Burns : journal of the International Society for Burn Injuries
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There have been concerns that fire-derived acid gases could aggravate thermal burns for individuals wearing synthetic flame retardant garments. A comparative risk assessment was performed on three commercial flame retardant materials with regard to relative hazards associated with acidic combustion gases to skin during a full engulfment flash fire event. The tests were performed in accordance with ASTM F1930 and ISO 13506: Standard Test Method for Evaluation of Flame Resistant Clothing for Protection against Fire Simulations Using an Instrumented Manikin. ⋯ Discoloration was inversely proportional to the amount of acid collected on the traps. A risk assessment was performed on the potential adverse impact of acid gases on both the skin and open wounds. The results indicated that the deposition and dissolution of the acid gases in surficial fluid media (perspiration and blood plasma) resulted in an increase in acidity, but not sufficient to induce irritation/skin corrosion or to cause necrosis in open third degree burns.
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Psychological symptoms are common among burn survivors. However, knowledge about epidemiology and predictors of psychopathology has shown great heterogeneity in this population. The Fenix-II Project was the first epidemiological study on the psychopathological consequences of burns developed in Spain, providing a detailed analysis of the progression of psychological symptoms during the first six months after injury. ⋯ Within this group of patients, anxiety, depression and hyperarousal increased at 30 days, and avoidance 90 days after injury. The most accurate predictors of PTSD were found to be being burned in a Motor Vehicle Crash, risk of social exclusion, low body-image adjustment, anterior trunk location of the burn and life threat perception during the burn-shock period. Considering these factors, clinicians may identify patients at risk of PTSD development, allowing an adequate follow up and preventive interventions which may minimize the psychological consequences of burns.
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Pulsed-field gel electrophoresis (PFGE) has been used as an adjunct to traditional hospital epidemiology in numerous outbreak investigations, including in burn centers. However, its most effective real-world application remains unclear, with few longitudinal descriptions of use. ⋯ PFGE contributed little to infection prevention interventions, and outbreaks resolved with increased focus on basic practices. Longitudinal studies including greater numbers of outbreaks in different settings are needed to clarify the utility of molecular typing in routine investigations.