Burns : journal of the International Society for Burn Injuries
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The effects of local treatment with highly purified tannic acid (HPTA) on serum transaminase and alkaline phosphatase activity in burn patients were studied, retrospectively. Temporary elevations in the activity of gamma-glutamyl transferase (GGT), aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT) and alkaline phosphatase (AP) were observed in both HPTA-treated patients and their matched controls. ⋯ These results seem to indicate that HPTA does not cause hepatotoxicity, at least when applied to a burned area corresponding to approximately 10% of the total body surface. This is in agreement with the widespread and frequent use of HPTA in the food, cosmetic and pharmaceutical industries.
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QT dispersion, defined as the maximal-minus-minimal QT interval on a 12-lead electrocardiogram, has emerged as a non-invasive measurement for quantifying the spatial inhomogeneity of ventricular repolarization under various conditions, including acute stress. Because burn injuries elicit acute stress reactions, it was hypothesized that QT dispersion increases with the severity of the burn injury. To test the hypothesis, 13 burned patients (age range of 22-76 years, nine males, ranging from 4.0 to 75.0% of total body surface area burned) in whom a measurable 12-lead electrocardiogram had been obtained within 4h after arrival at the emergency department were identified retrospectively, and their QTc intervals, i.e. ⋯ QTc dispersion (QTcd) was then calculated, and correlations were assessed with burn severity (burn index, BI; prognostic burn index, PBI). Of the 13 patients, nine patients had a prolonged QTcd (>40 ms), and linear correlation analyses showed significant positive correlations between QTcd and both BI and PBI (r=0.61 and 0.62, respectively). In conclusion, QT dispersion was greater in the burned patients, and although the pathophysiology was unclear from the present study, the findings suggested that acute stress contributed to the spatial inhomogeneity of ventricular repolarization.
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The aim of the study was to explore cognitive distortions in recovered burn patients. Previous studies in trauma patients have shown trauma-specific attentional bias, long response latencies, and deficits in memory specificity. Eighteen former patients, burn injured 5-19 years ago and 18 matched controls performed the emotional Stroop task, including burn and general trauma-related words, and the autobiographical memory test (AMT). ⋯ This may imply that the recovered burn patients consider the burn an important issue in life. The post-burn patients also presented signs of a slight cognitive slowness as compared to the controls. This finding deserves further attention in the rehabilitation of burn patients.
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This paper presents a retrospective study of the use of 346 expanders in 132 patients operated at the Ivo Pitanguy Clinic, between the period of 1985 and 2000. The expanders were used in the treatment of burn sequela. In the majority of cases, more than one expander was used at the same time. ⋯ The re-expanded flaps demonstrated good distension and viability. With the increase in area at each new expansion, larger volume expanders were employed, achieving an adequate advancement of the flaps to remove the injured tissue. The great advantage of using tissue re-expansion in the burned patient is the reconstruction of extensive areas with the same color and texture of neighboring tissues, without the addition of new scars.
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This paper presents a series of practical guides for use in planning and responding to a major incident involving large numbers of burns casualties. ⋯ This practical guide for emergency planners will improve the preparation and response to a major incident involving burns.