Burns : journal of the International Society for Burn Injuries
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To identify policies on the consumption of hot drinks by patients and visitors on all perinatal and postnatal wards in the United Kingdom, and to seek the opinions of members of the wider burns MDT as to whether standardised patient education or regulation of hot drinks around newborn babies is required. ⋯ Almost every postnatal unit in the UK has access to hot drink retailers on site allowing parents and visitors to bring them into close contact with babies. With varying local regulations, this poses potentially serious consequences during feeding or carrying. We propose a standardised antenatal education be made available, together with standardised designated areas on wards for parents and visitors to consume hot drinks away from infants.
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Silver sulfadiazine (SSD) has been widely used in burned patients for the prevention of local infections. To be biologically active and exert antimicrobial properties, silver needs to be present in the form of silver ions (Ag1+) that bind to negatively charged proteins, namely, the RNA and DNA in microorganisms. However, previous published studies conducted with SSD in the 1990s reported a high level of silver absorption through damaged skin and noted the potential cytotoxicity of Ag1+ to human cells. SSD toxicity, however, had been described in cell cultures using arbitrary silver concentrations. In the present study, we determined the serum silver levels in burned patients treated with SSD and, taking into account the molar Ag1+ concentrations found in these patients, we evaluated the Ag1+ toxicity effects on inflammatory cells (ROS and cytokine production) in vitro. ⋯ These findings suggest that Ag1+ may contribute to negative outcomes after burns, decreasing the primary defense mechanism (respiratory burst) and altering cytokine production.
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Burns are known to have an effect on coagulation in the early period after burn. Current coagulation tests have been criticised in acute burns due to their inherent limitations. This study aims to investigate the potential for a new quantitative functional biomarker of clot quality, fractal dimension, to identify changes in clot microstructure as a result of the burn inflammatory response and its treatment. ⋯ This is the first study to quantify the changes in clot microstructure following burn injury. This study confirms clot microstructure is significantly altered during the first 24h after burn, with the production of a weaker, more porous fibrin clot, consistent with a hypocoagulable state.
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Randomized Controlled Trial
Assessing the effects of 6 weeks of intermittent aerobic exercise on aerobic capacity, muscle fatigability, and quality of life in diabetic burned patients: Randomized control study.
Both burn and diabetes mellitus (DM) cause functional and psychosocial disabilities. A low-cost and safe approach is greatly required to reduce these disabilities and the effects of aerobic exercise have generated varied evidence to date. The aim of the study was to explore the effects of 6 weeks of intermittent aerobic exercise (IAE) on aerobic capacity, muscle fatigability, and quality of life (QoL) in diabetic burned patients (DBPs). ⋯ 6 weeks of intermittent aerobic exercise is an effective alternative modality to improve aerobic capacity, muscle fatigability, and QoL in DBPs. Adherence to intermittent aerobic exercise should be practicable into mainstream clinical intervention for those patients.
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Early burn wound assessment is a major problem in pediatrics. It involves regular clinical evaluations, and may be helped by objective tools, such as thermal imagers. Because of the skin temperature difference between partial and full thickness burns, due to injured vascular perfusion of the dermis in the latter, it could precisely identify areas with superficial burns which could heal from controlled wound healing, and those with deep burns which would need skin graft, at an early stage. The objective of this study was to assess the validity of the Flir one thermal imager® for this purpose. ⋯ The Flir One Thermal Imager® is an inexpensive, non-invasive, and easy-to-use device. It measures indirectly but with an excellent specificity the dermis perfusion reflecting the burns depth in children. However its low sensitivity calls for additional research to allow skin grafts earlier in common practice and decrease the length of stay.