Annals of burns and fire disasters
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Ann Burns Fire Disasters · Dec 2019
Self-inflicted burns in a National Swedish Burn Centre: an overview.
In the Western world, self-inflicted burns are often associated with mental health disorders, and the management, particularly the pain treatment, can often be complicated by the psycho-social background of the patients. The aim was to describe a group of patients with self-inflicted burns by analysing their in-hospital mortality and the use of sedation during procedures. All patients with self-inflicted burns admitted to the Linköping Burn Centre during 2000-2017 were included. ⋯ Multivariable analyses showed no difference in the use of sedation for procedures or in-hospital mortality after adjustment for TBSA%, full thickness burns, age and sex. Age and TBSA% were associated with in-hospital mortality, whereas the intentionality of the burn was not. TBSA% and female sex were associated with increased use of sedation for wound care procedures, whereas self-inflicted burns were not.
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Ann Burns Fire Disasters · Sep 2019
Factors affecting length of stay among pediatric and adult patients admitted to the Lebanese Burn Centre: a retrospective study.
Burn injuries are serious lesions requiring specialized medical care, and are associated with prolonged length of hospital stay (LOS). This study aims to elucidate the epidemiological and clinical factors affecting the LOS of pediatric and adult patients with burn wounds. A single-centre retrospective study was conducted at the Hopital Libanais Geitawi Burn Centre in Lebanon. ⋯ Multivariate analysis showed that both pediatric and adult LOS was significantly associated to number of operations, need for burn excision and skin grafting, and receiving a blood transfusion. Adult LOS was further affected by mechanical ventilation, infection and age. Our study demonstrated the differential influence of epidemiological and clinical factors among adult and pediatric populations, which allows better prediction of LOS and management of patients with burn injuries.
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Ann Burns Fire Disasters · Jun 2019
Respiratory and coagulation dysfunctions on admission as independent predictors of in-hospital mortality in critically ill burn patients.
Mortality rate for burns patients in developing countries is approximately 34%. Data show that most patients in burn units will likely experience organ dysfunction. Sequential Organ Failure Assessment (SOFA) score assesses organ dysfunction and is frequently used in the ICU, but there are no previous studies regarding SOFA score in burn units in Indonesia specifically. ⋯ SOFA score had very good discrimination (AUC 96.4%, CI 95% 0.933 - 0.995) and good calibration (Hosmer-Lemeshow p = 0.561). SOFA variables which had a statistically significant effect on 30-day mortality in the Burn Unit were PaO2/FiO2 ratio < 400, PaO2/FiO2 ratio < 300, PaO2/FiO2 ratio < 200 with mechanical ventilation and platelet count < 150,000/mm3. SOFA score was a valid instrument for predicting 30 day mortality of critically ill burn patients in the Burn HDU and ICU of Cipto Mangunkusumo General Hospital, especially respiration and coagulation variables.
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Ann Burns Fire Disasters · Mar 2019
ARDS among cutaneous burn patients combined with inhalation injury: early onset and bad outcome.
Our aims are to determine the clinical and preclinical characteristics and outcome of ARDS among burn patients with inhalation injury. A retrospective study was conducted on 66 selected patients with ARDS, treated in the ICU of the National Burns Hospital from 11/2013 to 10/2016. The patients were divided into two groups and matched by age and burn extent: the study group consisted of 33 patients with inhalation injury and the control group 33 patients without inhalation injury. ⋯ Mortality rate until 28 days post burn was significantly higher among the study group (69.7% vs. 54.6% respectively; p < .001). In addition, time from admission and from ARDS onset to death was shorter in the study group (P < .05). In conclusion, compared to cutaneous burn-induced ARDS, ARDS in patients with inhalation injury has earlier onset, causes more severe oxygenation disorder and has a higher mortality rate.
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Ann Burns Fire Disasters · Dec 2018
The effects of Platelet-rich Plasma on healing of partial thickness burns in a porcine model.
Platelet-rich plasma (PRP) derived from autologous peripheral blood is rich in platelets that release growth factors and cytokines. We determined the effects of topically applied autologous PRP in a partial thickness porcine burn model. Partial thickness burns were created on the backs and flanks of six domestic pigs (24 burns each) using an aluminium bar preheated to 80° C for 20 seconds. ⋯ Time to complete healing (presented as mean, [SD]) did not differ among the groups (antibiotics, 17.1 [3.5]; single PRP, 17.6 [4.0]; double PRP, 18.4 [3.9]; and triple PRP, 17.7 [3.3] days; ANOVA P=0.43). Scar depth (presented as mean, [SD]) in mm at day 28 by treatment group was: antibiotic 5.0 [1.0], single PRP 5.5 [1.1], double PRP 5.4 [1.1], and triple PRP 5.5 [0.6], ANOVA P=0.026. We conclude that PRP results in similar rates of reepithelialization and scar depth to standard topical antibiotics in a partial thickness porcine burn model.