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Biomedical subjects

R P Hermans

Publications and source records attributed to R P Hermans.

At least 19 recordsLinked to original sources
PubMed1993

Widely expanded postage stamp skin grafts using a modified Meek technique in combination with an allograft overlay.

A method for obtaining widely expanded postage stamp autografts, first described in 1963 by C.P. Meek, has been evaluated in our burns unit. The technique, in which an expansion ratio of 1:9 is achieved with the aid of special prefolded gauzes, was combined with an overlay of glycerol-preserved allografts applied 1 week after grafting. This delay did not appear to affect graft take. In a series of 16 consecutive skin graft procedures performed on 10 patients with extensive burns, the mean epithelialization rate was 90 per cent (range 70-100 per cent) within 5 weeks. Cosmetic results were comparable to those achieved with widely expanded mesh grafts. The Meek technique utilizes small pieces of autograft, and has proved to be a practical alternative to mesh grafts when donor sites are limited.

Adult↗
PubMed1990

The use of cultured autologous epidermis in the treatment of extensive burn wounds.

Seventeen patients with deep second- and third-degree burn wounds have been grafted with cultured autologous epidermis. These epidermal cell sheets were cultivated according to the feeder layer technique as described by Rheinwald and Green. After dispase treatment and detachment from the culture vessel, the cell sheets, mounted on a polyamide mesh, were ready for grafting. Patients with wounds excised at an early stage, prepared with human cadaver allografts or synthetic dressings, showed a significantly better graft take than nonexcised, chronic granulating wounds which were grafted at a later stage (47% versus 15%; p less than 0.002). Sandwich treatment of expanded mesh autografts and cultured autograft overlay did not improve the graft take, although in some cases wound healing was accelerated. The graft take was inversely correlated with the age of the patient (p = 0.01), and showed a weak inverse correlation with the day of first (and subsequent) culture grafting (p = 0.07). Wound infection was the main cause of graft failure. Up to 4 years after grafting, the grafted areas showed continued stability and the regenerated skin became supple, smooth, and pliable. Hypertrophic scar formation was less than observed in comparable areas treated with meshed grafts. Wound contraction occurred approximately to the same extent as in split-thickness skin grafts. We emphasize that by a better control of wound infection the graft take, also in secondary-stage procedures, can significantly improve.

Adolescent↗
PubMed1989

The use of non-viable glycerol-preserved cadaver skin combined with widely expanded autografts in the treatment of extensive third-degree burns.

Allograft skin lyophilised in 98% glycerol is an effective overlay for widely expanded autografts. The technique was evaluated clinically on a total of 58 sandwich grafting procedures in a group of 39 patients with extensive third-degree burns. Forty-five grafting operations performed within 10 days postburn all resulted in an epithelialisation rate of at least 75% within 5 weeks. Thirty-three of these procedures achieved complete (more than 95%) wound closure. Of 13 operations performed after the 14th postburn day, ten resulted in a wound epithelialisation of at least 75%. Epithelial quality and cosmetic results were good. The mean length of hospitalisation was 56 days. One patient died from unassociated respiratory failure. The absence of allograft viability did not impair its function as an autograft overlay. The apparent attenuation of allograft antigenicity conferred by the action of 98% glycerol may have contributed to the results achieved. The process of cadaver skin preservation in 98% glycerol is simple and inexpensive.

Adolescent↗
PubMed1986

Duoderm, an alternative dressing for smaller burns.

In this study Duoderm has been used for the treatment of superficial and deep partial thickness burns in 61 patients. In 15 patients a second similar burn was treated with human allografts or silver sulphadiazine cream. Five very small full skin thickness burned areas were also treated with Duoderm. Treatment with Duoderm had to be stopped before total epithelial cover had occurred in 3 patients. Duoderm is a very good alternative for the treatment of smaller superficial and deep partial thickness burns, since it provides very good results, both cosmetically and functionally, combined with fast re-epithelialization and comfort for the patients.

Adolescent↗
PubMed1985

Retrospective study of reconstructive surgery of the burned hand.

During the 5 years 1979-1983 915 patients were admitted to the Rode Kruis Ziekenhuis, Beverwijk, for the primary treatment of burns, including 618 cases in which the hands were involved. Subsequently 105 patients required secondary surgery to 180 burned hands. This study assesses the treatment of these burned hands, the aim being to describe the problems of burned hands in relation to post-burn sequelae, in general; and particularly to the reconstructive procedures employed, and to assess the final results.

Adolescent↗
PubMed1984

Preliminary report on the use of a new hydrocolloid dressing in the treatment of burns.

Twenty-four patients who were referred to our outpatient clinic for treatment of burns were included in a study to evaluate the clinical effectiveness of a new hydrocolloid dressing (HCD). The depth of their burns ranged from superficial partial thickness to full thickness burns and the average size was 1.63 per cent of the total body surface. Seven patients had similar burns on other areas of their body which served as control areas. In six patients healing occurred slightly faster in the HCD treated wounds as compared to silver sulfadiazine (1 per cent), and at least as fast as compared with human allografts in these patients. Two patients were removed from the study; in the remaining non-control group (15 patients) healing progressed rapidly and the patients reported the treatment to be very comfortable. Follow-up visits after 1, 3 and 6 months showed excellent healing and there were no signs of hypertrophic scarring.

Adult↗
PubMed1984

Topical treatment of serious infections with special reference to the use of a mixture of silver sulphadiazine and cerium nitrate: two clinical studies.

Much progress has been made in recent years in the field of topical burn therapy. Preparations are now available which meet most of the requirements for ideal topical agents and further improvements have been demonstrated. However, much work has to be done to find even better products, in particular agents that are sufficiently inexpensive, so that they could well be used in countries with limited resources for medical care.

Anti-Infective Agents, Local↗
PubMed1983

[Scalds in children: an extremely important problem].

Treatment of scalds in children with human allografts offers the following advantages: 1. Essential relief of pain. 2. Prevention of deepening of scalds by desiccation. 3. Fewer autografting procedures. 4. Shorter hospital stay. 5. Considerably less hypertrophic scarring.

Burns↗