Journal of burn care & research : official publication of the American Burn Association
-
Severe burns can cause major complications, such as infection and deforming scar formation. Burn wounds induce an excessive inflammatory response. Serum levels of complement and the acute phase reactant C-reactive protein (CRP) are upregulated in response to burn injury and have been shown to be related to the severity of burn trauma and to the clinical outcome. ⋯ Protein levels of both mediators are significantly elevated up to at least 46 days after injury in comparison with control wounds. In line with this, neutrophils and macrophages infiltrate the burn wound in high numbers up to at least 46 days after injury. The excessive presence of the inflammatory mediators, complement and CRP, and the increased infiltration of neutrophils and macrophages in burn wounds up to 46 days after injury implicate a persistent ongoing acute inflammation locally in the burn wound up to weeks after the initial trauma.
-
To determine whether the combination of aerosolized unfractionated heparin and N-acetylcystine reduces 28-days mortality and lung injury scores (LISs) in adult patients with smoke inhalation injury requiring mechanical ventilation. The study was a single-center retrospective study with historical control. The authors included 30 mechanically ventilated adult subjects who were admitted within 48 hours of their bronchoscopy confirmed smoke inhalation injury over a 5-year period. ⋯ There was a statistically significant survival benefit in the experimental group that was most pronounced in patients with APACHE-III scores >35. Survival for the control vs experimental group was 0.5714 +/- 0.1497 vs 0.9375 +/- 0.0605, respectively, (risk ratio -0.0055; 95% confidence interval -0.0314-0.0204; hazard ratio 1.003; number needed to treat 2.7). The use of aerosolized unfractionated heparin and N-acetylcystine attenuates lung injury and the progression of acute respiratory distress syndrome in ventilated adult patients with acute lung injury following smoke inhalation.
-
Clinical Trial
Efficacy of naltrexone in the treatment of chronic refractory itching in burn patients: preliminary report of an open trial.
Pruritus (itching) constitutes a source of severe distress for burn patients. The authors administered naltrexone to burn patients suffering from itching that was refractory to treatment with antihistamine and anticonvulsant medications to examine the efficacy of this medication as a treatment for pruritus in burn patients. Nineteen burn patients admitted to the Hallym Burn Center at Hangang Sacred Heart Hospital in Seoul, Korea, with burns over 40.32% (+/-18.3) of their total body surface were recruited for this study. ⋯ The authors observed a significant decrease in itching sensations after 2 weeks of treatment with naltrexone (z = -3.32, P = .001). Scratching activity was also decreased in 44.5% (+/-20.5) of subjects. The authors propose that naltrexone constitutes a potential antipruritic medication for burn patients suffering from treatment-refractory itching.
-
The abbreviated Burn-Specific Health Scale (BSHS) is an instrument that measures physical, mental, social, and general health in burn survivors. This scale is composed of 80 items. The aim of this study was to determine the reliability and validity of a Turkish version of the BSHS (the BSHS-Turkish). ⋯ The mean time that it took to complete the questionnaire was 31.06 +/- 15.2 minutes (range, 3-60 minutes). The test-retest, internal reliability, and construct validity of the BSHS-Turkish were satisfactory according to intraclass correlation coefficient, Cronbach's alpha, and the Mann Whitney U test. The BSHS-Turkish is a reliable and valid instrument for determining the health status of Turkish patients with burns.