The Journal of burn care & rehabilitation
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J Burn Care Rehabil · Sep 1995
Cultured epithelial autografting on meshed skin graft scars: evaluation of skin elasticity.
Many patients with meshed skin graft scars complain of the scars' unsightly appearance and hardness. Since 1989 we have shaved away meshed skin graft scars and then resurfaced the area with autologous cultured epithelium in nine patients. This method improved the disfigurement of meshed skin graft scars, with minimal sacrifice of normal donor skin. Furthermore, autologous cultured epithelium grafted areas had high skin elasticity compared with meshed skin graft scars, as measured with a noninvasive suction device.
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J Burn Care Rehabil · Sep 1995
The Vancouver Scar Scale: an administration tool and its interrater reliability.
The Burn Scar Index, often called the Vancouver Scar Scale, is widely used in clinical practice and research to document change in scar appearance. Several sections of the Index require equipment to accurately score the items. ⋯ We recently devised a pocket-sized tool to aid in scoring the scar and to increase staff compliance in use of the Index. With this tool interrater reliability is good, which makes the Burn Scar Index a viable measure for research.
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As funding for health care becomes a national concern, and workman's compensation and private health insurance companies attempt to limit their expenditures in the treatment of the client with burns, it may become the responsibility of the burn specialists to create a cost-effective approach to quality burn rehabilitation. Our outpatient rehabilitation program has taken a cost-effective approach that limits the use of inpatient rehabilitation, emphasizes the burn team guiding the client to a quick functional return to home and work, and concentrates costs for therapy rather than room and board. This cost-effective rehabilitation approach emphasizes an intensive 6-hours-per day, 5-days-per-week outpatient program that begins immediately after discharge. ⋯ In the cost-effective rehabilitation approach, 82% of the health care costs are concentrated for therapy. In the traditional inpatient rehabilitation program, room and board costs comprise 57% of the charges. Because it is the responsibility of the burn specialists to educate the health care payers, a program description to implement the cost-effective approach to burn rehabilitation is provided.