Burns : journal of the International Society for Burn Injuries
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Many burn patients are needed to be referred to a tertiary burn hospital according to the American Burn Association (ABA) criteria. The purpose of this study was to verify the reasons for referring of the burn patients to the hospital. ⋯ A total of 45% of the referrals were by request of the family and patients. Tele-medicine may help to establish a direct contact between expert burn physicians and the patients and thus reduce unnecessary transfers. Approximately 9% of the referrals were because of lack of some diagnostic facilities.
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The vacuum assisted closure device (VAC) improves wound-healing when utilized as a bolster to secure split thickness skin grafts (STSG). Patients typically remain hospitalized for VAC therapy; however, home VACs (hVAC) are now available. Limited studies examine burns treated with hVAC as a STSG bolster. ⋯ The hVAC is a cost-effective STSG bolster in the burn population for appropriate candidates. Excellent graft-take and low morbidity rates imply that this is an efficacious alternative for STSG bolster.
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Review Case Reports
The unusual presentation of a burn from methyl bromide exposure: A case report and review of the literature.
Methyl bromide chemical burns are rare. Only two cases have been reported to date. ⋯ The latency period lasts several hours prior to the development of chemical burn wounds. In this article, we review the literature on methyl bromide chemical burns and present our experience managing a patient with an extensive methyl bromide burn.
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Review
Oxidative stress in sepsis: Pathophysiological implications justifying antioxidant co-therapy.
Sepsis is one of the main causes of death among critically ill patients. Sepsis pathogenesis includes infection by gram-negative and gram-positive bacteria, fungi, or both; exacerbated inflammatory response; hypotension, with potential to cause vasodilatory shock; and lesser delivery of oxygen to tissues due to impairment of oxygen utilization by cells. The participation of reactive species and/or free radicals such as nitric oxide (NO), peroxynitrite (ONOO-), superoxide (O2-), hydrogen peroxide (H2O2), and hydroxyl radical (OH) has been reported to underlie these effects. ⋯ In addition, overproduction of NO due to inducible nitric oxide synthase (iNOS) activity has been associated with harmful effects such as general vasodilatation and hypo-responsiveness to therapeutic vasoconstrictor agents. Considering that iNOS expression is regulated by nuclear factor-κB, which may be activated by ROS, antioxidants could inhibit the overexpression of iNOS in sepsis. In line with this, several antioxidants such as vitamins C and E, polyphenols, melatonin, β-glucan, N-acetylcysteine, mitochondrion-targeted antioxidants (MitoQ, MitoE, and peptides associated with dimethyltyrosine), selenium salts, and organoselenium compounds were effective in ameliorating oxidative stress in animal models of sepsis and in a number of clinical trials with septic patients.
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Case Reports
3D-printed transparent facemasks in the treatment of facial hypertrophic scars of young children with burns.
Facial burns could create serious scar problems resulting disfigurement particularly on children. The conventional methods of producing transparent face masks for scar control remains complex and require dexterous skills of experienced clinician and patients' compliance during fitting. In this study, we adopted a portable 3D scanning and Computer-Aided Design (CAD) to produce 3D-printed transparent facemasks. Its efficacy was tested on two children with facial burns resulting hypertrophic scars. ⋯ 3D-printed transparent facemask is convenient and efficient to fabricate, and is suitable for treating pediatric facial hypertrophic scars after burn.