Journal of burn care & research : official publication of the American Burn Association
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This study reviews the natural history of neuropathic-like pain after burn injury. We undertook a retrospective chart review during a 24-month period of patients treated at an outpatient burn center. The medical records of patients with neuropathic-like pain complaints, including the sensation of pins and needles, burning, stabbing, shooting, or "electric" sensations, were included for analysis. ⋯ There is a patterned natural history for neuropathic-like pain after burn injury. This clinical entity involves significant pain complaints and persists, on average, for greater than 1 year after injury, which underscores the importance of long-term outpatient care after burn injury. Furthermore, an understanding of the natural history will assist clinicians in prognosticating and caring for burn survivors with pain after wound closure.
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This study prospectively examined the incidence and severity of large joint contractures after burn injury and determined predictors of contracture development. Data were collected prospectively from 1993 to 2002 for consecutive adult burn survivors admitted to a regional burn center. Demographic and medical data were collected on each subject. ⋯ Predictors of the severity of contracture include graft size (P < .005), amputation (P = .034), and inhalation injury (P = .036). More than one third of the patients with a major burn injury developed a contracture at hospital discharge, which highlights the importance of therapeutic positioning and intensive therapy intervention during acute hospitalization. Furthermore, this challenges the burn care community to find new and better ways of preventing contractures after burn injury.
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Prepackaged soups are a frequent cause of burn injury. We hypothesize that package design increases the risk for burn injury by affecting container stability. All pediatric scald burns caused by soup, between June 1997 and August 2004, were reviewed for burn and patient characteristics. ⋯ The most significant contributor to the ease of tipping over was height. Instant soups are packaged in containers that tend to be tall with a narrow base that predisposes them to being knocked over and spilled. Simple redesigning of instant soup packaging with a wider base and shorter height, along with the requirement for warnings about the risks of burns would reduce the frequency of soup burns.
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Randomized Controlled Trial
Objective measurement of scarring by multiple assessors: is the tissue tonometer a reliable option?
Depending on the patient population, the incidence of scarring is as great as 75% after burns. Skin pliability and functional recovery are affected negatively by hypertrophic scarring. Therapists use various treatment strategies to improve scar outcomes. ⋯ It can differentiate between injured and uninjured tissue. Hence, it provides clinicians with a reliable, transportable, and objective tool to document scar outcomes. The MTT provides a standardized method to longitudinally measure scar tissue pliability after burn injury.
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A case of iatrogenic full-thickness chemical burns from monochloroacetic acid (MCA) crystal application is described, followed by a brief review of the relevant literature and discussion of both local and systemic problems that may be encountered with absorption of this chemical. We believe this to be the first reported case of full-thickness burns in association with MCA. The degree of injury and systemic side effects encountered as a procedure complication highlights the importance of using this chemical with care in any clinical setting. In addition, an apparent predilection of MCA for the germinal matrix as found in this case may further complicate reconstructive options for associated injuries.