Burns : journal of the International Society for Burn Injuries
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Multicenter Study Comparative Study
A new, fast LDI for assessment of burns: A multi-centre clinical evaluation.
Laser Doppler imaging (LDI) provides early accurate determination of wound healing potential. LDI can scan large areas of up to 2500 cm2 within 2 min. This duration may require additional sedation in a mobile, uncooperative child. In five burn centres a faster Laser Doppler Line Scanner (LDLS) was assessed. This new imager scans 300 cm2 in 4s with potential benefit for patients and operators. The aim of this study was to assess the accuracy and convenience of the LDLS and to compare this with an established LDI imager. ⋯ The high accuracy of the new line-scan imager was comparable to that of the traditional LDI. Its size and mobility enabled easier ward and outpatient use. The higher scan speed was particularly beneficial for scans in paediatric patients.
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School reintegration programmes provide support to both children absent from school as a result of a serious health problem and their teachers, but little is known regarding their efficacy, or the impact of the situation on teachers. This qualitative study explored the experience of primary school teachers who were involved in a school reintegration programme, following a burn injury to a child in their class. Data was collected using semi-structured interviews with four primary school teachers. ⋯ The findings indicated that participants were positive regarding the programme, but detailed aspects which could be improved, for example better communication before the child's return. They discussed their fears and concerns, including a strong need to protect the child from further harm. Implications of this study include the need to provide adequate support to teachers in similar positions, and further develop school reintegration programmes to best facilitate the child's return to school.
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Keloids and hypertrophic scars occur anywhere from 30 to 90% of patients, and are characterized by pathologically excessive dermal fibrosis and aberrant wound healing. Both entities have different clinical and histochemical characteristics, and unfortunately still represent a great challenge for clinicians due to lack of efficacious treatments. ⋯ While we wait for these translational clinical products to be marketed, however, it is imperative to know the basics of the currently existing wide array of strategies to deal with excessive scars: from the classical corticotherapy, to the most recent botulinum toxin and lasers. The main aim of this review paper is to offer a useful up-to-date guideline to prevent and treat keloids and hypertrophic scars.
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Review Case Reports
Pseudoangiosarcomatous squamous cell carcinoma developing on a burn scar: A case report and review of the literature.
Pseudoangiosarcomatous squamous cell carcinoma, also known as pseudovascular, pseudovascular adenoid and pseudoangiomatous squamous cell carcinoma, is an exceedingly rare, aggressive variant of cutaneous squamous cell carcinoma with extreme acantholysis resulting in angiosarcoma-like areas. Histologically, a pseudoangiosarcomatous pattern includes complex anastomosing channels and spaces lined with neoplastic cells. ⋯ This case report describes pseudoangiosarcomatous squamous cell carcinoma developing on a burn scar on the ankle. In this report, we emphasize the importance of establishing a diagnosis with histological and immunohistochemical examination, and we review the described incidence of the age and sites with the prognosis for the treatment of pseudoangiosarcomatous squamous cell carcinoma of the skin.
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Randomized Controlled Trial
Clonidine for reduction of hemodynamic and psychological effects of S+ ketamine anesthesia for dressing changes in patients with major burns: An RCT.
Clonidine has anesthetic-sparing properties and it may reduce the hemodynamic and psychological effects of S+ ketamine. The objectives of this study were to evaluate the interactions between clonidine and ketamine in hemodynamic and the psychological effects. Psychological effects were evaluated in a very detailed way. ⋯ Clonidine in S+ ketamine plus midazolam anesthesia reduces the arterial pressures and the postoperative psychological effects.