Burns : journal of the International Society for Burn Injuries
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The objective of this study was to assess the quality of readily available evidence regarding critical care aspects of the management of patients with severe burn injuries. ⋯ There is very little high quality evidence to guide clinical practice in early management of the severely burnt patient. Eleven of 56 studies found in our search of critical care topics were of good methodological quality with low risk of bias.
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Review Comparative Study
Incidence of ventilator associated pneumonia in burn patients with inhalation injury treated with high frequency percussive ventilation versus volume control ventilation: A systematic review.
Pneumonia increases mortality in burn patients with inhalation injuries. We evaluated whether the use of High Frequency Percussive Ventilation (HFPV) in burn patients with inhalation injuries can decrease rates of Ventilator Associated Pneumonia (VAP) compared to Volume Control Ventilation (VCV). ⋯ Evidence about decreased incidence of VAP in burn patients with inhalation injuries who are on HFPV compared to those on VCV is inconclusive. Although enhanced airway clearance by HFPV was thought to play a role in decreasing VAP in this population, high tidal volume in the VCV arms could be a confounding factor that should be eliminated in future studies before a firm conclusion can be reached. More RCTs comparing HFPV to low tidal volume VCV are needed.
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According to the World Health Organization (WHO), burns result in more than 250,000 deaths and the loss of approximately 18 million disability adjusted life years (DALYs), more than 90% of which occur in low- and middle-income countries (LMICs), annually. This type of serious injury - one that is particularly devastating in LMICs - is preventable. To further explore the effectiveness of burn prevention strategies in LMICs, we performed a systematic review of the literature indexed in PubMed, EMBASE, Web of Science, Global Health, and the Cochrane Library databases as of October 2015. ⋯ Given that only 11 manuscripts are highlighted in this review, it is evident that original research is lacking. Further studies of preventative efforts tailored to populations in LMICs are needed. It is also essential that these studies be founded in population-based epidemiology and use meaningful end points, such as reductions in incidence, morbidity, and mortality.
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Review Case Reports
Treatment of cervical contractures utilising a closed platysmotomy like approach: Case report and review of the literature.
Contractures to the cervical region as a result of burns has the capacity to cause restrictions in range of movement, function of the lower face, cervical spine distortion and poor aesthetic outcomes that remain a surgical challenge. Consequently, physical and aesthetic deformities as a result of cervical contractures are reported to cause depression having implications for patients' quality of life and psychosocial wellbeing. ⋯ A closed platysmotomy approach for the treatment of cervical contractures is a less invasive technique. Further investigation is warranted to determine the feasibility of this reconstructive approach in the area of burn scar management.