Burns : journal of the International Society for Burn Injuries
-
Randomized Controlled Trial
Effect of N-acetylcysteine treatment on the expression of leukocyte surface markers after burn injury.
Oxidative stress and inflammatory processes generate edema in burns. Treatment of consequent hypovolemia is a challenge. The aim of study was to assess if glutathione pro-drug N-acetylcysteine (NAC) can influence inflammation and fluid requirement. ⋯ Expression of CD11a (p < 0.05), CD18 (p < 0.05) and CD97 (p < 0.01) on the granulocytes were significantly lower in the NAC treated group, similarly to lymphocyte CD 49d (p < 0.05) and monocyte CD 49d (p < 0.01) and CD 97 (p < 0.05) expression. No significant difference was found in the fluid requirement between groups but patients the NAC group required less vasopressor and inotropic drugs from day 4. NAC treatment is associated with a less pronounced inflammation reflected in lower CD marker expression and vasopressor requirement.
-
Randomized Controlled Trial
A novel technology approach to pain management in children with burns: A prospective randomized controlled trial.
Non-pharmacological approaches to supporting young children through painful medical procedures are an essential component of burn pain management protocols. New technology developed from collaborations between healthcare professionals and IT teams can enhance the preparation and distraction approaches used with children. This study follows on from previous studies using such technology, and aim to determine whether levels of pain and distress using a combined preparation and distraction content can be further reduced, and offer more efficient clinical outcomes. ⋯ A combined MMD protocol reduces the pain experiences for young children during burn care procedures. When compared with a previous MMD trial, outcomes reiterated the use of procedural preparation as an essential component of non-pharmacological approaches. In addition to minimizing pain and distress, this innovative technology reduced treatment length and pain adverse events, and may have an impact on reducing days to healing, providing evidence of clinical efficacy and utility.
-
Cytomegalovirus (CMV) infection has been shown to occur not rarely in critically ill patients in the past decade. However, little data are available on CMV infection in burn patients whereas their susceptibility to CMV infection has been proved. ⋯ CMV infection rate is considerable in burn patients with TBSA greater than 15%. This infection seems to be mostly due to reactivation of latently existing virus.
-
The advent of fishing rods made of carbon fiber and graphite rods has greatly increased the risks of electrical injuries associated with fishing. The braided fishing lines and metal hooks put the fishermen at risk for electrical injuries. ⋯ Fishing-related burns and illegal fishing can lead to serious injuries and death.
-
Reconstruction of the face and neck after burn necessitates high-quality tissue for improving the appearance. Tissue expansion provides a greater opportunity, but, unfortunately, with relatively high complication rates. One potential alternative to reduce these complications is to place the expander with the assistance of the endoscope. In this study, we evaluated endoscopically assisted tissue-expander placement for the treatment of face and neck deformities after burn. ⋯ Endoscopically assisted tissue-expander placement allows for the use of smaller incisions, which can be placed in more cosmetically acceptable areas and away from the expansion site. This benefit would reduce the risk of wound dehiscence, and permits expansion to be initiated earlier. We believe that this technique is a safe and effective method that needs to be confirmed with a comparative study.