Burns : journal of the International Society for Burn Injuries
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Randomized Controlled Trial Multicenter Study
Skin stretching for primary closure of acute burn wounds.
In burn care, a well-acknowledged problem is the suboptimal scar outcome from skin grafted burn wounds. With the aim of improving this, we focused on a new technique: excision of the burn wound followed by primary closure, thereby using a skin-stretching device to stretch the adjacent healthy skin. The short- and long-term effect of Skin Stretch was compared to split skin grafting (SSG) in a randomized controlled trial. ⋯ Skin Stretch for primary closure of acute burn wounds is a suitable technique and can be considered for specific circumscript full-thickness burn wounds. However, future research should be performed to provide additional scientific evidence.
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Medical support of military operations involves treatment of massive soft tissue wounds, thermal burns, open fractures, blast injuries and traumatic amputations under conditions that are often austere and far from supply lines. Military hospitals, as recently deployed in Iraq and Afghanistan, are designed and equipped for stabilization and rapid transfer of injured patients back to their home nation. These austere facilities are often tasked with the emergency or long-term treatment of local populations when injured or burned, further stressing the medical resupply system. ⋯ Compared to conventional burn dressings, they are easier to transport and store, easier to use, and do not need to be changed as frequently, allowing for conservation of nursing resources. In this literature review, the recent military uses of silver-nylon dressings are examined. The stockpiling and use of silver-nylon as a universal military burn and wound dressing is advocated.
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Burns remain disproportionately prevalent in developing countries. This study aims to describe the epidemiology of burns in Sierra Leone to serve as a baseline for future programs. ⋯ Burns are highly prevalent in Sierra Leone. Further research and resources should be allocated to the care and prevention of thermal injuries.
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Clinical Trial
The evaluation of nasal mupirocin to prevent Staphylococcus aureus burn wound colonization in routine clinical practice.
Staphylococcus aureus wound colonization frequently occurs in patients with burns and can cause impaired wound healing. Nasal mupirocin application may contribute to the reduction of burn wound colonization of endogenous origin, whereas colonization by the exogenous route can be reduced by blocking cross-infection from other sources. In this study we evaluated whether the implementation of routine treatment of patients and burn center personnel using nasal mupirocin ointment reduces S. aureus burn wound colonization. ⋯ Although S. aureus carriage is a significant risk factor for developing burn wound colonization, the routine use of nasal mupirocin did not contribute to a reduction of burn wound colonization.
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Quantitative studies of the clinical recovery of burn scars are currently lacking. Previous reports validate the objective, precise, diagnostic capabilities of high-frequency ultrasound to measure thickness, the Cutometer(®) to measure pliability and the Mexameter(®) to measure erythema and pigmentation of scars. Thus, we prospectively quantified clinical characteristics of patient-matched, after burn hypertrophic scar (HSc), donor site scar (D) and normal skin (N) using these instruments. ⋯ We found that post-burn HSc thickness, pliability and erythema differed significantly from D and N skin at 3, 6, and 12 months and does not return to normal by 12 months after-injury; however, significant improvements towards normal can be expected. Donor sites are redder than normal skin at 3 and 6 months but can be expected to return to normal by 12 months. Although the color of HSc and D sites change markedly with time these color changes are primarily due to changes in redness of the site, not melanin in this primarily Caucasian population.