Journal of burn care & research : official publication of the American Burn Association
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In low income countries, incidence of burns is high and severe burns are frequently managed at peripheral facilities. Outcome after burn care is poorly studied although it might help identify risk-group and improve treatment strategies. This study aimed to study factors associated with in-hospital outcomes in a burn cohort in the Democratic Republic of Congo. ⋯ In-hospital death was associated with TBSA% and FTB, prolongated LOS with FTB, and complication with burns characteristics and rural origin of the patients. Further studies are necessary to investigate the effect of provided burn care on outcomes.
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Fractional ablative CO2 laser is being used increasingly to treat burn scars; however, objective measures of outcome success vary widely. This systematic review and meta-analysis extracts and pools available data to assess the outcomes of patients with burn scars treated with fractional ablative CO2 laser. A search of MEDLINE, EMBASE, and the gray literature was performed. ⋯ Treatment regimens varied amongst studies, as did patient outcomes. Pooled data revealed an average VSS improvement of 29% across 282 patients following fractional CO2 ablative laser treatment. Although the heterogeneity of treatment regimens across studies limits this systematic review's ability to provide specific treatment recommendations, the overall trend towards improvement of burns scars treated with fractional CO2 laser based on the VSS encourages further exploration of this modality as a therapeutic tool.
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Pruritus is a commonly reported symptom after burn injury. Valid and reliable scales to measure itch in pediatric burn survivors are important for treatment and epidemiological studies. This study sought to develop psychometrically sound, publicly available self- and proxy-report measures of itch for use in pediatric burn survivors suitable for use in research and clinical practice. ⋯ Concordance between the self- and proxy-report scores was moderate (ICC = 0.68). The results support the reliability and validity of the itch scale in children and youth with burn injury. The new BMS Pediatric Itch Interference scales are freely and publicly available at https://burndata.washington.edu/itch.
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Acute kidney injury (AKI) early after a major burn has not been widely studied. Our purpose was to evaluate the prevalence of and risk factors for early AKI and the effect of early AKI on outcome. Retrospective cohort study of adults with burns ≥20% TBSA admitted between November 24, 2015 and July 1, 2019. "Early AKI" occurring within 7 days of injury was identified using urine output and serum creatinine Kidney Disease International Global Outcome criteria. ⋯ Older age, larger burn size, and development of early stage 3 AKI were independently associated with increased in-hospital death. Early AKI is common and carries a poor prognosis for survival. Resuscitation involving HDVC appears to be related to a higher likelihood of early and possibly very early AKI.