Burns : journal of the International Society for Burn Injuries
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Methods for handling burn wounds have changed in recent decades and increasingly aggressive surgical approach with early tangential excision and wound closure is being applied. Split-thickness skin (STSG) autografts are the "gold standard" for burn wound closure and remain the mainstay of treatment to provide permanent wound coverage and achieve healing. ⋯ Questions related to optimal cell type for culture, culture techniques, transplantation of confluent sheets or non-confluent cells, immediate and late final take, carrier and transfer modality, as well as final outcome, ability to generate an epithelium after transplantation, and scar quality are still not fully answered. Progress accomplished since Reinwald and Green first described their keratinocyte culture technique is reviewed.
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The eternal debate between quality and cost-effectiveness within the healthcare arena is challenging for healthcare professionals and organisations. This is a national and international priority in the field of burn care for implementing the projects of burns networks, outreach teams, regional commissioning groups and rehabilitation. This article focussed on several areas of cost-effective quality burn care from initial management to rehabilitation and explore whether that can assist the specialists in the provision of quality care and value for money.
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Multicenter Study
Survey of primary school educators regarding burn-risk behaviors and fire-safety education.
To assess primary school educator knowledge and opinions regarding fire-setting behaviors and burn-injury prevention education. ⋯ Nearly all primary school educators surveyed agreed that burn injuries and attempting to curb fire-play are important societal issues. There was wide agreement that including a description of the medical and social consequences of burns in a preventive curriculum would enhance its efficacy. The younger students are, the more time teachers require to adequately convey fire safety instruction.
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Randomized Controlled Trial
Enteral resuscitation and early enteral feeding in children with major burns--effect on McFarlane response to stress.
Early enteral feeding has become standard practice for burned patients. The aim of this study was to determine whether early enteral feeding could be used as an avenue for resuscitation and feeding and the effect it would have on the induction/amelioration of the hormonal stress response. ⋯ Enteral resuscitation and early enteral feeding is a safe and effective method and particularly suited for children in developing countries. It resulted in the amelioration of the hormonal stress response and improved outcome. Enteral resuscitation should not be introduced in a patient in shock or with existing gastrointestinal disease. Complications were minimal.
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Randomized Controlled Trial
Recombinant FVIIa decreases perioperative blood transfusion requirement in burn patients undergoing excision and skin grafting--results of a single centre pilot study.
Excision of burn wounds is frequently associated with a large volume of blood loss requiring allogeneic blood transfusion. We conducted a pilot study to investigate the effect of activated recombinant coagulation factor VII (rFVIIa) on the reduction of blood transfusion requirements in burn patients undergoing excision and skin grafting. ⋯ rFVIIa might be useful in decreasing blood transfusion requirements in burn patients undergoing excision and skin grafting.