Burns : journal of the International Society for Burn Injuries
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Review
Burn camps for burns survivors-Realising the benefits for early adjustment: A systematic review.
Child and adolescent burn survivors benefit from skills to cope with the physical and mental challenges associated with their injuries. Burn camps can offer an opportunity to build these skills. In this study, we systematically review the best available evidence on burn camps in order to better assess their impact on burn survivors. ⋯ Further research is required to understand the lack on congruence between qualitative and quantitative data. Qualitative data suggests burn camps are beneficial for children with burn injuries.
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'Fluid creep' or excessive fluid delivered to burn patients during early resuscitation has been suggested by several studies from individual burn centers. ⋯ Higher resuscitation volumes compared to Parkland estimates were reported, but the trend of increasing resuscitation volumes over the last 30 years is not supported by regression of total fluid infused versus year of study. Mean 24h fluid infused for all studies was 5.2±1.1mL/kg per %TBSA. The mean 24h urinary output reported in 30 studies was 1.2±0.5mL/kg per hr. Burns with inhalation injuries (5 studies) received significantly more fluid than non-inhalation injured burn patients (5.0±1.3 versus 3.9±0.9mL/kg per %TBSA). Fluid infused and urinary outputs were similar for adults and pediatric patients. The most striking finding of our analyses was the great ranges of the means and high standard deviations of volumes infused compared to the original Baxter publication that introduced the Parkland formula CONCLUSIONS: These analyses suggest that burn units currently administer volumes larger than Parkland formula with great patient variability. Individual patient hourly data is needed to better understand the record of burn resuscitation and Fluid Creep.
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Acid attacks, or vitriolage, are defined as violent assaults involving the deliberate throwing of an acid or similarly corrosive substance with the intention to "maim, disfigure, torture or kill" [1]. The Acid Survivors Trust International suggest a prevalence of 1500 attacks reported worldwide per annum, although this is likely to be an underestimate by 40% [2]. The UK is thought to have one of the highest of rates of recorded corrosive attacks, with an increase from 228 attacks in 2012 to 601 in 2016. ⋯ The chemical agents involved include acids, alkalis, oxidising and reducing agents, alkylating and chelating agents and solvents. They cause injury by producing a chemical interaction which can lead to extensive tissue destruction and extreme pain. Herein, we present a review on the changing epidemiology of corrosive attacks in the UK and currently employed management strategies.
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Influenza is a serious disease which can be life threatening. Patients with significant burns have reduced physiological reserve and are at risk both of incurring dangerous respiratory complications. In other susceptible patient groups the flu vaccine is used to reduce the risk of flu and lessen its effects. We aim to investigate whether there were any existing local and national trends in the use of flu vaccination in burns patients. Our second objective was to review any current evidence in the literature. ⋯ Through review of the literature on flu vaccination in immunocompromised patients we show how this could be extrapolated to patients with significant burns. We propose a guideline to aid in the decision to prescribe flu vaccine to patients with significant burns taking into account age, % TBSA burn and comorbidity. The decision to recommend the flu vaccine in this group should be considered on an individual basis. However, flu vaccination represents a simple, low-risk measure which could prevent the dangerous complications of influenza in an at risk group.
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The objective of this study was to describe and quantify the long-term hospital service use (HSU) after burn injury and associated costs in a population-based cohort of patients with unintentional burns and compare with uninjured people. ⋯ After adjustment for covariates, burn patients experienced greater hospital use for a prolonged period after the initial injury compared with uninjured people. The mean cost per episode of care was generally higher for members of the burn cohort compared to the uninjured cohort indicating either more complicated admissions or admissions for more expensive conditions.