Surgical Burn Care by Médecins Sans Frontières-Operations Center Brussels: 2008 to 2014
This study aimed to define the epidemiology of burn-related procedures to aid humanitarian response. In addition, operational data collected from humanitarian organizations are useful for describing surgical need otherwise unmet by national health systems. Procedures performed in operating theatres run by Médecins Sans Frontières-Operations Centre Brussels (MSF-OCB) from July 2008 through June 2014 were reviewed. Surgical specialist missions were excluded. Burn procedures were quantified, related to demographics and reason for humanitarian response, and described. A total of 96,239 operations were performed at 27 MSF-OCB...
Source: Journal of Burn Care and Research - November 1, 2016 Category: Rehabilitation Tags: Original Articles Source Type: research
Which Burn Outcomes Do Patients Anticipate as Most Likely to Be Important
Burn therapies should focus on achieving outcomes that are most important to patients. The authors wanted to discover which outcomes newly burned patients would anticipate as most important to them and explored the association between demographic/burn characteristics and patient preferences. The authors surveyed 753 of 776 patients seen by our burn service from 2008 to 2013 during the initial encounter. Patients were asked to rate the anticipated importance of several burn outcomes including cosmetic appearance, resumption of normal function, and the lack of pain/itching on a four-item Likert scale (not important, somewhat...
Source: Journal of Burn Care and Research - November 1, 2016 Category: Rehabilitation Tags: Original Articles Source Type: research
Whole Arm Water Displacement Volumetry Is a Reliable and Sensitive Measure: A Pilot to Assess Acute Postburn Volume Change
This study aimed to confirm the reliability and investigate the impact of time between repeated trials on the sensitivity of WDV as a measure of whole UL volume change in an uninjured cohort and a burn injured pilot group. Within session, duplicate measures of whole UL WDV were recorded in two groups of noninjured volunteers and a group of burn patients. Each noninjured group differed only in the time between WDV repeats. The reliability trials were performed 50 ml for noninjured and>100 ml for burn patients. Despite this, a systematic bias was demonstrated between the T10 group means. The T20 group trials did not indi...
Source: Journal of Burn Care and Research - November 1, 2016 Category: Rehabilitation Tags: Original Articles Source Type: research
Apyrase Elicits Host Antimicrobial Responses and Resolves Infection in Burns
The authors previously reported that adenosine triphosphate (ATP) stimulates biofilm formation and removal of the ATP could reduce biofilm formation. The main objective of this study was to evaluate the effects of the ATP-hydrolyzing enzyme, apyrase, on control of Acinetabacter baumannii infection in the burn wound as well as to assess host skin antimicrobial responses. The authors found that apyrase stimulated nitric oxide formation at the wound site and reduced CD55 expression, thereby inducing the assembly of membrane attack complexes. Apyrase treatment nearly eradicated multidrug-resistant A. baumannii from burn wounds...
Source: Journal of Burn Care and Research - November 1, 2016 Category: Rehabilitation Tags: Original Articles Source Type: research
Construction of Skin Graft Seams in Burn Patients: A Prospective Randomized Double-Blinded Study
Prominent scars and contractures may form along the seams between adjacent skin grafts. Seams may be constructed either by approximating the graft edges (AP), or by slightly overlapping the graft edges (OV), but it is not known if one technique creates a less conspicuous seam scar. The purpose of this study was to compare seam scars between seams constructed using the AP and OV techniques. This was a prospective within-patient and within-seam controlled study in adult burn patients treated at an American Burn Association-verified burn center. At skin graft application and seam construction, study seams were divided in half...
Source: Journal of Burn Care and Research - November 1, 2016 Category: Rehabilitation Tags: Original Articles Source Type: research
Grip and Muscle Strength Dynamometry Are Reliable and Valid in Patients With Unhealed Minor Burn Wounds
This study aimed to determine the reliability and validity of grip and muscle strength dynamometry in patients with unhealed, minor burn wounds. Grip and muscle strength were assessed three times on each side. Assessment occurred at presentation for the initial injury and again every other day (or every 5 days beyond 10 days post injury) until discharge from the service. Reliability was assessed using intraclass correlation. Minimum detectable differences were calculated for each muscle group. Validity was assessed using regression analysis, incorporating appropriate burn severity measures and patient demographics. Thirty ...
Source: Journal of Burn Care and Research - November 1, 2016 Category: Rehabilitation Tags: Original Articles Source Type: research
Prospective Evaluation of Fractional CO2 Laser Treatment of Mature Burn Scars
The authors conducted a prospective study of fractional CO2 laser treatment of mature burn scars, comparing objective and subjective scar measurements evaluating at least one treatment and one control scar on the same patient pre- and post treatments. After institutional review board approval, burn survivors with mature blatant burn scars were invited to enter the study. A series of three fractional CO2 laser treatments was performed in an office setting, using topical anesthetic cream, at 40 to 90 mJ, 100 to 150 spots per cm2. Subjective and objective measurements of scar physiology and appearance were performed before an...
Source: Journal of Burn Care and Research - November 1, 2016 Category: Rehabilitation Tags: Original Articles Source Type: research
Burn Injury Has Skeletal Site-Specific Effects on Bone Integrity and Markers of Bone Remodeling
To further understand the mechanisms of perturbations in bone remodeling following severe burn injury, the biomechanical properties, genetic expression, and serological markers were evaluated in rodents at six time intervals within 6 weeks following injury. Moreover, these effects were observed in rodent tibia and lumbar vertebrae to explore possible skeletal site localization of this pathologic bone loss. Rodents underwent either thermal injury (100°C water, 30 seconds, 30% BSA) or sham burn. Bone mineral density was evaluated though peripheral quantitative computer tomography, and specialized apparatus measured the weig...
Source: Journal of Burn Care and Research - November 1, 2016 Category: Rehabilitation Tags: Original Articles Source Type: research
Serum Decorin, Interleukin-1β, and Transforming Growth Factor-β Predict Hypertrophic Scarring Postburn
Hypertrophic scar after burn injury is a significant problem. Previous studies have examined the roles for decorin, interleukin-1β, and transforming growth factor-β1 in hypertrophic scar formation locally, but few have considered their systemic influence. The authors conducted a pilot study to examine whether serum levels of these molecules could predict hypertrophic scar formation. Serum levels were measured using enzyme-linked immunosorbent assay, and hypertrophic scar formation determined from chart reviews. Peripheral blood mononuclear cells and fibroblasts were stimulated with decorin, interleukin-1β, and transform...
Source: Journal of Burn Care and Research - November 1, 2016 Category: Rehabilitation Tags: Original Articles Source Type: research
Infrared Thermal Imaging Has the Potential to Reduce Unnecessary Surgery and Delays to Necessary Surgery in Burn Patients
Clinical distinction between superficial and deep burns is problematic. The authors determined whether an infrared thermal imaging (IRTI) camera could predict burn depth. Burn depth was assessed by an experienced surgeon, and the burns were imaged with a portable, lightweight IRTI camera that measures heat emission from the skin using long infrared wavelengths (7.5–13 μm). Burns were considered “deep” if they were surgically excised and confirmed to be of full thickness on microscopic evaluation or if they did not heal spontaneously within 21 days of injury. All other burns were considered “nondeep.” There were ...
Source: Journal of Burn Care and Research - November 1, 2016 Category: Rehabilitation Tags: Original Articles Source Type: research
Clinical and Histopathological Features of Post Burn Pruritus
The aim of the study was to evaluate the clinical and histopathological characteristics of patients with post burn pruritus. The authors took skin samples from 62 burn patients with or without pruritus. The measured skin condition includes thickness and paresthesia. Various clinical features were rated on patient assessment scale (PSAS) and observer scar assessment scale. The samples were stained with hematoxylin & eosin, Masson’s trichrome, Verhoeff’s elastic, and toluidine blue stain. The stained samples were analyzed in terms of epidermal thickness, mononuclear cell infiltration, collagen bundles, elastic fibers, an...
Source: Journal of Burn Care and Research - November 1, 2016 Category: Rehabilitation Tags: Original Articles Source Type: research
Molecular Imaging of Smoke-Induced Changes in Nuclear Factor-Kappa B Expression in Murine Tissues Including the Lung
Many inflammatory responses are mediated by activation of the transcription factor, nuclear factor-kappa B (NF-κB), and a wide variety of human diseases involve abnormal regulation of its expression. In this investigation, we evaluated the effect of smoke inhalation injury on NF-κB expression in lung using two strains of NF-κB reporter mice. Groups of reporter mice with viral thymidine kinase (TK) or “fire fly” luciferase (Luc) genes under control by the NF-κB promoter (TK/NF-κB mice and Luc/NF-κB mice) were subjected to nonlethal smoke inhalation injury. Sham-treated animals served as controls. Twenty-four hours...
Source: Journal of Burn Care and Research - November 1, 2016 Category: Rehabilitation Tags: Original Articles Source Type: research
Re: Utilizing GIS Technology to Improve Fire Prevention Activities in an Urban Fire Department
No abstract available (Source: Journal of Burn Care and Research)
Source: Journal of Burn Care and Research - September 1, 2016 Category: Rehabilitation Tags: Letters to the Editor Source Type: research
Re: Enteral Nutrition Intolerance in Critically Ill Septic Burn Patients
No abstract available (Source: Journal of Burn Care and Research)
Source: Journal of Burn Care and Research - September 1, 2016 Category: Rehabilitation Tags: Letters to the Editor Source Type: research
The Use of Dermal Regeneration Template (Matriderm® 1 mm) for Reconstruction of a Large Full-Thickness Scalp and Calvaria Exposure
No abstract available (Source: Journal of Burn Care and Research)
Source: Journal of Burn Care and Research - September 1, 2016 Category: Rehabilitation Tags: Letters to the Editor Source Type: research
