The Journal of burn care & rehabilitation
-
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.
-
J Burn Care Rehabil · Jul 2005
Comparative StudyOutpatient firefighter burn injuries: a 3-year review.
Previously, our Burn Center at the New-York Presbyterian/Weill Cornell Medical Center reported a decline during a 10-year period in the number of firefighters requiring hospitalization for burn injuries, from 53 patients per year to 15 patients per year. Because the incidence of structural fires continued at a constant rate of 26,240 to 30,841 per year during this time, it was postulated that an improvement in protective gear accounted for the decrease in injuries. However, it also was possible that more firefighters were being treated on an outpatient basis. ⋯ These findings, however, demonstrate that the extent of injury has decreased in this population and suggest that the protective gear used by firefighters has contributed to these findings. These injuries, although minor to moderate, preclude the use of personal protective equipment until the burns are completely healed and contribute to a delayed return to full-duty status. These findings are consistent with nationally reported findings.
-
In a car battery accident, a 21-year old man sustained a band of deep burn involving the dorsoradial aspect of the wrist. He was treated by excision and grafting on the third day after injury. ⋯ Although the underlying etiology that triggered the events leading to thermal injury was an electrical accident, the current did not pass through any part of the patient's body, as what happens in an electrical injury. In our current understanding, the pathophysiology of electrical injury dictates the transmission of current through living tissues, leading to a specific type of tissue damage that should be distinguishable from the type that results from a usual thermal injury, as it happened in our case.
-
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.
-
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.