The Journal of burn care & rehabilitation
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Donor site dressings are highly diverse. The ultimate goal of any coverage is to minimize pain and healing time. Recently, synthetic laminates have become popular. ⋯ Early removal did not affect the healing time of the donor site. These results demonstrate a modest effectiveness of Biobrane as a donor site dressing on the back and hip regions in pediatric patients with burns. Selection of sites for which good success can be expected should be paramount in the decision to use this donor site material in this patient population.
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J Burn Care Rehabil · Jan 1993
Comparative StudyA comparison of full-thickness versus split-thickness autografts for the coverage of deep palm burns in the very young pediatric patient.
From 1984 through 1989, 24 patients with 30 acute palmar burns (six were bilateral) that required skin grafting were evaluated to compare the efficacy of split-thickness versus full-thickness autografting. Sixteen of the palms had split-thickness skin grafts and 14 had full-thickness skin grafts. ⋯ Significantly fewer reconstructive surgical procedures were required in the palm burns that were treated with full-thickness skin grafts (full-thickness = 3 of 14 and split-thickness = 10 of 16). The results demonstrate improved function and decreased need for reconstructive procedures when full-thickness skin grafts are used for the treatment of deep palm burns in young pediatric patients.
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J Burn Care Rehabil · Jan 1993
The early release of axillary contractures in pediatric patients with burns.
In spite of the common teaching that contracture releases should be avoided until scars have matured, the Cincinnati Shriners Burns Institute has been releasing contractures in immature scars to prevent prolonged loss of range of motion. To evaluate the efficacy of axillary releases and, especially, to determine whether releases performed in immature scars were detrimental, axillary releases that were performed between January 1, 1988 and December 31, 1989 were evaluated for improvements in abduction and flexion. ⋯ Comparison of early (less than 1 year after burn injury) with late (more than 1 year after burn injury) releases revealed that the preoperative limitation was worse in the early release group but that the ultimate outcomes were similar. Waiting for scars to mature before performance of contracture releases is not necessary.
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Burn scar contractures of the foot cause significant morbidity. We reviewed 68 children in regard to number and rates of burn scar contracture recurrence, surgical techniques, and functional and aesthetic results. Two surgical techniques of foot burn scar contracture release have been used. ⋯ The time between burn injury and primary burn scar contracture release was 4.18 +/- 0.76 years, and the time until the first recurrence was 3.44 +/- 0.46 years. With release of only the longitudinal arch, recurrence of burn scar contractures occurred in 3.5 +/- 0.41 years and in 4.29 +/- 1.27 years in six patients who also received release of the transverse arch. Wound closure at the time of acute burn with split-thickness skin graft expansion ratios of 1:2 and 1:4 had burn scar contractures that required release in 4.21 +/- 0.70 and 2.29 +/- 0.52 years, respectively.
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In 1989 a Delphi study was undertaken to identify the nursing priorities in burn research. The Delphi technique is a series of questionnaires used to reach consensus. Ninety-four nurses involved in burn care completed four rounds of questionnaires containing 101 research questions. ⋯ Eleven (10%) of the 101 questions dealt with pain, whereas five were rated among the top 20 priority questions. As a category the questions concerning pain management had a mean score of 5.91 on a 0 to 7 Likert scale. The questions collectively were cited as having the most impact on the welfare of the patient with burns.