Journal of burn care & research : official publication of the American Burn Association
-
In 2015, 68,085 firefighters suffered work-related injury, according to estimates from the U. S. Fire Administration. ⋯ The NBR does not capture the full scope of firefighter injuries, likely due to issues with reporting, data extraction, and firefighters seeking burn care at facilities without dedicated burn centers. Firefighters have unique considerations when it comes to planning return to work in a high-heat environment after thermal injury. Firefighters should have access to burn centers when seeking treatment for burn injury.
-
Comparative Study
Burn Scar Evaluation Using the Cutometer® MPA 580 in Comparison to "Patient and Observer Scar Assessment Scale" and "Vancouver Scar Scale".
The effect of the "Patient and Observer Scar Assessment Scale" (POSAS) and "Vancouver Scar Scale" (VSS) on patients' quality of life and their correlation with objective scar assessment tools, such as the Cutometer®, is not fully elucidated. In addition, long-term results of the dermal substitute Matriderm® used in combination with split-thickness skin grafting (STSG) remain unclear. We evaluated burn scars of 45 patients at least 2 years postburn injury using the Cutometer® MPA 580, the VSS, and the POSAS with three additional questions regarding quality of life and correlated the results. ⋯ There was a significant correlation between POSAS and VSS, quality of life and the objective Cutometer® measurements. Conservatively treated superficial dermal burns do not reach the elastic qualities of healthy skin, and the use of Matriderm® significantly improves the long-term elastic qualities of STSG in deep dermal and full-thickness burns 2 years post injury. Results from the VSS and the POSAS correlate with restrictions in the quality of life of patients and also with objective Cutometer® measurements and are therefore useful tools in scar evaluation following burn injury.
-
Air ambulances rapidly transport burn patients to regional centers, expediting treatment. However, limited guidelines on transport introduce the risk for inappropriate triage and overuse. Given the additional costs of air vs ground transport, evaluation of transportation use is prudent. ⋯ Independent predictors of emergent procedures included transport for airway concern (odds ratio = 45.29, confidence interval = 2.49-825.21, P = .010) and % TBSA (odds ratio = 1.13, confidence interval = 1.02-1.27, P = .019). If the 23 inappropriately triaged patients had been transported by ground, a cost savings of $106,370 could have been realized using 2016 California Medicare reimbursements (per-patient savings of $4624). While appropriate in most circumstances, the cost of air ambulances should be weighed in light of their utility, as a significant proportion of patients did not benefit from air transport.
-
Marjolin's ulcer is an aggressive disease arising in chronic wounds and cutaneous scars. Corbo et al define Marjolin's ulcer an often overlooked or misdiagnosed tumor. We report a case of Marjolin's ulcer arose in a burn scar of a 51-year-old man who sustained a burn in childhood. ⋯ Histological examination confirmed a well-differentiated squamous cell carcinoma. Burn scars are the most commonly associated with these tumors, but other lesions may initiate this malignant transformation. The most common type of tumor reported in a Marjolin's ulcer is squamous cell carcinoma, but Pavlovic et al reported other malignancies.