Burns : journal of the International Society for Burn Injuries
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Patients with severe burns undergo a local and systemic response to the injury. As part of this response the patient becomes hypermetabolic. Current guidelines advise high protein intakes to counteract the catabolic response to burns, but this appears to be based on minimal experimental evidence. Hence the aim of this review was to examine the evidence for improvements in nutritional status and clinical outcome with the administration of high protein intakes for patients with burns. ⋯ There is currently only very weak evidence to justify administering high protein diets to patients following burns.
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While the benefits of early excision in burn surgery are clear, the advantages may be lost in low income countries with limited resources. It is important to identify the right timing of excision in different groups of patients, particularly those in low-income countries (LIC), as the burden of disease contributes to the highest global mortality and has the least resources. This systematic review and meta-analysis aims to determine the timing of excision in LICs and the outcomes associated with surgery: (1) mortality, (2) sepsis and (3) length of stay (LOS) compared to high income countries (HICs). ⋯ The variable definitions of age, timing of excision, variable nature of % TBSA comparison, mixed inclusion of inhalation injury, co-morbidities and unquantified access to resources make the data difficult to interpret and it is not possible to draw accurate conclusions on the role of early excision for burns in low-middle income countries. A prospective study is needed in order to answer this question.
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Visual evaluation is the most common method of evaluating burn wounds. Its subjective nature can lead to inaccurate diagnoses and inappropriate burn center referrals. Machine learning may provide an objective solution. The objective of this study is to summarize the literature on ML in burn wound evaluation. ⋯ Machine learning provides an objective adjunct that may improve diagnostic accuracy in evaluating burn wound severity. Existing models remain in the early stages with future studies needed to assess their clinical feasibility.
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Visual evaluation is the most common method of evaluating burn wounds. Its subjective nature can lead to inaccurate diagnoses and inappropriate burn center referrals. Machine learning may provide an objective solution. The objective of this study is to summarize the literature on ML in burn wound evaluation. ⋯ Machine learning provides an objective adjunct that may improve diagnostic accuracy in evaluating burn wound severity. Existing models remain in the early stages with future studies needed to assess their clinical feasibility.