使用次数：1
入库时间：None
&&& The poor are very wonderful people．One evening my sister and l went out and picked up four people from the street．One of &1 &was in the most terrible condition．I told my sister，“You& 2 the other three. I take care of this one who looks 3 ．”So I did for her all that I can do．I &4 her in bed，and there was such a beautiful smile on her face．She took hold of my hand as she 5 “Thank you!”，and then she died．I could not help but examined my heart before her．I asked myself &6 &I would say if I was in her place．My answer was very simple．I would say I was hungry，cold，homeless，and I was dying，or something else，but she gave me her thankful love．Then she died &7 &a smile on her face．
&&& I am going to try to make a home for many people who have no home．Because I believe that love begins at home，and if we can create a home for the poor，I think that 8 &love will pass on．Through this love will be able to bring peace to the poor．So let us always &9& each other with a smile，for the smile is the &10 &of love，and once we begin to love each other naturally，we will do something for others．
1．A．us&&& &&&&&&&&&&&&& &&&&&& B．them&&& &&&&&&&& &&&&&& &&&&&& C．you
2．A．look for&&& &&&&& &&&&&& B．listen to&&& &&&& &&&&&& &&&&&& C．1ook after
3．A．worse&&&
&&&&&& &&&&&& B．stronger&&& &&& &&&&&& &&&&&& C．better
4．A．gave&&& &&&&&&&&&& &&&&&& B．threw&&& &&&&&&&&&&&&& &&&&&& &&&&&& C．put
5．A．spoke&&& & &&&&&& &&&&&& B．told&&& &&&&&&&&& &&&&&& &&&&&& C．said
6．A．which&&&
&&&&&& &&&&&& B．what&&& &&&&&&&& &&&&&& &&&&&& C．when
7．A．with&&& &&&&&&&&&& &&&&&& B．in&&& &&&&&&&&&&&& &&&&&& &&&&&& C．from
8．A．less and less &&&& &&&&&& B．little and little&
&&&&&& C．more and more
9．A．meet&&& && &&&&&& &&&&&& B．to meet&&& &&&&&&&&&&& &&&&&& C．met
0．A．begin&&& && &&&&&& &&&&&& B．beginning&&& & &&&&&& &&&&&& C．end
<cooco.net.cn防止偷窃d1—5& BCACC&&&&&&&&&& 6—10& BACAB
如果没有找到你要的答案，请尝试下下面的试题答案搜索功能。
用户评论纠错：
&&&&&&暂无评论
我来说几句：
备课中心教案课件试卷下载CHARTS & TRENDS
There was an error trying to load your rating for this title.
Some parts of this page won't work property. Please reload or try later.
I'm Watching This!
Error Please try again!
Added to Your Check-Ins.
454 critic
Alice in Wonderland&()
0:31 | Trailer
Nineteen-year-old Alice returns to the magical world from her childhood adventure, where she reunites with her old friends and learns of her true destiny: to end the Red Queen's reign of terror.
(screenplay),
Popularity
IMDb editors highlight the stories, faces, and
that had us buzzing this week. What caught your eye?
Related News
AM, +08:00
AM, +08:00
PM, +08:00
Powered by ZergNet
User Lists
Related lists from IMDb users
a list of 45 titles
created 12&Mar&2011
a list of 47 titles
created 03&Jan&2012
a list of 29 titles
created 02&Apr&2012
a list of 29 titles
created 14&Jul&2012
a list of 22 titles
created 3&months&ago
Connect with IMDb
Share this Rating
Alice in Wonderland
Want to share IMDb's rating on your own site? Use the HTML below.
You must be a registered user to use the IMDb rating plugin.
User Polls
32 wins & 61 nominations.
A young boy wins a tour through the most magnificent chocolate factory in the world, led by the world's most unusual candy maker.
Tim Burton
Johnny Depp,
Freddie Highmore,
David Kelly
Alice returns to the whimsical world of Wonderland and travels back in time to help the Mad Hatter.
James Bobin
Mia Wasikowska,
Johnny Depp,
Helena Bonham Carter
Four kids travel through a wardrobe to the land of Narnia and learn of their destiny to free it with the guidance of a mystical lion.
Andrew Adamson
Tilda Swinton,
Georgie Henley,
William Moseley
A vengeful fairy is driven to curse an infant princess, only to discover that the child may be the one person who can restore peace to their troubled land.
Robert Stromberg
Angelina Jolie,
Elle Fanning,
Sharlto Copley
Lucy and Edmund Pevensie return to Narnia with their cousin Eustace where they meet up with Prince Caspian for a trip across the sea aboard the royal ship The Dawn Treader. Along the way they encounter dragons, dwarves, merfolk, and a band of lost warriors before reaching the edge of the world.
Michael Apted
Ben Barnes,
Skandar Keynes,
Georgie Henley
A newly recruited night security guard at the Museum of Natural History discovers that an ancient curse causes the animals and exhibits on display to come to life and wreak havoc.
Shawn Levy
Ben Stiller,
Carla Gugino,
Ricky Gervais
The Pevensie siblings return to Narnia, where they are enlisted to once again help ward off an evil king and restore the rightful heir to the land's throne, Prince Caspian.
Andrew Adamson
Ben Barnes,
Skandar Keynes,
Georgie Henley
When a shy groom practices his wedding vows in the inadvertent presence of a deceased young woman, she rises from the grave assuming he has married her.
Directors:
Tim Burton,
Mike Johnson
Johnny Depp,
Helena Bonham Carter,
Emily Watson
As Harry races against time and evil to destroy the Horcruxes, he uncovers the existence of three most powerful objects in the wizarding world: the Deathly Hallows.
David Yates
Daniel Radcliffe,
Emma Watson,
Rupert Grint
An eight-year-old trouble-maker must protect his home from a pair of burglars when he is accidentally left home alone by his family during Christmas vacation.
Chris Columbus
Macaulay Culkin,
Joe Pesci,
Daniel Stern
As Harry Potter begins his sixth year at Hogwarts, he discovers an old book marked as "the property of the Half-Blood Prince" and begins to learn more about Lord Voldemort's dark past.
David Yates
Daniel Radcliffe,
Emma Watson,
Rupert Grint
The magically long-haired Rapunzel has spent her entire life in a tower, but now that a runaway thief has stumbled upon her, she is about to discover the world for the first time, and who she really is.
Directors:
Nathan Greno,
Byron Howard
Mandy Moore,
Zachary Levi,
Donna Murphy
Cast overview, first billed only:
Alice, an unpretentious and individual 19-year-old, is betrothed to a dunce of an English nobleman. At her engagement party, she escapes the crowd to consider whether to go through with the marriage and falls down a hole in the garden after spotting an unusual rabbit. Arriving in a strange and surreal place called "Underland," she finds herself in a world that resembles the nightmares she had as a child, filled with talking animals, villainous queens and knights, and frumious bandersnatches. Alice realizes that she is there for a reason--to conquer the horrific Jabberwocky and restore the rightful queen to her throne.
Written by
Plot Keywords:
The Red Queen
Motion Picture Rating
Rated PG for fantasy action/violence involving scary images and situations, and for a smoking caterpillar
Parents Guide:
Official Sites:
Release Date: 26 March 2010 (China)
Also Known As: Alicia en el país de las maravillas
Filming Locations:
$200,000,000
(estimated)
Opening Weekend:
&10,555,220
(5 March 2010)
$334,185,206
(2 July 2010)
Production Co:
Show detailed
Sound Mix:
(IMAX version)
Aspect Ratio: 1.85 : 1
Did You Know?
were considered for the role of The Mad Hatter.
When Alice eats the sweet bar labeled &Eat Me& to get herself enlarged and be able to pick the key from the table and starts growing. The camera first takes the shot from up and her thighs can be seen coming out of her skirt as she grows bigger. The shot continues from the front and it shows the dress getting shortened again from the knees and her thighs coming out.
[first lines]
Charles, you have lost your senses? This picture is impossible.
Precisely. Gentlemen, the only way to achieve the impossible, is to believe it's possible.
Crazy Credits
The ending credits have flowers going from dead to blooming, a sun rising and setting, and vines moving around.
Connections
Featured in &(2014)
Soundtracks
String Quartet Op. 2, No. 6 In C: 4th movement
(uncredited)
KPM Music Ltd
Frequently Asked Questions
(Spoiler Alert!)&&
User Reviews
some stunning visuals, clumsy writing
It is still worth the high price of the 3-D admission to see some of the amazing animation and design, but the writing is extremely boring and clumsy, and the performances cannot save it. Too many liberties were taken with the originals here, and in no way improve upon them, it only barely resembles either of Carroll&#x27;s books in theme and some specific scenes. There are some &#x22;Disney moments&#x22; that literally set off a gag reflex as well.The animation is quite stunning and wonderful though, as is the costuming and set design (in so much as there were sets and not just green screens, I&#x27;m sure SOME actual props were used). There are some clever elements that owe only to good visual design and direction I&#x27;m sure, as the only other clever bits in the dialogue were the parts directly lifted from the originals.
303 of 465 people found this review helpful.&
Was this review helpful to you?
Contribute to This Page根据汉语提示，选择正确的选项，补全单词。&#13;&#13;(
) 1. k__te (风筝)
) 2. wond__ __ful (棒的)(
) 3. ab__ve (在……上)(
) 4. pa__ __a (熊猫)
) 5. pla__e (飞机)
) 6. gr__ __n (绿色)
) 7. chopst__ __ks (筷子)(
) 8. col__ __r (颜色)
B. tn B. h
B. ua &#13;C. e
C. to C. n
C. ou &#13;D. h
D. al - 跟谁学
跟谁学学生版:genshuixue_student精品好课等你领在线咨询下载客户端关注微信公众号
搜索你想学的科目、老师试试搜索吉安
跟谁学学生版:genshuixue_student精品好课等你领在线咨询下载客户端关注微信公众号&&&分类：根据汉语提示，选择正确的选项，补全单词。&#13;&#13;(
) 1. k__te (风筝)
) 2. wond__ __ful (棒的)(
) 3. ab__ve (在……上)(
) 4. pa__ __a (熊猫)
) 5. pla__e (飞机)
) 6. gr__ __n (绿色)
) 7. chopst__ __ks (筷子)(
) 8. col__ __r (颜色)
B. tn B. h
B. ua &#13;C. e
C. to C. n
C. ou &#13;D. h
D. al根据汉语提示，选择正确的选项，补全单词。&#13;&#13;(
) 1. k__te (风筝)
) 2. wond__ __ful (棒的)(
) 3. ab__ve (在……上)(
) 4. pa__ __a (熊猫)
) 5. pla__e (飞机)
) 6. gr__ __n (绿色)
) 7. chopst__ __ks (筷子)(
) 8. col__ __r (颜色)
B. tn B. h
B. ua &#13;C. e
C. to C. n
C. ou &#13;D. h
D. al科目:最佳答案1. B
8. C解析&#13;知识点:&&基础试题拔高试题热门知识点最新试题
关注我们官方微信关于跟谁学服务支持帮助中心Friendship And Memories Quotes - Desktop-Quotes
Friendship And Memories Quotes
Friendship and memories quotes are wonderful to bring back great memories of past times spent with special friends. You will always have these memories and treasure them with such joy.
We really hope our selection of friendship and memories quotes bring back all your wonderful memories. Why not brighten up your friends day and send them a few of our quotes to fill there thoughts of your wonderful memories that you share.
Enjoy our selection of friendship and memories quotes below:
1. Lots of people want to ride with you in the limo, but what you want is someone who will take the bus with you when the limo breaks down. - Oprah Winfrey
2. Never forget the days I spent with you. Continue to be my friend, as you will always find me yours. - Ludwig Van Beethoven
3. Friends are the most important part of your life. Treasure the tears, treasure the laughter, but most importantly, treasure the memories. - Dave Brenner
4. We all have our time machines. Some take us back, they're called memories. Some take us forward, they're called dreams. - Jeremy Irons
5. Friends the music may stop now and then, but the strings will last forever. - Author Unknown
6. When it hurts to look back and your scared to look ahead you can look beside you and your best friend will be there. - Author Unknown
7. The glory of friendship is not the outstretched hand, nor the kindly smile, nor the
it is the spiritual inspiration that comes to one when he discovers that someone else believes in him and is willing to trust him with friendship. - Ralph Waldo Emerson
8. How strange is the lot of us mortals! Each of us is here for what purpose we know not, though sometimes sense it. But we know from daily life that we exist for other people, first of all for whose smiles and well- being our own happiness depends. - Albert Einstein
9. No love, no friendship can cross the path of our destiny without leaving some mark on it forever. - Francois Mauriac
10. Friends... They cherish one another's hopes. They are kind to one another's dreams. - Henry David Thoreau
Free Inspiring Quotes By E-mail
Here are some users comments:-
You can STOP the inspirational quotation e-mails any time you like... ENJOY
11. Time goes by so fast, people go in and out of your life. You must never miss the opportunity to tell these people how much they mean to you. - Author Unknown
12. Sometimes being a friend means mastering the art of timing. There is a time for silence. A time to let go and allow people to hurl themselves into their own destiny. And a time to prepare to pick up the pieces when it's all over. - Octavia Butler
13. But every memory of friendship shared, even for a short time, is a treasure, like sunshine and warmth in our lives, like a cool breeze on a humid day, like a shower of rain refreshing the earth. - Author Unknown
14. Memory is a way of holding onto the things you love, the things you are, the things you never want to lose - From the television show The Wonder Years
we remember moments. - Cesare Pavese
16. Pleasure is th remembrance, the lasting perfume.
~ Jean de Boufflers
17. The best things in life come in threes, like friends, dreams, and memories. - Author Unknown
18. Life gives us brief moments with another...but sometimes in those brief moment we get memories that last a life time... - Author Unknown
19. Memories are the treasures that we keep locked deep within the storehouse of our souls, to keep our hearts warm when we are lonely. - Becky Aligada
20. Someday many years from now
We'll sit beside the candles glow
Exchanging tales about our past
And laughing as the memories flow
And when that distant day arrives
I know it will be understood
That friendship is the key to live
And we were friends and it was good. - Eileen HehlWound Care
Wound care
Definition
A wound is a disruption in the continuity of cells&#x2014;anything that
causes cells that would normally be connected to become separated. Wound
healing is the restoration of that continuity. Several effects may result
with the occurrence of a wound: immediate loss of all or part of organ
functioning, sympathetic stress response, hemorrhage and blood clotting,
bacterial contamination, and death of cells. The most important factor in
minimizing these effects and promoting successful care is careful asepsis,
which can be accomplished using aseptic techniques when treating a wound.
Description
Wound healing is a biological process that begins with trauma and ends
with scar formation. There are two types of tissue injury: full and
partial thickness. Partial thickness injury is limited to the epidermis
and superficial dermis, with no damage to the dermal blood vessels.
Healing occurs by regeneration of other tissues. Full thickness injury
involves loss of the dermis extends to deeper tissue layers, and disrupts
dermal blood vessels. Wound healing involves the synthesis of several
types of tissue and scar formation.
The three phases of repair are lag, proliferative, and remodeling.
Directly after injury, hemostasis is achieved with clot formation. The
fibrin clot acts like a highway for the migration of cells into the wound
site. Within the first four hours of injury, neutrophils begin to appear.
These inflammatory cells kill microbes, and prevent the colonization of
the wound. Next the monocyte, or macrophage, appears. Functions of these
cells include the killing of microbes, the breakdown of wound debris, and
the secretion of cytokines that initiate the proliferative phase of
repair. Synthetic cells, or fibroblasts, proliferate and synthesize new
connective tissue, replacing the transitional fibrin matrix. At this time,
an efficient nutrient supply develops through the arborization (terminal
branching) of adjacent blood vessels. This ingrowth of new blood vessels
is called angiogenesis. This new and very vascular connective tissue is
referred to as granulation tissue.
The first phase of repair is called the lag or inflammatory phase. The
inflammatory response is dependent on the depth and volume of tissue loss
from the injury. Characteristics of the lag phase include acute
inflammation and the initial appearance and infiltration of neutrophils.
Neutrophils protect the host from microorganisms and infection. If
inflammation is delayed or stopped, the wound becomes susceptible to
infection and closure is delayed.
The proliferative phase is the second phase of repair and is anabolic in
nature. The lag and remodeling phase are both catabolic processes. The
proliferative phase generates granulation tissue. In this process, acute
inflammation releases cytokines, promoting fibroblast infiltration of the
wound site, then creating a high density
of cells. Collagen is the major connective tissue protein produced and
released by fibroblasts. The connective tissue physically supports the new
blood vessels that form and endothelial cells promote ingrowth of new
vessels. These new blood vessels are necessary to meet the nutritional
needs of the wound healing process. The mark of wound closure is when a
new epidermal cover seals the defect. The process of wound healing
continues beneath the new surface. This is the remodeling or maturation
phase and is the third phase in healing.
The first principle of wound care is the removal of nonviable tissue,
including necrotic (dead) tissue, slough, foreign debris, and residual
material from dressings. Removal of nonviable tissue is referred to as
removal of foreign matter is referred to as cleansing. Chronic wounds
are colonized with bacteria, but not necessarily infected. A wound is
colonized when a limited number of bacteria are present in the wound and
are of no consequence in the healing process. A wound is infected when the
bacterial burden overwhelms the immune response of the host and bacteria
grow unchecked. Clinical signs of infection are redness of the skin around
the wound, purulent (pus-containing) drainage, foul odor, and edema.
The second principle of wound care is to provide a moist environment. This
has been shown to promote reepithelialization and healing. Exposing wounds
to air dries the surface and may impede the healing process. Gauze
dressings provide a moist environment provided they are kept moist in the
wound. These are referred to as wet-to-dry dressings. Generally, a
saline-soaked gauze dressing is loosely placed into the wound and covered
with a dry gauze dressing to prevent drying and contamination. It also
supports autolytic debridement (the body&#x0027;s own capacity to lyse and
dissolve necrotic tissue), absorbs exudate, and traps bacteria in the
gauze, which are removed when the dressing is changed.
Preventing further injury is the third principle of wound care. This
involves elimination or reduction of the condition that allowed the wound
to develop. Factors that contribute to the development of chronic wounds
include losses in mobility, mental status changes, deficits of sensation,
and circulatory deficits. Patients must be properly positioned to
eliminate continued pressure to the chronic wound. Pressure reducing
devices, such as mattresses, cushions, supportive boots, foam wedges, and
fitted shoes can be used to keep pressure off wounds.
Providing nutrition, specifically protein for healing, is the fourth
principle of healing. Protein is essential for wound repair and
regeneration. Without essential amino acids, angiogenesis, fibroblast
proliferation, collagen synthesis, and scar remodeling will not occur.
Amino acids also support the immune response. Adequate amounts of
carbohydrates and fats are needed to prevent the amino acids from being
oxidized for caloric needs. Glucose is also needed to meet the energy
requirements of the cells involved in wound repair. Albumin is the most
important indicator of malnutrition because it is sacrificed to provide
essential amino acids if there is inadequate protein intake.
Diagnosis/Preparation
Effective wound care begins with an assessment of the entire patient. This
includes obtaining a complete
and a physical assessment. Assessing the patient assists in identifying
causes and contributing factors of the wound. When examining the wound, it
is important to document its size, location, appearance, and the
surrounding skin. The health care professional also examines the wound for
exudate, necrotic tissue, signs of infection, and drainage, and documents
how long the patient has had the wound. It is also important to know what
treatment, if any, the patient has previously received for the wound.
Actual components of wound care include cleaning, dressing, determining
frequency of dressing changes, and reevaluation. Dead tissue and debris
can impede healing: the goal of cleaning the wound is its removal. When
cleaning the wound, protective goggles should be worn and sterile saline
solution should be used. Providone iodine, sodium hypochlorite, and
hydrogen peroxide should never be used, as they are toxic to cells.
Gentle pressure should be used to clean the wound if there is no necrotic
tissue. This can be accomplished by utilizing a 60 cc catheter tip syringe
to apply the cleaning solution. If the wound has necrotic tissue, more
pressure may be needed. Whirlpools can also be used for wounds having a
thick layer of exudate. At times, chemical or surgical debridement may be
needed to remove debris.
Dressings are applied to wounds for the following reasons: to provide the
proper environment for healing, to absorb drainage, to immobilize the
wound, to protect the wound and new tissue growth from mechanical injury
and bacterial contamination, to promote hemostasis, and to provide mental
and physical patient comfort. There are several types of dressings and
most are designed to maintain a moist wound bed:
Alginate: Made of non-woven fibers derived from seaweed, alginate forms
a gel as it absorbs exudate. It is used for wounds with
moderate-to-heavy exudate or drainage, and is changed every 12 hours to
three days, depending on when the exudate penetrates the secondary
Composite dressings: Combining physically distinct components into a
single dressing, composite dressings provide bacterial protection,
absorption, and adhesion. The frequency of dressing changes vary.
Foam: Made from polyurethane, foam comes in various thicknesses having
different absorption rates. It is used for wounds with moderate-to-heavy
exudate or drainage. Dressing change is every three to seven days.
Gauze: Available in a number of forms including sponges, pads, ropes,
strips, and rolls, gauze can be impregnated with petroleum,
antimicrobials, and saline. Frequent changes are needed because gauze
has limited moisture retention and properties, and there is little
protection from contamination. With removal of a dried dressing, there
is a risk of wound damage to the healing skin surrounding the wound.
Gauze dressings are changed two to three times a day.
Hydrocolloid: Made of gelatin or pectin, hydrocolloid is available as a
wafer, paste, or powder. While absorbing exudate, the dressing forms a
gel. Hydrocolloid dressings are used for light-to-moderate exudate or
drainage. This type of dressing is not used for wounds with exposed
tendon or bone, third-degree burns, or in the presence of bacterial,
fungal, or viral infection or active cellulitis or vasculitis because it
is almost totally occlusive. Dressings are changed every three to seven
Hydrogel: Composed primarily of water, hydrogel dressings are used for
wounds with minimal exudate. Some are impregnated in gauze or non-woven
sponge. Dressings are changed one or two times a day.
Transparent film: An adhesive, waterproof membrane that keeps
contaminants out while allowing oxygen and water vapor to cross through,
it is used primarily for wounds with minimal exudate. It is also used as
a secondary material to secure non-adhesive gauzes. Dressings are
changed every three to five days if the film is used as a primary
In cases where a wound is particularly severe, large, or if it is a third
degree burn, cellular wound healing products may be used to close the
wound and speed recovery. In some cases (i.e., a third-degree burn), a
skin graft will often be used. Although most surgeons prefer to use skin
donated from another person (known as cadaver skin, or human allograft),
skin donations are not always available. They must rely on more recent
products available, such as cellular wound dressings, for the treatment of
burns. For
of full-thickness burn wounds, surgeons use healthy skin from another
part of the person&#x0027;s own body (autografting) as a permanent
treatment. Surgeons may use cellular wound dressings as a temporary
covering when the skin damage is so extensive that there is not enough
healthy skin available to graft initially. This helps prevent infection
and fluid loss until autografting can be performed.
The survival rate for burn patients has increased considerably through the
process of quickly removing dead tissue and immediately covering the
wound. Burns covering half the body were routinely fatal 20 years ago but
today, even people with extensive and severe burns have a good chance of
survival, according to the American Burn Association.
Cellular wound dressings
In recent years, the technology of burn and wound care using cellular
wound dressings and grafts are helping to transform the treatment of burns
and chronic wounds by decreasing the risk of infection, protecting against
fluid loss, requiring fewer skin grafts, and promoting and speeding the
healing process. These dressings provide a cover that keeps fluids from
evaporating and prevents blood from oozing out once the dead skin has been
removed. Some of these products grow in place and expand natural skin when
Cellular wound dressings may look and feel like skin, but they do not
function totally like skin because they are missing hair follicles, sweat
glands, melanocytes, and Langerhans&#x0027; cells. Some cellular wound
dressings have a synthetic top layer structured like an epidermis. It
peels away over time, or is replaced with healthy skin through skin
grafting. How these products are involved in wound repair is a subject of
great it is known that they promote a higher rate of
healing than does standard wound care.
People with severe wounds, chronic wounds, burns, and ulcers can benefit
from cellular wound dressings. Several artificial skin products are
available for nonhealing wounds or burns such as: Apligraft&#x00AE;
(Norvartis), Demagraft&#x00AE;, Biobrane&#x00AE;, Transcyte&#x00AE;
(Advance Tissue Science), Integra&#x00AE; Dermal Regeneration
Template&#x00AE; (from Integra Life Sciences Technology), and
OrCel&#x00AE;.
Apligraf is a two-layer wound dressing that contains live human skin
cells combined with cow collagen. It delivers live cells from a
different donor (circumcised infant foreskin). Thousands of pieces of
Apligraf are produced in the laboratory from one small patch of cells
from a single donor.
Dermagraft is made from human cells placed on a dissolvable mesh
material. The mesh material is gradually absorbed and the human cells
grow and replace the damaged skin after being placed on the wound or
Biobrane is used as a temporary dressing for a variety of wounds,
including ulcers, lacerations, and full-thickness burns. It may also be
used on wounds that develop on
areas from which healthy skin is transplanted to cover damaged skin. It
consists of an ultrathin silicone film and nylon fabric. As the wound
heals, or until autografting becomes possible, the Biobrane is trimmed
TransCyte is used as a temporary covering over full thickness and some
partial thickness burns until autografting is possible, as well as a
temporary covering for some burn wounds that heal without autografting.
It consists of human cells from circumcised infant foreskin, and grown
on nylon mesh, combined with a synthetic epidermal layer. TransCyte
starts with living cells, but these cells die when it is shipped in a
frozen state to burn treatment facilities. The product is then thawed
and stretched over a burn site. In one to two weeks, the TransCyte
starts peeling off, and the surgeon trims it away as it peels.
Integra Dermal Regeneration Template is used to treat full thickness and
some partial thickness burns. Integra co the bottom
layer, made of shark cartilage and collagen from cow tendons, acts as a
matrix onto which a person&#x0027;s own cells migrate over two to three
weeks. A new dermis is created as the cells gradually absorb the
cartilage and collagen. The top layer is a protective silicone sheet
that is peeled off after several weeks, while the bottom layer is a
permanent cover. A very thin layer of the person&#x0027;s own skin is
then grafted onto the neo-dermis.
OrCel is also made from circumcised infant foreskin, grown on a cow
collagen matrix, and used to treat donor sites in burn patients. It is
also used to help treat epidermolysis bullosa, a rare skin condition in
To ensure the safety and quality of products such as cellular wound
dressings, the Food and Drug Administration (FDA) has initiated a new
regulatory system.
Hematoma: dressings should be inspected for hemorrhage at intervals
during the first 24 hours after surgery. A large amount of bleeding is
to be reported to a health care professional immediately. Concealed
bleeding sometimes occurs in the wound, beneath the skin. If the clot
formed is small, it will be absorbed by the body, but if large, the
wound bulges and the clot must be removed for healing to continue.
Infection: The second most frequent nosocomial (hospital-acquired)
infection in hospitals is surgical wound infections with
Staphylococcus aureus, Escherichia coli,
Pseudomonas aeruginosa.
Prevention is accomplished with meticulous wound management. Cellulitis
is a bacterial infection that spread systemic
are usually prescribed to treat it. If the infection is in an arm or
leg, elevation of
the limb reduces dependent edema and heat application promotes blood
circulation. Abscess is a bacterial infection that is localized and
characterized by pus. Treatment consists of surgical drainage or
excision with the concurrent administration of antibiotics.
Dehiscence (disruption of the surgical wound) and evisceration
(protrusion of wound contents): This condition results from sutures
giving way, infection, distention, or cough. Dehisc
the surgeon is called immediately. Prophylactically, an abdominal binder
may be utilized.
Keloid: refers to excessive growth of scar tissue. Careful wound
closure, hemostasis, and pressure support are used to ward off this
complication.
Normal results
The goals of wound care include reducing risks that inhibit wound healing,
enhancing the healing process, and lowering the incidence of wound
infections.
Dipietro, Luisa A. and Aime L. Burns, eds.
Wound Healing: Methods and Protocols (Methods in Molecular Medicine
Totowa, NJ: Humana Press, 2003.
Herndon, David, ed.
Total Burn Care,
2nd ed. London: W. B. Saunders Co., 2001.
Hess, Cathy Thomas.
Clinical Guide to Wound Care,
4th ed. Philadelphia, PA: Lippincott Williams &#x0026; Wilkins, 2002.
Hess, Cathy Thomas and Richard Salcido.
Wound Care,
3rd ed. Springhouse, PA: Springhouse Pub Co., 2000.
periodicals
Collins, Nancy. &#x0022;Obesity and Wound Healing.&#x0022;
Advances in Wound Care
16, no 1. (January/February 2003): 45.
Collins, Nancy. &#x0022;Vegetarian Diets and Wound Healing.&#x0022;
Advances in Wound Care
16, no. 2 (March/April 2003): 65.
McGuckin, Maryanne, Robert Goldman, Laura Bolton, and Richard Salcido.
&#x0022;The Clinical Relevance of Microbiology in Acute and Chronic
Wounds.&#x0022;
Advances in Wound Care
16, no 1. (January/February 2003): 12.
Trent, Jennifer T., and Robert S. Kirsner. &#x0022;Wounds and
Malignancy.&#x0022;
Advances in Wound Care
16, no 1. (January/February 2003): 31.
organizations
American Burn Association. 625 N. Michigan Ave., Suite 1530, Chicago, IL
60611. (800) 548-2876. Fax: (312) 642.9130. E-mail: info@ameriburn.org.
American Diabetes Association. 1701 North Beauregard Street, Alexandria,
VA 22311. (800) 342-2383. E-Mail: AskADA@diabetes.org.
American Professional Wound Care Association (APWCA). Suite #A1-853
Second Street Pike, Richboro, PA 18954. (215) 364-4100. Fax: (215)
364-1146. E-mail: .
National Institutes of Health. 9000 Rockville Pike, Bethesda, MD 20892.
(301) 496-4000. Email: NIHInfo@OD.NIH.GOV.
Lippincott Williams &#x0026; Wilkins.
Advances in Skin &#x0026; Wound Care
2003. [cited April 9, 2003].
Ren&#x00E9; A. Jackson, RN Crystal H. Kaczkowski, M. Sc.
Send comment}