Burns : journal of the International Society for Burn Injuries
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The process of wound healing involves a complex interplay of cells, mediators, growth factors and cytokines. GM-CSF has been shown to be involved in a number of processes essential in this event. ⋯ The overall effects of rhGM-CSF on the healing of wound are diverse. Topically applied rhGM-CSF is beneficial for deep partial-thickness burn wounds, chronic leg ulcers, and leprosy ulcers. rhGM-CSF may have a positive effect on other type of chronic ulcers such as pressure ulcers and cancer related ulcers, but the evidence is not sufficient for generalised use at present. rhGM-CSF is suggested have no accelerating effect on the healing of healthy wounds or surgical incisions.
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In this experimental animal study, the effects of three different topical antimicrobial dressings on Candida albicans contaminated full-thickness burn in rats were analyzed. ⋯ The animal data suggest that nystatin is the most effective agents in the treatment of C. albicans-contaminated burn wounds, and Acticoat™® is a choice of treatment on fungal burn wound infection with antibacterial effect and the particular advantage of limiting the frequency of replacement of the dressing.
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Risk factors for mortality and length of hospital stay in elderly burn patients are well established, but the influence of race and socioeconomic status has not been evaluated. This study evaluates the effect of neighborhood level socioeconomic indicators on burns risk, and determines whether race and neighborhood influence burn injury outcomes in the elderly. Data from the North Carolina Jaycee Burn Center was linked to United States Census Bureau block group socioeconomic data. ⋯ Minorities had significantly higher odds of increased length of hospital stay in individual (2.05; p=0.0020) and multilevel (2.55; 0.037) models. High proportions of rural households (RR=1.39; p=0.0010) and poverty (1.26; p<0.0001) were significantly associated with increased risk of burn. Additional investigation using larger databases will allow further elucidation of the contextual effects of socioeconomic status on burn in the elderly.
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Contracture deformities affecting the flexor aspect of the elbow joint and the 1st web space are not uncommon sequelae of burns. Surgical treatment is contemplated in those patients with established contractural deformities in whom non-surgical treatment is ineffective or functional integrity of the joint is at jeopardy. Surgical treatment consists of incising the scar tissue to release joint contracture and covering the defect that might result with skin grafting or various tissue flaps. In this work, we used a modification of the multilobed propeller flap to treat eight patients with contracture deformities. ⋯ The new modification has the advantages of being flexible, can be tailored to best match the defect so that it can be closed primarily or needs smaller skin grafts, can be used even when there is much scarring and, finally, the resultant appearance is cosmetically acceptable with little donor morbidity, if any.
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Burn centres are 'hubs' of referral for large areas and should be organised in a network optimised for the needs of their area. Burn centres' organisation and activity in Italy are analysed with reference to burn epidemiology in the country. ⋯ Italy seems to have less availability of beds for burn care than other countries, and distribution and organisation of the network may be improved. The high prevalence of child burns should be noticed and this makes prevention campaigns advisable.