Burns : journal of the International Society for Burn Injuries
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Traditional wound dressings, including cotton gauze, absorbent pads and bandages, can cause trauma and pain to wounds during dressing changes, leading to a variety of physical and psychosocial sequelae. The aim of this study was to adapt an in vitro model of adherence to evaluate the effects of various methods to theoretically reduce the adherence of wound dressings. Gelatin in liquid form was cast onto poly(ethylene terephthalate) (PET) fabric and allowed to solidify and progressively dry to simulate wound desiccation in the clinical setting. ⋯ As a long-term strategy for decreasing adherence, a thin layer of polyacrylamide (PAM) hydrogel was deposited onto PET fabric via UV irradiation. This resulted in a much lower peeling energy without severely compromising fabric flexibility. This hydrogel layer could also serve as a reservoir for bioactive and antimicrobial agents which could be sustainably released to create a microbe-free microenvironment for optimized wound healing.
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The epidemiology, referral patterns and outcome of patients admitted to a tertiary burns unit in southern Africa were reviewed. ⋯ The epidemiology and outcome of severe burns referred to the Burns Centre at IALCH is similar to those in other units in Africa. The management and referral of burns patients by other hospitals are inappropriate in a significant number of patients.
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Research on the adult psychiatric outcomes of childhood burns is limited. ⋯ High rates of suicidality and depression were concerning in adults with a history of childhood burns. Factors found to predict psychiatric outcomes could be used to direct interventions and further research is needed to establish how this could best be done.
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To develop an inter-professional clinical practice guideline for vocational evaluation following severe burn. ⋯ This guideline insures that vocational evaluators use an evidence-based approach to systematically assess elements within the individual, the work, workplace, personal and environmental facilitators and barriers to work participation. The guideline may be useful to clinicians, healthcare teams, employers and individuals with severe burns. Future steps will include guideline pilot testing and endorsement.
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More than three-quarters of deaths related to major burns are a consequence of infection, which is frequently ventilator associated pneumonia (VAP). A retrospective study was performed, over a five-year period, of ventilated children with major burns. 92 patients were included in the study; their mean age was 3.5 years and their mean total body surface area burn was 30%. 62% of the patients sustained flame burns, and 31% scalds. The mean ICU stay was 10.6 days (range 2-61 days) and the mean ventilation time was 8.4 days (range 2-45 days). ⋯ Streptococcus pneumonia, Pseudomonas aeruginosa, Acinetobacter baumanii and Staphylococcus aureus were the most prominent aetiological organisms. Broncho-alveolar lavage was found to be more specific and sensitive at identifying the organism than other methods. This study highlights the importance of implementing strictly enforced strategies for the prevention, detection and management of pneumonia in the presence of major burns.