Burns : journal of the International Society for Burn Injuries
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Reconstructive surgery remains the main approach to address burn scar contractures. Ablative fractional resurfacing is an increasingly popular tool for severe burn scar management, but its effect on overall burns reconstructive case-mix, operating time and patterns of hospital admission have not been reported. ⋯ AFL profoundly affects elective reconstructive burn case mix with a replacement of conventional reconstructive operations in favour of AFL-procedures. This results in reductions of average LOS and anaesthetic times. Consequently, increased use of AFL in burn scar management could potentially reduce overall costs associated with burn scar reconstruction.
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Observational Study
Management of combined massive burn and blast injury: A 20-year experience.
Blast injuries are complex types of physical trauma resulting from direct or indirect exposure to an explosion, which can be divided into four classes: primary, secondary, tertiary, and quaternary. Primary blast injury results in damage, principally, in gas-containing organs such as the lungs (blast lung injury, BLI). BLI is defined as radiological and clinical evidence of acute lung injury occurring within 12h of exposure to an explosion and not due to secondary or tertiary injury. BLI often combines with cutaneous thermal injury, a type of quaternary blast injury, either in terrorist bomb attacks or in civilian accidental explosions. This report summarizes our experience in the management of combined massive burn and BLI at a Shanghai Burn Center in China. ⋯ It is a formidable challenge for clinicians to diagnose and manage massive burn patients combined with BLI. A comprehensive treatment approach is strongly recommended, including fluid resuscitation, airway management, mechanical ventilation, and surgical treatment. Given the high mortality of massive burn patients combined with BLI even in a recognized burn center, more prospective studies are encouraged to assess more effective strategies for the treatment of such patients.
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Observational Study
The association between burn and trauma severity and in-hospital complications.
The aim of this study was to analyze the association between in-hospital complications and burn and trauma severity, inhalation injury, length of intensive care unit and hospital stay, and mortality in burned patients. ⋯ Complications are frequent in patients with severe burns and inhalation injuries, increasing length of hospital stay and mortality. Burn studies measuring severity of thermal and inhalation injuries and other associated traumas allow to expand the analysis of burned patients.
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Comparative Study
Comparison between distally based peroneal and posterior tibial artery perforator-plus fasciocutaneous flap for reconstruction of the lower extremity.
Distally based peroneal artery perforator-plus fasciocutaneous (DPAPF) flaps and distally based posterior tibial artery perforator-plus fasciocutaneous (DPTAPF) flaps are widely used to reconstruct soft-tissue defects of the distal lower leg, ankle, and foot. However, a comparative study of both flaps in a considerable sample size is lacking. This retrospective study aimed to compare the efficacy of the flaps and provide referential evidence for selection of flaps. ⋯ The DPAPF flap was superior to the DPTAPF flap with respect to reliability and decreased donor-site morbidities. The former is the recommended preferential choice between the two.