Journal of burn care & research : official publication of the American Burn Association
-
Severe burn injury has been shown to result in hypophosphatemia. Hypophosphatemia can cause cardiac, hematologic, immunologic, and neuromuscular dysfunction. This study compares serum phosphate levels and outcomes in patients who were administered a continuous, preemptive phosphate repletion protocol vs those who only received phosphate supplementation after they developed hypophosphatemia. ⋯ Continuous, pre-emptive repletion of phosphate prevents hypophosphatemia after severe burn injury when compared with responsive repletion in historical controls. The protocol resulted in less hypophosphatemia without increasing the risk of hyperphosphatemia. This study also suggests that continuous repletion may result in fewer complications, but this needs to be confirmed in larger, prospective studies.
-
One of the dramatic consequences of burns is scar contracture and deformities of the neck. Cervical contracture in children is especially dangerous, leading to face disfigurement and kyphosis; therefore, early reconstruction is indicated. Despite the existence of many various surgical techniques, the successful neck contracture treatment in pediatric patients remains a challenge for surgeons. ⋯ The flaps continued to grow and the skin grafts shrinkage was moderate. Local trapeze-flap plasty allows neck contracture elimination in children in the cases when a more complex technique is impossible or undesirable to use. Early surgical intervention prevents secondary complications, allotting enough time for patients to mature and be ready for more complex procedures.
-
This study sought to identify which commonly experienced burn-related issues parents/caregivers of burn-injured youth deemed most stressful, difficult, and disruptive during their child's initial acute burn care hospitalization, and following the child's discharge. Parents completed an 11-item survey, asking them to rate the difficulty of items regarding their child's burn injury. The scale was created by burn doctors, nurses, and psychologists with an average of 10.5 (SD ± 4.8) years of experience. ⋯ The other two items found to be "very hard" or "pretty hard" were the time spent away from their other children, and feelings of hopelessness in being unable to fix everything for their child. In this study, key parental problems occurred during the child's initial hospitalization. Burn staff cannot alleviate all problems, however, staff education regarding distressing problems faced by parents, as well as possible solutions, can be made available.
-
The purposes of this study were to translate the brief version of the Burn-Specific Health Scale (BSHS-B) into traditional Chinese (Taiwanese) and to evaluate its psychometric properties to measure quality of life of injured in Taiwan. The BSHS-B-Taiwanese was translated and reviewed by an expert committee. Patients were invited to participate in this study while they visited the outpatient burn clinic. ⋯ The discriminant validity of the BSHS-B-Taiwanese was demonstrated by significant score differences in several domains between subgroups of different severity regarding length of hospital stay and TBSA. Our finding suggests that the BSHS-Taiwanese is generally reliable and valid. A shorter version of BSHS-B-Taiwanese together with a generic instrument, such as SF-36, can be used to measure the quality of life of injured in Taiwan.
-
Randomized Controlled Trial Comparative Study
Prospective randomized controlled trial comparing two methods of securing skin grafts using negative pressure wound therapy: vacuum-assisted closure and gauze suction.
Negative pressure wound therapy (NPWT) has revolutionized the management of complicated wounds and has contributed an additional modality for securing split thickness skin grafts (STSG). The standard for NPWT is the vacuum-assisted closure (VAC) device. The authors' institution has accumulated experience using standard gauze sealed with an occlusive dressing and wall suction (GSUC) as their primary mode for NPWT. ⋯ The mean percent take in the GSUC group was 96.12% vs 96.21% in the VAC arm (P = .98). The use of NPWT in securing STSG is a useful method to promote adherence and healing. This study demonstrates that a low-cost, readily accessible system utilizing gauze dressings and wall suction (GSUC) results in comparable skin graft take in comparison to the VAC device.