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253 results on '"Heimbach DM"'

20. Cones of skin occur where hypertrophic scar occurs.

Author

Matsumura H, Engrav LH, Gibran NS, Yang T, Grant JH, Yunusov MY, Fang P, Reichenbach DD, Heimbach DM, and Isik FF

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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42. Adult campfire burns: two avenues for prevention.

Author

Klein MB, Heimbach DM, Honari S, Engrav LH, and Gibran NS

Abstract

Campfires are a common component of outdoor festivities. Pediatric campfire burns have been well described. Adult campfire injuries also are common and have several important distinguishing characteristics. We performed a retrospective review of adult patients admitted with campfire burns to our burn center from July 1998 to July 2003. Medical records were reviewed with attention to mechanism of injury, intoxication level, burn size, and surgeries performed. A total of 27 patients with this injury were treated as inpatients over the course of the study period. Two distinct mechanisms of injury emerged: 1) contact with the campfire and 2) flash/flame injuries from igniting the fire. Eighty-one percent (13/16) of patients who sustained contact burns were intoxicated, as compared with 11% (1/11) of those who sustained flash/flame injuries. Nearly half of the patients with contact burns and more than half the patients with flash/flame burns required excision and grafting. [ABSTRACT FROM AUTHOR]

Published
2005
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44. Laser Doppler monitoring of microcirculatory changes in acute burn wounds

Author

Holloway Ga, Green M, and Heimbach Dm

Subjects
Adult, Time Factors, Medicine, Animals, Humans, Laser doppler flowmeter, General Nursing, Skin, Wound Healing, integumentary system, business.industry, Lasers, Microcirculation, Rehabilitation, Rats, Inbred Strains, Blood flow, Laser Doppler velocimetry, Rats, Anesthesia, General Health Professions, Emergency Medicine, Surgery, business, Burns, Rheology, Perfusion
Abstract

Because burns are dynamic wounds that can change in apparent depth during the first 72 hours, we asked whether measuring changes in cutaneous blood flow might help predict the ultimate fate of burns that were not obviously shallow or deep. A laser Doppler flowmeter was used to study cutaneous perfusion for at least 72 hours in partial-thickness wounds on patients with burns of less than 15% TBSA and in experimental wounds of similar size on rats. Clinical wounds that healed without grafting consistently showed elevated perfusion levels which increased further within 72 hours, whereas wounds eventually requiring grafting experienced lower perfusion levels with no obvious pattern of increase. Differences between average flow levels for healing and nonhealing burns were statistically significant throughout the study period. Perfusion levels in experimental wounds were stratified according to burn severity, with shallower wounds showing a pattern of increase similar to the clinical wounds.

Published
1988

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