Burns : journal of the International Society for Burn Injuries
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Dermal preservation during acute burn excision is key to obtaining superior healing/scar outcomes, however, determining the most appropriate excision tool is an ongoing challenge. Novel tool development means the knife is no longer our only option, yet for the majority it remains the gold standard. This systematic review aims to evaluate evidence for burns excision approaches (knife/hydrosurgery/enzymatic). ⋯ Level 1 Evidence comparing excision modalities for acute burns is sparse. Although early excision with a knife is still often considered best practice, there is no tool choice consensus or robust comparison with alternate, possibly superior, tools. EDNX or Versajet™ should be considered alternatively. Further RCTs are indicated, with regards final scar outcomes and to allow consensus within current evidence.
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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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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.
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Accurate blood pressure monitoring is essential for burn management, with the intra-arterial line method being the gold standard. Here we evaluated agreement between cuff and intra-arterial line methods. ⋯ Cuff measurements vary widely from those of intra-arterial lines, which have a low complication rate. Intra-arterial lines are advisable when tight control of the hemodynamic response is essential.
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Treatment of burn wounds is technically demanding and several attempts have been taken to improve wound healing. Silver sulfadiazine antibiotic has been shown to have some beneficial effects on wound healing via reduction in infection. This study was designed to investigate the impact of collagen hydrogel-scaffold dressing with or without topical use of Saccharomyces cerevisiae on cutaneous burn wound healing in rat. ⋯ C.) significantly increased collagen content compared to the negative controls. Moreover, the CH-S-S treated lesions demonstrated greater ultimate load and stiffness compared to the untreated wounds. In conclusion, application of S. cerevisiae with a bi-phase biological dressing (CH-S) improved the morphological and biomechanical characteristics of the healing burned wounds in rats and the results were comparable to the positive control.