Burns : journal of the International Society for Burn Injuries
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A case of staphylococcal toxic shock syndrome (TSS) in a 15-year-old patient undergoing reconstructive burn surgery is reported. This syndrome, first described in menstruating women using tampons, can also occur as a postsurgical complication. The epidemiology, microbiology, clinical presentation and management of non-menstrual TSS are discussed and correlated with the patient present. We advise caution in the use of occlusive dressings and recommend constant isolation of patients with open wounds colonized with a TSST-1 producing strain of Staph. aureus.
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Randomized Controlled Trial Clinical Trial
Topical ketorolac has no antinociceptive or anti-inflammatory effect in thermal injury.
This study investigated the antinociceptive and anti-inflammatory effect of a topical non-steroidal anti-inflammatory drug in human thermal injury. Twelve healthy unmedicated volunteers had identical burn injuries produced on the medial side of both calves with a 49 degrees C 15 x 25 mm thermode. ⋯ Burn injury led to a decrease in HPDT, HPT and MPDT, an increase in EI and development of mechanical hyperalgesia (P < 0.05). Ketorolac gel had no effect on any of the nociceptive or inflammatory variables studies (P > 0.2).
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Two cases of burn injury following a dust explosion are presented. It is important to (1) rule out other serious injuries and (2) continuously reassess the patient for respiratory injury. The mechanism of dust explosions is described and preventative measures are discussed.
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Of 3371 patients admitted to the Vall D'Hebron Burns Center, Barcelona, between the years 1983 and 1991 inclusive, 67 patients had attempted self-inflicted burns (1.98 per cent). Over 75 per cent of these patients had previous psychiatric illness and 20 per cent had previously attempted suicide. The mean age was 38 years and the overall mortality rate was 30 per cent. Over 71 per cent were male patients.
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In patients with extensive deep burns and scarce donor sites autogenic cultured epithelial grafts (auto-CEG) have become a real alternative. In deep burns the 'take' rate of auto-CEG applied directly on subcutaneous fat, fascia or muscle is unreliable and frequently disappointing. The auto-CEG seems to need a dermal base. ⋯ The estimated 'take' rates were 70 and 77 per cent. The grafted areas remained stable for 4 and 8 months respectively. The two-layer skin substitute gave a permanent cover for full thickness burn wounds of higher quality and better 'take' rate than previous results, where the auto-CEG had been grafted directly onto the debrided wounds.