Articles: burns.
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Multicenter Study
The epidemiology of burns in secondary care, in a population of 2.6 million people.
The numbers of residents of the four counties in the west of Anglia and Oxford Region (UK) who were treated for burns (including scalds) in accident and emergency (A&E) departments or admitted to hospital in 1994-95 were obtained from A&E departments and district health authority records. Burns comprised about 1 per cent of the workload in the A&E departments. ⋯ Approximately half the patients admitted to hospital with burns were admitted to burns units, a quarter to plastic surgery wards and the rest to different specialties including trauma and orthopaedics, paediatrics, and ophthalmology. The median length of stay was 6 days for burns units and 3 days for plastic surgery units.
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One hundred and twenty-seven patients were studied prospectively for aerobic, anaerobic and fungal burn wound infections. All cases yielded organisms on culture. A total of 377 isolates were recovered (239 aerobes, 116 anaerobes and 22 fungi). ⋯ Seventeen patients presented with septic shock, 15 of them (88.2%) yielding positive anaerobic cultures. Bacteroides sp. were isolated from 14 patients with septic shock, and were recovered from the four patients who had anaerobic infection alone. These results indicate a significant role of Bacteroides sp. in burn wound sepsis.
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Multicenter Study Comparative Study Clinical Trial
Burn injuries, pain and distress: exploring the role of stress symptomatology.
Forty-three consecutive patients were assessed for post-traumatic stress 7 days after admission to hospital. Patients were asked to complete the Impact-of-Event Scale. ⋯ A Visual Analog Thermometer was employed to measure the pain experienced at rest and during therapeutic procedures. High levels of post-traumatic stress were associated with higher pain scores during therapeutic procedures and more pain when at rest.
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J Burn Care Rehabil · Jan 1997
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialA multicenter clinical trial of a biosynthetic skin replacement, Dermagraft-TC, compared with cryopreserved human cadaver skin for temporary coverage of excised burn wounds.
This multicenter study compared the use of a biosynthetic human skin substitute with frozen human cadaver allograft for the temporary closure of excised burn wounds. Dermagraft-TC (Advanced Tissue Sciences, Inc.) (DG-TC) consists of a synthetic material onto which human neonatal fibroblasts are cultured. Burn wounds in 66 patients with a mean age of 36 years and a mean burn size of 44% total body surface area (28% total body surface area full-thickness) were surgically excised. ⋯ DG-TC was equivalent or superior to allograft with regard to autograft take at postautograft day 14. DG-TC was also easier to remove, had no epidermal slough, and resulted in less bleeding than did allograft while maintaining an adequate wound bed. Overall satisfaction was better with DG-TC.
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J Burn Care Rehabil · Mar 1996
Multicenter Study Clinical Trial Controlled Clinical TrialClinical evaluation of an acellular allograft dermal matrix in full-thickness burns.
A multicenter clinical study assessed the ability of an acellular allograft dermal matrix to function as a permanent dermal transplant in full-thickness and deep partial-thickness burns. The study consisted of a pilot phase (24 patients) to identify the optimum protocol and a study phase (43 patients) to evaluate graft performance. Each patient had both a test and a mirror-image or contiguous control site. ⋯ Fourteen-day take rates of the dermal matrix were statistically equivalent to the control autografts. Histology of the dermal matrix showed fibroblast infiltration, neovascularization, and neoepithelialization without evidence of rejection. Wound assessment over time showed that thin split-thickness autografts plus allograft dermal matrix were equivalent to thicker split-thickness autografts.