Burns : journal of the International Society for Burn Injuries
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Randomized Controlled Trial
Propranolol kinetics in plasma from severely burned adults.
The aim of this study was to determine the appropriate propranolol dosing strategy for reducing heart rate in severely burned adults. ⋯ Heart rate can be decreased to a similar degree with Q6 and Q24 dosing strategies, with the Q8 dosing strategy being less effective. Q6 dosing is recommended to maintain reduced heart rate throughout dosing periods.
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Burns are devastating to the individual and society, representing a huge biomedical burden. Improved education in burns has however ignited a revolution in high-income countries-burn mortality is reducing. Education in burns is far-reaching. ⋯ Here, we examine the literature detailing burn education with a focus on past lessons, current trends and future objectives. We have identified key educational objectives to revolutionise burn care on a global perspective. Now is the time to build on promising educational strides to reduce the global burns burden.
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Cigarette lighters are frequent vectors in intentional contact burns. Time and temperature needed to cause thermal injury are considered to differentiate accidental from inflicted burns. This study examines the minimum time needed to heat a cigarette lighter's top to temperatures capable of inflicting any clinically visible skin burn. This information could be useful in child abuse and other forensic cases. ⋯ Cigarette lighter burns are often blamed on non-intentional occurrences. At least 50s of sustained flame is needed to heat typical cigarette lighter tops to temperatures capable of inflicting clinically visible skin burns. This time is longer than the time required to light a cigarette. Therefore, for a cigarette lighter to inflict a contact burn injury, there needs to be intent and preparation, making accidental cigarette lighter burns unlikely.
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Xeroform® is a petrolatum-based fine mesh gauze containing 3% bismuth tribromophenate. Bismuth, similar to other metals, has antimicrobial properties. Xeroform® has been used for decades in burn and plastic surgery as a donor site dressing and as a covering for wounds or partial thickness burns. Despite this, the antimicrobial spectrum of Xeroform® remains largely unknown. We examined the in-vitro efficacy of Xeroform® against common burn pathogens using zone-of-inhibition methodology in a commercial research facility. ⋯ While bismuth subsalicylate, and bismuth tribromophenate unbound to Xeroform® demonstrate antimicrobial activity, it appears that Xeroform® dressings do not. The utility of Xeroform® in burn medicine may relate more to use as an impervious dressing than to antimicrobial effect. Donor sites are clean surgical wounds and clean partial thickness burns may have minimal colonization present. In such circumstances, an inactive and impervious dressing may be all that is necessary to promote wound healing.
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Review Historical Article
Evolution of skin grafting for treatment of burns: Reverdin pinch grafting to Tanner mesh grafting and beyond.
Skin grafting is the current standard care in the treatment of full thickness burns. It was first described around 1500 BC but the vast majority of advancements have been achieved over the past 200 years. ⋯ Skin grafting technique have evolved significantly over past 200 years from Reverdin pinch grafting to modern day meshed skin grafts using powered dermatome. Increasing the expansion ratio and improving the cosmetic and functional outcome are the main focus of ongoing skin grafting research and emerging techniques (such as Integra®, Recell®, Xpansion®) are showing promise.