The Journal of burn care & rehabilitation
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J Burn Care Rehabil · Nov 2001
ReviewTime off work and return to work rates after burns: systematic review of the literature and a large two-center series.
The literature on time off work and return to work after burns is incomplete. This study addresses this and includes a systematic literature review and two-center series. The literature was searched from 1966 through October 2000. ⋯ In the two-center study, 66% and 90% of survivors had returned to work at 6 and 24 months post-burn. However, in the University of Washington subset of the data, only 37% had returned to the same job with the same employer without accommodations at 24 months, indicating that job disruption is considerable. The impact of burns on work is significant.
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Successful treatment of dorsal foot burns is a challenge. By extrapolating from various treatments of dorsal hand burns the design of a static progressive splint was applied to the treatment of dorsal foot burns to prevent contracture deformities. The splint is composed of a base, dorsal thermoplastic piece, and Velcro strap. ⋯ A thermoplastic piece is conformed to the dorsum of the toes and then affixed to the Velcro strap. The Velcro strap is then attached to the plantar surface of the base to create an adjustable static progressive stretch. This splint is designed to prevent dorsal foot contractures during the scar maturation phase of wound healing.
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J Burn Care Rehabil · Nov 2001
Major burn injuries among restaurant workers in New York City: an underappreciated public health hazard.
Major burns among food service workers appears to be an underappreciated source of morbidity and public expense in New York City. A retrospective study was conducted to identify workers requiring hospital admission over the past 3 years. Seventy-six restaurant workers (3.8% of all adult admissions) were identified. ⋯ Hospital care and further disability result in enormous publicly funded expenses. The morbidity and lost wages are a severe detriment to workers and their families. Greater public health awareness measures are warranted.
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J Burn Care Rehabil · Nov 2001
Microvascular assessment of burn depth conversion during varying resuscitation conditions.
Conversion of partial- to full-thickness injuries, even after the burning has stopped, remains a significant clinical problem. We developed a rat model with a wide range of burn depths to study this phenomenon by microvascular assessment. Fifty-four male Sprague-Dawley rats weighing 460 g on average were studied. ⋯ Animals received Ringer's lactate resuscitation at 0, 2, 4, 6, and 8 ml/kg/%burn. Serial laser Doppler scanning directly demonstrated progressive loss of perfusion to partial-thickness burns dependent upon the amount of fluid resuscitation. Conversion of partial- to full-thickness burns in this rat model (documented by laser Doppler microvascular assessment) was dependent upon how the animals were resuscitated.
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Paraquat is a bipyridyl compound widely used as a contact herbicide. Since its introduction in 1962, hundreds of deaths have occurred, usually after suicidal or accidental ingestion. Death after dermal absorption of paraquat is uncommon, but has occurred after either contact with undiluted paraquat, disruption of skin integrity, or prolonged exposure. ⋯ After 9.5 hours of cutaneous exposure, a paraquat level of 0.169 mg/ml was obtained at 20 hours, the standard lethal dose at 16 hours being 0.16 mg/ml. In light of the apparently irreversible pathophysiology of paraquat poisoning with plasma levels as low as 3 mg/L, prevention and early intervention are the best treatments. Our patient may have survived an otherwise routine thermal injury had his wounds been aggressively irrigated in the field.