Burns : journal of the International Society for Burn Injuries
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Rhabdomyolysis (RML), defined as creatine phosphokinase (CPK) >1000 U/L, is relatively common immediately after a significant burn. Late-onset RML, occurring a week or more after a burn, is less well understood and recognised. All patients admitted to the Intensive Care Unit (ICU) following an acute burn between May 2006 and December 2009 were retrospectively identified. ⋯ A severe late-onset RML occurred in 5/76 (7%) patients, with a CPK rise of over 5000 U/L, and all required haemodialysis. Potential triggering factors for late-onset RML include sepsis, nephrotoxic drugs and hypophosphataemia. It is important to consider measuring CPK in all patients with the above complications, even after it has previously been observed to be normal, in order to initiate early treatment.
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Unfortunately, burn prevention knowledge is low among nurses. Establishing efficient ways in which to increase burn prevention knowledge in nurses is warranted. The current multi-center study evaluated whether a web-based educational module was successful at increasing burn prevention immediately and whether the knowledge was retained over time. ⋯ Mean score prior to receiving the educational module was 82.3%; the mean score was 83.8% immediately following receiving the educational module, and 86.1% two weeks after receiving the educational module. The educational module developed by the authors (www.burnpreventionstudy.org) is an efficient way in which to increase burn prevention knowledge and is available at their convenience. This education module could be used as a training module with nurses involved in burn prevention outreach, and with nurse practitioners, physicians, and emergency responders involved in primary care across the life span.
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In 1957, Hynes first described the shaving and grafting procedure for the treatment of mature hypertrophic scars (HTSs). This procedure involved excision of mature HTS using a scalpel blade followed by split-skin grafting (SSG). ⋯ To date, this modified technique has shown excellent cosmetic results. A review of cases and an example of the technique is provided.
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Extended spectrum β-lactamase (ESBL)-producing trait was present in 48 out of the 112 (42.8%) Pseudomonas aeruginosa isolates collected from burn wound infections during a 12-month period. The presence of oxa-10, per-1, veb-1 and ges genes and the multiple-locus variable number of tandem repeats (VNTR) fingerprinting (MLVF) of 112 P. aeruginosa strains were determined by PCR and multiplex PCR. Disk diffusion methods were used to determine the susceptibility of the isolates to antimicrobial agents as instructed by CLSI. ⋯ A total of 100 P. aeruginosa strains were typed by MLVF typing method. MLVF produced 42 different DNA banding patterns. These data indicate that different MLVF types infect burn wounds in patients at a hospital in Tehran and also suggest an alarming rate of ESBL-producing isolates in this test location.
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Loss of sensory function in scar after burn is common, although the basis for this loss is not clear. Additionally, little is known about the effects of different treatment modalities on sensory function and neuroanatomical outcomes in burn patients. Here, we investigated the effects of the use of the INTEGRA(®) dermal scaffold on neuroanatomy and sensory function in acute burn patients. ⋯ Peripheral nerves do reinnervate the INTEGRA(®) dermal scaffold. There is no statistically significant reduction in reinnervation observed when compared to a control group. It is possible that the use of artificial dermal constructs, while permissive for nerve regrowth, limit functionality when compared to nerves that regrow through dermal tissue. Further research to understand the causes of this, and into enhancing reinnervation in dermal scaffolds may improve sensory outcome in the most severely burned patients.