Burns : journal of the International Society for Burn Injuries
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Bromelain-based enzymatic debridement has emerged as a valuable option to the standard surgical intervention for debridement in burn injuries. Adverse effects on coagulation parameters after enzymatic debridement have been described. The purpose of this study was to compare the effect of enzymatic and surgical debridement on coagulation. ⋯ Enzymatic debridement in burned patients does not appear to increase the risk of coagulation abnormalities compared with the regular surgical approach.
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Quality indicators (QIs) are tools for improving and maintaining the standard of care. Although burn injuries are a major global health threat, requiring standardized management, there is a lack of worldwide accepted quality indicators for burn care. This study aims to identify the best burn care-specific QIs as perceived by worldwide burn practitioners. ⋯ Specific QIs related to structures, clinical processes, and outcomes are needed to monitor the treatment of burn patients globally, assess the efficiency of the provided treatment, and harmonize the worldwide standard of burn care.
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Removal of necrotic tissue is a vital step in the treatment of full-thickness burn wounds, with surgical debridement being the most effective method. Since minor burn wounds are typically treated on an outpatient basis where surgical capabilities can be limited there is a need for alternative treatment options. In this study we aim to evaluate the use of amino acid buffered hypochlorite (AABH) as a chemical enhancement for wound debridement in a porcine infected burn wound model. ⋯ Our results indicate that AABH facilitates wound debridement and could be a helpful addition to an effective treatment modality for removal of necrotic tissue in full-thickness burns.
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Heat-press hand burn leads to complex and severe lesions, with potentiation of thermal burn by the crushing mechanism. Management remains poorly codified, and the surgical strategies found in the literature remain contradictory. The objective of our study is to report our experience and define the first burn excision delay through functional evaluation with a Quick-DASH questionnaire. ⋯ According to observations made in our unit and in agreement with Tajima, who first described heat-press injury, the first surgical excision should be performed approximately one week after the accident. Subsequent excisions may be performed to reassess the lesions and complete the debridement, with reconstruction to follow. Multidisciplinary management is still necessary, including early and intensive physiotherapy, psychological support, and assessment by an occupational physician.
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Extensive burns are devastating trauma. This study aimed to explore the predictive value of early lactate dehydrogenase (LDH) level, the abbreviated burn severity index (ABSI) and their combination on acute kidney injury (AKI) and mortality after severe burns. ⋯ Early LDH level is an independent risk factor for early AKI and AKI. LDH combined with ABSI can better predict mortality and AKI than single indicators.