Burns : journal of the International Society for Burn Injuries
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Exogenous arginine vasopressin (VP) has been increasingly used in the hemodynamic management of critically ill patients with septic shock, but its use in septic burn patients has not been systematically examined. ⋯ VP is a useful adjunctive pressor that spares NE requirements in septic burn patients, but its use is not without risks, particularly when VP is combined with sustained moderate to high infusions of NE.
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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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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.