Burns : journal of the International Society for Burn Injuries
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Successful burn care should facilitate comprehensive, functional recovery after an injury. But we have a poor understanding of which risk factors influence long-term outcomes after burn injury. Studies have correlated hospital-acquired complications (HACs) with poor long-term outcomes in some populations. The purpose of this study was to determine whether HACs alter patient-reported quality of life in adult burn survivors. ⋯ We demonstrate that inpatient complications negatively impact long-term quality of life, especially physical functioning for patients with burn injuries. Our data confirm the need to consider the influence of hospital-acquired complications on patient-reported long-term outcomes and to support national efforts to reduce complications in burn patients.
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Human cadaveric skin (allograft) is used in treating major burns both as temporizing wound coverage and a means of testing wound bed viability following burn excision. There is limited information on outcomes, and clinicians disagree on indications for application in intermediate-sized burns. This study aims to improve understanding of allograft use in 20-50% total body surface burns by assessing current utilization and evaluating inpatient outcomes. ⋯ Allograft use in major burns 20-50% TBSA was associated with a significant increase in inpatient mortality. There was a notable correlation with increased inpatient complications, longer length of stay, more burn operations, and greater total charges. Better studies are needed to justify the use of this costly and limited resource in the intermediate sized major burn population.
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The wounds of full- and deep partial-thickness burns result in hypertrophic scars and lead to skin contracture more severely than those of superficial partial-thickness burns. Therefore, preventing burn progression may help improve the aesthetic and functional outcomes after healing. Although a number of studies have focused on elucidating the underlying mechanisms of and preventing burn wound progression, it is still difficult to rescue burned dermis unless early tangential excision is performed. ⋯ We confirmed that heating at 55°C for 30s caused fibroblast necrosis immediately after heating, whereas heating at 46°C for 30s induced apoptosis 24h after heating. We also found that the supplementation of 100ng/ml betamethasone to the culture medium after heating decreased the number of apoptotic cells and increased that of live cells. Our studies suggest that glucocorticoids suppress apoptosis of heat-injured fibroblasts and may be useful for preventing burn wound progression.