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Burn care

Bradley D Stein, Andrew W Dick, Mark Sorbero, Adam J Gordon, Rachel M Burns, Douglas L Leslie, Rosalie Liccardo Pacula
BACKGROUND: Medication treatment (MT) with methadone and buprenorphine are effective treatments for opioid use disorders, but little information is available regarding the extent to which buprenorphine's approval resulted in more individuals receiving MT nor to what extent receipt of such treatment was equitable across communities. METHODS: To examine changes in MT utilization and the association between MT utilization and county-level indicators of poverty, race/ethnicity, and urbanicity, we used Medicaid claims of non-dually eligible Medicaid enrollees aged 18-64 from 14 states for 2002-2009...
June 22, 2018: Substance Abuse
Rachel M Nygaard, Frederick W Endorf
Frostbite is a form of thermal injury that can have devastating consequences for patients, including digit amputations and sometimes more proximal amputations. To the best of the authors' knowledge, no one has determined national characteristics of frostbite patients, nor the prevalence of these diagnostic and therapeutic modalities. This is the first look at nationwide trends in the treatment of frostbite in the United States. Patients with frostbite injury were identified in the National Trauma Data Bank (NTDB) and National Burn Repository (NBR)...
December 6, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
Ishan Radotra, Sonya Gardiner, David Barnes
Phytophototoxic burn injuries refer to dermal loss after contact with light-sensitizing plants and subsequent exposure to sunlight, which can at their most severe result in full-thickness burns. Phytophototoxic injuries secondary to the Herb of Grace, otherwise known as Ruta Graveolens or the "Common rue" plant, are very rare. The authors report the first case to have been referred directly and solely managed in a specialist burns unit along with a review of the literature. The authors report a case of a 50-year-old gentleman who suffered a phytophototoxic burn injury to his hand 2 days after contact with the "common rue...
December 5, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
Gretchen J Carrougher, Kathleen A Hollowed, Jill L Sproul, Bradley J Wiggins, Elizabeth Mann-Salinas
Competency standards for nurses who specialize in the care of burn-injured patients are lacking. Currently, there are no nationally agreed on standards that define safe and competent burn nursing practice. In 2014, nurse members of the American Burn Association proposed the Burn Nurse Competency Initiative (BNCI) with the intent of establishing a core set of competency standards for burn nursing. The BNCI used the Delphi technique of consensus building with input from up to 178 registered nurse burn care experts...
November 24, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
Ilmari Rakkolainen, Moustafa Elmasry, Ingrid Steinvall, Jyrki Vuola
B-type natriuretic peptide has shown promising results as a biomarker for acute kidney injury in general intensive care patients. It may also indirectly reflect fluid balance of the circulation. Among burn patients, it has been observed to indicate excessive fluid resuscitation and organ dysfunction, although its clinical use to indicate acute kidney injury or guide fluid resuscitation has not been validated. The aim of this study was to evaluate whether the N-terminal pro-brain natriuretic peptide values are related to the amount of fluids given after severe burn injury and whether it can act as a novel biomarker for acute kidney injury in these patients...
February 9, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
Francesco M Egro, Louise C Tayler-Grint, Sai K Vangala, Chibueze A Nwaiwu
An e-learning tutorial was developed to cover the basic aspects of acute burns management. The aim of this study was to provide objective educational evidence supporting the role of an e-learning on acute burns management ("basic burns management" or BBM) when compared with traditional teaching methods when introduced in different medical school settings around the world. A multicenter randomized controlled trial was conducted at the University of Pittsburgh, Peninsula College of Medicine and Dentistry, and St...
January 1, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
Giuseppe Giudice, Angela Filoni, Giulio Maggio, Domenico Bonamonte, Michele Maruccia, Eleonora Nacchiero, Domenico Ribatti, Tiziana Annese, Michelangelo Vestita
We present a case of symmetrical thermal intermediate-deep burns treated in a case-control fashion with the stromal vascular fraction (SVF) obtained with the MyStem™ device and a scaffold of hyaluronic acid. After enzymatic debridement and SVF harvesting and application, we observed quicker healing (as assessed by wound area histogram planimetry) in the case area as opposed to the control one, which eventually underwent skin grafting. At the 3 months follow-up, the Vancouver Scar Scale was 9 for the case side and 10 for the control side, with a tendency to hypertrophic scarring in both areas, while patient satisfaction Visual Analogue Scale was 7 for the case side and 2 for the control side...
December 4, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
Robert P Clayton, David N Herndon, Nicola Abate, Craig Porter
Severe burns represent a unique form of trauma in terms of the magnitude and persistence of the stress response they incur. Given advances in acute burn care in the last quarter of a century and the resultant reduction in mortality rates, even for those with massive burns, greater emphasis is now placed on understanding the metabolic stress response to severe burn trauma in order to devise strategies that promote recovery and reduce morbidity. Derangements in metabolism including protein and lipid redistribution and altered glucose handling are hallmarks of the pathophysiological response to burn trauma...
December 5, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
Hsu-Min Tseng, Whei-Mei Shih, Yung-Chao Shen, Lun-Hui Ho, Chu-Fang Wu
A Dust explosion that injured 499 patients occurred on June 27, 2015 in Taiwan. This tragedy inundated hospitals across northern Taiwan with an unprecedented number of burn patients. It caused extreme pressure and challenges for nurses. The purpose of this study is to investigate factors associated with nurses' work stress, resilience, and professional quality of life in caring for dust exposure patients. A cross-sectional survey data was collected from nurses in caring for dust explosion patients. A total of 83 nurses in burn unit, plastic surgery ward, and reconstructive microsurgery unit returned valid data for analysis...
December 6, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
Denis Ehrl, Paul I Heidekrueger, Johannes Rubenbauger, Milomir Ninkovic, P Niclas Broer
When treating burn injuries, to date, there still remains significant disagreement whether presence of hypothermia (HT) on burn centers' intensive care unit (BICU) admission improves or worsens outcomes. The presented single burn center experiences set out to further evaluate the incidence, cause, and potential effects of HT on outcomes in severely burned patients. Between January 2015 and February 2017, 142 severely burned patients were admitted to a BICU. Temperature at BICU admission of <36.0°C was defined as HT and ≥36...
February 2, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
Karl Walsh, Ioannis Goutos, Baljit Dheansa
Acute acalculous cholecystitis (AAC) is an acute inflammatory disorder of the gallbladder, which can complicate the recovery of burn patients. No formal literature review has been performed about this uncommon but potentially fatal complication in burn care. A Pubmed search from 1950 to 2015 was performed using MESH terms: "acalculous cholecystitis," "burns or thermal injuries or thermal damage," and "cholecystitis or gallbladder inflammation." The articles were analyzed and data collected individually on the incidence, presenting symptoms or signs, risk factors, investigations, and treatment modalities used...
February 9, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
Holger J Klein, Fabienne Lehner, Riccardo Schweizer, Barbara Rüsi-Elsener, Jakob Nilsson, Jan A Plock
BACKGROUND: Since the inception of clinical VCA almost two decades ago, burn victims have been identified as immunologically complex patients owing to preformed HLA antibodies. However, it remains unclear whether the detected HLA antibodies are the result of former alloantigenic events or if their de novo formation occurs during primary burn care. METHODS: Patients with burns >20% of total body surface area (TBSA) admitted to Zurich Burn Centre between May 2015 and September 2016 were screened for HLA antibodies at admission and 6 months post trauma...
August 2018: Burns: Journal of the International Society for Burn Injuries
Ashish Nagpal, Melissa-Moore Clingenpeel, Rajan K Thakkar, Renata Fabia, Jeffrey Lutmer
OBJECTIVE: To determine the association between fluid resuscitation volume following pediatric burn injury and impact on outcomes. METHODS: A retrospective chart review of pediatric patients (0-18 years) sustaining ≥15% TBSA burn, admitted to an American Burn Association verified pediatric burn center from 2010 to 2015. RESULTS: Twenty-seven patients met inclusion criteria and had complete data available for analysis. Fifteen (56%) patients received greater than 6ml/kg/total body surface area burn in first 24h and twelve (44%) patients received less than 6ml/kg/percent total body surface area burn in first 24h...
August 2018: Burns: Journal of the International Society for Burn Injuries
Michael A Manfredi, Susannah J Clark, Steven J Staffa, Peter D Ngo, C Jason Smithers, Thomas E Hamilton, Russell W Jennings
BACKGROUND: Esophageal perforation is a potentially life-threatening problem if not quickly diagnosed and treated appropriately. Negative pressure wound therapy (NPWT), commercially known as V.A.C.® therapy, was developed in the early 1990 s and is now standard of care for chronic surface wounds, ulcers, and burns. Adapting vacuum sponge therapy for use intraluminally for perforations of the esophagus was first reported in 2008. We report the first pediatric experience on a customized esophageal vacuum assisted closure (EVAC) device for closure of esophageal perforations...
June 20, 2018: Journal of Pediatric Gastroenterology and Nutrition
Fernanda Pedreira Magalhães, Flavio Eduardo Hirai, Luciene Barbosa de Sousa, Lauro Augusto de Oliveira
PURPOSE: To evaluate the long-term outcomes of Boston type I keratoprosthesis (B-Kpro) in the management of patients with ocular burn injuries. METHODS: This prospective study included all patients with ocular burns who underwent B-Kpro implantation at a tertiary eye care center between February 2008 and November 2015. Twelve patients (12 eyes) were enrolled. The procedures performed for managing ocular injury were identified, and information on ocular history, surgical procedures performed, and postoperative outcomes was collected...
June 2018: Arquivos Brasileiros de Oftalmologia
Alexandra Schulz, Benedikt Ribitsch, Paul Christian Fuchs, Alexandra Lipensky, Jennifer Lynn Schiefer
OBJECTIVE: Because genital burns are rare, only limited information on treatment guidelines is available in the literature. Vital tissue should be preserved to promote spontaneous healing because reconstruction does not always lead to satisfying results. The aim of this report is to present a general overview of current, prevailing treatment for genital burns and compare this to study authors' experiences. In addition, the article describes an entirely new approach of tissue-preserving bromelain-based enzymatic debridement of genital burn wounds...
July 2018: Advances in Skin & Wound Care
Andrea Bosio, Eugenio Alessandria, Ettore Dalmasso, Dario Peretti, Simone Agosti, Alessandro Bisconti, Paolo Destefanis, Roberto Passera, Paolo Gontero
PURPOSE: To evaluate in details the actual extent of double-J stent-related symptoms after semirigid (URS) and flexible (RIRS) ureteroscopy using a validated questionnaire. METHODS: We asked to complete the Ureteric Stent Symptoms Questionnaire (USSQ) to all stone patients undergoing URS or RIRS with stent placement from 2010 to 2015. Stent-related symptoms' prevalence, severity, and impact on daily life were analyzed using descriptive statistics and five-order Likert scales...
June 19, 2018: World Journal of Urology
Rachel M Nygaard, Frederick W Endorf
Numerous demographic, socioeconomic, and injury factors influence a burn patient's hospital course. Compared to the typical burn patient, frostbite injury frequently impacts those with high rates of mental illness, substance abuse, and those suffering homelessness. Our aim was to examine differences in the hospital course of frostbite patients compared to those with burns limited to the hands and feet. Patients with frostbite injury and those with isolated hand and/or foot burns were identified in the National Burn Repository...
June 15, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
C H Pham, Z J Collier, W L Garner, C M Kuza, T J Gillenwater
PURPOSE: Measuring gastric residual volumes (GRV) is common in intensive care units (ICU) in patients receiving enteral nutrition (EN) and are a common source of feeding interruptions. Interruptions in EN yield adverse outcomes and are an area of improvement in burn care. The objectives of this study are to summarize the literature's ICU GRV practices and offer practical suggestions to GRV management in the burn patient. METHODS: PubMed, SCOPUS, and OvidSP Medline were systematically reviewed using the keywords: burns; thermal injury; gastric residual volume; enteral feeding; tube feeding; enteral nutrition; gastric intolerance; ICU; critical illness...
June 15, 2018: Burns: Journal of the International Society for Burn Injuries
Animesh Biswas, Abu Sayeed Md Abdullah, Koustuv Dalal, Toity Deave, Fazlur Rahman, Saidur Rahman Mashreky
BACKGROUND: Burns can be the most devastating injuries in the world, they constitute a global public health problem and cause widespread public health concern. Every year in Bangladesh more than 365,000 people are injured by electrical, thermal and other causes of burn injuries. Among them 27,000 need hospital admission and over 5600 people die. Immediate treatment and medication has been found to be significant in the success of recovering from a burn. However, common practices used in the treatment of burn injuries in the community is not well documented in Bangladesh...
June 18, 2018: BMC Health Services Research
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