It is the aim of this research to create a manual and programme for the reintegration of burn-injured primary-school learners in order to assist in their re-socialisation, and to act as a buffer against depression, conduct disorders, and academic lag. Additional aims of the programme included being resource-efficient, flexible, and compatible with Outcomes-Based Education (aBE) principles evidenced in Curriculum 2005. The final aim of the research involved designing the programme in order for teachers to be able to facilitate it. The manual and programme were evaluated through an embedded case study, encompassing a mildly disfigured burn-injured learner, his family, and his school environment by way of his class and teacher. The programme was found to be efficient in its use of resources, congruent with aBE principles, and engaging of the learners and teacher. Participation in the intervention seemed to afford the burn-injured learner with a buffer against depression, but did not prevent academic lag. Minimal teasing was encountered after the programme was implemented, which is contrary to the expected outcomes based on the literature available. Teacher facilitation was not achieved, however, numerous benefits were derived from the intervention for the majority of the participants.

In recent years, advances in biotechnology has allowed the development of synthetic membranes associated with nanocomposites, which has shown promising results as dermal burns dressings. In this sense, silver nanoparticles (NPAg) has been the focus of interest because of their biological properties such as antimicrobial and antiinflammatory effect. The incorporation of NPAg in biological membranes of different natures, such as chitosan, polyester, polymethacrylate methyl and cellulose, has been successfully tested in several biological models. The association between NPAg and polymers produced by the micro-organism presents important advantages, such as water solubility and lack of toxicity. Recently we developed a technique for producing NPAg associated with xanthan (GX), a biopolymer with potential application in various sectors of the petrochemical industry, food and pharmaceutical, through fermentation by Xanthomonas sp performed in the presence of silver nitrate. Therefore, this study aimed to develop, characterize and evaluate the potential antimicrobial and healing membranes nanocomposite xanthan: silver on second-degree burns in the porcine model. Therefore, xanthan biocomposites: silver were used for fabrication of membranes (for casting process, which were subsequently characterized for thickness, mechanical properties (stress, strain, Young´s modulus) and the thermal profile (DSC, TG and DTG). Activity antimicrobial was tested against strains of Escherichia coli (ATCC 25922) and Staphylococcus aureus (ATCC 25923). analysis for tissue repair were made two dermal burns on the back nine male pigs breed Yorkshire (25 ± 5 kg), treated with Xanthan biosensor membrane: silver (XNPAg) with topical application of silver sulfadiazine 1% (SDZ). After eight, 18 and 30 days the wounds were examined macroscopically determined for each lesion area, and the animals euthanized for Microscopic study of the scar area observed that XNPAg membranes showed a significant increase in the values of thickness (P <0.05), density (p <0.01) and Young´s modulus (p <0.001) and reduced strength strain (p <0.05) when compared to membranes of xanthan. Were revealed changes in the thermal profile of the two membranes suggesting the incorporation of silver nanoparticles in the polymer xanthan. XNPAg The membrane induced the formation of inhibition zones 9, 7 mm and 9.6 mm and death rate of 89% and 100% for Staphylococcus aureus and Escherichia coli respectively. Histological analysis showed quantitative and qualitative increase in the reaction granulation and best architectural arrangement of collagen fibers along the the healing process of wounds covered with membranes XNPAg. Could be concluded that the membranes nanocomposite xanthan:silver showed satisfactory mechanical properties for its handling, transportation and storage, as well as important antimicrobial activity and pro-healing in dermal burns using porcine model. / Nos últimos anos, os avanços na área da biotecnologia tem propiciado o desenvolvimento de membranas sintéticas associados à nanocompostos, que vem apresentando resultados promissores como curativos de queimaduras dérmicas. Nesse sentido, as nanopartículas de prata (NPAg) tem sido foco de interesse devido as suas propriedades biológicas como atividade antimicrobiana e efeito antiinflamatório. A incorporação de NPAg em membranas biológicas de diferentes naturezas, como quitosana, poliéster, polimetacrilato de metila e celulose, vem sendo testada com sucesso em diversos modelos biológicos. A associação entre NPAg e polímeros produzidos por microrganismo apresenta importantes vantagens, como solubilidade em água e ausência de toxicidade. Recentemente foi desenvolvida uma técnica de produção de NPAg associadas a goma xantana (GX), um biopolímero com aplicação potencial em vários setores da indústria petroquímica, alimentícia e farmacêutica, através de processo fermentativo realizado pela Xanthomonas sp na presença de nitrato de prata. Diante disso, o presente estudo teve como objetivo desenvolver, caracterizar e avaliar o potencial antimicrobiano e cicatrizante de membranas de bionanocompósito xantana:prata sobre queimaduras de segundo grau em modelo suíno. Para tanto, biocompósitos xantana:prata foram utilizadas para confecção de membranas (por casting process, que foram posteriormente caracterizadas quanto a espessura, propriedades mecânicas (tensão, deformação, módulo de Young) e perfil termoanalítico (DSC, TG e DTG). A atividade antimicrobiana foi avaliada frente a cepas de Escherichia coli (ATCC 25922) e Staphylococcus aureus (ATCC 25923). Para análise do reparo tecidual foram confeccionadas duas queimaduras dérmicas no dorso de nove suínos machos, da raça Yorkshire (25 ± 5 kg), tratadas com membrana de biocompósito xantana:prata (XNPAg) e com aplicação tópica da sulfadiazina de prata a 1% (SDZ). Após oito, 18 e 30 dias, as feridas foram analisadas macroscopicamente, determinada a área de cada lesão, e os animais eutanasiados para estudo microscópico da área cicatricial. Observou-se que as membranas XNPAg apresentaram aumento significativo nos valores de espessura (p<0,05), deformação (p<0,01) e módulo de Young (p<0,001), e redução da força de tensão (p<0,05) quando comparados a membranas de xantana. Foram evidenciadas alterações no perfil termoanalítico das duas membranas sugestivas da incorporação das nanopartículas de prata no polímero de xantana. As membrana XNPAg induziram a formação de halos de inibição de 9,7 mm e 9,6 mm e Taxa de letalidade de 89% e 100% para Staphylococcus aureus e Escherichia coli respectivamente. A análise histológica mostrou incremento quantitativo e qualitativo na reação de granulação, bem como melhor disposição arquitetural das fibras de colágeno ao longo do processo cicatricial das feridas cobertas com membranas XNPAg. Pôde-se concluir que as membranas de bionanocompóstico xantana:prata apresentaram propriedades mecânicas satisfatórias para sua manipulação, transporte e armazenamento, bem como importante atividade antimicrobiana e pró-cicatrizante em queimaduras dérmicas utilizando modelo suíno.

The purpose of this study was to evaluate post-burn adjustment in light of the self-esteem of child burn survivors. The study attempted to assess the viability of using a single, explicit self-report measure of self-esteem (Piers-Harris Children's Self-Concept Scale) as an index of post-burn adjustment. It appears that pediatric burn patients do not suffer a compromised self-concept secondary to the burn injury and, rather, are successful in incorporating their post-burn state, physically and psychologically, into a positive self-concept. It is suggested that evaluation of overall self-esteem incorporate a comprehensive picture of post-burn adjustment, based upon psychological and physiological parameters. Further research is justified and suggestions for future examinations are presented.

A queimadura de 3º grau é um dos maiores traumas a que um ser humano pode ser submetido e em geral são as lesões mais frequentes na população mundial, tratando-se de um importante problema de saúde pública. Pensando neste problema, observou-se que a utilização da membrana amniótica (MA) pode ser o melhor tratamento que esses pacientes possam receber. Ela atua em benefício da epitelização, facilita a migração e a adesão das células epiteliais basais, a matriz estromal possui inibidores de proteases que previne a apoptose e restaura o fenótipo epitelial, antibacteriana do córion e âmnion, além de proteger a ferida e atuar na redução da dor. A descelularização, trata-se da retirada de todas as células e núcleo da MA utilizada, como forma de se evitar qualquer tipo de histoincompatibilidade. O presente trabalho teve como objetivo avaliar a eficácia do uso da membrana amniótica descelularizada (MAD) no tratamento de queimaduras de 3o grau em humanos, testada em ratos da linhagem Wistar. Trata-se de uma pesquisa descritiva, a qual investiga fundamentalmente a especificação e a disposição de dados acerca dos resultados obtidos a partir de um processo regenerativo de queimaduras utilizando-se a MAD. A amostra foi constituída de constituída por 20 ratos machos adultos da linhagem Wistar, dividida em 2 grupos (n=10): grupo controle (GC)–sem MA e grupo transplantado–com MA (TMAD). Os dois grupos foram submetidos a um processo padronizado de queimadura térmica, sendo retiradas duas amostras de tecido para análise, no 14º dia e no 30º dia. As amostras foram analisadas com o emprego de técnicas anatomopatológicas onde foram montadas em lâminas fragmentos de MA corados com solução Hematoxilina Eosina (HE) e, para análise histomorfométrica,as lâminas foram coradas com picro sirius red sob luz polarizada para verificação da descelularização e quantificação de colágeno do tipo I, II e III. As imagens foram quantificadas utilizando o programa Image Pro Plus®, versão 5.0 para Windows®. Os dados estatísticos foram analisados utilizando o programa computacional SSPS v.21.0. Observou-se um aumento significativo da quantificação de colágenos do tipo III no 14º dia no grupo TMAD em relação ao GC, do colágeno do tipo II no 14º e 30º dia comparado ao GC e do colágeno tipo I no 14º e 30º dia, mostrando que a utilização da MA foi eficaz no grupo TMAD. Concluiu-se que a MAD, aplicada topicamente, demonstrou eficácia no processo cicatricial em queimaduras de 3º grau. Esperava-se que a mesma promovesse a aceleração de cicatrização dos ferimentos, mas, o que se observou ao término do trabalho é que a MAD não só promoveu a cicatrização como foi mais eficiente no processo de regeneração dos tecidos lesados. / 3rd degree of burns are one of the greatest injury that a human being can be submitted and generally are the most frequent injuries in the world population, in the case of a major public health problem. Thinking this problem, it has been observed that the use of amniotic membrane (AM) may be the best treatment these patients can receive. It acts on behalf of epithelialization, facilitates migration and adhesion of basal epithelial cells, stromal matrix has protease inhibitors which prevent apoptosis and restores epithelial, antibacterial phenotype of the chorion and amnion, and protect the wound and act on reducing pain. The decellularization, it is the withdrawal of all cells and core AM used as a way to avoid any kind of histoincompatibility. This study aimed to evaluate the efficacy of the decellularized amniotic membrane (DAM) in the treatment of third degree burns in humans, tested in Wistar rats. It is a descriptive research which investigates mainly the specification and the arrangement of data on the results obtained from a regenerative process burns using DAM. The sample consisted of consisted of 20 Wistar adult male rats, divided into 2 groups (n = 10): control group (CG) - without MA, and group transplanted - with AM (TDAM). The two groups were submitted to a standard process of thermal burn, two samples being removed tissue for analysis on day 14 and day 30. Samples were analyzed with the use of pathological techniques which were mounted on slides DNA fragments stained with solution hematoxylin eosin (HE) for histomorphometric analysis, the slides were stained with picrosirius red under polarized light for verification of decellularization and quantifying collagen type I, II and III. Images were quantified using Image Pro Plus ®, version 5.0 for Windows. Statistical data were analyzed using the computer program SPSS v.21.0. There was a significant increase in type III collagen quantification on the 14th day in TDAM group compared to CG, type II collagen in the 14th and 30th day compared to the CG and type I collagen in the 14th and 30th day, showing that the use of MA were effective in TDAM group. It was concluded that the DAM, applied topically, has shown efficacy in the healing process in 3rd degree burns. It was expected that it would promote accelerated wound healing but which was observed at the end of work that MAD is not only promoted as the healing was more efficient the regeneration process of the damaged tissues.

A eletrocirurgia é uma técnica cirúrgica que utiliza o bisturi elétrico para a realização do corte, dessecação e coagulação do tecido orgânico, diminuindo dessa forma os riscos de hemorragia. O bisturi elétrico usa o processo da faiscância para a realização do trabalho. Esse processo provoca, entre outras coisas, o aquecimento da água intracelular e, consequentemente, o rompimento da célula do tecido. Embora se saiba a quantidade de energia entregue pelo bisturi elétrico, pouco se sabe sobre as parcelas de energia envolvidas nos vários fenômenos do processo eletrocirúrgico, principalmente no corte, onde as células sofrem ablação por vaporização. Com base neste problema, foi desenvolvida esta pesquisa, que teve o objetivo de determinar a energia necessária para o corte eletrocirúrgico, através dos parâmetros elétricos envolvidos e da energia utilizada para a vaporização da água do tecido orgânico. O método desenvolvido foi testado em três experimentos, com várias séries de cortes específicos em cada. Demonstrou-se que da energia total que é entregue pelo bisturi, menos de 10% é utilizada para o corte, ou especificamente, para a vaporização da água do tecido. O restante da energia acaba sendo utilizada em outros processos que começarão a ser analisados em outros trabalhos. / Electrosurgery is a surgical technique that uses an electrosurgical device for cutting, drying (desiccation), and coagulation of organic tissue, thereby reducing the risk of bleeding. Electrosurgical device uses sparking phenomena for this purpose. This process causes heating of intracellular water and, consequently, the rupture of the cell in the organic tissue. Although the amount of energy delivered by the electrosurgical device is easy to know, little is known about the exactly amount of energy involved in the various phenomena of electrosurgical procedure, especially in cutting, where cells suffer ablation by vaporization Based on this was developed this research, which objective is to determine the energy required for the electrosurgical cutting through the electrical parameters involved and the energy used for the vaporization of water of organic tissue. The method developed was corted in three experiments, with a series of specific tests in each. It has been show that only about 10% of total energy is used for cutting, or specifically, for the vaporization of water of organic tissue. The rest of the energy is used in other processes that need more investigation to be understood.

A eletrocirurgia é uma técnica cirúrgica que utiliza o bisturi elétrico para a realização do corte, dessecação e coagulação do tecido orgânico, diminuindo dessa forma os riscos de hemorragia. O bisturi elétrico usa o processo da faiscância para a realização do trabalho. Esse processo provoca, entre outras coisas, o aquecimento da água intracelular e, consequentemente, o rompimento da célula do tecido. Embora se saiba a quantidade de energia entregue pelo bisturi elétrico, pouco se sabe sobre as parcelas de energia envolvidas nos vários fenômenos do processo eletrocirúrgico, principalmente no corte, onde as células sofrem ablação por vaporização. Com base neste problema, foi desenvolvida esta pesquisa, que teve o objetivo de determinar a energia necessária para o corte eletrocirúrgico, através dos parâmetros elétricos envolvidos e da energia utilizada para a vaporização da água do tecido orgânico. O método desenvolvido foi testado em três experimentos, com várias séries de cortes específicos em cada. Demonstrou-se que da energia total que é entregue pelo bisturi, menos de 10% é utilizada para o corte, ou especificamente, para a vaporização da água do tecido. O restante da energia acaba sendo utilizada em outros processos que começarão a ser analisados em outros trabalhos. / Electrosurgery is a surgical technique that uses an electrosurgical device for cutting, drying (desiccation), and coagulation of organic tissue, thereby reducing the risk of bleeding. Electrosurgical device uses sparking phenomena for this purpose. This process causes heating of intracellular water and, consequently, the rupture of the cell in the organic tissue. Although the amount of energy delivered by the electrosurgical device is easy to know, little is known about the exactly amount of energy involved in the various phenomena of electrosurgical procedure, especially in cutting, where cells suffer ablation by vaporization Based on this was developed this research, which objective is to determine the energy required for the electrosurgical cutting through the electrical parameters involved and the energy used for the vaporization of water of organic tissue. The method developed was corted in three experiments, with a series of specific tests in each. It has been show that only about 10% of total energy is used for cutting, or specifically, for the vaporization of water of organic tissue. The rest of the energy is used in other processes that need more investigation to be understood.

Indiana University-Purdue University Indianapolis (IUPUI) / In the US, more than 1 million burn injuries are reported annually. About 45,000 injuries due to fires and burns result in hospitalization and ten percent of these result in death every year. Advances in burn treatment have led to a reduction in mortality rate over the last decades. Since more patients are surviving the initial resuscitation phase even with very large areas of skin being burned away, wound care has become increasingly important to ensure continued patient survival and improvement. While currently a common treatment for third degree burn wounds, skin grafts have several drawbacks. The availability of donor sites for autografts may be limited, especially in incidences of extensive skin loss. The rejection associated with the use of allografts and xenografts may render them inadequate or undesirable. Even if a suitable graft is found, poor retention due to infection, hematoma, and low vascularity at the recipient site are other drawbacks associated with the use of skin grafts as a primary treatment for severe burn wounds. As such, research has been done into alternative treatments, which include but are not limited to artificial skin, cell therapy, and growth factor application. We propose the delivery of adipose derived stem cells (ASC) in combination with endothelial progenitor cells (EC) via Integra Dermal Regenerative Template (DRT) to promote faster graft vascularization and thus faster healing of wounds. Integra DRT is an acellular skin substitute that consists of a dermal layer composed of bovine collagen and chondroitin-6-sulfate glycosaminoglycan, and an "epidermal" layer, which consists of silicone polymer. This silicone layer is removed after the collagen matrix is adequately vascularized (usually takes 2-3 weeks), and then a thin layer autograft is applied to the top of the neo-dermis. ASC are derived from the stromal-vascular fraction (SVF) of adipose tissue and are a readily available, pluripotent, mesenchymal cell known to promote angiogenesis. They are being explored as a treatment for a myriad of diseases and conditions, including wound healing. In combination with ECs, they form stable microvessel networks in vitro and in vivo. In our work, we found that ASC+EC form stable microvessel networks when cultured on Integra DRT. Also, ASC and ASC+EC conditioned media promoted both survival and migration of human epidermal keratinocytes compared to control medium. In a full thickness wound healing model, using healthy NSG mice, the ASC+EC case showed a significantly higher rate of wound closure compared to control. Based on best linear unbiased estimates (BLUE), the difference between the healing rates of ASC alone treatment and the Control treatment group is -0.45 +/- 0.22 mm²/day (p=0.041), which is not less than 0.025 and thus not statistically significant (Bonferroni Adjusted). However, the BLUE for the difference between the ASC+EC group and the Control group healing rates is -0.55 +/- 0.28 mm²/day (p = 0.017<0.025, Bonferroni Adjusted), which is statistically significant. Histology revealed a significantly higher number of vessels compared to control in both ASC alone and ASC+EC case. CD31 staining revealed the presence of human vessels in ASC+EC treatment scaffolds. We conclude that the combination of ASC and EC can be used to accelerate healing of full-thickness wounds when delivered to site of the wound via Integra. This result is especially compelling due to the fact that the mice used were all healthy. Thus our treatment shows an improvement in healing rate even compared to normal wound healing.