Burns : journal of the International Society for Burn Injuries
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Burn disasters present a challenge not only to burn centers but the entire healthcare system. Most burn centers worldwide are unprepared to deal with a burn disaster as it is an uncommon event. We investigated the status of burn center preparedness in German-speaking countries to respond to a burn disaster. ⋯ Nevertheless, there are some gaps in the areas of planning and preparation, funding for disaster activities, and regular training of staff for burn disasters. We call for a unified burn disaster plan and increased cooperation between burn centers and civil defense regarding communication and training. We strongly recommend the implementation of a special disaster fund and telemedicine in disaster management to circumvent shortages in burn staff.
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Burn wounds contain high levels of protease activity due to the need to remodel the damaged extracellular matrix proteins. While necessary, excessive protease activity can lead to improper wound healing and is associated with increased contraction and fibrosis. No studies to date have investigated the expression changes of all the collagenases and elastases in burn wounds. ⋯ None of the serine proteases were significantly altered in the wound tissues. In conclusion, matrix metalloproteinases appear to be the most highly elevated proteases after a pediatric burn wound injury, at least within the first 3-7 days. The data warrant further investigation into the effects of MMPs on burn wound healing.
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Comparative Study
Comparison of the efficacy of silver-based antimicrobial burn dressings in a porcine model of burn wounds.
A variety of silver-based antimicrobial dressings are available on the market and are commonly used to prevent infection. Such prophylaxis is particularly important in treating burns, yet there is a paucity of evidence confirming the efficacy of commercially available dressingsin vivo. We describe here an in vivo porcine model of burns, which we use to test the antimicrobial efficacy of three common wound dressings and a control. ⋯ Nanocrystalline silver-based wound dressings generally outperformed silver-plated nylon and high-oxidation silver salts in thisin vivo model of burn wounds. Relative to prophylactic use, it may be advisable to change the dressings more frequently when treating an infected wound.
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Improvement in the care of burn patients has led to decreased mortality. Length of stay (LOS) has been used as a marker for quality of care in this population. However, the historical association of LOS as correlating only with % burn surface area (BSA) injury has been questioned with retrospective data suggesting other factors may also be associated with LOS. A model to predict prolonged LOS does not exist but could provide important information for clinicians and patients. ⋯ Prolonged hospitalization following burns is predicted by patient age (in decades), TBSA, hypertension, perineal involvement, and abnormal white blood cell count.
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Burns are one of the major health issues that considerably affect variable groups of the population, varying in age and severity. Despite advances in burn surgical and non-surgical treatments, patient's appearance still represents public health issue. In regards to surgical treatment of burns, skin grafting is still considered the gold standard. One of the major burdens in the burn surgical treatments is the availability of the skin for grafting. As for the non-surgical treatment different modalities of skin dressings or substitutes are still available as an option. ⋯ The study concluded that the majority of participants were willing to donate their skin, and they were aware of the concept of skin donation and its crucial importance in surgical burn management. The current study showed the majority of participants were aware of skin donation and skin use for burn treatment, in addition to having positive attitude toward skin donation. Men were more aware than the women of skin donation. Religious concern was a major reason for participants' skin donation refusal, an issue that can be addressed by contacting Islamic scholars to issue a Fatwa approving the cause.