Burns : journal of the International Society for Burn Injuries
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Polyneuropathy is a debilitating condition which may be associated with large burns. The aim of this integrative review is to identify factors that contribute to the development of critical care polyneuropathy in patients admitted to an intensive care unit with a severe burn injury. PubMed, Scopus, CINHAL and EMBASE were searched up until July 2016. ⋯ Overall, factors identified as contributing to the development of critical care polyneuropathy in burn injured patients included prolonged ventilation (>7 days), large and deep total body surface area burns (mean TBSA 40%), and sepsis. Critical care polyneuropathy in burn patients remains challenging to diagnose and treat. To date, there is a lack of long term studies describing the impact of critical care polyneuropathy on functional performance or participation in activities of daily living in the burns population and this is consistent with the general literature addressing the lack of follow up assessments and long term consequences of persistent muscle weakness.
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Burn injury is common and depth is one measure of severity. Although the depth of burn injury is determined by many factors, the relationship between the temperature of the injurious agent and exposure duration, known as the time-temperature relationship, is widely accepted as one of the cornerstones of burn research. Moritz and Henriques first proposed this relationship in 1947 and their seminal work has been cited extensively. However, over the years, readers have misinterpreted their findings and incorporated misleading information about the time-temperature relationship into a wide range of industrial standards, burn prevention literature and medicolegal opinion. ⋯ Time-temperature relationships established for pain and superficial dermal burns in adult human skin have an extensive experimental modeling basis and reasonable clinical validation. However, time-temperature relationships for subdermal burns, full thickness burns and burn injury in children have limited clinical validation, being extrapolated from other data, and should be used with caution, particularly if presented during expert evidence.