The Journal of burn care & rehabilitation
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J Burn Care Rehabil · Jul 1986
Comparative Study Clinical TrialBurn depth evaluation with fluorometry: is it really definitive?
Clinical evaluation of burn depth soon after injury is subjective, based on gross visual assessment. Previous investigators have quantified this process using fluorometry. Their studies show fluorescein levels in full-thickness burns to be far below control levels and partial-thickness burns to be about 60% of nonburned skin. ⋯ The results showed no significant difference between partial-thickness and full-thickness burns using fluorometry, as standard deviations in both models for both depths of burn were large. Therefore, fluorometry did not provide a definitive evaluation of burn depth. These results differ from those reported by previous investigators.
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The records of 51 patients with chemical burns were reviewed to identify demographics, mechanism and place of injury, cause, distribution, initial management, and outcome of treatment. Patients were classified as having received adequate (immediate dilution or neutralization of the chemical treatment--group A, or inadequate (delayed or inappropriate) treatment--group B. ⋯ In group A, 19% required skin grafting (mortality 9.5%); in group B, 36% required grafting (mortality 21%). Alkali were the most frequent cause of burns, followed by sulfuric acid and, less often, gasoline, anhydrous ammonia, white phosphorus, and hydrofluoric acid.
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J Burn Care Rehabil · Jul 1986
Comparative StudyHeterotopic ossification: are range of motion exercises contraindicated?
The incidence, time of onset, and role of exercise in the progression of heterotopic ossification were documented retrospectively in burn patients. In 12 of 1,066 patients (1.2%) consecutively admitted to a burn center, the abnormal bone formed posteriorly around the elbow joint. The initial signs were localized joint pain and rapid decrease in range of motion, and the average time of onset was 12 weeks after thermal injury. ⋯ In patients who persisted with passive and active-assisted range of motion, especially beyond the range of pain-free movements, the ossification progressed to complete ankylosis and required surgical intervention to remove the heterotopic bone. On the other hand, postoperative patients and patients who followed a program of active exercise within the pain-free range gained excellent range of motion. It was concluded that passive stretching of the periarticular structures during the acute phase of heterotopic bone formation is detrimental to the final outcome.