Burns : journal of the International Society for Burn Injuries
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Randomized Controlled Trial
Propranolol kinetics in plasma from severely burned adults.
The aim of this study was to determine the appropriate propranolol dosing strategy for reducing heart rate in severely burned adults. ⋯ Heart rate can be decreased to a similar degree with Q6 and Q24 dosing strategies, with the Q8 dosing strategy being less effective. Q6 dosing is recommended to maintain reduced heart rate throughout dosing periods.
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Review Historical Article
Evolution of skin grafting for treatment of burns: Reverdin pinch grafting to Tanner mesh grafting and beyond.
Skin grafting is the current standard care in the treatment of full thickness burns. It was first described around 1500 BC but the vast majority of advancements have been achieved over the past 200 years. ⋯ Skin grafting technique have evolved significantly over past 200 years from Reverdin pinch grafting to modern day meshed skin grafts using powered dermatome. Increasing the expansion ratio and improving the cosmetic and functional outcome are the main focus of ongoing skin grafting research and emerging techniques (such as Integra®, Recell®, Xpansion®) are showing promise.
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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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Xeroform® is a petrolatum-based fine mesh gauze containing 3% bismuth tribromophenate. Bismuth, similar to other metals, has antimicrobial properties. Xeroform® has been used for decades in burn and plastic surgery as a donor site dressing and as a covering for wounds or partial thickness burns. Despite this, the antimicrobial spectrum of Xeroform® remains largely unknown. We examined the in-vitro efficacy of Xeroform® against common burn pathogens using zone-of-inhibition methodology in a commercial research facility. ⋯ While bismuth subsalicylate, and bismuth tribromophenate unbound to Xeroform® demonstrate antimicrobial activity, it appears that Xeroform® dressings do not. The utility of Xeroform® in burn medicine may relate more to use as an impervious dressing than to antimicrobial effect. Donor sites are clean surgical wounds and clean partial thickness burns may have minimal colonization present. In such circumstances, an inactive and impervious dressing may be all that is necessary to promote wound healing.
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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.