Burns : journal of the International Society for Burn Injuries
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This study explored whether the use of virtual reality (VR) was a standard of care during burn care at burn verified facilities in the United States. Surveys were sent to American Burn Association verified burn centers to investigate if VR was being used as a standard of care, if protocols for using VR are in place and how they were developed, and what barriers these facilities are facing and several other topics investigated. Out of the 64 facilities surveyed, 21 responses were collected. ⋯ Out of the seven hospitals currently using VR, two reported a decrease in opioid use with burn care with the use of VR. Although the current results indicate that VR is not frequently used clinically during burn care at most burn centers, 83.3% of burn centers reported they see themselves using VR in the future. As VR becomes more widely disseminated, future research should be conducted to continue to see if VR is becoming a standard of care and whether VR is making clinical impacts on pain, opioid use, and level of anxiety among burn patients.
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Cutaneous burns are commonly treated with autologous skin grafts. Following skin grafting, many patients complain of pain at the donor site. Donor sites are taken most commonly from the lateral thigh, which is innervated by the lateral femoral cutaneous nerve (LFCN). Use of a LFCN blocks should decrease nociception from the donor site. ⋯ Our data shows that use of LFCN block by landmark technique did not reduce narcotic usage in patients that undergo skin grafting procedures. Future studies should consider ultrasound-guided LFCN blocks.
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Frailty and comorbidities are important outcome determinants in older patients (age ≥65) with burns. A Geriatric Burn Bundle (Geri-B) was implemented in 2019 at a regional burn center to standardize care for older adults. Components included frailty screening and protocolized geriatric co-management, malnutrition screening with nutritional support, and geriatric-centered pain regimens. ⋯ Geri-B was perceived as valuable for the care of older burn patients and may serve as a framework for other burn centers.
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In burn trauma, hands are often injured due to defensive action or proximity to the causative agent, leading to significant morbidity during a patients work and social rehabilitation process. In this context, the use of patient-reported outcome measures is a first step in measuring and improving these outcomes. The Burned Hand Outcome Tool (BHOT) is a specific questionnaire for adults with burned hands aimed at quantifying outcomes related to this trauma. ⋯ The Burned Hand Outcome Tool has been translated, culturally adapted, and validated for a target population in Brazilian Portuguese.
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Comparative Study
Exploring the similarities and differences of burn registers globally: Results from a data dictionary comparison study.
Pooling and comparing data from the existing global network of burn registers represents a powerful, yet untapped, opportunity to improve burn prevention and care. There have been no studies investigating whether registers are sufficiently similar to allow data comparisons. It is also not known what differences exist that could bias analyses. Understanding this information is essential prior to any future data sharing. The aim of this project was to compare the variables collected in countrywide and intercountry burn registers to understand their similarities and differences. ⋯ We found some commonalities between registers and some differences. Commonalities would assist in any future efforts to pool and compare data between registers. Differences between registers could introduce selection and measurement bias, which needs to be addressed in any strategy aiming to facilitate burn register data sharing. We recommend the development of common data elements used in an international minimum data set for burn injuries, including standard definitions and methods of measurement, as the next step in achieving burn register data sharing.