Burns : journal of the International Society for Burn Injuries
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Often discovered late during the clinical course of burns, bone loss is widely accepted by clinicians as a de facto consequence of burn. Literature on this bone loss is limited and contradictory in details. More insight into the prevalence and magnitude of bone loss may facilitate its prevention. ⋯ Total femur and femoral neck T-scores exhibited a significant similar pattern with smaller differences across the two groups. The density scores also showed a significant reverse relationship to the total body surface area (TBSA) of burn (P<0.003). Our results indicate that thermal burn victims have lower bone density and higher prevalence of osteoporosis than their healthy counterparts and that this difference is significant enough to justify screening in these patients which requires further longitudinal studies to institute.
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Peripheral neuropathy is the most frequent disabling neuromuscular complication of burns. However, the insidious and progressive onset of burn neuropathy makes it often undiagnosed or overlooked. In our study, we reviewed the current studies on the burn-related peripheral neuropathy to summarize the morbidity, mechanism, detecting method and management of peripheral neuropathy in burn patients. ⋯ Surgical procedures, especially nerve decompression, showed good effect on functional recovery of both acute and delayed peripheral neuropathy in burn patients. It is noteworthy that, for early detection and prevention of peripheral neuropathy, electrodiagnostic examinations should be performed on burn patients independent of symptoms. Still, the underlying mechanisms of burn-related peripheral neuropathy remain to be clarified.
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Methicillin-resistant Staphylococcus aureus (MRSA) is a pathogen that can result in substantial morbidity and mortality. Early detection of MRSA colonization by screening nasal swabs may be important in the management of burn-injured patients. However, studies examining its use in this population are limited. The aim of this study was to study the utility of admission MRSA screening nasal swabs and determine if being positive for MRSA on admission impacted outcomes. ⋯ Burn patients who screened positive for MRSA had greater lengths of stay, more surgical procedures, and higher wound complications. Early identification of MRSA colonized patients in this patient population might allow for treatment modifications that improve outcomes. Further study is warranted in a prospective clinical trial.
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Despite major advances in therapeutic strategies for the management of patients with severe burns, significant morbidity and mortality is observed. Hyperbaric oxygen therapy (HBOT) increases the supply of oxygen to burn areas. The aim of this study was to determine whether HBOT is effective in the treatment of major thermal burns. ⋯ Multidisciplinary burn care combined with adjunctive HBOT improves sepsis control compared with standard treatment without HBOT. Prospective studies are required to define the role of HBOT in extensive burns.
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Patients with self-inflicted burns (SIB) are thought to have a longer length of stay compared to patients with accidental burns. However, other predictors for a longer length of stay are often not taken into account, e.g. percentage of the body surface area burned, age or comorbidities. Therefore, we wanted to study the outcome of patients with SIB at our burn center. ⋯ With the right and timely treatment, differences in mortality rate or length of stay in hospital could all be explained by the severity of the burn and the intention of the patient.