The Journal of burn care & rehabilitation
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J Burn Care Rehabil · Nov 2005
Randomized Controlled TrialEfficacy of a short-term, intensive social skills training program for burned adolescents.
This study examined the efficacy of an intensive, short-term social skills training program in improving the psychosocial adjustment of burned adolescents. Sixty-four adolescents who had suffered a burn injury 2 years previously or longer and who were identified as having psychosocial difficulties (elevated behavioral problems and/or diminished competence) were assigned randomly to receive the treatment intervention or to serve as controls (32 in each group). ⋯ One year after the training program, the group who had received the treatment showed significantly more improvement than did the control group. The program appears to offer advantages to a sizeable group of pediatric burn survivors and indicates the need for further study of interventions to enhance psychosocial competence in the development of pediatric burn survivors.
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J Burn Care Rehabil · Sep 2005
Randomized Controlled TrialThe long-term analgesic efficacy of a single-shot fascia iliaca compartment block in burn patients undergoing skin-grafting procedures.
In a previous study, we assessed the efficacy of a continuous fascia iliaca compartment block (FICB) in reducing the pain at thigh autograft skin donor sites. However, a continuous local anesthetic infusion may cause toxicity or infection. In this prospective, randomized double-blind study, we compared the analgesic efficacy of FICB when given as a single shot vs continuous infusion during the 72-hour postoperative period up to the first dressing change (1dc). ⋯ Both techniques were equally effective in diminishing dynamic pain and reducing the side effects normally associated with morphine. However, patients receiving a single block experienced less residual paresia and were more satisfied with their pain-relief treatment than those who received a continuous infusion. A single-shot FICB is an easy, inexpensive, and efficient method for diminishing pain at thigh donor sites during a 72-hour postoperative period and has limited side effects and no residual paresia.
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J Burn Care Rehabil · Jul 2005
Randomized Controlled Trial Comparative Study Clinical TrialA prospective, randomized trial of Acticoat versus silver sulfadiazine in the treatment of partial-thickness burns: which method is less painful?
Despite recent improvements in analgesia, pain control during dressing changes continues to be a major challenge in patients with burns. We investigated two different dressing modalities to compare how much pain the patient experienced during and after the dressing change. Patients with partial-thickness burns that required only topical wound care were assigned randomly to treatment with Acticoat (Smith and Nephew USA, Largo, FL) or silver sulfadiazine (AgSD). ⋯ The mean visual analog pain scores for the wounds treated with Acticoat or AgSD wounds were 3.2 and 7.9, respectively (P < .0001; paired Student's t-test). In 41 of the 47 paired pain score observations, the pain in the wound treated with AgSD was perceived as greater than in the wound treated with Acticoat. Burn wound care with Acticoat is less painful than burn wound care with AgSD in patients with selected partial-thickness burns.
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J Burn Care Rehabil · Jan 2004
Randomized Controlled Trial Clinical TrialBurn pain and anxiety: the use of music relaxation during rehabilitation.
Pain and anxiety are well-documented problems during the rehabilitation of patients with burns. This study examined the effect of music on anxiety and pain during range of motion. Eleven subjects with partial-thickness or deeper burns were randomly assigned to a control group (without music intervention) or experimental group (with music intervention). ⋯ Results showed no significant reduction in anxiety and pain during therapy with music relaxation. Limitations included nonhomogenous groups, small sample size, potentially unrepresentative sample, variation in exercise protocol, and small musical selection. Further research is recommended.
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J Burn Care Rehabil · Nov 2003
Randomized Controlled Trial Clinical TrialA double-blind study of the analgesic efficacy of oral transmucosal fentanyl citrate and oral morphine in pediatric patients undergoing burn dressing change and tubbing.
Burn wound care is extremely painful. The pain leads to added anxiety and therefore a distressing treatment that can negatively impact healing. Pain and anxiety management with oral transmucosal fentanyl citrate was compared with this institution's standard procedural pain medication, morphine. ⋯ Data were analyzed with repeated measures analysis of variance. Pain and anxiety appeared better managed with fentanyl citrate. Generalization is limited by small sample size, yet findings warrant additional investigation.