Invasive Conidiobolomycosis Can Be Successfully Treated on Burn Survivors
We report successful treatment of invasive conidiobolomycosis, only one third such report is in the literature, and the first case reported was on a burn survivor. Our patient is also the first case reported on an adult surviving conidiobolomycosis. This case illustrates that serum β-D-glucan (BDG) may be useful in the diagnosis and monitoring of invasive Conidiobolus infection, contrary to the misconception that Zygomycetes do not release detectable levels of BDG. Aggressive, surgical management and care in the burn unit can lead to successful treatment of this otherwise lethal infection. (Source: Journal of Burn Care and Research)
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Case Reports Source Type: research
A Severely Burned Hemophiliac
Patients suffering from moderate or severe hemophilia A are particularly vulnerable to trauma injury, being on high risk of immediate exsanguination. Due to a rareness of this disease, there are very few reports about the management of severe injuries of the affected patients. No guidelines for the management of burn trauma of hemophiliac patients have been yet established. Since, to our knowledge, this is the first case report about a successful treatment of a severely burned hemophiliac, requiring intensive care, long-time intubation, and multiple epifascial necrosectomies of third grade wounds, the authors are proposing...
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Case Reports Source Type: research
Toxic Epidermal Necrolysis with Gastrointestinal Involvement: A Case Report and Review of the Literature
Gastrointestinal involvement is a rare complication of toxic epidermal necrolysis syndrome (TENS) that results in sloughing of the intestinal epithelium. Prior case reports have noted the potential susceptibility of the entire gastrointestinal tract, from oropharynx and esophagus to sigmoid colon and rectum. Given its infrequency, the effect of gastrointestinal involvement on the treatment and prognosis of TENS is poorly understood. Here, the authors report a case of gastrointestinal symptoms in a patient diagnosed with toxic epidermal necrolysis, likely representing gastrointestinal involvement. In addition, the authors d...
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Case Reports Source Type: research
Back Grafting the Split-Thickness Skin Graft Donor Site
We present a method for graft donor site management that offers an alternative to healing by secondary intention for patients with higher risk of poor wound healing. In those patients considered to be at high risk for donor site healing complications, we chose to treat the donor site with a split-thickness skin graft, or “graft back” procedure. An additional graft is taken adjacent to the initial donor site, and meshed 4:1 to cover both donor sites at once. Out of the 17 patients who received this procedure, 1 patient had a complication from the procedure that did not require an operation, and all patients appear to ha...
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Case Reports Source Type: research
Epidemiology and Outcome of Patients With Burns Treated With Cerium Nitrate Silversulfadiazine
In this study, the outcome of treatment with Flammacerium in burn patients is studied. The retrospective study involved patients with acute burns admitted to the Burn Centre of Martini Hospital, Groningen, The Netherlands, between 2009 and 2014. The outcome parameters were mortality, complications (noninfectious and infectious), need of surgery, and length of stay. The group of patients consisted of 853 patients, of which 554 were male (64.9%). There were 23 patients with a total burn size of 40% TBSA or more (2.7%). In total, 13 of the 853 patients (1.5%) died, and none of them were children (40% TBSA was 30.4%. In the el...
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Original Articles Source Type: research
Burn Shock and Resuscitation: Proceedings of a Symposium Conducted at the Meeting of the American Burn Association, Chicago, IL, 21 April 2015
The Special Interest Groups of the American Burn Association provide a forum for interested members of the multidisciplinary burn team to congregate and discuss matters of mutual interest. At the 47th Annual Meeting of the American Burn Association in Chicago, IL, the Fluid Resuscitation Special Interest Group sponsored a special symposium on burn resuscitation. The purpose of the symposium was to review the history, current status, and future direction of fluid resuscitation of patients with burn shock. The reader will note several themes running through the following presentations. One is the perennial question of the pr...
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Original Articles Source Type: research
Silver Sulfadiazine Retards Wound Healing and Increases Hypertrophic Scarring in a Rabbit Ear Excisional Wound Model
This study evaluated the effects of topical use of silver sulfadiazine cream (SSD) on wound healing and subsequent scarring in a rabbit ear wound model. Seven millimeter full-thickness excisional wounds were created in rabbit ears. Twenty-four rabbits were randomized into four groups in which each group received base cream, 0.01% SSD, 0.1% SSD, or 1% SSD, respectively. Each treatment was applied at 2-day intervals from postoperative days (PODs) 2 to 14. At POD 7, half of the rabbits from each group were killed and tissues were harvested to measure wound healing parameters that included epithelial gap and granulation area. ...
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Original Articles Source Type: research
Inaccuracy of Urine Output Measurements due to Urinary Retention in Catheterized Patients in the Burn ICU
In this study, the authors explore the effects of airlock formation on urine output measured using an electronic urinary output monitor connected to either a standard commercial drainage tubing system or a drainage tubing system with an automated airlock clearing mechanism. In a multicenter study in the burn intensive care unit, urine output was compared between 10 control patients with a standard commercial drainage tubing system and 10 test patients with a novel automated airlock clearing drainage tubing system. The comparison was focused on identifying the number and magnitude of surges in urinary output because of airl...
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Original Articles Source Type: research
Psychometric Properties of the Modified 5-D Itch Scale in a Burn Model System Sample of People With Burn Injury
The aim of this study is to evaluate the psychometric properties of the 4-dimension (4-D) itch scale, a modified version of the 5-dimension itch scale, in a sample of individuals with severe burn injury and/or burn injuries to hands, face, and/or feet. Four of the five domains of the 5-dimension itch scale (4-D) were administered to individuals who reported itching (N = 173) in the Burn Injury Model System Centers Program longitudinal study at either 5 or 10 years after injury. Analyses of the scale included evaluation of dimensionality, internal consistency, associations with other symptoms or quality of life measures, an...
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Original Articles Source Type: research
Development of International Outcomes Instrument for Hand and Upper Extremity Burn Scar Contracture Release
Burn scar contractures remain a common source of severe disability in resource-limited countries. However, existing outcome measurements are unable to fully capture the impact of the scar contracture and surgical attempts at correction. To that end, we have developed a new outcome instrument, the Stanford-ReSurge Burn Scar Contracture Scale—Upper Extremity that can be used as a measurement of disability and reconstructive procedure outcomes. The outcome instrument was created through item generation, item reduction, and preliminary field testing. We performed a literature review using multiple databases to gather a compr...
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Original Articles Source Type: research
Halofuginone Alleviates Burn-Induced Hepatic and Renal Damage in Rats
The aim of this study was to evaluate the possible protective effects of halofuginone on burn-induced oxidative injury of the liver and kidney. For the induction of burn, backs of Wistar albino rats were shaved and exposed for 10 seconds to water bath at 90°C, whereas rats in the control group were exposed for 10 seconds at 25°C. Rats were then administered either saline (1 ml/kg) or halofuginone (100 μg/kg/day) intraperitoneally and decapitated at the 24th hour (early burn) or on the 7th day (late burn). Serum concentrations of creatinine, blood urea nitrogen, alanine aminotransferase, and aspartate aminotransferase ...
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Original Articles Source Type: research
Measuring the Social Impact of Burns on Survivors
This study was designed to develop a large item pool based on a strong conceptual framework using grounded theory analysis with focus groups of burn survivors and their caregivers. The 192 items represent 7 domains and reflect the unique experience of burn survivors within these important areas of social participation. This work will lead to developing the Life Impact Burn Recovery Evaluation profile, a self-reported outcome measure. (Source: Journal of Burn Care and Research)
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Original Articles Source Type: research
Postoperative Delirium in Severely Burned Patients Undergoing Early Escharotomy: Incidence, Risk Factors, and Outcomes
This study included 385 severely burned patients (injured 50 years old), a history of alcohol consumption (>3/week), high American Society of Anesthesiologists classification (III or IV), time between injury and surgery (>2 days), number of previous escharotomies (>2), combined intravenous and inhalation anesthesia, no bispectral index applied, long duration surgery (>180 min), and intraoperative hypotension (mean arterial pressure (Source: Journal of Burn Care and Research)
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Original Articles Source Type: research
Burn Injuries and Their Impact on Cognitive-Communication Skills in the Inpatient Rehabilitation Setting
The prevalence and extent of cognitive-communication disorders and factors that have impact on outcomes are examined in the burn population within an inpatient rehabilitation facility. A retrospective data analysis was conducted on adults diagnosed with burn injury (n = 144). Descriptive statistics were used to identify the prevalence of cognitive-communication deficits on admission and discharge. The main outcomes were cognitive-communication ratings on discharge from inpatient rehabilitation as measured by the memory and problem-solving domains of the Functional Independence Measure (FIM®) and composite score of the Fun...
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Original Articles Source Type: research
Optimal Timing for Early Excision in a Deep Partial Thickness Porcine Burn Model
Many deep partial thickness burns require more than 3 weeks to heal resulting in disfiguring and dysfunctional scarring. Early excision of the eschar has been shown to improve outcomes in deep burns; however, the optimal timing of the excision remains controversial. We compared wound healing and scarring of deep partial thickness burns that were excised at different time points in a porcine model. Deep partial thickness burns (2.5 by 2.5 cm each) were created on the backs of six anesthetized pigs using a previously validated model. The burns were randomly assigned to excision at days 2, 4, or 7 using an electric dermatom...
Source: Journal of Burn Care and Research - December 23, 2016 Category: Rehabilitation Tags: Original Articles Source Type: research
