Aaron Vunda

A silicone-coated nylon dressing reduces healing time in burned paediatric patients in comparison with standard sulfadiazine treatment: a prospective randomized trial

Mepitel is a new grid like silicone coated nylon dressing containing no additional biological compounds. We describe a prospective randomized pilot study comparing Mepitel to the standard silver sulfadiazine cream (Flamazine) dressing for the topical treatment of paediatric burns. Seventy-six children presenting within 24 h of injury with a non previously treated burn were randomly assigned to Mepitel treatment (group M) or Flamazine treatment (group F). Age, sex, surface area of burn and causal agent were noted at admission. The depth of the burn, cumulative number of dressings, presence or absence of a complete epithelial cover, infection, bleeding and allergy were noted at each dressing change. There were 41 children in group M and 35 children in group F. Five children were subsequently withdrawn from each group because they required skin grafting. Analysis of the above mentioned criteria showed no statistical difference between the two groups except for the healing time (group M: 7.58+/-3.12, group F: 11.26+/-6.02, p < 0.01) and the number of dressings (group M: 3.64+/-1.5, group F: 5.13+/-2.9, p < 0.05). Mepitel has proved to be an easy-to-remove dressing, adhering only to intact skin. The faster healing time found in the Mepitel group may be related to a direct effect of silicone on epithelial growth or to a decrease in surface-cell damage compared to the silver sulfadiazine group. This attractive product will be further assessed on a larger scale trial to confirm our observations.

Reliability of color Doppler and power Doppler sonography in the evaluation of intussuscepted bowel viability.

Abstract In two similar cases of irreducible intussusception with wall necrosis and perforation, symptoms had begun 24 h before admission and the plain radiographs showed signs of small-bowel obstruction. The sonographic (US) appearances, however, were different: color Doppler (CD) US showed vascular flow in the intussuscepted bowel in one case and no flow in the other. After radio-clinical assessment, both children underwent surgery and an intestinal resection had to be performed, manual reduction being impossible. The reliability of the US findings and the prognostic value of CD and power Doppler US in determining the viability of the intussuscepted bowel are discussed with a review of the literature.

Catheterization of the Urethra in Male Children

Urethral catheterization may be needed in a child for diagnostic purposes or for performing voiding cystourethrography or monitoring urine output in very ill or postoperative patients. This video demonstrates a diagnostic urethral catheterization in a male infant.

Reduction of Paraphimosis in Boys

Paraphimosis is a urologic emergency that must be treated immediately. This video demonstrates the proper technique for manual reduction, a noninvasive procedure that is usually successful.

Mydriasis in the Garden

A healthy 3-year old boy was brought to the emergency department because of an acutely dilated right pupil, which developed after he had played in the garden. Half an hour before presentation, his parents noticed he had been crying.

Catheterization of the Urethra in Girls

Indications Diagnostic indications include collection of a sterile urine specimen for culture and urinalysis (especially in a young child who cannot void on command but from whom it is important to obtain a urine sample), the performance of voiding cystourethrography, and the monitoring of urine output in certain postoperative patients or in critically ill patients. Urethral catheterization may also be used for therapeutic indications, such as the decompression of acute urinary retention, intermittent catheterization of neurogenic bladder, and continuous bladder irrigation for the removal of blood and clots, or for drug administration. However, urethral catheterization for therapeutic indications is not the focus of this video.