Burns : journal of the International Society for Burn Injuries
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Scarring following full thickness burns leads to significant reductions in range of motion and quality of life for burn patients. To effectively study scar development and the efficacy of anti-scarring treatments in a large animal model (female red Duroc pigs), reproducible, uniform, full-thickness, burn wounds are needed to reduce variability in observed results that occur with burn depth. Prior studies have proposed that initial temperature of the burner, contact time with skin, thermal capacity of burner material, and the amount of pressure applied to the skin need to be strictly controlled to ensure reproducibility. The purpose of this study was to develop a new burner that enables temperature and pressure to be digitally controlled and monitored in real-time throughout burn wound creation and compare it to a standard burn device. ⋯ The custom burn device's ability to continually heat the burn stylus and actively control pressure and temperature allowed for more rapid and reproducible burn wounds. Burns of tailored and repeatable depths, independent of user, provide a platform for the study of anti-scar and other wound healing therapies without the added variable of non-uniform starting injury.
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The objective of this review was to systematically examine whether there is clinical evidence to support recommendations for positioning patients with acute burn. Review of the literature revealed minimal evidence-based practice regarding the positioning of burn patients in the acute and intermediate phases of recovery. This manuscript describes recommendations based on the limited evidence found in the literature as well as the expert opinion of burn rehabilitation specialists. These positioning recommendations are designed to guide those rehabilitation professionals who treat burn survivors during their acute hospitalization and are intended to assist in the understanding and development of effective positioning regimens.
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Review Case Reports
Epidermal exfoliation of over 95% after a burn in an 18-month-old boy: Case report and review of the literature.
This report concerns an 18-month-old boy who presented with a 6% total body surface area scald. The subject of this report is unique in that he developed the largest exfoliation described in literature. After 3 days an epidermal exfoliation with the appearance of a deliberately inflicted scald developed. ⋯ The few reports published are all case reports and most frequently described visually infected burns with smaller epidermal exfoliations, and clinically based exfoliation diagnosis. S. aureus often cause burn wound infections that can lead to complications caused by cross-infection. It is important for burn surgeons and intensive care specialists to be aware of the increased possibility of Staphylococcal scalded skin syndrome occurring in patients who have a reduced barrier to infection such as burn patients and also, that the diagnosis can be difficult to make.
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The provision and practice of burn care changed dramatically during the latter half of the 20th century. Historically, indicators of outcomes that were employed were survival and length of hospital stay, but these have now been expanded with increased data capture. ⋯ The multiple domains covered by the term "patient outcome" aim to optimize the acute and long-term management of burn patients and have shifted the focus onto lifelong outcomes, rather than short-term gains. This review will investigate the current outcome measures employed in burn care in the UK, how this leads to commissioning and regulation of a burn service, and influences the future direction of travel.
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To develop a mathematical model of predicting mortality based on the admission characteristics of 6220 burn cases. ⋯ A mathematical model based on logistic regression and SVM could be used to predict the survival prognosis according to the admission characteristics.