Burns : journal of the International Society for Burn Injuries
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Randomized Controlled Trial
Occlusive drainage system for split-thickness skin graft: A prospective randomized controlled trial.
Split-thickness skin grafts are widely used in reconstruction of large area defects. Conventional postoperative recipient site care includes saline-moistened gauze with a protective layer of petroleum gauze and splints for immobilization. This method causes pain while changing the dressing. We designed a better occlusive drainage system for split-thickness skin grafts. We compared the treatment effect and subjective evaluation of our occlusive drainage system with that of the conventional method for coverage of split-thickness skin grafts. ⋯ Comparing with the indirect wet dressing method, this new method is practical for covering split-thickness skin grafts, causes less pain, and provides a better experience for patients.
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Observational Study
Paediatric burn unit in Portugal: Beds needed using a bed-day approach.
Despite the high burden of children with burns, there is not a paediatric burn unit (PBU) in Portugal. We aimed to estimate the Portuguese health care providing needs on paediatric burns. ⋯ Using a groundbreaking approach, the optimal number of PBU beds needed in Portugal is 13. However, as half of the patients who met burn transfer criteria are not transferred, this bed number might be overestimated if this pattern maintains, despite the underestimation with our method approach. If a PBU is to be created the preferable location is Porto. Cost-effectiveness studies should be performed.
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Randomized Controlled Trial
Controlling intraoperative hemorrhage during burn surgery: A prospective, randomized trial comparing NuStat(®) hemostatic dressing to the historic standard of care.
One of the primary intraoperative challenges during burn surgery is to adequately excise the burn while avoiding massive hemorrhage. This has become increasingly important, as we see more burn patients that are older and with more medical comorbidities. While adequate excision down to healthy tissues for deep burns is essential for skin graft to take, it also leads to active bleeding that can be a challenge to control. Good hemostasis is imperative as a hematoma is the most common cause of graft loss. Several new products have become available to help control intraoperative hemorrhage. A new hemostatic dressing, NuStat(®), is available and approved by FDA in United States. ⋯ Based on these findings, NuStat(®) hemostatic action should be comparable to the historic standard of care, and these newer hemostatic agents evaluated further in burn surgery and bleeding during other procedures such as trauma surgery.