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Graft burn rehabilitation

Justyna Glik, Marek Kawecki, Diana Kitala, Agnieszka Klama-Baryła, Wojciech Łabuś, Marek Grabowski, Agata Durdzińska, Mariusz Nowak, Marcelina Misiuga, Aleksandra Kasperczyk
Nearly 80% of all burns include the hands of affected individuals. Skin grafting is the gold standard in burns treatment, but in the case of the burn wound bed, it may require the necessity of utilising skin substitutes to facilitate closure. The aim of this study is to assess the impact of a porcine-derived wound dressing (Oasis™) for application to hand burns compared to a synthetic dressing (Suprathel™). Comparative assessments were made, including the time to heal, quality of healing and pain intensity...
February 21, 2017: International Wound Journal
Vladislav Shick, Evan E Lebovitz, Emerson Conrad
The management of pain after burn injuries is a clinical challenge magnified in patients with significant comorbidities. Presently, burn pain is treated via a wide variety of modalities, including systemic pharmacotherapy and regional analgesia. Although the latter can provide effective pain control in patients with burn injuries, it is relatively underused. Furthermore, the development of ultrasound guidance has allowed for novel approaches and sparing of motor nerve blockade with preference toward sensory-specific analgesia that has not been possible previously...
February 2017: Journal of Clinical Anesthesia
K A Wang, G S Wu, Y Sun, Z F Xia
Scar contracture deformity, which can lead to dysfunction of hand and low quality of life, is one of the common complication after hand burns. The prevention measures of scar contracture after hand burns include large skin grafting, prevention of infection, insistence on wearing pressure gloves, use of silicone sheets, wearing orthosis, accepting proper physical therapy, and early functional exercise. The primary treatments of postburn contractures of the hand are surgery, drugs, laser treatment, and rehabilitation therapy...
January 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
Shu-Fen Lo, Li-Jung Chang, Ting-Yuan Shiue, Ching-Yi Pan, Hui-Chuan Wu
Pruritus, a distressing symptom that affects burn patients, not only interferes with activities of daily living but also causes disturbed sleep, which has been associated with anxiety, depression, and other types of negative moods. Furthermore, the uncontrolled scratching that often accompanies pruritus causes tissue damage and may damage or destroy the skin graft. In this paper, the authors first describe the definition and mechanism of pruritus and next use itching-assessment tools to identify the triggering factors...
December 2016: Hu Li za Zhi the Journal of Nursing
H A Ismail, L E El-Bassiony
We evaluate function outcomes of the reverse-flow ALT perforator flap to reconstruct severe post-burn knee contracture. Between October 2012 and December 2014, 10 patients with severe post-burn knee contracture were subjected to reconstruction with 10 ipsilateral reversed-flow ALT perforator flaps. All the patients were male. Ages ranged from 15 to 47 years (mean = 32 years). Time from burn injury to patient presentation ranged from 2-8 months. All patients demonstrated post-burn flexion contracture of the knee joint, ranging from 35 to 75 degrees...
March 31, 2016: Annals of Burns and Fire Disasters
J Chateau, M Guillot, L Zevounou, F Braye, J-L Foyatier, J-P Comparin, D Voulliaume
Child palm burns arise by contact and are often deep. The singular difficulty of such a disease comes from the necessity of the child growth and from the potential occurrence of constricted scars. In order to avoid sequelae, the actual gold standard is to practice an early excision of the burn, followed by a skin graft. The aim of this study is to evaluate the results of spontaneous healing combined with rehabilitation versus early skin grafting and rehabilitation concerning the apparition of sequelae. We performed a retrospective study in two burn centers and one rehabilitation hospital between 1995 and 2010...
October 21, 2016: Annales de Chirurgie Plastique et Esthétique
Ingrid Parry, Soman Sen, Kelly Sattler-Petrocchi, David Greenhalgh, Tina Palmieri
Cutaneous functional units (CFUs) are fields of skin that functionally contribute to range of motion (ROM) at an associated joint. When replaced with scar tissue, the skin is less extensible and may result in loss of movement at the joint. Consideration of the amount of CFU affected by burn injury is increasingly being used to predict the development of burn scar contracture (BSC) in burn survivors. Previous work established that, in adults, burn rehabilitation time per CFU was the greatest predictor of preventing BSC...
March 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
Reg Richard, Alexis R Santos-Lozada, W Scott Dewey, Kevin K Chung
Burn scar contractures (BSCs) are a frequently recognized problem for survivors of burn injury. In the burn literature, many reports focus on the frequency and factors associated with the BSC development. To the contrary, few burn rehabilitation publications report on patients who are able to successfully avoid developing BSC. From a prospective, multicenter study, data were extracted and reviewed on a group of 56 adult burn survivors who were discharged from their acute hospitalization without any measured BSCs...
January 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
L Gottrand, F Devinck, V Martinot Duquennoy, P Guerreschi
Physical, non-painful processes guide the scar reshaping in children in order to prevent growth anomalies due to cutaneous shrinkage. The objective of the surgical treatment, coordinated with the reeducation care, is to improve the physical abilities of the skin, to restore the function and avoid the deformations. Reeducation uses various techniques (i.e. sensitive-motility, massage and mobilizations) with or without physical agent (water, aspiration and touch-drive technique). Posture and positioning rely on the small or major aids, from orthosis to prosthesis...
October 2016: Annales de Chirurgie Plastique et Esthétique
Jeremy Goverman, Katie Mathews, Richard Goldstein, Radha Holavanahalli, Karen Kowalske, Peter Esselman, Nicole Gibran, Oscar Suman, David Herndon, Colleen M Ryan, Jeffrey C Schneider
As the overall survival rate for burn injury has improved, increased emphasis is placed on postburn morbidity and the optimization of functional and cosmetic outcomes. One major cause of morbidity and functional deficits is that of joint contractures. The true incidence of postburn contractures and their associated risk factors remains unknown. This study examines the incidence and severity of contractures in a large, multicenter, burn population. The associated risk factors for the development of contractures are determined...
January 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
Jeremy Goverman, Katie Mathews, Richard Goldstein, Radha Holavanahalli, Karen Kowalske, Peter Esselman, Nicole Gibran, Oscar Suman, David Herndon, Colleen M Ryan, Jeffrey C Schneider
Joint contractures are a major cause of morbidity and functional deficit. The incidence of postburn contractures and their associated risk factors in the pediatric population has not yet been reported. This study examines the incidence and severity of contractures in a large, multicenter, pediatric burn population. Associated risk factors for the development of contractures are determined. Data from the National Institute on Disability and Rehabilitation Research Burn Model System database, for pediatric (younger than 18 years) burn survivors from 1994 to 2003, were analyzed...
June 22, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
A Chaibdraa, M S Medjelekh, A Saouli, M C Bentakouk
Use of local/regional anesthesia in burn patients is limited by many factors. It is considered as marginal in the multimodal treatment of nociceptive pain. We conducted a retrospective study on regional anesthesia used for analgesia over a period of three years. Given the lack of available literature on this subject, the results obtained from this study will enable suggestions to be made for possible uses of this technique. We identified 634 uses of regional anesthesia of which 96% were in adults. Most cases involved the lower limbs (76%)...
September 30, 2015: Annals of Burns and Fire Disasters
Derik L Davis, Charles S Resnik
History A 50-year-old woman presented with a 6-month history of polyarthralgia involving the left and right hands, wrists, elbows, ankles, and knees. Her pain was not associated with morning stiffness but did worsen over the course of the day. She denied experiencing fevers, chills, or mouth ulcers. She did not report paresthesias or blue discoloration of her fingers when they were exposed to cold. Her family history was remarkable for an aunt who died of systemic lupus erythematosus and for a brother with arthritis...
May 2016: Radiology
Jinshu Tang, Minghuo Xu, Wenwen Wu, Yuan Hu, Xiuxiu Shi, Shuxun Hou
The knee release surgery and postoperative rehabilitation of patients after burns and knee straight stiffness were investigated. Eleven patients were treated for 16 side burns and knee stiffness who consisted of nine males and two females, aged 19 to 54 years (mean = 33.2). The duration of the patients' knee stiffness ranged from 8 to 26 months, with an average of 12.6 months. Their preoperative flexion ranged from 5° to 50°, with an average of 26.2°. Their preoperative Hospital for Special Surgery (HSS) knee scores ranged from 46 to 72 points, with an average of 55...
December 2015: Indian Journal of Surgery
Benrong Lu, Yi Liu, Shilong Li, Gang Wang
After healing of burn wound, skin of scar, transplanted skin grafts, and healed donor site wound suffer from temporary or permanent loss of function of sebaceous glands and dysfunction of skin surface lipid film formation, resulting in desiccation, desquamation, and sensitiveness of the skin, making areas of newly formed skin unsatisfactory. Therefore a good rehabilitation may fail. In this paper, the composition, physiochemical properties, and reconstruction of skin surface lipid film are discussed.
February 2016: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
Hui-Min Wen
A dust explosion at the Formosa Fun Coast water park in Taiwan caused nearly 500 burn injury cases. One hundred of these cases involved burns over more than 20% of the total body surface area. This tragedy inundated hospitals across northern Taiwan with an unprecedented number of burn patients. Significant manpower and medical resources were targeted on related resuscitation and treatment efforts, with support and assistance provided by agencies and organizations nationwide. Most of the burn patients were young people in their teens and twenties, whose severe burns posed the greatest threat and challenge to their lives so far...
February 2016: Hu Li za Zhi the Journal of Nursing
Yu-Hsun Lin, Hsiu-Hua Lin, Li-Ping Shi, Eng-Kean Yeong
Major burn injuries constitute a systemic disease. In addition to completely understanding the mechanisms of wound healing, precise burn depth and area assessment is critical to the successful management of burn injuries. The recent advancements in post-burn fluid resuscitation, tangential burn excision and grafting, effective enteral tube feeding, and aggressive sepsis treatment have helped greatly increase the survival rates for major burn injuries. However, the restricted joint motion that results from hypertrophic scar contracture remains the main challenge facing burn survivors...
February 2016: Hu Li za Zhi the Journal of Nursing
S Boukind, H Droussi, O K Elatiqi, M Dlimi, O Dhaidah, M Ejjiyar, M Quaboul, A Dehhaze, S Fkhar, D Elamrani, Y Benchamkha, S Ettalbi
We conducted a retrospective study of data from September 2004 to September 2012, involving roughly 84 patients with burn sequelae of the hand who were treated surgically with full thickness skin grafts. The purpose of our study was to show the simplicity, effectiveness and reliability of this surgical technique. The average age at which the burn occurred was 4 years old. The average age of our patients was 18,3 years old (range=2-62 years old); males were affected in 60% of cases. The most frequent cause of injury were thermal burns, most often caused by hot liquids (56%)...
December 31, 2014: Annals of Burns and Fire Disasters
Hongming Li, Jiaping Zhang, Jian Chen, Huapei Song, Qiushi Liu, Xin Fan, Yizhi Peng, Jun Wu
This article reports the successful experience of integration of burn treatment and rehabilitation for a child suffering from 91% TBSA flame burn injury (with 60% TBSA full-thickness injury, 30% TBSA deep partial-thickness injury, and 1% TBSA superficial partial-thickness injury), severe inhalation injury, severe burn shock, stress ulcer, gastrointestinal bleeding and atelectasis of the right upper lung. The patient was given effective fluid infusion against shock, treatment for gastrointestinal bleeding, and other effective supportive treatment for functions of various organs after being admitted to our burn ward...
April 2015: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
Zelong Cui, Xiaohui Yang, Jiabao Shou, Guangyi Wang
OBJECTIVE: To investigate the feasibility and effectiveness of using scar split thickness skin grafts combined with acellular allogeneic dermis in the treatment of large deep II degree burn scar. METHODS: Between January 2013 and December 2013, 20 cases of large deep II degree burn scar undergoing plastic operation were enrolled. There were 14 males and 6 females, aged 4 to 60 years (mean, 40 years). Burn reasons included hydrothermal burns in 10 cases, flame burns in 9 cases, and lime burns in 1 case...
December 2014: Chinese Journal of Reparative and Reconstructive Surgery
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