Burns : journal of the International Society for Burn Injuries
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Burns education appears to be under-represented in UK undergraduate curricula. However current postgraduate courses in burns education provide formal training in resuscitation and management. ⋯ We present a literature review that summarises the format of current burns education, and provides detailed insight into historic, current and novel advances in burns simulation for both technical and non-technical skills, that can be used to augment surgical training. Addressing the economic and practical limitations of current immersive surgical simulation is important, and this review proposes future directions for integration of innovative simulation strategies into training curricula.
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Review
Appraising current methods for preclinical calculation of burn size - A pre-hospital perspective.
Calculation of the percentage of total body surface area burnt is a vital tool in the assessment and management of patients sustaining burns. Guiding both treatment and management protocols. Currently there is debate as to which method of estimation is the most appropriate for pre-hospital use. ⋯ Palm including digits measurements multiplied by 0.8 is suitable for assessing minor (<10%) burns however for larger burns Wallace's Rule of Nines is advocated. Further development of technology suggests computerised applications will become more commonplace.
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The contribution of human herpes viruses, including herpes simplex virus (HSV), cytomegalovirus (CMV), and varicella zoster virus (VZV) to morbidity and mortality after burns remains controversial. This systematic review was undertaken to assess evidence of herpes virus-related morbidity and mortality in burns. ⋯ No direct evidence linked CMV and HSV infection with increased morbidity and mortality in burns. Following burn, CMV reactivation was more common than a primary CMV infection. Active HSV infection impaired wound healing but was not directly correlated to mortality. Infections with VZV are rare after burns but when they occur, VZV infections were associated with severe complications including mortality. The therapeutic effect of antiviral agents administered after burns warrants investigation via prospective randomized controlled trials.
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Electrical burns are devastating, posing development of multiple injuries with high morbidity and mortality. Electrical burn management benefits from a multidisciplinary, multispecialty collaborative approach to improve outcomes. ⋯ Electrical burns affecting young adult men can impose a significant burden in developing countries. Electrical burns, especially due to high voltage, involve multiple organs benefitting from multidisciplinary management and have significant residual sequelae. Public awareness and education and proper training of industry workers remain the best way to minimize the prevalence of electric burns in the developing world.
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Visible scarring after burn causes social challenges which impact on interpersonal connection. These have health impacts which may worsen outcomes for burn patients and reduce the potential for posttraumatic growth (PTG). ⋯ Emotional and situational barriers reduced social connection and avoidant coping strategies reduced the interaction of people with burns with others. Active coping strategies need to be taught to assist with social reintegration. This highlights the need for peer support, family support and education, and social skills training.