Burns : journal of the International Society for Burn Injuries
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To share our 20-year experience in major burn management and the impact of a newly implemented burn protocol since 2015 at Tri-Service General Hospital (TSGH). ⋯ The new TSGH Burns Protocol revolutionized the care of major burns by introducing tailored, multidisciplinary burn management and improved patient outcomes.
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Burn injuries present a significant challenge globally, particularly in low- and middle-income countries (LMICs) where access to standard intravenous (IV) fluid resuscitation is often limited. In such austere settings, the feasibility of enteral resuscitation via oral rehydration solution (ORS) as an alternative to burn resuscitation is a critical consideration. We aimed to investigate the barriers and facilitators perceived by burn care providers in Nepal trained to use an enteral resuscitation protocol. ⋯ This study highlights the importance of stakeholder engagement, iterative refinement, and contextual adaptation in implementing an enteral resuscitation protocol for acute burn injuries. Findings offer insights into real-world applications and future clinical and research endeavors, informing the potential scalability and sustainability of enteral resuscitation protocols more broadly, to improve the care of patients with major burns in LMICs.
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Literature examining the impact of obesity on burn injury remains mixed. Previous examination of the National Burn Repository, now the BCQP, in obesity-related burn research is limited. The aim of this work was to provide an assessment of the BCQP dataset to examine the effect of obesity on burn-related outcomes. ⋯ The presence of obesity in this dataset was not found to be a predictor of mortality for any burn size, but was a predictor of overall LOS, ICU LOS, and total hospital costs. Including obesity-related variables in databases may improve analysis in obesity-related burn research.
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Pruritus, a common symptom of burn wounds, arises from skin tissue damage and abnormal tissue healing. Chronic post-burn pruritus (CPBP) is defined as itching that persists for six weeks or more. The brain mechanisms underlying CPBP are not understood adequately. This study aims to explore abnormal brain function in CPBP patients and identify potential pathogenesis of pruritus. ⋯ Our data suggest that patients with CPBP show alterations in ReHo, ALFF, and fALFF values primarily in brain regions associated with the default mode network and sensorimotor areas. These results may provide valuable insights relevant to the neuropathology of CPBP.
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Community-level disadvantage is associated with reduced quality of life after burn injury. We evaluated the association between community-level disadvantage and return to work after burn injury. ⋯ Patients from the highest distress communities have twice the odds of unemployment 6 months after injury. This association did not vary by race. Screening for DCI by ZIP code may be a useful tool to focus vocational rehabilitation resources.