The Journal of burn care & rehabilitation
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J Burn Care Rehabil · Jul 2005
Randomized Controlled Trial Comparative Study Clinical TrialA prospective, randomized trial of Acticoat versus silver sulfadiazine in the treatment of partial-thickness burns: which method is less painful?
Despite recent improvements in analgesia, pain control during dressing changes continues to be a major challenge in patients with burns. We investigated two different dressing modalities to compare how much pain the patient experienced during and after the dressing change. Patients with partial-thickness burns that required only topical wound care were assigned randomly to treatment with Acticoat (Smith and Nephew USA, Largo, FL) or silver sulfadiazine (AgSD). ⋯ The mean visual analog pain scores for the wounds treated with Acticoat or AgSD wounds were 3.2 and 7.9, respectively (P < .0001; paired Student's t-test). In 41 of the 47 paired pain score observations, the pain in the wound treated with AgSD was perceived as greater than in the wound treated with Acticoat. Burn wound care with Acticoat is less painful than burn wound care with AgSD in patients with selected partial-thickness burns.
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J Burn Care Rehabil · Jul 2005
Social support correlates with survival in patients with massive burn injury.
Large burn size, inhalation injury, age, and associated trauma increase the rate of mortality after burns. However, not all patients with large burns and significant risk factors die. In this study, we wanted to determine other presenting factors that might indicate a survival benefit for burn patients with large burns. ⋯ Survivors (81%) were more likely than nonsurvivors to have social support (35%; P = .007). A full-thickness burn > or =80 % TBSA was the only variable uniformly associated with mortality, suggesting that patients who survive large burns have a partial-thickness component that heals without surgery. The difference in degree of social support was one unique distinction that may impact patient survival and is worth further investigation.
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The aim of this study was to identify the epidemiological features of pediatric burn injuries in southern part of Turkey. In this retrospective study, 137 hospitalized pediatric patients (85 men and 52 women) who were admitted to our burn unit during a period of 3 years were analyzed. Pediatric patients were categorized into three groups: the infants and toddlers (0-2 years), early childhood (3-6 years), and late childhood (7-15 years). ⋯ A total of 74.4% of burn injuries occurred at home, and almost all were preventable, with 16 % of the burns occurring in the autumn; however, 42% occurred in the summer. These findings will be used as a basis for developing targeted preventive programs to protect children from burns. We also consider it is necessary to educate children and their parents about the prevention of burn injuries.
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J Burn Care Rehabil · Jul 2005
Epidemiology of scalds in vulnerable groups in New South Wales, Australia, 1998/1999 to 2002/2003.
In this study, the recently introduced International Classification of Disease, 10th revision, code for hot tap water scalds was used to examine the epidemiology of these cases and other scalds injuries in children younger than 5 years of age and adults aged 65 years and older. Although the trunk was the most common area in which scalds occurred, young children were more likely to sustain head and neck scalds (15%, 95% confidence interval 10.8-18.3) because of hot tap water than older people (2%, 95% confidence interval 0.2-4.4). Hospital separation rates for hot water scalds decreased significantly during the study period in both boys (chi(2) = 15.6, df = 1, P < .001) and girls (chi(2) = 5.6, df = 1, P < .001) who were younger than 5 years of age, which might be attributable to the introduction of new standards regulating the provision of hot tap water to various buildings. The severity of scalds cases did not seem to be correlated with the length of hospital stay, which remained unchanged in both age groups.
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J Burn Care Rehabil · Jul 2005
Comparative StudyComparison of battlefield-expedient topical antimicrobial agents for the prevention of burn wound sepsis in a rat model.
Topical antimicrobial therapy has the potential to limit the mortality and morbidity of contaminated battlefield injuries. Many agents available are ill-suited for use on the battlefield; however, mafenide acetate solution (MAS) has known efficacy as a burn dressing adjunct, and previous work with mafenide as a direct chemotherapeutic has shown promise. A total of 71 male Sprague-Dawley rats underwent a 20% TBSA full-thickness scald. ⋯ We did not demonstrate significant prevention of wound sepsis with these agents as we used them. These techniques should not be substituted for established burn care. Aqueous direct topical antimicrobial agents have logistical advantages over creams and dressing soaks for field use, and the search for a battlefield-expedient agent for use at or near the point of wounding should continue.