Burns : journal of the International Society for Burn Injuries
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The current standard of care for severe burns includes autografting; however, there is scarce knowledge regarding the long-term economic burden associated with thermal burns and inpatient autografting. The objective of this study was to characterize healthcare resource utilization, treatment patterns, and cost of care for thermal burn patients in two large privately insured populations in the United States who underwent inpatient autografting between 01/01/2011 and 06/30/2016. ⋯ The percentage of patients with burn-related healthcare resource utilization and average burn-related costs were considerably reduced in the year 2 evaluation period (HIRD: mean=$3020; MarketScan: mean=$1990). Consistent with previous studies, mean length of hospital stay (days) and mean total medical costs generally increased as the percentage of total body surface area burned increased.
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Hypopigmentation is a major problem in deep dermal burns. To date, no standard treatment is available for the post burn hypopigmentation disorder. Therefore, understanding the molecular and cellular events are of benefit for therapeutic intervention. ⋯ Culture data exhibited a change of dendritic structure, reduced proliferation rate, faulty melanin synthesis and transfer of melanin from melanocytes to keratinocytes in PBHS samples. To the best of our knowledge, this is the first study showing structural and functional aberrations of melanocytes and keratinocytes, as a potential cause of hypopigmentation in burned patients. Our study, therefore, provides valuable insight for the basis of hypopigmentation in post burn patients, which may pave the way for clinical intervention in the future.
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Bromelain-based Enzymatic Debridement has been introduced as an additional concept to the burn surgeon's armamentarium and is best indicated for mid-to deep dermal burns with mixed patterns. Increasing evidence has been published focusing on special regions and settings as well as on limitations of Enzymatic Debridement to improve patient care. To better guide Enzymatic Debridement in view of the increasing experience, there is a need to update the formerly published consensus guidelines with user-orientated recommendations, which were last produced in 2017. ⋯ The updated guidelines in this publication represent further refinement of the recommended indication, application and post-interventional management for the use of ED. The published statements contain detailed, user-orientated recommendations aiming to align current and future users and prevent pitfalls, e.g. for the successful implementation of ED in further countries like the USA. The significance of this work is reflected by the magnitude of patient experience behind it, larger than the total number of patients treated in all published ED clinical trials.
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Profound differences exist in the cost of burn care globally, thus we aim to investigate the affected factors and to delineate a strategy to improve the cost-effectiveness of burn management. ⋯ The majority of the cost were associated with the use of antibiotics and burns care. Consequently, it is crucial to prevent nosocomial infection in order to promote healthcare quality and reduce in-hospital costs.
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Time to return to school in child and adolescent burn patients from a sub-Saharan tertiary hospital.
Africa, with the largest number of paediatric burns needs to focus more attention on paediatric burn survivors. Burn injury truncates schooling in child and adolescent burn patients. The aim of this study was to determine the time to return to school and factors influencing this in child and adolescent burn patients. ⋯ Time to return to school from burn injury and from discharge in child and adolescent burn survivors in this study are at least three times longer than previous studies. The burn care team needs to consider school re-entry programs for these children.