Burns : journal of the International Society for Burn Injuries
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Measuring gastric residual volumes (GRV) is common in intensive care units (ICU) in patients receiving enteral nutrition (EN) and are a common source of feeding interruptions. Interruptions in EN yield adverse outcomes and are an area of improvement in burn care. The objectives of this study are to summarize the literature's ICU GRV practices and offer practical suggestions to GRV management in the burn patient. ⋯ We advocate a GRV threshold of 500mL should be used to optimize the benefits of EN in burn ICUs. A single incident of elevated GRVs should not mandate immediate EN rate reduction or cessation but should prompt a thoughtful examination of secondary causes of gastrointestinal intolerance. Randomized controlled trials are needed to define the ideal GRV threshold and re-evaluate its role in burn care.
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Observational Study
Cross-cultural validation of the Itch Man Scale in pediatric burn survivors in a South African setting.
Pruritus or itch is a common symptom after burn injuries. The Itch Man Scale has been recommended to assess itch severity in children. The aim of this prospective observational study was to perform a cross-cultural validation of the Itch Man Scale by comparing it with the Numeric Rating Scale (NRS) and the Toronto Pediatric Itch Scale. ⋯ We concluded that the Itch Man Scale has promising validity and is a user-friendly tool to use in clinical practice to determine the itch intensity in children younger than 13years in a South African setting.
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Social support and spirituality are important issues among burn survivors that appear to affect their posttraumatic growth (PTG). ⋯ The mediating role of spirituality should provide new visions for the augmentation of PTG in burn survivors.
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After similar extent of injury there is considerable variability in scarring between individuals, in part due to genetic factors. This study aimed to identify genetic variants associated with scar height and pliability after burn injury. An exome-wide array association study and gene pathway analysis were performed on a prospective cohort of 665 patients treated for burn injury. ⋯ Using this approach biological processes related to the nervous system and cell adhesion were the predominant gene pathways associated with both SH and SP. This study suggests genes associated with innervation may be important in scar fibrosis. Further studies using similar and larger datasets will be essential to validate these findings.
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The scalp is the only hidden donor site for split thickness skin grafts. Nevertheless, it is underappreciated due to fear of iatrogenic scarring alopecia. Long-term data showing whether androgenetic hair loss can reveal previously hidden scarring alopecia is unavailable. We aimed to evaluate results and patient satisfaction up to 30years after skin harvest from the scalp. ⋯ Long-term morbidity of scalp skin harvest and the risk of clinically significant alopecia is very low while patient satisfaction is high. AGA is unlikely to reveal harvest damage previously hidden by regrown hair.