Burns : journal of the International Society for Burn Injuries
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Observational Study
Plasma protein C levels are directly associated with better outcomes in patients with severe burns.
Protein C circulates in human plasma to regulate inflammation and coagulation. It has shown a crucial role in wound healing in animals, and low plasma levels predict the presence of a wound in diabetic patients. However, no detailed study has measured protein C levels in patients with severe burns over the course of a hospital admission. ⋯ Together, these four variables predicted increased support utilisation with 93.2% accuracy, 83.3% sensitivity and 97.6% specificity. However if protein C values were disregarded, only 49.5% of the variance was explained, with 82% accuracy, 63% sensitivity and 91.5% specificity. Thus, protein C may be a useful biomarker of burn severity and study replication will enable validation of these novel findings.
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The error rates of forensic techniques need to be evaluated. The charred body scale is a method for quantifying the level of decomposition in burned remains. 51 files containing photographs of burned pigs at different stages of decomposition were scored by nine participants. Each pig in the photographs was uniformly burned to a different level (Crow Glassman Scale levels 1 to 3). ⋯ Interobserver error, hence reliability, of the scores was tested using individual and average absolute agreement interclass correlations. The charred body scale is reliable for remains burned to a Crow Glassman Scale level 1 but not in higher burn levels. It is suggested that a universal scoring method be developed that accounts for multiple burn levels in a single case.
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Currently, chronic wounds and microbial resistance to antibiotics have led to search new healing agents. Combinations of natural products are widely practiced in traditional medicine and exhibited synergistic activity with increased efficacy in treating several pathologies. This study assays the antioxidant, synergistic antimicrobial and burn wound healing activities of Euphorbia honey and Allium sativum (garlic). ⋯ However, the mixture showed higher wound healing activity reflected by shorter epithelialization and wound contraction time, as well as, better histological recovery of the treated tissues. Our results also showed that burn wound healing is not affected by gender. Our findings support the idea of combining natural products as an effective therapy.
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Patient -reported experience measures (PREMs) are a valuable tool in assessing patient's subjective experiences within healthcare settings. They assist the evaluation and development of clinical services, and could be considered most useful when they assess elements of care pertinent to the specific health condition or clinical service. Currently there is no existing PREM to assess this in an NHS burns service. ⋯ While small, this pilot suggested that patients found the measure acceptable to complete and relevant to their care. It also yielded information not currently assessed by the service in any other format, appearing to promise utility for service development activities. Further work is needed to validate the tool and determine how its use could be implemented at a local and national level.
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It is the basic task of burn therapy to cover the wound with self-healthy skin timely and effectively. However, for patients with extensive burns, autologous skin is usually insufficient, and allogenic or heterogeneous skin leads to strong immune response. It is vital to choose an appropriate treatment for deep extensive burns. ⋯ Then BM-MSCs-seeded DADM (DADM/MSCs) was implanted into mice cutaneous wound, and the effect of DADM/MSCs dermal substitute was assessed on skin regeneration. As a result, BM-MSCs survived well and DADM/MSCs scaffolds significantly promoted wound healing in terms of angiogenesis, re-epithelialization and skin appendage regeneration. DADM/MSCs scaffold may represent an alternative promising therapy for wound healing in deep extensive burns.