Burns : journal of the International Society for Burn Injuries
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This study was carried out in the critical care area of a burn unit. The mortality of burn patients was studied over three periods: 1971-83; 1984-87; 1988-91. The first period was studied retrospectively, the more recent periods were studied prospectively. ⋯ We believe that the observed mortality reduction was due to these reasons. Using logistic regression a predictive mortality equation was obtained with three risk factors: age, total body surface area burned and burn depth. We are now able to obtain a mortality score soon after the patient is admitted to the unit.
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To document the risk of catheter sepsis associated with central venous catheter changes every 7 days in paediatric burn patients, and analysis of data collected prospectively on 234 such catheters was performed. During an 18-month period there were 301 acutely burned children admitted to a regional paediatric burn facility of whom 53, with an average burn size of 42 per cent TBSA, required 234 central venous catheters. A central venous catheter management protocol was followed which included catheter changes every 7 days. ⋯ There was no difference in sepsis rates between catheters placed at a new site or replaced by guidewire. There were no deaths attributed to catheter-related sepsis. We conclude that a protocol allowing for catheter change to a new site, or replacement by guidewire, every 7 days was associated with a low risk of catheter sepsis in paediatric burn patients.
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Comparative Study Clinical Trial Controlled Clinical Trial
Advantages of early burn excision and grafting in the treatment of burn injuries of the anterior cervical region.
Excision and grafting in deep partial and full skin thickness burns of the anterior cervical region in a series of 40 patients treated between 1982 and 1992 is reported. The advantages of surgical management of deep burns in this region in a single staged operation have proved its efficacy compared to the severe sequelae which appear when the standard conservation treatment is used. A comparative study of two groups of patients treated either by early excision and grafting (n = 19/40), or by delayed excision and grafting (n = 21/40) demonstrated the advantages of elective early excision and grafting with respect to: length of hospital care, complications and their severity, and surgical repair.
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This study describes the burn injuries and characteristics of patients admitted to the major adult burn unit in New South Wales, Australia. Data were collected from the medical records of all patients admitted in the 30-month study period (184 persons, 143 (78 per cent) males, 41 (22 per cent) females). The findings identified that patients were most likely to be males, aged between 25 and 34 years, who experienced a 11-20 per cent total surface burn area flame injury whilst using an accelerant in a domestic environment. ⋯ Prevention appears to be the most effective way to reduce burn injury through education of at-risk groups. However, because of the multicausality identified in the study, other preventive measures, such as improvement in product safety design, are suggested. Some similarities and differences with studies reported from Australia and overseas are noted.
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One hundred and seventy-six patients aged 65 years and above, treated in Bangour Burns Unit during a 10-year period between 1982 and 1991 were studied in detail. Annual number of burn cases treated as inpatients in the South East of Scotland, within or outwith the Bangour burns unit, and all deaths due to burns, during the period from 1975 to 1991, among the estimated population were analysed to assess the trend in incidence and rates of burns in elderly persons in the community.