Burns : journal of the International Society for Burn Injuries
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Case Reports
A new flap design for release of parallel contracture bands: Dual opposing five-flap z-plasty.
Skin contractures secondary to burn and other types of trauma can be encountered on almost every part of human body, best addressed by a custom treatment protocol tailored for each patient. Skin graft, local flap as well as distant flap options are available, each with intrinsic advantages and disadvantages. In the presence of weblike contracture the utilization of local tissue, when available, is a prefered approach for a relatively better appearance through a reasonably simpler surgical intervention, compared to skin graft applications and distant flap options. Among many other techniques and modalities utilized for this purpose, the dual opposing five-flap z-plasty method which is a novel method designed as a modification of the paired five-flap z-plasty technique promises to be a useful treatment option for the release of parallel contracture bands with satisfactory results in selected patients.
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Observational Study
The impact of inhalation injury in patients with small and moderate burns.
Inhalation injury is an independent risk factor of mortality in burn patients. The burn index (BI), which includes burn depth and size, also plays a role in predicting mortality. We aimed to establish a relationship between survival rate, inhalation injury, and BI. ⋯ Inhalation injuries significantly reduced the survival rate, especially when the BI was less than 50. The possibility of pulmonary dysfunction and complications arising from inhalation injury should be considered even in patients who have small cutaneous burns associated with inhalation injuries.
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Pseudomonas aeruginosa is resistant to many antibiotics due to production of different classes of extended spectrum β-lactamases (ESBLs). Prevalence of ESBLs among P. aeruginosa has been increased in recent years, demonstrate a serious health problem especially in burn units worldwide. ⋯ The rate of ESBL producing P. aeruginosa was notable in present study. Since there are only limited effective antibiotics against the bacterium, therefore all isolates must be investigated by antimicrobial susceptibility testing, which limits resistance development in burn units and helps the management of treatment strategy.
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This was a novel, prospective and interventional animal study designed to develop and evaluate a new infliction device for the experimental burn model. Four paired sets of contact burns measuring 36mm diameter were inflicted on the dorsum of an anesthetized pig using a stainless steel round bar heated up to 80-110°C. The bar was applied using a push-pull force gauge designed to control 1kgf mechanical force applied to the skin for a period of 20s. ⋯ The results found the depth of injury to the collagen (Seg1) correlated with the temperature (Ti) at which the burns was inflicted, Seg1=0.038Ti-2.57 (r=0.973, P<0.05). Also, the histological studies show a high correlation between the depth of collagen denaturation in wounds and the exposure temperature, Seg1=0.0268Ti-0.165 (r=0.991, P<0.05). This model is useful to assess more closely the therapeutic agents used for wound healing in experimental burn wounds.
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The aim of this study was to approximate the direct health care costs of fire-related injuries in inpatient care in Finland. Using the PERFECT costing method, cost data from both Finnish burn centres were linked to the fire-related injury patient data from the Finnish National Hospital Discharge Register (FHDR, 2001-2009). Additionally, a sample of 168 patients from the Helsinki Burn Centre was linked to the FHDR to examine the relation of %TBSA. ⋯ Approximately 7-8% of the most expensive cases constitute 50% of the total costs. Successful prevention of extreme cases would yield considerable savings in relation to total annual inpatient care costs. However, a cost-benefit analysis would be needed.