Burns : journal of the International Society for Burn Injuries
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Randomized Controlled Trial Comparative Study
A comparison on the scar development when done through overlapping versus approximating seams techniques - A clinical trial.
Skin autografting is performed widely for deep burn wounds as an ideal coverage. Scaring at the site of grafting has been always a challenge for surgeons. Many methods have been proposed to lessen the probability of scaring, but conflicting results have been obtained. It is said that the suture type is important in the development of scaring. Seams technique has also been introduced to decrease scar after autografting. ⋯ We compared two techniques of Seams between the normal skin and the graft edge for the first time. We showed that the AP method had a better Vancouver score compared to the OV regarding pigmentation, height, and pliability indices.
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The management of burns is costly and complex with inpatient burns accounting for a high proportion of the costs associated with burn care. We conducted a study to estimate the cost of inpatient burn management in Nepal. Our objectives were to identify the resource and cost components of the inpatient burn care pathways and to estimate direct and overhead costs in two specialist burn units in tertiary hospitals in Nepal. ⋯ This study is a first step towards a comprehensive estimate of the costs of severe burns in Nepal.
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The objective of this work was to describe an efficient and sustainable outreach model in a resource-constrained environment, with a multifaceted approach focusing on national policy change, telemedicine, injury prevention, education and treatment of burns. ⋯ Broadly, our model could be an example of building sustainable outreach programs in resource-constrained environments. Through collaboration with local healthcare providers, we have developed and implemented an outreach program in a resource-constrained environment.
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Vancomycin is a common and critical drug for empiric antimicrobial therapy in the infected burn patient. However, profound physiologic changes may impede the clinical effectiveness and amplify the potential nephrotoxicity of vancomycin. ⋯ Continuous infusion vancomycin was associated with more rapid attainment of target levels and a lower rate of nephrotoxicity.
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This paper illustrates the efficacy of an artificial intelligence (AI) (a convolutional neural network, based on the U-Net), for the burn-depth assessment using semantic segmentation of polarized high-performance light camera images of burn wounds. The proposed method is evaluated for paediatric scald injuries to differentiate four burn wound depths: superficial partial-thickness (healing in 0-7 days), superficial to intermediate partial-thickness (healing in 8-13 days), intermediate to deep partial-thickness (healing in 14-20 days), deep partial-thickness (healing after 21 days) and full-thickness burns, based on observed healing time. In total 100 burn images were acquired. ⋯ After that, the remaining 83 burn-wound images were evaluated using the different network during the cross-validation, achieving an accuracy and dice coefficient, both on average 92%. This technique offers an interesting new automated alternative for clinical decision support to assess and localize burn-depths in 2D digital images. Further training and improvement of the underlying algorithm by e.g., more images, seems feasible and thus promising for the future.