Burns : journal of the International Society for Burn Injuries
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Although burn is a highly traumatic experience, little has been reported on the perception of the individual burn patient in the Chinese cultural context. For developing more culturally sensitive rehabilitation strategies for burn survivors, the present study was conducted to elucidate their perceived changes and to construct a theoretical model of their subjective experience and coping strategies. ⋯ The findings of the present study suggested that burn survivors encountered such challenges as "unexpected suffering," "culture-related stigma," "perceived social rejection," and "constructing a new identity." Limited and inappropriate coping strategies may hinder the effective rehabilitation of burn survivors. In addition, burns must be understood in the social-cultural context to develop effective coping strategies for reintegration into society.
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To attenuate burn-induced catabolism, patients are often enrolled in a resistance exercise program as part of their physical rehabilitation. This study assessed how lower body burn locations affected strength and cardiopulmonary function. ⋯ Physical function and performance are detrimentally affected by burns that traverse specific lower body joints. The most significant relationship on exercise performance was that of hip joint burns as it affected both strength and cardiopulmonary measurements. Ultimately, burns at hip and toe joints need to be considered when interpreting exercise test results involving the lower body.
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Currently, the only evidence-based adjunct to clinical evaluation of burn depth is laser Doppler imaging (LDI), although preliminary studies of alternative imaging modalities with instant image acquisition are promising. This is a study to investigate the accuracy of infrared thermography (IRT) and spectrophotometric intracutaneous analysis (SIA) for burn depth assessment, and compare this to the current gold standard: LDI. We include a comparison of the three modalities in terms of cost, reliability and usability. ⋯ FLIR E60 and Scanoskin™ both present advantages to moorLDI2-BI-VR in terms of cost, ease-of-use and acceptability to patients. IRT is unlikely to challenge LDI as the gold standard as it is subject to the systematic bias of evaporative cooling. At present, the LDI colour-coded palette is the easiest method for image interpretation, whereas Scanoskin™ monochrome colour-palettes are more difficult to interpret. However the additional analyses of pigment available using SIA may help more accurately indicate the depth of burn compared with perfusion alone. We suggest development of Scanoskin™ software to include a simplified colour-palette similar to LDI and additional work to further investigate the potential of SIA as an alternative to the current gold standard.
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Vascularity and pigmentation are two important indicators of the maturing status of hypertrophic scars. We used the dermoscope to measure vascularity and pigmentation of hypertrophic scars to examine its validity and reliability. ⋯ The dermoscope is a promising objective tool for vascularity and pigmentation assessments of hypertrophic scars with good validity and reliability.
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Comparative Study
Dermoscopic insight into skin microcirculation - Burn depth assessment.
To investigate the effectiveness of dermoscopic observation of skin microcirculation, the dermal capillary integrity of burn wounds was evaluated by dermoscopy according to a proposed algorithm that is designed to distinguish burn wounds between superficial dermal burns: SDB, and deep dermal burns: DDB. As the gold standard for comparison, two widely accepted endpoints of primary healing within 21 days (SDB) or over 21 days after injury (DDB) were used. A number of dermatologists conducted diagnostic imaging by dermoscopy. ⋯ Dermoscopy measurements were significantly more accurate than clinical assessment (p<0.05). The recognition of dots increased for NPD, vessels were most clearly observed under PCD and colours tended to be more distinctly recognized under polarized light. Dermoscopy is a useful and simple tool to evaluate not only epidermal and superficial dermal skin components but also the skin microcirculation.