Burns : journal of the International Society for Burn Injuries
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Randomized Controlled Trial
Effects of intravenous tranexamic acid on bleeding during burn surgery: A double-blinded randomized clinical trial.
Blood loss during burn surgery significantly contributes to morbidity and mortality. Tranexamic acid (TXA), an antifibrinolytic agent, is hypothesized to reduce intraoperative bleeding. This double-blinded, randomized clinical trial aimed to assess the efficacy of systemic TXA in severe burn patients (total body surface area [TBSA] > 20 %) undergoing surgery. ⋯ Results demonstrated significant reductions in blood loss (P = 0.043), total IV fluid volume (P = 0.021), OR time (P = 0.002), LOS (P = 0.0001), and transfusions (P = 0.024) in the TXA group. Notably, women and patients without inhalation injuries exhibited better responses to TXA treatment, and graft survival was lower in the TXA group. The study concludes that IV TXA administration during burn surgery can reduce bleeding, minimize IV fluid and blood transfusion needs, and shorten surgery duration, enhancing overall surgical outcomes.
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Randomized Controlled Trial
Wireless Micro Current Stimulation (WMCS) therapy to enhance burn wound healing: A randomized clinical trial.
Pediatric burn injuries are often associated with significant morbidity, and require specialized care. The primary advantage of Wireless Micro Current Stimulation (WMCS) is the ability to deliver electric current without direct contact with the wound, which is particularly advantageous in the pediatric population and in those with wounds over multiple areas or over sensitive regions. ⋯ Our study shows statistically significant improvement in healing time with WMCS therapy, despite a two times higher average TBSA% in the WMCS group.
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Extensive burns are associated with a high mortality rate. Early prediction and action can reduce mortality. The National Early Warning Score (NEWS) is considered the best early warning score for predicting mortality. However, there has been no assessment conducted on the clinical prognostic significance of NEWS in individuals suffering from severe burns. The objective of this research was to establish a nomogram based on burn characteristics and the NEWS to predict survival in severely burned patients. ⋯ This study introduces an innovative nomogram that predicts the survival rate of individuals with severe burn injuries by combining clinical attributes and laboratory examinations, demonstrating superior efficacy compared to conventional NEWS systems.
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Observational Study
Identification and quantification of physical activity in critically ill burn patients: A feasibility study.
Physical activity is essential in burn care to counteract the effects of severe burns and inactivity during hospitalization. However, detailed knowledge of performed physical activities is lacking. This study evaluated the feasibility of a dual accelerometer-based method to assess type, frequency, and duration of physical activity in critically ill burn patients during hospitalization. ⋯ The dual accelerometer-based method proved feasible for research purposes. For clinical application, further refinement of data processing is required.
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Access to healthcare and insurance coverage are associated with quality of life, morbidity, and mortality outcomes. However, most studies have only focused on same-admission and short-term outcomes due to the lack of national longitudinal datalthere are limited data on this topic in the burn literature. Our aim was to determine the effect of insurance status on long-term outcomes in a national sample of burn patients. ⋯ Having Medicaid and Medicare insurance was significantly associated with a lower health-related quality of life at long-term follow up, even after adjusting for demographics and burn injury severity.