Burns : journal of the International Society for Burn Injuries
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Burns are major cause of morbidity and mortality in developing countries. Better understanding of the nature and extent of injury remains the major and only available way to halt the occurrence of the event. The present study was conducted to determine the prevalence of by self and by other unintentional burn, their comparison and the possible mode of acquisition by obtaining the history of exposure to known risk factors. ⋯ The burden of unintentional burn by self was considerably higher. Male gender and no schooling were found more at risk to have unintentional burn by self.
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Emotional trauma is recognised as a common feature in the experience of patients and families following burn injury and incidence may be unrelated to burn size and severity. ⋯ Emotional trauma is highly prevalent among patients and families in the early burn recuperation period where both distress and recovery may co-occur. Despite an initial sense of vulnerability, normality is gradually redefined through practices that keep family close, engage patients in early self-care and allow time, space and support for return to work. Patients, initially confronted by their own physical otherness, share their recovery with fellow burns survivors and seek affirmation from family to negotiate a 'different' normal, integrated into a new self-concept. Early rehabilitation may be strengthened by promoting carer involvement, patient self-efficacy and peer support.
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The objective of this study was to assess the quality of readily available evidence regarding critical care aspects of the management of patients with severe burn injuries. ⋯ There is very little high quality evidence to guide clinical practice in early management of the severely burnt patient. Eleven of 56 studies found in our search of critical care topics were of good methodological quality with low risk of bias.
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Review Comparative Study
Incidence of ventilator associated pneumonia in burn patients with inhalation injury treated with high frequency percussive ventilation versus volume control ventilation: A systematic review.
Pneumonia increases mortality in burn patients with inhalation injuries. We evaluated whether the use of High Frequency Percussive Ventilation (HFPV) in burn patients with inhalation injuries can decrease rates of Ventilator Associated Pneumonia (VAP) compared to Volume Control Ventilation (VCV). ⋯ Evidence about decreased incidence of VAP in burn patients with inhalation injuries who are on HFPV compared to those on VCV is inconclusive. Although enhanced airway clearance by HFPV was thought to play a role in decreasing VAP in this population, high tidal volume in the VCV arms could be a confounding factor that should be eliminated in future studies before a firm conclusion can be reached. More RCTs comparing HFPV to low tidal volume VCV are needed.
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Review
Progress of clinical practice on the management of burn-associated pain: Lessons from animal models.
Opioid-based analgesics provide the mainstay for attenuating burn pain, but they have a myriad of side effects including respiratory depression, nausea, impaired gastrointestinal motility, sedation, dependence, physiologic tolerance, and opioid-induced hyperalgesia. To test and develop novel analgesics, validated burn-relevant animal models of pain are indispensable. Herein we review such animal models, which are mostly limited to rodent models of burn-induced, inflammatory, and neuropathic pain. ⋯ Moreover, common clinical concerns such as systemic inflammatory response syndrome and multiple organ dysfunction remain unaddressed. For development of analgesics, these aberrations can significantly alter the potential efficacy and/or adverse effects of a prescribed analgesic following burn trauma. We therefore suggest that a multi-model strategy would be the most clinically relevant when evaluating novel analgesics for use in burn patients.