Burns : journal of the International Society for Burn Injuries
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Acute bacterial endocarditis (ABE) is a rare but deadly complication following major thermal injury. Typically the presentation is silent, with persistent fever and positive blood cultures being the only consistent findings. Fibrin-platelet vegetations on the valvular endocardium are thought to be seeded during bacteremic episodes. ⋯ Diagnosis is most easily obtained by echocardiography. Treatment usually involves prolonged administration of intravenous antibiotics. In rare circumstances, valvular resection and replacement may be indicated.
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Warming lights, circulating-water blankets, space heaters, and the Bair Hugger are used by surgeons in the perioperative period to maintain a patients core body temperature. Warming lights in particular are often used by plastic surgeons to augment the postoperative vasodilatation of reconstructive flaps by increasing the ambient temperature of the area around the flap. A review of the literature fails to elucidate even anecdotal experience regarding the actual intensity of thermal energy directly imparted to tissues from these modalities with respect to distance. ⋯ However, temperatures obtained at 71 cm for the focused and defocused beams plateaued at 93.2 and 96.8 degrees F (34 and 36 degrees C) respectively, which is well within physiologic limits and below the temperature resulting in tissue necrosis. Our conclusion is that warming lights can be successfully used as a safe adjuvant in order to optimize flap vasodilatation without compromising the thermal threshold of tissue damage if maintained at the manufacturer's minimum recommended distance of 71 cm. If this source of thermal energy is used, however, strict precautions and nursing guidelines must be instituted to maintain this minimum distance parameter and prevent patient morbidity.