Burns : journal of the International Society for Burn Injuries
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A 1-year prospective study of 112 burn patients up to 19 years of age aimed to identify and study the determinants and mortality experiences in these burn patients and found flame burns to be the commonest, followed by scalds and electric burns. All burns other than those caused by electricity were commoner in females, more so between 15 and 19 years of age. Burns were more frequent in winter and 85 per cent of them were domestic. ⋯ The patient fatality rate (41.1 per cent) was associated with total burn surface area. Referral time-lag was an important determinant of mortality especially in less severe burns. As would be expected, hospital stay was significantly longer in survivors.
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Comparative Study
Visual analogue thermometer: a valid and useful instrument for measuring pain in burned patients.
This study assessed the psychometric qualities of a new pain rating instrument--the visual analogue thermometer (VAT)--which was developed to measure pain in burned patients. The validity and utility of the VAT was assessed and compared with a conventional numeric (NUM) and adjective pain scale (ADJ) with a group of 103 burned patients and 51 nurses. Analyses of the results support the concurrent and construct validity of the VAT as a pain measure. ⋯ The same was true for the nurses' evaluation except for those who had more clinical experience with the VAT and who tended to prefer this scale for its accuracy and ease of utilization. The VAT appears to be a valid, sensitive and clinically useful tool to measure pain in burned patients. A systematic pain assessment procedure which can be easily implemented in burn care facilities is presented.
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Comparative Study
Contraction and growth of deep burn wounds covered by non-meshed and meshed split thickness skin grafts in humans.
A group of 18 burned patients was excised between days 2 and 5 postburn days, while 20 patients were operated later, between days 25 and 35 postburn. After early excision the wounds covered with meshed grafts contracted to a mean wound size of 56 per cent while the wounds covered with non-meshed grafts contracted to a mean wound size of 64 per cent. ⋯ With early excision, meshed grafts grew back to a size of 78.5 per cent while non-meshed grafts grew back to a size of 91 per cent. With late excision, meshed grafts grew back to a size of 69.5 per cent while non-meshed grafts grew back to a size of 75.5 per cent.
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This is a retrospective study of 348 patients with burn injuries admitted to a peripheral industrial hospital over a period of 10 years. The patients were from all walks of life. The study compared the incidence of burns occurring in various industries and those in other situations, assessed the morbidity and mortality profile of burn injuries treated in a hospital devoid of a modern burn care unit and presents ways of improving the treatment of burn injuries. ⋯ The overall mortality was 18.3 per cent. The average hospital stay was 17.5 days. The treatment given to the patients is briefly discussed and the importance of the introduction of modern methods of burn management in our hospital is also emphasized.
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Prolongation of skin allograft survival by immunosuppression of burn casualties has been reported sporadically during the past two decades. Recently cyclosporin A (CycA) has been used effectively for such an indication. We report here two paediatric patients with extensive burns (85-95 per cent BSA) treated with fresh, family-related skin allografts that were rejected during CycA treatment after 14-18 days. One of these children survived while the other died with candida sepsis.