Burns : journal of the International Society for Burn Injuries
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Patients with severe burns often show systemic coagulation changes in the early stage and even develop extensive coagulopathy. Previous studies have confirmed that soluble TREM-like transcript-1 (sTLT-1) mediates a novel mechanism of haemostasis and thrombosis in inflammatory vascular injury. At present, the role of sTLT-1 in patients with severe burns is not well known. ⋯ Low sTLT-1 levels at 48 h after burn in patients with severe burns is associated with increased coagulation disorders. Low circulating sTLT-1 levels were an independent predictor of increased 30-day mortality.
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To examine the associations between premorbid nutritional status and in-hospital mortality in severe burn patients according to age in Japan. ⋯ The results suggest that pre-morbidly underweight elderly patients aged 75-84 years with severe burns have high mortality risks. Further research is needed to identify optimal care strategies for this population.
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Bacterial resistance to antibiotics is growing dramatically worldwide due to several contributing factors, including inappropriate antibiotic utilization in the clinical setting and widespread use in the food production industry. Consequently, it is imperative to characterize antibiotic resistance in high-risk populations, such as burn patients, particularly in resource-limited settings where prevention strategies may be high-yield and new antibiotics are not readily available. We therefore sought to characterize and identify predictors of multi-drug resistant (MDR) bacteria colonization in burn patients at our center in Malawi. ⋯ Our study identified that almost half of the patients in a Malawian burn unit had MDR bacteria colonizing burn wounds after only a week in the hospital. This increased to almost 70% during hospitalization. We also found that for patients with flame burns, increasing %TBSA, and operative intervention put patients at greater risk of MDR colonization. Interventions such as isolation of burn patients, consistent disinfection and sterilization of wards and operating rooms, and optimization of wound care management are imperative to decrease spread of MDR bacteria and to improve burn-associated clinical outcomes in resource-limited environments.
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Burn is a major trauma that causes physical and psychosocial impairments, leading to sleep disorders. However, the data about risks for sleep disorders in patients over 3 years following burn injury are limited. ⋯ Burn had long-term negative effects on sleep during both the first year of burn injury and the subsequent follow-up 14 years. It is important for physicians to long-term assess the sleep quality of burn patients regardless of the number of years after burn injury.
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Currently information regarding burn size from referring departments to burn centres varies in accuracy. Inaccurate assessment of burn size can lead to over or under treatment. Photographs of injuries may improve accuracy of assessment. We aimed to assess the accuracy of measuring burn size on a static image by including a standard object in the image. ⋯ Static images tend to overestimate burn size despite the use of a standard object in the image.