Burns : journal of the International Society for Burn Injuries
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Persons with severe burns often develop long-term psychosocial difficulties such as posttraumatic stress disorder (PTSD) and depression. Significant appearance changes following burn injury (e.g., scarring and disfigurement) can lead to body image dissatisfaction (BID) that causes psychological problems. Using a two-wave longitudinal design, this study examined the association between burn severity and psychosocial adjustment after burns (symptoms of PTSD and depression), particularly through the mediating role of BID. ⋯ The current findings highlight the importance of BID in the development and maintenance of psychosocial maladjustment long after burn injury.
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Burns are estimated to cause up to 1% of admissions to emergency department in low- and middle-income countries, and up to 220 admissions per 100 K people in high income countries. Knowing the special features in every population could help formulate prevention strategies tailored for the specific group targeted and thus help decrease the incidence of burns in the general population. ⋯ Pediatric burn patterns were found correlate to population, timing, and customs. Mapping the hazardous rituals that may cause burns in different populations, is the first step towards prevention.
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There is a common, well-known and established recommendation to excise burn wounds within 24-72 h in order to mitigate the systemic inflammatory and immunomodulatory response, shorten length of hospitalization through early grafting and optimize patient survival. Despite this apparent consensus, surprisingly few systematic studies have evaluated the actual adherence to this practice and its implications on patient outcomes. In this registry study, we sought to objectify the current status of early burn wound excision, its influencing factors and impact on patient outcomes for all German burn centers. ⋯ Despite apparent consensus among burn physicians, early excision of burn wounds is performed in less than 50% of cases in German burn centers. The relationship of EE to TBSA burned is expected and clinically sound, while a dependence on admission weekday raises administrative and infrastructural questions, especially when patients who receive EE have significantly shorter hospital stays. More analyses from other burn repositories are needed to compare and benchmark the international status quo of early burn wound excision.
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Efforts with the utilization of an Input/Output ratio (I/O ratio) are done with success for analyzing and moving forward the treatment in the resuscitation phase of the burn patient. The need for conducting this research is to apply the I/O ratio in our cohort as a helpful index for classifying the resuscitation response of the burn patients. Our prespecified hypothesis is if it matters the analysis of the I/O ratio at 8 h of fluid resuscitation period. ⋯ The I/O ratio is a very useful parameter not only at 12 h and 24 h but also at 8 h after burns. By classifying the patients into outcome groups that reflect not only the volume given but moreover the physiologic reactions to the resuscitation volume gotten, we were more attentive to patients in under-responders at 8 h. This parameter fulfills the criteria for better classifying patients and a better understanding of the physiology of burns.
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The Burnt Hand Outcome Tool (BHOT) is a comprehensive tool assessing the multiple impacts of hand burn injuries which makes it essential to burn care practice, but is currently only available in English. ⋯ The BHOT-F demonstrates adequate clinimetric properties to be used in clinical practice.