Examination of the Life Expectancy of Patients with Burns over 20% of Their Total Body Surface Area in Comparison to the Rest of the Population
Patients with extensive burn injuries suffer from multisystem trauma, which affects their medical, psychological, and social well-being for many years. Monitoring those patients has revealed changes in the endocrine, cardiac, and respiratory systems years after the injury. Our study tries to examine whether changes manifest as a higher risk of death during their lifespan, compared with the general population. Data from the years 1998 to 2013 regarding two groups of patients was obtained from a national trauma registry: one group had suffered burns over 20% of their TBSA and survived the hospitalization period and the secon...
Source: Journal of Burn Care and Research - November 1, 2017 Category: Rehabilitation Tags: Original Articles Source Type: research
Economical Burden of Burn Injuries in a Developing Country
Burn injuries have economical impacts on patients in several ways. Understanding the charges of burn treatment is very important for patients, families, governmental authorities, and insurance companies. During the protocol of their treatment, they may be admitted several times for treatment of acute burn and then for reconstructive treatments of burn’s complications. Calculating the hospital burn charges can serve as an objective criteria for authorities to plan for a sufficient budget for acute burn treatment, for additional management for chronic complications, and as a guide for planning preventive and public educati...
Source: Journal of Burn Care and Research - November 1, 2017 Category: Rehabilitation Tags: Original Articles Source Type: research
Burn-Related Dysregulation of Inflammation and Immunity in Experimental and Clinical Studies
The purpose of this study was to evaluate burn-related variations of inflammation and immunity. Fifty-five mice were divided randomly into sham burn and burn groups. Eighty-seven hospitalized burn patients were also reviewed. In mice, neutrophils and monocytes were elevated significantly on post burn day (PBD 1). Lymphocytes were reduced on PBDs 1 and 3. Levels of serum tumor necrosis factor-α and interleukin-6 were highest on PBD 1. Interleukin-1β levels were the highest on PBD 3. On PBD 3, CD4+CD25+T regulatory cells/CD4+ cells in spleen were higher. On PBDs 1, 3, 7, and 14, percentage of splenic dendritic cells were s...
Source: Journal of Burn Care and Research - November 1, 2017 Category: Rehabilitation Tags: Original Articles Source Type: research
Healthcare Resource Utilization Associated with Burns and Necrotizing Fasciitis: A Single-Center Comparative Analysis
This study shows that NF requires substantially more HRU compared with burns. This information is important in recognizing the impact of these patients on burn units and planning for allocation of appropriate resources. (Source: Journal of Burn Care and Research)
Source: Journal of Burn Care and Research - November 1, 2017 Category: Rehabilitation Tags: Summary Article Source Type: research
Enzymatic Versus Traditional Surgical Debridement of Severely Burned Hands: A Comparison of Selectivity, Efficacy, Healing Time, and Three-Month Scar Quality Erratum
No abstract available (Source: Journal of Burn Care and Research)
Source: Journal of Burn Care and Research - November 1, 2017 Category: Rehabilitation Tags: Erratum Source Type: research
Safety of Nebulized Epinephrine in Smoke Inhalation Injury
This pilot study was conducted to profile safety of nebulized racemic epinephrine when used as a therapy for smoke inhalation injury in severely burned children. We enrolled 16 patients who were 7 to 19 years of age ([mean ± SD], 12 ± 4 years) with burns covering more than 30% of the TBSA (55 ± 17%) and smoke inhalation injury, as diagnosed by bronchoscopy at burn center admission. Patients were randomized to receive either standard of care (n = 8), which consisted of nebulized acetylcysteine, nebulized heparin, and nebulized albuterol, or to receive standard of care plus nebulized epinephrine (n = 8). Primary e...
Source: Journal of Burn Care and Research - November 1, 2017 Category: Rehabilitation Tags: Original Articles Source Type: research
Severity of Inhalation Injury is Predictive of Alterations in Gas Exchange and Worsened Clinical Outcomes
Inhalation injury (INH) is present in one third of large burn injuries and increases oxygenation and fluid resuscitation requirements, incidences of pulmonary complications, risk for multiple organ dysfunction syndrome (MODS), and overall mortality. Previous studies have demonstrated inconsistent correlation between bronchoscopic evaluation and clinical outcomes. The authors reviewed 161 patients admitted with a diagnosis of INH or underwent diagnostic bronchoscopy for suspected INH over a period of 8.5 years. One hundred one patients had concomitant burn injury and 60 had isolated INH. Seventeen patients had abbreviated i...
Source: Journal of Burn Care and Research - November 1, 2017 Category: Rehabilitation Tags: Original Articles Source Type: research
Improving Nutritional Support of Burn Service Patients by Increasing the Number of Days When 100% of Prescribed Formula Is Given
The authors sought to increase the number of days when burn service patients receive 100% of prescribed enteral nutrition. The authors first performed a retrospective review of 37 patients (group 1) receiving enteral nutrition. The authors then created and implemented a nurse-directed feeding algorithm, placing patients into three age groups addressing maximum hourly infusion rates, high residual limits, initiating feeding, refeeding residuals, and replacing formula. The authors then performed a prospective review of 37 patients (group 2) fed utilizing the new algorithm. The amount of prescribed, infused, discarded, and mi...
Source: Journal of Burn Care and Research - November 1, 2017 Category: Rehabilitation Tags: Original Articles Source Type: research
Vascularized Composite Allotransplantation—An Emerging Concept for Burn Reconstruction
Vascularized composite allotransplantation (VCA) has demonstrated utility in the reconstruction of extensive soft-tissue defects following severe burns. However, pre-VCA events such as multiple transfusions, previous transplantation and pregnancies, the use of skin allografts, and mechanical support devices may result in sensitization and ultimately exclude a burn patient, who may benefit most through VCA, from a hand or face transplant. The authors sought to identify the immunologic challenges involved. All reported VCA cases up to July 2016 were reviewed. Relevant data analyzed include patient demographics, burn etiology...
Source: Journal of Burn Care and Research - November 1, 2017 Category: Rehabilitation Tags: Original Articles Source Type: research
Surgical Management of Hidradenitis Suppurativa: A 14-Year Retrospective Review of 98 Consecutive Patients
Hidradenitis suppurativa (HS) is a debilitating suppurative disease of the apocrine/follicular glands. Medical treatment has some efficacy in early-stage disease but is costly and requires frequent physician visits. Advanced disease usually requires surgical intervention. This treatment has not been well described in the literature. We sought to review our experience with HS treatment in a large surgical cohort. A retrospective review of 98 consecutive HS patients from 2000 to 2014 was performed. A two-stage operative approach was used. The first stage involved the removal of all the hair-bearing skin in the affected areas...
Source: Journal of Burn Care and Research - November 1, 2017 Category: Rehabilitation Tags: Original Articles Source Type: research
The Effect of Wound Dressings on a Bio-Engineered Human Dermo-Epidermal Skin Substitute in a Rat Model
Autologous bio-engineered dermo-epidermal skin substitutes are a promising treatment for large skin defects such as burns. For their successful clinical application, the graft dressing must protect and support the keratinocyte layer and, in many cases, possess antimicrobial properties. However, silver in many antimicrobial dressings may inhibit keratinocyte growth and differentiation. The purpose of our study was to evaluate the effect of various wound dressings on the healing of a human hydrogel-based dermo-epidermal skin substitute in preparation for the first-in-human clinical trials. Human dermo-epidermal skin substitu...
Source: Journal of Burn Care and Research - November 1, 2017 Category: Rehabilitation Tags: Original Articles Source Type: research
The Benefit of Microskin in Combination With Autologous Keratinocyte Suspension to Treat Full Skin Loss In Vivo
This study explores a new method using microskin in combination with autologous keratinocytes in the treatment of extensive deep burn. Wounds in the combination group were treated with automicroskin at an area expansion ratio of 20:1 (wound area to automicroskin area) and autologous keratinocyte suspension, which were compared with the following treatments: no autotransplant, only allografts (control group); autologous keratinocyte suspension only (keratinocyte only group); automicroskin at an area expansion ratio of 20:1 (20:1 group); and automicroskin at an area expansion ratio of 10:1 (10:1 group, positive control). The...
Source: Journal of Burn Care and Research - November 1, 2017 Category: Rehabilitation Tags: Original Articles Source Type: research
Pain Management in Pediatric Burn Patients: Review of Recent Literature and Future Directions
This article aims to identify the best strategies to guide clinical practice through a review of the past 10 years’ development in pediatric burn pain management. However, because clinical investigations remain limited in burned children, we also aim to draw attention to those areas where the data do not identify an optimal approach and further work is needed. Overall, in addition to just the traditional pharmacological approaches to pain, such as acetaminophen, benzodiazepines, and opioids, there is growing evidence to support more widespread use of regional anesthesia and novel technologies such as virtual reality. Sta...
Source: Journal of Burn Care and Research - November 1, 2017 Category: Rehabilitation Tags: Summary Article Source Type: research
Serum Levels of Cardiotroponin I in Burn Patients and Its Relation to Outcome of the Disease
No abstract available (Source: Journal of Burn Care and Research)
Source: Journal of Burn Care and Research - November 1, 2017 Category: Rehabilitation Tags: Letters to the Editor Source Type: research
Risk of Intubations Before Transport to Burn Center
No abstract available (Source: Journal of Burn Care and Research)
Source: Journal of Burn Care and Research - November 1, 2017 Category: Rehabilitation Tags: Letters to the Editor Source Type: research
