Burns : journal of the International Society for Burn Injuries
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The objective of this review was to systematically examine whether there is clinical evidence to support recommendations for positioning patients with acute burn. Review of the literature revealed minimal evidence-based practice regarding the positioning of burn patients in the acute and intermediate phases of recovery. This manuscript describes recommendations based on the limited evidence found in the literature as well as the expert opinion of burn rehabilitation specialists. These positioning recommendations are designed to guide those rehabilitation professionals who treat burn survivors during their acute hospitalization and are intended to assist in the understanding and development of effective positioning regimens.
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Review Case Reports
Epidermal exfoliation of over 95% after a burn in an 18-month-old boy: Case report and review of the literature.
This report concerns an 18-month-old boy who presented with a 6% total body surface area scald. The subject of this report is unique in that he developed the largest exfoliation described in literature. After 3 days an epidermal exfoliation with the appearance of a deliberately inflicted scald developed. ⋯ The few reports published are all case reports and most frequently described visually infected burns with smaller epidermal exfoliations, and clinically based exfoliation diagnosis. S. aureus often cause burn wound infections that can lead to complications caused by cross-infection. It is important for burn surgeons and intensive care specialists to be aware of the increased possibility of Staphylococcal scalded skin syndrome occurring in patients who have a reduced barrier to infection such as burn patients and also, that the diagnosis can be difficult to make.
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The provision and practice of burn care changed dramatically during the latter half of the 20th century. Historically, indicators of outcomes that were employed were survival and length of hospital stay, but these have now been expanded with increased data capture. ⋯ The multiple domains covered by the term "patient outcome" aim to optimize the acute and long-term management of burn patients and have shifted the focus onto lifelong outcomes, rather than short-term gains. This review will investigate the current outcome measures employed in burn care in the UK, how this leads to commissioning and regulation of a burn service, and influences the future direction of travel.
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To develop a mathematical model of predicting mortality based on the admission characteristics of 6220 burn cases. ⋯ A mathematical model based on logistic regression and SVM could be used to predict the survival prognosis according to the admission characteristics.
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Randomized Controlled Trial
A prospective clinical trial comparing Biobrane(®) Dressilk(®) and PolyMem(®) dressings on partial-thickness skin graft donor sites.
In a single-center, prospective, randomized clinical trial three different configured wound dressings Biobrane(®), Dressilk(®) and PolyMem(®) were compared with each other regarding objective and subjective healing parameters and cost efficiency. ⋯ The "ideal" wound dressing maximizes patients' comfort while reducing pain and the risk of pulling off migrating epidermal cells from the wound surface. In addition reliable wound status evaluation (minimizing complications), an increase of treatment cost value efficacy, and reduced hospitalization rates should be provided. Dressilk(®) and Biobrane(®) were favored by patients and surgeons for providing an effective and safe healing environment, with overall low complication rates with respect to infection and exudation. Regarding cost-effectiveness PolyMem(®) and Dressilk(®) presented superior to Biobrane(®).