Burns : journal of the International Society for Burn Injuries
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Burns are responsible for significant mortality and morbidity worldwide and are among the most devastating of all injuries, with outcomes spanning the spectrum from physical impairments and disabilities to emotional and mental consequences. Management of burns and their sequelae even in well-equipped, modern burn units of advanced affluent societies remains demanding and extremely costly. Undoubtedly, in most low and middle income countries (LMICs) with limited resources and inaccessibility to sophisticated skills and technologies, the same standard of care is obviously not possible. ⋯ The present review is a summary of what has already been accomplished in terms of burn prevention highlighting some of the successes but above all the numerous pitfalls and failures. Recognizing these failures is the first step towards development of more effective burn prevention strategies particularly in LMICs in which burn injury remains endemic and associated with a high mortality rate. Burn prevention is not easy, but easy or not, we have no options; burns must be prevented.
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Randomized Controlled Trial
A model for predicting mortality among critically ill burn victims.
To develop a model for predicting mortality among burn victims. ⋯ We propose a mortality predictive equation for burned victims. In this model, MV and not inhalation injury is a mortality risk factor.
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The aim of this retrospective, comparative study was to analyse the management of extensive burns so as to decrease morbidity and mortality. Over 1987-1996, 24 people with burns >80% of total body surface area and >50% full-thickness burn were admitted to the burn unit of Anhui Medical University Hospital (group A); 30 similar admissions over 1997-2006 formed group B. No significant difference was found in age, male:female ratio, % total body surface or full-thickness burn area between the two groups. ⋯ Prophylactic tracheotomy was undergone by 8/24 casualties in group A and 22/30 in group B. Mortality in group A was significantly higher than in group B (95.8% vs. 63.3%, p<0.05) and survival was longer in group B. These results showed that refinements in burn shock resuscitation, and advances in early wound excision, skin grafting and respiratory management were associated with decreased morbidity and mortality after severe burn.
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The aim of this prospective study was to find predictors of patient satisfaction with burn care. Sixty-nine consecutive adult patients undergoing acute treatment in a Burn Unit completed the following questionnaires: the Swedish universities Scales of Personality, the Impact of Event Scale-Revised, and the Hospital Anxiety and Depression Scale. Socio-demographic data and burn severity were registered. ⋯ Variables remaining in the models were: intrusive symptoms, and the personality trait stress susceptibility for QCN; age, education, and symptoms of hyperarousal for QCM; trait irritability for INF; and age and the personality traits detachment and social desirability for GS. In conclusion, psychological and socio-demographic variables predicted satisfaction to some degree, whereas injury severity did not. The low amount of explained variance suggests that other factors, hypothetically related to care itself, determine patient satisfaction as assessed by the PS-RESKVA.
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Case Reports Comparative Study
The comparative study of solvents to expedite removal of bitumen.
Hot-bitumen burn is a unique case in all types of burns. This melting substance is difficult to remove when it adheres to the skin and solidifies. It causes burns and sticks to the skin when it is cooled to the skin temperature. ⋯ Afterwards, the concentrations of the bitumen in the solvents were quantified with the fluorescence measurement technique. We consider De-solv-it is the one of the best solvent for the removal of bitumen and highly recommended for hot-bitumen burns. The results of this study suggest that dressing change should be done every 4 to 8 h or as frequently as needed until the bitumen is entirely removed.