Burns : journal of the International Society for Burn Injuries
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Randomized Controlled Trial
The effects of massage and music on pain, anxiety and relaxation in burn patients: Randomized controlled clinical trial.
The aim of this study was to evaluate the effects of massage and music on pain intensity, anxiety intensity and relaxation level in burn patients. ⋯ Our results revealed that music, massage and a combination of both interventions were effective on reducing pain and anxiety intensity and increasing relaxation level. Due to easy, low-cost and availability of the interventions applied, these complementary therapies are suggested for the burn patients. Although application of a single complementary therapy is cost-effective, further studies are required to determine the most effective and cost-effective method to improve the burn care.
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The lack of autograft donor site is one of the greatest limiting factors for the treatment of extensive burn. Micrografting is an important revolution in burn surgery where autografts are cut into small pieces for wide and rapid coverage of burn wound. Our early experiences with the current standard micrografting technique were fraught with poor graft take as well being time and labor intensive. ⋯ Micrografting remains an important treatment for major burn surgery. The aim of micro-allograft combination is to allow autografts re-epithelization under a reliable temporary skin coverage in a single stage procedure. A prospective study is warranted to measure the objective outcome of this renewed technique.
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In hypertrophic scar assessment, laser Doppler imaging (LDI), colorimetry and subjective assessment (POSAS) can be used to evaluate blood flow, erythema and redness, respectively. In addition, the microvasculature (i.e. presence of microvessels) can be determined by immunohistochemistry. These measurement techniques are frequently used in clinical practice and/or in research to evaluate treatment response and monitor scar development. However, until now it has not been tested to what extent the outcomes of these techniques are associated, whilst the outcome terms are frequently used interchangeably or replaced by the umbrella term 'vascularization'. This is confusing, as every technique seems to measure a specific feature. Therefore, we evaluated the correlations of the four measurement techniques. ⋯ Blood flow, the presence of microvessels and erythema appear to be different hypertrophic scar features because they show an absence of correlation. Therefore, in the field of scar assessment, these outcome terms cannot be used interchangeably. In addition, we conclude that the term 'vascularization' does not seem appropriate to serve as an umbrella term. The use of precise definitions in research as well as in clinical practice is recommended.
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Case Reports
Sub fascial flap based on the supraclavicular artery in reconstruction of neck burn contractures.
This study presents 3 cases of women ages ranged from 25 to 52 years with anterior cervical contractures caused by burns that resulted in functional and aesthetic deficit. Contracture release in 3 patients and reconstruction was done using a sub-fascial flap whose main pedicle was the supraclavicular artery and the occipito-postero-cervical vessels that were preserved. The flap was designed differently from the classically described that uses the skin of the shoulder but which presents differences of color and texture with relation to the skin of the neck. The results were satisfactory and no complications such as infections or necrosis.