Treatment of symptomatic abnormal skin scars with electrical stimulation.

OBJECTIVE: To evaluate the effect of non-invasive biofeedback electrical stimulation on symptomatic abnormal skin scars. METHOD: Thirty patients with over 140 scars with long-term pain and itch were recruited into the study. Patients monitored the intensity of symptoms (pain and itching) on a numerical rating scale. In addition, a modified Manchester scar scale was used to objectively assess digital photographs of each scar in terms of colour, contour, distortion and texture, while a non-invasive spectrophotometric intracutaneous analysis was used to monitor the scars' physical characteristics. RESULTS: The electrical stimulation device resulted in a clinically and statistically significant (p < 0.05) reduction of symptoms and scar scores. Pain and itch scores were both reduced to a median score of 0 by 2 months, from a baseline of 7 and 6 respectively. Scar scores were reduced from a baseline of 14 to a median score of 11 by 2 months. CONCLUSION: These results give a preliminary indication of the potential role of non-invasive biofeedback electrical stimulation in the management of chronic scar pain and itch. However, further large scale controlled studies are warranted to elucidate its overall efficacy and mechanistic action. CONFLICT OF INTEREST: Funding was provided from Fenzian Ltd for this study.

Australian snowboard injury data base study. A four-year prospective study.

Information on the rate and spectrum of snowboarding injuries is limited. This 4-year prospective study at 3 major Australian ski resorts assesses incidence and patterns of snowboarding injuries, particularly in relation to skill level and footwear. Ski injury data were collected for the same period. In a predominantly male study population (men:women, 3:1), 276 snowboarding injuries were reported; 58% occurred in novices. Fifty-seven percent of injuries were in the lower limbs, 30% in the upper limbs. The most common injuries were sprains (53%), fractures (24%), and contusions (12%). Comparing skiers' versus snowboarders' injuries, snowboarders had 2.4 times as many fractures, particularly to the upper limbs (21% versus 35% of upper limb injuries), fewer knee injuries (23% versus 44% of lower limb injuries), but more ankle injuries (23% versus 6% of lower limb injuries). Ankle injuries were more common with soft-shell boots, worn most by intermediate and advanced riders. Knee injuries and distal tibial fractures were more common with hard-shell boots, worn most by novices. Overall, novices had more upper limb fractures and knee injuries; intermediate and advanced riders had more ankle injuries. Falls were the principal mode of injury. To prevent injury, beginners should use "hybrid" or soft-shell boots and take lessons.

Effects of Cold and Compression on Edema.

In brief: A 40-minute cooling period was used to treat artificially induced acute inflammatory reactions in human tissue. Results showed no significant change in the volume of the inflammatory reaction at one hour, though a transient attenuation during the first 15 minutes was detected. The addition of mild pressure (10 mm Hg) to mild cooling (range, 15° to 25° C) produced a highly significant reduction in swelling from 15 minutes onward, This effect was sustained as long as swelling was detectable. Pressure alone (20 mm Hg) had a nonsignificant effect. The authors compare two cooling devices, an inflatable cooling cuff and an evaporative bandage, which were both found to be effective. The authors suggest that these devices could be used more routinely in emergency medicine.

Rural health centre use: variation with distance and disease.

Utilisation of a rural health centre in respect to distance and disease is examined. Some deficiencies in health care provision are revealed, and strategies implemented to correct these through aid post-orderlies (APO) inservice, maternal child health (MCH) reorganisation and health education are outlined. This type of survey is easy to conduct, uses data routinely collected and can help plan improvement of health services.