Journal of pediatric surgery
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Randomized Controlled Trial Comparative Study
Incision and drainage of subcutaneous abscesses without the use of packing.
The classic intervention for subcutaneous abscesses is incision and drainage followed by wound packing. This is thought to aid hemostasis, and prevent reorganization of the abscess. Removal of packing material may be painful and anxiety provoking. We sought to determine whether packing could be omitted with equal efficacy. ⋯ Incision and drainage of subcutaneous abscesses without the use of packing is a safe and effective technique. This approach omits a traditional, but painful and anxiety provoking, component of therapy.
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Randomized Controlled Trial Comparative Study
Oral ketamine and midazolam for pediatric burn patients: a prospective, randomized, double-blind study.
The aim of this study was to compare the efficacy of oral midazolam and ketamine with oral midazolam, acetaminophen, and codeine in providing sedation and analgesia for wound care procedures in children with burns. ⋯ The combination of oral midazolam and ketamine provides better analgesia than the combination of midazolam, acetaminophen, and codeine for painful procedures in burned children.
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Randomized Controlled Trial
Psychological and behavioral effects of chloral hydrate in day-case pediatric surgery: a randomized, observer-blinded study.
This prospective, randomized, and observer-blinded study was performed to evaluate the effects of oral chloral hydrate on perioperative psychological and behavioral phenomena in children. ⋯ Decreasing preoperative anxiety with oral chloral hydrate improves induction compliance and reduces postoperative pain intensity without delaying recovery in young boys. However, chloral hydrate had little impact on emergence delirium and postoperative maladaptive behavior.
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Randomized Controlled Trial Comparative Study
Topical silver sulfadiazine vs collagenase ointment for the treatment of partial thickness burns in children: a prospective randomized trial.
The 2 most commonly used topical agents for partial thickness burns are silver sulfadiazine (SSD) and collagenase ointment (CO). Silver sulfadiazine holds antibacterial properties, and eschar separation occurs naturally. Collagenase ointment is an enzyme that cleaves denatured collagen facilitating separation but has no antibacterial properties. Currently, there are no prospective comparative data in children for these 2 agents. Therefore, we conducted a prospective randomized trial. ⋯ There are no differences in outcomes between topical SSD or CO in the management of childhood burns results.
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Randomized Controlled Trial Comparative Study
Evaluation of a new pediatric intraosseous needle insertion device for low-resource settings.
The Near Needle Holder (NNH) (Near Manufacturing, Camrose, Alberta, Canada) is a reusable tool to introduce a standard hollow needle for pediatric intraosseous (IO) infusion. We compared the NNH to the Cook Dieckmann (Cook Critical Care, Bloomington, IN) manual IO needle in a simulation setting. ⋯ After training, all subjects successfully inserted the NNH IO device in a simulation environment, and most rated it as easy to use and safe. The NNH is a significant advance because IO needles are often not available in emergency departments in developing countries. Further studies are needed to evaluate clinical effectiveness of the NNH.