Burns : journal of the International Society for Burn Injuries
-
There is an extreme paucity of studies examining cost of burn care in the developing world when over 85% of burns take place in low and middle income countries. Modern burn care is perceived as an expensive, resource intensive endeavour, requiring specialized equipment, personnel and facilities to provide optimum care. If 'burn burden' of low and middle income countries (LMICs) is to be tackled deftly then besides prevention and education we need to have burn centres where 'reasonable' burn care can be delivered in face of resource constraints. ⋯ The bottom line of management is strict observation by burn staff. The low mean hospital stay also reflects our admission and discharge policy which is to benefit the maximum number of patients who require resuscitative/intensive care, and who have extensive and deep wounds, or injury of critical nature. We conclude that providing burn care based on our model can be emulated in other LICs as the costing is driven by 'necessity of expense' rather than 'ability to spend'.
-
The use of objective methods for assessment of burns is limited. Laser Speckle Contrast Imaging (LSCI) is a non-invasive technique for instant measurement of tissue perfusion, making it potentially valuable for early prediction of burn wound outcome. ⋯ LSCI allows for robust, instant measurement of burns and can easily be applied in a clinical setting. Differences in perfusion during the first week post-burn are related to the outcome after 14 days.
-
There currently exists a need for evidence-based information and tools in burns care. It was therefore the aim of a working party of the Joanna Briggs Institute to establish an evidence based resource to assist professionals in the burns community to practice evidence based healthcare. ⋯ This paper outlines the details and processes surrounding the development of the JBI Burns Node, and how it has grown from humble beginnings into a resource that can assist in the translation of evidence into practice for burns care professionals.
-
Real-time monitoring of mortality in burns units has the potential to immediately mark when mortality rates are significantly higher or lower than predicted. Rapid feedback from targeted internal audit allows early intervention, to reinforce positive practices, and improve systems where outcomes are unsatisfactory. This is the first study to describe prospective use of cumulative sum (CUSUM) methodology in mortality monitoring outside of cardiac surgery. ⋯ This study describes a successful design for an early-warning system to monitor outcomes in a burns intensive care setting.
-
The transfer of drug resistance between hospital pathogens has led to alarming increase of multidrug resistant strains imposing therapeutic challenges. These resistant isolates harbor various mechanisms to counteract the drugs administered and have been reported to deliver these factors to sensitive strains in hostile environment. The present study aimed to screen for multidrug resistant Pseudomonas aeruginosa strains for the production of extended-spectrum β-lactamases, metallo-β-lactamases, AmpC β-lactamase, drug efflux phenotypes and co-transfer the resistance for cephalosporin and other non-beta lactam antibiotics in CaCl2 treated drug sensitive E. coli strains. ⋯ A putative efflux mechanism was observed in 8 out of 23 isolates that showed decrease in the MIC of meropenem with reserpine. The plasmid profile was characterized for all the common isolates obtained from burn and ICU units. About 69.66% of E. coli recombinants scored positive for both beta lactam and non-beta lactam antibiotics is due to co transfer of resistant plasmid obtained from P. aeruginosa.