Journal of burn care & research : official publication of the American Burn Association
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Comparative Study
The Effect of Illicit Drug Use on Outcomes Following Burn Injury.
Illicit drug use is common among patients admitted following burn injury. The authors sought to evaluate whether drug abuse results in worse outcomes. The National Burn Repository (NBR) was queried for data on all patients with drug testing results available. ⋯ After propensity score weighting, drug use did not affect mortality, hospital LOS, or duration of ventilator support, but did increase the average ICU LOS by 1.2 days (P = .001). Drug use does not affect mortality, hospital LOS, or duration of ventilator support among burned patients. After controlling for burn size, age, mechanism of injury, and gender, patients with a positive drug screen had an average increase in ICU LOS by 1 day.
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After sustaining burn injuries overseas, U. K. Armed Forces personnel are evacuated to the Royal Centre for Defence Medicine. ⋯ The number of accidental noncombat burns remained constant. The decrease in combat burns may reflect a relative decrease in military intensity and effective protective equipment and safety measures. Further education may allow for an additional decrease in preventable burn injuries.
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Many deep partial thickness burns require more than 3 weeks to heal resulting in disfiguring and dysfunctional scarring. Early excision of the eschar has been shown to improve outcomes in deep burns; however, the optimal timing of the excision remains controversial. We compared wound healing and scarring of deep partial thickness burns that were excised at different time points in a porcine model. ⋯ Scar depth and percentage wound contraction were also similar among the wounds excised at 2, 4, and 7 days (4.4 ± 1.1 mm vs 3.9 ± 1.1 mm vs 4.1 ± 1.2 mm and 52.9 ± 17.9% vs 52.6 ± 15.6% vs 52.5 ± 13.8%, respectively). Timing of eschar excision (at 2, 4, or 7 days) does not affect the rates of re-epithelialization and scarring in a deep partial thickness porcine burn model. Timing of eschar excision may not change outcomes if performed within the first 2 to 7 days after injury.
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Burn scar contractures remain a common source of severe disability in resource-limited countries. However, existing outcome measurements are unable to fully capture the impact of the scar contracture and surgical attempts at correction. To that end, we have developed a new outcome instrument, the Stanford-ReSurge Burn Scar Contracture Scale-Upper Extremity that can be used as a measurement of disability and reconstructive procedure outcomes. ⋯ Patients who underwent burn scar contracture release of the upper extremity showed an average of 14 points improvement between the preoperative and 1-month postoperative time point. The Stanford-ReSurge Burn Scar Contracture showed clinical utility for assessing outcomes in burn scar contracture release of the upper extremity. Our goal is to develop a standardized outcome instrument for burn reconstruction in the world's poorest burn patients.
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Many burn survivors experience social challenges throughout their recovery. Measuring the social impact of a burn injury is important to identify opportunities for interventions. The aim of this study is to develop a pool of items addressing the social impact of burn injuries in adults to create a self-reported computerized adaptive test based on item response theory. ⋯ This study was designed to develop a large item pool based on a strong conceptual framework using grounded theory analysis with focus groups of burn survivors and their caregivers. The 192 items represent 7 domains and reflect the unique experience of burn survivors within these important areas of social participation. This work will lead to developing the Life Impact Burn Recovery Evaluation profile, a self-reported outcome measure.