Burns : journal of the International Society for Burn Injuries
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Throughout history there have been many different and sometimes bizarre treatments prescribed for burns. Unfortunately many of these treatments still persist today, although they often do not have sufficient evidence to support their use. This paper reviews common first aid and pre-hospital treatments for burns (water--cold or warm, ice, oils, powders and natural plant therapies), possible mechanisms whereby they might work and the literature which supports their use. From the published work to date, the current recommendations for the first aid treatment of burn injuries should be to use cold running tap water (between 2 and 15 degrees C) on the burn, not ice or alternative plant therapies.
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Heterotopic ossification (HO) is an uncommon, but high profile complication of burns. In this paper, a retrospective study was undertaken to evaluate our treatment and results of HO. Relevant literature was also reviewed to search for new advances in prevention and management for patients with HO after burns. ⋯ Although HO after burn is uncommon, physicians should keep the complication in mind. When burn patients complain decreased ROM or "locking sign" in their joints, X-ray examination is indicated to rule out HO. Surgery is the treatment of choice when the diagnosis of HO is confirmed.
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Review Case Reports
CS gas--completely safe? A burn case report and literature review.
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The majority of burn centres use the crystalloid-based Parkland formula to guide fluid therapy, but patients actually receive far more fluid than the formula predicts. Resuscitation with large volumes of crystalloid has numerous adverse consequences, including worsening of burn oedema, conversion of superficial into deep burns, and compartment syndromes. ⋯ Starches are effective volume expanders and early use of newer formulations may limit resuscitation requirements and burn oedema by reducing inflammation and capillary leak. Advanced endpoint monitoring may guide clinicians in when to 'turn off' aggressive fluid therapy and therefore avoid the problems of over-resuscitation.