Burns : journal of the International Society for Burn Injuries
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The study aimed to determine the factors which influence clinician behaviour and adherence to best practice when clinicians provide the initial care for paediatric burn patients admitted to a burns unit. ⋯ Telehealth services support clinicians when providing burn care, however IT issues are an major barrier to both best practice and accessing the telehealth service and should be optimised to support clinical care IMPACT STATEMENT: What does this paper contribute to the wider global community? It provides burn clinicians with an insight into the factors which facilitate optimal care for patients prior to transfer to burn units, as well as the barriers faced by non-burn specialist clinicians when patients initially present for care. Models of care which acknowledge these factors can help facilitate optimal patient care.
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Severe burn injuries are associated with high morbidity and mortality. Well-implemented scoring systems for patients with major burns exist in the literature. A major disadvantage of these scores is the partial non-consideration of patient-related comorbidities. Published data on this matter is limited to small study cohorts and/or single center studies. Further, the effect of comorbidities on clinical outcome of patients with severe burn injuries has not yet been examined nationwide in a large cohort in Germany. Hence, the aim of this study was to examine the influence of comorbidities on clinical outcome of these patients based on data from the national registry. ⋯ Preexisting comorbidities have a significant impact on the clinical outcome of patients with severe burn injuries. Further investigation is warranted in order to supplement existing prognostic scores with new mortality-associated parameters.
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Burn injury and reconstructive operations often result in severe pain, particularly at skin graft donor sites. Traditional local anesthetics administered intraoperatively control pain at donor sites, but the duration of action is short. Liposomal bupivacaine, a novel local anesthetic, can provide sustained-release analgesia for 72h. The primary aim of this study was to describe the efficacy of liposomal bupivacaine for postoperative donor site pain control for patients undergoing skin graft procedures. ⋯ Patients who received liposomal bupivacaine reported less postoperative donor site pain and found the donor site to be less bothersome without major complications. Liposomal bupivacaine may be a safe and promising agent for prolonging postoperative analgesia and minimizing donor site pain.
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Recently, self-heating consumer pressure cookers have found reinvigorated use with consumers wanting faster, more convenient, and healthier cooking. With the increased popularity, injury reports have also increased. Hazards associated with dispersion from pressurized vessels, although qualitatively understood through elementary scientific principles, have not been experimentally characterized in the literature, nor has the human ability to respond to a sudden dispersion of contents been directly reviewed. ⋯ This study found that both pressure and volume level influence the dispersion of contents after lid opening as well as the lid departure speed. Results also indicate that the speed of both the departing lid and the dispersing liquid occurred quicker than a bystander, within arm's reach, can consciously react to avoid or to shield themselves from the hot contents. The results confirmed analytical analyses found in the literature that a single layer cotton shirt (e.g., a t-shirt) saturated with water is more likely to trap hot liquid, increasing the likelihood of a more severe burn in that area due to prolonged skin contact.
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A 10-year retrospective study of heat press injury: Characteristics and risk factors for amputation.
The diagnostic grading system for heat press injury has remained the same for decades and depends solely on surgical observation. This study described the demographic and clinical characteristics of such patients and investigated potential predictive factors for amputation. ⋯ Industrial machines, working age, small TBSA, digit or hand injuries, and full-thickness skin injuries were common in our patients. Insufficient perfusion of extremities was an independent risk factor for amputation, while other indicators, including TBSA, D-dimer level, and white blood cell count, did not.