Burns : journal of the International Society for Burn Injuries
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The role of cooling in the acute management of burns is widely accepted in clinical practice, and is a cornerstone of basic first aid in burns. This has been underlined in a number of animal models. The mechanism by which it delivers its benefit is poorly understood, but there is a reduction in burns progression over the first 48 h, reduced healing time, and some subjective improvements in scarring when cooling is administered after burning. ⋯ Animal models have used oedema formation, preservation of dermal perfusion, healing time and hair retention as indicators of burns severity, and have shown cooling to improve these indices, but pharmacological or immunological blockade of humoural and cellular mediators of inflammation did not reproduce the benefit of cooling. More recently, some studies of tissue from human and animal burns have shown consistent, reproducible, temporal changes in gene expression in burned tissues. Here, we review the experimental evidence of the role and mechanism of cooling in burns management, and suggest future research directions that may eventually lead to improved treatment outcomes.
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Review Comparative Study
The use of split-thickness versus full-thickness skin graft to resurface volar aspect of pediatric burned hands: A systematic review.
The aim of this systematic review was to discuss the comparison of split-thickness skin graft (STSG) and full-thickness skin graft (FTSG) use as the treatment for volar digital and palmar burns in children. ⋯ Currently, there is no strong, high-quality evidence to prove that FTSG is superior to STSG to cover pediatric palmar burns. Either FTSG or STSG can be utilized with consideration of several influential factors especially splinting and physiotherapy.
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To synthesise and evaluate the evidence of the effectiveness of interventions to prevent scalds in children. ⋯ Education, home safety checks along with thermometers or thermostatic mixing valves should be promoted to reduce tap water scalds. Further research is needed to evaluate the effectiveness of interventions on scald injuries and to disentangle the effects of multifaceted interventions on scald injuries and safety practices.
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Refractory carbapenem resistant Acinetobacter baumannii (CRAB) isolates increase mortality and morbidity rates among patients with underlying disorders, especially in patients with burns. The aim of the current study was to understand the resistant determinants of CRAB isolates and their clonal relatedness collected from referral Burn center. ⋯ CRAB harboring ISAba1/blaOXA-23-like family is widely disseminated in the studied Burn ward setting and the emergence of infection control measures should be regarded to limit refractory CRABs.
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The current standard of care in determining the need to excise and graft a burn remains with the burn surgeon, whose clinical judgment is often variable. Prior work suggests that minimally invasive perfusion technologies are useful in burn prognostication. Here we test the predictive capabilities of Laser Doppler Imaging (LDI) and indocyanine green dye (ICG) angiography in the prediction of burn scarring 28 days after injury using a previously validated porcine burn model that shows vertical progression injury. ⋯ This was significantly different from the LDI linear regression (p < .05), which was measured at r(2) of .20 (95% CI .02 to .39). ICG angiography linear regression was superior to LDI at all timepoints. Findings suggest that ICG angiography may have significant potential in the prediction of long-term burn outcomes.