The Journal of burn care & rehabilitation
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J Burn Care Rehabil · Jul 1999
Randomized Controlled Trial Clinical TrialThe search for cost-effective prevention of postoperative nausea and vomiting in the child undergoing reconstructive burn surgery: ondansetron versus dimenhydrinate.
Postoperative nausea and vomiting (PONV) is a common and unpleasant problem for children with burns who are undergoing reconstructive burn surgery. Ondansetron and dimenhydrinate have been found to be effective for the prevention of PONV in other patient populations, but they have not been directly compared in the pediatric population. A prospective, randomized, double-blind, placebo-controlled comparison of ondansetron and dimenhydrinate was performed. ⋯ The differences between ondansetron and dimenhydrinate were not significant. The average cost to our pharmacy for the prescribed dose of ondansetron was $19.34; the cost for dimenhydrinate was $0.90. In this patient population, dimenhydrinate was as effective as ondansetron for the prevention of PONV and postoperative vomiting, and it was much less expensive.
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J Burn Care Rehabil · May 1999
Randomized Controlled Trial Clinical TrialMassage in hypertrophic scars.
Various attempts have been made to intervene with the formation of hypertrophic scarring (HTS) or to ameliorate it once it has developed, but none have yet proved effective. Massage therapy is routinely used by therapists for the treatment of various conditions, and there have been reports of increased scar pliability and decreased scar banding with the use of massage. This study examines the use of friction massage over a 3-month period in a group of 30 pediatric patients with HTS. ⋯ A modified Vancouver Burn Scar Assessment Scale was used to measure the characteristics of the identified scars (10 cm by 10 cm) before and after the implementation of massage therapy. The study failed to demonstrate any appreciable effects of massage therapy on the vascularity, pliability, and height of the HTS studied, although there were reports of a decrease in pruritus in some patients. Further studies, with prolonged treatment intervals, are necessary to conclusively demonstrate the ineffectiveness of this therapy for HTS.
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J Burn Care Rehabil · Mar 1999
Randomized Controlled Trial Clinical TrialLorazepam given the night before surgery reduces preoperative anxiety in children undergoing reconstructive burn surgery.
A high level of preoperative anxiety frequently occurs in children undergoing reconstructive burn surgery. Reduction of this anxiety may have a number of physiological and psychological benefits. Various pharmaceutical and nonpharmaceutical regimens to reduce preoperative anxiety have been devised; however, most regimens are not initiated until the period immediately before surgery. ⋯ Postoperatively, patients rated their recall of anxiety with the use of the VAS. When queried preoperatively, patients who received lorazepam the night before surgery self-reported significantly less anxiety than those receiving placebo. Investigator observations did not detect this difference; this reinforces the assertion that patient self-rating of anxiety may be the best tool for rating anxiety.
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J Burn Care Rehabil · Nov 1998
Randomized Controlled Trial Clinical TrialA matched-pair, randomized study evaluating the efficacy and safety of Acticoat silver-coated dressing for the treatment of burn wounds.
A new silver-coating technology was developed to prevent wound adhesion, limit nosocomial infection, control bacterial growth, and facilitate burn wound care through a silver-coated dressing material. For the purposes of this article, Acticoat (Westaim Biomedical Inc, Fort Saskatchawan, Alberta, Canada) silver-coated dressing was used. After in vitro and in vivo studies, a randomized, prospective clinical study was performed to assess the efficacy and ease of use of Acticoat dressing as compared with the efficacy and ease of our institution's standard burn wound care. ⋯ The frequency of burn wound sepsis (> 10(5) organisms per gram of tissue) was less in Acticoat-treated wounds than in those treated with silver nitrate (5 vs 16). Secondary bacteremias arising from infected burn wounds were also less frequent with Acticoat than with silver nitrate-treated wounds (1 vs 5). Acticoat dressing offers a new form of dressing for the burn wound, but it requires further investigation with greater numbers of patients in a larger number of centers and in different phases of burn wound care.
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J Burn Care Rehabil · Jul 1998
Randomized Controlled Trial Comparative Study Clinical TrialProspective, randomized study of the efficacy of Mepitel on children with partial-thickness scalds.
We performed a randomized clinical trial in which children with partial-thickness scald burns of less than 15% total body surface area were assigned treatment with either Mepitel (Mölnlycke Health Care) or silver sulfadiazine. Data were collected on time to wound healing, pain at dressing change, infection, and resource use. Student's t and chi-square tests were used to determine differences in the two groups. ⋯ They also had significantly lower mean daily hospital charges ($1937 vs $2316; p = 0.025); as well as significantly lower charges for dressing changes and narcotics. There was no significant difference in wound infection. We believe the use of Mepitel represents a significant advance in the treatment of partial-thickness scald wounds in children.