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1.
Ann Plast Surg ; 87(4): 421-426, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34559711

RESUMO

BACKGROUND: Burns are devastating injuries, carry significant morbidity, and require long-term treatment or multiple reconstructive procedures. Wound healing and secondary insults caused by burn wound conversion are amendable to therapeutic intervention, where ischemia has been cited as one of the major factors (Dermatol Surg. 2008;34:1159-1169). Halting injury progression in the zone of stasis is crucial as conversion creates increased burn surface area and depth, leading to local and systemic consequences (J Burns Wounds. 2006;5:e2). Oxygen-carrying micro/nanobubbles, MNB(O2), offer a novel technology that can be used to effectively deliver oxygen to burn wounds and potentially counteract burn wound ischemia. METHODS: Topical irrigation with MNB(O2) of full-thickness burn wounds on a rodent model (n = 3) was compared against saline-treated controls (n = 3). Tissue structure (reduced scattering coefficient, µs'), oxyhemoglobin concentration (cHbO2), and tissue perfusion were quantified over the course of 28 days through spatial frequency domain imaging and laser speckle imaging. Histological samples taken at the end of the experiment were examined for evidence of wound healing. RESULTS: Findings in this preliminary study showed hastened healing with significant differences in spatial frequency domain imaging-measured µs' during wound healing (days 11-28) in MNB(O2) group. The healing "tipping point" seemed to occur at days 9 to 11 with increased collagen organization and increased cHbO2 occurring around that period confirming the gross healing improvements observed. In addition, histological evidence indicated that only the MNB(O2) burns had reached the remodeling phase by the end of 28-day study period. CONCLUSIONS: These preliminary findings propose the potential of MNB(O2) as a topical method for improving burn wound healing.


Assuntos
Queimaduras , Queimaduras/terapia , Humanos , Cicatrização
2.
Int J Mol Sci ; 22(16)2021 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-34445299

RESUMO

Deep partial-thickness burns damage most of the dermis and can cause severe pain, scarring, and mortality if left untreated. This study serves to evaluate the effectiveness of crosslinked keratin-alginate composite sponges as dermal substitutes for deep partial-thickness burns. Crosslinked keratin-alginate sponges were tested for the ability to support human dermal fibroblasts in vitro and to support the closure and healing of partial-thickness burn wounds in Sus scrofa pigs. Keratin-alginate composite sponges supported the enhanced proliferation of human dermal fibroblasts compared to alginate-only sponges and exhibited decreased contraction in vitro when compared to keratin only sponges. As dermal substitutes in vivo, the sponges supported the expression of keratin 14, alpha-smooth muscle actin, and collagen IV within wound sites, comparable to collagen sponges. Keratin-alginate composite sponges supported the regeneration of basement membranes in the wounds more than in collagen-treated wounds and non-grafted controls, suggesting the subsequent development of pathological scar tissues may be minimized. Results from this study indicate that crosslinked keratin-alginate sponges are suitable alternative dermal substitutes for clinical applications in wound healing and skin regeneration.


Assuntos
Alginatos/uso terapêutico , Queimaduras/terapia , Queratinas/uso terapêutico , Cicatrização , Alginatos/química , Alginatos/farmacologia , Animais , Curativos Hidrocoloides , Queimaduras/patologia , Queimaduras/fisiopatologia , Células Cultivadas , Derme/efeitos dos fármacos , Derme/patologia , Derme/fisiopatologia , Humanos , Hidrogéis/química , Hidrogéis/uso terapêutico , Queratinas/química , Queratinas/farmacologia , Masculino , Teste de Materiais , Índice de Gravidade de Doença , Pele/efeitos dos fármacos , Pele/patologia , Pele/fisiopatologia , Suínos , Cicatrização/efeitos dos fármacos , Cicatrização/fisiologia
3.
Medicine (Baltimore) ; 100(31): e26404, 2021 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-34397792

RESUMO

BACKGROUND: In clinical settings, burn wounds are frequently encountered. Since burn wounds are a form of physical injury, they can have long-term adverse effects on the human body. It has been a significant challenge to treat burn wounds completely. Since traditional treatment strategies have been unable to heal burn wounds completely, they lack the efficacy to cure the wounds without long-term effects, such as heavy scarring. Reportedly, platelet-rich plasma (PRP) has shown potential to accelerate wound healing. Yet, there are no conclusive reports on a methodological comparative study of research that has assessed the medical benefits of PRP for treating individuals carrying burn wounds. Thus, the present meta-analysis and systematic study aims to assess the medical benefits of PRP for treating patients carrying burn wounds. METHODS: The authors will conduct a comprehensive search for randomized controlled trials that evaluate the safeness and efficiency of PRP to treat burn wounds. The search includes 3 Chinese language databases (WanFang database, Chinese BioMedical Literature database, and China National Knowledge Infrastructure) and 4 English language databases (Cochrane Library, EMBASE, Web of Science, and MEDLINE). These electronic databases will be searched from their establishment till May 2021. A pair of independent authors will be selecting eligible studies for extracting data. The same authors will employ the Cochrane risk of bias tool to evaluate the bias risk. We will make use of RevMan (version: 5.3) software to complete data synthesis. RESULTS: The present protocol will establish practical and targeted results evaluating the efficacy and safeness of using PRP to treat burn wounds. The current study also provides a reference for clinical use of PRP. CONCLUSION: Stronger evidence about the effectiveness and safety of using PRP to treat and heal burn wounds will be provided for clinicians to refer. ETHICS AND DISSEMINATION: Ethics approval is unrequired. REGISTRATION NUMBER: March 31, 2021.osf.io/whauj. (https://osf.io/whauj/).


Assuntos
Queimaduras/terapia , Plasma Rico em Plaquetas , Cicatrização , Humanos , Metanálise como Assunto , Revisões Sistemáticas como Assunto
4.
Aust J Rural Health ; 29(4): 521-529, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34423511

RESUMO

OBJECTIVE: Early intervention with appropriate first aid following burn injury improves clinical outcomes. Previous evidence suggests geographic remoteness may be a barrier to receiving appropriate burns first aid. This study investigated the prevalence of gold standard first aid in patients managed in Australian burn services and whether geographic remoteness was associated with receiving gold standard first aid. DESIGN: Registry-based cohort study. SETTING: Binational clinical quality registry. PARTICIPANTS: Burn-injured patients admitted to a specialist Australian burn service. MAIN OUTCOME MEASURES: Receiving gold standard first aid following a burn injury. RESULTS: Approximately two-thirds of patients received gold standard first aid. Patients whose burns were sustained in very remote regions had a greater risk of receiving no first aid, compared to gold standard first aid, relative to patients who sustained their burn injuries in major cities. CONCLUSIONS: Nearly two-thirds of patients received gold standard burns first aid following injury. However, patients who were injured in the most remote regions of Australia were at an increased risk of not receiving gold standard first aid treatment within 3 hours of injury. Further examination of factors contributing to poorer first aid standards in remote areas is required.


Assuntos
Queimaduras , Primeiros Socorros , Qualidade da Assistência à Saúde , Serviços de Saúde Rural , Austrália/epidemiologia , Queimaduras/epidemiologia , Queimaduras/terapia , Estudos de Coortes , Hospitalização , Humanos
5.
Zhonghua Shao Shang Za Zhi ; 37(8): 781-787, 2021 Aug 20.
Artigo em Chinês | MEDLINE | ID: mdl-34404165

RESUMO

Objective: To explore the effects of scenario simulation teaching of junior nurses in a burns department on the fluid resuscitation care of massive burn patients during shock stage. Methods: From March 2018 to July 2019, 25 junior nurses fixed in the Department of Burn of Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine met the inclusion criteria and were recruited in this prospective before-after self-control study, including 21 females and 4 males, aged 23 to 26 years. They had a work experience of 1.0 (1.0, 2.0) years in the Department of Burn. Three teaching scenarios were made according to the three major problems in the fluid resuscitation nursing of extensive burn patients during shock stage. The teaching plans were written based on the theoretical framework of Jeffrie's nursing simulation teaching. The high feasibility and practicability of the teaching plans was verified through expert consultation and evaluation by junior nurses. According to the three scenarios in the teaching plan, the junior nurses were performed with scenario simulation teaching, with 2 hours for each scenario, 6 hours in total. In one month before and after the teaching (hereinafter referred to as before and after teaching), the comprehensive ability of junior nurses was evaluated by the teachers using the self-designed junior nurse comprehensive ability evaluation scale, and their behaviors were evaluated by themselves with Performance Self-rating Scale for Nursing Students on High Simulation Training. Data were statistically analyzed with paired sample t test. Results: After teaching, the scores on communication skills, patient admissions, condition assessments, fluid resuscitation, emergency treatment, drug management, nursing skills, instrument use, teamwork, and humanitarian care and total score in the comprehensive ability evaluation of junior nurses as evaluated by teachers were significantly higher than those before teaching (t=-8.060, -11.421, -17.232, -24.800, -4.670, -11.916, -12.131, -11.606, -14.632, -13.325, -25.068, P<0.01), with 4 items including fluid resuscitation, condition assessment, nursing skills, and equipment operation having higher scores. After teaching, the nurses' self-rating scores on communication, division of labor and cooperation, clinical decision-making, professional knowledge and skills, and professional development and critical thinking and total score were (4.6±0.4), (4.8±0.3), (4.6±0.3), (4.6±0.4), (4.6±0.4), and (23.2±1.5) points respectively, which were significantly higher than the corresponding scores of (4.1±0.7), (4.2±0.7), (3.9±0.5), (3.7±0.6), (3.9±0.5), and (18.8±2.6) points before teaching (t=-3.361, -5.721, -6.987, -7.923, -7.922, -7.367, P<0.01). Conclusions: With solving the practical problems in nursing works of fluid resuscitation care of massive burn patients during shock stage as entry point, scenario simulation teaching aims to train the clinical practice ability and adaptability of junior nurses, thereby improving junior nurses' comprehensive ability of clinical practice in the fluid resuscitation care of massive burn patients during shock stage, enhancing their self-confidence and critical thinking ability.


Assuntos
Queimaduras , Enfermeiras e Enfermeiros , Autocontrole , Queimaduras/terapia , China , Feminino , Humanos , Masculino , Estudos Prospectivos
6.
Zhonghua Shao Shang Za Zhi ; 37(8): 797-800, 2021 Aug 20.
Artigo em Chinês | MEDLINE | ID: mdl-34420281

RESUMO

Deep partial-thickness burns are the most common type of pediatric burns, in which hypertrophic scars usually develop, causing functional and cosmetic impairment. The choice of wound management method and surgical procedures for deep partial-thickness burn are often the issues that concern burn surgeon and the family members of patients. The development of modern functional wound dressings, the establishment of the concept of full rehabilitation of pediatric burns, and the implementation of comprehensive rehabilitation therapy for hypertrophic scars will inevitably change the traditional therapeutic strategies for pediatric deep partial-thickness burn wounds to a certain extent.


Assuntos
Queimaduras , Cicatriz Hipertrófica , Bandagens , Queimaduras/terapia , Criança , Humanos , Cicatrização
7.
Rev Esc Enferm USP ; 55: e20200502, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34415007

RESUMO

OBJECTIVE: To develop a proposal of a terminological subset of the International Classification for Nursing Practice for burned patients. METHOD: This is a methodological study following the steps: identification of clinical findings; mapping of terms; construction of statements of diagnoses/results and nursing interventions; content validation of statements; and structuring of the subset with the theoretical model of Basic Human Needs. Content validation was performed by 26 specialist nurses, through the Content Validity Index, with statements ≥ 0.80 being considered validated. RESULTS: A total of 36 diagnoses/results and 119 interventions were validated. Among these, the ones with the highest index were: Respiratory System Function, Impaired/Respiratory System Function, Effective; Volume of Fluids, Impaired/Volume of Fluids, Effective; Burn Wound/Wound Healing, Effective; Pain, Acute/Pain, Absent, and as interventions: To Monitor Vital Signs; to Monitor Fluid Balance; to Treat Skin Condition; to Assess Response to Pain Management (Control). CONCLUSION: The validated statements depict the burned people basic human needs, with the psychobiological ones being the most prevalent.


Assuntos
Queimaduras , Terminologia Padronizada em Enfermagem , Queimaduras/terapia , Humanos , Modelos Teóricos , Dor , Manejo da Dor
8.
J Craniofac Surg ; 32(6): 2097-2100, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34260468

RESUMO

ABSTRACT: This study is the first to investigate pediatric craniomaxillofacial (CMF) trauma patients that present with concomitant burns. The authors aim to identify differing etiologies, presentations, facial fracture patterns, interventions, and outcomes between pediatric CMF trauma patients with versus without concomitant burns. In this retrospective cohort study of a tertiary care center between the years 1990 and 2010, concomitant burns were identified among pediatric patients presenting with CMF fractures. Patient charts were reviewed for demographics, presentation, burn characteristics (total body surface area %, location, and degree), imaging, interventions, involvement of child protective services, and long-term outcomes. Data were analyzed using two-tailed Student t tests and chi-square analysis. Of the identified 2966 pediatric CMF trauma patients (64.0% boys; age 7 ±â€Š4.7 years), 10 (0.34%) patients presented with concomitant burns. Concomitant burn and CMF traumas were more likely to be due to penetrating injuries (P < 0.0001) and had longer hospital lengths of stay (13 ±â€Š18.6 versus 4 ±â€Š6.2 days, P < 0.0001). 40% were due to child abuse, 40% due to motor vehicle collisions, and 20% due to house fires. All four child abuse patients presented in a delayed fashion; operative burn care was prioritized and 70% of the CMF fractures were managed nonoperatively. Concomitant burn and CMF trauma is a rare injury pattern in pediatrics and warrants skeletal surveys with suspicious injury patterns. Future research is necessary to develop practice guidelines.


Assuntos
Queimaduras , Pediatria , Fraturas Cranianas , Superfície Corporal , Queimaduras/complicações , Queimaduras/epidemiologia , Queimaduras/terapia , Criança , Pré-Escolar , Feminino , Humanos , Tempo de Internação , Masculino , Estudos Retrospectivos , Fraturas Cranianas/complicações , Fraturas Cranianas/epidemiologia
9.
J Trauma Acute Care Surg ; 91(2S Suppl 2): S233-S240, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34324475

RESUMO

BACKGROUND: Role 2 medical treatment facilities (MTFs) are frequently located in austere settings and have limited resources. A dedicated assessment of burn casualties treated at this level of care has not been performed. Therefore, the objective of this study was to characterize burn casualties presenting to role 2 MTFs in Afghanistan, along with the procedures they required, complications, and mortality to begin understanding the resources consumed by their care. METHODS: We identified burn casualties from the Department of Defense Trauma Registry (DODTR). The inclusion criteria were (1) experienced burn injuries in Afghanistan between October 2005 and April 2018 and (2) had documentation of treatment at role 2 in the DODTR. We excluded casualties with only first-degree burns, not otherwise specified burns, or only corneal burns. Casualty demographics, injury characteristics, procedures, and outcomes were reported. RESULTS: We identified 453 burn casualties with a median (interquartile range) Injury Severity Score of 10 (4-22) and percent total body surface area burned of 11 (5-30). There were 123 casualties (27.2%) with inhalation injury, and the casualties experienced 3,343 additional traumatic injuries and needed 2,530 procedures. Casualties with documentation of resuscitation information received a median (interquartile range) of 1.9 (0.7-3.7) L of crystalloid fluids. Complications were documented in 53 casualties (11.7%). Final mortality was reported in 36 casualties (8.0%), and mortality at role 2 MTFs was reported in 7 casualties (1.5%). CONCLUSION: Burn casualties had many injuries and needed many procedures, including those related to airway management, resuscitation, and wound care. Given the urgency of these procedures, ensuring that there is enough equipment and supplies will be important in the future. Although infrequent, some casualties experienced complications. Factors that may influence resuscitation include injury severity, concomitant traumatic injuries, and available supplies. Obtaining more contextual information on the patient care environment will be useful going forward. LEVEL OF EVIDENCE: Epidemiological, level III.


Assuntos
Queimaduras/epidemiologia , Adulto , Campanha Afegã de 2001- , Afeganistão/epidemiologia , Queimaduras/mortalidade , Queimaduras/patologia , Queimaduras/terapia , Criança , Pré-Escolar , Feminino , Humanos , Escala de Gravidade do Ferimento , Masculino , Estudos Retrospectivos , Lesões Relacionadas à Guerra/epidemiologia , Lesões Relacionadas à Guerra/mortalidade , Lesões Relacionadas à Guerra/patologia , Lesões Relacionadas à Guerra/terapia , Adulto Jovem
10.
Zhonghua Shao Shang Za Zhi ; 37(7): 668-669, 2021 Jul 20.
Artigo em Chinês | MEDLINE | ID: mdl-34304408

RESUMO

At present, there is no special rapid cooling device for burn injury site in field battle training environment. To solve this problem, our research team designed a rapid cooling device for burns in field battle training. Based on the principle of rapid cooling of liquid nitrogen, the device monitors the temperature of the wound surface to regulate the release of liquid nitrogen so as to reduce the wound temperature. The device is simple in design, light in material, small in size, easy to carry, and can be used in various parts of the body. In addition, it is easy to operate and is expected to deliver a rapid cooling effect on the burn injury site to avoid the secondary damage caused by heat conduction to deep tissue.


Assuntos
Queimaduras , Queimaduras/terapia , Temperatura Baixa , Humanos
11.
Transfusion ; 61 Suppl 1: S183-S187, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34269462

RESUMO

BACKGROUND: Donated blood is a valuable and limited resource. Excision of burn wounds often leads to significant blood loss requiring transfusion. Accurately estimating blood loss is difficult, so examining the amount of blood products given intraoperatively is a clinically relevant way to measure utilization of this valuable resource. In this study, we examined the factors that influenced the amount of blood given intraoperatively during burn wound excisions. STUDY DESIGN AND METHODS: A retrospective analysis of patients admitted to a single burn center over 5 years who underwent excision of their burn wounds and received intraoperative blood products was performed. Patient and burn characteristics as well as pertinent surgical data and laboratory values on the day of surgery and postoperatively were gathered. A linear regression analysis examined factors influencing the number of units of products given and a predictive model was generated. RESULTS: A total of 563 operations performed on 166 patients were included. The amount of burn excised was the most influential variable on the amount of blood products given. Hemoglobin level, international normalized ratio, and platelet count on the day of surgery were associated with transfusion of different blood products. A predictive model was generated to aid in preoperative ordering of blood products. CONCLUSION: The amount of burn excised and common hematology and coagulation lab values were associated with the amount of different blood products administered during burn surgery. The predictive model generated needs to be validated prospectively to aid in preoperative planning for burn excisions.


Assuntos
Transfusão de Sangue , Queimaduras/terapia , Adulto , Transfusão de Sangue/métodos , Queimaduras/sangue , Queimaduras/cirurgia , Feminino , Humanos , Cuidados Intraoperatórios , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
12.
Molecules ; 26(13)2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34279375

RESUMO

Infection is the major reason that people die from burns; however, traditional medical dressings such as gauze cannot restrain bacterial growth and enhance the healing process. Herein, an organic- and inorganic-base hydrogel with antibacterial activities was designed and prepared to treat burn wounds. Oxidized dextran (ODex) and adipic dihydrazide grafted hyaluronic acid (HA-ADH) were prepared, mixed with quaternized chitosan (HACC) and silver nanoparticles to fabricate Ag@ODex/HA-ADH/HACC hydrogel. The hydrogel, composed of nature biomaterials, has a good cytocompatibility and biodegradability. Moreover, the hydrogel has an excellent antibacterial ability and presents fast healing for burn wounds compared with commercial Ag dressings. The Ag@ODex/HA-ADH/HACC hydrogel will be a promising wound dressing to repair burn wounds and will significantly decrease the possibility of bacterial infection.


Assuntos
Antibacterianos/química , Queimaduras/terapia , Quitosana/análogos & derivados , Hidrogéis/química , Nanopartículas Metálicas/química , Cicatrização , Adipatos/química , Animais , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Bandagens , Queimaduras/tratamento farmacológico , Linhagem Celular , Dextranos/química , Hidrogéis/farmacologia , Hidrogéis/uso terapêutico , Masculino , Camundongos , Pseudomonas aeruginosa/efeitos dos fármacos , Ratos , Ratos Sprague-Dawley , Prata/química , Staphylococcus aureus/efeitos dos fármacos
13.
Molecules ; 26(13)2021 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-34202446

RESUMO

Multidrug resistance infections are the main cause of failure in the pro-regenerative cell-mediated therapy of burn wounds. The collagen-based matrices for delivery of cells could be potential substrates to support bacterial growth and subsequent lysis of the collagen leading to a cell therapy loss. In this article, we report the development of a new generation of cell therapy formulations with the capacity to resist infections through the bactericidal effect of antimicrobial peptide dendrimers and the anti-virulence effect of anti-quorum sensing MvfR (PqsR) system compounds, which are incorporated into their formulation. Anti-quorum sensing compounds limit the pathogenicity and antibiotic tolerance of pathogenic bacteria involved in the burn wound infections, by inhibiting their virulence pathways. For the first time, we report a biological cell therapy dressing incorporating live progenitor cells, antimicrobial peptide dendrimers, and anti-MvfR compounds, which exhibit bactericidal and anti-virulence properties without compromising the viability of the progenitor cells.


Assuntos
Antibacterianos , Queimaduras , Terapia Baseada em Transplante de Células e Tecidos , Dendrímeros , Proteínas Citotóxicas Formadoras de Poros , Infecções por Pseudomonas/tratamento farmacológico , Pseudomonas aeruginosa/crescimento & desenvolvimento , Percepção de Quorum/efeitos dos fármacos , Antibacterianos/química , Antibacterianos/farmacologia , Queimaduras/microbiologia , Queimaduras/patologia , Queimaduras/terapia , Células Cultivadas , Dendrímeros/química , Dendrímeros/farmacologia , Humanos , Proteínas Citotóxicas Formadoras de Poros/química , Proteínas Citotóxicas Formadoras de Poros/farmacologia , Infecções por Pseudomonas/metabolismo , Infecções por Pseudomonas/mortalidade
15.
Comput Methods Programs Biomed ; 207: 106166, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34077867

RESUMO

BACKGROUND AND OBJECTIVE: To deal with burn mass casualty incidents (BMCIs), various countries have established national or regional BMCI emergency response plans (ERPs). A burn care capacity ranking model for hospitals can play an integral role in ERPs by providing essential information to emergency medical services for distributing and handling mass burn patients. Ranking models vary across countries and contexts. However, Taiwan has had no such model. The study aims to develop a ranking model for classifying hospitals' burn care capacity in preparation for the development of a national BMCI ERP. METHODS: Multiple methods were adopted. An expert panel provided consultations on data selection and clustering validation. Data on 116 variables from 535 hospitals were collected via open data platforms under the Ministry of Health and Welfare. Data selection and streamlining was conducted to determine 42 variables for cluster analysis. SAS 9.4 was used to analyze the data set -via a hierarchical cluster analysis using Ward's method, followed by a tree-based model analysis to identify the criteria for each cluster. Both internal and external cluster validation were performed. RESULTS: Four clusters of burn care capacity were determined to be a suitable number of clusters. All hospitals were arranged into capacity levels accordingly. Results of the Kruskal-Wallis test showed that the difference between clusters were significant. Tree-based model analysis revealed four determining variables, among which the refined level of emergency care responsibility hospital was found to be most influential on the clustering process. Responses from the questionnaire were used as an external validation tool to corroborate with the cluster analysis results. CONCLUSION: The use of open government data and cluster analysis was suitable for developing a ranking model to determine hospitals' burn care capacity levels in Taiwan. The proposed ranking model can be used to develop a BMCI emergency response plan and can also serve as a reference for using cluster analysis with open government data to rank care capacity or quality in other domains.


Assuntos
Queimaduras , Planejamento em Desastres , Queimaduras/terapia , Análise por Conglomerados , Explosões , Governo , Hospitais , Humanos , Taiwan , Triagem
16.
Plast Reconstr Surg ; 148(1): 226-238, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34181622

RESUMO

BACKGROUND: The role of nutritional intervention in wound care has been a topic of controversy. Although the efficacy of macronutrient supplementation has been well described, there is a paucity of evidence and no official recommendation regarding the use of vitamins and minerals to optimize wound healing. This is the first review of vitamin and mineral wound intervention that systematically summarizes the literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and distills the evidence by wound type. METHODS: In this comprehensive review, the authors outline the nutrients and delivery methods used in the identified studies, analyze reported treatment outcomes, summarize nutrient effectiveness, and propose evidence-based conclusions to improve wound healing outcomes and enhance the consistency of nutritional intervention in wound care. RESULTS: Thirty-six studies with a combined total of 2339 patients investigated the use of oral, topical, or intravenous vitamin and/or mineral supplementation for treatment of the following wound types: burn wounds (n = 3), pressure ulcers (n = 7), diabetic ulcers (n = 4), venous ulcers (n = 7), digital ulcers (n = 1), skin incisions (n = 9), hypertrophic scars (n = 4), and sinonasal wounds (n = 1). Improved outcomes were reported in patients with burn wounds receiving vitamins A, B1, B6, B12, D, and E and zinc, calcium, copper, magnesium, selenium, and zinc; patients with pressure ulcers receiving vitamin C and zinc; patients with diabetic ulcers receiving vitamin A, B9, D, and E; patients with venous ulcers receiving zinc; and patients with hypertrophic scars receiving vitamin E. CONCLUSIONS: Based on the high-level data provided in this review, the use of specific nutritional interventions may improve the outcome of certain wound types. Further investigation is warranted to draw definitive conclusions.


Assuntos
Queimaduras/terapia , Cicatriz Hipertrófica/terapia , Apoio Nutricional/métodos , Seios Paranasais/lesões , Úlcera Cutânea/terapia , Humanos , Oligoelementos/administração & dosagem , Resultado do Tratamento , Vitaminas/administração & dosagem , Cicatrização
17.
Zhonghua Shao Shang Za Zhi ; 37(6): 582-585, 2021 Jun 20.
Artigo em Chinês | MEDLINE | ID: mdl-34167284

RESUMO

Objective: To observe and explore the clinical therapeutic effects of a self-developed novel low-temperature boric acid wet dressing on the face and neck wounds of patients with superficial burns. Methods: A prospective randomized controlled study was conducted. One hundred cases of superficial burn (sunburn) patients who met the inclusion criteria were admitted to Department of Dermatology of Chongqing Hospital of Traditional Chinese Medicine from October 2016 to June 2018, the course of sunburn was less than 15 days. According to the of random number table, the patients were divided into new dressing (ND) group (30 males and 20 females, aged (55±14) years) and conventional dressing (CD) group (28 males and 22 females, aged (59±12) years). Patients in ND group were treated with a self-developed new low-temperature boric acid wet dressing, and patients in CD group were treated with normal temperature boric acid solution wet dressing, 3 times a day. The Eczema area and severity index (EASI) score and Visual Analogue Scale (VAS) score of patients before and 14 days after treatment (patients discharged from hospital within 14 days were recorded on the day of discharge), the number of cured patients at 6, 8, 10, and 11 to 14 days after treatment, and the efficacy were compared between the patients in 2 groups. The nurse operators were investigated by self-made convenience questionnaire, and the time and convenience required of 2 dressings were compared. Data were statistically analyzed with independent sample t test or Mann-Whitey U test. Results: Before the treatment, the EASI and VAS score in those two groups showed no significantly difference (t=1.576, 1.492, P>0.05). At 14 days after treatment, the EASI score (2.4±0.4) points in ND Group was significantly lower than (4.6±0.7) points in CD Group (t=3.552, P<0.01); the VAS score (0.51±0.12) points in ND Group was significantly lower than (0.98±0.19) points in CD Group (t=3.496, P<0.01). At 14 days after treatment, the cured time of sunburns in ND Group was significantly shorter than that in CD Group (Z=-6.690, P<0.01); the treatment effects of ND Group showed better than that in CD Group (Z=3.387, P<0.01). The time for nurses operating ND was significantly shorter than that in CD (Z=-5.575, P<0.01); the nurses also believed the operation of ND was more convenient than CD (Z=-4.304, P<0.01). Conclusions: Compared with that of CD, the application of ND can shorten the recovery time and improve the treatment efficiency. At the same time, the application of ND can significantly reduce the time of nursing operations, and the material is easy to use. This new material is worthy of clinical promotion for the treatment of superficial burns.


Assuntos
Queimaduras , Adulto , Idoso , Bandagens , Ácidos Bóricos , Queimaduras/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Temperatura , Resultado do Tratamento
18.
Medicina (Kaunas) ; 57(6)2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34071253

RESUMO

Burn injuries are still one of the most common and devastating injuries in humans and the treatment of major burns remains a major challenge for physicians worldwide [...].


Assuntos
Queimaduras , Queimaduras/terapia , Humanos
19.
Wiad Lek ; 74(6): 1360-1364, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34159920

RESUMO

OBJECTIVE: The aim: To establish the frequency, structure and features of the clinical course of facial and neck burns in children. PATIENTS AND METHODS: Materials and methods: During 5 years, 78 patients aged from 6 months to 15 years with isolated burns of the face and neck and in combination with lesions of other anatomical areas were treated. In the dynamics of observation of patients were used classical methods of examination, and in their treatment we followed the protocol of medical care for this category of patients. RESULTS: Results: Thermal injuries of the face and neck accounted for 12.6% of the total number of patients with burns. Their isolated lesion was 26.9%, and in combination with other areas it was 73.1%. The most frequently affected were children of nursery, primary school and preschool age, with a predominance of rural residents (52.6%), mostly boys (78.0%). Anesthesia support had to be used in the treatment of 24 patients (30,8%). The features and nature of the burns depended on the relief of the face and the most damaged are its protruding parts.


Assuntos
Queimaduras , Queimaduras/epidemiologia , Queimaduras/etiologia , Queimaduras/terapia , Criança , Pré-Escolar , Face , Feminino , Humanos , Masculino , Pescoço
20.
Clin Rehabil ; 35(8): 1126-1141, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34107792

RESUMO

OBJECTIVE: The longer-term effectiveness of silicone and pressure burn scar interventions was evaluated at 12-months postburn. DESIGN: Parallel group, randomised trial. SETTING: Hospital outpatient clinics, research centre. PARTICIPANTS: Children referred for burn scar management following grafted or spontaneously healed acute burn injuries or scar reconstruction surgery. INTERVENTIONS: Participants were randomised to: (1) topical silicone gel only, (2) pressure garment only, or (3) combined topical silicone gel and pressure garment. MAIN MEASURES: Primary outcomes were scar thickness (blinded ultrasound measurement) and itch intensity (caregiver proxy-report, numeric rating scale). RESULTS: Of 153 participants randomised who received the interventions (silicone n = 51, pressure garment n = 49, combined n = 53), 86 were followed-up at 12-months postburn (n = 34, n = 28, n = 24). No differences were identified for the primary outcomes using intention-to-treat analysis. Scar thickness mean difference (95% confidence interval) = 0.00 cm (-0.04, 0.05); -0.03 cm (-0.07, 0.02); 0.03 cm (-0.02, 0.08) and scar itch = 0.09 (-0.88, 1.06); -0.21 (-1.21, 0.79); 0.30 (-0.73, 1.32) for silicone vs pressure; silicone vs combined and combined vs pressure respectively. No serious adverse effects occurred. CONCLUSION: Similar to short-term results, the combined intervention offered no statistically or clinically significant benefit for improving the primary outcomes compared to each intervention alone. No differences in the primary outcomes were identified between the silicone and pressure alone groups.


Assuntos
Queimaduras/complicações , Cicatriz Hipertrófica/prevenção & controle , Bandagens Compressivas , Géis de Silicone/uso terapêutico , Queimaduras/terapia , Criança , Pré-Escolar , Vestuário , Humanos , Masculino , Ultrassonografia
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