Burns : journal of the International Society for Burn Injuries
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Hypertrophic scars are usually evaluated based on scar assessment scales such as Vancouver Scar Scale (VSS) and the Patient and Observer Scar Assessment Scale (POSAS) which are difficult in recording small changes in the scar conditions over time. This study adopts a simple method to quantify the size of hypertrophic scars on hands by using a camera and tripod set-up for image capturing and a free software, ImageJ, for analysis. The ability to record the changes in scars condition and healing progress of this method were investigated. ⋯ No significant within-subject effect of the repeat of measurements (p>0.05) and between-subject effect of the three operators (p>0.05) were found on the scar area measurements and the proportion of the scars on hands but significant differences were found between different time-points of the image capturing (p<0.05). The image analysis method is more sensitive to the change of scars conditions over time than the VSS record. This is an economical and relatively easy method to quantify the changes in the hypertrophic scars which could be useful for monitoring the progress of therapy and encourage treatment compliance.
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The objective of this study is to review our experience in the implementation of an innovative Telemedicine Platform (the Teleburns Project) for the acute care of burned patients. ⋯ The use of Telemedicine for burn assessment can improve the accuracy of burn patients triage, resulting in enhanced resource utilization, time and cost saving for the health system and increased quality of care.
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Electrical burns are an uncommon yet devastating class of burn injuries. Shriners Hospitals for Children - Boston a pediatric burn center in New England and cares for both domestic and international patients. We utilized our experience over the past 13 years to review surgical management and evaluate historical trends for this unique patient group. ⋯ Based on our experience, epidemiology and surgical intervention varied based on voltage of the burn injury and residence of the patient. We have seen a reduction in US pediatric high voltage injuries over the past two decades, likely due to enhancement of electrical safety. It may be possible to use a similar strategy to reduce the frequency of severe high voltage electrical burn injuries in developing countries.
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Extracorporeal shock wave therapy (ESWT), first described in the eighties for the treatment of urolithiasis, has also been applied in other fields such as orthopaedics and chronic wound care. Recently it has also been used in the treatment of burns and its sequelae since several studies suggest it could be an important tool in the conservative management of these conditions. The aim of this article is to review the literature for published evidence on the use of ESWT for the treatment of acute burn patients and its sequelae and to elaborate a brief report on the current state of the matter. ⋯ Scientific evidence on the use of ESWT for the treatment of burn patients is weak due to the paucity of studies and their low quality. However, ESWT seems to be a promising tool in this field and therefore more high-quality trials should be conducted.
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Burn injuries are a major cause of morbidity and mortality worldwide. Despite advances in therapeutic strategies for the management of patients with severe burns, the sequelae are pathophysiologically profound, up to the systemic and metabolic levels. Management of patients with a severe burn injury is a long-term, complex process, with treatment dependent on the degree and location of the burn and total body surface area (TBSA) affected. In adverse conditions with limited resources, efficient triage, stabilisation, and rapid transfer to a specialised intensive care burn centre is necessary to provide optimal outcomes. This initial lag time and the form of primary treatment initiated, from injury to specialist care, is crucial for the burn patient. This study aims to investigate the efficacy of a novel visco-elastic burn dressing with a proprietary bio-stimulatory marine mineral complex (MXC) as a primary care treatment to initiate a healthy healing process prior to specialist care. ⋯ Utilisation of this EBD + MXC as a primary treatment is an effective and easily applicable treatment in cases of burn injury, proving both a cooling and hydrating environment for the wound. It regulates inflammation and promotes healing in preparation for specialised secondary burn wound management. Moreover, it promotes a healthy remodelling phenotype that may potentially mitigate scarring. Based on our findings, this EBD + MXC is ideal for use in all pre-hospital, pre-surgical and resource limited settings.