International journal of burns and trauma
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In the past, the authors performed a comprehensive literature review to identify all randomized controlled trials assessing the impact of early tracheostomy on severe brain injury outcomes. The search produced only two trials, one by Sugerman and another by Bouderka. ⋯ For severe brain injury, analyses indicate that ventilator-associated pneumonia rates are not decreased with early tracheostomy. Further, this study implies that mechanical ventilation is reduced with early tracheostomy. Both the randomized trial and retrospective meta-analysis indicate that risk for hospital death increases with early tracheostomy. Findings imply that early tracheostomy for severe brain injury is not a prudent routine policy.
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Length of stay is a standard variable used to evaluate outcomes in burn care. Is the target of 1 day length of stay per 1% total body surface area burned actually being achieved? ⋯ Many factors can contribute to patients' length of hospital stay. It is valuable to identify areas of practice which can be altered to minimise the impact of these factors. For example, consider the use of laser Doppler imaging to help assess burn depth more accurately; this leading to potentially more accurate requirements for surgery or not, early excision of deep burns, improved infection control and use of dressings may all contribute to reduce the length of inpatient stay with a view to improving patient outcome.
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Burn injuries in low and middle income countries still remain a significant health problem, even though numbers of burn injuries in high income countries have decreased showing that such events are not "accidents" but are usually preventable. WHO states that the vast majority (over 95%) of fire-related burns occur in low and middle income countries. Burn injuries are a major cause of prolonged hospital stays, disfigurement, disability, and death in Africa Region. ⋯ Children need to be kept away from fires. Epileptics should be monitored for medication and kept away from cooking fires as well. Community members need to be encouraged to bring wrong doers to the police.
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Pediatric burns mortality risk factors in a developing country's tertiary burns intensive care unit.
This study aimed at identifying risk factors related to pediatric burns mortality in a middle income country such as Ghana. ⋯ Age, scald, TBSA and Inhalation Injury were identified as pediatric burns mortality risk factors in a developing country such as Ghana's RPSBU. These identified factors will serve as a guideline for plastic surgeons and other health professionals practicing in countries such as Ghana.
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This is a large cohort analysis in severely burned pediatric children to determine whether C-reactive protein (CRP) can be used as a predictor for severe infection or sepsis. Nine-hundred eighteen pediatric burn patients were enrolled in this study. CRP values were measured throughout acute hospitalization and for up to 6 months postburn. ⋯ Significantly higher levels of CRP were found in large burns, in non-survivors, and in females, p<0.05. Using various described models to determine whether CRP levels change before and after an event can predict sepsis or severe infection, we found that CRP cannot predict severe infection or sepsis. Although CRP is a marker of the inflammatory response postburn, CRP fails to predict infection or sepsis in severely burn patients.