Burns : journal of the International Society for Burn Injuries
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The Burn Specific Health Scale-Brief (BSHS-B) evaluates 9 aspects of health and has been validated globally. Existing reports typically focus on outcomes shortly after injury. The purpose of this study is to determine whether quality of life remains a concern for burn survivors ten years after-injury. ⋯ Our results suggest certain domains of burn specific health benefit from support at 10 years after injury, and select populations such as females may necessitate additional treatment to restore burn-specific health. These results support that burn injuries represent a chronic condition and long-term medical and psychosocial support may benefit burn survivor recovery.
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Electrical burns cause significant morbidity and mortality worldwide. Here we measured changes in levels of serum oxidative stress and telomerase in children suffering from high-voltage electrical burn (HVEB) injuries and other burns and the significance of these parameters in terms of amputation. ⋯ HVEBs are more destructive than thermal burns; damage may progress over time, and healing takes longer. Healing can be followed biochemically by measuring levels of oxidative stress indicators. Indications for amputation, if not initially obvious, can be predicted by evaluating these indicators, affording therapeutic advantages.
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As silver dressings gain more widespread use, it is more likely that patients with silver-based dressings will also undergo magnetic resonance imaging (MRI). In current practice, these dressings are removed prior to imaging due to concerns over heating and image distortion. As dressing changes can be painful, the need to remove dressings simply for MRI may increase pain and contribute to opioid dependency. ⋯ Additionally, dressings, in dry and hydrated forms, caused no image distortion in any MRI scan performed. Evaluation of MRI safety and compatibility revealed no concerns for safety or image distortion in any of the silver-containing wound dressings tested thus it would be acceptable to leave these dressings intact during MRI. The ability to leave dressings in place during imaging will provide a significant benefit to patient care by reducing pain associated with dressing removal.
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This study aimed to investigate whether a three-dimensional (3-D) wound scanner could be used to measure the area of scars. Scar models were constructed using flesh-colored, brown-colored (simulating hyperpigmented scars), orange-colored (simulating scars with obvious vascularization), and white-colored (simulating hypopigmented scars) plastic. Each colored plastic was used to construct scar models with regular and irregular base surfaces (four each). ⋯ Regarding correlation, Spearman's coefficient using the 3-D wound scanner was 0.992, showing the strongest correlation. With respect to inter-experimenter reliability and stability of retesting, each Cronbach's coefficient of the 3-D wound scanner between the two experimenters was >0.90, showing high reliability; thus, fulfilling the requirements for clinical measurement. The 3-D wound scanner took an average time of 38.87±3.45s for measurement, which was significantly shorter compared that for other methods The 3-D wound scanner showed greater accuracy and correlation, and a shorter measurement time, compared with other measurement methods The inter-experimenter reliability and retesting stability of the 3-D wound scanner also fulfilled the requirements for clinical measurement.
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Despite advances in critical care and the surgical management of major burns, highly moribund patients are unlikely to survive. Little is known regarding the utilization and effects of palliative care services in this population. ⋯ 7424 major burns were included; 1.9% received palliative care services. Patients receiving palliation had a mean age of 63.6 years (SD 19.6), mean total body surface area of 62.2% (SD 24.9%), and mean modified Baux score of 127.1 (SD 26.7). Adjusting for covariates, the incidence rate ratio was 1.42 over the 10-year period (95% CI, 1.31-1.54, p<0.001). Independent predictors of palliative consultations included older age, larger burns, deeper burns, and higher Elixhauser comorbidity score. Among patients with modified Baux scores between 100-153, those receiving palliative care services were significantly more likely to die without surgery, OR 3.24 (95% CI 1.13-10.39, p=0.029), with no significant difference in mortality, OR 11.72 (95% CI 0.87-22.57, p=0.051) CONCLUSION AND RELEVANCE: Palliative care services were increasingly used during the study period. Palliative care services in highly moribund burn patients do not impact survival and may decrease the likelihood of surgical intervention in select patients.