The Journal of burn care & rehabilitation
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J Burn Care Rehabil · Jan 1988
Managing the difficult airway in patients with burns of the head and neck.
A five-phase defined protocol for airway security was developed and administered to a consecutive, selected series of surgical patients with burns to the head and neck that limited their mouth opening or neck mobility. The protocol uses fiberoptic light and scope systems to allow the anesthesia team to visually place the endotracheal tube properly before anesthesia is induced. The technique provides safe, efficient airway management for patients with burns to the head and neck and significantly diminishes patient risks.
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J Burn Care Rehabil · Jan 1988
Comparative StudyComparison of complications during rehabilitation between conservative and early surgical management in thermal burns involving the feet of children and adolescents.
To evaluate the long-term sequelae of early surgical management compared with conservative therapy, a retrospective review from January 1976 to December 1984 was undertaken. Through inspection of burn diagrams, 395 patients were identified with burns involving the foot. ⋯ No statistical difference was found in mortality, amputations, incidence of open wounds, development of contractures, or number of patients requiring reconstructive procedures between conservative and early excision therapy except in those children treated with skeletal suspension. Thus in burns involving the feet in children, early excision and grafting does not alter the resultant morbidity compared with conservative burn management.
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J Burn Care Rehabil · Jan 1988
Case ReportsMultidisciplinary approach to working with burn victims of child abuse.
Successful outcomes in abuse cases are dependent upon close coordination of professional hospital staff with referring agencies including child protective services and the legal and judicial systems. A four-year retrospective study of 369 pediatric burn patients admitted to our Burn/Trauma Center was completed to: (1) assess demographic factors of patients and families that differentiate cases of child abuse from cases of children burned as a result of accidental injury, and (2) determine the impact of a multidisciplinary team approach to working with abused children and their families during the course of hospitalization. ⋯ This includes the obtainment of photographs and detailed documentation of the burn injury. A plan of evaluation and the effective coordination of services during hospitalization and following discharge have proven essential to meeting the best interests of the child.
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J Burn Care Rehabil · Jan 1988
Comparative StudyDimethylsulfoxide with heparin in the treatment of smoke inhalation injury.
Recent studies suggest that lung lesions occurring in inhalation injury result from actions of oxygen-free radicals released from polymorphonuclear leukocytes marginating in the pulmonary microcirculation and tracheobronchial region. Peroxide and hydroxyl ions have been implicated as mediators in the increased microvascular permeability and pulmonary edema noted after inhalation injury. In this study we evaluated the use of an O2-free radical scavenger, dimethylsulfoxide (DMSO), and heparin in the treatment of smoke inhalation. ⋯ All animals in the DMSO plus heparin group survived, four of the DMSO group died, and two of the heparin group died. Lung lymph flow was not as high in the DMSO plus heparin group as in the heparin-only group. DMSO was proved effective in reducing the lung injury associated with smoke inhalation.
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J Burn Care Rehabil · Jan 1988
The microstomia prevention appliance: 14 years of clinical experience.
Partial- or full-thickness perioral facial burns may lead to a contracture of the tissues surrounding the oral commissures that results in microstomia. The current investigators have used the microstomia prevention appliance (MPA) exclusively in the management of commissure burns at the University of Iowa Burn Center since 1972. ⋯ The chart analysis of 83 patients revealed that, with diligent and persistent use of the MPA, only one patient required surgical repair for the development of microstomia. The MPA has proved effective in decreasing the need for reconstructive procedures and in preventing the occurrence of microstomia.