Articles: burns.
-
Multicenter Study
Children under 4 years are at greater risk of mortality following acute burn injury: evidence from a national sample of 12,902 pediatric admissions.
It is important to have an accurate understanding of mortality risk in children to make sound treatment decisions and to advise parents and families. Several studies have found that children younger than 4 years are at greater risk for mortality from burn injury than older children, although other studies have found no difference. All of these studies, however, have been limited by small sample sizes from single burn centers. ⋯ Logistic regression analysis was used to assess age-related mortality risk. After adjusting for sex, burn size, inhalation injury, and type of burn (flame versus scald), the risk of mortality was substantially higher for children aged 0 to 1.9 years (odds ratio, 2.70; P<0.001) and for children aged 2.0 to 3.9 years (odds ratio, 2.00; P<0.01) as compared with children aged 4 years or older. This study provides strong evidence that when comparing children based on burn injuries of similar size and etiology, children younger than 4 years are at substantial risk for death as compared with older children.
-
Zhonghua Shao Shang Za Zhi · Aug 2006
Randomized Controlled Trial Multicenter Study[Analysis of the influence on the prognosis and safety of arginine in patients with severe trauma and burns--a multi-center randomized double blinded, placebo controlled, clinical trail in 86 patients].
To observe the influence on prognosis and possible side-effects of arginine in ⋯ Oral feeding of arginine is beneficial in enhancing wound healing, reduction of hospital stay days in severe trauma patients and with little side-effects, but it is not beneficial to improve the prognosis of severe burn patients. Maybe this is due to inadequate number of case involved in the study.
-
Critical care medicine · Jun 2006
Multicenter Study Comparative StudyEffect of blood transfusion on outcome after major burn injury: a multicenter study.
To delineate blood transfusion practices and outcomes in patients with major burn injury. ⋯ The number of transfusions received was associated with mortality and infectious episodes in patients with major burns even after factoring for indices of burn severity. The utilization of blood products in the treatment of major burn injury should be reserved for patients with a demonstrated physiologic need.
-
Randomized Controlled Trial Multicenter Study
Randomized clinical study of Hydrofiber dressing with silver or silver sulfadiazine in the management of partial-thickness burns.
This prospective, randomized study compared protocols of care using either AQUACEL Ag Hydrofiber (ConvaTec, a Bristol-Myers Squibb company, Skillman, NJ) dressing with silver (n = 42) or silver sulfadiazine (n = 42) for up to 21 days in the management of partial-thickness burns covering 5% to 40% body surface area (BSA). AQUACEL Ag dressing was associated with less pain and anxiety during dressing changes, less burning and stinging during wear, fewer dressing changes, less nursing time, and fewer procedural medications. Silver sulfadiazine was associated with greater flexibility and ease of movement. ⋯ The AQUACEL Ag dressing protocol tended to have lower total treatment costs (Dollars 1040 vs. Dollars 1180) and a greater rate of re-epithelialization (73.8% vs 60.0%), resulting in cost-effectiveness per burn healed of Dollars 1,409.06 for AQUACEL Ag dressing and Dollars 1,967.95 for silver sulfadiazine. A protocol of care with AQUACEL(R) Ag provided clinical and economic benefits compared with silver sulfadiazine in patients with partial-thickness burns.
-
Randomized Controlled Trial Multicenter Study
Cultured skin substitutes reduce requirements for harvesting of skin autograft for closure of excised, full-thickness burns.
Rapid and effective closure of full-thickness burn wounds remains a limiting factor in burns of greater than 50% of the total body surface area (TBSA). Hypothetically, cultured skin substitutes (CSS) consisting of autologous cultured keratinocytes and fibroblasts attached to collagen-based sponges may reduce requirements for donor skin, and morbidity from autograft harvesting and widely-meshed skin grafts. ⋯ These results demonstrate that CSS reduce requirements for donor skin harvesting for grafting of excised, full-thickness burns of greater than 50% TBSA with qualitative outcome that is comparable to meshed AG. Availability of CSS for treatment of extensive, deep burns may reduce time to wound closure, morbidity, and mortality in this patient population.