Burns : journal of the International Society for Burn Injuries
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The well documented susceptibility of burn patients to acquired infections via damaged skin mandates application of antimicrobial agents. These agents are dissolved in various vehicles that augment skin absorption thus allowing greater efficacy. Polyethylene glycol (PEG) and Propylene glycol (PropG) are among the most commonly used vehicles, and both have been used in numerous medications and cosmetic products over the past few decades. Rarely, burn patients treated with agents containing these glycols present with a life threatening systemic toxidrome of hyperosmolar metabolic acidosis. We present a systematic review of outcomes in burn patients treated with similar agents. ⋯ This first systematic review found very few cases of documented hyperosmolar metabolic acidosis, all within one study that had set to specifically explore this toxidrome. High index of suspicion with frequent osmolar gap monitoring may help identify future toxicities in a timely manner.
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The well documented susceptibility of burn patients to acquired infections via damaged skin mandates application of antimicrobial agents. These agents are dissolved in various vehicles that augment skin absorption thus allowing greater efficacy. Polyethylene glycol (PEG) and Propylene glycol (PropG) are among the most commonly used vehicles, and both have been used in numerous medications and cosmetic products over the past few decades. Rarely, burn patients treated with agents containing these glycols present with a life threatening systemic toxidrome of hyperosmolar metabolic acidosis. We present a systematic review of outcomes in burn patients treated with similar agents. ⋯ This first systematic review found very few cases of documented hyperosmolar metabolic acidosis, all within one study that had set to specifically explore this toxidrome. High index of suspicion with frequent osmolar gap monitoring may help identify future toxicities in a timely manner.
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Diphoterine is a hypertonic, amphoteric, polyvalent and chelating decontamination solution used in the treatment of cutaneous and ocular chemical burns. Due to infrequent use by emergency physicians along with the small number of available studies, its debate in the literature as to its efficacy and safety remains inconclusive. ⋯ Diphoterine appears to be safe to use and is probably superior to other rinsing solutions. However, immediate decontamination is imperative and if Diphoterine is not available a different rinsing solution should be used. The methodology of the published literature for Diphoterine is generally poor and future publications should use the frameworks given as templates.
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Diphoterine is a hypertonic, amphoteric, polyvalent and chelating decontamination solution used in the treatment of cutaneous and ocular chemical burns. Due to infrequent use by emergency physicians along with the small number of available studies, its debate in the literature as to its efficacy and safety remains inconclusive. ⋯ Diphoterine appears to be safe to use and is probably superior to other rinsing solutions. However, immediate decontamination is imperative and if Diphoterine is not available a different rinsing solution should be used. The methodology of the published literature for Diphoterine is generally poor and future publications should use the frameworks given as templates.
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Review Meta Analysis
Resistance training for rehabilitation after burn injury: A systematic literature review & meta-analysis.
Resistance training is beneficial for rehabilitation in many clinical conditions, though this has not been systematically reviewed in burns. The objective was to determine the effectiveness of resistance training on muscle strength, lean mass, function, quality of life and pain, in children and adults after burn injury. ⋯ Further research with robust methodology is recommended to assess the potential benefit suggested in this review.