Burns : journal of the International Society for Burn Injuries
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Case Reports
3D-printed transparent facemasks in the treatment of facial hypertrophic scars of young children with burns.
Facial burns could create serious scar problems resulting disfigurement particularly on children. The conventional methods of producing transparent face masks for scar control remains complex and require dexterous skills of experienced clinician and patients' compliance during fitting. In this study, we adopted a portable 3D scanning and Computer-Aided Design (CAD) to produce 3D-printed transparent facemasks. Its efficacy was tested on two children with facial burns resulting hypertrophic scars. ⋯ 3D-printed transparent facemask is convenient and efficient to fabricate, and is suitable for treating pediatric facial hypertrophic scars after burn.
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Pain Scrambler therapy is a patient-specific electrocutaneous nerve stimulation device. Burn pruritus is a common form of chronic and disabling neuropathic pain that is often difficult to treat effectively. Pruritus is mediated by histamines, which are effector molecules stored in mast cells and released locally during injury or inflammation. Burn pruritus may be accompanied by peripheral neuropathic pain, which may result from injury to sensory nerves that hampers conductance of neuronal messages along the large A and small C afferent fibers to the spinal cord. In this study, we investigated the effect of pain Scrambler therapy on burn scar pruritus. ⋯ Scrambler therapy is a non-invasive, non-medicinal modality that significantly reduced burn-associated pruritus. Scrambler therapy should be considered as a treatment option for burn survivors with severe pruritus.
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Descriptions of burns as the presenting features of underlying neurological pathology are very rare, with only two previously published case reports available. Both of these reports featured meningioma as the pre-existing pathology and both described burn excision and wound healing, prior to surgical tumour ablation. The authors describe the case of a 35-year-old female, who presented with 25% total body surface area burns and recent global neurological deterioration. ⋯ Burn excision and skin grafting was carried out successfully, two weeks later. This case differs from the previous two reported cases, which both described burn excision, as a pre-requisite to neurosurgery. This case establishes that the presence of a burn wound is not a total contra-indication to intracranial surgery.
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Comparative Study
Comparison between high-frequency ultrasonography and histological assessment reveals weak correlation for measurements of scar tissue thickness.
Current methods for evaluating scar tissue volume following burns have shortcomings. The Vancouver Burn Scar scale is subjective, leading to a high variability in assessment. Although histological assessment via punch biopsy can discriminate between the different layers of skin, such an approach is invasive, inefficient, and detrimental to patient experience and wound healing. This study investigates the accuracy of high-frequency ultrasonography, a non-invasive alternative to histology, for measuring dermal and epidermal thickness in scar tissue. ⋯ Measurements of scar thickness using high-frequency ultrasonography did not recapitulate the in vivo dermal, epidermal and total thickness. Based on these findings, strategies for further optimization of 2-D ultrasonography is discussed before clinical and research use.
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Damage to the peripheral nervous system influences wound healing and, after a deep burn, imperfect cutaneous nerve regeneration occurs. A third-degree burn model was developed in rats combined with the use of resiniferatoxin (RTX), known to promote sensory neuropathy. ⋯ Our study confirms the important roles of innervation during skin healing and the defect of nerve regeneration after burn.