Hydrocodone, but Neither Morphine nor Oxycodone, Is Effective in Suppressing Burn-Induced Mechanical Allodynia in the Uninjured Foot Contralateral to the Burn
This study monitored the development of mechanical allodynia and compared the abilities of morphine, oxycodone, and hydrocodone to reduce burn-induced mechanical allodynia in the limb contralateral to the burn. Mice were examined for their baseline pain sensitivity thresholds using the von Frey filaments test. Then, they were subjected to burn or sham injury and treated orally with morphine, oxycodone, hydrocodone (20 or 40 mg/kg), or saline twice daily throughout the study. They were retested on days 4, 7, 11, 14, 21, and 28 postburn. Hyperalgesia was developed in the contralateral, uninjured foot beginning 21 days afte...
Source: Journal of Burn Care and Research - August 28, 2017 Category: Rehabilitation Tags: Original Articles Source Type: research
Comparison of Automated Methods Versus the American Burn Association Sepsis Definition to Identify Sepsis and Sepsis With Organ Dysfunction/Septic Shock in Burn-Injured Adults
To develop an algorithm to identify sepsis and sepsis with organ dysfunction/septic shock in burn-injured patients incorporating criteria from the American Burn Association sepsis definition that possesses good test characteristics compared with International Classification of Diseases, Ninth Revision-Clinical Modification (ICD-9) codes and an algorithm previously validated in nonburn-injured septic patients (Martin et al method). This was a retrospective cohort study of consecutive patients admitted to the burn intensive care unit between January 2008 and March 2015. Of the 4761 admitted, 8.6% (n = 407) met inclusion crit...
Source: Journal of Burn Care and Research - August 28, 2017 Category: Rehabilitation Tags: Original Articles Source Type: research
Mitochondrial DNA-Induced Inflammatory Responses and Lung Injury in Thermal Injury Rat Model: Protective Effect of Epigallocatechin Gallate
Lungs are easily damaged by the inflammatory responses induced after extensive burns. The aim here was to investigate the protective role of epigallocatechin gallate (EGCG) in mitochondrial DNA (mtDNA)-mediated inflammatory responses and acute respiratory distress syndrome (ARDS) in a rat model of thermal injury. Male Sprague-Dawley rats were randomly assigned to five groups. In the first experiment, a full-thickness thermal injury or control procedure, covering 30% of the TBSA, was inflicted on three groups designated as the thermal injury, EGCG, and sham control groups. In the second experiment, another two groups were e...
Source: Journal of Burn Care and Research - August 28, 2017 Category: Rehabilitation Tags: Original Articles Source Type: research
Intraoperative Feeding Improves Calorie and Protein Delivery in Acute Burn Patients
The objective of this study was to describe our American Burn Association–certified burn center’s experience implementing an intraoperative feeding protocol in severely burned patients defined as a cutaneous burn ≥20% TBSA. A retrospective review of patients with major thermal injuries (2008–2013). Thirty-three patients with an average of seven operating room trips (range, 2–21 trips) were evaluated. Seventeen patients received intraoperative enteral feeds (protocol group) and 16 patients did not (standard group). Feeding was performed using an enteral feeding tube placed postpylorically and was continued intraop...
Source: Journal of Burn Care and Research - August 28, 2017 Category: Rehabilitation Tags: Original Articles Source Type: research
MR-proADM: A New Biomarker for Early Diagnosis of Sepsis in Burned Patients
Mid regional pro-adrenomedullin (MR-proADM) has been used as a marker of sepsis, but its dynamics and role in a burn injury setting has not been tested. In a prospective observational study, we included 42 consecutive patients with>15% TBSA. Daily blood specimens collected over the initial 20 days of treatment were submitted for laboratory analysis of MR-proADM and procalcitonin (PCT) via immunoluminometric sandwich assay (Kryptor, BRAHMS, Berlin, Germany). In patients with an absence of sepsis, an initial increase in MR-proADM and PCT levels was noted post-burn injury, peaking on the second day postadmission and thereafte...
Source: Journal of Burn Care and Research - August 28, 2017 Category: Rehabilitation Tags: Original Articles Source Type: research
Artiss Sealant®: An Alternative to Stapling Skin Grafts on the Dorsal Side of the Hand and Fingers
The aim of this study was to evaluate the benefit of using a new slow-setting fibrin sealant compared with staples for adherence of split-thickness skin grafts on the backs of hands and fingers. Staple removal is often painful for patients. Twenty-eight patients were included for a graft total of 34 hands. The authors chose to test this sealant on zones that are often difficult to graft given their varied topographies. Its low concentration of thrombin (4 IU/ml) compared with other sealants provides it with prolonged polymerization time (60 seconds) making it easier to use in this location. All 34 grafts had taken at 5 day...
Source: Journal of Burn Care and Research - August 28, 2017 Category: Rehabilitation Tags: Original Articles Source Type: research
Risk Factors for Acute Kidney Injury in Patients With Burn Injury: A Meta-Analysis and Systematic Review
Acute kidney injury (AKI) is a fatal complication of burn injury. Few systematic reviews to date have focused on the risk factors predisposing to AKI in patients with burn injury. The aim of this article is to identify the risk factors for the occurrence of AKI in burn patients, thus providing theoretical evidence for prevention and treatment. We performed a systematic review and meta-analysis of studies determining the prevalence, risk factors, and outcomes of AKI in patients with burn injury. An electronic search (up to April 2016) was performed using Pubmed, Embase, Web of Knowledge, and the Cochrane Library databases. ...
Source: Journal of Burn Care and Research - August 28, 2017 Category: Rehabilitation Tags: Summary Article Source Type: research
Wound Management
No abstract available (Source: Journal of Burn Care and Research)
Source: Journal of Burn Care and Research - June 24, 2017 Category: Rehabilitation Tags: Editorial Source Type: research
Scald Burn Injuries Caused by Showers Among the Adult Population in the Southwest Region
No abstract available (Source: Journal of Burn Care and Research)
Source: Journal of Burn Care and Research - June 24, 2017 Category: Rehabilitation Tags: Letter to the Editor Source Type: research
Thyroid Crisis in a Patient With Burn Injury
Thyroid crisis is an exacerbation of hyperthyroidism that results in severe systemic disturbances and could be fatal. Similarly, severe burn injury also has a hypermetabolic response as part of its presentation. When these two conditions are present concurrently, one must be cognizant that the patient requires urgent optimization of their hyperthyroid status before surgery, and continuous monitoring in an intensive care unit setting. We offer a systematic approach to managing these patients. (Source: Journal of Burn Care and Research)
Source: Journal of Burn Care and Research - June 24, 2017 Category: Rehabilitation Tags: Case Reports Source Type: research
Nonoperative Treatment of a Tracheocutaneous Fistula in a Burn Patient
We describe a case of a TCF in a burn patient treated without surgery. No previous cases have been described. A 65-year-old woman presented with symptomatic hypertrophic burn scar contractures of the anterior neck 6 months after undergoing excision and grafting of full-thickness burns to the neck and chest. She had a history of tracheostomy placement at the time of burn. Two months later, she was decannulated with no evidence of TCF. She subsequently underwent excision of hypertrophic burn scar contractures of the neck with placement of bilayer wound matrix followed by split-thickness skin grafting. Postoperatively she was...
Source: Journal of Burn Care and Research - June 24, 2017 Category: Rehabilitation Tags: Case Reports Source Type: research
Evaluation of the New North Carolina Burn Registry
The objective of this evaluation was to review the literature for best practices in designing a disease registry, benchmark the design of the NC burn registry with the best practices identified in the literature, and compare data quality before and after implementation of the new NC burn registry. The NC burn registry was evaluated using six measurable elements identified from essential indicators of the Agency for Healthcare Research and Quality user’s guide for design, implementation, analysis, interpretation, and quality evaluation of registries. These elements were achieving objectives, using literature to inform the...
Source: Journal of Burn Care and Research - June 24, 2017 Category: Rehabilitation Tags: Original Articles Source Type: research
Shake It Off: A Randomized Pilot Study of the Effect of Whole Body Vibration on Pain in Healing Burn Wounds
Whole body vibration (WBV) has been shown to improve strength in extremities with healed burn wounds. We hypothesize that WBV reduces pain during rehabilitation compared to standard therapy alone. Patients with ≥1% TBSA burn to one or more extremities from October 2014 to December 2015 were randomized to vibration (VIBE) or control. Each burned extremity was tested separately within the assigned group. Patients underwent one to three therapy sessions (S1, S2, S3) consisting of five upper and/or lower extremity exercises with or without WBV. Pain was assessed pre-, mid-, and postsession on a scale of 1 to 10. Mean pain sc...
Source: Journal of Burn Care and Research - June 24, 2017 Category: Rehabilitation Tags: Original Articles Source Type: research
Enzymatic Versus Traditional Surgical Debridement of Severely Burned Hands: A Comparison of Selectivity, Efficacy, Healing Time, and Three-Month Scar Quality
Severe burns of the hands are extremely challenging, given their anatomic complexity and vulnerability. Although excisional debridement with autografting remains the standard of care (SOC), previous studies have shown that use of enzymatic debridement with bromelain (NexoBrid, EDNX) enables rapid, selective enzymatic debridement, preserving viable tissue. To date, only two studies accruing data on EDNX in this setting have been published. The current study was conducted to compare EDNX with traditional surgical debridement (TSD) of deep dermal and full-thickness hand burns. This single-center, controlled clinical trial inc...
Source: Journal of Burn Care and Research - June 24, 2017 Category: Rehabilitation Tags: Original Articles Source Type: research
Assessing Primary Care Trainee Comfort in the Diagnosis and Management of Thermal Injuries
Thermal injuries are common and the majority will initially present to primary care physicians. Despite being a part of the objectives of training in family medicine (FM) and emergency medicine (EM), previous study has shown that in practice, gaps exist in the delivery of care. An electronic survey was sent to all FM/EM trainees at our university for the 2014 to 2015 academic year. Plastic Surgery trainees were included as a control group. Demographics and educational/clinical experience were assessed. Trainee comfort was measured on a five-point Likert scale across 15 domains related to thermal injuries. Preferences for e...
Source: Journal of Burn Care and Research - June 24, 2017 Category: Rehabilitation Tags: Original Articles Source Type: research
