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Burn resuscitation

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https://www.readbyqxmd.com/read/28717655/the-neck-burn-scar-contracture-a-concept-of-effective-treatment
#1
REVIEW
Sadanori Akita, Kenji Hayashida, Satoshi Takaki, Yoshihisa Kawakami, Takuto Oyama, Hiroyuki Ohjimi
A neck scar contracture can severely and negatively affect the function of mastication, phonic, or breathing and result in neck pain and issues with esthetics. The best way is of course to avoid such contracture by means of non-surgical treatment such as use of a growth factor. The basic fibroblastic growth factor is clinically well proven in decreasing scar formation and improving healing. There are numerous reconstructive methods for neck contracture, especially when the lesions are relatively limited in part of the neck...
2017: Burns and trauma
https://www.readbyqxmd.com/read/28700086/antiseptics-for-burns
#2
REVIEW
Gill Norman, Janice Christie, Zhenmi Liu, Maggie J Westby, Jayne M Jefferies, Thomas Hudson, Jacky Edwards, Devi Prasad Mohapatra, Ibrahim A Hassan, Jo C Dumville
BACKGROUND: Burn wounds cause high levels of morbidity and mortality worldwide. People with burns are particularly vulnerable to infections; over 75% of all burn deaths (after initial resuscitation) result from infection. Antiseptics are topical agents that act to prevent growth of micro-organisms. A wide range are used with the intention of preventing infection and promoting healing of burn wounds. OBJECTIVES: To assess the effects and safety of antiseptics for the treatment of burns in any care setting...
July 12, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28697018/the-renaissance-man-of-burn-surgery-basil-a-pruitt-jr
#3
Karel D Capek, Guillermo Foncerrada, R Patrick Clayton, Michaela Sljivich, Charles D Voigt, Gabriel Hundeshagen, Janos Cambiaso-Daniel, Craig Porter, Ashley Guillory, David N Herndon
Dr. Basil A. Pruitt Jr., a consummate clinical and translational surgeon-scientist, has been spent over half a century at the forefront of an advancing standard of burn care. Commanding the US Army Institute for Surgical Research in San Antonio, he trained generations of leading burn clinicians and allied scientists. At his direction, there were forged discoveries in resuscitation from shock, treatment of inhalation injury, control of burn-related infections, prevention of iatrogenic complications, and understanding the sympathetic, endocrine, and immune responses to burn injury...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28697015/the-p50-research-center-in-perioperative-sciences-how-the-investment-by-the-national-institute-of-general-medical-sciences-in-team-science-has-reduced-post-burn-mortality
#4
Celeste C Finnerty, Karel Capek, Charles Voigt, Gabriel Hundeshagen, Janos Cambiaso-Daniel, Craig Porter, Linda E Sousse, Amina El Ayadi, Ramon Zapata-Sirvent, Ashley Guillory, Oscar E Suman, David N Herndon
Since the inception of the P50 Research Center in Peri-Operative Sciences (RCIPS) funding mechanism, the National Institute for General Medical Sciences has supported a team approach to science. Many advances in critical care, particularly burns, have been driven by RCIPS teams. In fact, burns that were fatal in the early 1970s, prior to the inception of the P50 RCIPS program, are now routinely survived as a result of the P50-funded research. The advances in clinical care that led to the reduction in post-burn death were made by optimizing resuscitation, incorporating early excision and grafting, bolstering acute care including support for inhalation injury, modulating the hypermetabolic response, augmenting the immune response, incorporating aerobic exercise, and developing anti-scarring strategies...
July 8, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28682941/reduction-in-mortality-rates-of-postinjury-multiple-organ-dysfunction-syndrome-a-shifting-paradigm-a-prospective-population-based-cohort-study
#5
Karlijn J P van Wessem, Luke P H Leenen
INTRODUCTION: The incidence of Multiple Organ Dysfunction Syndrome (MODS) has decreased in the last decade by improvement in trauma care. However, it still remains a major cause of morbidity and mortality. This study investigated the current incidence and mortality of MODS in polytrauma patients. MATERIALS AND METHODS: A 3-year prospective study included consecutive trauma patients admitted to a Level-1 Trauma Center ICU. Isolated head injuries, drowning, asphyxiation and burns were excluded...
July 4, 2017: Shock
https://www.readbyqxmd.com/read/28649575/ecmo-in-major-burn-patients-feasibility-and-considerations-when-multiple-modes-of-mechanical-ventilation-fail
#6
Jason D Kennedy, Wesley Thayer, Reuben Beuno, Kelly Kohorst, Avinash B Kumar
BACKGROUND: We report two cases of acute respiratory distress syndrome in burn patients who were successfully managed with good outcomes with extra corporeal membrane oxygenation (ECMO) after failing multiple conventional modes of ventilation, and review the relevant literature. CASE PRESENTATION: The two patients were a 39-year-old male and 53-year-old male with modified Baux Scores of 79 and 78, respectively, with no known inhalation injury. After the initial modified Parkland-based fluid resuscitation and partial escharotomy, both patients developed worsening hypoxemia and acute respiratory distress syndrome...
2017: Burns and trauma
https://www.readbyqxmd.com/read/28644688/intraosseous-administration-of-antidotes-a-systematic-review
#7
Audrée Elliott, Pierre-André Dubé, Amélie Cossette-Côté, Laura Patakfalvi, Eric Villeneuve, Martin Morris, Sophie Gosselin
CONTEXT: Intraosseous (IO) access is an established route of administration in resuscitation situations. Patients with serious poisoning presenting to the emergency department may require urgent antidote therapy. However, intravenous (IV) access is not always readily available. OBJECTIVE: This study reviews the current evidence for IO administration of antidotes that could be used in poisoning. The primary outcome was mortality as a surrogate of efficacy. Secondary outcomes included hemodynamic variables, electrocardiographic variables, neurological status, pharmacokinetics outcomes, and adverse effects as defined by each article...
June 23, 2017: Clinical Toxicology
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
#8
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
#9
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/28600109/the-cardio-respiratory-effects-of-intra-abdominal-hypertension-considerations-for-critical-care-nursing-practice
#10
REVIEW
Martin Christensen, Judy Craft
Intra-abdominal hypertension can be classified as either primary or secondary. Primary intra-abdominal hypertension is often associated through trauma or diseases of the abdominopelvic region such as pancreatitis or abdominal surgery, while secondary intra-abdominal hypertension is the result of extra-abdominal causes such as sepsis or burns. The critically ill patient offers some challenges in monitoring in particular secondaryintra-abdominal hypertension because of the effects of fluid resuscitation, the use of inotropes and positive pressure ventilation...
June 6, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28592938/thermal-burn-in-a-30-minute-old-newborn-report-on-the-youngest-patient-with-iatrogenic-burn-injury
#11
L Abboud, G Ghanimeh
Burns in infants are rare. The majority of neonatal burns occur in the hospital setting. The immaturity of their immune system, their fragile and thin skin, difficulties in resuscitation, engraftment paucity limited by donor sites, and long-term complications make taking care of burned newborns extremely difficult. We present the case of a newborn burned 30 minutes after his birth over a total body surface of 35%, when the hot water bottle used in the hospital accidentally burst. This is the earliest iatrogenic burn in a newborn reported to date...
March 31, 2017: Annals of Burns and Fire Disasters
https://www.readbyqxmd.com/read/28586577/pattern-and-profile-of-electric-burn-injury-cases-at-a-burn-centre
#12
Saeed Ashraf Cheema
BACKGROUND: Electrical burns are quite different from thermal and chemical burns. This study is from a centre which deals with job related electric burn injuries alone and thus can give a pure account of the electric burns and discuss the related peculiarities. Study aims to highlight the differences in the mechanism of electric burn injury, its mode of presentation, morbidity, complications and thus the treatment strategies as compared to rest of the burn injuries. METHODS: This is a descriptive case series study of first consecutive 61 electric burn victims treated at a Burn Unit and Plastic Surgery centre...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28576250/patient-safety-in-burn-care-application-of-evidence-based-medicine-to-improve-outcomes
#13
REVIEW
Elizabeth L Dale, Charles Scott Hultman
This article reviews 5 areas in burn care that increasingly use evidence-based medicine to optimize quality and safety: resuscitation protocols, transfusion practices, vascular access, venous thromboembolic prophylaxis, and rational use of antibiotics.
July 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28576249/pediatric-burn-care-unique-considerations-in-management
#14
REVIEW
Amita R Shah, Lillian F Liao
Severe pediatric burns require a multidisciplinary team approach at a specialized pediatric burn center. Special attention must be paid to estimations of total body surface area, fluid resuscitation and metabolic demands, and adequate analgesia and sedation. Long-term effects involve scar management and psychosocial support to the child and their family. Compassionate comprehensive burn care is accomplished by a multidisciplinary team offering healing in the acute setting and preparing the child and family for long-term treatment and care...
July 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28576239/inhalation-injury-pathophysiology-diagnosis-and-treatment
#15
REVIEW
Samuel W Jones, Felicia N Williams, Bruce A Cairns, Robert Cartotto
The classic determinants of mortality from severe burn injury are age, size of injury, delays of resuscitation, and the presence of inhalation injury. Of the major determinants of mortality, inhalation injury remains one of the most challenging injuries for burn care providers. Patients with inhalation injury are at increased risk for pneumonia (the leading cause of death) and multisystem organ failure. There is no consensus among leading burn care centers in the management of inhalation injury. This article outlines the current treatment algorithms and the evidence of their efficacy...
July 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28576238/acute-fluid-management-of-large-burns-pathophysiology-monitoring-and-resuscitation
#16
REVIEW
Justin Gillenwater, Warren Garner
This article reviews the pathophysiology of large burn injury and the extreme fluid shifts that occur in the hours and days after this event. The authors focus on acute fluid management, monitoring of hemodynamic status, and end points of resuscitation. Understanding the need and causes for fluid resuscitation after burn injury helps the clinician develop an effective plan to balance the competing goals of normalized tissue perfusion and limited tissue edema. Thoughtful, individualized treatment is the best answer and the most effective compromise...
July 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28576236/burn-care-in-low-and-middle-income-countries
#17
REVIEW
Anthony G Charles, Jared Gallaher, Bruce A Cairns
This article examines the societal impact of thermal injury in low- and middle-income countries. The authors describe the unique challenges of these health care systems in providing care for burned patients, focusing on resuscitation, excision and grafting, rehabilitation, and reconstruction.
July 2017: Clinics in Plastic Surgery
https://www.readbyqxmd.com/read/28573147/the-progress-of-chinese-burn-medicine-from-the-third-military-medical-university-in-memory-of-its-pioneer-professor-li-ao
#18
REVIEW
Haisheng Li, Junyi Zhou, Yizhi Peng, Jiaping Zhang, Xi Peng, Qizhi Luo, Zhiqiang Yuan, Hong Yan, Daizhi Peng, Weifeng He, Fengjun Wang, Guangping Liang, Yuesheng Huang, Jun Wu, Gaoxing Luo
Professor Li Ao was one of the founders of Chinese burn medicine and one of the most renowned doctors and researchers of burns in China. He established one of the Chinese earliest special departments for burns at Third Military Medical University (TMMU) in 1958. To memorialize Professor Li Ao on his 100th birthday in 2017 and introduce our extensive experience, it is our honor to briefly review the development and achievement of the Chinese burn medicine from TMMU. The epidemiology and outcomes of admitted burn patients since 1958 were reviewed...
2017: Burns and trauma
https://www.readbyqxmd.com/read/28570316/severity-of-inhalation-injury-is-predictive-of-alterations-in-gas-exchange-and-worsened-clinical-outcomes
#19
Tia Sutton, Ian Lenk, Peggie Conrad, Marcia Halerz, Michael Mosier
Inhalation injury (INH) is present in one third of large burn injuries and increases oxygenation and fluid resuscitation requirements, incidences of pulmonary complications, risk for multiple organ dysfunction syndrome (MODS), and overall mortality. Previous studies have demonstrated inconsistent correlation between bronchoscopic evaluation and clinical outcomes. The authors reviewed 161 patients admitted with a diagnosis of INH or underwent diagnostic bronchoscopy for suspected INH over a period of 8.5 years...
May 12, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28570315/assessment-of-outreach-by-a-regional-burn-center-could-referral-criteria-revision-help-with-utilization-of-resources
#20
Nicholas H Carter, Clint Leonard, Lisa Rae
The objective of this study was to identify trends in preburn center care, assess needs for outreach and education efforts, and evaluate resource utilization with regard to referral criteria. The authors hypothesized that many transferred patients were discharged home after brief hospitalizations and without need for operation. Retrospective chart review of all adult and pediatric transfers to our regional burn center from July 2012 to July 2014. Details of initial management including TBSA estimation, fluid resuscitation, and intubation status were recorded...
May 19, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
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