Burns : journal of the International Society for Burn Injuries
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Integra Artificial Skin, a biosynthetic dermal template, is well established in acute burn surgery. The aim of the study was to determine the role of Integra in the surgical treatment of postburn scars in a younger population. Between March 1998 and November 2004, 17 patients (n=17; mean age=13.15 years) underwent complete excision of hypertrophic scars or keloids (1-4% TBSA; extremities=47%, head/neck=35%, trunk=18%) with subsequent implantation of Integra for defect closure. ⋯ Functional and cosmetic long-term outcome showed results scored "excellent" in 53%, "good" in 36%, and "fair" in 11%. Comparison of pre- and postoperative findings revealed a significant functional improvement in all and a considerable cosmetic improvement in all but two patients. These results suggest that Integra is a valid new treatment modality for extensive burn scar revision in younger patients.
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This study aims to demonstrate the epidemiologic characteristics of outpatient burn injuries in Tehran. This cross-sectional study was performed over a 1-year period in a referral burn centre in Tehran and included all outpatient burns. The required data were recorded by two trained physicians. ⋯ Significant association was present between the aetiology and depth of burn (P<0.001). The mean affected total body surface area (TBSA) was 3.16+/-2.92% and there was significant association between burnt TBSA and the mechanism of injury (P<0.001). In conclusion, it seems that women aged 21-30 years and children younger than 10 years are at greater risk of these injuries and therefore should be the target for preventive strategies.
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Resistance of Pseudomonas aeruginosa strains to the broad-spectrum cephalosporins may be mediated by the extended-spectrum beta-lactamases (ESBLs). These enzymes are encoded by different genes located on either chromosomes or plasmids. This study aimed to investigate the prevalence of ESBLs and antimicrobial susceptibilities of P. aeruginosa isolated from burn patients in Tehran, Iran. ⋯ The results revealed that 148 (87.05%) of the isolates were multidrug resistant and 67 (39.41%) of the isolates were ESBL positive. Fifty (74.62%), 33 (49.25%) and 21 (31.34%) strains among 67 ESBL-producing strains amplified blaOXA-10, blaPER-1 and blaVEB-1 respectively. In conclusion, the high prevalence of multidrug resistance (87.05%) and production of OXA-10, PER-1 and VEB-1 genes in P. aeruginosa isolates in burn patients confirm that protocols considering these issues should be considered in burn hospitals.
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The ABLS course sponsored by the ABA has not yet been made available in Japan, although it is strongly desired. During the 3 years between 2006 and 2008, authorized ABLS provider courses were given once a year in Japan as part of preparations to reach an agreement between the ABA and the JSBI for the continuation of ABLS provider courses in Japan. These courses were provided as one of the programs available at the annual meeting of the JSBI. ⋯ Regarding the organization of future ABLS courses in Japan, the active involvement of the JSBI is inevitable. Several areas of the ABLS course content may need to be revised to accommodate differences in standard medical treatment between the United States and Japan. A joint effort between the ABA and the JSBI regarding appropriate curriculum changes to accommodate societal differences as well as modifications to some sections would increase the applicability of the course in Japan.
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Following a burn, the wound may become colonized and septic complications may ensue. Many organisms, commonly isolated from burn wounds produce biofilms, which are defined as a collection of organisms on a surface surrounded by a matrix. Biofilms are associated with development of antibiotic resistant organisms and are refractory to the immune system. The presence of biofilm in the burn wound has not been documented. ⋯ The finding of biofilm in the burn wound has significance in our understanding of burn wound sepsis and supports the evidence for early excision and closure of the burn wound. Due to the recalcitrant nature of biofilm associated sepsis and the difficulty in disrupting biofilm it has implications for the future development of wound care dressings.