The Journal of burn care & rehabilitation
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In order to facilitate excellent comprehensive burn care for patients discharged from our burn center, we instituted a study to determine the quality of our discharge teaching program. As a result of high census and high acuity levels, our burn center transfers patients with smaller burns to adult and pediatric surgical floors. ⋯ In an effort to evaluate the quality of discharge teaching provided to patients discharged from the Burn Intensive Care Unit (BICU), pediatric, and surgical step-down units, we developed a questionnaire to be completed at their first clinic visit. After consideration of these preliminary results, an education program was developed to improve discharge teaching techniques for nurses caring for burn patients in stepdown areas.
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J Burn Care Rehabil · Nov 1988
Use of 5% sulfamylon (mafenide) solution after excision and grafting of burns.
In previous reports, 5% sulfamylon solution has been utilized on unexcised burns and granulation tissue. We prospectively evaluated 67 burn patients to determine graft take and the incidence of side effects with use of sulfamylon solution dressings after excision and grafting. Of patients excised and grafted, the mean graft take for a total of 100 procedures was 86%. ⋯ Pain intensity was rated on a Visual Analog Scale with a mean score of 2.4; in no case was the pain considered severe enough by the patient to terminate treatment. Acidosis was present in 3% of patients but felt to be unrelated to the sulfamylon treatment. As an antimicrobial agent, 5% sulfamylon solution is a viable alternative for fresh autografts with excellent graft take and acceptable side effects.
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J Burn Care Rehabil · Nov 1988
A new instrument for serial measurements of elasticity in hypertrophic scar.
The "elastometer," a hand-held device, was designed and constructed to permit noninvasive quantification of the elastic properties of normal skin or hypertrophic scar. The instrument utilizes a constant-tension spring and a sensitive strain gauge to distract two loci of skin. Normal skin from 15 dogs was measured in vivo with the elastometer and in vitro using standard tensometry. ⋯ There was a trend towards higher values in older scars. Elastometric measurements have increased appreciably in some burn scars undergoing treatment. The elastometer should be useful in documenting objectively the spontaneous maturation of burn scars and/or their response to treatment.
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J Burn Care Rehabil · Nov 1988
The role of oxygen-derived free radicals in burn-induced myocardial contractile depression.
The release of oxygen free radicals from ischemic myocardium has been implicated as a causative factor of cardiac dysfunction after thermal injury. In this study, isolated coronary perfused guinea pig hearts were used to determine if free radical scavengers improve left ventricular (LV) intrinsic contractile response to burn shock. Parameters measured included peak isovolumic LV pressure (LVP) and maximal rate of LVP rise (+dP/dtmax) and fall (-dP/dtmax) at a constant preload. ⋯ There was no significant difference in heart rate or time to peak pressure or time to maximal contraction or relaxation among the groups. Left ventricular function curves for burned hearts were shifted downward and to the right of curves obtained from control hearts (P less than 0.01), regardless of scavenger treatment. PEG-SOD, 6,000 U, improved left ventricular contractility (+dP/dt) at maximal levels of end-diastolic pressure but deficits in left ventricular pressure and relaxation persisted.(ABSTRACT TRUNCATED AT 400 WORDS)