Burns : journal of the International Society for Burn Injuries
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Telemedicine technologies have a valuable potential when it comes to improving the accuracy of triage protocols in selecting severely injured patients who may benefit from transportation. The main objective of this study was to evaluate the correlation of the urgent diagnosis made by telemedicine through an App with traditional face-to-face urgent care and the final diagnosis, made by scheduled consultation. ⋯ The telemedicine system for planning referrals is a useful tool that may make significant differences in the management of burned patients although further research needs to be taken in that direction.
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The current evidence to support the use of massage for scar management is conflicting in the literature. The purpose of this study was to compare two scar massage protocols administered with pediatric burn survivors to determine if a more structured and standardized approach to scar massage could improve outcome. A retrospective review of the medical records of 100 children who received massage during the time period when two different protocols were implemented was conducted and data that was collected as part of the clinical exam regarding scar height, vascularity, pliability, itch and pain were extracted. ⋯ However, when comparing patients who received Protocol A to those who received Protocol B, there was no difference found in scar height, vascularity, pliability, itch or pain. Using commonly applied subjective scar assessment tools, we did not find clinically meaningful changes in scar characteristics with the implementation of a structured scar massage program compared to a general approach to massage. Further research is needed to better define the impact of massage on the recovery experience for burn survivors.
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Unsafe tap water temperatures (>120 °F) are a risk factor for pediatric burns, which may disproportionally impact low-income, urban communities. We sought to estimate the incidence and demographic characteristics of tap water burns and their association with housing characteristics. ⋯ Our results identified a significant number of tap water burns in children. Primary prevention efforts targeting education or regulation of water temperatures may work to reduce burns in underserved areas.
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Appropriate fluid administration in severe burns is a cornerstone of early burns management. The American Burns Association's (ABA) recommendation is to administer 2 mL-4 mL × burnt Body Surface Area (BSA) × weight in the first 24 h with half administered in the first eight hours. Unfortunately, the calculations involved are complex and clinicians do not estimate the BSA or weight well, which can lead to errors in the amount of fluid administered. To simplify cognitive load to calculate the fluid resuscitation of early burns, the investigators derived the PHIFTEEN B (15-B) guideline. The 15-B guideline estimates the initial hourly fluid for adults ≥ 50 kg to be: 15 mL × BSA (to the nearest 10%) AIMS: To model and determine the accuracy of the 15-B calculated based on the characteristics of a retrospective cohort of patients admitted with ≥ 20% BSA to the Royal Brisbane and Women's Hospital (RBWH) Intensive Care Unit (ICU). ⋯ The 15-B formula is a simple, easy to calculate guideline which approximates the early fluid estimates in severely burned patients despite inaccuracy in prehospital BSA estimates.
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Burn injuries are common afflictions; however, conservative wound care frequently leads to poor treatment compliance and physical disability in deep burn patients. Therefore, regenerative biologic materials, which are more effective for tissue repair, are required, particularly for deep second-degree burns. A novel spray formulation of basic fibroblast growth factors (bFGF) was produced by synthesizing fibroblast growth factor proteins. In this post-marketing surveillance (PMS) study, we assessed the safety and efficacy of bFGF and indirectly compared this formulation with cultured epidermal autografts (CEAs) for treating deep second-degree burns. ⋯ Our study demonstrated that bFGF is a compelling regenerative therapy with competitive clinical efficacy and safety for deep second-degree burns and reduced treatment time, which is expected to reduce medical costs, particularly for deep second-degree burn patients.