Burns : journal of the International Society for Burn Injuries
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Randomized Controlled Trial Comparative Study
Comparison of intralesional verapamil versus intralesional corticosteroids in treatment of keloids and hypertrophic scars: A randomized controlled trial.
Keloids and hypertrophic scars are due to overgrowth of dermal collagen following trauma to the skin that usually cause major physical, psychological and cosmetic problems. ⋯ Our results did not support verapamil's capability in treatment of keloid nor hypertrophic scars.
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Recent reports on the use of extracorporeal membrane oxygenation (ECMO) in critically ill burn patients with Acute Respiratory Distress Syndrome (ARDS) recommended against the use of ECMO. The authors cited the high mortality rates associated with the use of ECMO in these patients with no appreciable benefit. Accumulating evidence from referral centers suggests improved survival in patients with ARDS receiving ECMO. We report our recent experience treating patients with severe ARDS with ECMO in a burn intensive care unit. ⋯ To our knowledge, this is the lowest mortality rate reported to date in burn patients with ARDS place on ECMO. ECMO is a viable therapy that can be utilized successfully as a rescue modality when conventional interventions are unsuccessful.
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Burn injuries are a debilitating cause of morbidity and mortality associated with the long-term impact of psychological factors on quality of life. Accurate assessment of the differential impact of burn sequelae and anxiety is often complicated by the overlap between psychological and somatic symptoms in burns patients. The Beck Anxiety Inventory (BAI) is one validated psychometric tool for anxiety assessment. The primary objective of this study is to investigate whether utilising the BAI as a tool to assess for anxiety in burns patients is biased due to the confounding of symptoms of anxiety with the physical sequelae of a burn injury. ⋯ This feasibility study found preliminary evidence suggesting that the BAI may, in part, represent misattributed symptoms of cutaneous injury from burns. However, whilst our findings suggest an attribution bias, there is not enough evidence from this data to comment on whether its use should be restricted in burns patients. Further research is needed to formally quantify convergent and divergent validity through structured interviews. In addition, further research using other self-report tools of anxiety in burns patients would be useful to corroborate the prospect of biased and confounded anxiety scores.
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Aromatherapy is often used to manage several conditions, including pain, psychological distress, and burn-related symptoms. The objective of this review was to assess the current evidence regarding the efficacy of aromatherapy as a treatment for burn wounds. ⋯ The evidence from the above trials is not sufficient to conclude that aromatherapy effectively relieves symptoms in patients with burns. However, the findings of the trials do not seem very plausible, and the trials themselves were of low quality and included only small numbers of patients. Studies that are adequately powered and feature better designs are needed to investigate the potential mechanisms underlying the effects of aroma therapy on pain and anxiety.
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Here, we investigated whether the abbreviated burn severity index (ABSI) scoring system predicts acute respiratory distress syndrome (ARDS) in a retrospective analysis of a severe flammable starch-based powder burn population. Demographics, total body surface area (TBSA) burn, the presence of mouth and nose burn, ABSI, inhalation injury, and clinical outcomes for each patient were analysed for association with inpatient ARDS based on the Berlin definition. We treated 53 patients (64% male, 36% female) and observed no fatalities. ⋯ The mean TBSA burn percentage for ARDS and the non-ARDS groups were 61.4±13.9% and 34±18%, respectively (P<0.001). The area under the curve of the receiver operating characteristic curves for an ABSI≥9 was 0.905. Our results show that the ABSI is effective for predicting ARDS in young individuals with severe starch-based powder burn.