Burns : journal of the International Society for Burn Injuries
-
Pressure garment therapy (PGT) is an established treatment for the prevention and treatment of hypertrophic scarring; however, there is limited evidence for its effectiveness. Burn survivors often experience multiple issues many of which are not adequately captured in current PGT trial measures. To assess the effectiveness of PGT it is important to understand what outcomes matter to patients and to consider whether patient-reported outcome measures (PROMs) can be used to ascertain the effect of treatments on patients' health-related quality of life. This study aimed to (a) understand the priorities and perspectives of adult burns patients and the parents of burns patients who have experienced PGT via in-depth qualitative data, and (b) compare these with the concepts captured within burn-specific PROMs. ⋯ The outcome domains presented reflect a complex holistic patient experience of scar management and treatments such as PGT. Some currently available PROMs do capture the concepts described here, although none assess psychological adjustments and attainment of a sense of normality following burn injury. The routine use of PROMs that represent patient experience and their relative contribution to trial outcome assessment versus clinical measures is now a matter for further research and debate.
-
Once-daily aminoglycoside dosing (ODA) is used in most patient populations to optimize antibacterial activity and reduce toxicity. Unfortunately, burn patients are excluded from ODA due to concerns over altered pharmacokinetics resulting in a shortened half-life and low peak aminoglycoside concentrations. Retrospective studies suggest that ODA may be appropriate if higher milligram/kilogram doses are used. However, no prospective clinical trials in burn patients exist to confirm these findings. ⋯ Burn patients with adequate renal function and <20% TBSA are candidates for ODA. Tobramycin half-life was similar to healthy, non-burn patients. The larger than normal volume of distribution supports the use of the higher empiric dose of 10mg/kg total body or adjusted weight in non-obese and obese patients, respectively, with further dose adjustment based on therapeutic drug monitoring.
-
New technologies in the field of burn wound and scar assessment are continually being evaluated. Accurate estimation of total body surface area (TBSA) burn wound is of paramount importance in fluid resuscitation to prevent complications which are associated with morbidity and mortality. Estimating the TBSA is performed by a multitude of different methods, however a gold standard would be ideal. The aim of this study was to compare the estimation of burned TBSA% between 3D photography by Panasonic FZ-M1 Toughpad in conjunction with WoundCare Lite software and expert opinion volunteered by burns doctors. ⋯ This study has demonstrated that the wound mapping software WoundCare Lite in conjunction with the Panasonic FZ-M1 Toughpad 3D camera compares well with expert opinion in determining burn surface area on a mannequin. Further research is needed to establish whether this is the case in burns on patients in an acute setting.
-
Burns are a very painful skin injury, or injury of soft tissues. The development of post-traumatic stress disorder can develop, even in those with minor injuries (Ia-IIb degree). Development of problems is very rapid and intense since, according to developmental embryology, the skin and central nervous system (CNS) descend from the same germ layer-ectoderm. ⋯ The time of the first application of the ACU treatment after burn was followed and evaluated with a random set. The best results were achieved when the first ACU treatment was applied as soon as possible after BT injury (ideally immediately, optimally within 48h). The positive effect of ACU on burns is medical, economical and biopsychosocial.
-
Corneal alkali burns are a severe disease and commonly encountered in the emergent clinic. A rapid medical treatment for the burn is very important. Gly-thymosin β4 (Gly-Tβ4) is a biomimic derivative of natural thymosin β4. The aim of this study is to evaluate the corneal recovery effects of Gly-Tβ4 topical therapy on alkali burns in rabbit corneas. ⋯ Gly-Tβ4 solutions are a promising formulation for topical treatment of corneal alkali burns.