Burns : journal of the International Society for Burn Injuries
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To describe the epidemiology of pediatric burn patients seen in U.S. emergency departments (EDs) and to determine factors associated with inter-facility transfer. ⋯ Over 90% of pediatric burn ED patients meet ABA burn referral criteria but are not transferred from low volume hospitals. Perhaps a portion of the 92% of patients currently receiving definitive care in low volume hospitals are under-referred and would have improved clinical outcomes if transferred at the time of presentation.
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In reconstructive burn surgery full thickness skin grafts (FTSGs) are frequently preferred over split thickness skin grafts because they are known to provide superior esthetic results and less contraction. However, the contraction rate of FTSGs on the long term has never been studied. ⋯ FTSGs showed a significant reduction in surface area, followed by a relaxation phase, but remained significantly smaller. Furthermore, the trunk should be preferred as donor site location over the extremities.
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Case Reports
Second-degree burns with six etiologies treated with autologous noncultured cell-spray grafting.
Partial and deep partial-thickness burn wounds present a difficult diagnosis and prognosis that makes the planning for a conservative treatment versus mesh grafting problematic. A non-invasive treatment strategy avoiding mesh grafting is often chosen by practitioners based on their clinical and empirical evidence. However, a delayed re-epithelialization after conservative treatment may extend the patient's hospitalization period, increase the risk of infection, and lead to poor functional and aesthetic outcome. ⋯ The treatment results with autologous non-cultured cells, support rapid, uncomplicated re-epithelialization with aesthetically and functionally satisfying outcomes. Hospital stays averaged 7.6±1.6 days. Early autologous cell-spray grafting does not preclude or prevent simultaneous or subsequent traditional mesh autografting when indicated on defined areas of full-thickness injury.
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Bioimpedance spectroscopy (BIS) is a tool utilized in health care to investigate body composition and fluid distribution. Limited research has addressed the clinical use of BIS in burns. This study aimed to examine the effects of silver dressings on BIS measurements in burns patients. ⋯ There were significant interactions between dressing condition, %TBSA and body mass, whereby the difference in ECF, ICF and TBW between the ND and AD conditions were increased as %TBSA and body mass increased. Algorithms were developed subsequently to adjust BIS outputs for use when AD is in place. Clinician's may continue to use BIS in real-time using the predictive algorithms established during this study.
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The objective of this study was to evaluate (1) the effect of 4-hexylresorcinol (4HR) application on TNF-α expression in RAW264.7 cells and (2) the effect of 4HR ointment on burn wound healing in a rat burn wound model. ⋯ 4HR reduced TNF-α expression in RAW264.7 cells and in the burn wounds of rats. Burn wounds dressed with ointment containing 4HR also exhibited rapid epithelization and collagen regeneration.