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342 results on '"Engrav, Loren H."'

52. Burden of Burn: A Norm-Based Inquiry into the Influence of Burn Size and Distress on Recovery of Physical and Psychosocial Function

Author

Fauerbach, James A., primary, Lezotte, Dennis, additional, Hills, Rebecca A., additional, Cromes, G Fred, additional, Kowalske, Karen, additional, de Lateur, Barbara J., additional, Goodwin, Cleon W., additional, Blakeney, Patricia, additional, Herndon, David N., additional, Wiechman, Shelley A., additional, Engrav, Loren H., additional, and Patterson, David R., additional

Published
2005
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54. UW Burn Center

Author

Gibran, Nicole S., primary, Klein, Matthew B., additional, Engrav, Loren H., additional, and Heimbach, David M., additional

Published
2005
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66. The Unna 'Sleeve'

Author

Nakamura, Dana Y., primary, Gibran, Nicole S., additional, Mann, Roberta, additional, Engrav, Loren H., additional, Heimbach, David M., additional, Dutcher, Kristi D., additional, and Grube, Baiba J., additional

Published
1998
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76. ENGINE BLOCK BURNS

Author

Gibran, Nicole S., primary, Engrav, Loren H., additional, Heimbach, David M., additional, Swiontkowski, Michael F., additional, and Foy, Hugh M., additional

Published
1994
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86. Upper Abdominal Wall Defects

Author

Gottlieb, Jourdan R., primary, Engrav, Loren H., additional, Walkinshaw, Marcus D., additional, Eddy, A. Craig, additional, and Herman, Clifford M., additional

Published
1990
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89. Cones of skin occur where hypertrophic scar occurs.

Author

Matsumura, Hajime, Engrav, Loren H., Gibran, Nicole S., Yang, Tai‐Mei, Grant, John H., Yunusov, Murad Y., Fang, Peiyao, Reichenbach, Dennis D., Heimbach, David M., and Isik, F. Frank

Subjects
*SCARS, *HYPERTROPHY, *SKIN injuries
Abstract

Hypertrophic scarring is devastating for the patient, however the pathophysiology and treatment remain unknown after decades of research. The process follows deep dermal injury, occurs only on certain body parts, does not occur in the early fetus or in animals, and is a localized event. This suggests that an anatomic structure in human, deep dermis may be involved. The dermis is a matrix perforated by cones containing many structures including skin appendages and fat domes. We hypothesized that studying the cones might reveal a structure related to scarring. We examined tangential wounds from various body parts on human cadavers along with skin histology from various human body parts, the early fetus, partial thickness burns, hypertrophic scars, and two other species—rats and rabbits. We found that the cones may in fact be the structure. They exist where hypertrophic scar occurs—cheek, neck, chest, abdomen, back, buttock, arm, forearm, dorsal hand, thigh, leg, dorsal foot, helix and ear lobe. They do not exist where hypertrophic scar does not occur—scalp, forehead, concha, eyelid, palm, early fetus, and in rat, or rabbit. It also became apparent that the cones have been omitted from most considerations of skin histology. We suggest that the cones need to be studied in relation to hypertrophic scarring and restored to skin diagrams. [ABSTRACT FROM AUTHOR]

Published
2001
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97. The 2004 Clinical Research Award

Author

Fauerbach, James A., Lezotte, Dennis, Hills, Rebecca A., Cromes, G Fred, Kowalske, Karen, de Lateur, Barbara J., Goodwin, Cleon W., Blakeney, Patricia, Herndon, David N., Wiechman, Shelley A., Engrav, Loren H., and Patterson, David R.

Abstract

This prospective, longitudinal study examined the influence of baseline physical and psychological burden on serial assessments of health-related quality of life among adults with major burns from three regional burn centers (n = 162). Physical burden groups were defined by % TBSA burned: <10%, 10% to 30%, or >30%. Psychological burden groups were defined by in-hospital distress using the Brief Symptom Inventory Global Severity Index T-score with scores of < 63 or = 63. Analyses compared groups across level of burden and with published normative data. Assessments reflected health and function (Short Form 36) during the month before burn, at discharge, and at 6 and 12 months after burn. Physical functioning was significantly more impaired and the rate of physical recovery slower among those with either large physical burden or large psychological burden. Notably, psychosocial functioning also was more impaired and the rate of psychosocial recovery slower among those with greater psychological burden. These results suggest that, in addition to aggressive wound closure, interventions that reduce in-hospital distress may accelerate both physical and psychosocial recovery.

Published
2005
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98. FullThickness Grafting of Acute Eyelid Burns Should Not Be Considered Taboo

Author

Lille, Sean T., Engrav, Loren H., Caps, Michael T., Orcutt, James C., and Mann, Roberta

Abstract

Splitthickness skin grafts are commonly used for the treatment of acute eyelid burns in fact, this is dogma for the upper lid. Ectropion, corneal exposure, and repeated grafting are common sequelae, almost the rule. It was hypothesized that for acute eyelid burns, the use of fullthickness skin grafts, which contract less than splitthickness skin grafts, would result in a lower incidence of ectropion with less corneal exposure and fewer recurrences. The records of all patients n18 who underwent primary skin grafting of acutely burned eyelids n50 between 1985 and 1995 were analyzed retrospectively. There were 10 patients who received fullthickness skin grafts 12 upper lids,8 lower lids and 8 patients who received splitthickness skin grafts 15 upper lids, 15 lower lids. Three of 10 patients 30 percent who received fullthickness skin grafts and 7 of 8 patients 88 percent who received splitthickness skin grafts developed ectropion and required reconstruction of the lids p0.02. No articles were found substantiating the concept that only splitthickness grafts be used for acute eyelid burns. The treatment of acute eyelid burns with fullthickness rather than splitthickness skin grafts results in less ectropion and fewer reconstructive procedures. It should no longer be considered taboo and should be carried out whenever possible and appropriate. Plast. Reconstr. Surg.104 637, 1999.

Published
1999

99. Improved Treatment of the Stevens-Johnson Syndrome

Author

Marvin, Janet A., Heimbach, David M., Engrav, Loren H., and Harnar, Timothy J.

Abstract

• The Stevens-Johnson syndrome (SJS), a disease resulting in greater than 30% body surface area epidermal and mucosal desquamation, is reported to have a mortality of greater than 50%. Recommended treatment has included steroids, prophylactic antibiotics, nutritional support, and application of topical antibacterials. Since the lesions represent only epidermal loss without dermal necrosis, rapid reepithelialization should occur if the dermis is protected from desiccation with a biological dressing. Five nonburned patients with severe SJS were treated in the University of Washington burn center, Seattle, with urgent operative débridement of their wounds and application of porcine xenograft immediately after admission. Steroid administration was stopped. Antibiotics were used only for culture-proved infections. All patients completely reepithelialized within a mean of 18 days. There was one death, a 9-year-old boy who was completely reepithelialized when sudden fatal sepsis that originated from a ventriculovenous shunt placed when he was an infant developed. In this group of patients, rapid wound closure with xenograft and supportive care permitted rapid reepithelialization and decreased mortality and morbidity.(Arch Surg 1984;119:601-605)

Published
1984
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100. LimbSalvage in Reconstruction of Recalcitrant Pressure Sores Using the Inferiorly Based Rectus Abdominis Myocutaneous Flap

Author

Kierney, Philip C., Cardenas, Diana D., Engrav, Loren H., Grant, John H., and Rand, Richard P.

Abstract

Pressure sore closure is frequently a reconstructive challenge. This challenge is particularly evident in cases of multiply recurrent sores. In such settings, there are often opportunities to manage the recurrent wounds either by repeated advancement of previous flaps or by design of alternative ones. However, these interventions are not always feasible, and limb amputation with total thigh flap closure must be considered. A review of operative experience with seven such complex pressure sores in seven patients is presented. Each patient had previously suffered a permanent thoraciclevel spinal cord injury. Prior attempts at wound closure were unsuccessful. Despite consideration of all described locoregional flaps, no limbsparing procedure could be designed satisfactorily. As an alternative to either hip disarticulation and total thigh flap coverage or distant freetissue transfer, we reconstructed the debrided ulcer beds with inferiorly based rectus abdominis myocutaneous flaps. Six of the seven wounds healed primarily, whereas one required repeated debridement and the addition of a gracilis muscle flap to achieve complete closure. Postoperative followup has ranged from 6 to 45 months. Each patient has returned to his baseline preoperative activity level with no clinical compromise of abdominal wall function. All wounds have healed. Successful application of the inferiorly based vertical rectus abdominis myocutaneous flap for cases of both recalcitrant ischial and trochanteric pressure sores is demonstrated and its consideration is advocated if no reconstructive options short of extremity amputation and total thigh flap coverage exist for such challenging sores. Plast. Reconstr. Surg.102 111, 1998.

Published
1998

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