Burns : journal of the International Society for Burn Injuries
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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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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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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.
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The study aimed to investigate intracortical inhibition following a burn injury, and to establish transcranial magnetic stimulation (TMS) as a useful and sensitive tool to investigate the cortical response to a burn injury. ⋯ These results demonstrate significantly shorter cSP in the burned arm in patients with upper limb burn sustained <2years ago, those with partial thickness burns, those with upper limb burns only, and those with burns of less than 10% TBSA. The results are consistent with the existing literature, which demonstrates a reduction in cSP duration in patients with a range of peripheral nerve injuries. There is a strong suggestion that cortical inhibition is altered following burn injury, and that TMS is a useful and sensitive method for investigating changes in cortical inhibition 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.