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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/28661983/u-s-pediatric-burn-patient-30-day-readmissions
#9
Krista K Wheeler, Junxin Shi, Andrew B Nordin, Henry Xiang, Jonathan I Groner, Renata Fabia, Rajan K Thakkar
The objectives of the study were to determine unscheduled 30-day readmission rates for pediatric burn patients and to identify readmission reasons. We used the 2013-2014 National Readmission Database to produce 30-day all-cause unscheduled readmission rates by patient and hospital characteristics. Readmission risk factors were evaluated with multivariable logistic regression. An estimated 11,940 U.S. pediatric burn patients were discharged in January through November 2013 and 2014, and 325 had unscheduled readmissions within 30 days (2...
August 18, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28661988/bowel-necrosis-and-3-limb-amputation-from-high-voltage-electrical-injury
#10
Elie P Ramly, Rebekah MacFie, Niknam Eshraghi, Frederick Cole, Delphine Engel
The objective of this study was to report the case and multidisciplinary management of a 44-year-old man with 40% TBSA third- and fourth-degree burns sustained during high-voltage electrical injury including 3 limb amputation and bowel necrosis requiring small bowel resection. This study is a case report and review of the literature. A 44-year-old man was brought to the Emergency Department with 40% TBSA third- and fourth-degree burns sustained during accidental contact with high-voltage electric current. He had multisystem injury including injuries to 3 of his extremities ultimately requiring a forequarter amputation of the left upper extremity and guillotine amputations of his bilateral lower extremities...
June 28, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28661987/upper-gastrointestinal-endoscopic-evaluation-following-household-sodium-hypochlorite-ingestion
#11
Shahriar Nikpour, Elnaz Masoumi-Moghaddam, Soha Pazoki, Hossein Hassanian-Moghaddam, Nasim Zamani
Endoscopy is generally speculated to be unnecessary in sodium hypochlorite (NaClO) ingestions; however, a significant number of endoscopic evaluations are still being performed when this chemical is ingested. Therefore, the aim of the current study was to compare the outcome and endoscopic findings between patients who had ingested household NaClO and those who had ingested other types of corrosives. This retrospective cohort study enrolled 137 patients with a history of corrosive substance ingestion admitted to a tertiary hospital...
June 28, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28661986/comparison-of-pain-severity-and-management-in-burn-and-nonburn-trauma-patients
#12
Atulya Prasad, Naureen Osman, Henry C Thode, Adam J Singer
Burn injuries are generally considered to be among the most painful. However, there is little evidence to support this. It is also unknown if pain management in burn patients differs from patients with other sources of pain. We compared pain severity among patients presenting to emergency departments (EDs) across the United States with burn and nonburn injuries using data generated from the National Hospital Ambulatory Care Survey. Multivariate analyses was performed to determine the association between predictor variables and pain severity as well as pain management in the ED...
June 28, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28661985/a-novel-approach-to-sealing-the-denuded-dermis-of-the-abdominal-wall-with-a-negative-pressure-wound-device-after-a-decompressive-laparotomy
#13
John Davis, Daniel M Caruso, Kevin N Foster, Marc R Matthews
The open abdomen is a well-known technique that is applied in a wide variety of clinical situations, including treatment of abdominal compartment syndrome, damage control laparotomy, and severe intraabdominal sepsis. Disease states such as Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis or extensive deep partial and/or full-thickness torso burns involving the abdomen often result in a complete epidermal and partial dermal loss. When ABThera Open Abdomen Negative Pressure Wound Therapy is attempted in these patients, the exposed subcutaneous tissue rarely allows for an adequate seal between the adhesive barrier and the denuded skin...
June 28, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28661984/resting-%C3%AE-adrenergic-blockade-does-not-alter-exercise-thermoregulation-in-children-with-burn-injury-a-randomized-control-trial
#14
Eric Rivas, Serina J McEntire, David N Herndon, Oscar E Suman
The objective of this study was to test the hypothesis that propranolol, a commonly prescribed β-blocker to burned children, in combination with exercise-heat stress, increases the risk of heat illness and exercise intolerance. In a randomized double-blind study, propranolol was given to 10 burned children, and placebo was given to 10 additional burned children (matched for TBSA burned; mean ± SD, 62 ± 13%), while nonburned children served as healthy controls. All groups were matched for age and body morphology (11...
June 28, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28661982/extra-articular-soft-tissue-calcification-after-burn-injury-a-case-study
#15
Young Jae Moon, Seong-Yup Jeong, Kwang-Bok Lee
Soft-tissue calcifications after burn injury commonly develop in periarticular regions, especially in the elbow joint. They can be easily recognized in patients because calcification in the joint limits range of motion and brings about tingling sensation due to compression of ulnar nerve. However, the incidence of extra-articular soft-tissue calcification after burn injury has rarely been reported. We present a patient with massive soft-tissue calcification in extra-articular burn scar with nonhealing ulcer after a long latency period of 40 years...
June 28, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28661981/an-external-wire-frame-fixation-method-of-skin-grafting-for-burn-reconstruction
#16
Yukiko Yoshino, Hyakuzoh Ueda, Simpei Ono, Rei Ogawa
The skin graft is a prevalent reconstructive method for burn injuries. We have been applying external wire frame fixation methods in combination with skin grafts since 1986 and have experienced better outcomes in percentage of successful graft take. The overall purpose of this method was to further secure skin graft adherence to wound beds in hard to stabilize areas. There are also location-specific benefits to this technique such as eliminating the need of tarsorrhaphy in periorbital area, allowing immediate food intake after surgery in perioral area, and performing less invasive fixing methods in digits, and so on...
June 28, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28846992/improving-research-enrollment-of-severe-burn-patients
#17
Anne M Lachiewicz, Felicia N Williams, Shannon S Carson, Jessica M Trexler, Carrie A Nielsen, David van Duin, David J Weber, Shannon D Williams, Samuel W Jones, Bruce A Cairns
Enrolling severely burn injured patients into prospective research studies poses specific challenges to investigators. The authors describe their experience of recruiting adults with ≥20% TBSA burns or inhalation injury admitted to a single academic burn unit into observational research with minimally invasive specimen collection. The authors outline iterative changes that they made to their recruitment processes in response to perceived weaknesses leading to delays in enrollment. The primary outcome was the change in days to consent for enrolled patients or cessation of recruitment for nonenrolled patients before and after the interventional modifications...
September 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28846576/blood-and-tissue-silver-levels-following-application-of-silver-based-dressings-to-sulfur-mustard-chemical-burns
#18
David J Barillo, Claire R Croutch, Frances Reid, Tara Culley, William Sosna, Julie Roseman
Silver-based dressings are commonly used in burn care. Silver sulfadiazine use is associated with elevated blood, urine, and tissue levels of silver ion. We examined wound and tissue levels of silver ion in a two-species model of sulfur mustard chemical burn injury treated with two different silver-based dressings. Superficial dermal and moderate thickness dermal chemical burns were induced in 16 hairless guinea pigs and in 16 Gottingen minipigs by exposure to sulfur mustard vapor. After debridement, silver-nylon burn dressings or silver-calcium alginate dressings were applied and changed every 7 days until wound healing or a maximum of 60 days post exposure...
September 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28447971/the-local-and-systemic-inflammatory-response-in-a-pig-burn-wound-model-with-a-pivotal-role-for-complement
#19
H Ibrahim Korkmaz, Magda M W Ulrich, Wessel N van Wieringen, Marcel Vlig, Reindert W Emmens, Klaas W Meyer, Paul Sinnige, Paul A J Krijnen, Paul P M van Zuijlen, Hans W M Niessen
In patients with burns, a massive inflammatory response is induced which negatively affects the healing process of the burn wound and additionally exerts systemic effects. An important factor herein is the complement system. Here we analyzed the effects of burns on complement and inflammatory cells both locally and systemically after burn in time in a pig burn wound model. In burned pigs, burn wound biopsies and blood were collected up to 60 days after burn. Complement in blood as well as complement and inflammatory cells in the burn wound and several organs were determined...
September 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28296671/the-use-of-thrombolytic-therapy-in-the-treatment-of-frostbite-injury
#20
Allyson Wexler, Sarah Zavala
Frostbite can lead to severe consequences including loss of digits and limbs. One of the mechanisms of frostbite includes vascular thrombosis. The use of tissue plasminogen activator (tPA) in frostbite has been shown to be effective in case reports and small prospective studies. A retrospective chart review was performed on all patients admitted for frostbite between January 2008 and April 2015, and six patients were identified as having received treatment with intravenous tPA. Patients received an initial bolus dose followed by a 6-hour infusion of tPA...
September 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
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