The Journal of burn care & rehabilitation
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J Burn Care Rehabil · May 1999
Pediatric patients experiencing postoperative nausea and vomiting after burn reconstruction surgery: an analysis.
Nausea and vomiting after a surgical procedure has a significant impact on a patient's hospital course. A perceived increased incidence of postoperative nausea and vomiting (PONV) in pediatric patients undergoing reconstructive scalp surgery had been clinically observed. A chart review to determine if a relationship existed between the surgical procedure and the incidence of PONV was conducted by selecting patients who were 5 to 12 years old and whose surgery fell between April 1995 and August 1995. ⋯ Data from the retrospective review suggested that pediatric patients with reconstructive surgeries of the scalp experienced PONV at 100% (24 procedures), whereas only 45% (10 procedures) of patients whose surgeries did not involve the scalp experienced PONV. In addition, despite significant earlier return of bowel sounds, episodes of PONV and time to oral intake were also increased in the group of patients whose operations involved the scalp. On the basis of these findings, a prospective study has been initiated to determine if changes in the perioperative protocol will improve patient outcomes and reduce the incidence of PONV.
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J Burn Care Rehabil · May 1999
Our chemical burn experience: exposing the dangers of anhydrous ammonia.
Although chemical injuries account for only a small number of one burn unit's cases, the diversity, resulting complications, and sequelae of these burns pose special problems. We reviewed a 19-year period of the chemical burn experience of our burn unit. The population of patients with these types of burns consisted of young men (mean age: 29.8 years), the majority of whom were injured on the job. ⋯ From the analysis of our retrospective review, adequate education and treatment at the scene appear to be well implemented in the industrial and farming communities. The focus of our education efforts should be directed toward the public and emphasize the safe use of household chemicals. Finally our review illuminated the potential benefit of immediate excision and grafting for decreasing the length of stay, complications, and loss of productivity.
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For a 10-year period, the cases of 236 patients aged 60 years old or older were evaluated with regard to mortality and length of hospital stay. Multiple variables were evaluated. Total mortality for the entire group was 41.9%. ⋯ Mean length of stay for survivors was 34.04 days. Length of stay (LOS) was increased in association with larger burn size, preexisting medical problems, and the development of complications after admission. The increase in the number of elderly patients as part of the in-hospital burn population mandates evaluation of this growing group.
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J Burn Care Rehabil · May 1999
Case ReportsThe use of the brachioradialis muscle flap for the coverage of burns of the acute elbow joint.
Early coverage of deep burns of the elbow is vital to preserving the range of motion. Although various methods are used for coverage of this site, the brachioradialis muscle flap provides good coverage after debridement, with minimal donor site morbidity.
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J Burn Care Rehabil · May 1999
High frequency percussive ventilation in pediatric patients with inhalation injury.
The objective of this study was to present data that showed high frequency percussive ventilation (HFPV) was superior to traditional mechanical ventilation for the treatment of children with inhalation injuries. Inhalation injuries continue to be the number one cause of death of patients with thermal injuries in the United States. Therapy for this condition has consisted of conservative pulmonary toilet and mechanical ventilation. ⋯ Patients ranged in age from 6 to 9 years, and most had burns covering greater than 50% of their total body surface areas. No deaths occurred in either group, but the patients who were treated with HFPV had no cases of pneumonia (P < .05), better P/F ratios (P < .05), lower peak inspiratory pressures, and less work of breathing (P < .05) as compared with our control group. On the basis of our clinical experience and data, the use of HFPV seems to be an effective treatment for the reduction of pulmonary morbidity in pediatric patients with inhalation injuries.