The Journal of burn care & rehabilitation
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Obesity is seldom recognized as a risk factor for the patient with burns. However, the overweight patient with burns presents major problems for the burn team, especially in the areas of wound care, pulmonary care, and general nursing care. One-hundred eighty adults (9.1% weighed more than 45 kg above ideal body weight or more than 100 kg in total weight. ⋯ The obese patient presents problems disproportionate to burn size, burn location, and age. The obese patient's problems are related to weight. Care is often compromised by the physical constraints of a patient's size.
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J Burn Care Rehabil · Jan 1990
Review Case ReportsBranhamella catarrhalis pneumonia with bacteremia in a pediatric patient with smoke inhalation.
Branhamella catarrhalis, a common inhabitant of the upper respiratory tract, has been identified recently as a cause of lower airway infection. In this report we present a case of B. catarrhalis pneumonia and bacteremia in a child with smoke inhalation as the first description of invasive disease involving this organism in a traumatized airway. In addition, other pediatric cases of B. catarrhalis bacteremia are reviewed, suggesting immunocompromise as a risk factor.
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A review of 1987 patients treated during the years 1981 to 1986 was conducted to answer the following questions about perineal burns: (1) Are Foley catheters necessary for all patients? (2) Is there any advantage to early excision of the perineal burn wound? (3) What are the complications of perineal wounds? One hundred three patients with perineal burns were identified; mean burn size was 36% of total body surface area. There were 29 deaths in this group but none were related to the perineal burns. Of the 74 survivors 36 (49%) needed Foley catheters. ⋯ In conclusion, we found no genitourinary complications associated with perineal burns. Almost all perineal and genital burns were managed without indwelling catheters. Early excision of the perineal burn wound is not necessary, and most of these wounds will heal satisfactorily without grafting.
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Fibrin plate assays revealed that human burn blister fluid represses plasmin-induced fibrinolysis. While this repression is significant, it is not as potent as that of human serum. ⋯ The activity of ibuprofen appears to be unrelated to the synthesis of prostaglandins because other nonsteroidal drugs that were tested, such as indomethacin, imidazole, and tolmetin had significantly less antagonistic activity. This plasmin inhibition, which is contained in burn blister fluid, may contribute to vascular occlusion after burn injury, which leads to secondary dermal ischemia and necrosis in patients traumatized by burns.