Severe Skin Burns Research Articles

Fresh tilapia fish skin graft treatment of severe skin burns in a cat

AbstractAn entire female cat presented with extensive third‐degree burns covering greater than 30% of total body surface. The wound was cleaned and debrided with daily dressing management to heal with second intention. Dressing applied included honey‐based product, L‐Mesitran Ointment, and silver alginate dressing, Askina Calgitrol Thin, until healthy granulation tissue had formed. Fresh tilapia skin grafts were harvested and prepared and secured onto the wound bed. Daily lavage and graft evaluation occurred, and subsequently the skin grafts were removed on Day 13 and Day 7, respectively. Wound healing was observed without any complications or adverse side effects. In conclusion, the use of fresh tilapia skin grafts proves to be a safe, innovative, low‐cost, and effective therapeutic and promising option in treatment of challenging skin burn wounds. Tilapia fish skin grafts resulted in a clinically favourable outcome in a cat with extensive third‐degree burn wounds.

4-aminopyridine attenuates inflammation and apoptosis and increases angiogenesis to promote skin regeneration following a burn injury in mice

Severe thermal skin burns are complicated by inflammation and apoptosis, which delays wound healing and contributes to significant morbidity. Diverse treatments demonstrate limited success in mitigating these processes to accelerate healing. Agents that alter cell behavior to improve healing would alter treatment paradigms. We repurposed 4-aminopyridine (4-AP), a drug approved by the US FDA for multiple sclerosis, to treat severe burns in mice (10-week-old C57BL/6 J male mice weighing 25 ± 3 g). We found that 4-AP, in the early stages of burn healing, significantly reduced the expression of pro-inflammatory cytokines IL1β and TNFα while increasing the expression of anti-inflammatory markers CD206, ARG-1, and IL10. We demonstrated increased intracellular calcium effects of 4-AP through Orai1-pSTAT6 signaling, where 4-AP significantly mitigated inflammatory effects by promoting M2 macrophage differentiation in in-vitro macrophages and post-skin burn tissues. 4-AP attenuated apoptosis, with decreases in apoptotic markers BAX, caspase-9, and caspase-3 and increases in anti-apoptotic markers BCL2 and BCL-XL. Furthermore, 4-AP promoted angiogenesis through increases in the expression of CD31, VEGF, and eNOS. Together, these likely contributed to accelerated burn wound closure, as demonstrated in increased keratinocyte proliferation (K14) and differentiation (K10) markers. In the later stages of burn healing, 4-AP increased TGFβ and FGF levels, which are known to mark the transformation of fibroblasts to myofibroblasts. This was further demonstrated by an increased expression of α-SMA and vimentin, as well as higher levels of collagen I and III, MMP 3, and 9 in mice treated with 4-AP. Our findings support the idea that 4-AP may have a novel, clinically relevant therapeutic use in promoting burn wound healing.

4-aminopyridine attenuates inflammation and apoptosis and increases angiogenesis to promote skin regeneration following a burn injury.

Severe thermal skin burns are complicated by inflammation and apoptosis, which delays wound healing and contributes to significant morbidity. Diverse treatments demonstrate limited success with mitigating these processes to accelerate healing. Agents that alter cell behavior to improve healing would alter treatment paradigms. We repurposed 4-aminopyridine (4-AP), a drug approved by the US FDA for multiple sclerosis, to treat severe burns. We found that 4-AP, in the early stages of burn healing, significantly reduced the expression of pro-inflammatory cytokines IL1β and TNFα while increasing the expression of anti-inflammatory markers CD206, ARG-1, and IL10. 4-AP attenuated apoptosis, with decreases in apoptotic markers BAX, caspase-9, and caspase-3 and increases in anti-apoptotic markers BCL2 and BCL-XL. Furthermore, 4-AP promoted angiogenesis through increases in the expression of CD31, VEGF, and eNOS. Together, these likely contributed to accelerated burn wound closure, as demonstrated in increased keratinocyte proliferation (K14) and differentiation (K10) markers. In the later stages of burn healing, 4-AP increased TGFβ and FGF levels, which are known to mark the transformation of fibroblasts to myofibroblasts. This was further demonstrated by an increased expression of α-SMA and vimentin, as well as higher levels of collagen I and III, MMP 3, and 9 in animals treated with 4-AP. Our findings support the idea that 4-AP may have a novel, clinically relevant therapeutic use in promoting burn wound healing.

Europium-based complex crosslinked with hyaluronic acid sponge with controllable adaptive capability to promote effective scarless regeneration of burn wound

The occurrence of severe skin burns may lead to delayed wound healing and persistent scarring. Agents that promote angiogenesis hold great promise for enhancing the effectiveness of wound healing, while modulation of oxidative stress, inflammation, and anti-fibrotic cytokines exhibits significant potential in alleviating scars. In this study, a novel hyaluronic acid- chitooligosaccharides/europium (HA-CE) sponge was prepared. HA-CE sponge were highly absorbent and could scavenge free radicals, as well as promoted macrophages polarized toward M2. HA-CE sponge also promoted the angiogenesis, which was related to the increased vascular endothelial growth factor (VEGF) expression. The expression of CD26 in fibroblast was down-regulated and the transforming growth factor-β3 (TGF-β3) was elevated by HA-CE sponge. The HA-CE sponge in the burnt wound model enhanced angiogenesis and anti-inflammatory responses, thereby accelerating healing of burnt wounds and ameliorating scarring-related factors to inhibit scar formation. These findings identified HA-CE sponge had potential to be developed as a dressing for burnt skin wound.

Notes on the morphology, distribution and bionomics of Phyllodiscus semoni (Anthozoa: Actiniaria: Aliciidae)

Phyllodiscus semoni Kwietniewski, 1897, a little-known species of sea anemones of the family Aliciidae, is quite widely distributed in the tropics but has not been recorded from the Spratly Islands so far. The reason that the range of this species is poorly studied lies not only in the fact that many tropical areas are still poorly explored but also in the peculiar appearance of this animal in the sea. It rarely extends its tentacles during daylight hours and is not readily recognised by divers and researchers as an actinian. Our underwater observations, accompanied by high-resolution photography and specimen collection, evidence the presence of this species along the continental coast of Vietnam and in the waters of the Spratly Archipelago. During the dives, some observations were made on the behavior of the polyps and symbiotic shrimp living on their bodies. This species of sea anemones can cause severe skin burns in humans, which is confirmed by our experience. Summarised literature data on the distribution of Ph. semoni is provided.

Physician and Patient-Reported Outcomes of a Phase III Trial of Ultra-Hypofractionated vs. Moderate Hypofractionated Radiotherapy to the Whole Breast after Breast-Conserving Surgery

To report a final analysis evaluating physician and patient-reported outcomes of early breast cancer patients receiving moderate hypofractionation or ultra-hypofractionated whole breast radiotherapy (RT). Between April 4, 2018, and February 11, 2020, patients with localized breast cancer (T1-T3, N0-N1, and M0) managed with breast-conserving surgery (BCS) were enrolled. Patients were randomized to receive whole breast RT with moderate hypofractionation to 40 Gy in 15 fractions (Arm A) or ultra-hypofractionation to 25 Gy in 5 fractions (Arm B). An optional concurrent integrated boost to 48 Gy on Arm A or 30 Gy on Arm B was allowed. Early toxicity (<3 months), late toxicity (> 3 months), quality of life (QOL), cosmesis, Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE), and deterioration of cosmesis were analyzed. One hundred and seven patients were randomized to moderate hypofractionation (n = 54) or ultra-hypofractionation (n = 53). With a median follow-up of 36 months, no significant differences in patient characteristics were noted between the two arms. There were no patients with a grade ≥3 or higher toxicity. Grade 2 toxicities were 7.4% in Arm A and 7.5% in Arm B, and primarily consisted of radiation dermatitis (6 patients), fibrosis (1 patient) and lymphedema (1 patient). The average Harvard Cosmesis score and overall QoL were similar between arms at all time points, with no patients developing cosmetic deterioration. Patient-reported moderate to severe radiation skin burns were more commonly reported in Arm A (21.05%) vs. Arm B (6.25%) at the end of treatment (EOT) (p = 0.078). At EOT, patients receiving moderate hypofractionation had higher mean toxicity scores in breast tenderness (2.66 vs. 1.5, p = 0.018), skin flaking or peeling (0.63 vs. 0.06, p = 0.035), blistering (0.74 vs. 0.06, p = 0.028), pruritis (2.53 vs. 0.87, p < 0.001), erythema (4.24 vs. 2.0, p <0.001), telangiectasias (1.0 vs. 0.28, p = 0.021). Additionally, patients receiving moderate hypofractionation reported significantly worse changes from baseline at EOT in breast tenderness (-2.25 vs. -.86, p = 0.02), telangiectasia (-0.81 vs. 0.18, p = 0.012), skin discoloration (-4.31 vs. -1.04, p < 0.001), skin flaking or peeling (-.55 vs. 0.04, p = 0.053), blistering (-0.82 vs. -0.07, p = 0.033), and pruritus (-2.27 vs. -.67, p = 0.002). There was a return to baseline in all patient-reported breast domains by 3 months (p >0.05) in both arms. Ultra-hypofractionated whole breast irradiation, consisting of 25 Gy in 5 fractions, provided comparable provider assessed toxicity and cosmetic outcomes to 40 Gy in 15 fractions. At the EOT assessment, ultra-hypofractionation had a better patient reported toxicity profile. Our findings provide further evidence to support daily ultra-hypofractionated whole breast radiotherapy as an appropriate treatment option for early-stage breast cancer.

Hazards Of Monopolar Diathermy Plate In Surgery.

Respected Madam, I would like to draw attention to the hazard of severe skin burns from the using the monopolar diathermy plate electrode during surgical procedures. Diathermy operates in two modes. The monopolar mode where the current enters the patient’s body through an active electrode and exits via a grounding pad attached to the patient.(1) During a recent total abdominal hysterectomy with bilateral salpingo-oophorectomy of a 30-year-old lady with a complex mass, the grounding pad for the electro-cautery had been applied to the left foot, which was found to have third degree burns after completion of the procedure. Similarly, an elderly diabetic lady presented to our outpatient department with the history of a 32 days old non-healing lesion on her left thigh and a Pfannenstiel incision on her abdomen. She had undergone a complete abdominal hysterectomy in another health care centre. During the surgery, the grounding pad was placed on her left thigh which suffered partial thickness burns. According to the patient’s history, the lesion was coin sized at the beginning, but due to poor glycemic control, it continued to involve the surrounding healthy tissue, including the bone. She had previously undergone multiple debridements for the lesion and was advised hip disarticulation after a thorough assessment by the senior management at our department. Even though the procedure was carried out, she, unfortunately, could not survive a few days following the disarticulation. The reason for the burns was a loose application of the grounding pad to the skin of the patient resulting in heat generation and sparking at the site preventing the current to pass safely causing skin burns. To prevent this, the grounding pad should be firmly applied to the skin preferably with crepe bandage. Some other ways to help prevent such complications are adhesive grounding pads and utilization of diathermy machines alarm system.(1)Surgical briefing with the entire perioperative team is necessary so that each individual understands their role in preventing electrosurgical hazards.(2) In addition to this, case reporting of surgical burns to the national database is necessary for implementation of such preventive measures.(3)

Purification Method Optimization of Recombinant Platelet-Derived Growth Factor rhPDGF-BB Expressed in Methylotrophic Yeast &lt;i&gt;Pichia pastoris&lt;/i&gt;

Recombinant human platelet-derived growth factor rhPDGF-BB is one of the major cytokines, which has been approved for medical use. Medical drug “becaplermin”, containing rhPDGF-BB has been approved for neuropathic ulcer and severe skin burns treatment, as well as in periodontal surgery (in combination with osteoconductive matrices). In this article, we sought to optimize purification process to obtain high purity rhPDGF-BB using methylotrophic yeast Pichia pastoris – a production host for rhPDGF-BB. A faster and simpler chromatography purification method has been suggested which allows to obtain rhPDGF-BB with purity 98% as determined by SDS-PAGE and containing host cell proteins (HCP) 33 ± 4 ng/mg, as measured by ELISA. The effective proliferative dose of rhPDGF-BB measured by WST-1 proliferative assay on 3T3 mouse fibroblast cell culture is 5.02 ± 2.64 ng/mL, which is comparable to commercially available analogues. The optimized method can be attractive for production scale use.

Triage of in vivo burn injuries and prediction of wound healing outcome using neural networks and modeling of the terahertz permittivity based on the double Debye dielectric parameters.

The initial assessment of the depth of a burn injury during triage forms the basis for determination of the course of the clinical treatment plan. However, severe skin burns are highly dynamic and hard to predict. This results in a low accuracy rate of about 60 - 75% in the diagnosis of partial-thickness burns in the acute post-burn period. Terahertz time-domain spectroscopy (THz-TDS) has demonstrated a significant potential for non-invasive and timely estimation of the burn severity. Here, we describe a methodology for the measurement and numerical modeling of the dielectric permittivity of the in vivo porcine skin burns. We use the double Debye dielectric relaxation theory to model the permittivity of the burned tissue. We further investigate the origins of dielectric contrast between the burns of various severity, as determined histologically based on the percentage of the burned dermis, using the empirical Debye parameters. We demonstrate that the five parameters of the double Debye model can form an artificial neural network classification algorithm capable of automatic diagnosis of the severity of the burn injuries, and predicting its ultimate wound healing outcome by forecasting its re-epithelialization status in 28 days. Our results demonstrate that the Debye dielectric parameters provide a physics-based approach for the extraction of the biomedical diagnostic markers from the broadband THz pulses. This method can significantly boost dimensionality reduction of THz training data in artificial intelligence models and streamline machine learning algorithms.

MiR-31, miR-155, and miR-221 Expression Profiles and Their Association With Graft Skin Tolerance in a Syngeneic vs Allogeneic Murine Skin Transplantation Model.

Grafting is the preferred treatment for severe skin burns. Frequently, allogeneic tissue is the only transient option for wound coverage, but their use risks damage to surrounding tissues. MicroRNAs have been associated with acute rejection of different tissues/organs. In this study, we analyzed the expression of miR-31, miR-155, and miR-221 and associate it with graft tolerance or rejection using a murine full-thickness skin transplantation model. Recipient animals for the syngeneic and allogeneic groups were BALB/c and C57BL/6 mice, respectively; donor tissues were obtained from BALB/c mice. After 7 days posttransplantation (DPT), the recipient skin and grafts in the syngeneic group maintained most of their structural characteristics and transforming growth factor (TGF)-β1 and TGF-β3 expression. Allografts were rejected early (Banff grades II and IV at 3 and 7 DPT, respectively), showing damage to the skin architecture and alteration of TGF-β3 distribution. miRNAs skin expression changed in both mouse strains; miR-31 expression increased in the recipient skin of syngeneic grafts relative to that of allogeneic grafts at 3 and 7 DPT (P < .05 and P < .01, respectively); miR-221 expression increased in the same grafts at 7 DPT (P < .05). The only significant difference between donor tissues was observed for miR-155 expression at 7 DPT which was associated with necrotic tissue. Only miR-31 and miR-221 levels were increased in the blood of BALB/c mice that received syngeneic grafts after 7 DPT. Our data suggest that local and systemic miR-31 and miR-221 overexpression are associated with graft tolerance.

Bicyklo[4.4.0]dekan. Metoda oznaczania w powietrzu na stanowiskach pracy

Bicyclo[4.4.0]decane (BCD), also known as decalin, is a colorless liquid with the scent of camphor, menthol and naphthalene. This substance can be fatal if swallowed or entered a respiratory tract. It can cause severe skin burns and eye damage, and is toxic if inhaled. The aim of this study was to develop a method for determining BCD in workplace air, which will allow the determination of its concentrations at the level of 5 mg/m3 . The method was based on adsorption of BCD vapors on activated carbon, desorption with acetone solution in carbon disulfide and chromatographic analysis of the obtained solution. The study was performed with a gas chromatograph (GC) with a flame ionization detector (FID) equipped with a DB-VRX capillary column (60 m × 0.25 mm, 1.4 µm). The method was validated in accordance with the requirements of Standard No. EN 482. The method allows the determination BCD in workplace air in the concentration range 5–200 mg/m3 . The method for determining BCD has been recorded in the form of an analytical procedure (see Appendix). This article discusses the problems of occupational safety and health, which are covered by health sciences and environmental engineering.

2021 ASTRO annual meeting.

Cameron Thorpe (Mayo Clinic Arizona, Phoenix, AZ, USA) presented early results from the MC1635 trial. 107 patients with localised breast cancer who had breast-conserving surgery were randomly assigned (1:1) to whole-breast radiotherapy with moderate hypofractionation (40 Gy in 15 fractions; n=54) or extreme hypofractionation (25 Gy in five fractions; n=55). At a median follow-up of 20 months, there were no grade 3 adverse effects; grade 2 adverse effects were reported in 7% of patients in each group. Average cosmesis and quality-of-life scores were similar between groups. Moderate to severe radiation skin burns were more common with moderate hypofractionation (58·7%) than with extreme hypofractionation (27·9%; odds ratio 3·7, 95% CI 1·5–8·9; p=0·004).

Post-Mastectomy Acute Skin Toxicity Assessment Between Particle and Photon Therapy

<h3>Purpose/Objective(s)</h3> To compare acute skin toxicity following post-mastectomy photon (XRT) and skin-sparing proton radiotherapy (PRT). <h3>Materials/Methods</h3> 179 consecutive women with unilateral, non-inflammatory breast cancer were treated with conventionally fractionated post-mastectomy radiotherapy (PMRT) between 2015 and 2019. Prescription was 50 Gy (RBE) in 25 fractions to the chest wall and regional lymph nodes. PRT was administered with a median of two multi-field optimized fields (intensity modulated proton therapy). The chest wall skin was defined as the first 3 mm from the external body surface. XRT and PRT planning objectives with respect to skin were to achieve microscopic disease target coverage while limiting surface hot spots. For XRT 3-5 mm daily bolus was most commonly employed to achieve these objectives. PRT planning objectives were V90% > 90% and D1cc < 102%. Dermatitis was evaluated by physicians using CTCAE version 4.0, and patient reported outcomes (PROs) regarding skin burn severity were prospectively collected. <h3>Results</h3> Treatment was PRT in 96 and XRT in 83 (95% 3D conformal radiotherapy with a wide tangent technique, 5% intensity modulated radiotherapy). There was no significant difference between the two groups with respect to age, stage, receipt of chemotherapy, immediate breast reconstruction, diabetes mellitus, body mass index (BMI), or current or former smoking history. 65% PRT and 61% XRT pts had immediate breast reconstruction. Median follow-up was 25 months. There was no significant difference in grade ≥2 or grade 3 dermatitis between PRT and XRT at 47% vs 48%, <i>P</i> = 0.86 and 3% vs 7%, <i>P</i> = 0.22, respectively. There was a trend for higher grade ≥2 dermatitis in current or former smokers vs never smokers (60% vs 43%, <i>P</i> = 0.06). BMI (<i>P</i> = 0.11), diabetes (<i>P</i> = 0.41), and breast reconstruction (<i>P</i> = 0.63) were also not associated with grade ≥2 dermatitis. Dosimetric parameters including the skin dose to 1 cc (<i>P</i> < 0.0001) and 10 cc (<i>P</i> < 0.0001), skin V105% (<i>P</i> < 0.0001), and the mean skin dose (<i>P</i> = 0.0009) were significantly associated with grade ≥2 dermatitis. In multivariable analysis, former or current tobacco use was the only variable significantly associated grade ≥2 dermatitis (OR 2.02 [1.01-4.06], <i>P</i> = 0.05). Silver sulfadiazine was prescribed in 30% of PRT and 42% of XRT pts (<i>P</i> = 0.1). There was no difference in moderate or more severe patient-reported skin burns between PRT and XRT (40% vs 40%, <i>P</i> = 1.0). <h3>Conclusion</h3> Post-mastectomy PRT administered with our skin-sparing technique is not associated with higher rates of acute dermatitis than XRT.

Biofabrication and preclinical evaluation of a large-sized human self-assembled skin substitute

Severe skin burns are widely treated using split-thickness skin autografts. However, the accessibility of the donor site may be limited depending on the size of the injured surface. As an alternative to skin autografts, our laboratory is clinically investigating a model of human self-assembled skin substitute (SASS) with a standard size of 35 cm2. For the management of extensive skin wounds, multiple grafts are required to cover the entire wound bed. Even if SASSs could provide an adequate and efficient treatment, in some cases, the long-term follow-up of the skin graft site reveals the appearance of marks at the junction between SASSs. This study aims to produce a large-sized self-assembled skin substitute (L-SASS; 289 cm2) and evaluate its preclinical potential for skin wound coverage. The L-SASSs and SASSs shared similar contraction behavior on an agar surface, thickness, and epidermal differentiation in vitro. After grafting, similar histological results were obtained for skin substitutes produced with both methods. Hence, the self-assembly approach of tissue engineering is a scaffold-free method that allows the production of living skin substitutes in a large format.

Wraths of Fire

The way people understand and encounter illnesses include influences from human cognition as well as from their cultural surroundings. A conception of illness termed “the wraths of fire” (tulen vihat in Finnish) was a general explanation for severe skin burns in early modern Finland and Karelia, and it included ideas about personified fire and its magically contagious essence. However, the academic conversation on this notion has mostly concentrated on the socio-cultural influences behind it. In this article, I argue that the intuitive level of human cognition (e.g., Kahneman and Frederick 2005; Evans and Frankish 2009) has formed the basic guidelines for this conception of illness. The research materials consist of approximately six hundred archive units of narrated memories on healing events and healing instructions. As the materials are not based on empirical observations by the author, the article also introduces certain methodological questions important for connecting the cognitive perspective with historical materials, such as questions on the reliability of the descriptions of past events.

The Effect of Air Gap and Moisture for the Skin Burn Injury of the Firefighter’s Personal Protective Clothing (PPC)

Fire fighters are commonly exposed to intense heat and fire. They suppressed fire by spraying water to avoid flame from spreading. They are enforced to use the Personal Protective Clothing (PPC) made of the flame-retardant material to protect themselves from the skin burn injury. Skin burn injury is the most common injury occurs among them. Yet, the exposure to extreme heat and moisture absorption into the clothing layers caused severe burn injury formation. The purpose of this study is to investigate the effect of air gap combined with the moisture absorption in the fabrics using Finite Element Method (FEM) and the Bio heat Equation. From the simulation experiment it is discovered the air gap is a good insulator capable of preventing skin burn with a skin temperature of 48°C. However, the presence of moisture strongly affects skin temperature. It had elevated to 59.64°C forming a second-degree type burn injury. The presence of moisture had weakened thermal protection of the flame-retardant material and the air gap against the heat flux. It is found the moist material properties had enhanced heat transfer from the heat flux to the skin surface resulting severe skin burn despite they were encapsulated with the Personal Protective Clothing (PPC).

595. Intranasal Mupirocin with Chlorhexidine Bathing has Limited Effectiveness for MRSA Decolonization among Neonates

BackgroundMRSA colonization is a common neonatal problem and is associated with invasive infection. Good hand-washing and contact precautions reduce transmission. However, long-term contact isolation, sometimes for months, causes dissatisfaction among neonatal intensive care unit (NICU) care providers and parents. We examined the effectiveness of MRSA decolonization among neonates over 3 years.MethodsOur NICU patients are routinely screened for MRSA colonization by PCR testing of nasal and rectal swabs upon admission and every 2 weeks. Patients with a history of MRSA infection or colonization became eligible for MRSA eradication upon reaching 2000g. Our protocol included intranasal muporocin 2% ointment applied to both nares twice daily for 5 days and 2% chlorhexidine wipe bath daily for 7 days. Wipes were used for bathing from the neck down for at least 20 sec per wipe. Two wipes were used for patient’s < 10 kg with the first wipe being used on the neck, chest, arms, and back, and the second wipe being used on the legs, buttocks, and perineum. Patients were excluded from chlorhexidine bathing if they had a known allergy, were < 27 weeks gestation, < 1 week chronological age, receiving phototherapy, or had severe skin disease, open wounds, or burns. Contact isolation was discontinued if 2 sets of nares and rectal PCR swabs 5 days apart were negative and the patient had not been on antibiotics during the screening period. Surveillance MRSA PCR testing continued. Contact isolation was to be re-initiated if subsequent MRSA screening was positive. Patients were not decolonized a second time.ResultsAmong infants admitted to the NICU during from 2016 to 2018 MRSA colonization was identified in 102 patients. Fifty-six were noted to have colonization present on admission and 46 were acquired on or after hospital day 3. The decolonization protocol with follow-up screening was completed in 33 infants. Successful decolonization was achieved for only 5 (15%) of infants. There were no adverse reactions noted among neonates and no MRSA decolonized patients reverted to positive by PCR screening while in hospital.Conclusion85% of neonates with MRSA failed decolonization. Using mupirocin intranasally and chlorhexidine bathing to decolonize neonates with MRSA was welcomed by staff and families, but was poorly effective. Disclosures All authors: No reported disclosures.

Phosphoryl trichloride. Documentation of proposed values of occupational exposure limits (OELs)

Phosphoryl trichloride is a clear, colorless or yellowish liquid with an unpleasant, pungent odor. In contact with water or steam, it rapidly hydrolyses by releasing hydrogen chloride and phosphoric(V) acid. Phosphoryl trichloride is used in industry primarily for the production of alkyl and aryl triesters of phosphoric(V) acid. It is also used in the production of plasticizers, flame retardants, hydraulic fluids, insecticides, pharmaceuticals, gasoline additives and dye intermediates. Phosphoryl trichloride is also used as chlorinating agent, pH regulator, catalyst, solvent in cryoscopy, dopant for semiconductor grade silicon, and as reagent in laboratories. Phosphoryl trichloride is classified for acute toxicity as category 2 with inhalation (inhalation may lead to death) and as category 4 if swallowed (harmful if swallowed). In addition, it is classified as corrosive category 1A (causes severe skin burns and eye damage) and toxic to target organs due to repeated exposure, category 1 (causes damage to organs through prolonged or repeated exposure). Both in acute and chronic cases of inhalation exposure, the primary effect was irritating to the respiratory tract and eyes (burning eyes and throat, feeling of breathlessness, tearing, coughing, bronchospasm, pain behind the sternum, pleurisy). In exposed workers, deterioration of pulmonary spirometric parameters was observed. The late effects of exposure were asthmatic problems and obstructive respiratory disease. Available animal studies are poorly documented. Phosphoryl trichloride did not show any mutagenic effects. There is no information on the carcinogenic, embryotoxic or teratogenic effects of this substance in the available literature. The critical effect of the action of phosphoryl trichloride is a strong irritation on the mucous membranes of the eyes and upper respiratory tract. A concentration of 0.48 mg/m3 constituting the threshold for toxic effects of phosphoryl trichloride in studies in rats and guinea pigs was taken as the LOAEC value. After applying the uncertainty coefficients, the MAC value of phosphoryl trichloride calculated on this basis is 0.06 mg/m3. It is proposed to adopt the MAC value in accordance with the SCOEL and ACSH recommendation, i.e., 0.064 mg/m3. Phosphoryl trichloride is a strongly irritating substance, in order to prevent peak concentrations of this substance it is proposed to set the maximum allowable short-term concentration (MAC-STEL) at level 2 x MAC value, i.e., 0.13 mg/m3. There are no substantive foundations to determine the permissible biological exposure indices to phosphoryl trichloride (DSB). Due to the corrosive effect of phosphoryl chloride, it is proposed to label it with the letter "C" (a substance with a corrosive effect). This article discusses the problems of occupational safety and health, which are covered by health sciences and environmental engineering.

Protective effect of Myrtle (Myrtus communis) on burn induced skin injury

Thermal skin burns cause local injury as well as triggers acute systemic inflammation response where the imbalance between oxidative and antioxidative system occurs.As an alternative treatment, various medicinal herbs are used to treat burn injuries in many countries. In this study, the possible protective role of oral or topical Myrtle (Myrtus communis L.) treatment against burn-induced damage was investigated. The dorsum of the Wistar Albino rats was shaved and exposed to 90 °C water bath in burn group or 25 °C water bath in control group for 10 s under ether anesthesia. Myrtle extract was applied 100 mg/kg/day for 2 days either orally or topically. In skin samples; malondialdehyde and glutathione levels, catalase, superoxide dismutase, nitric oxide and tissue factor activities were determined. Skin tissues were also examined by light microscopy. Severe thermal skin burn injury caused a significant decrease in glutathione level, superoxide dismutase, catalase and tissue factor activities as well as nitric oxide level, which was accompanied with significant increases in skin malondialdehyde level. Myrtle treatment reversed all these biochemical indices except topical Myrtle treated group’s nitric oxide level, as well as histopathological alterations, which were induced by thermal trauma. Both oral and topical Myrtle extract treatment was found to have protective role in the burn induced oxidative injury, which may be attributed to the potential antioxidant effect of Myrtle. As a conclusion, Myrtle significantly diminishes burn-induced damage in skin.

Zinc dichloride. Determination in workplace air

Zinc dichloride is very soluble in water. It is used in galvanic processes, for wood impregna-tion, in the textile industry, in organic synthesis and for the production of explosives, for example smoke candles. Zinc dichloride has an irritating, corrosive and damaging effect on the eyes, mucous membranes of the airways, causes severe pneumonia, skin burns and systemic poisoning. Maximum allowable concentration value (MAC) for the inhalable fraction of zinc dichloride in Poland is 1 mg/m3 and the short-term exposure limit value (STEL) is 2 mg/m3. The aim of the study was to amend standard PN-Z-04367:2008 and to develop a method for determining zinc dichloride in workplace air in the range from 1/10 to 2 MAC values. The developed method of determination is based on taking a sample of air into two membrane filters, washing out zinc dichloride from the filters with deionized water and de-termining that compound as zinc by atomic absorption spectrometry (F-AAS) with atomiza-tion in air-acetylene flame. The method allows determination of zinc dichloride in the work-place air in the concentration range of 0.07–2.17 mg/m3 (for an air sample with a volume of 720 L, which corresponds to 0.1–2.2 of the MAC value. The method is characterized by good precision and accuracy and meets the requirements of European Standard PN-EN 482 for procedures for the determination of chemical substances. The method for the determination of zinc dichloride has been recorded in the form of an analytical procedure (see Appendix). This article discusses the problems of occupational safety and health, which are covered by health sciences and environmental engineering.