Articles: burns.
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Randomized Controlled Trial Clinical Trial
Randomized trial of efficacy of crystalloid and colloid resuscitation on hemodynamic response and lung water following thermal injury.
To assess the effects of crystalloid and colloid resuscitation on hemodynamic response and on lung water following thermal injury, 79 patients were assigned randomly to receive lactated Ringer's solution or 2.5% albumin-lactated Ringer's solution. Crystalloid-treated patients required more fluid for successful resuscitation than did those receiving colloid solutions (3.81 vs. 2.98 ml/kg body weight/% body surface burn, p less than 0.01). In study phase 1 (29 patients), cardiac index and myocardial contractility (ejection fraction and mean rate of internal fiber shortening, Vcf) were determined by echocardiography during the first 48 hours postburn. ⋯ Cardiac index increased progressively and identically in both treatment groups over the study period (p less than 0.01). These data refute the existence of myocardial depression during postburn resuscitation and document hypercontractile left ventricular performance. The addition of colloid to crystalloid resuscitation fluids produces no long lasting benefit on total body blood flow, and promotes accumulation of lung water when edema fluid is being reabsorbed from the burn wound.
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Randomized Controlled Trial Clinical Trial
A prospective study of prophylactic penicillin in acutely burned hospitalized patients.
The use of prophylactic low-dose penicillin acutely burned, hospitalized patients remains controversial. Fifty-one adult patients with burns of 1% to 91% total body surface area were prospectively studied to determine the efficacy of prophylactic penicillin in the prevention of wound cellulitis and burn wound sepsis, and to examine the influence of prophylactic penicillin on the emergence of antibiotic resistant microorganisms. ⋯ No patient in either group developed gentamicin-resistant Gram-negative organisms, although the gastrointestinal tracts of two patients in the penicillin group showed new colonization by yeast. We conclude that the routine administration of prophylactic penicillin neither protects against cellulitis and burn wound sepsis, nor promotes selection of antibiotic-resistant bacteria in hospitalized patients with acute thermal injury.
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Randomized Controlled Trial Comparative Study Clinical Trial
Cerium nitrate-silver sulfadiazine cream in the treatment of burns: a prospective evaluation.
In a prospective, randomized study of patients with major burns, the efficacy of cerium nitrate-silver sulfadiazine cream was compared with that of silver sulfadiazine cream alone. Sixty patients were studied, in two groups, with matching mean ages and mean burns sizes. Patients with associated injuries, smoke inhalation, or major medical illnesses were excluded from the study. ⋯ The distribution of bacterial isolates by organism was similar in both groups. In vitro sensitivity determinations indicated a comparable efficacy between the two agents. In this study no clear-cut superiority of one topical agent over the other could be demonstrated.
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The American surgeon · Apr 1979
Randomized Controlled Trial Comparative Study Clinical TrialCerium nitrate-silver sulfadiazine cream in the treatment of burns: a prospective, randomized study.
In a prospective, randomized study of 34 patients with thermal burns, treatment with the topical agent Cerium nitrate-silver sulfadiazine was compared with therapy with silver sulfadiazine alone. Despite randomization, there was a significant difference in mean burn size, being larger in the silver sulfadiazine group. There was no significant difference between the two groups in clinical course, mortality, septic deaths, or quantitative microbiology of the burn wound. It is concluded that from these preliminary data no clearcut superiority for one cream over the other can be demonstrated at this time.
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Randomized Controlled Trial Clinical Trial
Compression treatment of hypertrophic scars in burned children.
The formation of hypertrophic scars is common following healing of the burn wound, particularly in children. The control of scar formation is an important part of overall treatment in these cases and this paper describes a newer method that applies compression to the burn scar in an attempt to improve the ultimate appearance. The 35 patients treated by this method included some with partial-thickness and others with full-thickness burns. ⋯ The design of facial moulages and their use in compression of facial scars are dealt with. Overall there was a 75% to 80% improvement in the state of burn scars. The reasons for this improvement are discussed.