Journal of burn care & research : official publication of the American Burn Association
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Burns to the upper extremity and axilla frequently result in the formation of contractures that can impede shoulder range of motion. The purpose of this study was to determine the long-term effects of upper extremity burn scar contracture release on motion during activities of daily living in the first year postrelease. Upper extremity motion analysis was conducted on children aged 4 to 17 years before and 1, 3, 6, and 12 months after axillary contracture release surgery. ⋯ Improvements were maintained for 1 year after surgery with majority of the improvement involving shoulder flexion. Axillary contracture release surgery improves functional shoulder mobility and decreases compensatory motions used during activities of daily living in the first year postrelease. Additional follow-up is needed to evaluate the impact of growth on scar development.
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Randomized Controlled Trial
Effects of fluid resuscitation methods on burn trauma-induced oxidative stress.
The aim of the study was to analyze the oxidative stress response after severe burn injury. We studied the effect of two methods of fluid resuscitation regimes on the oxidative stress reaction. Sixteen patients were involved in the study. ⋯ Plasma malondialdehyde level (P<.05 vs control population), reactive oxygen species production in whole blood (P<.05 vs control population), and catalase activity were elevated, whereas glutathione, plasma sulfhydryl groups level (P<.05 vs control population), and superoxide dismutase enzyme activity lowered in both groups. Our results confirmed that burn injury induces pronounced oxidative stress. The main finding is that fluid resuscitation regimes have different impact on prooxidant status, mainly on the granulocyte function but not on the changes in endogenous antioxidants in burned patients.
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More than 1 million burn injuries occur in the United States each year and as many as half of these injuries require medical treatment. Most data used to describe burns are from national databases derived from random or purposive samples of injuries. Few studies describe burn rates within a state. ⋯ Scald burns were the most common etiology. The mortality rate was 0.4%. The results of this study and future studies using this methodology may be used to identify populations at increased risk for burns and to target burn prevention and outreach medical education more appropriately.
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Acute respiratory distress syndrome (ARDS) remains a challenging disease leading to increased mortality in burn patients, and inhalation injury may contribute to the development of severe ARDS. Extracorporeal life support (ECLS) provides a method of gas exchange while allowing time for lung recovery in the setting of early, severe ARDS. Recent study suggests that a selected population of patients with severe ARDS may benefit from ECLS, especially if initiated early. ⋯ The patient was discharged home on hospital day 50 on room air. ECLS aids innate lung recovery by allowing time for the diminution of high peak inspiratory pressures, prevention of barotrauma, and ultimately mitigating ventilator-induced lung injury. ECLS should be considered early as a viable supportive modality after inhalational injury in patients failing advanced ARDS management strategies.