Burns : journal of the International Society for Burn Injuries
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Randomized Controlled Trial Multicenter Study
Sustainable effect of skin stretching for burn scar excision: long-term results of a multicenter randomized controlled trial.
Primary wound closure of large defects after burn scar excision may be facilitated by intraoperative stretching of the adjacent skin. In a randomized controlled trial (RCT), the effect of skin stretching for wound closure after scar excision (SS) was compared to scar excision without additional techniques (SE). Short-term results already showed that in the SS group larger scars could be excised in a one-step procedure. In this paper, the long-term scar outcome using reliable and valid measurement tools was evaluated. ⋯ This RCT demonstrates the long-term beneficial and sustainable effect skin stretching for wound closure after scar excision without leading to wider linear scars or more scar hypertrophy.
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Multicenter Study
Epidemiology of children admitted to the Dutch burn centres. Changes in referral influence admittance rates in burn centres.
In the Beverwijk Burn Centre a remarkable rise has been noted in the number of paediatric admissions since 2000. To investigate if this is a national trend and, if so, what may have caused it, a retrospective epidemiological study has been undertaken. ⋯ There has been a shift in paediatric burn care towards a greater volume of admissions in specialized burn care of especially young children with less severe burns. A possible explanation for the increased number of referred children may be the introduction of the EMSB course in 1998, since EMSB guidelines dictate stricter and generally accepted referral criteria.
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Multicenter Study
A survey of current practice patterns in prophylaxis against venous thromboembolism (VTE) and gastrointestinal (GI) ulceration among Canadian burn centers.
Prospective data on efficacy of routine thromboprophylaxis in burn population remains limited. We believe that this uncertainty has lead to diverse management practices across Canada. Similarly, despite data supporting effectiveness of early enteral nutrition (EEN) for gastrointestinal (GI) ulcer prophylaxis, we hypothesize that many burn centers continue to use additional medical prophylaxis. ⋯ With regards to GI ulcer prophylaxis, 62.5% of respondents indicated limiting use of ulcer prophylactic medications to ICU patients. Three (37.5%) centers reported practicing EEN for prophylaxis, 1 of which administered it as the sole modality. 7 of 8 centers used additional pharmacologic prophylaxis, most commonly an H2-blocker, ranitidine. There remains lack of consensus among Canadian burn centers in areas of VTE and GI ulcer prophylaxis, reflecting the limited prospective data in these fields.