial autografts) for treatment of the donor site. METHODS: From July 2015 to January 2016, 20 patients who had undergone STSG were enrolled. The grafts harvested with a same manner and the donor sites were managed with Xe-derma® or Kaloderm®. We compared days for re-epithelization, number of dressings, ease of application, ease of wound monitoring, pain level and complications. RESULTS: All patients managed by these dressing materials were well healed without any complications. There is no statistically difference (P=0.830) between the days for re-epithelization of Xe-derma® (11.10±0.944) and Kaloderm® (11.00±1.054). Number of dressings of Xe-derma® (1.2±0.421) was lower than Kaloderm® (2.3±0.483). Ease of application of Kaloderm® (7.40±0.516) was easier than Xe-derma® (6.36±0.343). Ease of wound monitoring of Xe-derma® (7.77±0.856) was easier than Kaloderm® (6.25±0.720). Xe-derma® was more painless in 1 day and 3 days after operation than Kaloderm®. CONCLUSION: Advantageous properties of Xe-derma® are improving wound healing, reducing pain by contact to the wound immediately after application and easy of wound monitoring due to its transparency. Therefore, we expected Xe-derma® can be used for management of various wound.
Bandages ; Biological Dressings* ; Humans ; Skin* ; Tissue Donors* ; Transplants* ; Wound Healing ; Wounds and Injuries

BACKGROUND: Amniotic membrane contains basement membrane components and several growth factor proteins. Therefore, transplantation of amniotic membrane might help epithelialization. OBJECTIVE: The purpose of this study was to compare efficacies of amniotic membrane patches (amniotic group), polyurethane film (TegadermTM, 3M, USA: wet group), and nonadherent dressing (dry group) in wound healing. METHOD: Six rabbits were included in this study. We made wound defects on the back of each rabbit. Amniotic membrane patches (amniotic group) was applied to each wound defect in the first group, polyurethane film (TegadermTM, 3M, USA: wet group) to the second group, and nonadherent dressings (dry group) to the third group. We compared the time taken for each wound defect to heal, and the gross and histopathologic change of the wound defect from baseline, over time. RESULTS: The results were as follows: 1. In the early phase, the amniotic membrane patch (amniotic group) resulted in a faster healing time than either the polyurethane film (TegadermTM, 3M, USA: wet group) or the nonadherent dressing (dry group). 2. On day 10, all groups achieved histological epithelialization. 3. In the late phase, the amniotic membrane patch (amniotic group) might inhibit collagen fiber arrangement and development of skin appendages. CONCLUSION: The amniotic membrane patch is effective in the treatment of rabbit wound defects. It can serve as a biological dressing in the early phase of wound defects.
Amnion* ; Bandages ; Basement Membrane ; Biological Dressings ; Collagen ; Polyurethanes ; Rabbits ; Skin* ; Wound Healing* ; Wounds and Injuries*

PURPOSE: The biggest problem of wound healing is a possible occurrence of lesion. Especially, in the case of patients who have a skin injury around exposed body parts, if their treatment period drag on for long time, they can suffer from after-effects and the costs can be passed on to a society. Therefore, in this research, we investigated the need to develop the effective medicine and appliances for the patients by examining which therapy methods are being applying to the skin damage and what is the advantage and limit by evaluating the patient's satisfaction level. METHODS: We carried out an online and offline survey targeting medical teams in order to analyze device for wound care. A total of 125 medical teams applied to the research, and investigate the level of customer satisfaction. RESULTS: The moist dressings are the most used method for wound healing. When it comes to the level of customer satisfaction, biological dressing product also has a high satisfaction level. However its high cost tends to limit the use. CONCLUSION: This research reached a conclusion that it is need to develop a low cost and high efficiency wound care product considering the fact that its high cost and low efficiency induced economic problems. Generally, it is needed to develop a product for skin regeneration based on biological technologies, not a product just for damage cure.
Bandages ; Biological Dressings ; Human Body ; Humans ; Methods ; Regeneration ; Skin ; Wound Healing ; Wounds and Injuries*

PURPOSE: Facial abrasions have been treated by moist occlusive dressing for many years. But previous dressing methods have several disadvantages such as difficulty of fixation due to varied contours, too frequent dressing changes with pain, discomfort due to volume of the dressing materials. The authors applied dried bovine amniotic membrane (Amnisite BA(R)) to facial abrasions as a new therapeutic option and compared its efficacy with previous foam dressing treatments. METHODS: From June 2010 to May 2011, thirty two patients suffering from facial abrasions were included in this study, with a mean age of 32.4. Patients were divided into two groups by patient preference. One group was treated with dried bovine amniotic membrane while the other group was treated with ointment and foam dressings. Subjects were followed by regular outpatient clinic visits until complete epithelization. Healing time, treatment costs, scar formation, skin elasticity and moisture content were evaluated to compare the efficacy of dried bovine amniotic membrane in comparison to foam dressing groups. RESULTS: All of thirty two patients were well healed after appliance of dried bovine amniotic membrane or foam dressing without any complication. The healing time for patients treated with dried bovine amniotic membrane was significantly shorter (P<0.05) and no significant difference between the two groups regarding treatment costs, scar formation, skin elasticity or moisture content was shown. CONCLUSION: Facial abrasion can be effectively treated with dried bovine amniotic membrane with a shortening of epithelization period and similar effectiveness as previous foam dressings. In addition, dried bovine amniotic membranes have several benefits. easy appliance to any parts of face, reducing the frequency of dressing changes, early adaptation to social life and so on, These presented benefits make this material a new standard for treatment of facial abrasion.
Ambulatory Care Facilities ; Amnion ; Bandages ; Biological Dressings ; Cicatrix ; Elasticity ; Health Care Costs ; Humans ; Occlusive Dressings ; Patient Preference ; Skin ; Stress, Psychological ; Treatment Outcome

Oxygen enrichment of room air is an effective way to resist hypoxia at high altitude, but it may introduce a potential fire hazard. In common, the burning rate of light and thin homogeneous solid in oxygen enriched atmosphere was used to assess the fire hazard. For the purpose of measuring the burning rate of light and thin homogeneous solid in oxygen enriched atmosphere, we used the methods of laser contact ignition and direct calculation of burning rate, and invented a device that includes mixing gas system, ignition equipment, system of measuring the burning rate and self-made specimen frame. By using the homemade device, we studied the burning rate of filter paper under low pressure and in oxygen-enriched atmosphere and in that of the oxygen concentration of reached stationary burning rate. The results showed that this device was simple, and could obtain the burning rate of light and thin homogeneous solid quantitatively.
Air Pressure ; Altitude ; Atmosphere Exposure Chambers ; Environment, Controlled ; Equipment Design ; Fires ; prevention & control ; Oxygen ; analysis

This article introduces the working principle and the structural design of an initiative lung simulator based on plunger. The lung simulator is intended to test the monitor parameter and trigger function of the ventilator. Lung simulator can ventilate initiatively by adjusting the parameters such as tidal volume(VT). frequency and inspiration time.
Artificial Organs ; Equipment Design ; Lung

Readiness of Health Care Staff: Statement 1. Family physicians and their staff should prepare themselves mentally, physically and emotionally before resuming clinic services. Prior to starting every clinic day, physicians and their staff should take their temperature and note respiratory symptoms. Statement 2. All clinical staff should be properly trained on proper use of PPEs, clinic disinfection, infection control and other safety procedures. Statement 3. Family Physicians should design an office management and operations plan that includes triage, patient flow, treatment and other patient care protocols including strict implementation of infection prevention and control procedures, management of PPE supplies and potential staff shortages. Statement 4. The clinic staff must inform their patients of the changes that may result from the new management and operations plan that will be made in the facility Clinic Procedures, Disinfection and Infection Control: Statement 5. After undergoing proper triage, non-COVID 19 patients entering the clinic should use a hand sanitizer, step on a foot bath or pad soaked in chlorine or any approved disinfectant solution at the entrance. All clinic staff, patients and accompanying persons should be wearing at least a mask inside the clinic. They should be instructed to avoid touching their face or mask and perform hand hygiene immediately before and after if cannot be avoided. Statement 6. Appropriate visual alerts or educational posters regarding infection control, proper handwashing, cough or sneezing etiquette should be visible inside the clinic. Statement 7. The clinic facility must have infection prevention and control measures that adhere to international and local standards. Statement 8. After appropriate triaging, a family physician when attending to a patient shall wear mask, single use gloves and eye protection while apron or gown is optional. It is up to the discretion of the family physician to use higher level of protection based on his risk assessment of the clinic environment and if resources are available. Clinical Services Statement 9. As much as possible, family physicians should continue all primary care services in the clinics. However, it is advisable to first limit the service to non-COVID-19 (suspect or diagnosed) patients. Patients needing COVID-19 assessment and management should be referred to appropriate facilities and follow the guidelines set forth by the Department of Health. Statement 10. A patient who consulted and whose symptoms were resolved may choose not come back for follow-up. Patients with chronic diseases may be followed-up at longer intervals if their illness is stable. Statement 11. Referrals for further assessment, diagnostic tests, or other procedures not available in the clinic must first be coordinated with the referral center/site
Personal Protective Equipment ; Triage ; Disinfection