Burns : journal of the International Society for Burn Injuries
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Comparative Study
Factors influencing the sequelae of high tension electrical injuries.
The purpose of this study was to conduct a retrospective analysis of the clinical spectrum, treatment and morbidity of the patients who have suffered high tension electrical injuries with current passage through their body (59 patients). Voltage, localization and surgical treatment seem to be the main factors influencing the lesion and the morbidity. The following points were considered: (1) Is there any relation between known factors such as voltage and the localization of the points of contact with the incidence and the type of complications and sequelae? (2) Do the observations show that wound management and the excision of dead tissues is the most adequate? From factors studied in our patients (voltage, point of entry and pathway of current, associated multiple trauma or flame burns, surgical treatment) we have found that the voltage does not have any influence on the severity of the wound nor on the percentage of sequelae (cataracts, limb amputation, neurologic complications). ⋯ The presence of associated burns was not related to any other complications or sequelae. For those patients whose length of contact has been shorter we find a lower rate of amputations despite having associated limb fractures. Fasciotomy incisions appear to confer benefit as this series shows that this procedure decreases the rate of limb amputations.
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Randomized Controlled Trial Comparative Study Clinical Trial
A silicone-coated nylon dressing reduces healing time in burned paediatric patients in comparison with standard sulfadiazine treatment: a prospective randomized trial.
Mepitel is a new grid like silicone coated nylon dressing containing no additional biological compounds. We describe a prospective randomized pilot study comparing Mepitel to the standard silver sulfadiazine cream (Flamazine) dressing for the topical treatment of paediatric burns. Seventy-six children presenting within 24 h of injury with a non previously treated burn were randomly assigned to Mepitel treatment (group M) or Flamazine treatment (group F). ⋯ Mepitel has proved to be an easy-to-remove dressing, adhering only to intact skin. The faster healing time found in the Mepitel group may be related to a direct effect of silicone on epithelial growth or to a decrease in surface-cell damage compared to the silver sulfadiazine group. This attractive product will be further assessed on a larger scale trial to confirm our observations.
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The financial burden imposed on society by abusing children through burn injury is unknown. This study retrospectively evaluates the economic impact and demographics of such abuse on patients and their families treated at Children's Hospital Medical Center of Akron (CHMCA) from four counties over a 5 year period. The inclusive group consisted of all children evaluated during the stated period referred to Social Services for possible child abuse. ⋯ Child abuse through burns imposes a potentially preventable financial burden. This study does not take into account the socioeconomic and psychological impact on the abused victims through life, which is incalculable. By increasing awareness about the demographics and financial burden of child abuse, this paper may serve as a focus for further study and prevention of such abuse.
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Comparative Study
The comparison of early fluid therapy in extensive flame burns between inhalation and noninhalation injuries.
Over the last half century, advances in treatment have changed the principal cause of death in burn patients from burn shock and wound sepsis to pulmonary sepsis, of which inhalation injury has always played a key role in morbidity and mortality. Even though Navar et al., Am. J. ⋯ The mean amounts of fluid requirements of both inhalation and noninhalation burned patients were 3.1 +/- 1.0 and 2.3+/-0.8 ml/kg/% burn respectively (p < 0.05). Our study showed less fluid requirement for both inhalation and noninhalation injured patients in comparison with the Navar study and Parkland predictions in the first 24 h postburn. Furthermore, the inhalation injured patients definitely required volumes of fluid in excess of those required in noninhalation injured cases.
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Burn injury is a major public health problem in many areas of the world. Pseudomonas aeruginosa is one of the most common causes of burn wound infection in burn patients. Septicemia due to this organism is a major cause of mortality among burn patients. ⋯ P. aeruginosa was found more frequently in the ICU than in the wards. These findings show that P. aeruginosa remains the leading cause of nosocomial infections in our burn center. It is necessary to introduce urgent measures for restriction of the spread of P. aeruginosa infections in our burn center.