The Journal of burn care & rehabilitation
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J Burn Care Rehabil · Sep 1995
The Vancouver Scar Scale: an administration tool and its interrater reliability.
The Burn Scar Index, often called the Vancouver Scar Scale, is widely used in clinical practice and research to document change in scar appearance. Several sections of the Index require equipment to accurately score the items. ⋯ We recently devised a pocket-sized tool to aid in scoring the scar and to increase staff compliance in use of the Index. With this tool interrater reliability is good, which makes the Burn Scar Index a viable measure for research.
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Traditional methods for judgment of burn depth by clinical evaluation of the wound based on appearance and sensation remain in wide use but are subject to individual variation by examiner. In addition to the clinical difficulties with burn wound management, observer dependency of wound assessment complicates clinical trials of burn wound therapy. ⋯ Laser Doppler flowmetry had a positive predictive value of 100% for nonhealing wounds on postburn days 1 and 3. These data suggest that laser Doppler flowmetry is a potentially useful tool for burn wound assessment.
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Though suicide by burning is well-described, little information is available regarding patients who mutilate themselves by burning without suicidal intent. We reviewed 31 patients admitted from 1980 to 1991 with self-inflicted burns to describe differences between self-mutilation and attempted suicide (AS). In 16 patients who had mutilated themselves, mean burn size was 1.6% TBSA (range 0.3% to 9.0% TBSA) compared with 35.4% TBSA in the 15 patients who had attempted suicide (range 11.5% to 90% TBSA; p < 0.0001). ⋯ Case examples of both types of injuries are presented. Burn care professionals should be familiar with syndrome of self-mutilation by burning. Patients often present with puzzling injuries and require psychiatric treatment in addition to burn care.
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J Burn Care Rehabil · Jul 1995
Comparative StudyDose effects of morphine and butorphanol alone and in combination after burn injury in the rat.
To test the effectiveness of analgesics after thermal trauma, butorphanol, a predominately opioid kappa-receptor agonist, and morphine, a mu-agonist, were administered alone and in combination 2 days after rats were subjected to scald burn or sham burn. After graded doses of morphine were administered, analgesia, assessed by tail flick latency and tail pinch latency, was similar in the sham-burn and scald-burn rats. ⋯ When graded doses of butorphanol were given with a fixed dose of morphine (0.5 mg/kg), the tail pinch latency response was less in scald-burn rats and markedly less in sham-burn rats. The tail flick latency responses, however, moved in opposite directions in sham-burn and scald-burn rats receiving the drug combination: in sham-burn rats, tail flick latency effects were the same as with butorphanol alone; whereas in scald-burn rats, tail flick latency increases were suppressed except at the lowest dose.
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J Burn Care Rehabil · Jul 1995
School reentry for the patient with burn injuries: video and/or on-site intervention.
The student who has sustained a burn injury, the school's personnel, and the student's peer groups benefit from a school reentry program. Concrete, factual information about the burn injury assists to open lines of communication between the returning student and peers. Also, the concerns and expectations of school personnel are addressed.