The Journal of burn care & rehabilitation
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J Burn Care Rehabil · Jul 2003
Noncontact laser Doppler imaging in burn depth analysis of the extremities.
The purpose of this study was to determine the accuracy and practical utility of a noncontact laser Doppler imager (PIM-II, Lisca Development AB, Linköping, Sweden) in the estimation of burn depth in the upper and lower extremities. At 48 hours after burn injury, we performed scans of 35 burns in 22 patients and obtained histological samples for burn determination with hematoxylin and eosin and vimentin immunohistochemical staining. Additionally, sequential scans and tissue specimens were obtained on 10 burns at 24, 48, and 72 hours. ⋯ Superficial dermal burns exhibited increased perfusion in the early burn period. Wounds showed a progressive decline in perfusion and a progressive increase in the depth of injury during a 72-hour period. This study demonstrates the advantage and accuracy of using a noncontact laser Doppler to differentiate deep dermal from superficial partial thickness burns in the extremities.
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J Burn Care Rehabil · Jul 2003
Case ReportsAn unusual cause of burn injury: fig leaf decoction used as a remedy for a dermatitis of unknown etiology.
Medicinal plant extracts are commonly used worldwide. Their use relies mostly on historical and anecdotal evidence and might be so hazardous. Phytophotodermatitis is a well-known entity that is caused by the sequential exposure to certain species of plants containing furocoumarins and then to sunlight. ⋯ All reported cases to date have in common that patients are exposed to direct sunlight or to artificial UVA lights (like solarium) of varying durations. In our case neither direct sun exposure, other than inevitable indoor UVA influence, nor blister formation was present. The etiologic factors, symptoms, signs, course, and treatment alternatives for phytophotodermatitis are also reviewed briefly.
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J Burn Care Rehabil · Jul 2003
Population-based assessment of burn injury in southern Iowa: identification of children and young-adult at-risk groups and behaviors.
Although nonfatal burn injuries vastly outnumber fatal injuries, their epidemiology is not well defined. We sought to determine the epidemiology of nonfatal burn injuries in a largely rural region of a midwestern state to target intervention efforts at populations and injury mechanisms at risk. Data were retrospectively collected on a population-based sample of medically treated burn injuries in 10 counties in southern Iowa from 1997 to 1999 using International Classification of Diseases, 9th Revision, Clinical Modification codes (ICD-9-CM, Ncode 940-949) to identify burn-related emergency room visits from computerized lists. ⋯ Children and young adults ages 5 to 24 were also the most likely to be injured by flame and fire-related causes secondary to open fires. Nonfatal burn injuries typically afflict children and young adults in definable patterns, suggesting intervention strategies. Future studies need to better delineate the contributing factors associated with these injuries to refine the intervention strategies.
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Self-inflicted burn injuries, although uncommon, are a significant source of morbidity and mortality. The purpose of this study was to delineate the characteristics of these burns and to examine their impact on society. Records of 32 adult patients admitted for self-inflicted burns at our regional burn center between January 1996 and August 2001 were retrospectively reviewed. ⋯ Only four patients had private insurance, whereas the remainder relied on underfunded state- and county-sponsored programs or were uninsured. In addition to well-described psychiatric factors, common characteristics predisposing to self-inflicted burns include chronic medical illnesses, long-term disability, and a lack of access to adequate mental health care. Better treatment of mental illness in the underfunded population might ultimately save the high costs of these burn injuries.
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J Burn Care Rehabil · Jul 2003
Serial measurements increase the accuracy of laser Doppler assessment of burn wounds.
Traditional methods of judging burn depth by clinical evaluation of the wound based on appearance and sensation remain in wide use but are subject to individual variation by examiner. In addition to the clinical difficulties with burn wound management, observer dependency of wound assessment complicates clinical trials of burn wound therapy. ⋯ Serial measurement with laser Doppler flowmetry had an 88% specificity and a positive predictive value of 81% for identifying nonhealing wounds. These results suggest that laser Doppler flowmetry is a potentially useful tool for burn wound assessment.