Burns : journal of the International Society for Burn Injuries
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Comparative Study Clinical Trial Controlled Clinical Trial
The tumescent technique to significantly reduce blood loss during burn surgery.
Burn surgery is complicated by blood loss. The tumescent technique of subdermal injection of epinephrine has been utilized to decrease intraoperative blood loss. We hypothesized that this would safely decrease blood loss during burn surgery. ⋯ The tumescent technique significantly reduced intraoperative blood loss. It is safe, inexpensive and easy to use. The subdermal epinephrine/saline injection creates a smooth, tense surface which assists with debridement and donor harvest.
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The key difficulty of skin grafting is keeping the graft immobilized on uneven surfaces involved with motion, such as the nuchal area, axilla, web spaces, and the perineal area. This study reports the development of a new idea of negative pressure dressing (NPD) to maintain good immobilization of the skin graft and, at the same time, not cause any significant distress in the patient's daily life. ⋯ In this report, there are eight cases of skin grafts which were applied by this method, and the average success rate was approximately 97%. Therefore, use of negative pressure dressings to safeguard immobilization of the skin graft is an appropriate alternative method for grafts on uneven or mobile surfaces.
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Different types of injuries are described as caused by the use of microwave ovens. Four of 41 burns from microwave ovens, presented by an international survey in 1986, were due to exploding microwave-heated eggs. Careful review of the English language literature through a Medline search from 1966 to 2000 was performed, in search of burns caused by exploding eggs. ⋯ Long-term skin complications were not reported. In summary, the clinical presentation of a facial injury from an exploding microwave-heated egg is relatively constant and mild. Favorable outcome can be expected but a meticulous ophthalmologic evaluation and a close follow-up are mandatory for prevention of long-term sequelae.
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Randomized Controlled Trial Comparative Study Clinical Trial
Psychological approaches during dressing changes of burned patients: a prospective randomised study comparing hypnosis against stress reducing strategy.
A prospective study was designed to compare two psychological support interventions in controlling peri-dressing change pain and anxiety in severely burned patients. Thirty patients with a total burned surface area of 10-25%, requiring a hospital stay of at least 14 days, were randomised to receive either hypnosis or stress reducing strategies (SRS) adjunctively to routine intramuscular pre-dressing change analgesia and anxiolytic drugs. Visual analogue scale (VAS) scores for anxiety, pain, pain control and satisfaction were recorded at 2-day intervals throughout the 14-day study period, before, during and after dressing changes. ⋯ No difference was observed for pain, pain control and satisfaction, although VAS scores were always better in the hypnosis group. The study also showed that, overall, psychological support interventions reduced pain and increased patient satisfaction. These results confirm the potential benefits of psychological assistance during dressing changes in burned patients.
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Comparative Study
A survey of the need for psychological input in a follow-up service for adult burn-injured patients.
Increasingly, burns services are incorporating clinical psychologists as members of their acute care and rehabilitation teams. This study aimed to provide evidence for the necessity of psychological input in a follow-up service for victims of burn injuries in Manchester. Psychological morbidity and need of consecutive burn-injured patients (n=68) attending an outpatient clinic was surveyed in comparison to a sample of consecutive plastics and trauma patients attending the same clinic (n=44). ⋯ The accuracy of medical staff in identifying psychological difficulties during a routine follow-up consultation was examined in a sub-group of burns victims (n=21). Medical staff was able to correctly identify the presence of psychological difficulties in 58% of cases. Implications regarding referral routes to psychological services were highlighted.