Burns : journal of the International Society for Burn Injuries
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Randomized Controlled Trial
Butorphanol in combination with dexmedetomidine provides efficient pain management in adult burn patients.
This study aimed to compare the sedation and analgesic effects of butorphanol alone and butorphanol in combination with dexmedetomidine on dressing changes in adult burn patients. ⋯ Butorphanol combined with dexmedetomidine can reduce analgesic use of butorphanol during dressing change. This combination resulted in a higher sedation score and fewer adverse effects.
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The majority of patients who sustained small (low % total body surface area [TBSA]) burns are assessed in an outpatient setting. This can be a traumatic experience, particularly, for paediatric patients. During the initial assessment pharmacological and non-pharmacological adjuncts, such as distraction therapy, can be employed to provide an environment that may reduce and minimise distress. In this study, we investigated whether distraction therapy reduces objective pain scores during the outpatient assessment of small acute burns in children. ⋯ This study of pain scores in small acute paediatric burns has shown that distraction therapy provided by a qualified play specialist can reduce maximal pain by over 2 points on the Wong-Baker™ VAS. Consideration should be given to ensure that distraction therapy is available at all times during initial consultations for children who have sustained small burns.
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Burn care is a highly relevant medical specialty in every part of the world. Different infrastructure, healthcare systems and access to medical supplies lead to different needs, treatment strategies and outcomes. A fundamental tool in a burn care provider's armamentarium is the use of different dressings. Several studies have investigated the question of the ideal burn dressing, but none could achieve a proper global perspective. With advanced dressings being on the rise, we conducted this study to get a global understanding of the actual use and idea of the ideal burn dressing. ⋯ This investigation has delivered valuable insights into the global perspective of the ideal burn dressing. Yet, the question of the ideal burn dressing is still inconclusive. Wound dressing research is of fundamental interest for patients, healthcare providers and healthcare systems.
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The effect of TGFβRI inhibition on fibroblast heterogeneity in hypertrophic scar 2D in vitro models.
In burn patients, wound healing is often accompanied by hypertrophic scarring (HTS), resulting in both functional and aesthetic problems. HTSs are characterized by abundant presence of myofibroblasts (MFs) residing in the dermis. HTS development and MF persistence is primarily regulated by TGF-β signalling. ⋯ Furthermore, collagen gel contraction analysis showed that ALK5 exon skipping reduced TGF-β- induced contraction together with decreased alpha-smooth muscle actin expression levels. In conclusion, we show for the first time that exon skipping primarily targets pro-fibrotic fibroblasts. This could be a promising step towards reduced HTS development of burn tissue.
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The COVID-19 pandemic has dramatically impacted healthcare provision in the UK and burns services have had to adapt to ensure the continuity of a safe care. As we return to "normality" we reflect on lessons learnt from our response to this pandemic. A service evaluation was performed from patient notes between March 23rd and May 8th 2020 and an anonymous survey given to patients attending outpatient appointments. 258 patients were referred to our burns service and 148 patients completed the survey. ⋯ The outreach team treated 22 patients. During the pandemic telemedicine has improved the efficiency of outpatient burn care and outreach nurses have enabled treatment of vulnerable patients. More must be done to raise public awareness of preventable causes of burn injury and to reassure them to seek help when burns occur.