Burns : journal of the International Society for Burn Injuries
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Burns are traumatic events that can affect multiple systems beyond the skin. The rapid removal of the burn eschar is a key step in the effective treatment of severe burns, and surgical debridement is currently the standard of care for eschar removal in burn patients. However, surgical debridement is highly hemorrhagic. Tranexamic acid, an antifibrinolytic lysine analog, may reduce bleeding. ⋯ These findings suggest that tranexamic acid was effective at reducing intraoperative hemorrhage volume and the need for transfusion in burn surgery patients. It was shown to be safe for use in these patients.
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Oliceridine, a biased, selective opioid agonist, has shown a 3-fold preferential activation of the G-protein (i.e., analgesia) over β-arrestin pathway. β-arrestin activation is believed to be associated with higher adverse events, such as constipation, respiratory depression, and desensitization. There is no literature of use in patients with burn injuries. We hypothesized the use of oliceridine would provide adequate and safe analgesia after acute burn injury. ⋯ There were no unexpected adverse events related to oliceridine. Oliceridine demonstrated significant pain relief, which was maintained over the 7-day study period. The control group demonstrated initial relief, which was not maintained despite similar MME.
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The severity of electrical injuries depends on the voltage, the duration of exposure to current, and the trajectory of the current through the body. The reconstruction for defects caused by electric current is a difficult process. ⋯ The reverse FDMA flap is a safe and effective method for the reconstruction for electrical injuries developing in the distal foot in which one-stage surgery is sufficient. We recommend the usage of the reverse FDMA flap for the closure of soft tissue defects caused by electrical injury in the sole, dorsal region of the foot, and great toes.
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Skin flaps are often used to repair wounds and improve a patient's appearance, particularly after severe burns. Although skin flaps are widely used, they are prone to necrosis, which poses a major clinical challenge. Tyrosol is a natural phenolic antioxidant found in olive oil that has anti-inflammatory, anti-apoptotic, antioxidant, and pro-angiogenic properties. ⋯ Western blot analysis showed that the expression of p38, NF-κB, and BAX was significantly down-regulated, while that of Bcl-2 was significantly up-regulated, in the high- and low-dose tyrosol groups. This modulation of key signaling pathways and apoptotic proteins not only validates the impact of tyrosol but also reinforces its role in providing protection, thus promoting flap survival. In summary, tyrosol may inhibit inflammation, oxidative stress, and apoptosis by downregulating the p38-NF-κB signaling pathway and promoting angiogenesis, thereby enhancing skin flap survival.
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Inhalation injury may be associated with increased risk of dysphonia and laryngotracheal pathology; however, presentation and recovery patterns are not well documented. ⋯ Dysphonia occurs in one of every two burn patients with inhalation injury, and a quarter of patients with severe injury will still have persistent dysphonia at six months.