Burns : journal of the International Society for Burn Injuries
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Comment Letter Randomized Controlled Trial
Effect of autologous fat transfer in acute burn wound management: A randomized controlled study.
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We find a lack of high-quality published evidence on risk factors for burn contracture formation. The vast majority of research is from High Income Countries (HICs), where many potential risk factors are controlled for by standardised and high-quality healthcare systems. To augment the published literature, burn care professionals with Low Middle Income Countries (LMICs) experience were interviewed for their opinion on risk factors for burn contracture formation. ⋯ Although participants had no doubts that they could recognise a contracture, none provided a standardised system of measurement or an operational definition of contracture. Burn care professionals have a wealth of experience and untapped knowledge of risk factors for burn contracture formation in their own population base, but many of the risk factors highlighted by participants have not yet been explored in the literature. Variations in clinicians' diagnosis and measurement of a burn contracture underscores the need for an agreed, standardised, simple and easily reproducible method of diagnosing and classifying burn contractures.
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Prompt management of burn-related globe trauma can prevent long term complications. Delays in diagnosis may occur when globe trauma is associated with life-threatening injuries. We aimed to improve the understanding of the epidemiology, acute assessment and management of burns-related globe and adnexal trauma admitted to two trauma centres in Sydney, Australia. ⋯ Chemicals in household-products can cause severe globe trauma. Globe trauma can occur alongside large burns leading to delay in its diagnosis and management. Ophthalmology can assist in the early diagnosis and management of globe trauma.
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A paucity of evidence is available to guide integration of specialist palliative care into burn care. This study's purpose was to develop consensus on referral criteria using a modified Delphi process. Content experts were defined as burn or palliative care providers in locations where the teams have collaborative history; published at least one manuscript or presented nationally on burn and palliative care collaboration; or nomination as having equivalent expertise. ⋯ Iteration 3 presented three models; participants ranked in order of preference and suggested revisions. Consensus was achieved on a final set of criteria for specialist palliative care for persons who sustain burn injuries. Future research should prospectively evaluate the criteria against meaningful outcomes.
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Post-burn pruritus is one of the most common complaints reported by patients with limited evidence for a gold-standard treatment. ⋯ Current evidence suggests that current modalities have a statistically significant, but not clinically significant, reduction in pruritus. This review highlights the limited quality of evidence in the literature and the poor quality of reporting among excluded studies.