The Journal of burn care & rehabilitation
-
J Burn Care Rehabil · Jul 1990
Management of pediatric perineal and genital burns: twenty-year review.
Between 1966 and 1986, fifty-seven pediatric patients with partial and/or full-thickness perineal and genital burns with a minimum of 1-year follow-up were identified. Fifty percent of the patients with genital burns and 20% of the patients with perineal and/or buttock burns required skin grafting in the acute stage. No patient required suprapubic cystostomies, diverting colostomies, or local flap coverage of exposed testicles. ⋯ Four patients developed rectal stenosis with fecal incontinence because of burn scar contracture and were treated by anal dilatation, local transposition flaps, and/or excision of the scar and primary closure. Acute management of pediatric patients with such injuries can be conservative. Delayed complications of contractures of the perineum and genitals can be easily corrected with scar excisions, skin grafts, or the use of local skin flaps.
-
Biobrane temporary biosynthetic skin substitute has been well demonstrated in the treatment of superficial and deep wounds. We have used this product nearly 1000 times. ⋯ The following study covers an attempt to adapt this dressing for use in these difficult areas. Ninety-eight applications of meshed Biobrane temporary wound dressing were placed in anatomic locations, which ranged from the head to the foot, with an 86% success rate.
-
Secure positioning of orally or nasally placed endotracheal and gastric tubes is a necessity for the patient with burns. This article describes a technique for securing these tubes with a simple modification to avoid compression on the ear that may lead to subsequent necrosis and infection.
-
J Burn Care Rehabil · May 1990
A knowledge-based information system for advice in the crisis management of the patient with burns.
A knowledge-based information system that has been designed to be used as an electronic advisor to guide in fluid resuscitation and in the management of the most frequently occurring complications during the first 48 hours after burn injury is described. The system was also developed for training physicians and nurses and may eventually be used for peer review of the management of patients in the burn unit. Ten data screens are used for entry of the administrative data, the clinical background, and the monitored data. ⋯ The system's conclusions, the fluid and ventilation prescription, and other required patient management measures are then displayed as a report. The underlying reasoning for each case may be explored by means of the system's explanation facility. The system has been successfully validated by 125 hypothetic cases that represent typical situations of patients with severe burns.
-
A reliable, objective, and universal method of assessing burn scars does not exist in today's burn literature. Such a method is necessary to provide a descriptive terminology for the comparison of burn scars and the results of treatment. The method should be applicable to patients both within an institution and between burn centers. ⋯ For each parameter a Cohen's kappa statistic of approximately 0.5 +/- 0.1 indicates a statistically significant agreement between observers. These values were found to improve with time. This appears to be a useful tool for the assessment of burn scars, allowing objective comparison of the same scar by different observers.