Annals of burns and fire disasters
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Ann Burns Fire Disasters · Mar 2014
ReviewImprovement of survival in patients with extensive burns involving the perineum with use of a faecal management system.
The purpose of this study is to assess the effectiveness of faecal management systems in improving survival of patients with extensive burns involving the perineum. All adults with burns of more than 30% total body surface area (TBSA) who were actively treated in our regional burn service between December 2008 and July 2012 were reviewed and compared to an historical cohort of 18 adult patients with similar injury involving the perineum, treated in our regional burn service between 1999 and 2001. For the last five years, faecal management systems (FMS) have been in use for patients with extensive burns involving the perineum. ⋯ No significant complications were reported in relation to the use of FMS. FMS allows faecal diversion, reduced perineal soiling and improved personal hygiene. We believe this allows easier management of these difficult injuries, may reduce the incidence of sepsis and improves survival.
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Ann Burns Fire Disasters · Mar 2014
ReviewIntegra™ in burns reconstruction: Our experience and report of an unusual immunological reaction.
Limited availability of autologous donor sites poses significant challenges for soft-tissue reconstruction in severe and complex burns. Integra™ is a bi-layered dermal regeneration template (DRT) which has played a significant role in soft tissue reconstruction since its initial use for full-thickness burn defects. The purpose of this study is to report our institutional experience of Integra™ in burns management over a 4-year period and highlight an unusual reaction to its second application. ⋯ The main advantage of Integra™ is its immediate availability in unlimited quantities for soft-tissue reconstruction in major and complex burns. The main drawbacks are financial implications, twostage procedure, complex wound care and risk of infection. We believe that Integra™ can be considered as a promising modality in burns management.
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Burns from domestic irons are potentially preventable injuries which can result in significant morbidity. Several studies have reported these injuries in children but there are no reports to date in adults. Epidemiology, management and outcome of these injuries is described, and possible preventative strategies are discussed. ⋯ Burns from domestic irons are relatively common and cause significant morbidity despite their small size. A bimodal presentation is seen with injuries occurring either before the age of 4 years or during adulthood, when they are typically associated with an underlying medical condition. Education campaigns and design features such as a retractable cord may further reduce the incidence of this type of burn.
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Ann Burns Fire Disasters · Sep 2013
ReviewThe properties of the "ideal" donor site dressing: results of a worldwide online survey.
Split skin grafting is a widely used technique for reconstructing skin defects. Although a vast number of different coverage options for donor sites have become available in daily clinical practice, no optimum dressing material has been found to date. For this reason, we conducted a globally-distributed online survey to poll for the properties of such an "ideal" donor site dressing, possibly leading to an improved clinically-driven direction of future wound dressing developments. ⋯ The majority of respondents also denied the current availability of an "ideal" donor site dressing (49/69, 71%). The strength of this study was the remarkable geographic distribution of responses; all parts of the world were included and participated. We believe that this globally conducted online survey has polled for the properties of the "ideal" donor site dressing and possibly will lead to an improved clinically-driven direction of future wound dressing development.
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Ann Burns Fire Disasters · Sep 2013
ReviewOpen burn wound dressing: a practical option in resource constrained settings.
Various types of wound care products abound for the treatment of burn injuries. Most of these products are rather expensive and beyond the means of many patients in poorer countries. This poses a challenge to burn care workers in these environments and calls for the adoption of practical solutions with the use of less expensive and readily available alternatives. ⋯ The TBSA range was 1 to 99% with a median of 28.5%. The mean duration from time of injury to wound healing was 21.5 days with a median of 17 days. Open burn wound dressing with silver sulphadiazine offers a satisfactory outcome and should be considered for burn dressing in low resource settings.