The Journal of burn care & rehabilitation
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J Burn Care Rehabil · Mar 1999
Randomized Controlled Trial Clinical TrialLorazepam given the night before surgery reduces preoperative anxiety in children undergoing reconstructive burn surgery.
A high level of preoperative anxiety frequently occurs in children undergoing reconstructive burn surgery. Reduction of this anxiety may have a number of physiological and psychological benefits. Various pharmaceutical and nonpharmaceutical regimens to reduce preoperative anxiety have been devised; however, most regimens are not initiated until the period immediately before surgery. ⋯ Postoperatively, patients rated their recall of anxiety with the use of the VAS. When queried preoperatively, patients who received lorazepam the night before surgery self-reported significantly less anxiety than those receiving placebo. Investigator observations did not detect this difference; this reinforces the assertion that patient self-rating of anxiety may be the best tool for rating anxiety.
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J Burn Care Rehabil · Mar 1999
Case ReportsSelf-inflicted burn injuries: an 11-year retrospective study.
The burns unit at the Royal Brisbane Hospital accepted a total of 2275 admissions from 1986 to 1996. During this 11-year period, 65 cases of self-inflicted burn injury were treated, which made up 2.9% of the total number of admissions. A mortality rate of 21.5% (14 patients) is noted, with all patients dying after admission to the hospital. ⋯ Those patients with self-inflicted injuries have an increased mean of 31.4% total body surface area burned as compared with those patients whose injuries are accounted for as accidental, which have a mean total body surface area burned of 10%. Additionally, the mean length of stay in the hospital for patients with self-inflicted injuries was 40 days for acute injuries, which is prolonged; the mean length of stay for acute injuries that were not self-inflicted was 14 days. This investigation discovered 3 cases of repeated self-inflicted burn injury.
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J Burn Care Rehabil · Mar 1999
Comparative Study Clinical TrialIncidence of the concrete scalp deformity associated with deep scalp donor sites and management with the Unna cap.
The scalp has become a popular donor site for split-thickness skin grafts. This donor site does, however, have complications, including the concrete scalp deformity, which consists of hairs embedded in a thick, desiccated, exudative crust. This article presents our burn unit's experience with this complication. ⋯ None of the patients treated with the Unna cap developed the deformity. Although useful, the deep scalp donor site has complications, including the concrete scalp deformity. However, with use of the Unna cap dressing, we have had no occurrences of this problem.
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J Burn Care Rehabil · Mar 1999
Comparative StudyPediatric burn patients with respiratory failure: predictors of outcome with the use of extracorporeal life support.
Extracorporeal life support (ECLS) for pediatric burn patients is a viable option for respiratory failure that is unresponsive to maximal conventional therapy. No criteria have been identified that are predictive of the success of the use of ECLS for these patients. This article presents a retrospective review of the pediatric burn patients placed on ECLS at a single pediatric medical center. ⋯ It is felt that ECLS is a life-saving therapy for pediatric patients with thermal injury. Greater ventilator requirements before ECLS are associated with nonsurvival. Early institution of ECLS in pediatric burn patients with severe respiratory failure may prevent excessive barotrauma and thus discourage the onset of irreversible lung injury.
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J Burn Care Rehabil · Jan 1999
Contribution of the regulatory gene lasR to the pathogenesis of Pseudomonas aeruginosa infection of burned mice.
Pseudomonas aeruginosa is a gram-negative opportunistic pathogen that causes severe infections in patients with burns. The P aeruginosa regulatory gene, lasR, regulates the expression of several virulence factors. The specific lasR isogenic mutant, PAO-R1, is defective in the synthesis of the 2 elastases (LasB and LasA) and produces low levels of exotoxin A and alkaline proteases. ⋯ Furthermore, at 8 hours postinfection, equivalent numbers of PAO1 and PAO-R1 were detected at the inoculation site of the burned skin. However, only PAO1 microorganisms were detected at other sites of the burned skin. These results suggest that the lasR gene contributes (directly and indirectly) to the dissemination of P aeruginosa within the body of burned mice and its horizontal spread within the burned skin.