Burns : journal of the International Society for Burn Injuries
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Burn wound progression is a significant problem as burns initially thought to be superficial can actually become full thickness over time. Cooling is an efficient method to reduce burn wound conversion. However, if the cooling agent is below room temperature, depending on the wound size the patient is at risk of hypothermia. Additionally, tissue perfusion is reduced leading to an aggravation of burn wound progression. We investigated if wound dressings based on non-pre-cooled bacterial nanocellulose (BNC) with a high water content cool a burn just by evaporation and reduce the intradermal damages in the skin. ⋯ Based on our results, BNC-based wound dressings cool a burn. Intradermal temperature as well as thermal damage of the tissue was reduced. The tested BNC-based wound dressing can be used without pre-cooling to cool a burn as well as to reduce the burn BNC-based wound progression through its evaporation cooling effect.
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Healthcare-associated infections (HAIs) remain a major challenge in burn research and care. We aimed to describe the epidemiology and timeline of HAIs and to estimate the association of demographics and clinical characteristics with time to HAI among burn patients. ⋯ These data have implications toward generating empirical antibiotic guidelines and preventive strategies targeting the patients at highest risk for HAI.
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Sink-bathing is common practice among parents. However, this puts infants and young children at unrecognized risk for burn injuries. As the only verified pediatric burn center in a large urban area, we treat burn patients from a large variation in socioeconomic status. ⋯ Analysis of 71 patients revealed infants under one year of age are most commonly afflicted. Additionally, that families of low-socioeconomic means are disproportionately affected. Understanding the different circumstances surrounding sink-bathing burns allows us to be more specific in our community education efforts and efficiently guide our resources.
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Shear-wave elastography (SWE) is an ultrasound based technology that can provide reliable measurements (velocity) of scar stiffness. The aim of this research was to evaluate the concurrent validity of using both the measured velocity and the calculated difference in velocity between scars and matched controls, in addition to evaluating potential patient factors that may influence the interpretation of the measurements.
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Observational Study
Lactate and lactate clearance in critically burned patients: usefulness and limitations as a resuscitation guide and as a prognostic factor.
Lactate levels to guide resuscitation in critically burned patients are controversial. The purpose of our study was to determine whether absolute lactate values or lower lactate clearance predict mortality, and whether these are useful tools in the resuscitation phase. ⋯ Initial elevated lactate levels are a factor of poor prognosis and the cut-off point that best predicts mortality should be adjusted in the patients with TBSA burned < 20%. The global clearance of lactate in the first 24 h, unlike what occurs in other injuries, does not correlate with mortality. Monitoring lactate can ensure adequate peripheral perfusion during resuscitation with lower than normal fluid preload values.