Burns : journal of the International Society for Burn Injuries
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Recreational open fires are an important and preventable cause of burn. In contrast to adults, who often sustain flame burns, children are at higher risk of thermal contact burns caused by hot embers many hours after the fire was first lit. Cases of thermal contact injury in children due to recreational fires were reviewed and the potential of a small charcoal fire to cause burns over a prolonged period was tested. ⋯ Injury was most commonly sustained after falling into (40%), or accidentally crawling or walking on (30%), the remnants of an unextinguished fire. Small charcoal fires retain sufficient heat to cause injury at least 16h after lighting. Strategies for prevention of these injuries are outlined.
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Multicenter Study
PTSD in persons with burns: an explorative study examining relationships with attributed responsibility, negative and positive emotional states.
A sample of 90 persons who had been hospitalized for severe burns were interviewed 1-4 years after the incident. Current DSM-IV post-traumatic stress disorder (PTSD) was assessed with the Composite International Diagnostic Interview. Perceived attributed responsibility and related positive and negative emotional states were examined using a semi-structured interview. ⋯ However, the model including emotional state showed to have the best fit. Although further research is needed, these results may indicate that professionals working in burn care should consider the emotional state in relation to perceived attribution of responsibility when considering PTSD. Promoting forgiveness may be a beneficial strategy in dealing with post-traumatic stress reactions.
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In the year 2007, approximately 1000 original burn research articles were published in scientific journals using the English language. This article reviews approximately 90 of these which were deemed by the author to be the most important in terms of clinical burn care. Relevant topics include epidemiology, wound characterisation, critical care physiology, inhalation injury, infection, metabolism and nutrition, psychological considerations, pain management, rehabilitation, and burn reconstruction. Each selected article is mentioned briefly with editorial comment.
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Mortality rates are important outcome parameters after burn, and can serve as objective end points for quality control. Causes of death after severe burn have changed over time; in the international literature, multisystem organ failure is seen as the most important cause, but the exact distribution of causes of death remains unknown. Insight into underlying agents of mortality can be directive in research and prevention programmes. ⋯ The most frequent cause of death appeared to be multisystem organ failure, in 64.9% of cases; 93% of these had systemic inflammatory response syndrome at time of death and, in 45.9%, infection was deemed responsible for the fatal clinical deterioration (in 21.3% sepsis was proved and in 24.6% was highly suspected). To compare mortality rates between different burn centres and periods of time, uniform classifications are needed, particularly for presence of inhalation injury and for causes of death. Prevention of multisystem organ failure, by better management of infection and systemic inflammatory response syndrome, might do most to decrease mortality after burn.
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This study investigates the hand surface area (HSA) and palm surface area (PSA) percentages of body surface area (BSA). The HSA and PSA of 135 men and 135 women were measured by scanner and incorporated into an existing BSA database to derive %HSA/BSA and %PSA/BSA using five stature heights and three body weights in accordance with population distribution. Allowing for various degrees of specificity, the mean %HSA/BSA and mean %PSA/BSA were found to be 2.29% (0.24%) and 0.89% (0.09%), respectively. Gender and body weight group were significant factors.