Burns : journal of the International Society for Burn Injuries
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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.
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Free tissue transfer is a rarely indicated procedure in burns. However, in well selected cases it may play a pivotal role in optimizing outcomes in both primary and secondary burn reconstruction. We undertook a systematic review, based on the PRISMA statement for systematic reviews, of all published literature relating to the use of free flaps in acute burns and in secondary reconstructive procedures. ⋯ We present the indications, timing, complications and failure rates for free flaps in primary and secondary reconstruction based on the available literature. We also provide a list of the various free flap options for the commonest sites undergoing reconstruction following burns. Finally an algorithm to ensure optimal success of free flaps when used in primary and in secondary burn reconstruction is presented.
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Z-plasty is one of the most widely used techniques in plastic and reconstructive surgery. It is useful especially to release linear-scar contractures, yet difficult to use for wide scars. The aim of this study was to report on a new technique for the effective release of contractures for wide scars using reversed Z-plasty and its variations. ⋯ This procedure is useful and practical for wide-scar contractures.
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Randomized Controlled Trial
Community partnership to promote home fire safety in children with special needs.
Parents of children with special needs are vigilant as their child may have difficulty independently escaping a burning home. The purpose of this study was to evaluate if providing home fire safety information via a digital video disc (DVD) increases families' knowledge, behavior and ability regarding home fire safety. ⋯ Parents of children with special needs had a significant increase in knowledge and behavior over those parents of children without special needs. They also perceived having a high fire safety ability. Many of the post-test questions/behaviors (e.g., capable of exiting home during a fire, etc.) were reported at 100%. The intervention was well received, but may not necessarily be needed. Focus for home fire safety may need to look at younger children and smaller families. Parents of special needs children may have had frequent interaction with health care professionals.