Burns : journal of the International Society for Burn Injuries
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Despite widespread use of wound dressings containing silver, few studies have investigated patients' serum silver levels. An earlier study of Acticoat use in small burns showed transient elevations of serum silver. The aim of this study was to examine the serum silver profile when Acticoat is used in major burns. ⋯ One adverse event, partial skin graft loss was thought to be dressing related. In this small study, serum silver levels were elevated but remained similar to that reported following the use of silver sulfadiazine. This study confirmed our view that Acticoat is safe to use on patients with burns, even when they are extensive.
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Evaluation of burn depth is an essential and difficult step that conditions surgical or non-surgical treatment. The purpose of the study is to evaluate the opportunity to diagnose burn depth only with initial photography of the burn. ⋯ Even though a photographic analysis cannot replace clinical examination, photographic evaluation may be one option to consider for an early distance diagnosis.
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With improved survival in burn patients, Clostridium difficile infection (CDI) remains a significant potential complication. The incidence of, risk factors for, and outcomes of CDI in severely burned patients are poorly studied and remain unclear. This study involves retrospective case control and cohort studies using electronic medical records from February 1, 2002 to January 31, 2009 at the US Department of Defense's only burn unit. ⋯ There was no difference in treatments, morbidity, or mortality. The comparison of patients with positive and negative C. difficile toxin among those in the BICU revealed few significant differences in risk factors or outcomes. Differences in risk factors between burn and non-burn patients were likely markers of the populations rather than independent risk factors for CDI in the burn population with overall lower rates likely reflective of younger, healthier patients in the BICU and more aggressive infection control practices.
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How do clinicians determine the acceptable level of recovery of quality of life (QoL) after a burn? Many use the Burn Specific Health Scale (BSHS). The aim of this study was to examine normative values of the BSHS-Brief (BSHS-B) questionnaire in the general population. ⋯ The study showed the non-burned population do not respond with full scores to all questions in the BSHS-B. The result was more notable in the non-physical questions related to the psychological and environmental factors. The data presented prompts clinicians to collect and define acceptable recovery of quality of life after a burn as measured by the BSHS-B for their local burn population.
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Patients who attempted suicide by self-immolation were compared to patients who attempted suicide by poisoning to identify features that might discriminate risk of self-immolation from other suicide methods. ⋯ In Iran, patients who attempt suicide by self-immolation have distinct and specific risk factors compared to patients who commit suicide by poisoning. Results have implications for intervention development targeting at-risk populations.