The Journal of burn care & rehabilitation
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J Burn Care Rehabil · Mar 2003
Alterations in functional movement after axillary burn scar contracture: a motion analysis study.
Children with axillary burns often develop scar contractures that restrict shoulder movement. Objective data on functional movement patterns after contracture formation is sparse. The purpose of this study was to determine how axillary contractures affect shoulder movement during activities of daily living (ADLs). ⋯ Axillary contractures result in quantifiable movement changes during ADLs. Aggressive rehabilitation is required to prevent contracture formation. Three-dimensional motion analysis is a unique tool for the quantification of functional limitations and provides an objective method to evaluate treatment efficacy in patients with axillary contractures.
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J Burn Care Rehabil · Mar 2003
A prospective study on the implications of a base deficit during fluid resuscitation.
An excessive base deficit (BD) and elevated serum lactate are increasingly recognized as important markers of a malperfusion state during the resuscitation of thermally injured patients. In a previous retrospective study, we found that patients with a BD less than -6 mmol/l during fluid resuscitation developed more severe systemic inflammatory response syndrome (SIRS), more frequent acute respiratory distress syndrome (ARDS), and more severe multiple organ dysfunction syndrome (MODS). The object of this study was to reexamine prospectively the relationship between the BD during fluid resuscitation and the subsequent development of SIRS, ARDS, and MODS by undertaking a prospective observational study of a cohort of consecutive burn patients. ⋯ The results concur with those of our previous retrospective study. Despite resuscitation to an acceptable urinary output, some burn patients develop a more extreme BD and go on to experience more severe organ dysfunction than do patients who do not generate a BD. The effect of specific correction of the BD during fluid resuscitation is not known at this time.
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J Burn Care Rehabil · Mar 2003
Impact on the family: psychosocial adjustment of siblings of children who survive serious burns.
This study examined the psychosocial adjustment of 79 siblings of children suffering from burn injuries. Nonparametric statistics were used to compare psychosocial adjustment of the study group, as measured by the Child Behavior Checklist with an age-matched and gender-matched reference groups. Analyses found that the study group was better adjusted than the normative group on psychological dimensions; however, the study group fared worse than the normative group on overall competence, particularly social competence. ⋯ Descriptive analysis of measures developed for the study for parent and sibling reports supported findings of the Child Behavior Checklist quantitative analysis and offered insight into reasons for findings. Results indicate that the burn injury to one child in a family significantly impacts the siblings of that child. The noninjured child may be strengthened in the process of adapting to the changes imposed on the family, but it is also possible that the sibling's growth in one dimension is at the cost of success in another dimension.