The Journal of burn care & rehabilitation
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J Burn Care Rehabil · Jul 1995
Arch bar stabilization of endotracheal tubes in children with facial burns.
Endotracheal tube stabilization in children with facial burns can be difficult. Several methods rely on straps or complex devices that apply undesirable pressure to the face, potentially destroying skin grafts and making wound care difficult. Techniques that rely on a single wire or suture can be unreliable. ⋯ Christopher's Hospital for Children. Wound care and successful skin grafting were performed without difficulty. No complications related to the arch bars occurred.
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A scald burn is a superficial to mid second-degree burn with a viable dermis beneath the blisters and a good blood flow. However, the burn may be incapacitating because of pain and fluid and heat loss. Biobrane adheres very well to this depth of burn and mechanically and biochemically closes the wound. We have used Biobrane on scald burns for the last 5 years and have found it to be an excellent method of treating superficial second-degree burns.
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Biobrane (standard adherence) and Biobrane L (light adherence) were compared for their degree of adherence to donor site wounds on rabbits at 1, 4, 7, and 9 days. Biobrane, which has more nylon fabric exposed to the wound surface, had significantly greater adherence levels to the wound at all time periods when compared with Biobrane L, which has less nylon fabric exposed to the wound.
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J Burn Care Rehabil · May 1995
Comparative StudyComparative analysis of bedside and operating room tracheostomies in critically ill patients with burns.
The objective of this study was to demonstrate that bedside burn intensive care unit tracheostomy is a safe and cost-effective procedure and has advantages over operating room tracheostomy. The charts of all patients who underwent tracheostomies in the burn unit between January 1990 and September 1993 were reviewed retrospectively. All tracheostomies were performed by residents in their second to fourth postgraduate years. ⋯ No statistical difference existed in age, sex, mean total body surface area percent burned, mean inspired oxygen, mean positive end expiratory pressure, mean pretracheostomy intubated days, presence of inhalation injury, or complication rate between groups. The average combined cost for operating room and anesthesia was $1740 per tracheostomy performed in the operating room. No charge was given to the patient for a bedside tracheostomy apart from the surgeon's fee and tracheostomy tube.(ABSTRACT TRUNCATED AT 250 WORDS)
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J Burn Care Rehabil · May 1995
The risk of pneumonia in thermally injured patients requiring ventilatory support.
The risk of pulmonary infectious complications in critically ill patients requiring ventilatory support is well established. To evaluate the impact of tracheal intubation on the risk of pneumonia, the records of three hundred seventy thermally injured patients (mean age, 37.6 years, mean total body surface area burn, 44.7%) who were admitted during a 6-year interval and required ventilatory support were reviewed. ⋯ Actuarial life table analysis considering only pneumonia acquired during ventilatory support was used to evaluate the relation between the risk of pneumonia and duration of ventilatory support. In this cohort of patients with burns, no difference in the risk of pneumonia was observed between patients with and without inhalation injury who required ventilatory support; the hazard of pneumonia was relatively constant during the first 6 weeks of intubation and was similar for all who underwent ventilation.