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Burn pain management

Anne-Claire Pierrefeu-Lagrange, Karine Mari, Caroline Hoss, Breda Cullen, Lorraine Nisbet
INTRODUCTION: Dressings are a mainstay for wound management; however, dressing adherence to the wound or periwound area can cause pain and trauma at removal. Dressing-related trauma includes skin reactions, adherence to the wound, and skin stripping. The development of atraumatic wound contact layer dressings has been a major advancement in reducing trauma. OBJECTIVE: This study compares the benefits of a cellulose acetate mesh (CAM) coated with soft silicone versus a flexible polyamide net (FPN) coated with soft silicone...
January 26, 2018: Wounds: a Compendium of Clinical Research and Practice
Sara Smith, Jane Hunt
Reflection can help nurses make sense of their clinical surroundings and understand risks, challenges and opportunities. Learning the art required for reflective practice begins as a student when critical reflection is particularly important during practice placements. A suitable reflective framework is provided by Rolfe et al ( 2011 ). Adopting this framework, this article draws on the placement experiences of a second-year undergraduate children's nursing student in an acute setting, caring for a toddler with 13% partial and full-thickness burns...
March 7, 2018: Nursing Children and Young People
Moon-Jong Kim, Hong-Seop Kho
Burning mouth syndrome (BMS) is a chronic pain condition characterised by a persistent burning sensation in clinically normal oral mucosa. BMS most commonly occurs in middleaged and elderly women. Various local and systemic factors can cause oral burning symptoms. When all possible local and systemic factors are excluded, burning mouth symptoms can be diagnosed as BMS. Psychophysical tests and histopathological data suggest the involvement of peripheral and central neuropathic mechanisms in BMS etiopathogenesis...
2018: Chinese Journal of Dental Research
Hahn-Sol Bae, Mu-Young Lee, Ji-Ung Park
RATIONAL: Burns at the site of the return electrode (i.e., grounding pad) are possible effects of electrosurgery. Despite this knowledge, however, ignorance or negligence with regards to proper handling of the grounding pads still often occurs. Burn injuries can be easily prevented by taking the necessary precautions; thus, during plastic surgery, careful attention should to be paid. PATIENT CONCERNS: A 38-year-old female patient was admitted to our ward to be performed augmentation mammoplasty...
January 2018: Medicine (Baltimore)
Christelle Khadra, Ariane Ballard, Johanne Déry, David Paquin, Jean-Simon Fortin, Isabelle Perreault, David R Labbe, Hunter G Hoffman, Stéphane Bouchard, Sylvie LeMay
Background: Virtual reality (VR) is a non-pharmacological method to distract from pain during painful procedures. However, it was never tested in young children with burn injuries undergoing wound care. Aim: We aimed to assess the feasibility and acceptability of the study process and the use of VR for procedural pain management. Methods: From June 2016 to January 2017, we recruited children from 2 months to 10 years of age with burn injuries requiring a hydrotherapy session in a pediatric university teaching hospital in Montreal...
2018: Journal of Pain Research
Ahmed A Abouarab, Adham Elmously, Jeremy R Leonard, Mohammed J Arisha, Mario Gaudino, Naveent Narula, Arash Salemi
Systemic lupus erythematosus (SLE) is a major cause of nonbacterial thrombotic endocarditis (NBTE) associated with intracardiac sterile vegetations. It is rare for vegetations to present as an atrial tumor. This report describes a 48-year-old female with SLE and antiphospholipid syndrome complicated by recurrent thrombosis on anticoagulation. A large left atrial mass lesion was detected on echocardiography during a work-up for leg burning. Infective endocarditis could not be confirmed, and hence left atrial mass lesion was the most likely diagnosis...
February 15, 2018: Cardiology
Vincent J Noori, Kanika Trehan, Alisa Savetamal, Damien W Carter
INTRODUCTION: Marjolin' s ulcer, an aggressive ulcerating squamous cell carcinoma, is a well-known phenomenon that occurs in chronically inflamed or scarred tissue; however, squamous cell carcinoma arising in the acute setting after tissue trauma - specifically autograft donor harvest sites for burns - is a rare, but notable event. METHODS: This case series describes three instances of squamous cell carcinoma diagnosed in split-thickness skin graft donor sites in the immediate post-operative period...
February 10, 2018: International Journal of Surgery
So Young Joo, June-Bum Kim, Yoon Soo Cho, Yong Suk Cho, Cheong Hoon Seo
PURPOSE: Pruritus, a common, chronically disabling condition is often refractory to treatment. The pruritus sensation is mediated in the spinal cord and post-burn pruritus is considered a form of neuropathic pain. We investigated cold pack therapy as a treatment modality for post-burn pruritus. METHODS: We studied 23 patients with severe pruritus scoring at least 5 on the visual analogue scale (VAS) and refractory to antihistamine and gabapentin administration. Each cold pack therapy lasted more than 20min...
February 5, 2018: Burns: Journal of the International Society for Burn Injuries
Judith L Nicholls, Muhammad A Azam, Lindsay C Burns, Marina Englesakis, Ainsley M Sutherland, Aliza Z Weinrib, Joel Katz, Hance Clarke
Background: Inadequately managed pain is a risk factor for chronic postsurgical pain (CPSP), a growing public health challenge. Multidisciplinary pain-management programs with psychological approaches, including cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and mindfulness-based psychotherapy, have shown efficacy as treatments for chronic pain, and show promise as timely interventions in the pre/perioperative periods for the management of PSP. We reviewed the literature to identify randomized controlled trials evaluating the efficacy of these psychotherapy approaches on pain-related surgical outcomes...
2018: Patient related Outcome Measures
Estela Irene Bortoli, Rioko Kimiko Sakata
Erythromelalgia is a neuropathic pain syndrome due to an autosomal dominant gene, characterized by erythema, increased skin temperature and burning pain in hands and feet, whose treatment is often unsatisfactory. In this paper, we report a case of a 9 years old female patient whose first episode of burning pain, erythema and edema of the hands, without triggering factors, had instant relief after immersion in cold water. She presented with systemic arterial hypertension and had seizures. The patient was treated with gabapentin (150mg...
February 2, 2018: Revista Brasileira de Anestesiologia
Terrie Beeson, Carmen Davis
BACKGROUND: Strategies to decrease use of female indwelling urinary catheters and catheter-associated urinary tract infections are challenging due to the limited availability of proper fitting external collection devices. Female urinary incontinence predisposes the skin to potential pain, itching, burning, infection, or pressure injuries. CASE STUDIES: This article discusses 3 patients' trajectory of care with use of an external female urinary collection device...
February 1, 2018: Journal of Wound, Ostomy, and Continence Nursing
Leila Musavi, Alexandra Macmillan, Rachel Pedriera, Joseph Lopez, Amir H Dorafshar, A Lee Dellon
Trigeminal injury can cause intractable facial pain. However, surgical approaches to the superior alveolar nerves have not been widely described. We report resection of the anterior superior alveolar nerve (ASAN), middle superior alveolar nerve (MSAN), and posterior superior alveolar nerve (PSAN) in a patient with refractory facial pain and outline an algorithmic approach to the treatment of trigeminal nerve injury. A 56-year-old woman presented with a 3-year history of refractory facial pain in the distribution of the right superior alveolar nerves after dental trauma...
January 8, 2018: Journal of Oral and Maxillofacial Surgery
Juliana Tolles, Nachi Gupta, Jeffrey Nusbaum
Thermal burn injuries are a significant cause of morbidity and mortality worldwide. In addition to treatment of the burns, emergency clinicians must assess for inhalation injury, exposure to toxic gases, and related traumatic injuries. Priorities for emergency resuscitation include stabilization of airway and breathing, intravenous fluid administration, pain control, and local wound care. Special populations, including children and pregnant women, require additional treatment considerations. Referral to specialized burn care for select patients is necessary to improve long-term outcomes...
February 1, 2018: Emergency Medicine Practice
Chee Peng Hor, Wai Yee Fung, Hock Aun Ang, Sheau Chin Lim, Li Ying Kam, Su-Way Sim, Luen Hui Lim, Wai Yee Choon, Jia Woei Wong, Alan Swee Hock Ch'ng, Kelvin Khai Meng Beh, Hong Chin Wee, Loke Meng Ong, Nurzalina Abdul Karim Khan, Syed Azhar Syed Sulaiman, Ibrahim Lutfi Shuaib, Adlina Bakar, Yusnita Yusof, Yusmawati Mohd Yusof, Fatimah Abu Bakar, Wei Shuong Tang, Hoon Lang Teh, Normala Abdul Wahid, Suriani Saaidin, Najihah Idris, Chee Kin Yoon, Hoon Ngoh Ong, Jayasumithra T Ganapathy, Ching Ee Loo, Michelle M Samy, Hadzlinda Zainal, Shalini C Sree Dharan, Bee Yen Ooi, Pei Yeing Teoh, Yi Loon Tye, Chin Aun Yeoh, Dy Win Low, Irene Looi, Kah Hay Yuen
Importance: Management of painful diabetic peripheral neuropathy remains challenging. Most therapies provide symptomatic relief with varying degrees of efficacy. Tocotrienols have modulatory effects on the neuropathy pathway and may reduce neuropathic symptoms with their antioxidative and anti-inflammatory activities. Objective: To evaluate the efficacy of oral mixed tocotrienols for patients with diabetic peripheral neuropathy. Design, Setting, and Participants: The Vitamin E in Neuroprotection Study (VENUS) was a parallel, double-blind, placebo-controlled trial that recruited participants from January 30, 2011, to December 7, 2014, with 12 months of follow-up...
January 29, 2018: JAMA Neurology
Sharmila Dissanaike, Jayne McCauley, Carlo Alphonso
Donor site pain associated with skin graft procedures is frequently intense and difficult to treat. Liposomal bupivacaine, a prolonged-release local anesthetic indicated for single-dose administration to produce postsurgical analgesia, may be a viable option in managing donor site pain.
January 2018: Clinical Case Reports
Juliana Tolles
Thermal burn injuries are a significant cause of morbidity and mortality worldwide. In addition to treatment of the burns, emergency clinicians must assess for inhalation injury, exposure to toxic gases, and related traumatic injuries. Priorities for emergency resuscitation include stabilization of airway and breathing, intravenous fluid administration, pain control, and local wound care. Special populations, including children and pregnant women, require additional treatment considerations. Referral to specialized burn care for select patients is necessary to improve long-term outcomes...
February 2018: Emergency Medicine Practice
Priscilla Tu
The differential diagnosis of heel pain is extensive, but a mechanical etiology is the most common. The specific anatomic location of the pain can help guide diagnosis. The most common diagnosis is plantar fasciitis, which leads to medial plantar heel pain, especially with the first weight-bearing steps after rest. Other causes of plantar heel pain include calcaneal stress fractures (progressively worsening pain after an increase in activity or change to a harder walking surface), nerve entrapment or neuroma (pain accompanied by burning, tingling, or numbness), heel pad syndrome (deep, bruise-like pain in the middle of the heel), and plantar warts...
January 15, 2018: American Family Physician
Marjorie A Bowman, Dean A Seehusen, Anne Victoria Neale
Being realistic while helping our patients is this issue's theme. Given the volume of tasks required in family medicine, recommendations for improvements in direct care or care measurement cannot just be evidence-based but must also be realistic. On the list of realistic: ordering antipsychotics for symptoms of dementia in the elderly, despite recommendations to not do so; ordering antidepressants without fear that the patient could develop hypertension; mental health care providers in primary care offices; forced choice for opioid management; plus agenda setting for visit efficiency...
January 2018: Journal of the American Board of Family Medicine: JABFM
Marc R Matthews, Joel C VanderVelde, Daniel M Caruso, Kevin N Foster
INTRODUCTION: Phytophototoxic dermatitis is a strong phototoxic reaction to ultraviolet A (UV-A) radiation exposure after cutaneous contact with citrus fruit containing furocoumarins, leading to skin injury. At the Arizona Burn Center (Phoenix, AZ), the majority of these injuries are managed in the outpatient setting. CASE REPORT: The authors present a pediatric admission for burn-like injuries following prolonged cutaneous exposure to lemons while playing in the Arizona sunshine...
December 2017: Wounds: a Compendium of Clinical Research and Practice
Pedro Vieira-Baptista, Gilbert Donders, Lynnette Margesson, Libby Edwards, Hope K Haefner, Faustino R Pérez-López
Vulvodynia, defined as vulvar pain or burning sensation for more than 3 months, without an identifiable cause, can occur at any age. In this paper, the authors address the classification, epidemiology, etiology, diagnosis, and treatment of this condition, focusing on postmenopausal women. In postmenopausal women, vulvar pain and dyspareunia can often be attributed to low levels of estrogen resulting in vulvovaginal atrophy. While correction of vulvovaginal atrophy is an important part of the management of these patients, it will usually be insufficient to manage vulvodynia...
February 2018: Maturitas
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