Articles: burns.
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Randomized Controlled Trial Multicenter Study
A multicenter clinical trial of recombinant human GM-CSF hydrogel for the treatment of deep second-degree burns.
Wound healing is a complex and dynamic biological process. The efficacy and safety of a recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) hydrogel to promote deep-second-degree burn wound healing is evaluated in this study. In this multicenter, randomized, double-blind, and placebo-controlled clinical trial, 90 patients with deep second-degree burns were randomly assigned into two groups. ⋯ A statistically significant difference was noted at each time point (p<0.01). No side effects were observed. These results suggest that rhGM-CSF hydrogel can significantly accelerate deep second-degree burn wound healing and is considered to be safe.
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Multicenter Study
Epidemiology of burn injuries presenting to North Carolina emergency departments in 2006-2007.
Approximately 600,000 burns present to Emergency Departments each year in the United States, yet there is little systematic or evidence-based training of Emergency Physicians in acute burn management. We retrospectively accessed the North Carolina Disease Event Tracking and Epidemiologic Collection Tool (NC DETECT) database to identify all thermal burns and electrical injuries with associated thermal burns presenting to 92% of North Carolina Emergency Departments over a 1-year period. ⋯ This is the first state-wide study of burn injury and identifies Emergency Physicians as the major providers of acute burn care. Ninety-two percent of 10,501 burn visits, including the majority of severe injuries, were managed exclusively by Emergency Physicians. This supports a need for improved, evidence-based training of Emergency Physicians in the acute management of burns of all types.
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Multicenter Study
The effect of burn center and burn center volume on the mortality of burned adults--an analysis of the data in the National Burn Repository.
Regional variations of care, and improved outcomes with larger volumes, have been well described in the medical and surgical literature for a variety of conditions including heart surgery, vascular surgery, and orthopedic surgery. Burn care has not been recently subjected to such an analysis. The National Burn Repository (NBR) contains de-identified patient and burn center data to allow this analysis. ⋯ Mortality does not linearly improve with burn center volume and plateaus with increasing burn center size. The optimal burn center size is a complicated and contentious question. Future discussions about burn center size and density should incorporate not only mortality but also the region's ability to absorb surges in volume, and the optimal "staffing" ratios for the multidisciplinary aspects of burn care.
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Multicenter Study
Telemedicine evaluation of acute burns is accurate and cost-effective.
As the number of US burn centers has declined, access to burn care is increasingly limited. Inexperience in burn wound assessment by referring physicians often results in overtriage or undertriage. In an effort to improve access to burn care in our region, we instituted a program of telemedicine evaluation of acute burns. ⋯ Acute evaluation of burn patients can be performed accurately by telemedicine. This can reduce undertriage or overtriage for air transport, improve resource utilization, and both enhance and extend burn center expertise to many rural communities at low cost.
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Multicenter Study
Burns surgery handover study: trainees' assessment of current practice in the British Isles.
Effective handover of clinical information between working shifts is essential for patient safety. The aim of this study was to identify current practice and trainees' assessment of handover in the burns units of the British Isles. ⋯ Effective handover remains a keystone in safe and effective communication between doctors. The study highlights areas for improvement in handover practice, including greater involvement of an integrated multidisciplinary team. Those working under the "surgeon of the week" pattern are more satisfied.