Burns : journal of the International Society for Burn Injuries
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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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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(®).
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Current methods of assessing burn depth are limited and are primarily based on visual assessments by burn surgeons. This technique has been shown to have only 60% accuracy and a more accurate, simple, noninvasive method is needed to determine burn wound depth. Forward-looking infrared (FLIR) thermography is both noninvasive and user-friendly with the potential to rapidly assess burn depth. The purpose of this paper is to determine if early changes in burn temperature (first 3 days) can be a predictor of burn depth as assessed by vertical scarring 28 days after injury. ⋯ FLIR imaging is a fast and simple tool that has been shown to predict burn wound outcome in a porcine vertical injury progression model. Data showed that more severe burn wounds get cooler between 1 and 2 days after burn. We found four analytic methods of FLIR images that were predictive of burn progression at 1 and 2 days after burn; however, temperature minima 2 days after burn appeared to be the best predictive test for injury progression to a full-thickness burn. Although these results must be validated in clinical studies, FLIR imaging has the potential to aid clinicians in assessing burn severity and thereby assisting in burn wound management.
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Objective scar assessment tools were designed to help identify problematic scars and direct clinical management. Their use has been restricted by their measurement of a single scar property and the bulky size of equipment. The Scarbase Duo(®) was designed to assess both trans-epidermal water loss (TEWL) and colour of a burn scar whilst being compact and easy to use. ⋯ The Scarbase Duo(®) TEWL function had excellent correlation with the Dermalab(®) (r=0.93) whilst the colorimetry erythema value had moderate correlation with the Minolta Chromameter (r=0.72). The Scarbase Duo(®) is a reliable and objective scar assessment tool, which is specifically designed for burn scars. However, for clinical use, standardised measurement conditions are recommended.