Burns : journal of the International Society for Burn Injuries
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Despite the multitude of preventative methods, postburn hand contractures are poorly controlled and often require surgery. However, there is no consensus on which hand reconstruction technique is most efficacious. This systematic review aims to compare the efficacy of available postburn hand contracture reconstruction techniques over the long term and to evaluate the quality of current literature. Effectiveness is assessed with functional improvement, increase of skin surface area, and scar quality/enhanced cosmesis. ⋯ No consensus remains on the superiority of a single reconstruction technique. Meticulous preoperative planning and intensive rehabilitation are vital. A stepwise approach, considering individual patient and contracture characteristics and the limitations of each technique, should be followed. Well-designed and conducted future studies, utilizing reliable and validated contracture description methods and outcome assessment, are now imperative.
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For nurses working in specialized units such as burn units, having adequate levels of job satisfaction and motivation is crucial for enhanced productivity in order to maintain quality nursing care. ⋯ A positive correlation was observed between job satisfaction and job motivation of the nurses. If older nurses cannot get support from their supervisors, their satisfaction will be decreased. In addition, if more experienced nurses in the burn unit do not feel importance on the job, their satisfaction will be decreased.
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Autologous fat grafting (AFG), mostly in combination with adhesiolysis, has become the workhorse for reconstructing a dysfunctional or absent subcutaneous layer. In a previous study we showed that fat grafts isolated by centrifuging led to more than 20 % improvement in scar pliability. Nevertheless, there is still debate on which technique should be used to process and purify fat grafts. ⋯ Objectively measured pliability and erythema and melanin showed no statistically significant differences at 12 months follow-up. Patient-reported outcomes revealed a significant improvement in scar quality, especially scar pliability, after AFG processed by filtration in patients with adherent scars. However, no scar quality improvement was found when assessed with objective tools.
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Randomized Controlled Trial
Potential therapeutic effects of topical recombinant human erythropoietin on burn wound healing: A preliminary randomized double-blind controlled clinical trial.
Burn injuries can cause significant mortality and morbidity. This study aimed to evaluate the efficiency of topical recombinant human erythropoietin (rhEPO) on enhancing burn wound healing. ⋯ At the second follow-up visit, all parameters were significantly lower in the rhEPO group compared with the control group except for itchiness. The results of the next two follow-up sessions were also the same. The total value of the modified Vancouver Scar Scale (VSS) at days 5, 7, and 14 was significantly lower in the rhEPO group compared with the routine of care group. Trial Registry Date: 2022-03-02, Trial Registry number: IRCT20190810044500N23 CONCLUSIONS: The results of the present study suggested that topical rhEPO is a potential option in burn wounds and patient satisfaction, without causing intolerable side effects.
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Randomized Controlled Trial
Randomized, controlled, within-patient, single-blinded pilot study to evaluate the efficacy of 12-weeks of endermotherapy with adult burn survivors.
Vacuum massage, or endermotherapy, is applied to scar tissue with the primary therapeutic goal of promoting structural or physiological changes. These changes are intended to enhance pliability, enabling the skin to possess the strength and elasticity required for normal mobility. The advantage of vacuum massage compared to therapist-generated manual massage is that it provides a standardized dosage using rollers and suction valves to mobilize the tissue. However, research documenting and supporting its impact on post-burn hypertrophic scar is lacking. Thus, this study was designed to objectively characterize the changes in scar elasticity, erythema, melanin, thickness, and transepidermal water loss immediately after a vacuum massage session and after a 12-week course of treatment compared to intra-individual matched control scars. ⋯ This pilot study did not find a treatment benefit of vacuum massage therapy for elasticity, erythema, melanin, thickness or TEWL, but it did find an improvement with time in elasticity, erythema and TEWL. Despite the lack of objective improvement of the treated scar site, participants were satisfied with the results and believed vacuum massage was very effective. Further high-quality research is required to better inform clinicians patient education and treatment decisions for this costly, burdensome treatment approach that has high participant satisfaction.