Articles: burns.
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Multicenter Study
Considerations for the provision of psychosocial services for families following paediatric burn injury--a quantitative study.
The purpose of the study was to quantify and report levels of psychosocial distress in a sample of parents of burned children to inform evidence-based recommendations for psychosocial support programmes. This paper reports on the cross-sectional quantitative strand of a mixed-methodology study. Standardised instruments measuring anxiety, depression, family functioning, personality, child behaviour and social experience were administered to 72 parents at different points after burn. ⋯ Potential vulnerability markers for parental distress included lower emotional stability, younger age of mother and poorer family functioning. The wide range and high proportion of parents reporting clinically significant distress support the recommendation that screening should be a routine part of care. The relative importance of social factors over objective measurements of injury, such as TBSA, in explaining the observed levels of distress, supports the recommendation that routine assessment and a family-centred approach to the delivery of psychosocial support should be adopted and be offered to all parents, irrespective of the size of their child's burn.
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Acta chirurgiae plasticae · Jan 2008
Randomized Controlled Trial Multicenter StudyEnzymatic necrolysis of acute deep burns--report of preliminary results with 22 patients.
Enzymatic debridement by the use of a proteolytic enzyme complex derived, isolated and purified from pineapple stems proves to be an innovative, rapid, effective, selective and safe method of postburn necrotic skin removal. The major advantages of the procedure include minimal invasivity, rapidity, effectiveness, possibility to perform the debridement at the bedside, minimal or no loss of blood and minimal interference with natural wound healing processes. Our preliminary experience with this treatment method showed that in most of the cases treated the debridement was excellent, safe and rapid. ⋯ No serious adverse events or reactions have been observed during the study. The time for healing was comparable with the standard of care methods. The second randomized multicenter study is still in progress and has not yet been finished.
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Itching (pruritus) following burns is a well-known clinical problem. However, there are no long-term prospective studies that document the course and the extent of the problem. Studies on risk factors are anecdotal. ⋯ Itching remains a significant problem over a 2-year period. Individuals having undergone surgical procedures and experiencing early post-traumatic distress are more likely to suffer from long-term and persistent itching. Implications regarding practice and research are discussed.
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Multicenter Study
Positive fungal cultures in burn patients: a multicenter review.
Fungal infections are increasingly common in burn patients. We performed this study to determine the incidence and outcomes of fungal cultures in acutely burned patients. Members of the American Burn Association's Multicenter Trials Group were asked to review patients admitted during 2002-2003 who developed one or more cultures positive for fungal organisms. ⋯ Positive fungal cultures occur frequently in patients with large burns. The low mortality for untreated patients suggests that appropriate clinical judgment was used in most treatment decisions. Nonetheless, indications for treatment of fungal isolates in burn patients remain unclear, and should be developed.
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To describe the effectiveness of a community-based program targeting prevention of self-immolation. Suicide by burning is rare in developed countries (0.1-1.8% of all suicides), but more frequent in developing countries (up to 41% of all suicides). Self-immolation constitutes from 0.4% to 40% of admissions to burn centers worldwide. During 2001, an average of 11 Iranians committed suicide daily, 4 of these being self-immolations (36%). Self-immolation caused from 4% to 28% of all admissions to Iranian burn centers. Approximately 80% of hospitalized self-immolation patients die. All descriptive self-immolation studies in Iran emphasize the need for implementing prevention programs. ⋯ A community prevention program targeting self-immolation can be effective. Local data and the showing of videos depicting victim stories from self-immolation attempts provided a stimulus for community action.