Journal of burn care & research : official publication of the American Burn Association
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As the overall survival rate for burn injury has improved, increased emphasis is placed on postburn morbidity and the optimization of functional and cosmetic outcomes. One major cause of morbidity and functional deficits is that of joint contractures. The true incidence of postburn contractures and their associated risk factors remains unknown. ⋯ Predictors of the number of contractures included male sex, medical problems, flash burn, neuropathy, TBSA burned, and TBSA grafted. Similar to a previous single-center study on postburn contractures, approximately one third of the patients with an eligible burn injury requiring autografting developed a contracture at hospital discharge. It is likely that these contractures develop despite early therapeutic interventions such as positioning and splinting; therefore, the challenge to the burn community remains, to identify new and better prevention strategies.
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Burn injury to the face can lead to scarring and contractures that may impair oral competence for articulation, feeding, airway intubation access, oral/dental hygiene, aesthetics, and facial expression. Although a range of therapy interventions has been discussed for preventing contracture formation, there is minimal information on current practice patterns. This research examined patterns of clinical practice for orofacial burns management during a 4-year period to determine the nature and extent of clinical consistency in current care. ⋯ Furthermore, in 2014, there was an increased use of assessment tools and clinical indicators to guide patient treatment. Agreement regarding clinical practice pathways for orofacial contracture rehabilitation is still emerging, and treatment continues to be predominantly guided by clinical experience. There is an urgent need for treatment efficacy research utilizing validated outcome measure tools to inform clinical consensus and practice guidelines.
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Visual diagnosis of second-degree burns has proven inadequate for determining the appropriate treatment regimen. Although multiple noninvasive imaging techniques have shown promise for providing information about burn wound severity, the ideal technology to aid burn wound excision would provide real-time readouts. Herein, the authors examine a high-resolution infrared (IR) camera (thermography) and a multiprobe adapter system (MPAS-6; transepidermal evaporative water loss, colorimetry) to assess their usefulness in predicting burn severity. ⋯ Importantly, surface temperature taken on every single day after injury was predictive of all histologically determined measurements of burn depth (ie, collagen coagulation, apoptosis, necrosis, vascular occlusion). The results indicate that IR imaging and skin quality probes can be used to support the diagnosis of burn severity. Most importantly, IR measurements gave insight into both the zone of coagulation and the zone of stasis on every postburn day studied.
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Asociacion Pro-Ninos Quemados de Nicaragua (APROQUEN) is a comprehensive burn center that provides a holistic and integrated approach to treating burns. APROQUEN has set the standards internationally with acute treatment for burns, intensive care, reconstructive surgeries, nutritional care, rehabilitation, occupational therapy, and psychological treatment. APROQUEN is excelling within Central and South America with life-saving techniques and quality of care. ⋯ The results indicate that Camp Confio en Mi had a significant impact on campers' level of anxiety, depression, and self-esteem. Future burn camps are an important part of the continued advancement of postpediatric burn care in Nicaragua. This study reveals the importance of future researches necessity to focus on generalizing the results of this study to other children who have experienced similar burn injuries.
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Patients suffering from moderate or severe hemophilia A are particularly vulnerable to trauma injury, being on high risk of immediate exsanguination. Due to a rareness of this disease, there are very few reports about the management of severe injuries of the affected patients. No guidelines for the management of burn trauma of hemophiliac patients have been yet established. ⋯ The patient was healed and was dismissed after 68 days. The surgical blood loss was comparable with noncoagulopathic patients with similar burn extension. In case of a vast burn injury of the moderate or severe hemophiliacs, where the trauma-related consumption coagulopathy is expected and deep necrosectomies are required, the authors suggest starting a substitution of the factor VIII immediately after the admission, followed by a structured operative planning.