Journal of burn care & research : official publication of the American Burn Association
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Comparative Study
The effect of hand burns on quality of life in children.
There is limited data regarding the long-term outcomes for children with hand burns. The objective of this study was to prospectively document recovery after burn injury using a validated health outcomes burn questionnaire for infants, children, and adolescents. A single center prospective study was conducted on consecutive children aged 0 to 4 years and 5 to 18 years comparing outcomes between children with and without hand burns. ⋯ Despite severe injury, children with hand burns have continued improvement in quality of life for at least 2 years after injury. The presence of a hand burn in the context of large TBSA burn is a marker of more severe acute illness and predicts increased resource utilization. Rehabilitative efforts after upper extremity injury should continue to target both physical function and the psychosocial impact of burn injury.
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Burns are preventable injuries, and prevention campaigns have been conducted with varying success. To develop successful prevention programs, it is imperative that burn risk be identified and factors associated with increased risk elucidated. The aims of this study were to determine the risk of burn injury to Utah residents, identify demographic and geographic subgroups at increased risk, and to examine sociodemographic factors associated with risk. ⋯ The counties were predominantly rural and tended to have higher rates of American-Indian populations, increased poverty levels, lower percentages of individuals with high school degrees, and lower employment rates. The characteristics of these high-risk counties do not imply causality, and further research is warranted to determine whether these factors contribute to burn risk. The results of this study provide the foundation for future research and prevention programs targeted toward populations and geographic areas with the greatest risk of burn injury.
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Clinically, the initial blanching in burn scar seen on transparent plastic face mask application seems to diminish with time and movement requiring mask alteration. To date, studies quantifying perfusion with prolonged mask use do not exist. This study used laser Doppler imaging (LDI) to assess perfusion through the transparent face mask and movement in subjects with and without burn over time. ⋯ Changing facial expressions with the mask on did not alter perfusion. Hyperemic response occurs on removal of the mask. This study exposed methodology and statistical issues worth considering when conducting future research with the face, pressure therapy, and with LDI technology.
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Impairment and burn injury outcomes are often influenced by an intermingling of physical and psychosocial factors. We hypothesized that patients without insurance would be more likely to return home. We also believed that patients with inadequate social support would be less likely to return home. ⋯ In contrast, our uninsured group has significantly higher FIM scores, and also tends to be younger in age. Physical predictors of disposition include TBSA of injury, age, sex, and presence of inhalation injury. Our study illustrates that social support and access to insurance are important variables that predict outcome and disposition.
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Historically, it has been difficult to provide adequate humidification delivery with the high frequency percussive ventilator (HFPV) used in many burn centers. It is possible burn centers have avoided using HFPV because of the risk of mucus plugging, dried secretions, and cast formation. Experiences with HFPV provided doubt that the HFPV ventilator circuit could supply adequate humidification to patients receiving this mode of ventilation. ⋯ The new device called the Hydrate Omni (Hydrate, Inc., Midlothian, VA) uses a small ceramic disk to provide fine water particles delivered by a pump to the HFPV circuit. This new device may alleviate previous concerns related to the delivery of adequate humidification with the HFPV. This case report was approved by the University of North Carolina School of Medicine Institutional Review Board.