Burns : journal of the International Society for Burn Injuries
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Observational Study
Measuring serum albumin levels at 0 and 24h: Effect on the accuracy of clinical evaluations in the prediction of burn-related mortality.
To evaluate whether measuring serum albumin levels in clinical assessments affects the accuracy of mortality predictions in large burns and to compare patients' serum albumin levels at hour 0(Alb0h) and hour 24(Alb24h) following their admission. ⋯ Measuring serum albumin levels in clinical assessments slightly increases the accuracy of mortality predictions; however, different cut-off points for Alb0h and Alb24h needs to be considered to avoid interpretation errors.
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The nanocrystalline silver (NCS) dressing Acticoat is commonly used in clinical practice for the treatment of burns and other open wounds as a topical antimicrobial. The dressing may dry resulting in traumatic dressing changes; hence the variety of contact layer dressings used in conjunction with it. Dressing combinations that do not permit NCS penetration are not cost effective and deprives the wound of the needed anti-microbial. ⋯ Our results illustrate that we should perhaps reconsider dressing combination choices with Acticoat in view of their redundancy or synergistic effect.
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The school is an essential context for children's social interaction with peers and to develop academic skills. Therefore, a fast reintegration can help children with burns to normalize their life. Thus, school reintegration is an important outcome after burns. The aim of this review was to systematically synthesize the literature addressing school reintegration programs of pediatric burns survivors. ⋯ The review emphasizes the necessity of an integrated school reintegration program empowering both the child, the parents and the teachers and tailored to the child's specific situation. Furthermore, it offers recommendations for further improvement of the field.
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Comparative Study
Extension of flaps associated with burn scar reconstruction: A key difference between island and skin-pedicled flaps.
The choice between local flap designs for burn reconstruction is largely shaped by aesthetic, vascularity, procedural complexity, and wound-closure considerations. However, another key consideration is how well specific local flap designs release post-burn scar contractures. This is because constant tension on wound edges can generate pathological scarring. However, the ability of specific local flap to release post-burn scar contractures is poorly understood. This question was addressed by this study of patients who underwent local flap surgery to release post-burn scar contractures. ⋯ While it was technically easier to transfer island flaps to the recipient site, they released contractures less effectively than skin-pedicled flaps. The postoperative extensibility of flaps should be considered when determining which flap design is optimal for the individual patient.
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Review
Burn injury models of care: A review of quality and cultural safety for care of Indigenous children.
Safety and quality in the systematic management of burn care is important to ensure optimal outcomes. It is not clear if or how burn injury models of care uphold these qualities, or if they provide a space for culturally safe healthcare for Indigenous peoples, especially for children. This review is a critique of publically available models of care analysing their ability to facilitate safe, high-quality burn care for Indigenous children. ⋯ There was also limited or no cultural consultation documented in the models of care reviewed. Quality in the documents against National Health and Medical Research Council guidelines was evident; however, description or application of quality measures was inconsistent and incomplete. Gaps concerning safety and quality in the documented care pathways for Indigenous peoples' who sustain a burn injury and require burn care highlight the need for investigation and reform of current practices.