Aplicaciones de la dermis artificial para la prevención y tratamiento de cicatrices hipertróficas y contracturas Artificial dermis aplications to prevent and treat hypertrofyc scars and skin retractions
Bibliographic record
Abstract
En nuestro centro hospitalario fueron ingresados 517 pacientes por quemaduras a lo largo de los últimos 8 años, de los cuales 48 fueron reconstruidos con dermis artificial. Presentamos un grupo de 8 grandes quemados en los que aplicamos Integra® en el periodo agudo y en el periodo de secuelas, con el propósito de tratar o prevenir la formación de cicatrices hipertróficas y contracturas. Evaluamos las siguientes variables: hematoma, infección y pérdida total o parcial de la dermis artificial. Durante el periodo postoperatorio analizamos la pigmentación, vascularización, pliabilidad y altura de la cicatriz con la escala de Vancouver. Medimos el grado de satisfacción de los pacientes empleando una encuesta con puntuación de 0 a 10. Ninguna de las áreas tratadas con dermis artificial presentó cicatrización patológica y no hubo recurrencia en los pacientes con cicatrices hipertróficas. Observamos que en el quemado agudo, las áreas tratadas con dermis artificial desarrollaron mejor calidad de cicatriz que las áreas tratadas únicamente con injertos de piel. Conseguimos una cobertura satisfactoria de las áreas con exposición tendinosa. Consideramos que en pacientes seleccionados, la dermis artificial puede aplicarse en el periodo agudo de la quemadura en zonas especiales para prevenir contracturas y cicatrices hipertróficas; también puede servir como cobertura de estructuras no injertables con defectos menores de 3 cm., en los que normalmente también un colgajo podría servir para solucionar el problema. Durante la fase crónica de la quemadura, la dermis artificial puede ser útil como tratamiento de contracturas y cicatrices hipertróficas. Over the last 8 years, 517 patients were admitted to our centre with burn injuries; of these, 48 had reconstruction with artificial dermis. We present a group of 8 extensively burned patients, who were treated with Integra�� during the acute and later phases to prevent and treat hypertrophic scars and contractures. The following variables were evaluated: haematoma, infection and total or partial loss of artificial dermis. The scar quality was reviewed during the postoperative period, using the Vancouver Scar Scale (VSS). Patients´ satisfaction was measured using a 0-10 score survey. None of the areas treated with artificial dermis showed adverse scarring and in patients with prior hypertrophic scars no recurrence was found. We also observed that in acute burns, the areas treated with artificial dermis developed much better scar quality compared with those areas treated with split skin grafts. We achieved satisfactory coverage in areas with tendon exposure. Artificial dermis can be selectively applied to special areas during acute burn injury to prevent scar hypertrophy and contracture. It can also be used as coverage for normally non-graftable structures less than 3 cm where skin flaps are usually required. During the chronic stage, artificial dermis can be useful to treat contractures, as well as hypertrophic scars.
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How this classification was reachedexpand
Direct model labels (unvalidated)
Per-model category and study-design labels from the labeling rounds. They are machine output, unvalidated, and the disagreement between models ships as data. No study design here is MEDLINE-validated yet.
| Model arm | Categories | Study design | Confidence |
|---|---|---|---|
| gemma | no category Domain: not available · Genre: Empirical About the Canadian research system: no · About a Canadian topic: no | Not applicable | low |
| gpt | no category Domain: not available · Genre: Review About the Canadian research system: no · About a Canadian topic: no | Other design | medium |
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedLabeled directly by 2 models reading the full record.
The models disagree on parts of this classification; every voice is preserved in the section at the end of the page.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".