The Journal of burn care & rehabilitation
-
J Burn Care Rehabil · Nov 2001
Randomized Controlled Trial Comparative Study Clinical TrialProspective trial of thick vs standard split-thickness skin grafts in burns of the hand.
For best function and appearance, thick skin grafts for hands are generally preferred to thinner grafts. But how thick is thick enough? This prospective randomized trial was designed to compare 0.015-inch skin grafts for burned hands to hand grafts that are 0.025 inches thick. Consecutive patients receiving skin grafts to hands were randomized to have sheet grafts using donor sites of 0.015-inch or 0.025-inch thickness. ⋯ There were no significant differences in range of motion, final appearance, or patient satisfaction between the two groups at 1 year. There were problems with donor site healing in both groups. We recommend that hand grafts for adults be at least 0.015 inches thick but do not see an advantage to the use of very thick (0.025-inch) grafts, even with thin split-thickness skin grafts to the donor site.
-
J Burn Care Rehabil · Nov 2001
Storage media and temperature maintain normal anatomy of cadaveric human skin for transplantation to full-thickness skin wounds.
Cadaveric human skin provides an optimal temporary cover after early excision of full-thickness burns; however, engraftment is reduced greatly by cryopreservation. Refrigerated skin is generally preferred because of its rapid revascularization, presumably caused by its greater viability. In this study, the effects of storage solutions, temperature, and the changing of the storage media on skin graft anatomy were evaluated as an indicator of graft viability. ⋯ Skin stored in media maintained better histologic anatomy than skin in saline, suggesting better maintenance of viability. There was also better preservation of anatomy after storage at RT for 21 days with media changes every 3 days when compared to unchanged media and all conditions at 4 degrees C. These results support the hypothesis that increased availability of nutrients and increased storage temperature maintain higher viability of cadaveric human skin for transplantation to full-thickness cutaneous wounds.
-
J Burn Care Rehabil · Nov 2001
ReviewTime off work and return to work rates after burns: systematic review of the literature and a large two-center series.
The literature on time off work and return to work after burns is incomplete. This study addresses this and includes a systematic literature review and two-center series. The literature was searched from 1966 through October 2000. ⋯ In the two-center study, 66% and 90% of survivors had returned to work at 6 and 24 months post-burn. However, in the University of Washington subset of the data, only 37% had returned to the same job with the same employer without accommodations at 24 months, indicating that job disruption is considerable. The impact of burns on work is significant.
-
Successful treatment of dorsal foot burns is a challenge. By extrapolating from various treatments of dorsal hand burns the design of a static progressive splint was applied to the treatment of dorsal foot burns to prevent contracture deformities. The splint is composed of a base, dorsal thermoplastic piece, and Velcro strap. ⋯ A thermoplastic piece is conformed to the dorsum of the toes and then affixed to the Velcro strap. The Velcro strap is then attached to the plantar surface of the base to create an adjustable static progressive stretch. This splint is designed to prevent dorsal foot contractures during the scar maturation phase of wound healing.
-
J Burn Care Rehabil · Nov 2001
Major burn injuries among restaurant workers in New York City: an underappreciated public health hazard.
Major burns among food service workers appears to be an underappreciated source of morbidity and public expense in New York City. A retrospective study was conducted to identify workers requiring hospital admission over the past 3 years. Seventy-six restaurant workers (3.8% of all adult admissions) were identified. ⋯ Hospital care and further disability result in enormous publicly funded expenses. The morbidity and lost wages are a severe detriment to workers and their families. Greater public health awareness measures are warranted.