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Journal of Burn Care & Research: Official Publication of the American Burn Association

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https://www.readbyqxmd.com/read/28877135/want-correct-percentage-of-tbsa-burned-let-a-layman-do-the-assessment
#1
Ilaria Tocco-Tussardi, Benjamin Presman, Fredrik Huss
Accurate determination of burn size significantly impacts both immediate management and long-term outcome. In the era of evidence-based medicine, the variability in TBSA% assessment shown by traditional methods may prove unacceptable and technology-aided systems become the "accepted standard." The objective of this study was to push this scenario to the limit by investigating the accuracy and consistency of TBSA% estimations using a computer-aided tool. Five Laymen (health care-burn management naïve people) were trained on the handling of the technology-aided assessment tool Burn Case 3D and asked to calculate TBSA% for 18 clinical pictures of burns with different patterns and sizes...
August 31, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28877134/the-use-of-intravenous-and-inhaled-colistin-therapy-during-a-burn-center-outbreak-of-multidrug-resistant-acinetobacter-baumannii
#2
Tomas J Saun, Alan D Rogers, Jerome A Leis, Robert Cartotto
The authors report on the use of combination intravenous and inhaled colistin therapy in 2 patients with major burns admitted to an American Burn Association-verified burn center during a multidrug-resistant (MDR) Acinetobacter baumannii outbreak. Both patients had documented, culture-proven MDR Acinetobacter ventilator-associated pneumonia and bacteremia leading to sepsis. Both patients were successfully extubated and subsequently discharged from hospital. In this article, the authors provide the timeline of events and treatments that were used in these 2 cases...
August 31, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28877133/tear-dysfunction-syndrome-after-burn
#3
Jeong Won Seo, Hyun Sun Jeon, Jae Ryong Han
The objective of this study was to evaluate tear dysfunction of burn patients objectively. We retrospectively reviewed medical records of patients who had been examined within 1 week after burn injury. Visual acuity, intraocular pressure, cilia burned state, tear film break-up time (TBUT), and fluorescein corneal staining were evaluated. Sixty-four eyes of 32 patients (man 27, female 5) were included. Mean age was 44.41 ± 12.76 years old. Mean best corrected visual acuity was logMAR 0.04 ± 0.08, mean intraocular pressure was 13...
August 31, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28877132/parameters-for-ordering-blood-cultures-in-major-burn-injury-patients-improving-clinical-assessment
#4
James D Vargo, Jacob N Grow, Susan Yang, Abby Bernard, Niaman Nazir, Dhaval Bhavsar
Hypermetabolic and catabolic states in large TBSA burns lead to higher basal body temperature and tachycardia. These metabolic changes complicate the diagnosis of bacteremia and sepsis. Current indications for obtaining blood cultures (BCs) in this population are poorly described and nonstandardized. Fever, leukocytosis, and lactic acidosis are common during sepsis. This study aims to identify limits of these parameters with the highest rates of bacteremia. A retrospective review was performed for burn patients with > 20% TBSA between January 2009 and June 2011...
August 31, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28877131/resolvin-d2-limits-secondary-tissue-necrosis-after-burn-wounds-in-rats
#5
Yoshitaka Inoue, Yuk Ming Liu, Masayuki Otawara, Isabel Chico Calero, Ahhyun Stephanie Nam, Yong-Ming Yu, Philip Chang, Kathryn L Butler, Rosalynn M Nazarian, Jeremy Goverman, Benjamin J Vakoc, Daniel Irimia
Secondary burn necrosis is the expansion and deepening of the original burn injury several days after injury. Limiting the extent of secondary burn necrosis may improve outcomes. In this study, we examined the ability of the lipid mediator of inflammation-resolution resolvin D2 (RvD2) and chromatin-lysing enzyme (DNase) to reduce secondary burn necrosis. Male Wistar rats were injured using a brass comb with 4 prongs heated in boiling water. This method created 2 parallel rows of 4 rectangular burned areas separated by 3 unburned interspaces...
August 31, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28877130/fatigue-following-burn-injury-a-burn-model-system-national-database-study
#6
Laura C Simko, Leda F Espinoza, Kara McMullen, David N Herndon, Oscar Suman, James A Fauerbach, Karen Kowalske, Shelley Wiechman, Lewis E Kazis, Colleen M Ryan, Jeffrey C Schneider
Fatigue is a commonly reported but not well-documented symptom following burn injury. This study's objective was to determine the frequency and severity of fatigue over time and to identify predictors of fatigue in the adult burn population. Data from the Burn Model System National Database (April 1997 to January 2006) were analyzed. Individuals over 18 years of age who were alive at discharge were included. The vitality subscale of the Short-Form 36 Item Health Survey was examined at preinjury and discharge and at 6, 12, and 24 months postinjury...
August 31, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28877129/iatrogenic-full-thickness-frostbite-injury-caused-by-the-use-of-a-conductive-cooling-device
#7
Corbin Muetterties, Eric Weiss, Sandra Tomlinson-Hansen, William Hughes
Reports of iatrogenic cold thermal injuries are rare in the literature. Conductive cooling devices, typically employed for their neuroprotective effects, use conductive hydrogel pads to achieve rapid and precise temperature control approaching the level of water immersion. Despite a number of built-in safeguards, prolonged or improper use of these devices can lead to significant thermal injury. To the best of their knowledge, the authors describe the first report of a significant iatrogenic full-thickness injury caused by the use of a surface cooling system in a patient who had recently suffered a cerebrovascular accident...
August 31, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28877128/antioxidant-and-trace-element-supplementation-reduce-the-inflammatory-response-in-critically-ill-burn-patients
#8
Sarah Rehou, Shahriar Shahrokhi, Rimona Natanson, Mile Stanojcic, Marc G Jeschke
Oxidative stress after burn injury induces inflammatory and hypermetabolic responses associated with adverse outcomes. We propose that antioxidant and trace element supplementation may reduce oxidative stress and subsequently alleviate inflammation and hypermetabolism, thus improving clinical outcomes. We conducted a cohort study of adult patients with an acute burn injury admitted to our provincial burn center. Patients in the antioxidant group received an intravenous infusion of multivitamins and trace elements for the first 14 days after admission...
August 31, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29088008/risk-of-intubations-before-transport-to-burn-center
#9
Lee C Woodson, Mark Talon, Felipe Medieros, S Lynn Knox, Alexis McQuitty
No abstract text is available yet for this article.
November 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29088007/the-effect-of-wound-dressings-on-a-bio-engineered-human-dermo-epidermal-skin-substitute-in-a-rat-model
#10
Martina Hüging, Thomas Biedermann, Monia Sobrio, Sarah Meyer, Sophie Böttcher-Haberzeth, Edith Manuel, Maya Horst, Sally Hynes, Ernst Reichmann, Clemens Schiestl, Fabienne Hartmann-Fritsch
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...
November 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28570317/safety-of-nebulized-epinephrine-in-smoke-inhalation-injury
#11
Guillermo Foncerrada, Francisco Lima, Robert P Clayton, Ronald P Mlcak, Perenlei Enkhbaatar, David N Herndon, Oscar E Suman
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)...
November 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28570316/severity-of-inhalation-injury-is-predictive-of-alterations-in-gas-exchange-and-worsened-clinical-outcomes
#12
Tia Sutton, Ian Lenk, Peggie Conrad, Marcia Halerz, Michael Mosier
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...
November 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28394880/the-variation-of-hemodynamic-parameters-through-picco-in-the-early-stage-after-severe-burns
#13
Chen Gong, Fang Zhang, Lei Li, Fang He, Gong-Cheng Liu, Shi-Hui Zhu, Guang-Yi Wang, Zhao-Fan Xia
To investigate early hemodynamics of severely burned patients via PiCCO and to discuss clinical significance of hemodynamic monitoring for burn shock resuscitation, 55 extensive burn patients were enrolled in this retrospective study. The fluid resuscitation was guided according to Chinese General Formula and adjusted with urinary output of 0.5-1.0 ml/h/kg as a resuscitation goal. All patients were diagnosed within a relatively stable condition during burn shock stage, and they received PiCCO monitoring within 6 hours after burn...
November 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28394879/early-diagnosis-and-prevention-of-ischemic-enterocolitis-in-massive-burns
#14
Jennwood Chen, Giavonni M Lewis
To summarize the most salient literature regarding the pathogenesis, diagnosis, and prevention of ischemic enterocolitis (IE) in thermal injury. IE is a poorly characterized gastrointestinal complication associated with large burns. This entity occurs irrespective of abdominal trauma. The diagnostic challenges, paucity of treatment options and related complications make IE particularly lethal. Herein we present a case of profound IE in a 40-year-old male who sustained 80% total body surface area (TBSA) burns...
November 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28346302/the-benefit-of-microskin-in-combination-with-autologous-keratinocyte-suspension-to-treat-full-skin-loss-in-vivo
#15
Shang Yuru, Li Dawei, Shen Chuanan, Yin Kai, Ma Li, Li Longzhu, Zhao Dongxu, Cheng Wenfeng
Patients with extensive deep burns often lack enough autologous skin to cover the wounds. 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)...
November 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28346298/defining-sepsis-in-burn-patients-still-a-long-way-to-go
#16
David G Greenhalgh
No abstract text is available yet for this article.
November 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28338519/incidence-of-sinusitis-in-burn-victims-and-association-with-inhalational-injury
#17
Nicole M Melchior, Eric M Melchior, Linwood R Haith, Mary Lou Patton
The purpose of this study is to determine the incidence of sinusitis in mechanically ventilated burn victims and to examine if the presence of inhalational injury increases the likelihood of developing sinusitis. The authors hypothesize that the incidence of sinusitis will be increased in burn victims who have concomitant inhalational injury. A retrospective chart analysis was performed on all patients who were admitted to the Nathan Speare Regional Burn Treatment Center over a 24-month time frame. Patients who were mechanically ventilated for greater than 24 hours were then selected, resulting in a total of 137 patients for analysis...
November 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28338517/improving-nutritional-support-of-burn-service-patients-by-increasing-the-number-of-days-when-100-of-prescribed-formula-is-given
#18
Peggie F Conrad, Julie Liberio, Razia Aleem, Marcia M Halerz, Michael J Mosier, Arthur P Sanford, Neelam Balasubramanian, Richard L Gamelli
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...
November 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28328662/surgical-management-of-hidradenitis-suppurativa-a-14-year-retrospective-review-of-98-consecutive-patients
#19
Kathleen S Romanowski, Alice Fagin, Bridget Werling, Gretchen Kass, Junlin Liao, Thomas Granchi, Gerald P Kealey, Lucy Wibbenmeyer
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...
November 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28328660/addressing-the-barriers-to-bioimpedance-spectroscopy-use-in-major-burns-alternate-electrode-placement
#20
Pippa Kenworthy, Tiffany L Grisbrook, Michael Phillips, William Gibson, Fiona M Wood, Dale W Edgar
Bioimpedance spectroscopy (BIS) is a method used to assess body composition and fluid distribution. As a technology for measurement of fluid shifts during acute burn resuscitation, there are potential barriers to its use due to the location of wounds. This study aimed to determine whether alternate electrode positions were a suitable alternative compared to standardized (manufacturer) positions in moderate to large size burns for the measurement of BIS resistance and fluid changes. BIS measurements were collected in standard and alternate electrode placements and in an open wound and Acticoat™ dressing condition...
November 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
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