Burns : journal of the International Society for Burn Injuries
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Treatment of people with burn injuries includes recovery of optimal function for survivors to fully participate in society, psychologically and physically. Increased likelihood of physical survival has led to greater concern for potential psychological morbidity for the burn survivor. Based on research and on many years of clinical experience in providing psychosocial care to burned children and adults, the authors outline their approach to assisting burn survivors and their families through the arduous process of recovery from admission through critical care, inpatient recuperation and reintegration upon hospital discharge. A philosophy of rehabilitation, a process that may occur for many months or years after patients' discharge from their acute hospitalization, is presented in the form of seven guidelines for working with burn survivors.
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Severe burn is a major public health issue in developing nations. Although burn and smoke inhalation in 2002 were documented as being responsible for over 322,000 deaths worldwide, this figure is most likely a gross underestimate. The burden of suffering from fire is exceedingly distributed among the poor. ⋯ Ignorance of safe usage techniques is also contributory. Industry and government regulations and standards are either nonexistent or not adequately enforced. Solving this substantial problem will depend on improved surveillance by means of formal epidemiologic studies, and the contributions and collaboration of international governmental and nongovernmental organizations.
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A large proportion of burns in developing countries are related to the nature of domestic appliances used for cooking, heating, and lighting. Our overview of the problem elucidated the need for better surveillance with epidemiologic studies, which will more accurately assess the true incidence in vulnerable populations. ⋯ We propose an initial strategic outline plan for interventions based on values that are suited to the problem and the setting, are culturally appropriate, and can be employed in a reasonable period of time for a sustained period to ensure success. Recommended action steps include promoting the use of alternative energy sources, encouraging an integrated approach to finding interdisciplinary solutions, devising a better system of kerosene containerization, re-engineering appliance designs, legislating for enforcement of health and safety standards, taking a holistic approach through government inter-departmental collaboration, formally discouraging corruption, encouraging ventilation of cooking or living areas, implementing building codes, educating consumers, and training caregivers and health and emergency workers.
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The multiple Y-V plasty is often used in the release of burn scar contracture bands. Although there are established views regarding its design, no attempts have yet been made to describe the mathematical principles upon which it is based. An understanding of the mathematics, however, should incur a greater ability to "fine tune" or "tailor" the outcome. ⋯ This equation illustrates that (a) neither the angles of the Ys nor the number of triangles in the design play a role in the ultimate length gained and (b) the distance of advancement of the individual triangular flaps is the sole determinant of final length.
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Review
Dental and skeletal changes during pressure garment use in facial burns: a systematic review.
Concern exists regarding the combined effect of the burn itself in addition to the continuous use of the pressure garments on craniofacial structures. The purpose of this systematic review was to evaluate the available evidence regarding dental and skeletal changes produced during pressure garment use in facial burns. ⋯ There is scarcity of studies reporting dentomaxillofacial effects after pressure garment use in facial burns. The level of evidence presented in these articles does not give support to any strong conclusion regarding the craniofacial effects of facial burn management.