Burns : journal of the International Society for Burn Injuries
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Tachyarrhythmias in critically ill surgical patients can have varying effects, from minimal consequence to lifetime sequelae. Atrial fibrillation can be common in the post-operative period, often a result of fluctuations in volume status and electrolyte derangements. While there is extensive literature regarding the critically ill medical or cardiac patient, there is less focusing on the critically ill surgical or trauma patient. ⋯ The latter population tends to have frequent and wide variations in volume status given initial resuscitation and after major excisions, concomitant with acute blood loss anemia, which can contribute to cardiac disturbances. A literature review was conducted to investigate the incidence and consequences of tachyarrhythmias in critically ill surgical and trauma patients, with a focus on the burn population. While some similarities and conclusions can be drawn between these surgical populations, further inquiry into the unique burn patient is necessary.
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Randomized Controlled Trial Comparative Study
Comparison of non-surgical methods for the treatment of deep partial thickness skin burns of the hand.
This paper describes a randomized, controlled, parallel-group, single-center clinical trial designed to compare non surgical treatment methods of deep partial thickness skin burns of the hand. All patients were scanned with the Laser Doppler Imaging device to determine the depth of the burn wound. Viable keratinocytes sites were determined according to the established Perfusion Units (PU) measurement system. ⋯ Burn scars and injured extremity function were assessed after six months according to the Vancouver Scar Scale and Disabilities of the Arm, Shoulder and Hand Outcome Measure. The fastest epithelialization of hand burn wounds was observed in the patients group treated with hydrocolloid dressings (15, 7 days, p<0,05). The patients of this group also had less scars and a better hand function.
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The Baux score - the sum of age and total body surface area burned (TBSA %) - is a good predictor of mortality has a high specificity but low sensitivity. Our aim was to examine the causes of death in patients who die with Baux scores of <100, which may explain the lower sensitivity and possibly affect the prediction of mortality. ⋯ Patients with burns who died with a Baux score <100 were a quarter of all the patients who died. An important finding is that most of these deaths were caused by reasons other than the burn, usually cerebrovascular disease. This may be the explanation why the sensitivity of the Baux score is low, as factors other than age and TBSA % explain the fatal outcome.
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Platelet cells, or thrombocytes, have additional roles to haemostasis. After burn injury, platelet counts drop to a nadir at days 2-5 then rise to a peak between days 10-18. The nadir has previously been associated with mortality but there is currently no thorough investigation of its potential to predict sepsis in adults. The primary objective of this study is to assess whether platelet count can predict survival and sepsis in adults with severe burn injuries. ⋯ A reduced peak platelet count is a strong predictor of 50-day mortality. Platelet count nadir may have some association with sepsis.
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The aesthetic outcome after burn of exposed areas such as the hand and face is of high importance. A number of wound dressings used for the treatment of superficial and partial thickness burns promise rapid wound healing and reduced scarring. Previously, wound healing of hands and faces with superficial burns treated with Dressilk® compared to Biobrane® was evaluated intra-individually with similar results. Nevertheless, up to date objective information regarding the scarring after superficial burns treated with Dressilk® does not exist. ⋯ Dressilk® is an interesting alternative to Biobrane® for the treatment of superficial burns of aesthetic and functional important areas.