Burns : journal of the International Society for Burn Injuries
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Randomized Controlled Trial Multicenter Study
Suprathel, a new skin substitute, in the management of donor sites of split-thickness skin grafts: results of a clinical study.
A prospective, randomized, two center clinical study was conducted to evaluate the impact on wound healing of Suprathel in donor sites of split-thickness skin grafts. Suprathel represents an absorbable, synthetic wound dressing with properties of natural epithelium. ⋯ Suprathel represents a solid, reliable epidermal skin substitute with impact on wound healing, patient comfort and ease of care. The material effectiveness contributes to the reduction of overall treatment costs.
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Adult burn patients experience pain during wound care despite pharmacological interventions. Additional nursing interventions are needed to improve pain management. A systematic review was undertaken in order to examine the implications of previous research for evidence based decisions concerning the use of non-pharmacological nursing interventions and for future research. ⋯ Although 17 studies showed that the intervention had a positive effect on pain outcomes and no adverse effects of the reviewed interventions were reported, the best available evidence was found for active hypnosis, rapid induction analgesia and distraction relaxation. However, in order to reduce methodological limitations, further research is needed before well-founded evidence based decisions for nursing practice can be made. Aspects that seem important for future research, like the type of the intervention, theoretical framework, manner of giving instruction and guidance, cost, outcomes, measurement instruments and data collection points are considered.
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There is a need, both in clinical and research settings, for an affordable, objective method of assessing burn depth. This study compares burn depth assessment by videomicroscopy with laser Doppler imaging (LDI) in patients with dermal burns. The videomicroscope is inexpensive compared to LDI, and can visualise the dermal capillary structure, therefore potentially allowing objective assessment of dermal burn injuries. ⋯ The videomicroscope is capable of accurately and objectively assessing burn depth. The results correlated well with both the clinical outcome and the laser Doppler findings. In addition, videomicroscopy is significantly cheaper than LDI and avoids several of the disadvantages of LDI.
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Comparative Study
Comparative study of skin grafting with and without surgical removal of granulation tissue in chronic burn wounds.
A prospective comparative study of skin grafting of chronic wounds with and without surgical removal of granulation tissue was done on 51 patients with an objective of finding a better method of skin grafting objectively in the chronic burns wounds. Comparative study was done on those patients who had wounds on both the sides of their body. Wounds present on the right side of the body labeled as Group A were skin grafted after removal of granulation tissue and wounds present on left side of the body labeled as Group B were skin grafted without removal of granulation tissue. ⋯ We found no effect of bacteriology and chronicity of the wounds on the uptake of grafts in the two groups. Serum albumin levels <4 g% was found to be associated with statistically significant decreased graft uptake only in Group A wounds. It was further observed that Group A wounds were associated with more blood loss, less secure haemostasis, prolonged surgical duration and thus more cost of surgery as compared to Group B wounds.
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To assess the duration and magnitude of immunosuppression induced by burns as measured by the neutrophil oxidative burst in vitro. ⋯ This study provides evidence that immunosuppression in those injured by burns, as assessed by the in vitro oxidative burst of neutrophils, remains long after the event of the burn (up to 3.5 months after burn). Absence of correlations to TBSA%, FTB%, blood transfusion, opiates provided, and multiple organ failure score and laboratory infection variables together with the finding that decreased oxidative burst was uniform after the injury, suggesting that this immunosuppression is primarily due to the general metabolic response rather than recurring infections.