Burns : journal of the International Society for Burn Injuries
-
To study the relationship between insurance provider and important outcomes among patients with burn injury. ⋯ Primary payer does not affect in-hospital mortality or treatment metrics among patients admitted for burn injury. However, compared with private insurance, Medicaid was associated with both higher morbidity and resource utilization, whereas uninsured patients had lower resource utilization.
-
Randomized Controlled Trial
Photographic evaluation of different adrenaline-containing tumescent solutions on skin graft donor site bleeding: A prospective randomised trial.
Tumescent infiltration is a technique to reduce skin graft donor site bleeding, however there are no studies comparing tumescent solutions with different concentrations of adrenaline on donor site blood loss. We sought to evaluate the effect on skin donor site bleeding of different adrenaline concentrations in adrenaline-containing tumescent solutions in a prospective randomised trial. ⋯ We demonstrate that donor site infiltration with different adrenaline-containing tumescence solutions cause significantly different photographic bleeding scores. Adrenaline 1:250,000 tumescence resulted in significantly lower bleeding scores than lower concentrations of adrenaline without compromising safety or wound healing. These findings suggest that adrenaline tumescence reduces donor site blood loss in a dose-dependent manner.
-
Burn injury in the elderly is associated with increased morbidity and mortality. It is not uncommon for biological age, or frailty, to differ from chronological age in this patient group and thus predicting individual clinical outcomes remains challenging. It has been previously shown that Rockwood's Clinical Frailty Scale, a global clinical measure of fitness and frailty in older people, can be a useful adjunct for predicting outcomes for elderly patients with burns >10% TBSA. We refine our previous work to investigate the impact of frailty on mortality of elderly patients with thermal burns of any size admitted to a burns unit and explore its role as a meaningful adjunct to the modified Baux score. ⋯ We demonstrate that Frailty Score can be used to independently predict in-hospital and one-year mortality for thermal burns of any size in the elderly admitted as an in-patient to a burns unit. We also find that the Frailty Score can be employed in combination with the modified Baux score to improve mortality prediction. We recommend that Frailty Score is integrated into the modified Baux score and used to focus burn care resources appropriately.
-
To describe the monthly variation in the prevalence and patterns of unfinished nursing care and to determine the relationships between the system of nursing care and unfinished nursing care at the US Army Burn Center. ⋯ The prevalence of unfinished nursing care at the US Army Burn Center was high and generally consistent with other studies of unfinished nursing care in non-burn settings. The inability to meet the demand for nursing care, as evidenced by the presence of unfinished nursing care, may be the result of a limited surge capacity. Implications for research, policy, and practice were discussed.
-
Review Meta Analysis
Hypnosis for burn wound care pain and anxiety: A systematic review and meta-analysis.
Evidence from clinical trials suggests psychological interventions should be considered as an adjunct to medications. ⋯ These results suggest that hypnosis reduces pain intensity and anxiety ratings in adults undergoing burn wound care. However, because of the limitations discussed, clinical recommendations are still premature.