Burns : journal of the International Society for Burn Injuries
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Infection risk, sepsis and mortality after severe burn are primarily determined by patient age, burn size, and depth. Whether genetic differences contribute to otherwise unexpected variability in outcomes is unknown. We sought to determine whether there was an association between IL-6, IL-10 and IL-17 polymorphisms with cytokine production and development of sepsis. ⋯ Only IL-10 promoter -1082GG genotype was related to an increased IL-10 production in burned patients. In addition, septic subjects bearing -1082G/G genotype have shown the highest and non-septic bearing -1082A/* genotypes the lowest IL-10 serum levels. All together these data seem to indicate that genetically determined individual difference in IL-10 production might influence the susceptibility to septic complications in burned patients and suggest that these markers might be useful in burned patient management.
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Patients' health-care needs are an important issue, but have not been studied in the burn field. The aims of this study were to explore discharged burn patients' health-care needs and related factors. This cross-sectional study used convenience sampling and four questionnaires, including basic information, Mental Status Inventory, Burn Patients' Social Support and Burn Patients' Healthcare Needs for data collection. ⋯ Self-reported psychosocial needs and physiological care needs correlated with each other. The multiple regressions showed that the most important predictors of overall health-care needs were numbers of visible scarred areas, time since discharge and previous psychiatric history. The findings revealed the burn patients provided clinically useful information and supported further evaluation in the area of care needs for burn patients.
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Laser Doppler imaging (LDI) has been investigated and used since 1993 for the assessment of burn wounds. Here we describe tests that validate use of the dedicated colour palette, derived in Part 1, for a standardised interpretation of LDI images for prediction of healing time (<14 days, 14-21 days or >21 days). We also describe clinical and technical factors to be taken into account during LDI imaging and during image interpretation. ⋯ LDI can be used in a standardised way as a valid tool for improving on clinical assessment of burn wounds. This can enable earlier appropriate management.
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To examine the effect of inpatient rehabilitation therapy on range of motion, hand function and balance in the burn population. ⋯ Specific functional measures, range of motion, hand function and balance, demonstrate significant improvement during inpatient rehabilitation. Future work is needed to investigate other functional benefits of rehabilitation and to compare the impact of inpatient rehabilitation to other therapeutic interventions.
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Split-thickness skin autografts are the gold-standard in providing permanent acute wound closure in major burns. Split-thickness dermal grafts harvested from the same donor site may provide an additional autologous option for permanent acute coverage and increase the number of potential autologous donor sites. ⋯ Dermis grafts can provide an additional autologous option for permanent coverage in acute major burn wounds without increasing donor site size or morbidity.