The Journal of burn care & rehabilitation
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J Burn Care Rehabil · May 1996
Case ReportsIntradermal injection of epinephrine to decrease blood loss during split-thickness skin grafting.
After a burn injury, the hemodynamics of a patient is changed. There is usually a fall in hematocrit. ⋯ The method we use to help decrease the loss of blood during skin grafting is an injection of epinephrine intradermally before the graft and eschar are excised. We have found this method to be useful in a select group of patients.
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J Burn Care Rehabil · May 1996
Reduced albumin extravasation in experimental rat skin and muscle burn injury by D-myo-inositol-1,2,6-trisphosphate treatment.
This study investigated the effects of the anti-inflammatory agent D-myo-inositol-1,2,6-trisphosphate (IP3) on burn edema. Two sets of experiments were performed. In the first set, a full-thickness burn injury was induced in the abdominal skin of anesthetized rats. ⋯ Resulted showed a significant reduction of albumin extravasation in the skin at all four dose levels and in the abdominal muscle at three of four doses. Indomethacin had no significant effect on postburn edema formation. The mechanisms responsible for the inhibition of albumin leakage by IP3 could be secondary to reduced formation of edema-promoting inflammatory mediators by the agent, resulting in improved vascular patency.
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J Burn Care Rehabil · Mar 1996
Multicenter Study Clinical Trial Controlled Clinical TrialClinical evaluation of an acellular allograft dermal matrix in full-thickness burns.
A multicenter clinical study assessed the ability of an acellular allograft dermal matrix to function as a permanent dermal transplant in full-thickness and deep partial-thickness burns. The study consisted of a pilot phase (24 patients) to identify the optimum protocol and a study phase (43 patients) to evaluate graft performance. Each patient had both a test and a mirror-image or contiguous control site. ⋯ Fourteen-day take rates of the dermal matrix were statistically equivalent to the control autografts. Histology of the dermal matrix showed fibroblast infiltration, neovascularization, and neoepithelialization without evidence of rejection. Wound assessment over time showed that thin split-thickness autografts plus allograft dermal matrix were equivalent to thicker split-thickness autografts.
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J Burn Care Rehabil · Mar 1996
The revised burn diagram and its effect on diagnosis-related group coding.
Diagnosis-related group (DRG) codes for burn injuries are defined by thresholds of the percentage of total body surface area and depth of burns, and by whether surgery, debridement, or grafting or both occurred. This prospective study was designed to determine whether periodic revisions of the burn diagram resulted in more accurate assignment of the International Classification of Diseases and DRG codes. The admission burn diagrams were revised after admission and after each surgical procedure. ⋯ In 77% of the cases, the revised diagram correctly depicted the percentage of body surface area third-degree burn as confirmed intraoperatively. In 7.3% of the cases, diagram revision changed the DRG code. Documenting wound evolution in this manner allows more accurate assignment of the International Classification of Diseases and DRG codes, assuring optimal reimbursement under the prospective payment system.
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J Burn Care Rehabil · Mar 1996
Burn incidence and medical care use in the United States: estimates, trends, and data sources.
Recent estimates related to annual burn incidence and medical care use in the United States include 5500 deaths from fire and burns (1991), 51,000 acute hospital admissions for burn injury (1991 to 1993 average), and 1.25 million total burn injuries (1992). Time trends from 1971 to 1991 reveal significant declines in each estimate. Taking into account the 25% increase in the U. ⋯ The rates of decline are similar in sample statistics for all burns receiving medical care and for all burns above a reportable level of severity. In addition to providing current and time-series estimates, this article discusses burn injury coding issues and describes the data sources from which national and state estimates can be derived. The principal objective is to establish and describe a set of burn injury data baselines in a manner that will facilitate future tracking of burn incidence and medical care use at the national and state level by practitioners and researchers.