Burns : journal of the International Society for Burn Injuries
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MRSA is an on-going problem for burn patients. ⋯ The negative impact of MRSA positivity on burn patients outcome indicates the need for improved screening procedures for early identification and further efforts toward MRSA infection control to prevent cross-infection as this may significantly impair patients' outcome.
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Outcomes after burn have continued to improve over the last 70 years in all age groups including the elderly. However, concerns have been raised that survival gains have not been to the same magnitude in elderly patients compared to younger age groups. The aims of this study were to analyze the recent outcomes of elderly burn injured patients admitted to the Birmingham Burn Centre, compare data with a historical cohort and published data from other burn centres worldwide. ⋯ Mortality has improved in all burn size groups, but differences were highly statistically significant in the medium burn size group (10-20% TBSA, p≤0.001). Burn outcomes in the elderly have improved over the last decade. This reduction has been impacted by a reduction in overall injury severity but is also likely due to general improvements in burn care, improved infrastructure, implementation of clinical guidelines and increased multi-disciplinary support, including Geriatric physicians.
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Stem cell therapy has been introduced as a new and promising modality of wound covering in recent decade. It has been used for improvement of burn wound, post burn scar and saving stasis zone of burn with good results. However, there have been some differences between the various experimental burn wound trials in stem cell source, therapeutic dose, delivery method and timing of stem cell delivery. In our study, we aimed to review stem cell biology and investigate discrepancies in animal trials of use of stem cells in burn wound account for the variation in, stem cell source, therapeutic dose, delivery method and timing of stem cell delivery.
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Burn and other major injuries often impair survivors' capacity to work. We investigated predictors for not returning to work by six months after acute burn. Differences in demographic, clinical and psychiatric characteristics between burn patients returning to work and those not were examined. ⋯ Majority of the burn patients working at baseline returned to work by six months. Capacity to work after burn is predicted by both smaller %TBSA burned and lack of diagnosable mental disorders, particularly delirium or MDD, after burn.
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Complications following paediatric burns are well documented and care needs to be taken to ensure the appropriate follow up of these patients. Historically this has meant follow up into adulthood however this is often not necessary. The centralisation of burns services in the UK means that patients and their parents may have to travel significant distances to receive this follow up care. ⋯ There was also a significant financial benefit for the service as the follow up clinics were on average 50% cheaper with burns outreach than burns physician. Burns outreach is a feasible service that not only benefits the patients but also is cheaper for the burns service. The optimum length of follow up for paediatric burns in 18 months, after which if there have not been any complications they can be discharged.