Burns : journal of the International Society for Burn Injuries
-
Flammacerium (cerium nitrate-silver sulphadiazine) is marketed throughout Europe, but is only available in UK on a named patient basis. Anecdotally it is widely used in civilian burns units across the country despite the regulatory constraint, although little literature exists regarding its use in UK. We designed a postal survey to assess the use of Flammacerium countrywide and whether its 'named patient only' designation causes problems in treating burns patients. ⋯ Replies were received from 14 units (response rate=78%). Six units use Flammacerium frequently, six occasionally and two units never use it. It is used in those patients not undergoing early wound excision and closure because of co-morbidity, general age or frailty, paucity of donor sites or mixed depth pattern burns. It was generally used in the belief that it reduces the inflammatory response to burn injury (8/12), decreases bacterial colonization (10/12) and provides a firm eschar for easier wound management (11/12). Although 8 units had no problems with supplies of the agent, 10 respondents indicated they would like to see Flammacerium fully licensed in UK.
-
Multicenter Study
Burn prevention programs for children: do they reduce burn-related hospitalizations?
Severe burns in children can result in prolonged suffering, disability, disfigurement, and in impaired physical and mental development. Hospitalization rates of children with burns are much higher than for children with other trauma. Therefore, various child burn prevention programs have been implemented, but their efficacy has been evaluated only by assessment of knowledge or satisfaction rather than evaluating actual changes in burn-related hospitalizations. Our objective was to map Israeli child burn prevention programs and to measure their success from the rate of burn-related hospitalizations. ⋯ Injury prevention programs are effective in reducing burn-related hospitalizations among infants and toddlers, especially from more affluent communities, but not among school-aged children.
-
The axilla is a frequent site of adduction contracture after deep thermal injury, especially in burns in developing countries where the timely treatment of burns and the prevention of contracture are not possible for lack of appropriate services. Chronic contractures are difficult to treat, as large areas of wounds need to be covered with skin grafts or flaps. However, the most daunting aspect of adduction contracture is the maintenance of release after correction; this is often dealt with using long-term abduction splints, most of which are very uncomfortable. ⋯ All the cases were treated with simple release and skin grafting followed by a figure-of-8 sling. Preoperative limb abduction ranged from 0 degrees to 80 degrees; whereas, the postoperative range, at 1 year of follow-up, was from 140 degrees to 180 degrees. Hence, we conclude that the application of a figure-of-8 sling for axillary post-burn contractures is a safe, comfortable, easy and more compliant way of splintage with at least as reliable results as with other abduction splints.
-
Multicenter Study
Burn injuries related to motorcycle exhaust pipes: a study in Greece.
To identify measures that should reduce the incidence of burn injuries resulting from motorcycle exhaust pipes through epidemiological analysis of such injuries. ⋯ Motorcycle exhaust burns could be substantially reduced by systematically wearing long pants, by incorporating in the design of motorcycles external thermo resistant shields with adequate distance to the exhaust pipe, and by avoiding riding with children on motorcycles.
-
Pulse oximetry is being used in everyday clinical practice in anaesthesia utilising a peripheral probe. However, it may be unreliable in certain clinical situations such as hypothermia, hypovolemia, vasoconstriction and decreased cardiac output. Similar situations occur in burns patients and, more importantly, burns to extremities which limit the sites available for measurement of peripheral oxygen saturation (SpO(2)). ⋯ D.) of the differences between the oesophageal oxygen saturation results and those from CO-oximetry was 0.50+/-0.69%. A Bland and Altman analysis showed that the bias and the limits of agreement between the oesophageal and commercial toe pulse oximeters were 0.4% and -3.6% to 4.6%, respectively. This study suggests that the oesophagus can be used as an alternative site for monitoring arterial blood oxygen saturation by pulse oximetry in burned patients.