Burns : journal of the International Society for Burn Injuries
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Keloids and hypertrophic scars occur anywhere from 30 to 90% of patients, and are characterized by pathologically excessive dermal fibrosis and aberrant wound healing. Both entities have different clinical and histochemical characteristics, and unfortunately still represent a great challenge for clinicians due to lack of efficacious treatments. ⋯ While we wait for these translational clinical products to be marketed, however, it is imperative to know the basics of the currently existing wide array of strategies to deal with excessive scars: from the classical corticotherapy, to the most recent botulinum toxin and lasers. The main aim of this review paper is to offer a useful up-to-date guideline to prevent and treat keloids and hypertrophic scars.
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Toxic epidermal necrolysis (TEN) is a rare condition characterised by mucocutaneous exfoliation of greater than 30% total body surface area (%TBSA), increasingly being treated in burns centres. The rate of mortality varies significantly in the literature, with recent prospective studies in non-burns centres reporting percentage mortality of approximately 45%. We undertook a systematic review of published studies that included TEN patients treated specifically in burns centres to determine a cumulative mortality rate. ⋯ The review highlights the variation between principles of treatment and mortality amongst burns centres. It offers a standard that burns centre can use to internationally compare their mortality rates. The review supports the ongoing reporting of outcomes in TEN patients with epidermal detachment greater than 30%.
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Standardized courses for the care of the burn patient have historically been developed in High Income Countries (HIC). These courses do not necessarily reflect the challenges and needs of Low Income Countries (LIC) and some components may not be relevant there (i.e. use of ventilators in a country that has no or very limited number of ventilators). We are developing a Burn Management Course for East Africa. This course was created and trialed in a LIC and subsequently a formal manual and course curriculum created. Recently the first iteration of the course was undertaken in a major regional burn centre in East Africa. We present participant feedback on the course content, and potential future directions for course development. ⋯ It is possible to create a course that translates knowledge from a HIC setting to meet the needs of the end-user in a LIC setting.
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The emergence of imipenem non-susceptible Pseudomonas aeruginosa isolates is a matter of great concern because these isolates can become resistant to all available antibiotics. This study conducted to characterize β-lactamase genes in imipenem resistant P. aeruginosa isolates from bloodstream. ⋯ The result of this study indicated the emergence of multidrug resistant MBL and non-MBL producing P. aeruginosa, particularly in the Burn hospital and blaVIM was dominant β-lactamase genes in imipenem resistant isolates. The isolation of carrier patients may lead to prevent a further dissemination.
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The aim of the study is to understand the incidence of burns among outpatients and inpatients of Taiwan in 2010. Characteristics of the burned patients were also studied in terms of gender, age, burn sites, burn degree, reconstructive surgical treatment, as well as which specialty and medical facility they are treated in. ⋯ This is a population-based study demonstrating the epidemiology of burns among outpatients and inpatients in Taiwan, leading us closer to the reality of burns treated in different settings of medical facilities.