Burns : journal of the International Society for Burn Injuries
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Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but severe adverse drug reactions with high mortality. The use of corticosteroids and the management of complications (e.g. infection) in SJS/TEN remains controversial. ⋯ The mortality of patients in this study was lower than that predicted by SCORTEN, although there was no significant difference between them. Hyperglycemia, high-dose corticosteroid, and the TBSA were closely related to the infections of patients with SJS/TEN.
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Observational Study
Resuscitation with albumin using BET formula keeps at bay fluid administration in burned patients. An observational study.
BET (Biological Engineering Technology) formula uses fluids with high albumin concentration to resuscitate burn patients. It estimates fluid resuscitation as a function of Body Burned Surface Area (BBSA) (ml/h = BBSA (m2) × 220) and administers it through a combination of lactated ringer and 20% Albumin starting at a 1:1 relationship. The proportion of albumin is decreased every 8 h, and infusion rate is modified according to urinary output. ⋯ Patients were successfully resuscitated showing a significant base excess increase and lactate clearance during the resuscitation period (base excess 120%; lactate 29%; P < 0.05). Burn related complications where: ARDS 27%, renal dysfunction 53%, wound deepening 20%, abdominal compartment syndrome 4.5%. In conclusion, BET formula is capable of resuscitating burn patients successfully, limiting fluid administration.
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Chemical ocular burns are among the most frequently eye-related injuries, which require immediate and intensive evaluation and care since they may lead to potential complications such as superinfection, corneal perforation, and blindness.Vasconcellea cundinamarcensis, a species from Caricaceae family, contains highly active proteolytic enzymes in its latex that show healing activity in animal models bearing lesions of different etiologies. ⋯ Our work was the first one to evaluate the ophthalmic application of P1G10. Here we demonstrated that P1G10 is suitable for ocular administration and it has a promising corneal healing activity which may emerge as a new pharmacological tool to the development of a new drug for ocular surface chemical injuries in the future.
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Hypopigmentation is a major problem in deep dermal burns. To date, no standard treatment is available for the post burn hypopigmentation disorder. Therefore, understanding the molecular and cellular events are of benefit for therapeutic intervention. ⋯ Culture data exhibited a change of dendritic structure, reduced proliferation rate, faulty melanin synthesis and transfer of melanin from melanocytes to keratinocytes in PBHS samples. To the best of our knowledge, this is the first study showing structural and functional aberrations of melanocytes and keratinocytes, as a potential cause of hypopigmentation in burned patients. Our study, therefore, provides valuable insight for the basis of hypopigmentation in post burn patients, which may pave the way for clinical intervention in the future.
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Time to return to school in child and adolescent burn patients from a sub-Saharan tertiary hospital.
Africa, with the largest number of paediatric burns needs to focus more attention on paediatric burn survivors. Burn injury truncates schooling in child and adolescent burn patients. The aim of this study was to determine the time to return to school and factors influencing this in child and adolescent burn patients. ⋯ Time to return to school from burn injury and from discharge in child and adolescent burn survivors in this study are at least three times longer than previous studies. The burn care team needs to consider school re-entry programs for these children.