Burns : journal of the International Society for Burn Injuries
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The scalp is the only hidden donor site for split thickness skin grafts. Nevertheless, it is underappreciated due to fear of iatrogenic scarring alopecia. Long-term data showing whether androgenetic hair loss can reveal previously hidden scarring alopecia is unavailable. We aimed to evaluate results and patient satisfaction up to 30years after skin harvest from the scalp. ⋯ Long-term morbidity of scalp skin harvest and the risk of clinically significant alopecia is very low while patient satisfaction is high. AGA is unlikely to reveal harvest damage previously hidden by regrown hair.
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Keloid is a healing disorder that occurs exclusively in humans. This pathology is considered a benign cicatricial neoplasm, whose physiopathogenesis has not yet completely clarified. Its disfiguring appearance often could potentially cause a disturbance in the patient regarding his/her body image. The objective is to evaluate the impact of keloid on body image. ⋯ The presence of a keloid negatively affects body image.
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Surviving the first episode of bacteremia predisposes burn casualties to its recurrence. Herein, we investigate the incidence, mortality, bacteriology, and source of infection of recurrent bacteremia in military burn casualties admitted to the U.S. Army Institute of Surgical Research Burn Center over a 10year period. ⋯ Recurrent bacteremia increases mortality in military burn casualties. Additional research is needed to address and mitigate the underlying causes, thereby improving survival.
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A high prevalence of self-inflicted burn injury is noted in severe burn injury. It remains unclear as to whether gender and past psychiatric history impact upon whether injury is self-inflicted and the outcomes. ⋯ Psychiatric clinicians should assertively screen the psychiatric history of patients with severe burn injury, and participate in the acute and longer-term management of persons admitted with a self-inflicted burn.
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Burn injury induces an acute hyperactive immune response followed by a chronic immune dysregulation that leaves those afflicted susceptible to multiple secondary infections. Many murine models are able to recapitulate the acute immune response to burn injury, yet few models are able to recapitulate long-term immune suppression and thus chronic susceptibility to bacterial infections seen in burn patients. This has hindered the field, making evaluation of the mechanisms responsible for these susceptibilities difficult to study. Herein we describe a novel mouse model of burn injury that promotes chronic immune suppression allowing for susceptibility to primary and secondary infections and thus allows for the evaluation of associated mechanisms. ⋯ Burn-mediated protection from infection is transient, with a secondary infection inducing immune protection to collapse. Repeated infection leads to increased neutrophil and macrophage numbers in the lungs late after burn injury, with diminished innate immune cell function and an increased anti-inflammatory cytokine environment.