The Journal of burn care & rehabilitation
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J Burn Care Rehabil · Nov 2005
Impact of an inpatient rehabilitation facility on functional outcome and length of stay of burn survivors.
This study reviewed the use of an inpatient rehabilitation unit for burn survivors. We hypothesized that adult burn patients admitted earlier to inpatient rehabilitation have an equal or better functional outcome than those remaining in acute burn center for rehabilitation care. Functional Independence Measure (FIM) data were prospectively collected on our burn center admissions dating January 2002 to August 2003. ⋯ REHAB had larger burn injuries, more inhalation injuries, higher incidence hand/foot burns, and longer length of stay (LOS). REHAB had lower FIM upon rehabilitation facility admission than national averages but greater FIM improvement during comparable rehabilitation LOS. Although our earlier rehabilitation admission strategy results in more frequent rehabilitation unit referrals, patients had shorter burn center LOS and greater FIM improvement compared with limited national burn patient functional outcome data currently available.
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J Burn Care Rehabil · Nov 2005
Close relative intermingled skin allograft and autograft use in the treatment of major burns in adults and children.
Major burns still continue to pose problems of inadequate auto skin closure. Patients suffering severe burns lack adequate skin graft donor site. We present the results of 17 major adult and pediatric burns that we applied close relative intermingled skin allograft and autograft in the course of treatment. ⋯ Mean percent TBSA of the dead and surviving patients were 55.5 +/- 11.16 (range, 40-70) and 55.0 +/- 4.08 (range, 50-60) respectively. Mean age of the dead and surviving patients were 16.1 +/- 13.77 (range, 2-42) and 11.1 +/- 6.74 (range, 2-21), respectively. We present a safe and satisfactory means of effective alternative treatment to resurface major burns in case of limited auto skin graft donor site without exposure to bacteria, human immunodeficiency virus, and hepatitis virus when keratinocyte culture facilities and skin banks are not available.
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J Burn Care Rehabil · Nov 2005
Axillary burns: extended grafting and early splinting prevents contractures.
The development of contractures is a common complication after burn injuries. Axillary burns often result in limited abduction of the arm and present a major hindrance in rehabilitation. To prevent axillary contractures after burn injury, we perform a special grafting technique. ⋯ After 12 months, the mean abduction of the successfully treated axillary burns was 152 degrees. A secondary reconstruction was needed in only 5 of the 23 treated axillary burns. For the treatment of axillary burns, we recommend the described grafting technique in combination with early splinting and intensive physiotherapy.
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J Burn Care Rehabil · Nov 2005
Ginkgo biloba extract improves oxidative organ damage in a rat model of thermal trauma.
This study was designed to determine the possible protective effect of Ginkgo biloba extract (EGb) against oxidative organ damage distant from the original burn wound. Under brief ether anesthesia, the shaved dorsum of the rats was exposed to 90 degrees C (burn group) or 25 degrees C (control group) water bath for 10 seconds. EGb (50 mg/kg/day) or saline was administered intraperitoneally immediately and at 12 hours after the burn injury. ⋯ However, treatment with EGb reversed all these biochemical indices, as well as histopathological alterations that were induced by thermal trauma. Our results show that thermal trauma-induced oxidative damage in hepatic and renal tissues is protected by the administration of EGb, with its antioxidant effects. Therefore, its therapeutic role as a "tissue injury-limiting agent" must be further elucidated in oxidant-induced tissue damage.
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J Burn Care Rehabil · Nov 2005
Comparative StudyBacteriological profile and antibiotic resistance: comparison of findings in a burn intensive care unit, other intensive care units, and the hospital services unit of a single center.
The purpose of the study was to define the bacteriological profile and antibiotic resistance patterns of a burn intensive care unit (ICU) and to compare them with the patterns from three other hospital areas in the same center (ie, cardiovascular-coronary ICU, a general ICU, and the hospital service unit). Bacterial isolates were collected prospectively from the burned patients and the patients from the other hospital areas between May 2001 and November 2003. In the burn ICU, Pseudomonas aeruginosa was the isolated pathogen most frequently (40.4%), followed by Staphylococcus aureus (29.3%) and Acinetobacter spp. (9.8%). ⋯ We observed higher antimicrobial resistance in burn ICU than in the other hospital areas studied. In conclusion, bacteriological profile and antibiotic resistance patterns of patients in the burn ICU are significantly different from those in other ICUs and hospital units at our center. This knowledge is crucial for early treatment of infections in burned patients.