Journal of burn care & research : official publication of the American Burn Association
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We conducted a systematic review of the literature to identify evidence to support the use of measures of depression for adults with burn injuries. Our goal was to be able to identify the most reliable, valid, and efficient means of identifying adults with symptoms of depression including major depressive disorder. We modified established guidelines for conducting systematic reviews by excluding measures that focused on distress or anxiety or only used depression as a predictor of interest. ⋯ Greater understanding of depression after burn injury can be gained by evaluating the existing general measures of depression and how they are used in the field of burn injury rehabilitation. The ultimate goal is to develop a set of recommendations for the standardization of how depressive symptomatology is assessed in this population. In this review, we highlight the deficiencies of validated measures of depression in the field of burn recovery and provide specific recommendations for both clinicians and researchers to advance our knowledge of depression following a burn injury, which will allow us to advance treatment.
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Frostbite injury in children can lead to abnormal growth and premature fusion of the epiphyseal cartilage with long-term sequela including, but not limited to, arthroses, deformity, and amputation of the phalanges. This was a retrospective chart review of pediatric frostbite identified in an in-house burn center registry from March 1999 to March 2014. Therapeutic management included negative pressure wound therapy (NPWT). ⋯ They presented within 24 hours after injury, underwent 5-6 days of NPWT after excision of blisters, and did not lose the distal portion of their digits, or require amputations. On follow-up, all hands were healed well with only minimal or no effect on the growth plate of these pediatric patients. In the early period after frostbite, NPWT may be beneficial in preserving the epiphyseal cartilage in children and preventing long-term complications.
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The modified Meek micrografting technique constitutes a rapid and efficient surgical approach for the skin coverage of extensive full-thickness burn injuries. A total of 10 burn patients (mean 68 ± 9.2% TBSA) admitted to our burn unit required one or more Meek micrografting procedures (mean 2.2 ± 0.5) to cover in average 43.4 ± 11.6% TBSA (range between 10 and 75% TBSA). This goal was achieved using a donor site area ranging between 2.5 and 18% TBSA. ⋯ The period to obtain stable definitive wound closure was in average of 67.2 ± 21 days post injury. The modified Meek micrografting provides a reliable and versatile method for the coverage of large burn wounds with limited autograft donor sites and is now routinely used in our institution. Its systematic use improves operating times and overall outcomes reducing the number of surgeries, increasing the percentage of graft take, and decreasing the length of stay.