Burns : journal of the International Society for Burn Injuries
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Burned tissue is necrotic and it is surrounded by a zone of stasis and hyperaemia with changed cell metabolism. The removal of burned tissue using an electric knife releases large amounts of surgical smoke. The aim of the research was to analyse volatile, nonpolar, organic compounds that are released during the excision of burned tissue using an electric knife (mono- and bipolar). ⋯ Our study revealed the presence of complex toxic hydrocarbon derivatives in surgical smoke. We also observed that the content of surgical smoke is different depending on the type of the conducted intervention. So far, no studies focusing on hazards posed by surgical smoke that is released during the resection of burned tissue are in the literature.
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Observational Study
PenKid measurement at admission is associated with outcome in severely ill burn patients.
Proenkephalin A 119-159 (penKid) has been proposed as a sensitive biomarker of renal function. This study evaluated the association of concentrations of plasma penKid with death and risk of acute kidney injury (AKI) in severely ill burn patients. ⋯ Plasma penKid concentration at admission was associated with an increased risk of death in burn patients. PenKid has additional prognostic value on top of Screat and SOFA to predict 90-day mortality.
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An important challenge in pain assessment is the inability of an evaluator to corroborate, using objective signs or indicators, the subjective pain report of a patient. In this scenario, the Electronic von Frey (EVF) anaesthesiometer rises as a valuable Quantitative Sensory Testing modality for pain evaluation. Although EVF showed good reproducibility when applied to healthy areas in humans, its use for evaluation of burn-related pain threshold has not yet been validated. ⋯ Baseline clinical and demographic parameters did not significantly affect the association between EVF and VAS. Additionally, EVF had significant and moderate positive correlation with the amount of analgesic used and with the Burns Specific Pain Anxiety Scale scores. Regular pain assessment is essential for the establishment of an appropriate treatment plan; thus, it is critical that we continue to refine our pain assessment skills to avoid chronic pain and psychological trauma in burn patients.
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The development of acute outpatient clinics has enabled burns services to assess the majority of smaller paediatric burns the day after injury. This event can be distressing and it is therefore important to ensure that children are initially assessed in an optimal environment. ⋯ This national survey has shown that 5% total body surface area (TBSA) is generally considered to be the upper limit for new paediatric referrals to be seen in the outpatient setting 5%. Furthermore, we advocate that Paracetamol and Ibuprofen be given 60 min prior to an allocated appointment time.