Burns : journal of the International Society for Burn Injuries
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Chemical burns continue to pose a variety of dilemmas to the clinician managing such cases. Assessment of burn depth is often difficult and the decision whether to excise the wound early is not always clear-cut. In this updated review, common agents are classified and the basic principles of management and specific recommendations are examined. The complications arising from exposure to these chemicals and the supportive measures needed during treatment are also described.
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Paediatric burns are a significant international public health problem. Developing and developed countries report similar challenges regarding paediatric burn prevention programs. Paediatric burns requiring healthcare often incur significant health and opportunity costs, death or long-term disability. This paper reviews international burn prevention strategies, and considers implementation of effective prevention strategies in South Africa. REVIEW QUESTION: Are there differences between developed and developing countries regarding causes and prevalence of paediatric burns, prevention strategies, and evidence of effectiveness? REVIEW FRAMEWORK: Implementing effective burn prevention strategies in South Africa. ⋯ More work is required to establish effective, sustainable community-wide prevention programs in developed and developing countries. Effective paediatric burn prevention programs for South Africa should acknowledge parent and child literacy, how and where information is best accessed, the need to adapt effective hazard reduction programs to informal settlements, and the importance of legislated minimum safe housing standards. This requires significant commitment from Government, communities and individuals.
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Platelet-rich plasma stimulates angiogenesis, promoting vascular in-growth and fibroblast proliferation. In addition, PRP functions as haemostatic by forming a fibrin clot. Also application of PRP enhances wound-healing in both soft and hard tissue. ⋯ The value of PRP application in burns remains unclear. A definitive assessment as to the application of PRP in burn treatment will require further studies. Theoretically the effects of PRP in burn wounds could be beneficial, however the interaction in tissue repair and regeneration must be better understood.
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For 2008, approximately 1200 original burn research articles were published in scientific journals using the English language. This article reviews those with the most impact on burn treatment according to the Editor of one of the major journals (Burns). As in the previous year's review, articles were divided into the following topic areas: epidemiology, wound characterisation, critical care physiology, inhalation injury, infection, metabolism and nutrition, psychological considerations, pain management, rehabilitation, and burn reconstruction. Each selected article is mentioned briefly with editorial comment.
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The adverse sequalae of inadequate pain control in the burn population have been long recognised, yet control of pain remains inadequate globally. The dynamic evolution of burn pain both centrally and peripherally, and the many factors which influence pain perception illustrate the need for a therapeutic plan which is similarly dynamic and flexible enough to cope with the facets of background, breakthrough, procedural and post-operative pain. Regular, ongoing and documented pain assessment is key in directing this process. ⋯ Non-pharmacological methods of pain control can play an important role in suitable patients but resources vary widely between units. With this review article, we have set out to give practical guidance to all healthcare professionals with examples from our practice. We have found the addition of pain specialists as an integral part of the burns multi-disciplinary team, and an environment where pain is given a high clinical priority to be invaluable in our approach to pain control.