Burns : journal of the International Society for Burn Injuries
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The standard of care for deep burns is autologous split thickness skin grafting. Although adequate to resurface a deep wound, the resulting skin is chronically abnormal. The purpose of this study was to describe the experience of patients with split thickness skin grafts to help guide future investigations related to skin regeneration. ⋯ Eight male patients and four female patients 20-62 years old ranging 2-29 months post-skin grafting were enrolled in the study. The most significant concerns voiced by patients were identified and organized into five themes: (1) a new normal, (2) split thickness skin graft symptoms, (3) appearance of new skin, (4) coping, and (5) participation in future clinical trials. Participants reported that the abnormalities related to their split thickness skin grafts were significant enough that they would be willing to participate in a future clinical trial investigating new cell-based therapies.
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Traditional wound dressings, including cotton gauze, absorbent pads and bandages, can cause trauma and pain to wounds during dressing changes, leading to a variety of physical and psychosocial sequelae. The aim of this study was to adapt an in vitro model of adherence to evaluate the effects of various methods to theoretically reduce the adherence of wound dressings. Gelatin in liquid form was cast onto poly(ethylene terephthalate) (PET) fabric and allowed to solidify and progressively dry to simulate wound desiccation in the clinical setting. ⋯ As a long-term strategy for decreasing adherence, a thin layer of polyacrylamide (PAM) hydrogel was deposited onto PET fabric via UV irradiation. This resulted in a much lower peeling energy without severely compromising fabric flexibility. This hydrogel layer could also serve as a reservoir for bioactive and antimicrobial agents which could be sustainably released to create a microbe-free microenvironment for optimized wound healing.
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Response to the 2010 Haitian earthquake included an array of diverse yet critical actions. This paper will briefly review the evacuation of a small group of patients with burns to burn centers in the southeastern United States (US). This particular evacuation brought together for the first time plans, groups, and organizations that had previously only exercised this process. ⋯ The patient population with burns being evacuated from Haiti was very small compared to the overall operation. Nevertheless, the outcomes included a better understanding of how a larger event could challenge the limited resources for all involved. This paper includes aspects of the patient movement, the logistics needed, and briefly discusses reimbursement for the care provided.
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More than three-quarters of deaths related to major burns are a consequence of infection, which is frequently ventilator associated pneumonia (VAP). A retrospective study was performed, over a five-year period, of ventilated children with major burns. 92 patients were included in the study; their mean age was 3.5 years and their mean total body surface area burn was 30%. 62% of the patients sustained flame burns, and 31% scalds. The mean ICU stay was 10.6 days (range 2-61 days) and the mean ventilation time was 8.4 days (range 2-45 days). ⋯ Streptococcus pneumonia, Pseudomonas aeruginosa, Acinetobacter baumanii and Staphylococcus aureus were the most prominent aetiological organisms. Broncho-alveolar lavage was found to be more specific and sensitive at identifying the organism than other methods. This study highlights the importance of implementing strictly enforced strategies for the prevention, detection and management of pneumonia in the presence of major burns.