The Journal of burn care & rehabilitation
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J Burn Care Rehabil · May 1998
ReviewPosttraumatic stress disorder in burn populations: a critical review of the literature.
This review of the literature examines studies concerning posttraumatic stress disorder (PTSD) in burn populations. Retrospective, cross-sectional, and prospective research and case studies are critiqued. Although the data are equivocal, several trends are clearly emerging. ⋯ There was a clear trend for patients who had no symptoms of PTSD while hospitalized to have PTSD develop after discharge. Finally, prevalence rates of PTSD vary greatly based on time of screening. Methodological problems with studies were related to sampling and follow-up; suggestions for future research are provided.
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J Burn Care Rehabil · May 1998
A retrospective study of the incidence and prevalence of thermal corneal injury in patients with burns.
The clinical course of thermal corneal injuries is not well described. A review of 1750 burn admissions to a regional burn center between 1979 through 1993 was done to determine the clinical course of thermal corneal injuries. Twenty-five out of 1750 burn admissions (1%) presented with a thermal corneal injury. ⋯ Open-flame burns were the most common cause of injury. Improvement of corneal injury occurred in all survivors who had an intact globe on initial examination. Initial visual acuity was not a good predictor of outcome, and long-term complications were uncommon.
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J Burn Care Rehabil · May 1998
Reduction in mortality in pediatric patients with inhalation injury with aerosolized heparin/N-acetylcystine [correction of acetylcystine] therapy.
Smoke-inhalation injury causes a destruction of the ciliated epithelium that lines the tracheobronchial tree. Casts produced from these cells, polymorphonuclear leukocytes and mucus, can cause upper-airway obstruction, contributing to pulmonary failure. We have reported that a combination of aerosolized heparin and a mucolytic agent, N-acetylcystine [corrected], can ameliorate cast formation and reduce pulmonary failure secondary to smoke inhalation. ⋯ The number of patients requiring reintubation for successive pulmonary failure was recorded, as was mortality. The results indicate a significant decrease in reintubation rates, in incidence of atelectasis, and in mortality for patients treated with the regimen of heparin and N-acetylcystine [corrected] when compared with controls. Heparin/N-acetylcystine [corrected] nebulization in children with massive burn injury and smoke-inhalation injury results in a significant decrease in incidence of reintubation for progressive pulmonary failure and a reduction in mortality.
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J Burn Care Rehabil · May 1998
Reconstitution of basement membrane after 'sandwich-technique' skin grafting for severe burns demonstrated by immunohistochemistry.
Reconstitution of basement membrane structures after "sandwich-technique" grafting of severe deep burns is demonstrated with use of immunohistochemical techniques. Cryosections of human skin after epifascial burn wound excision and sandwich grafting were stained with monoclonal antibodies against type IV and VII collagen, polyvalent antiserum against type VI collagen, and polyvalent antibody against laminin. Standard hematoxylin and eosin histologies were performed for morphologic correlation. ⋯ To our knowledge this is the first report of the expression of type VI collagen in these types of wounds. The findings are compared with the expression of type VI collagen in healthy skin. The results indicate that the modified sandwich-grafting technique is an adequate means for early burn wound closure and resurfacing of third-degree burn wounds and leads to the reconstitution of dermal qualities.