Burns : journal of the International Society for Burn Injuries
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Skin coverage remains a significant hurdle in large-sized burns. Recent advances have allowed to grow Bilaminar Cultured Skin Autografts (BCSGs) from patients' own donor sites. The aim of this study was to report long-term outcomes in patients with large-sized burns having received BCSGs. ⋯ This is the first report investigating the long-term outcome of a newly developed BCSG. BCSGs demonstrated comparable results with patients' autografts, functional outcomes on self-reported questionnaires and excellent psychological states. Precaution given the extensive unexpected hyperpigmentation must be taken and a randomized controlled study is underway.
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Rapid estimation of acute hand burns is important for communication, standardisation of assessment, rehabilitation and research. Use of an individual's own thumbprint area as a fraction of their total hand surface area was evaluated to assess potential utility in hand burn evaluation. ⋯ We have demonstrated how thumbprint area serves as a simple method for evaluating hand burn surface area.
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To describe the epidemiology of genital burns in the U.S. and investigate the underlying etiology. ⋯ Children sustain genital burns at a higher rate than adults and many appear to have a preventable mechanism. Improved product design for safety and educating caregivers about potential hazardous situations are needed.
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The Linköping burn score has been used for two decades to calculate the cost to the hospital of each burned patient. Our aim was to validate the Burn Score in a dedicated Burn Centre by analysing the associations with burn-specific factors: percentage of total body surface area burned (TBSA%), cause of injury, patients referred from other (non-specialist) centres, and survival, to find out which of these factors resulted in higher scores. Our second aim was to analyse the variation in scores of each category of care (surveillance, respiration, circulation, wound care, mobilisation, laboratory tests, infusions, and operation). ⋯ To our knowledge this is the first long term analysis and validation of a system for scoring burn interventions in patients with burns that explores its association with the factors important for outcome. Calculations of costs are based on the score, and it provides an indicator of the nurses' workload. It also gives important information about the different dimensions of the care provided from thorough investigation of the scores for each category.
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Patients with extensive burn injuries are susceptible to a host of accompanying adverse effects should they develop perioperative hypothermia, which occurs in up to ¼ of all major burn cases. This quality improvement project aimed to reduce the incidence of perioperative hypothermia to below 10% of cases in patients with major burn (Total Body Surface Area [TBSA] >15%), within a one year period. ⋯ The inevitable drop in temperature is ameliorated by sound perioperative practices, rather than just intraoperative ones. This initiative demonstrated the potential benefits of, and motivates for, the broad application of preoperative warming in the context of major acute burn surgery. Further investigations include PDSA cycles to determine whether the duration or degree of intraoperative hypothermia is more virulent. To consolidate the pre-warming initiative, we have introduced a standard order within our admission order sets to include preoperative warming for all eligible patients.