The Journal of burn care & rehabilitation
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Although rare, burns suffered by neonates can be fatal. Many complex difficulties are faced during the management of burns in neonates because of the neonate's complex physiological and pathological changes. We compiled a retrospective review from the treatment of four burned neonates (including a premature neonate). ⋯ All the patients were treated in the Burn Intensive Care Unit with close co-operation of burn surgeons and neonatologists. Based on our experience as well as a review of literature, management recommendations are proposed as the following: 1) prompt and aggressive fluid resuscitation, 2) early administration of oxygen and keeping the patient warm, 3) application of specific biological dressing and recombinant human growth hormone if necessary, 4) establishment of a multidisciplinary team, and 5) removal of necrosis tissue early and aggressively. Furthermore, a very important issue is also discussed, which is about the prevention of newborn burns in the neonate unit in developing countries.
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J Burn Care Rehabil · May 2004
Personality characteristics and perceived health problems after burn injury.
The relationship between personality traits and the perceived outcome of burn injury 1 to 18 years (mean, 9.2 years) after severe burn injury was evaluated in 166 individuals treated at the Uppsala Burn Unit. The perceived outcome was measured with the Burn Specific Health Scale-Brief (BSHS-B) and was related to personality traits evaluated by means of the Swedish universities Scales of Personality. ⋯ The neurotic traits Somatic trait anxiety, Psychic trait anxiety, Stress susceptibility, Embitterment, and Mistrust each or in different combinations explained the observed relationships. The data suggest that personality is related to health status because it is perceived a long time after severe burn injury and that its effect is not confined only to psychological but also to physical aspects of life.
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J Burn Care Rehabil · May 2004
Comparative StudyEvaluation of a pediatric scald burn clinical pathway.
Scald burns make up more than 75% of the pediatric burns patients who are admitted to our burns unit. A pediatric scald burn pathway was implemented at our center in November 1999, the aim of which was to improve consistency in the management of the acute phase of injury. This study assessed the effectiveness of the first 18 months of this scald burn pathway. ⋯ The patients within the three groups were similar in age and burn size. A comparison among the groups with respect to compliance with the treatment guidelines is presented graphically. In conclusion, the management of pediatric scald burns in the acute phase is more consistent since the implementation of the clinical pathway.
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J Burn Care Rehabil · May 2004
Favorable short- and long-term outcomes of prolonged translaryngeal intubation in critically ill children.
In those children who require protracted mechanical ventilation, we use long-term intubation in order to avoid the consequences of tracheostomy in young children. A retrospective 9-year review was performed to document the efficacy and safety of this practice. A retrospective review of children admitted from January 1, 1991, to December 31, 1998, who required mechanical ventilatory support for at least 7 consecutive days was performed. ⋯ Patients were followed up for a mean of 2.99 +/- 2.24 years (range, 1 month to 8 years). Possible sequelae related to prolonged intubation were noted in follow-up visits in 8 patients, including sinusitis (one; resolved without treatment), subglottic stenosis (one; required reconstructive surgery), persistent cough (three; all resolved spontaneously), occipital breakdown because of ET ties (one; healed after 1 month), soft voice (two; resolved spontaneously), and decreased pharyngeal sensation (one; resolved without treatment). Translaryngeal intubation is a safe and effective method to provide long-term ventilatory support in children.
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Our objective was to compile data on the mechanism and severity of injuries associated with hot beverage burns in children. We identified 152 children over a 3-year period who attended a tertiary level burns center, representing 18% of all children treated. Their median age was 17.5 months and median body surface area burned was 4% (range, 0.25% to 32%). ⋯ In 80% of incidents, a primary care giver witnessed the injury. These findings indicate that scalding from hot beverages carries significant morbidity and is an important pediatric public health issue. It is clear that further research towards effective education programs for primary caregivers is warranted.