Burns : journal of the International Society for Burn Injuries
-
To validate the use of photographic burn wound assessment in evaluation of burn size and wound characteristics. ⋯ Burn assessment with digital photography is a valid and affordable alternative to direct clinical exam, alleviating access issues to burn care in developing countries.
-
Burns are characterized by the loss of varying proportions of the protective layers of the skin, depression of immune responses, and increased wound susceptibility to infection. Wound infection is a major cause of morbidity and mortality in burn cases. This study characterizes those factors that predispose burn wounds to infection and the bacteriology of the microorganisms in our environment. ⋯ Factors predisposing to invasive wound infections in our environment were highlighted and suggestions made on methods that could reduce the infections and thus reduce morbidity and mortality in burns.
-
To analyze trends in incidence and treatment of thermal injuries over the last two decades. ⋯ The severity of burn injuries during the last two decades declined, probably reflecting the success of prevention campaigns. Concerning mortality, the chance of dying for a given severity of injury has decreased.
-
Paediatric burn follow-up optimally follows a balance between complication detection and avoiding unnecessary hospital visits. In a long-term review, we assessed complication patterns in children with burns requiring surgery. Using the Welsh Burns Centre database, a retrospective note review of paediatric burns over 3 years from 1995 was performed, identifying all children undergoing surgery for their burns. 94 patients were identified with a median follow-up since injury of 13.6 years. ⋯ All patients sustaining axillary burns developed contractures, whilst 75% of contractures developed around the upper limb. In conclusion, younger patients with larger TBSA burns in the upper limb were at higher risk for contractures and hypertrophic scarring, which all presented within 18 months. Therefore any patients that are complication-free 18 months after-injury can be safely discharged, allowing streamlining of follow-up for the benefit of patients, parents and hospital resources.
-
Many burn patients experience more intense pain from the split thickness skin donor site than in the grafted burn wound in their postoperative period. Often, split thickness autografts are harvested from the lateral thigh area, which is innervated by the lateral femoral cutaneous nerve (LFCN). Sonographic nerve localization has been an increasingly popular technique to provide regional nerve blocks and we explore its role in improving pain control during skin harvesting. ⋯ The size of the anesthetized field ranged from 119 to 630 cm(2), with a mean surface area of 268.5 cm(2). Donor site sensation returned within 5-16 h with a mean time of 9.1h. Ultrasound guided LFCN block provides a simple and safe choice of anesthesia for harvesting skin from the lateral thigh.