Zhonghua shao shang za zhi = Zhonghua shaoshang zazhi = Chinese journal of burns
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Zhonghua Shao Shang Za Zhi · Aug 2021
[Clinical effect of fractional carbon dioxide laser in the treatment of contracture scars].
Objective: To explore the clinical effect of the fractional carbon dioxide laser in the treatment of contracture scars. Methods: A retrospective before-after self-control study was conducted. From December 2016 to April 2021, 16 patients (7 males and 9 females, aged 3-49 years) with contracture scars causing impaired function of the adjacent joint were admitted to Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. ⋯ No adverse effects such as blisters, infection, or hypertrophic scar formation were observed in the treatment area of 16 patients after treatment. Most patients adopted physical therapy, compression, silicone gel or sheets, and braces during the treatment interval and follow-up period. Conclusions: The fractional carbon dioxide laser can soften the scar and increase the range of motion of the affected joint, which is suitable for the clinical treatment of mild contracture scars.
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Zhonghua Shao Shang Za Zhi · Jul 2021
Controlled Clinical Trial[Repair methods and clinical effects of full-thickness burn wounds deep to tendon or even bone in fingers].
Objective: To explore the repair methods and clinical effects of full-thickness burn wounds deep to tendon or even bone in fingers. Methods: A retrospective non-randomized controlled trial was conducted on the 98 patients with full-thickness finger burns deep to tendon or even bone who met the inclusion criteria and were hospitalized in Xiangya Hospital of Central South University from January 2010 to December 2019. Among the 98 patients, there were 81 males and 17 females, aged from 1 to 72 years, with 160 fingers involved. ⋯ The satisfaction of patients with fingers repaired by free tissue flaps was significantly higher than that by pedicled abdominal flap (P<0.05). Conclusions: According to the specific situation of full-thickness burn wounds deep to tendon or even bone in fingers, the pedicled abdominal flap is used to repair the multiple full-thickness burn wounds deep to tendon or even bone in multiple fingers of adult or the full-thickness burn wounds deep to tendon or even bone in fingers of children, the pedicled internal hand flap or free tissue flap is used to repair the full-thickness burn wounds deep to tendon or even bone in single or two fingers of adult patients, and the first toenail flap or the dorsal foot flap with the second toe is used to reconstruct the thumbs with full-thickness burn deep to tendon or even bone, with high postoperative tissue flap survival rate and few complications. The functional recovery of the affected finger is better after repair with free tissue flap and pedicled internal hand flap, and the patients' satisfaction is the highest after free tissue flap repair.
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Zhonghua Shao Shang Za Zhi · Jun 2021
[Establishment of an early risk prediction model for bloodstream infection and analysis of its predictive value in patients with extremely severe burns].
Objective: To establish an early prediction model for bloodstream infection in patients with extremely severe burns based on the screened independent risk factors of the infection, and to analyze its predictive value. Methods: A retrospective case-control study was conducted. From January 1, 2010 to December 31, 2019, 307 patients with extremely severe burns were admitted to the Department of Burns and Plastic Surgery of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medcine, including 251 males and 56 females, aged from 33 to 55 years. ⋯ The area under the ROC curve in validation group was 0.759 (95% confidence interval=0.637-0.882). Conclusions: The total burn area, days of ICU stay, and combination of inhalation injury are the risk factors of bloodstream infection in patients with extremely severe burns. The early prediction model for bloodstream infection risk in patients with extremely severe burns based on these factors has certain predictive value for burn centers with relatively stable treatment methods and bacterial epidemiology.
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Zhonghua Shao Shang Za Zhi · May 2021
[Effects of positive end-expiratory pressure setting of mechanical ventilation guided by esophageal pressure in the treatment of patients with traumatic craniocerebral injury combined with acute respiratory distress syndrome].
Objective: To investigate the effects of positive end-expiratory pressure (PEEP) setting of mechanical ventilation guided by esophageal pressure in the treatment of patients with traumatic craniocerebral injury combined with acute respiratory distress syndrome (ARDS). Methods: The retrospective cohort study was conducted. From June 2016 to June 2018, 55 patients with traumatic craniocerebral injury combined with ARDS who met the inclusion criteria were admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University. ⋯ The central venous pressure of patients in esophageal pressure group at 24, 48, and 72 h after treatment was significantly higher than that in PEEP-FiO2 table group (t=12.632, 5.247, 8.994, P<0.01), and there was no statistically significant difference in mean arterial pressure of patients between the 2 groups at 24, 48, and 72 h after treatment (P>0.05). The intracranial pressure of patients in esophageal pressure group was higher than that in PEEP-FiO2 table group at 24, 48, and 72 h after treatment, but there was no statistically significant difference between the 2 groups (P>0.05). Conclusions: For patients with traumatic craniocerebral injury combined with ARDS, the optimal PEEP can be set under the guidance of esophageal pressure method, and the mechanical ventilation parameters adjusted according to the optimal PEEP can improve lung compliance and accelerate recovery of lung function more effectively, with no adverse effect in mean arterial pressure and intracranial pressure.
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Zhonghua Shao Shang Za Zhi · May 2021
[A cross-sectional study on psychological needs of family members of critically ill inpatients in semi-closed wards and analysis of influence factors].
Objective: To analyze and discuss the psychological needs of family members of critically ill burn inpatients in semi-closed wards and their related influence factors. Methods: A cross-sectional survey was conducted among the 82 burn patients, who met the inclusion criteria and were admitted to the Department of Burns and Plastic Surgery of Ruijin Hospital of Shanghai Jiao Tong University School of Medicine from October 2018 to April 2019, and their family members. A general condition questionnaire of 15 indexes was applied to investigate the general data of burn patients and their family members including cause of burn, gender, age, total burn area, burn depth, burn severity, burn site, and type of medical insurance of patients, kinship with the patients, gender, age, experience of accompanying in intensive care isolation wards, occupation, education level, and monthly income of their family members. ⋯ The SS score of male family members of patients was significantly lower than those of female patients (t=4.149, P<0.05). Conclusions: The family members of burn patients in semi-closed ward have the most urgent need to ensure the patients receive the best treatment. Patients' age, total burn area, and their family members' gender, education level, experience of accompanying in intensive care isolation unit are the main factors affecting the psychological needs of family members of patients.