Burns : journal of the International Society for Burn Injuries
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Diagnosis of sepsis is difficult, particularly in cases of burn where signs of sepsis may be present in the absence of a real infection. This study compared serum levels of procalcitonin (PCT), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell (WBC) among 60 burned people with and without infection, in order to assess the value of the information for diagnosis of sepsis. ⋯ Non-survivors had a mean PCT level significantly higher than that of survivors. Thus the serum PCT level was a highly efficient laboratory parameter for the diagnosis of severe infectious complications after burn, but WBC, neutrophil, ESR and CRP levels were of little value.
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Tissue expanders have become useful adjuvants in reconstruction after burn. This study reviews experience with of tissue expanders in the treatment of head and neck burns, from April 2002 to February 2007; 82 expanders were used for 72 patients, all of whom underwent reconstruction at least 6 months after complete healing. The only major difference in this study from other techniques was the preoperative approach for selecting flaps and implants. ⋯ This was based on previous laboratory studies demonstrating that large flaps with very narrow pedicles remain well vascularised and can be transposed to cover very large defects. Satisfactory results were achieved after reconstruction in all cases. Tissue expansion, if carefully planned and conducted, is part of the treatment of choice for post-burn reconstruction of the head and neck, allowing an expanded flap suitable for versatile coverage.
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Burns to the perineal, buttock and upper thigh areas are frequently exposed to continual faecal contamination which results in sepsis, graft loss, delayed wound healing and shrinkage of scars. A temporary diverting colostomy may be required. Two specifically designed intrarectal catheters were evaluated for their safety and ability to divert faeces away from the burn and allow wound healing. ⋯ A specifically designed intrarectal catheter can divert faeces to allow wound healing, and may avert colostomy. More studies are necessary to evaluate safety.
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Patient satisfaction is an important outcome in health care but has not been studied in relation to burn care. The aim was to explore factors related to satisfaction with care 1-6 years after a burn. Participants were 86 adult burn patients, injured on average 3.6 years previously. ⋯ Total amount of explained variance ranged between 18% and 25% for the PS-RESKVA subscales. In summary, satisfaction with burn care was only moderately explained by health and personality characteristics. Further, former patients rated satisfaction with nursing staff higher than other aspects of care, especially information routines.
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A wealth of data exists concerning paediatric burn epidemiology in general, but very little exists specifically in infants under 1 year of age, a special group in which mobility begins to develop. A retrospective study of all burn admissions of infants under 1 year old to The Welsh Centre for Burns from January 2003 to January 2006 was performed. During the 3-year period there were 104 new burns cases identified which represents 11.8% of all paediatric admissions. 63.5% (66) were treated as inpatients and 36.5% (38) treated as out-patients. ⋯ The frequency of burns in the under 1 year old population highlights a need for emphasis of burn prevention directed to this group. Special attention is needed to look at the specific aetiology of these burns. Starting points for prevention should address the number of burns surrounding hot drinks and bottle warming practices in the case of scalds and the dangers of household radiators and hot water pipes in the case of contact burns.