SUMMARY. The authors describe their experience using the CLINITRON airbed at the Bums Centre in Brindisi.
The bed has been in use only for a few months and the number of patients treated in it not very high. However, despite the limits of this experience, the CLINITRON has proved to be very useful particularly with regard to the patient's comfort, the length of hospitalization and nursing.

It is well known how difficult it is to treat patients with burns in the posterior surfaces of the body and how unsatisfactory alternatives to standard beds are in such circumstances.
We believe that the air fluidized bad (Clinitron MK 11) is a satisfactory solution to the problem, and that it is useful not only for bum patients but also for long-term patients (2) (3) (9) and those from whom it is necessary to remove dermis in the dorsal regions.
According to Artz (1), who first used the Clinitron system as a support in the treatment of bums, this type of bed must be considered one of the most important innovations in this field.
Burn patients also need to be cared for in a particular microclimate and many authors have shown the advisability of keeping the patient in a warm dry atmosphere (5) (15) (17).
The air fluidized bed (CLINITRON) uses the principle of "flotation" on porcelain beads, obtained by means of a weak airflow pumped by a compressor through a filter.
This system was first described by Hargest and Artz of South Carolina University in 1968 (4). It allows the patient to "float" on a substrate of siliconated porcelain beads of mean diameter 90 l.L; a special filter sheet with a mesh lower than 37 I.L prevents escape of the beads but allows the passage of warm dry air, also separating the patient from the moving beads.
Thus when the bed is functioning the patient is, as it were, immersed in a fluid to a depth of about 10 cm, where it has been calculated that pressure on the body surface is less than about 10 min Hg of capillary pressure (3). This allows a more equal distribution of pressure on the usual support areas (head, back, sacral area and heels) as well as better oxygenation of local tissue, as demonstrated by measuring PO 2 in the sacral region with the bed not operating (PO 2 : 15-20 min Hg) and operating (PO 2 : 70-75 mm Hg).
The velocity and temperature of the airflow surrounding the patient can be varied according to the needs and the comfort of the individual; maceration of the tissues is prevented as bum areas are kept dry and a satisfactory state of comfort is maintained.
The bed is fitted with a system for weighing the patient and a winch mechanism for lifting and moving the patient atraumatically in order to allow medication.

The air fluidized bed CLINITRON MK 11 has been in use in our Bums Centre for about a year.
Some technical problems arose when it was first installed in our already functioning Centre because of the hygroscopic nature of the beads and it was necessary to adapt the climatization system in the room in order to prevent their excessive aggregation.
We then proceeded to select patients to be placed on the bed, following certain guidelines. Obviously, considering the highly sophisticated nature of the apparatus and its high running costs, the bed cannot be systematically used for any type of burn.
First of all we considered the depth of the bums and their site, opting for second degree intermediate and intermediate deep bums and third degree bums involving the dorsal regions.
We then considered age; when we were obliged to make a choice we opted for babies and young children, as the movement that is set up on the Clinitron bed "rocks" the child, allowing him to relax calmly and reducing agitation.
No patient weighing over 100 kg was treated on the Clinitron bed. Altogether we treated 15 patients aged between 3 and 50 yearsl with burned body surface area between 15 and 45%, mostly involving the back, buttocks and posterior surface of the legs.
The patient was placed on the Clinitron immediately upon admission to the Centre, compatibly with the logistic situation, and kept there until full recovery or, when surgery was necessary, until skin grafts had taken.
Adult bum patients were placed directly on the bed with just a normal sheet, while children were placed on the Clinitron with a Metalline sheet.
Whenever possible we used open treatment, but in third degree bums we preferred the closed method in order to ensure, with the aid of salicylate vaseline, more rapid debriding of necrotic areas. Five patients were not placed immediately on the Clinitron because on their admission the bed was already occupied.
Surgery was necessary for 6 patients, performed on average on the 18th day.
The period of treatment varied between 2 and 3 weeks.
Particular attention was paid to the patient's water and sodium balance. There is ample evidence in the literature that a patient placed on the Clinitron has notable water loss (about 1.5 1) without any simultaneous loss of sodium, frequently leading to hypernatremia; this would appear to be caused by an increased loss of water without sodium from the bum areas, due to the patient's being surrounded by warm dry air (7) (8) (11) (15) (16) (18).

RÉSUMÉ. Les auteurs exposent leur experience sur l'utilisation d'un lit à air "Clinitron" à l'Hopital des Grands Brûlés de Brindisi. L'expérience en question, bien que limitée par le petit nombre de cas traités (en effet le lit n'a été attribué qu'il y a quelques mois) se révèle positive surtout en ce qui concerne le "confort" des patients, le temps du séjour à l'hôpital et le travail du personnel sanitaire.