Burns : journal of the International Society for Burn Injuries
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Burns are a significant source of pediatric morbidity and frequently result in transfer of care to a pediatric burn center. Data suggest that referring facilities often overestimate the total body surface area (%TBSA) of burns in comparison to the subsequent assessment at the pediatric burn center. Such discrepancies may trigger inappropriately aggressive interventions with potential for patient harm. Our baseline assessment of data from 106 patients transferred to our pediatric burn center over a one-year period showed that 59/106 (56%) patients had a %TBSA recorded at the time of transfer and 18/59 (31%) had clinically significant differences (>5% difference) in estimates between the referring facility and the pediatric burn center. ⋯ Referring facilities often overestimate the %TBSA in comparison to the subsequent assessment at the pediatric burn center. The consistency of the %TBSA estimates can be improved by interventions that utilize the sharing of a common clinical assessment instrument and standardization of the transfer intake process.
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The emotional impact after a child's burn injury is poorly understood. Greater insight into the emotional journey can aid services' ability to meet patients/families' needs. To bridge the gap, this study employed an abbreviated form of Experience Based Co-Design (EBCD) to explore the emotional/experiential aspects of moderate to severe burn injuries in children. ⋯ EBCD facilitated collaborative discussion between researchers, families and health professionals. Families felt empowered to shape the future of burn care and health professionals felt included. Study challenges were mainly in participant engagement and the scheduling of interviews and the focus event. Overall the study outcome was successful in generating ideas for service improvements, and the production of a training video for healthcare professionals.
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Scar often occurred during wound repair. It was known that there were differences in collagen structure in dermal tissues at millimeter scale and micron scale, however, it was not known whether there were differences in collagen structure in dermal tissues at nanoscale during wound repair. In order to compare the difference at nanoscale, skin samples from patients were selected, the control groups were the normal skin from the same patients. ⋯ The transmission electron microscopy (TEM) was used as a comparison. The results showed that there were not only significantly differences between the normal tissue and scar tissue, but also between the center and the margin of the scar tissue at nanoscale by SAXS and WAXS, which was not demonstrated by other studies. These findings demonstrated that the SAXS and WAXS were excellent tools to detect the collagen structure at nanoscale and the orientation of the collagen alignment, which was beneficial for skin tissue engineering and skin regenerative medicine.
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The objective of this study was to evaluate where and when pediatric burn injuries occurred. Furthermore the quality of first aid treatment, ratio of skin grafting and length of hospital stay were evaluated. The patient records of 749 children with acute burns admitted to the University Children's Hospital of Zurich, Switzerland, were retrospectively reviewed over an 11-year period. ⋯ As a result, patients with flame injuries had to stay significantly longer in hospital (flames: 21 days (range: 1-259 days; median: 30; interquartile range (IQR): 30) versus scalds: 7 days (range: 1-130 days; median: 7; IQR: 12); p < 0.001). Furthermore high voltage injuries often resulted in lower-leg amputations (n = 3; 43%). Based on these facts, targets for the improvement of a prevention campaign and the treatment for burned children were named.
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This qualitative study aims to explore former burn patients' perception of burn-specific health and investigate how these experiences correspond to the subscales in the Burn Specific Health Scale-Brief (BSHS-B). ⋯ The BSHS-B alone may not be sufficient in providing a comprehensive picture of former burn patients' self-perceived health in the long-term perspective. Investigating supplementary areas reflecting former patients' sociocultural and attitudinal environment, as well as personal factors, may be of great importance.