Burns : journal of the International Society for Burn Injuries
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Randomized Controlled Trial
The clinical utility of extracorporeal shock wave therapy for burn pruritus: A prospective, randomized, single-blind study.
To investigate the effect and mechanisms of extracorporeal shock wave therapy (ESWT) on burn scar pruritus. ⋯ ESWT is a non-invasive modality that significantly reduced burn-associated pruritus.
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Randomized Controlled Trial Comparative Study
Outcomes of post burn flexion contracture release under tourniquet versus tumescent technique in children.
To compare the clinical outcomes of release of flexion contractures after burn of the hand in children using tourniquet or tumescent technique in terms of operative time, postoperative pain score, and percentage of graft take. ⋯ We found that the use of the tumescent technique for the release of flexion contracture resulted in better graft take, lower pain scores, and lesser consumption of analgesic than the use of tourniquet.
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Stevens Johnson Syndrome/toxic epidermal necrolysis (SJS/TEN) are rare, potentially fatal desquamative disorders characterised by large areas of partial thickness skin and mucosal loss. The degree of epidermal detachment that occurs has led to SJS/TEN being described as a burn-like condition. These patients benefit from judicious critical care, early debridement and meticulous wound care. This is best undertaken within a multidisciplinary setting led by clinicians experienced in the management of massive skin loss and its sequelae. In this study, we examined the clinical outcomes of SJS/TEN overlap & TEN patients managed by our regional burns service over a 12-year period. We present our treatment model for other burn centres treating SJS/TEN patients. ⋯ Management in our burns service with an aggressive wound care protocol involving debridement of blistered epidermis and wound closure with synthetic and biological dressings seems to have produced benefits in mortality when compared to predicted outcomes.
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Observational Study
Characterization of variables for potential impact on vancomycin pharmacokinetics in thermal or inhalation injury.
To characterize the pharmacokinetics of vancomycin dosing in thermal or inhalation injury as they relate to percent total body surface area burn (TBSA) and days since injury (DSI). ⋯ DSI, percent TBSA, and CrCl can be used to predict faster vancomycin CL and need for higher total daily doses. Augmented pharmacokinetics can occur as early as two days after injury and decrease with time. Acceptable target trough attainment is still lacking and this data should assist in performance improvements for initial vancomycin dosing.
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Burns are a common cause of morbidity and mortality worldwide. Post-traumatic stress disorder (PTSD) is among the most prevalent psychopathologies documented among burn patients. However, little is known regarding the risk factors for post-burn PTSD outside the well-documented Western world context. The present study aims to elucidate the biopsychosocial correlates of PTSD among burn patients in Pakistan. ⋯ There is a remarkably high prevalence of PTSD among burn patients in Pakistan. Improving accessibility to reconstructive surgery and social support may help to alleviate this burden.