Burns : journal of the International Society for Burn Injuries
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Although the use of peripherally inserted central catheters (PICCs) has increased in burn patient treatment, little is known about the subjective experiences of these patients with PICCs. These experiences may be similar to those of other patients, particularly cancer patients receiving long term care but it is not clear if this is the case. Burn patients' exposure to skin injury may result in pain and apprehension similar but different from that felt by cancer patients. The aim of this study was to explore the subjective experiences of PICC insertion procedures among burn patients treated and managed in a burn center in South Korea. ⋯ The major findings from our focus group interviews were that frequent venipunctures are a significant sources of distress for burn patients. However, most participants reported that PICC provided a very convenient route for venous infiltration and for that they were generally positive about the procedure. This knowledge may enable clinicians to better the needs of their patients when undergoing PICC insertion and management.
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Acinetobacter baumannii infection is a serious threat to burn patients. Bacteremia due to A. baumannii is becoming the most common cause of mortality following burn. However, the epidemiology of A. baumannii causing burn-related bloodstream infections has rarely been reported. ⋯ The above results indicated that ST368 isolates possessing both the blaOXA-23-like gene and ampC gene were the main culprits of the increasing nosocomial A. baumannii infection in this study. More attention should be paid to monitoring the molecular epidemiology of A. baumannii isolates from burn patients to prevent further distribution. Such information may help clinicians with therapeutic decisions and infection control in the Burns Institute.
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To describe the epidemiology of pediatric burn patients seen in U.S. emergency departments (EDs) and to determine factors associated with inter-facility transfer. ⋯ Over 90% of pediatric burn ED patients meet ABA burn referral criteria but are not transferred from low volume hospitals. Perhaps a portion of the 92% of patients currently receiving definitive care in low volume hospitals are under-referred and would have improved clinical outcomes if transferred at the time of presentation.
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Work reintegration constitutes a major milestone in the rehabilitation process of adults who have sustained a burn. Research studies with other conditions demonstrated that open, explicit communication about the worker's condition and potential limitations may facilitate this transition. However, the best approach to enable this discussion to occur has yet to be described. The aim of this exploratory qualitative study was to investigate burn survivors' and clinicians' perspectives of the barriers and facilitators to work reintegration that could be addressed through education of work colleagues, which information to communicate to the workplace and the most effective method to disseminate this knowledge. ⋯ Extensive literature demonstrating the benefits of educational programs for the peers and teachers of pediatric burn survivors when they return to school already exists. This study provides evidence that there is a need for a similar process for adult burn survivors returning to work. The educational material must be versatile enough so that it can be customized to individual burn survivor's needs and the environments in which they work.
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Case Reports
Second-degree burns with six etiologies treated with autologous noncultured cell-spray grafting.
Partial and deep partial-thickness burn wounds present a difficult diagnosis and prognosis that makes the planning for a conservative treatment versus mesh grafting problematic. A non-invasive treatment strategy avoiding mesh grafting is often chosen by practitioners based on their clinical and empirical evidence. However, a delayed re-epithelialization after conservative treatment may extend the patient's hospitalization period, increase the risk of infection, and lead to poor functional and aesthetic outcome. ⋯ The treatment results with autologous non-cultured cells, support rapid, uncomplicated re-epithelialization with aesthetically and functionally satisfying outcomes. Hospital stays averaged 7.6±1.6 days. Early autologous cell-spray grafting does not preclude or prevent simultaneous or subsequent traditional mesh autografting when indicated on defined areas of full-thickness injury.