The Journal of burn care & rehabilitation
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Present day economics have challenged health care providers to minimize the length of hospitalization without sacrificing quality of care. Within this context, the purpose of this study was to determine whether supporting the hand and wrist with an Unna's boot dressing (Medicopaste bandage; Graham-Field, Inc., Hauppauge, N. Y.) and splint, and covering the skin graft donor site with calcium alginate (Kaltostat; Calgon Vestal, St. ⋯ This and subsequent follow-up visits revealed a 95% or more take on all skin grafts, without any infectious complications. These results demonstrate the efficacy of Unna's boot support and calcium alginate dressings of donor sites in limited skin graft procedures. Furthermore, these results suggest that more extensive surgical debridements and skin graftings may be successfully shifted to outpatient procedures with use of these adjuvants.
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This retrospective study evaluated 55 patients with burn scar cellulitis who required hospital readmission from January 1977 to July 1994. The overall incidence of burn scar cellulitis was 1.6%, and it was highest among patients who had undergone fascial excision (17.1%) as compared to those who had undergone tangential excisions (1.5%), or those who received nonoperative therapies (0.7%). ⋯ The lower extremity was involved 80% of the time, and the most commonly affected age group was 11 to 15 years. All patients were healthy and displayed no vascular, immunologic, or neurologic compromise at the time of readmission.
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J Burn Care Rehabil · Jul 1996
Degree of burn, location of burn, and length of hospital stay as predictors of psychosocial status and physical functioning.
The purpose of this study was to identify predictors of psychologic and physical functioning of the victim with burn injuries from initial hospitalization to discharge. Thirty-one patients admitted to a burn center participated in the study and completed the Burn-Specific Health Scale. Most patients were men between 17 and 45 years of age. ⋯ Having a second-degree burn was not associated with reported psychologic or physical functioning. If the burn involved either the patient's hand or head, the location of the burn predicted certain areas of physical functioning at the first-alert and predischarge stage. Length of hospital stay predicted physical functioning; patients who stayed longer in the hospital reported lower mobility and hand function.
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J Burn Care Rehabil · May 1996
Randomized Controlled Trial Comparative Study Clinical TrialDermasorb versus Jelonet in patients with burns skin graft donor sites.
A prospective and randomized trial that compares Jelonet (Smith & Nephew PLC, London, England) with a new hydrocolloid dressing, Dermasorb (Convatec Ltd., Clwyd, United Kingdom), is presented. The dressings were applied on contiguous donor sites in 21 patients that required skin grafting for burn wounds. Pain experienced with the dressing in situ was assessed on days 2, 4, 7, and on two subsequent occasions. ⋯ No clinical or laboratory evidence of any differences of colonization or infection were found. All results were statistically significant. We would strongly recommend the use of Dermasorb as a split-thickness skin graft donor site dressing for a patient with burns.
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Precise determination of burn depth during the immediate postburn period remains an unresolved clinical problem. In an attempt to provide a new clinical option to aid in diagnosis of burn depth, an immunohistochemical marker (antivimentin) was used to examine excisional tissues or serial punch biopsies, or both, in partial-thickness human burn injuries. To test the hypothesis that burn injury continues to progress beyond the first 24 hours, burn depth was assessed by quantitative morphometric analysis in both a partial-thickness porcine burn model and in sequential samples from human patients. ⋯ Similarly, 13 of 14 patients showed significant progression in burn depth between 1 to 5 days after burn injury. In conclusion, immunohistochemical staining with an antisera targeted toward a widely dispersed cell population in the dermis can be utilized as an effective tool to confirm the depth of tissue injury during the acute postburn period. Data from our randomly selected patients with partial-thickness burn suggest that burn wounds continue to demarcate for several days.