Burns : journal of the International Society for Burn Injuries
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Enterally-based resuscitation (EResus) is safe, efficacious, and has operational advantages, particularly in low-resource settings. However, there is a lack of real-world effectiveness studies and evidence-based protocols, which hinders implementation. To address this gap, we conducted a feasibility study ahead of a randomized controlled trial (RCT) of enterally based versus usual resuscitation at a tertiary burn center in Nepal which had no prior clinical trial experience. We aimed to assess the feasibility of conducting collaborative and prospective clinical research in this setting, the acceptability of the intervention, and compliance with the resuscitation and study protocols. ⋯ This study established the feasibility of performing a randomized trial in a low-resource context with no prior trial experience. Enterally-based resuscitation is an acceptable and favored intervention with a high rate of enrollment. Hospital staff were able to follow the study and resuscitation protocols with high fidelity, though some optimization was requested. With this evidence of feasibility, the trial will continue enrollment, and the future data may provide valuable insights for advancing burn resuscitation in low-resource settings.
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Burn injuries are a global health challenge, causing significant pain, tissue damage and complex wound management issues. Traditional treatments like surgical debridement, while effective, pose challenges such as blood loss, grafting requirements, and prolonged hospital stays. Enzymatic debridement, such as the Nexobrid procedure, effectively removes necrotic tissue but can be painful for patients. This study evaluates the efficacy of tumescent anesthesia with lidocaine (TLA) in managing pain during this procedure. ⋯ TLA effectively manages pain in burn patients undergoing enzymatic debridement.This approach improves patient outcomes and satisfaction by providing effective pain control, minimizing recovery time, and offering a viable alternative to traditional anesthesia methods. Further research with larger, multi-center studies is recommended to validate these findings and establish standardized protocols for TLA in burn care.
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This study focused on the potential of Gliricidia sepium (Jacq.) Kunth. ex. Walp. leaves zinc oxide nanoparticles hydrogel (GSL ZnONPs HG) for diabetic wound healing. The major components identified through HPLC analysis in Gliricidia sepium (Jacq.) Kunth. ex. ⋯ It is important to highlight the dose-dependent behavior of GSL ZnONPs, demonstrating their effectiveness in promoting diabetic wound healing even at lower concentrations. This was supported by their response to various biomarkers through a significant reduction in vascular cell adhesion molecule-1 (VCAM-1) and advanced glycation end products levels (AGEs), and a notable increase in interleukin-10 (IL-10) and platelet-derived growth factor concentrations (PDGF). Collectively, the study highlights the potential of GSL ZnONPs HG as a promising approach to enhance diabetic wound healing.
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The combination of burns and non-thermal trauma may have a synergistic effect on mortality. Our objective was to determine if burn patients with concomitant trauma are at increased risk of mortality in both the prehospital and in-hospital settings. ⋯ Prehospital mortality was increased in patients with combined burns and trauma.
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The aim of this study was to investigate the efficacy of limiting increases in theatre ambient temperature to 27°C to prevent intraoperative patient hypothermia. ⋯ Increasing theatre ambient temperature to 27°C is adequate in most cases. A more nuanced approach with selective increase of theatre ambient temperature beyond 27°C, only where clinically indicated, is a refinement that will benefit both patients and staff.