Burns : journal of the International Society for Burn Injuries
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Atrial fibrillation is a well-documented complication following cardiac surgery. It is associated with increased inpatient and long-term mortality. There have been few prior studies on perioperative atrial fibrillation following burn surgery in severely burned patients. The purpose of this study was to identify the incidence, predictors, and prognosis of perioperative atrial fibrillation after burn surgery in severely burned patients. ⋯ Atrial fibrillation was a relatively rare complication among severely burned patients admitted to surgery and was associated with TBSA% and full thickness TBSA%. All of our patients exhibited at least one of the modifiable risk factors for atrial fibrillation, confirming the importance of optimization of electrolytes and fluid status and limitation of sympathetic activation.
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Acute kidney injury (AKI) is a common complication in critically ill burn patients and is associated with a number of serious adverse outcomes. The clinical decision-making process related to the management of AKI in burn patients is complex and has not been sufficiently standardized. The main aim of this study was to explore the diagnostic approach and clinician's attitudes toward the management of AKI and RRT in burn patients around the world. ⋯ The majority of burn specialists use specific consensus classifications to detect acute kidney injury. Continuous renal replacement therapy appeared to be the most preferred option, while the expertise to deliver a particular modality and resources availability play a significant role in modality selection. The use of ultrasound and specific biomarkers for AKI evaluation is infrequent in routine clinical practice.
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The purpose of this research was to understand the current status of stigma and illness uncertainty in patients with visible burns and explore the correlation between them. Measures to help patients alleviate shame and uncertainty in illness are also discussed. A cross-sectional study was conducted in a tertiary hospital from November 2020 to March 2021 for patients with burns on exposed parts of the face, neck, or limbs. ⋯ Multiple regression analysis showed a relationship between stigma and uncertainty of illness (B = 0.215, p = 0.000), itching (B = 2.555, p = 0.01), residence (B = 2.545, p = 0.029), and age (B = 0.074, p = 0.037). The stigma level of patients with visible burns increased with increasing uncertainty regarding illness. Therefore, reducing the patients' uncertainty in illness is a way to intervene in stigma.
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Retrospective auditing identified the need to implement a client centered tool to measure occupational performance and re engagement in activities after burn injury. The Canadian Occupational Performance Measure (COPM) was chosen as it has a broad focus on occupational performance across the lifespan. However, given the time constraints that acute care clinicians work within in a tertiary teaching hospital, a feasibility study was warranted to identify the time to complete the COPM and any potential barriers which may arise in order to evaluate the appropriateness of using this tool. ⋯ This study found that the time to administer the COPM is feasible within the acute tertiary setting. Perceived barriers identified can be overcome with increased knowledge of client centred practice and the importance of goal directed care. The use of patient reported outcome measures in clinical practice empowers consumers to identify what goals they would like to achieve.
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Randomized Controlled Trial
Biosynthetic cellulose compared to porcine xenograft in the treatment of partial-thickness burns: A randomised clinical trial.
The aim was to compare two dressing treatments for partial-thickness burns: biosynthetic cellulose dressing (BsC) (Epiprotect® S2Medical AB, Linköping, Sweden) and porcine xenograft (EZ Derm®, Mölnlycke Health Care, Gothenburg, Sweden). ⋯ The results showed the dressings performed similarly when used in adults with burns evaluated as partial thickness.