Burns : journal of the International Society for Burn Injuries
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Multicenter Study
Prognostic implications of inhalation injury in burn patients in Tokyo.
Inhalation injury has recently emerged as the major cause of mortality in burn patients. However, the prognostic value of inhalation injury has not been thoroughly assessed in Japanese burn facilities. The aim of the present study was to evaluate the impact of inhalation injury on burn patients' mortality in Tokyo. ⋯ The overall in-hospital mortality rate of the patients with inhalation injury was higher than that of those without inhalation injury (33.6% versus 8.1%, odds ratio, 5.72 [95% CI, 4.91-6.67]). The results of the multivariate analysis indicated that inhalation injury; full- and partial-thickness burn size, and age were independent predictors of outcome (relative risk, 2.58 [2.03-3.29], 1.10 [1.09-1.11], 1.06 [1.06-1.07], 1.05 [1.05-1.06], respectively). In conclusion, inhalation injury was the most important predictor of overall mortality among burned patients in Tokyo.
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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.
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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.
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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.
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Multicenter Study
Disseminated intravascular coagulation: a rare entity in burn injury.
Severe burns are traditionally quoted as causes for acute disseminated intravascular coagulopathy (DIC). However, literature is scarce, and the real incidence of DIC is still unknown. In order to determine the incidence and the clinical implications of DIC in the burned population, 3331 consecutive burned patients were review. ⋯ In conclusion, disseminated intravascular coagulopathy is a rare complication following severe burn trauma. It complicates the course of the critically ill burn patient, although appropriate therapy prevents its fulminant course. However, a prospective multicenter study with close monitoring of all coagulation parameters may be necessary to elucidate the real incidence of DIC in burn patients.