Burns : journal of the International Society for Burn Injuries
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Disparities affecting incarcerated burn-injured patients: Insight from the National Burn Repository.
Incarcerated patients are a vulnerable population and little is known regarding the epidemiology of burn injury and subsequent outcomes. This study utilizes a national database to assess disparities in care affecting this understudied population. ⋯ Although incarcerated burn-injured patients sustain smaller injuries and receive fewer operations they remain hospitalized for similar durations as non-incarcerated patients. Enhanced understanding of burn etiologies and injury characteristics as well as improved insight into the impact of psychosocial factors such as substance abuse and prevalence of psychiatric disorders may help improve care.
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The most common burn wound assessment continues to be the clinical inspection and the tactile examination, which are subjective and remain challenging even for experienced burn surgeons. Recently, hyperspectral imaging camera systems have been increasingly used to support the evaluation of burn wounds. The aim of our study was to determine if hyperspectral imaging analysis differentiates and objectifies the assessment of burn wounds in burns of the upper extremities. ⋯ We found that hyperspectral imaging analysis effectively differentiates burn wounds and shows the ability to distinguish even superficial partial burns from deep partial burns in the near-infrared perfusion analysis feature. Although, it was not possible to differentiate burn wounds in all features. Currently, it is important to optimize the respective reference values of the individual burn degrees for an objectified assessment.
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Randomized Controlled Trial
Tranexamic acid reduced blood transfusions in acute burn surgery: A retrospective case-controlled trial.
Early excision and grafting of burn wounds are key for reducing prevalence of infection and sepsis. However, it is associated with massive blood loss and patients frequently require large numbers of blood transfusions. This study aimed to evaluate the effect of tranexamic acid (TXA) on blood transfusion requirements in acute burn surgery. ⋯ This study shows that necessity for blood transfusions in acute burn surgery may be reduced significantly by administration of TXA perioperatively. Randomized-controlled trials are needed to prove these findings.
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Multicenter Study
Wound healing and dermal regeneration in severe burn patients treated with NovoSorb® Biodegradable Temporising Matrix: A prospective clinical study.
For extensive burns, autologous donor skin may be insufficient for early debridement and grafting in a single stage. A novel, synthetic polyurethane dermal template (NovoSorb® Biodegradable Temporising Matrix, BTM) was developed to address this need. The aim of this study was to evaluate use of BTM for primary dermal repair after deep burn injury. ⋯ These results provide additional clinical evidence on the safety and performance of BTM as an effective dermal substitute in the treatment of patients with deep burn injuries.
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National guidance in the UK advises that psychosocial screening is completed for all inpatients admitted to burns services for over 24 h. Acceptable methods of psychosocial screening have been nationally agreed. However, little is known about how different services conduct psychosocial screening. ⋯ Results highlight the value and cost-effectiveness of a tiered approach to psychosocial screening and in guiding subsequent intervention. Future study is needed in relation to inpatient psychosocial screening and its validity and reliability. Investigating the predictive value of screening methods in identifying those with longer-term psychological difficulties would also be important clinically.