Burns : journal of the International Society for Burn Injuries
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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.
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We investigated the urinary fluoride level in patients with hydrofluoric acid (HF) burns of different severities and explored the clinical significance of these levels in the diagnosis of acute HF burn. ⋯ Urinary fluoride level can be used for the early diagnosis of HF burns and to determine the severity of fluoride poisoning, which is crucial for early treatment.
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As silver dressings gain more widespread use, it is more likely that patients with silver-based dressings will also undergo magnetic resonance imaging (MRI). In current practice, these dressings are removed prior to imaging due to concerns over heating and image distortion. As dressing changes can be painful, the need to remove dressings simply for MRI may increase pain and contribute to opioid dependency. ⋯ Additionally, dressings, in dry and hydrated forms, caused no image distortion in any MRI scan performed. Evaluation of MRI safety and compatibility revealed no concerns for safety or image distortion in any of the silver-containing wound dressings tested thus it would be acceptable to leave these dressings intact during MRI. The ability to leave dressings in place during imaging will provide a significant benefit to patient care by reducing pain associated with dressing removal.
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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.
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This study aimed to investigate whether a three-dimensional (3-D) wound scanner could be used to measure the area of scars. Scar models were constructed using flesh-colored, brown-colored (simulating hyperpigmented scars), orange-colored (simulating scars with obvious vascularization), and white-colored (simulating hypopigmented scars) plastic. Each colored plastic was used to construct scar models with regular and irregular base surfaces (four each). ⋯ Regarding correlation, Spearman's coefficient using the 3-D wound scanner was 0.992, showing the strongest correlation. With respect to inter-experimenter reliability and stability of retesting, each Cronbach's coefficient of the 3-D wound scanner between the two experimenters was >0.90, showing high reliability; thus, fulfilling the requirements for clinical measurement. The 3-D wound scanner took an average time of 38.87±3.45s for measurement, which was significantly shorter compared that for other methods The 3-D wound scanner showed greater accuracy and correlation, and a shorter measurement time, compared with other measurement methods The inter-experimenter reliability and retesting stability of the 3-D wound scanner also fulfilled the requirements for clinical measurement.