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Burn management

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https://www.readbyqxmd.com/read/28634032/ciclosporin-use-in-epidermal-necrolysis-is-associated-with-an-important-mortality-reduction-evidence-from-three-different-approaches
#1
C González-Herrada, S Rodríguez-Martín, L Cachafeiro, V Lerma, O González, J A Lorente, A Rodríguez-Miguel, J González-Ramos, G Roustan, E Ramírez, T Bellón, F J de Abajo
Several immunomodulatory agents are used in the treatment of Epidermal Necrolysis (EN), but evidence of their efficacy is limited. The Autonomous Community of Madrid has two reference Burn Units (BUs) to which all patients with EN are referred to. One BU has mostly used ciclosporin (CsA), while the other has used non-CsA therapies (mainly high-dose intravenous immunoglobulin). The allocation of patients to one or another BU was mainly based on proximity resembling a random assignment. Thus, we took advantage of this "natural experiment" to estimate the mortality risk ratio (MRR) of CsA (N=26) as compared to non-CsA (n=16) using hospital as an instrumental variable (IV) over the period 2001-2015...
June 17, 2017: Journal of Investigative Dermatology
https://www.readbyqxmd.com/read/28632967/prevalence-and-orthopedic-management-of-foot-and-ankle-deformities-in-charcot-marie-tooth-disease
#2
Matilde Laurá, Dishan Singh, Gita Ramdharry, Jasper Morrow, Mariola Skorupinska, Davide Pareyson, Joshua Burns, Richard A Lewis, Steve Scherer, David N Herrmann, Nicholas Cullen, Christopher Bradish, Luca Gaiani, Nicolò Martinelli, Paul Gibbons, Glenn Pfeffer, Phinit Phisitkul, Keith Wapner, James Sanders, Sam Flemister, Michael E Shy, Mary M Reilly
INTRODUCTION: Foot deformities are frequent complications in Charcot-Marie-Tooth disease (CMT) patients, often requiring orthopedic surgery. However there are no prospective randomized studies on surgical management, and there is variation in the approache between centers in the same country and between different countries. METHODS: We assessed the frequency of foot deformities and surgery among patients recruited to the Inherited Neuropathies Consortium (INC). We also designed a survey addressed to orthopedic surgeons at INC centers to determine whether surgical approaches to orthopedic complications in CMT are variable...
June 20, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/28629932/systemic-antimicrobial-prophylaxis-in-burn-patients-a-systematic-review
#3
REVIEW
Guillermo Enrique Ramos
OBJECTIVE: To review studies of systemic antibiotic prophylaxis in burn patients. METHODS: Human clinical trials during the period 1966-2016 where prophylactic systemic antibiotics were compared with placebo or no intervention were identified in electronic databases. RESULTS: Nineteen trials met the selection criteria. Early post-burn period prophylaxis was assessed in non severe burn patients (6 trials), and in severe burn patients (7 trials)...
June 16, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28626295/restoring-effective-sleep-tranquility-rest-a-feasibility-and-pilot-study
#4
Aaron M Eakman, Arlene A Schmid, Kimberly L Henry, Natalie R Rolle, Catherine Schelly, Christine E Pott, Joshua E Burns
INTRODUCTION: The purpose of this pilot study was to establish the feasibility of completing a future controlled trial of a multi-component cognitive behavioral therapy for insomnia program for military veterans with sleep disturbance. METHOD: This was a single-arm feasibility and pilot study. Participants were United States post-9/11 veterans with service-connected injuries, university students, and had self-reported sleep disturbances. Restoring Effective Sleep Tranquility was a multi-component cognitive behavioral therapy for insomnia intervention consisting of seven sessions of group therapy and eight 1:1 sessions delivered by occupational therapists...
June 2017: British Journal of Occupational Therapy
https://www.readbyqxmd.com/read/28624042/wound-management-and-outcome-of-595-electrical-burns-in-a-major-burn-center
#5
Haisheng Li, Jianglin Tan, Junyi Zhou, Zhiqiang Yuan, Jiaping Zhang, Yizhi Peng, Jun Wu, Gaoxing Luo
BACKGROUND: Electrical burns are important causes of trauma worldwide. This study aims to analyze the clinical characteristics, wound management, and outcome of electric burns. METHODS: This retrospective study was performed at the Institute of Burn Research of the Third Military Medical University during 2013-2015. Data including the demographics, injury patterns, wound treatment, and outcomes were collected and analyzed. RESULTS: A total of 595 electrical burn patients (93...
June 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28623905/educational-standards-for-training-paramedics-in-ultrasound-a-scoping-review
#6
Ben Meadley, Alexander Olaussen, Ashleigh Delorenzo, Nick Roder, Caroline Martin, Toby St Clair, Andrew Burns, Emma Stam, Brett Williams
BACKGROUND: Paramedic-performed out-of-hospital ultrasound is a novel skill that has gained popularity in some services in recent years. In this setting point-of care ultrasound (POCUS) can provide additional information that can assist with management and guide transport to the most appropriate facility. We sought to explore the different educational approaches used for training paramedics in ultrasound in the out-of-hospital setting. METHODS: Ovid MEDLINE, EMBASE, EBM Reviews, The Cochrane Library, CINAHL plus, The Monash University Research Repository and the British Thesis Library were searched from the 1(st) of January 1990 to the 6(th) of April 2016...
June 17, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28620921/consistency-of-total-body-surface-area-assessment-in-severe-burns-implications-for-practice
#7
Stephen Face, Sarah Dalton
BACKGROUND: Paediatric burn injury is common and often serious. Injuries occur across New South Wales (NSW), with specialised treatment provided in a centralised burns unit. Early management prior to transfer is essential but variation is seen. OBJECTIVES: To determine if differences exist between referring hospital estimates of the total body surface area (TBSA) of burns, and estimates for the same burns by the Burns Unit. To consider if differences in estimations influence initial and ongoing management, and decisions regarding transfer/retrieval...
June 15, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28615829/primary-management-of-post-burn-contracture-neck-with-tracheostomy-a-surgeon-and-an-anaesthetist-s-perspective
#8
Madhubari Vathulya, Seema Shukla, Navin Shukla
No abstract text is available yet for this article.
January 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/28609467/land-cover-more-than-monthly-fire-weather-drives-fire-size-distribution-in-southern-qu%C3%A3-bec-forests-implications-for-fire-risk-management
#9
Jean Marchal, Steve G Cumming, Eliot J B McIntire
Fire activity in North American forests is expected to increase substantially with climate change. This would represent a growing risk to human settlements and industrial infrastructure proximal to forests, and to the forest products industry. We modelled fire size distributions in southern Québec as functions of fire weather and land cover, thus explicitly integrating some of the biotic interactions and feedbacks in a forest-wildfire system. We found that, contrary to expectations, land-cover and not fire weather was the primary driver of fire size in our study region...
2017: PloS One
https://www.readbyqxmd.com/read/28602591/skin-grafts-from-genetically-modified-%C3%AE-1-3-galactosyltransferase-knockout-miniature-swine-a-functional-equivalent-to-allografts
#10
D A Leonard, C Mallard, A Albritton, R Torabi, M Mastroianni, D H Sachs, J M Kurtz, C L Cetrulo
Burn is associated with a considerable burden of morbidity worldwide. Early excision of burned tissue and skin grafting of the resultant wound has been established as a mainstay of modern burn therapy. However, in large burns, donor sites for autologous skin may be limited. Numerous alternatives, from cadaver skin to synthetic substitutes have been described, each with varying benefits and limitations. We previously proposed the use of genetically modified (alpha-1,3-galactosyl transferase knockout, GalT-KO) porcine skin as a viable skin alternative...
June 8, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28602587/surgical-management-of-leukoderma-after-burn-a-review
#11
REVIEW
Eric L Maranda, Mindy X Wang, Shahjahan Shareef, Bryon A Tompkins, Christopher Emerson, Evangelos V Badiavas
Burns are a common and sometimes devastating injury causing a significant amount of pain, disability, and occasionally death. Burns can have serious aesthetic and functional consequences such as pigmentary changes and formation of scar tissue. Hypopigmentation or depigmentation is often a result of partial- or full-thickness burns, which is referred to as leukoderma after burn. Thus, this study is aimed at systematically reviewing the surgical options for treating leukoderma after burn in order to gain insight into the advantages, disadvantages, and future implications of each surgical technique...
June 8, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28601484/resuscitation-using-less-fluid-has-no-negative-impact-on-hydration-status-in-children-with-moderate-sized-scalds-a-prospective-single-centre-uk-study
#12
Linda Hollén, Karen Coy, Andrew Day, Amber Young
BACKGROUND: After a burn, optimal fluid resuscitation is critical for positive patient outcome. Although national guidelines advocate using resuscitation fluids of 4mL per kg body weight and percent body surface area (%BSA) for paediatric burns of >10% BSA, evidence in adults suggest that such volumes lead to over-resuscitation and related complications. Our aim was to investigate whether children managed with biosynthetic dressings (Biobrane™) and reduced fluid volumes remain well hydrated, as determined by clinical and laboratory parameters...
June 7, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28601203/the-care-of-thermally-injured-patients-in-operational-austere-and-mass-casualty-situations
#13
REVIEW
Booker T King, Wylan C Peterson
Burn injury affects a half million people in the United States annually. The severe thermal injury can have long-term debilitating effects. The management of burn patients in austere and operational environments is more complex. Mass casualty incidents can result in a large number of patients with multiple traumatic injuries, which often include burn injury. Appropriate triage of casualties is essential. Severely burned patients should be evacuated to a burn center if possible. Airway management and fluid resuscitation of burn patients present unique challenges...
June 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28599967/challenging-surgical-dogma-in-the-management-of-proximal-esophageal-atresia-with-distal-tracheoesophageal-fistula-outcomes-from-the-midwest-pediatric-surgery-consortium
#14
Dave R Lal, Samir K Gadepalli, Cynthia D Downard, Daniel J Ostlie, Peter C Minneci, Ruth M Swedler, Thomas H Chelius, Laura Cassidy, Cooper T Rapp, Deborah Billmire, Steven Bruch, R Carland Burns, Katherine J Deans, Mary E Fallat, Jason D Fraser, Julia Grabowski, Ferdynand Hebel, Michael A Helmrath, Ronald B Hirschl, Rashmi Kabre, Jonathan Kohler, Matthew P Landman, Charles M Leys, Grace Z Mak, Jessica Raque, Beth Rymeski, Jacqueline M Saito, Shawn D St Peter, Daniel von Allmen, Brad W Warner, Thomas T Sato
PURPOSE: Perioperative management of infants with esophageal atresia and tracheoesophageal fistula (EA/TEF) is frequently based on surgeon experience and dogma rather than evidence-based guidelines. This study examines whether commonly perceived important aspects of practice affect outcome in a contemporary multi-institutional cohort of patients undergoing primary repair for the most common type of esophageal atresia anomaly, proximal EA with distal TEF. METHODS: The Midwest Pediatric Surgery Consortium conducted a multicenter, retrospective study examining selected outcomes on infants diagnosed with proximal EA with distal TEF who underwent primary repair over a 5-year period (2009-2014), with a minimum 1-year follow up, across 11 centers...
June 1, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28598952/a-pediatric-burn-outpatient-short-stay-program-decreases-patient-length-of-stay-with-equivalent-burn-outcomes
#15
Tiffany Zens, Amy Yan, Christina Lee, Cindy Schmitz, Lee Faucher, Angela Gibson
Traditionally, small pediatric burns are managed with inpatient admission and daily dressing changes. In 2011, our burn center implemented an outpatient short stay (OSS) program in which small pediatric burns were managed as an outpatient utilizing Mepilex Ag dressings changed under moderate sedation every 5 to 7 days. Pediatric burn cases were queried for 2 time periods: before the OSS program (2009-2010) and after the OSS program (2013-2014). Burns > 15% TBSA, children with polytrauma, and children > 10 years old were excluded...
June 6, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28598907/treating-pain-on-skin-graft-donor-sites-review-and-clinical-recommendations
#16
Sarthak Sinha, Amanda J Schreiner, Jeff Biernaskie, Duncan Nickerson, Vincent A Gabriel
Split-thickness skin grafting (STSG) is the most common reconstructive procedure in managing burn injuries. Harvesting split-thickness skin creates a new partial thickness wound referred to as the donor site. Pain at the donor site is reported to be one of the most distressing symptoms during the early post-operative period. Here, we a) identify strategies for managing donor site pain, b) assess the quality of individual studies and c) formulate evidence-based recommendations based on the amount and consistency of evidence...
June 9, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28598760/the-use-of-modern-dressings-in-managing-split-thickness-skin-graft-donor-sites-a-single-centre-randomised-controlled-trial
#17
M Kazanavičius, A Cepas, V Kolaityte, R Simoliuniene, R Rimdeika
OBJECTIVE: To identify the most appropriate, most suitable and most efficient dressing for split-thickness skin graft (STSG) donor sites. Comparing the wound healing rate, pain severity and duration, as well as the dressing change frequency in four randomised patient groups. METHODS: A single-centre non-blinded randomised controlled trial was carried out during 2010-2014. All patients treated for skin defects/lesions (due to burns, trauma or ulcers) using STSG were included in the study...
June 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28597554/clinical-outcomes-in-a-specialist-male-genital-skin-clinic-prospective-follow-up-of-600-patients
#18
M Shah
It is important to assess outcomes for medical interventions in order to focus scarce resources on outcomes with a known positive benefit. An open, observational study was performed to assess the clinical outcomes of 600 male patients with a genital skin problem attending a specialist secondary care dermatology facility. Patients were mainly referred by general practitioners and genitourinary medicine physicians. Outcome was measured at 3 and 6 months, and was determined by clinical examination and assessment of patient symptoms...
June 8, 2017: Clinical and Experimental Dermatology
https://www.readbyqxmd.com/read/28594320/silver-containing-foam-dressings-with-safetac-a-review-of-the-scientific-and-clinical-data
#19
Phil Davies, Sara McCarty, Kristina Hamberg
Background Topical antimicrobials, such as silver dressings, are progressively being used alongside systemic antibiotics to provide adjunctive, antimicrobial therapy to wounds that are clinically infected or at risk of infection. To help improve wound management, dressings that use Safetac soft silicone technology in combination with a silver-impregnated foam dressing material were developed by Mölnlycke Health Care (Gothenburg, Sweden). The range comprises Mepilex Ag, Mepilex Border Ag and Mepilex Transfer Ag...
June 1, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28592936/grafting-both-acute-wound-site-and-adjacent-donor-site-with-the-same-graft-an-easy-and-safe-procedure-to-improve-healing-and-minimize-pain-in-elderly-and-bedridden-patients
#20
C Keilani, D Agard, A Duhoux, A Lakhel, O Giraud, M Brachet, P Duhamel, E Bey
In harvesting skin to cover the defect caused by a burn, a second wound is created, the donor site wound. We propose an alternative method to manage the donor site: taking a split-thickness skin graft (STSG) from a donor site adjacent to the burn wound to be treated, and meshing at a 3:1 ratio to cover both sites at once. The main objective of this study is to evaluate the effectiveness of covering both burn wound and adjacent donor site with the same STSG in elderly and bedridden patients. We retrospectively reviewed the medical records of 6 patients over 60 years old or/and bedridden presenting with a small burn wound who underwent STSG of both burn wound and adjacent donor site between April 2016 and November 2016 in the Department of Plastic Surgery and Burn Treatment at Percy Military Hospital (France)...
March 31, 2017: Annals of Burns and Fire Disasters
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