Burns : journal of the International Society for Burn Injuries
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Phagocytic and bactericidal activities are important functions of the human polymorphonuclear leucocytes (PMNL) as the host defence against burn wound infection. The zone of stasis, just below the zone of coagulation, is a site of interaction between invading bacteria and PMNL. For many reasons the osmotic pressure at this site is elevated. ⋯ At a sodium concentration of 180 mEq/l, phagocytic activity was suppressed. Although on average superoxide production was maintained within the normal range, it was suppressed in three of the ten cases studied. We conclude that the hypernatremic condition may weaken local defence against burn wound infection at the zone of stasis and may be a risk factor for burn wound sepsis.
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Multicenter Study Comparative Study Clinical Trial
Burn injuries, pain and distress: exploring the role of stress symptomatology.
Forty-three consecutive patients were assessed for post-traumatic stress 7 days after admission to hospital. Patients were asked to complete the Impact-of-Event Scale. ⋯ A Visual Analog Thermometer was employed to measure the pain experienced at rest and during therapeutic procedures. High levels of post-traumatic stress were associated with higher pain scores during therapeutic procedures and more pain when at rest.
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Comparative Study
The value of early enteral nutrition in the prophylaxis of stress ulceration in the severely burned patient.
A retrospective analysis of prospectively collected data was performed to compare the frequency of upper gastrointestinal bleeding (GIB) in seriously burned patients treated with either cimetidine and antacids or enteral nutrition for ulcer prophylaxis. Five hundred and twenty-six seriously burned patients admitted to the burn intensive care unit of the BG Trauma Centre Ludwigshafen during a 4-year period were included into the study. All patients admitted to the burn unit from 1989 to 1991 received i.v. cimetidine (400 mg q4) for ulcer prophylaxis. ⋯ The difference in the overall frequency of overt GIB between the groups studied was statistically significant (< 0.05). In our experience, early enteral nutrition is effective in the prevention of stress haemorrhage in the upper gastrointestinal tract. Additional medicinal prophylaxis is not required in burn patients.
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A 10-bed state-of-the-art burns unit was commissioned at King Fahd Specialist Hospital, Buraidah, Al-Qassim and the first 90 cases admitted to the unit over an 18-month period were analysed. The mean age (+/-SD) was 14.9 (+/-1.5) years with a range of 6 months-55 years. Fifty-one per cent were males, 52.2 per cent were children under 12 years of age and of these 85.1 per cent were under 5 years of age. ⋯ Factors that can improve the morbidity and mortality rates in patients are highlighted. The study also reveals certain patterns and etiological factors in the Qassim region. Prevention by education through a national campaign remains the keystone in reducing the incidence of burns particularly in children and the maximization of resources.
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Comparative Study
Does tea tree oil have a place in the topical treatment of burns?
Burnaid is a sorbalene-based cream containing 40 mg/g of tea tree oil and 1 mg/g of triclosan. This investigation was carried out to determine the effect of Burnaid, a commercial tea tree oil preparation, against Enterococcus faecalis (ATCC29212), Staphylococcus aureus (ATCC29213), Escherichia coli (ATCC25922), and Pseudomonas aeruginosa (ATCC27853), with the activity of the base product in the commercial preparation. The organisms were suspended in sterile saline (0.5 McFarland Standard) and inoculated onto horse blood agar (E. faecalis and S. aureus) or Mueller-Hinton agar (E. coli and P. aeruginosa). ⋯ Zones of growth inhibition (22 mm) were similar for the active product (Burnaid) and the base (Tinasolve). There was no activity against E. faecalis or P. aeruginosa. In view of our findings and literature indicating the cytotoxicity of tea tree oil against human fibroblasts and epithelial cells, it is recommended that this product should not be used on burn wounds.