Thermal injury destroys the physical skin barrier that normally prevents invasion of microorganisms. This and concomitant depression of local and systemic host cellular and humoral immune responses are important factors that contribute to colonization and infection of the burn wound. One of the most common burn wound pathogens is Staphylococcus aureus. Staphylococcus aureus is both a human commensal and a frequent cause of infections leading to mild to life-threatening diseases. Despite a variety of infection control measures, for example patient cohorting and contact precaution at burn centres, S. aureus is still frequently encountered in burn wounds. Colonization with S. aureus has been associated with delayed wound healing, increased need for surgical interventions, and prolonged length of stay at burn centres. In this minireview, we focus on S. aureus nasal carriage in relation to S. aureus burn wound colonization and subsequent infection, and its impact on strategies for infection control. © 2009 Federation of European Microbiological Societies Published by Blackwell Publishing Ltd.
A local operating theater ventilation device to specifically ventilate the wound area has been developed and investigated. The ventilation device is combined with a blanket which lies over the patient during the operation. Two configurations were studied: Configuration 1 where HEPA-filtered air was supplied around and parallel to the wound area and Configuration 2 where HEPA-filtered air was supplied from the top surface of the blanket, perpendicular to the wound area. A similar approach is investigated in parallel for an instrument table. The objective of the study was to verify the effectiveness of the local device. Prototype solutions developed were studied experimentally (laboratory) and numerically (CFD) in a simplified setup, followed by experimental assessment in a full scale mock-up. Isothermal as well as non-isothermal conditions were analyzed. Particle concentrations obtained in proposed solutions were compared to the concentration without local ventilation. The analysis procedure followed current national guidelines for the assessment of operating theater ventilation systems, which focus on small particles (<10 mm). The results show that the local system can provide better air quality conditions near the wound area compared to a theoretical mixing situation (proof-of-principle). It cannot yet replace the standard unidirectional downflow systems as found for ultraclean operating theater conditions. It does, however, show potential for application in temporary and emergency operating theaters
In this chapter, we propose that the democracy we wish to see out in the world is influenced by the quality of our own “inner democracies”—that is: the quality of the democracies among and between the selves or voices in the landscape of the self. We must find ways out of the I-prisons we experience and perpetuate. With this in mind, we propose that ”writing the self,” a method whereby creative, expressive, and reflective writing is used to cultivate an internal dialogue and construct a new identity narrative (Lengelle, 2014), can assist in reshaping our stories about ”the Other and ourselves” and can contribute to personal and cultural healing and reconciliation. The inner dialogue reconciled is foundational for the external dialogue at the heart of global citizenship within education. Indeed, as Schellhammer argues, we must cultivate the self in order to become inter-culturally competent, and this includes facing shadow aspects through truthful dialogues with the self and caring for the self. https://doi.org/10.1007/978-3-319-62861-5_6 LinkedIn: https://www.linkedin.com/in/reinekke-lengelle-phd-767a4322/
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