Burns : journal of the International Society for Burn Injuries
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Burns are devastating to the individual and society, representing a huge biomedical burden. Improved education in burns has however ignited a revolution in high-income countries-burn mortality is reducing. Education in burns is far-reaching. ⋯ Here, we examine the literature detailing burn education with a focus on past lessons, current trends and future objectives. We have identified key educational objectives to revolutionise burn care on a global perspective. Now is the time to build on promising educational strides to reduce the global burns burden.
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Little is known about long term survival risk factors in critically ill burn patients who survive hospitalization. We hypothesized that patients with major burns who survive hospitalization would have favorable long term outcomes. ⋯ Critically ill patients with major burns who survive to hospital discharge have decreased 5year mortality compared to those with less severe burns. ICU Burn unit patients who survive to hospital discharge are younger with less comorbidities. The observed relationship is likely due to the relatively higher physiological reserve present in those who survive a Burn ICU course which may provide for a survival advantage during recovery after major burn.
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Tissue expansion is frequently used in reconstructive surgery. Although the surgical procedure is typically considered simple, reported complication rates of tissue expansions exceed 40%. There is little evidence concerning risk factors for complications in tissue expansion in body regions other than breast. The aim was to determine risk factors for complications in non-breast tissue expansion. ⋯ This is the first study revealing female gender and low BMI as risk factors in tissue expander surgery. Thus, careful patient selection is mandatory to avoid complications in tissue expansion. Burn patients do not develop complications more often.
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Severe burn triggers systemic responses that result in reduced muscle mass and changes in bone formation, with recent evidence also suggesting systemic effects on bone after minor burns. The aim of this study was to assess if people hospitalised with a burn have increased admissions for fractures after discharge. ⋯ Burn patients experienced significantly higher age and gender standardised rates of admissions for fractures after discharge from hospital for their index burn. Further prospective research is indicated to clarify any underlyling pathogenic processes linked to the burn that may increase a patient's risk of having a fracture serious enough to undergo admission.
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Current strategies for estimating positive scar volume following burns is limited to employing subjective scar scales. This study assesses the accuracy and reliability of Measurement of Area and Volume Instrument System (MAVIS) III, a portable 3D active stereophotogrammetric imaging system, for non-invasive assessment of hypertrophic scar volume and elucidates factors that leads to inaccurate volume determination. ⋯ This study finds that MAVIS III is accurate in its volumetric measurements and is reliable between users; making it a potential candidate for non-invasive assessment of hypertrophic scars. Further considerations for refining active stereo-photogrammetry and the user interface of the software are also highlighted to allow superior evaluation of scar volume.