Burns : journal of the International Society for Burn Injuries
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We investigated a novel system that uses image-processing algorithms to accurately measure the hemoglobin content of discarded surgical sponges to determine how blood loss relates to the excised area when current methods to minimize bleeding are employed. The system was used during 130 procedures in adult patients having wound excisions ≥1% BSA (study group). An historic group of 105 similar cases in whom visually estimated blood was determined was also evaluated. ⋯ As demonstrated in the historic group, visual estimates of blood loss tend to be more related to the size of excision than the amount of bleeding. The actual blood loss is not well correlated with the extent of excision. Clinicians should not rely on traditional blood loss estimates. Accurate measurement is needed to inform transfusion decisions and guide care.
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Low-and middle-income (LMIC) countries account for 90% of all reported burns, nevertheless there is a paucity of providers to treat burns. Current studies on burns in LMICs have not evaluated the gap between care seeking and receiving. This study explores this gap across socioeconomically similar populations in a multi-country population based assessment to inform burn care strategies. ⋯ Despite similar country socioeconomic characteristics there was significant variability in burn demographics, timing, and disability. Nevertheless, being geographically and economically disadvantaged predict lack of access to burn care.
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In burn patients, meshed split thickness skin grafts are commonly used on large and non-flat areas whom immobilization is difficult to achieve. The frequent mobilizations of burn patients can make the graft slip and prevent the revascularization and therefore the taking of the skin graft. ⋯ Some cautions are necessary in order to avoid any infection. This original and easy-to-perform procedure answers to the difficulties of large split-thickness skin grafts in burn patients.
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Since the inception of clinical VCA almost two decades ago, burn victims have been identified as immunologically complex patients owing to preformed HLA antibodies. However, it remains unclear whether the detected HLA antibodies are the result of former alloantigenic events or if their de novo formation occurs during primary burn care. ⋯ Formation of HLA antibodies during acute burn care might be lower than that previously expected by using glycerol-preserved donor skin and restrictive administration of blood products. Modern concepts of burn care may contribute to a revised outlook on burn patients as potential candidates for VCA.
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The aim was to examine guilt and embitterment in mothers and fathers of children with burns and its associations with depression and burn severity. ⋯ Parents with general guilt may suffer from symptoms of depression. An implication is that clinicians should address guilt feelings among parents in order to alleviate distress and to identify any need for further counseling.