Burns : journal of the International Society for Burn Injuries
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Ocular and cutaneous disease are common chronic sequelae of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) and have been well described in the literature. Long-term complications affecting other organ systems have not been so well described. The purpose of this review article is to highlight non-ocular and non-cutaneous chronic complications of SJS/TEN. ⋯ SJS/TEN is a multi-organ disease requiring multidisciplinary care from a variety of specialists. Affected patients have complex hospital stays, and their quality of life may be severely impacted by multiple long-term complications. We believe that preventative care in the acute setting might limit the development and progression of many of the sequelae described above.
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Standardised Mortality Ratio (SMR) based on generic mortality predicting models is an established quality indicator in critical care. Burn-specific mortality models are preferred for the comparison among patients with burns as their predictive value is better. The aim was to assess whether the sum of age (years) and percentage total body surface area burned (which constitutes the Baux score) is acceptable in comparison to other more complex models, and to find out if data collected from a separate burn centre are sufficient for SMR based quality assessment. ⋯ The analysis suggests that SMR based on the Baux score is eligible as an indicator of quality for setting standards of mortality in burn care. More advanced modelling only marginally improves the predictive value. The SMR can detect mortality differences in data from a single centre.
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Randomized Controlled Trial
Effects of community-based exercise in children with severe burns: A randomized trial.
To counteract long-lasting muscle break down, muscle weakness, and poor physical fitness resulting from severe burns, we recommend a 12-week in-hospital exercise training rehabilitation program. Unfortunately, this in-hospital training program requires time away from home, family, school or work. This study was undertaken to evaluate an alternative exercise rehabilitation strategy involving a 12-week community-based exercise training rehabilitation program (COMBEX) carried out at or near the patient and caretaker's home. ⋯ Both EX and COMBEX are efficacious in improving lean mass, strength, and cardiopulmonary capacity in severely burned children.
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Pressure therapy garments apply pressure to suppress the growth and flatten hypertrophic scars caused by serious burns. The amount of pressure given by the pressure garments is critical to the treatment adherence and outcomes. In the present study, a biomechanical model for simulating the pressure magnitudes and distribution over hand dorsum given by a pressure glove was developed by using finite element method. ⋯ Through validation, the simulated contact pressure showed a good agreement with the experimental interface pressure measurement. The simulation model can be used to predict and visualise the pressure distribution exerted by a pressure therapy glove onto hand dorsum. It can provide information for optimising the material mechanical properties in pressure garment design and development, give a clue to understand the mechanisms of pressure action on hypertrophic scars and ultimately improve the medical functions of pressure garment.
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Since opening its doors in 1962, the Parkland Burn Center has played an important role in improving the care of burned children through basic and clinical research while also sponsoring community prevention programs. The aim of our study was to retrospectively analyze the characteristics and outcomes of pediatric burns at a single institution over 35 years. ⋯ Over 35 years in North Texas, the median burn size and incidence of pediatric burn admissions has decreased. Concomitantly, length of stay and mortality have also decreased.