Burns : journal of the International Society for Burn Injuries
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This study aimed to describe the nature, scope or meaning of the concept 'burn scar', from the perspective of adults and children with burn scarring, caregivers of children with burn scarring and health professionals who were considered experts in the treatment of burn scarring. The impact of the identified characteristics on burn scar health-related quality of life (HRQOL) was also examined. ⋯ This study identified there are differences in the burn scar characteristics considered important by health professionals and those characteristics that adult/child/caregivers perceived to impact on indicators of burn scar HRQOL. It is recommended that outcome measures of burn scarring include the burn scar characteristics of 'stretchability' and 'scar sensitivity' at a minimum. The inclusion of 'fragility', 'scar surface appearance' and 'color' should also be considered.
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To describe frostbite (freezing cold injured tissue) in children and intrinsic (psychological and behavioral) and extrinsic (meteorological and safety hazard) factors related to the injury. ⋯ Frostbite injuries in children begins at temperatures <-6°C; with risk of tissue loss increasing at temperatures below -23°C. Lack of supervision and intoxication are major risk factors for frostbite in children. Two-thirds of younger children were unsupervised, whereas intoxication was frequently related to frostbite in adolescents. Both of these factors can be addressed through an education-based prevention program.
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The process of standardising burn care and creating protocols within burn centres has, at its core, evidence-based practice principles combined with the clinical experiences of burn care specialists. Although protocols and pathways have been created for certain topics of burn care, they tend to be tailored to the local individual needs of each burn centre, which is a limiting factor for consideration of larger/nationwide approaches. ⋯ We describe the steps put in place in Canada to design and adopt a nationwide protocol from a single burn centre on the topic of wound healing and dermal substitutes as the initial exemplary process. This report summarizes the Canadian experience for this type of initiative, which can be used as framework for developing additional guidelines/protocols in other relevant burn care related topics in Canada or other countries.
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Burn scars can be associated with significant loss of cutaneous sensation, paresthesia and chronic pain. Long-term systemic changes in cutaneous innervation may contribute to these symptoms and dorsal root ganglia have been implicated in the development of chronic neuropathic pain. Therefore we hypothesized that changes in cutaneous innervation after burn injury may be mediated at the level of the dorsal root ganglia. ⋯ Type B cells constituted a greater proportion of the viable cell population in the ipsilateral DRG after a burn injury. This change may be important in the induction of signalling related to pain and itch and has important implications for the restoration of normal cutaneous innervation after burn injury. Investigating whether neuro-protective or neuro-restorative approaches can ameliorate damage to the DRG will be important to improve sensory outcomes for burn patients.
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Skin expansion in the lower limb is a difficult procedure with a significant rate of complications. We propose, in this retrospective mono centric study, a systematic review of our skin expansion procedures on the lower limb in burn sequelae with a 30-years follow-up. The objective was to evaluate the overall result of our procedure and present its technical specificities. ⋯ The success of our expansion procedures in burn sequelae of lower limb is due to technical key points such as the choice of the prosthesis size, the position of the remote internal valve, the position of the drain and a delayed inflation start. Level IV.