Thesis
EL USO TEMPRANO DE ESTEROIDES EN LA SEPSIS SEVERA EVITA LLEGAR AL CHOQUE SÉPTICO O SU DURACIÓN EN TIEMPO DE ESTE Y MEJORA LA SOBREVIDA DEL PACIENTE CON SEPSIS CON MENOR TIEMPO DE USO DE AMINAS
Autor
SALGADO CURIEL, ROSA MARÍA
Institución
Resumen
Background: Appropriate cutaneous wound healing depends on dressings, synthetic or biologic. Some extracellular matrices, as well as homologous epithelial cells have growth factors that provide the signals to promote epidermal and dermal remodelation. Aim: To evaluate the quality of the epithelium and dermal matrix after early remodeling by comparing the treatment with biological and synthetic dressings on partial thickness burns. Methods: Ten patients with partial thickness thermal and acute burns were recruited. Affected total body surface was less than 10%, but at least 300cm2. On every patient, lesions were divided in two equivalent areas and they were treated in a section with cellulose hydrofiber impregnated with silver (control) and in the other section with a suspension of autologous keratinocytes or swine intestinal submucosa (experimental); regular dressings and bandages were placed. After 7 days, patients were evaluated and a new dressing was administered only whenever was considered. Two full thickness skin biopsies were taken at the beginning and at day 7 post-treatment. Clinical and histomorphological evaluation was performed for skin architecture and epithelialization. Results: Clinically we observed epithelialization in all patients after 7 days. Histomorphologically we did not find any change in inflammatory infiltrate or vascularity among the treatments. Only it was observed an increase in type I collagen in the tissues from the patients treated with swine intestinal submucosa. Epithelialization index was significant increased after the treatment with the biological dressings. In the tissues from patients treated with hydrofiber it was evident epithelial hypertrophy and lack of rate ridges. Conclusion: Synthetic or biological wound dressings are important for partial thickness burn treatment. Nevertheless the biological strategies are capable to supply stimulatory molecules capable to improve epithelialization, dermal architecture and quality of repair. Based on this characteristics the biological dressings are more effective to diminish hospital stay and materials needed for the treatment.