Accession Number : ADA539925


Title :   Medical Management of Cutaneous Sulfur Mustard Injuries


Descriptive Note : Journal article


Corporate Author : ARMY MEDICAL RESEARCH INST OF CHEMICAL DEFENSE ABERDEEN PROVING GROUND MD


Personal Author(s) : Graham, John S ; Stevenson, Robert S ; Mitcheltree, Larry W ; Hamilton, Tracey A ; Deckert, Robin R ; Lee, Robyn B ; Schiavetta, Ann M


Full Text : http://www.dtic.mil/dtic/tr/fulltext/u2/a539925.pdf


Report Date : Jan 2009


Pagination or Media Count : 13


Abstract : Background: Sulfur mustard (2,2 -dichlorodiethyl sulfide; HD) is a potent vesicating chemical warfare agent that poses a continuing threat to both military and civilian populations. Significant cutaneous HD injuries can take several months to heal, necessitate lengthy hospitalizations, and result in long-term complications. There are currently no standardized or optimized methods of casualty management. New strategies are needed to provide for optimal and rapid wound healing. Objective: The primary aim of this research was to develop improved clinical strategies (treatment guidelines) for optimal treatment of superficial dermal (second degree) cutaneous HD injuries, with the goal of returning damaged skin to optimal appearance and normal function in the shortest period of time. Methods: Superficial dermal HD injuries were created on the ventral abdominal surface of weanling pigs. At 48 h post-exposure, lesions were laser debrided and a treatment adjunct applied. Cultured epithelial allografts and 11 commercial off-the-shelf (COTS) products were examined for their efficacy in improving wound healing of these injuries. Clinical evaluations and a variety of non-invasive bioengineering methods were used at 7 and 14 days post-surgery to follow the progress of wound healing and evaluate various cosmetic and functional properties of the wounds. Measurements included reflectance colorimetry to measure erythema; evaporimetry to examine transepidermal water loss as a method of evaluating barrier function; torsional ballistometry to evaluate the mechanical properties of skin firmness and elasticity; and two-dimensional high frequency ultrasonography (HFU) to monitor skin thickness (e.g., edema, scar tissue). Histopathology and immunohistochemistry were performed 14 days following surgery to examine structural integrity and quality of healing. Logical Decisions for Windows was used to rank the 12 Results.


Descriptors :   *HD AGENT , *MUSTARD AGENTS , *EPIDERMIS , WOUNDS AND INJURIES , SULFIDES , HISTOPATHOLOGY , HEALING , SWINE , IMMUNOCHEMISTRY , SKIN DISEASES , SUBCUTANEOUS TISSUE , HISTOCHEMISTRY , CLINICAL MEDICINE , ERYTHEMA , EPITHELIUM , TISSUES(BIOLOGY)


Subject Categories : Medicine and Medical Research
      Chemical, Biological and Radiological Warfare


Distribution Statement : APPROVED FOR PUBLIC RELEASE