Biomedical subjects

L D Faucher

Publications and source records attributed to L D Faucher.

3 recordsLinked to original sources

PubMed2006

Clinical experience with Alloderm: a one-staged composite dermal/epidermal replacement utilizing processed cadaver dermis and thin autografts.

UNLABELLED: Alloderm has been advocated for the management of acute burns. However, few studies have demonstrated the feasibility of this technique. METHODS: We reviewed the medical records of all patients treated in our burn center who received Alloderm since 1999. RESULTS: Alloderm was used in 21 burn patients and 6 patients with traumatic skin loss. The average size of Alloderm used in the burn patients was 517+/-144 cm(2) (range 24-3000 cm(2)). The average Alloderm thickness used was 0.008 in. and autografts were harvested at an average of 0.007 in. Overall, Alloderm was used in a variety of locations including the face in 3 patients (2 burns, 1 traumatic skin loss) and hands in 7 patients (6 burns, 1 traumatic skin loss). Successful take was observed in 26/27 patients. CONCLUSIONS: Alloderm can be used successfully in patients with acute burns requiring grafting.

Adolescent↗

PubMed2001

Burn center management of necrotizing soft-tissue surgical infections in unburned patients.

BACKGROUND: Patients with necrotizing soft-tissue infections present great challenges in management from initial presentation through definitive care. Because burn centers concentrate expertise in critical care, wound management, and rehabilitation, we examined the effectiveness of burn center care for patients with necrotizing infections. METHODS: We reviewed our burn center's experience with all patients admitted from 1990 through 1999 with a primary diagnosis of necrotizing fasciitis (NF) or Fournier's gangrene (FG). RESULTS: Fifty-seven patients were identified, 18 with FG and 39 with NF. Patients had a high incidence of preexisting medical problems, including diabetes (37%), obesity defined as greater than 20% above ideal body weight (33%), and hypertension (33%). Seven of 57 (12%) patients died. Patients required a mean of 4.1 operative procedures (range 1 to 15) for definitive wound closure. The mean length of stay (survivors only) was 28.5 days, (range 3 to 70). Although costs increased throughout this period, a formal program of cost-containment resulted in no increase in actual charges per day, from a mean of $4,735 in 1991 to $5,202 in 1999. CONCLUSIONS: Burn centers can provide successful and cost-effective acute care, definitive wound closure, and rehabilitation for patients with NF and FG.

Burn Units↗

PubMed1995

Different mechanisms for use-dependent depression of two GABAA-mediated IPSCs in rat hippocampus.

1. The mechanisms involved in the use-dependent depression of GABAA,fast and GABAA,slow, two GABAA-mediated IPSCs in the rat hippocampal slice preparation, were investigated by observing the effects of paired-pulse depression and of baclofen and CGP 35348 on monosynaptic inhibitory currents recorded from CA1 pyramidal neurons. 2. The second of a pair of evoked responses that consisted of both inhibitory components was depressed and decayed more rapidly compared to the first at an interpulse interval (IpI) of 200 ms. This effect was due to a decrease in the amplitude of GABAA,slow, with no effect on the time constant of decay or on the amplitude or time constant of GABAA,fast. 3. The time course of paired-pulse depression of both components at IpIs ranging from 5 to 2560 ms was compared. GABAA,slow was depressed maximally by 55% at IpIs of 80-160 ms. GABAA,fast was depressed maximally by 38% at 5 ms, and recovered exponentially with a time constant of 130 ms. 4. GABAA,slow was more sensitive than GABAA,fast to depression by baclofen. GABAA,slow was susceptible to complete block, with an ED50 of approximately 200 nM for (+/-)-baclofen and 100 nM for the active enantiomer, (R)-(+)-baclofen. GABAA,fast was blocked by only 50% by the highest concentrations of baclofen tested (10-100 microM (R)-(+)-baclofen), with an ED50 of approximately 2 microM for (+/-)-baclofen and 1 microM for (R)-(+)-baclofen. Paired-pulse depression of GABAA,fast was not occluded by 10 or 100 microM (R)-(+)-baclofen. 5. The GABAB antagonist CGP 35348 (0.4-1 mM), prevented paired-pulse depression of GABAA,slow at IpIs of 160 to 200 ms, and reversed the depression of GABAA,fast by baclofen, but had no effect on paired-pulse depression of GABAA,fast at IpIs of 20 to 40 ms. 6. It is concluded that use-dependent depression of GABAA,slow, but not GABAA,fast, is mediated by a presynaptic GABAB receptor. It is speculated that use-dependent depression of GABAA,fast, which occurs only over a much faster time scale, may be due to rapid postsynaptic GABAA receptor desensitization.

Animals↗