Burns : journal of the International Society for Burn Injuries
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Is HBOT treatment effective in recovering zone of stasis? An experimental immunohistochemical study.
Studies aimed at recovering the zone of stasis are one of the major issues of experimental burn studies. Hypoxia and oedema at that zone may cause irreversible changes. Due to anti-oedematous and antihypoxic effects of hyperbaric oxygen treatment (HBOT), it may be beneficial in recovering the zone of stasis. ⋯ Wet and dry weight measurements of excised skin fragments were taken. As a result, HBOT showed a positive effect at the cellular level in the first 24h. It increased recovery potential by augmenting neovascularisation and decreasing oedema in the 5-day group.
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Hypertrophic scarring after partial-thickness burns is common, resulting in raised, erythematous, pruritic, and contracted scars. Treatment of hypertrophic scars, especially on the face, is challenging and has high failure rates. Excisional treatment has morbidity and can create iatrogenic deformities. ⋯ Multiple studies have shown its ability to decrease scar erythema and thickness while significantly decreasing pruritus and improving the cosmetic appearance of the scar. The history of laser therapy and the mechanism of action and results of the PDL in burn scars will be reviewed. The PDL should become an integral part of the management of burn scarring and will significantly decrease the need for excisional surgery.
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Randomized Controlled Trial
Pain relief during dressing changes of major adult burns: ideal analgesic combination with ketamine.
Pain management during burn dressing changes is a critical part of treatment in acute burn injuries. Although several treatment options have been suggested, it is still a challenge in a clinical setting. This study is aimed at finding out an ideal analgesic, sedative and/or anxiolytic combination that would minimise the unwanted effects of ketamine. ⋯ Any adverse effects of ketamine were recorded. The results showed that group II had better outcomes with respect to pain management during dressing changes. As a conclusion, the use of the combination of ketamine, tramadol and dexmedetomidine was found to be a good treatment option for the prevention of the procedural pain suffered by adult patients during dressing changes.
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Considerable advancements in shock resuscitation and wound management have extended the survival of burned patients, increasing the risk of serious infection. We performed a 6-year review of bacteria identification and antibiotic susceptibility records at the US Army Institute of Surgical Research Burn Center between January 2003 and December 2008. The primary goal was to identify the bacteria recovered from patients with severe burns and determine how the bacteriology changes during extended hospitalization as influenced by population and burn severity. ⋯ All 4 pathogens were recovered throughout the course of hospitalization. A. baumannii was the most prevalent pathogen recovered from patients with total body surface area (TBSA) burns less than 30% (203) and 30-60% (338) while P. aeruginosa was most prevalent in patients with burns greater than 60% TBSA (292). Shifting epidemiology of bacteria recovered during extended hospitalization, bacteriology differences between combat-injured and local burn patients, and impact of % TBSA may affect patient management decisions during the course of therapy.
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This study aims to review the changes in management of inhalation injury and the associated reduction in mortality over the past 2 decades. ⋯ The care of inhalation injury has made significant progress over the past 2 decades. The early diagnosis of inhalation injury, early airway control and pulmonary function assistance with mechanical ventilation contribute to the reduction of mortality.