J Trauma
-
The outcome of burn care is conventionally measured in terms of mortality. To extend our understanding beyond this level, and specifically to develop insight into the morbidity and other sequelae or burn injury, we have constructed a Burn-Specific Health Scale (BSHS). ⋯ Preliminary internal consistency and reliability testing of the scale has proved satisfactory. We present here the results of testing in 40 initial patients, with the following conclusions: 1) The psychosocial performance of patients with major burns lags behind their performance in other areas, and we need to explore alternate clinical strategies for their support; 2) The BSHS can be used to determine both individual and group performance and needs for intervention; 3) The postburn recovery is dynamic and undergoes marked changes for a prolonged period of time, at least 1 year post-hospitalization: this must be considered when such patients are being evaluated for various purposes, e.g., disability.
-
Even though metal refineries require workers to wear safety boots, molten metal splash causes serious burns to the feet and ankles of these employees. Twenty cases are reported which illustrate the need for safety boot top protection. In analyzing these cases, it was found that these molten aluminum and brass alloy burns were not full-thickness, and dermis could be preserved. The technique of dermabrasion-debridement was found to be a valuable tool for accurate debridement of such wounds in this location.
-
A period of aggressive surgical treatment of early identification of fungal infection of the burn wound was compared with the previous 5 years' experience with patients suffering from fungal infection of burn wounds. The portion of those patients with Candida infections diagnosed and treated premortem increased from 48.0% to 63.6% and of patients with noncandidal infections from 40.8% to 67.0% in the more recent period. ⋯ Local surgical control of the infected portion of burn wounds is an effective way of improving the survival in noncandidal burn wound infections. Surgical excision of burn wounds does not alter the poor prognosis of patients with Candida invasion of the burn wound.