Burns : journal of the International Society for Burn Injuries
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Review
Appraising current methods for preclinical calculation of burn size - A pre-hospital perspective.
Calculation of the percentage of total body surface area burnt is a vital tool in the assessment and management of patients sustaining burns. Guiding both treatment and management protocols. Currently there is debate as to which method of estimation is the most appropriate for pre-hospital use. ⋯ Palm including digits measurements multiplied by 0.8 is suitable for assessing minor (<10%) burns however for larger burns Wallace's Rule of Nines is advocated. Further development of technology suggests computerised applications will become more commonplace.
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Burn scar contractures are the pathological outcome of excessive scarring and ongoing scar contraction. Impairment of joint range of motion is a threat to performing activities in daily living. To direct treatment strategies to prevent and/or correct such contractures, insight into the prevalence, course, and determinants is essential. ⋯ The prevalence of burn scar contractures varies considerably between studies. When prevalence is unclear, it is also difficult to investigate potential determinants and evaluate changes in interventions. There is a need for extensive, well-designed longitudinal (inter)national studies that investigate prevalence of scar contractures, their evolvement over time, and risk factors.
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Burns education appears to be under-represented in UK undergraduate curricula. However current postgraduate courses in burns education provide formal training in resuscitation and management. ⋯ We present a literature review that summarises the format of current burns education, and provides detailed insight into historic, current and novel advances in burns simulation for both technical and non-technical skills, that can be used to augment surgical training. Addressing the economic and practical limitations of current immersive surgical simulation is important, and this review proposes future directions for integration of innovative simulation strategies into training curricula.
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Review Meta Analysis
Albumin administration for fluid resuscitation in burn patients: A systematic review and meta-analysis.
The objective was to systematically review the literature summarizing the effect on mortality of albumin compared to non-albumin solutions during the fluid resuscitation phase of burn injured patients. ⋯ The pooled estimate demonstrated a neutral effect on mortality in burn patients resuscitated acutely with albumin solutions. Due to limited evidence and uncertainty, an adequately powered, high quality trial could be required to assess the impact of albumin solutions on mortality in burn patients.
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Review Comparative Study
The effects of honey compared to silver sulfadiazine for the treatment of burns: A systematic review of randomized controlled trials.
Evidence from animal studies and trials suggests that honey may accelerate wound healing. The objective of this review was to assess the effects of honey compared with silver dressings on the healing of burn wounds. Relevant databases for randomized controlled trials (RCTs) of honey compared with silver sulfadiazine (SSD) were searched. ⋯ Nine RCTs met the inclusion criteria. Based on moderate quality evidence there was a statistically significant difference between the two groups, favoring honey in healing time (MD -5.76days, 95% CI -8.14 to -3.39) and the proportions of infected wounds rendered sterile (RR 2.59; 95% CI 1.58-2.88). The available evidence suggests that honey dressings promote better wound healing than silver sulfadiazine for burns.