Burns : journal of the International Society for Burn Injuries
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Many studies show a "obesity paradox", which seems to protect against death. Whether an obesity paradox space is present in severe burn patients remains a matter of great debate. Most research on the obesity paradox of burn injuries is classified by body mass index (BMI) rather than by age. ⋯ In this study of patients with severe burns, overweight and obesity had protective effect on burn injury in the younger group (18 ≤ age<65 years), but not in the older group (age ≥ 65 years). Investigating the obesity paradox in burn patients needs to consider age differences. However, multicentre clinical trials are needed to verify the results.
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Hospital volume has been identified as an independent outcome parameter for a number of medical fields and surgical procedures, and there is a tendency to increase required patient numbers for center verification. However, the existing literature does not support a clear correlation between patient load and clinical outcome in adult burn care and recent data from Germany does not exist. We therefore evaluated the effect of patient volume in German burn centers on clinical outcome. ⋯ Interestingly a division into three groups showed significant differences with the best outcome for patients in medium-volume centers. Nevertheless, mortality did not differ significantly. Therefore, our data demonstrates that in contrast to many other medical fields, outcome and mortality are not automatically improved in burn care by simply increasing the patient load, at least in centers treating 20-100 BICU patients/year.
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The objective of this study was to make an equivalent and culturally adapted translation of an already existing scale for itching, the 5-D itch scale (5-D IS), developed as a short questionnaire and designed to measure pruritus, in order to be applied in a Spanish-speaking population. The 5-D IS consists of five sections that evaluate duration, degree, direction, disability and distribution of itching. ⋯ The result was a culturally adapted Spanish version of the 5-D IS which was then field-tested in a burn population with an internal reliability of 0,83, considered good. As pruritus and pain are bothersome symptoms present in more that 90% of burned patients during the rehabilitation phase, this culturally adapted scale allows Spanish speakers clinicians to easily objectivize the severity of pruritus and measure the impact of any intervention or treatment.
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Observational Study
The association between improved standard of living and paediatric burns.
In the "Children's Hospital Zagreb Referral Centre for Paediatric Trauma of the Ministry of Health Republic of Croatia (MHC)" we observed a significant decline in the number of both hospitalised and ambulatory treated paediatric patients with burn injuries in the period from 2011 to 2018. Our hypothesis is that this decline could be either due to the decline of the paediatric population of Croatia or due to the economic growth and the improvement in the standard of living that Croatians have enjoyed in the past decade. ⋯ Apart from the decline of the paediatric population of Croatia, it is reasonable to assume that the improvement in the standard of housing, level of education and employment rate as well as the reduction in the risk of poverty and social exclusion in children had a notable contribution to the decline in the rate of paediatric burns in the observed period.
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A burn is one of the most difficult injuries people can face. The primary pathology is coagulation necrosis resulting from tissue damage. Many wound care products have been developed to be used in situations such as the poor general condition of the patient and lack of solid area to be grafted. ⋯ Histopathological examination results in no significant difference between groups in neutrophil infiltration. The difference between the groups in vascularization was statistically significant between Group II and Group V (p < 0.001) and between Group I and Group V (p = 0.005) Epithelialization was present in 75% of the rats in Group V, while no epithelialization was observed in any of the other groups. In conclusion, we observed a significant improvement in the stasis zone of the group receiving Pulsed Electromagnetic Field for two weeks.