Burns : journal of the International Society for Burn Injuries
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Comparative Study
A comparison of the epidemiology of paediatric burns in Scotland and South Africa.
In South Africa burns affect 3.2% of the population annually and are particularly common among children. In Scotland paediatric burns are generally much less common and less severe. This study aimed to explore the epidemiological differences in the emergency presentation of paediatric burns in the Royal Aberdeen Children's Hospital (RACH) in Scotland and the Red Cross War Memorial Children's Hospital (RXH) in Cape Town. ⋯ At RACH 89% children were discharged immediately, whereas 49% of RXH patients were admitted to the burn unit. Paediatric burns are more common and generally more severe in Cape Town than in Aberdeen. All children have the right to a safe environment and protection from harm; to reduce the high burns incidence in Cape Town preventative strategies should be targeted at creating safer homes.
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Randomized Controlled Trial
Recombinant human granulocyte-macrophage colony-stimulating factor hydrogel promotes healing of deep partial thickness burn wounds.
To assess the effects of recombinant human granulocyte/macrophage colony-stimulating factor (rhGM-CSF) hydrogel on the healing of deep partial thickness burn wounds. ⋯ rhGM-CSF hydrogel promotes the healing process of deep partial thickness burns effectively. No adverse reaction of the drug was observed during the study.
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Supraclavicular flaps had been widely used as pedicled flaps to reconstruct face and neck defects. However, the size of this traditional flap was limited even after expansion. In this study, we present a flap pedicled by the thoracic branch of supraclavicular artery (TBSA). The flap is located at the subclavicular region, and has the advantage of large dimension, matching colour and thin thickness. ⋯ This expanded subclavicular flap pedicled by the TBSA has proved to be a promising method with satisfactory outcome and high success rate.
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The lack of autograft donor sites with major burns provides the impetus to develop innovative solutions due to the difficulty of wound closure. Autograft donor sites are particularly limited in patients with burns involving over 50% total body surface area (TBSA). The introduction of cultured epithelial cell autografts offers a potential solution to assist in wound closure. The objective of this study was the assessment of clinical results after sprayed application of the cultured epithelial autograft (CEA, Keraheal™, Seoul, Korea, MCTT) suspension onto the wounds of extensively burned patients. ⋯ The use of a sprayed cultured epithelial cell autograft (Keraheal™) in treating a full-thickness skin wound in severely burned patients results in favourable quality of scars and also good potential to save lives by providing epidermal cover.
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Postburn ankle scar contractures cause functional limitations of all lower extremities and create a serious cosmetic defect, not allowing patients to use normal foot wear, and, therefore, needing surgical reconstruction. The anatomic features of ankle dorsiflexion contractures and their treatment have been covered in the literature far less than other joint contractures, and their treatment is still a challenge for many surgeons. A common treatment method is incisional release of the contracture and defect resurfacing with skin graft. Rarely, distally based sural or free flaps and Ilizarov fixator are used. ⋯ Three anatomic types of ankle dorsiflexion scar contractures were identified: edge, medial, and total. An anatomically justified technique for edge and medial contractures is trapeze-flap plasty; total contractures are effectively eliminated with scar excision and skin grafting.