International journal of burns and trauma
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Fat embolism syndrome (FES) is a multi-organ dysfunction caused by the fat emboli. The diagnostic of FES remains a challenge for clinicians. The clinical criteria including those of Gurd's and Wilson's although universally used for its diagnosis are not specific. Different methods of imaging are increasingly performed in the patients with presumed FES. The objective of this study is to determine whether there is a correlation between the clinical parameters and the imaging findings in confirming the FES diagnosis. ⋯ The FES is common in young males with long bone fractures. Respiratory distress and neurological deterioration were common presentations. We suggest that the all patients with suspected FES by clinical criteria should have imaging studies to confirm the diagnosis.
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The present study describes initial burn injury care in Tanzania-materials applied, sources of information, reasons for applying the materials, and time to a health centre-in order to suggest ways to optimize initial care. Eight small studies were conducted in which burn-injured patients were interviewed who had been admitted to referral hospitals in four regions in Tanzania. Most burn injuries in Tanzania occur in the home cooking area, and it was found that the first responders were family members, friends, and neighbours. ⋯ A national mass media campaign should start immediately to inform ordinary citizens about proper initial treatment of burns. In addition, curricula of all schools that train health workers need to be reviewed for accuracy, and appropriate knowledge about initial care of burn victims should be added if necessary. Measures to improve burn first aid, are relatively easy, even in a low-income country such as Tanzania.
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The value of prehospital red blood cell (RBC) transfusion for trauma patients is controversial. The purposes of this literature review were to determine the mortality rate of trauma patients with hemodynamic instability and the benefit of prehospital RBC transfusion. A 30-year systematic literature review was performed in 2016. ⋯ Trauma patient mortality increases with the magnitude of hemodynamic instability and anatomic injury. Some literature evidence indicates no survival advantage with prehospital RBC availability. However, other data suggesting a potential benefit is confounded or likely to be biased.
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Negative Pressure Wound Therapy (NPWT) has proven to be a powerful tool in facilitating healing of difficult wounds of a variety of etiologies. The pediatric experience with NPWT has been limited due to concerns about vascular compression and pain associated with treatment. ⋯ NPWT has a useful role in the pediatric burn unit in facilitating wounds healing and improving life qualities. We also found that a significant correlation between third degree burned wound size and the number of negative pressure therapies received, which indicated that NPWT could be more effective in treating complicated burned wounds. NPWT seems safe and effective when applied to well-debrided wounds. It does not seem to be associated with excessive bleeding or discomfort in children.
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Different surgical techniques have evolved since excision and autografting became the treatment of choice for deep burns in the 1970s. The treatment plan at the Burn Center, Linköping University Hospital, Sweden, has shifted from single-stage excision and immediate autografting to staged excisions and temporary cover with xenografts before autografting. The aim of this study was to find out if the change in policy resulted in extended duration of hospital stay/total body surface area burned (LOS/TBSA%). ⋯ Staged excisions with temporary cover did not affect adjusted LOS/TBSA% or total operating time. Staged excisions may be thought to be more expensive because of the cost of covering the wound between stages, but this needs to be further investigated as do the factors that predict long term outcome.