Burns : journal of the International Society for Burn Injuries
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Ninety-one patients with at least 5 per cent (median 10 per cent, maximum 50 per cent) total body surface area (TBSA) burns were clinically re-examined on average 17.3 yr after primary injury. The patients had sustained mostly superficial dermal scalds. The most common long-term functional sequelae were impaired tanning (n = 67; 77.7 per cent), diminished tactile sensibility (n = 50; 56.2 per cent) and increased reddening (n = 14; 15.6 per cent) either in the sun or the Finnish sauna. ⋯ In this series the harmful functional consequences were generally slight. The aetiological background (scalds) and the relatively small, superficially burned skin area probably explains the good late outcome. However, since nearly every burn-injured child will have some signs of the injury in adulthood, children present a constant challenge in the effort for better burn care and prevention.
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Case Reports
The revolutionary dual cyclone vacuum cleaner--a new cause of digital friction burns in children.
Household domestic appliances are often sources of potential hazard for young children. This case report illustrates this with reference to a revolutionary dual cyclone vacuum cleaner causing a full thickness burn in a young child.
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Doubts and questions about clinical decision making need to be answered. Evidence-based medicine aims to provide answers by systematically finding information from the vast assortment of research papers in the literature and bringing it together to use in everyday practice and in the best interests of the patient. ⋯ Using contemporary information retrieval systems and the numerous establishments set up to help track down information of research in medicine relevant to health practice and policy the numbers of RCTs, systematic reviews and meta-analyses of burn care have been established. Whilst the numbers of RCTs are increasing there is little evidence that burn care is an evidence-based practice.
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Skin banking was set up in Sheffield in 1991 to provide a readily available source of allograft material to be used both for research purposes and also as a means of providing immediate wound cover for major burns patients. Once skin was available, however, clinical demand for it both within and outside Sheffield, outstripped the resources to run the bank. Logistical difficulties were encountered in the day to day running of the bank. ⋯ The decision was made to transfer the now established skin bank to the National Blood Service where it now operates with staff and resources dedicated specifically to this purpose. Experience leads to the suggestion that there is a clinical need for allograft skin in the UK which is not being met at the present time. There is a need for dedicated properly resourced skin banks and for the Department of Health to introduce regulation, monitoring and inspection of skin bank facilities in order to safeguard standards.
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Inhalation injury and bacterial pneumonia represent some of the most important causes of mortality in burn patients. We describe 11 severely burned patients with acute respiratory failure due to inhalation injury who did not respond adequately to conventional respiratory support. High-frequency percussive ventilation (HFPV) is a recent ventilatory mode, which combines the advantages of conventional ventilation with some of those of high-frequency ventilation. ⋯ All the other patients survived; two developed bronchiolitis obliterans symptoms before discharge. No side-effects were noted and haemodynamic tolerance of HFPV was excellent. Our findings suggest that HFPV can improve pulmonary function and gas exchange in these catastrophic pulmonary failures following inhalation injury.