Burns : journal of the International Society for Burn Injuries
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Meta Analysis
MRSA colonization and acquisition in the burn unit: A systematic review and meta-analysis.
Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most commonly encountered bacteria in the burn unit. In order to investigate the magnitude of this challenge, we assessed the prevalence of MRSA colonization on admission and the incidence of MRSA acquisition within burn units. ⋯ Our study yielded that among burn victims, MRSA colonization prevalence on admission is not negligible and the risk of becoming MRSA colonized during hospitalization is higher when no decolonization protocols are implemented. Flame burns, admission to ICU, and inhalation injury were found to be associated with MRSA acquisition.
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Review Biography Historical Article
Dakin's Solution: "One of the most important and far-reaching contributions to the armamentarium of the surgeons".
Henry Drysdale Dakin is a notable person in the history of surgery, wound care, military medicine and infectious disease control. Dakin is an exemplar scientist who in the midst of war forged an international collaboration with scientists in multiple fields to create and universalize an antiseptic utopia, which saved thousands lives during World War I, remarkably diminished functional disabilities from wounds and continues to be a "far-reaching armamentarium" of the surgeons and wound care specialists around the globe. Dakin investigated over 200 different antiseptic substances to finally conclude that a 0.5% buffered sodium hypochlorite solution satisfies his criteria for an ideal antiseptic. ⋯ Nevertheless, Dakin contributed more to science than just his solution. In this article, Dakin's life story, his unique scientific career and his contributions to surgical literature are explored. The article also illustrates how a wartime necessity resulted in a medical discovery that is still in use to date.
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Comparative Study Observational Study
Prospective observational study comparing burn surgeons' estimations of wound healing after skin grafting to photo-assisted methods.
Appropriate graft healing after split-thickness skin graft and early recognition of complications (graft loss) are critical to burn patient management. Larger mesh ratio expansions and Meek micrografting may pose a greater challenge in estimating the percentage of wound healing. This study looks at the reliability of photograph assessments and the concordance of bedside evaluation to photograph assessments of wound healing after skin grafting. ⋯ Bedside wound healing assessments show variability; photograph documentation of sequential wound progression could supplement active clinical management or studies for more reliable assessments.
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Clinical practice benefits from the measurement of health-related quality of life (HRQoL) to reflect the impact of the disease and treatments from the patient's lived experience. The Brisbane Burn Scar Impact Profile (child and young person version, BBSIP8-18), developed in 2013, is a self-report measure of burn scar-specific HRQoL. The purpose of the study was to test reliability, validity and responsiveness of this measure for an evaluative purpose. ⋯ The BBSIP8-18 has acceptable reliability, validity and responsiveness supporting its use as an evaluative self-report measure of burn scar-specific HRQoL in the early post-acute phase after burn injury.
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Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is an autoimmune condition with significant morbidity and mortality. ⋯ Etanercept can be considered in the treatment of SJS/TEN patients in addition to IVIg, and supportive care in a burn unit.