Burns : journal of the International Society for Burn Injuries
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Randomized Controlled Trial Clinical Trial
Selective decontamination of the digestive tract in severely burned pediatric patients.
Infection is still one of the leading causes of morbidity and mortality in severely burned patients. Evidence suggests that many of the responsible organisms are endogenous. Systemic antibiotic prophylaxis is not effective, and produces resistant strains of microorganisms. ⋯ Serum levels of all cytokines studied were also comparable, suggesting a similar inflammatory status in all patients, regardless of the treatment received. Patients in the SDD group, however, had a significantly higher incidence of diarrhea (P=0.003). We can conclude that selective decontamination of the digestive tract with Polymixin E, Tobramycin and Amphotericin B is not effective to decrease bacterial colonization and infectious episodes in severely burned pediatric patients.
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Assault by burning is a serious form of trauma that often results in higher incidence of inhalation injury, longer intensive care unit (ICU) and hospital stay, and higher mortality rate than is observed in the general burn population. We evaluated the epidemiology and outcome of assault burn victims treated in a tertiary burn center over a 6-year period. Among the 1063 acute burn patients who had been admitted to the Burns Unit between March 1993 and February 1999, 28 (2.6%) had assault burn injuries either by scald, chemical or fire. ⋯ When these 28 victims were grouped according to the type of assault burn injury into a fire group, chemical group and scald group, all the 9 ICU admission and the 3 mortalities belonged to the fire group. Assault by fire resulted in larger burn size (P=0.03), more inhalation injury (P<0.001) and longer ICU stay (P=0.02). Although the fire group had a longer hospital stay and higher mortality rate, this was statistically insignificant.
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Comparative Study Clinical Trial Controlled Clinical Trial
The effect of short-term growth hormone treatment on growth and energy expenditure in burned children.
Delays in growth are commonly observed in children who have sustained a severe cutaneous burn. The reasons for this growth delay are not completely known, but in adults, plasma growth hormone (GH) levels have been shown to decrease after thermal injury. If this is also the case in severely burned children, the low GH levels may contribute to their chronic growth delay. ⋯ For rhGH-treated children, the REE was elevated by 34+/-4% versus 35+/-5% for controls. Recombinant human GH, given during acute hospitalization, maintained growth in severely burned children who would otherwise experience a significant growth delay. Treatment with rhGH did not atttenuate their elevated REE.
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Phosphorus burns are a rarely encountered chemical burn, typically occurring in battle, industrial accidents, or from fireworks. Death may result even with minimal burn areas. Early recognition of affected areas and adequate resuscitation is crucial. ⋯ Cooling affected areas with tap water or normal saline, prompt removal of phosphorus particles with mechanical debridement, intensive monitoring, and maintenance of electrolyte balance are critical steps in initial management. Fluid resuscitation can be adjusted according to urine output. Early excision and skin autografts summarize our phosphorus burn treatment protocol.
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Randomized Controlled Trial Comparative Study Clinical Trial
Topical use of Sucralfate Cream in second and third degree burns.
This clinical study was undertaken to test the efficacy of topical Sucralfate Cream in second and third degree burns. Topical Sucralfate Cream has been used on a wide variety of lesions from radiation proctitis and dermatitis to keratoconjunctivitis with remarkable results. The study was carried out in two phases. ⋯ The difference in the two rates of healing was statistically significant with a P value of 0.00067. Histopathological studies were also carried out in 10 patients of phase I of the trial. Sucralfate Cream promotes rapid epithelialisation of second degree burns with minimal said effects and offers another topical agent in the burn care specialist's armamentarium.