Articles: burns.
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Meta Analysis
The efficacy of cellulose dressings in burn wound management: a systematic review and meta-analysis.
Burn wound management is challenging, especially in paediatric patients when optimising outcomes. Superficial burns are generally managed conservatively with dressings; however, frequent dressing changes can be a source of pain and discomfort. Cellulose dressings mitigate these problems, and current reports in the literature have demonstrated positive outcomes when compared against routine dressing types. The authors aim to report a systematic review and meta-analysis on the use of cellulose-based dressings in burn wound management. ⋯ Cellulose dressings can expedite wound healing whilst reducing the duration of hospitalisation and frequency of dressing changes compared to standard dressings in burn wound management. The authors however recommend further high quality trials to enhance the current evidence base.
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Randomized Controlled Trial
Effects of intravenous tranexamic acid on bleeding during burn surgery: A double-blinded randomized clinical trial.
Blood loss during burn surgery significantly contributes to morbidity and mortality. Tranexamic acid (TXA), an antifibrinolytic agent, is hypothesized to reduce intraoperative bleeding. This double-blinded, randomized clinical trial aimed to assess the efficacy of systemic TXA in severe burn patients (total body surface area [TBSA] > 20 %) undergoing surgery. ⋯ Results demonstrated significant reductions in blood loss (P = 0.043), total IV fluid volume (P = 0.021), OR time (P = 0.002), LOS (P = 0.0001), and transfusions (P = 0.024) in the TXA group. Notably, women and patients without inhalation injuries exhibited better responses to TXA treatment, and graft survival was lower in the TXA group. The study concludes that IV TXA administration during burn surgery can reduce bleeding, minimize IV fluid and blood transfusion needs, and shorten surgery duration, enhancing overall surgical outcomes.
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Collecting patient-reported outcome measures (PROMs) has been a longstanding priority for the Burns Registry of Australia and New Zealand (BRANZ). An earlier pilot of hospital-led PROM collection encountered low participation rates and high loss to follow-up, indicating consideration for an alternative model was warranted. ⋯ Collecting PROMs from burns patients in the first 12 months after injury via a centralised approach was shown to be feasible, with higher participation rates and low missingness.
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Observational Study
Identification and quantification of physical activity in critically ill burn patients: A feasibility study.
Physical activity is essential in burn care to counteract the effects of severe burns and inactivity during hospitalization. However, detailed knowledge of performed physical activities is lacking. This study evaluated the feasibility of a dual accelerometer-based method to assess type, frequency, and duration of physical activity in critically ill burn patients during hospitalization. ⋯ The dual accelerometer-based method proved feasible for research purposes. For clinical application, further refinement of data processing is required.
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Burn injuries present a significant challenge globally, particularly in low- and middle-income countries (LMICs) where access to standard intravenous (IV) fluid resuscitation is often limited. In such austere settings, the feasibility of enteral resuscitation via oral rehydration solution (ORS) as an alternative to burn resuscitation is a critical consideration. We aimed to investigate the barriers and facilitators perceived by burn care providers in Nepal trained to use an enteral resuscitation protocol. ⋯ This study highlights the importance of stakeholder engagement, iterative refinement, and contextual adaptation in implementing an enteral resuscitation protocol for acute burn injuries. Findings offer insights into real-world applications and future clinical and research endeavors, informing the potential scalability and sustainability of enteral resuscitation protocols more broadly, to improve the care of patients with major burns in LMICs.