The Journal of burn care & rehabilitation最新文献_第10页

The incidence and impact of pre-existing protein energy malnutrition on outcome in the elderly burn patient population. 老年烧伤患者既往蛋白质能量营养不良的发生率及其对预后的影响。

The Journal of burn care & rehabilitation Pub Date : 2005-01-01 DOI: 10.1097/01.bcr.0000150302.71007.80

Robert H Demling

{"title":"The incidence and impact of pre-existing protein energy malnutrition on outcome in the elderly burn patient population.","authors":"Robert H Demling","doi":"10.1097/01.bcr.0000150302.71007.80","DOIUrl":"https://doi.org/10.1097/01.bcr.0000150302.71007.80","url":null,"abstract":"Protein energy malnutrition (PEM) and involuntary weight loss is a common problem in the elderly population. Our purpose was to determine the incidence and the effect on outcome of PEM in the elderly burn patient population. A chart review and review of the burn data registry was undertaken to determine the incidence and effect of PEM in patients older than 65 years of age with major burns from 1% to 30% TBSA. PEM was diagnosed using standard physiological and biochemical markers. Data were compared with those from a well-nourished elderly burn group to assess the impact. Of the 123 patients studied, we found that PEM was present in 61%. There was a significant increase in infection rate, decrease in the rate of healing of a standard skin graft donor site, and an increase in length of stay in the PEM group compared with the nourished elderly burn group. Mortality with PEM was 17% compared with 9% without PEM, a significant increase. We conclude that PEM is a common comorbid factor in the elderly burn population that increases morbidity and mortality.","PeriodicalId":22626,"journal":{"name":"The Journal of burn care & rehabilitation","volume":"26 1","pages":"94-100"},"PeriodicalIF":0.0,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.bcr.0000150302.71007.80","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24896411","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 102

Self-inflicted burns in Athens, Greece: a six-year retrospective study. 希腊雅典的自残烧伤:一项为期六年的回顾性研究。

The Journal of burn care & rehabilitation Pub Date : 2005-01-01 DOI: 10.1097/01.bcr.0000150304.30777.c8

Evangelia Tsati, Thomais Iconomou, Despina Tzivaridou, Evangelos Keramidas, Stefanos Papadopoulos, Dimosthenis Tsoutsos

{"title":"Self-inflicted burns in Athens, Greece: a six-year retrospective study.","authors":"Evangelia Tsati, Thomais Iconomou, Despina Tzivaridou, Evangelos Keramidas, Stefanos Papadopoulos, Dimosthenis Tsoutsos","doi":"10.1097/01.bcr.0000150304.30777.c8","DOIUrl":"https://doi.org/10.1097/01.bcr.0000150304.30777.c8","url":null,"abstract":"Self-inflicted burns represent a major social and medical problem. The aim of this study was to record the epidemiology, mortality and etiology of suicide attempts by burning, in Athens, Greece. Over a 6-year period from April 1997 to April 2003, all the medical charts of the patients who were admitted to the Burn Center of the General State Hospital of Athens, Greece, with self-inflicted burns were retrospectively studied. Of the 1435 burn patients, 53 (3.69%) had attempted suicide by self-inflicted burn. Their ages ranged from 18 to 90 years old (mean 53.5 years). Females (57%) outnumbered males (43%). The mean total body surface area (TBSA) burned was 41.6% (range: 15-100%). The overall mortality rate was very high (75.4%). A preexisting psychiatric disorder was present in 43.3% of the patients. In conclusion, the extent and the depth of the burn injuries could explain the high mortality rate seen in these patients, in correlation with their negativism to the treatment. Burn care professionals should be familiar with self-inflicted burn patients who constitute a considerable proportion of major burns and require constant psychiatric support in addition to burn care.","PeriodicalId":22626,"journal":{"name":"The Journal of burn care & rehabilitation","volume":"26 1","pages":"75-8"},"PeriodicalIF":0.0,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.bcr.0000150304.30777.c8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24895935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 35

Report on a more rational approach to managed care for burns. 报告烧伤管理护理的更合理的方法。

The Journal of burn care & rehabilitation Pub Date : 2005-01-01 DOI: 10.1097/01.bcr.0000150299.38425.08

Alan Dimick, D Nathan Cope, David Barillo, Robert Gillespie, David Mozingo

引用次数: 9

Therapeutic efficacy of three silver dressings in an infected animal model. 三种银敷料对感染动物模型的治疗效果。

The Journal of burn care & rehabilitation Pub Date : 2005-01-01 DOI: 10.1097/01.bcr.0000150298.57472.26

John Heggers, Rick E Goodheart, Joyce Washington, Lana McCoy, Edith Carino, Thanh Dang, Pat Edgar, Cassie Maness, David Chinkes

{"title":"Therapeutic efficacy of three silver dressings in an infected animal model.","authors":"John Heggers, Rick E Goodheart, Joyce Washington, Lana McCoy, Edith Carino, Thanh Dang, Pat Edgar, Cassie Maness, David Chinkes","doi":"10.1097/01.bcr.0000150298.57472.26","DOIUrl":"https://doi.org/10.1097/01.bcr.0000150298.57472.26","url":null,"abstract":"The organic salt AgNO3 has been available as a topical armamentarium to the medical arena for centuries and for burns for the past 60 years. Thirty-five (1968) years later, Charles Fox introduced and popularized a new topical agent known as silver sulfadiazine. More recently, several new slow-release silver dressings came to the forefront. Acticoat (Smith & Nephew, Largo, FL) Silverlon (Argentum, Lakemont, GA) & Silvasorb (Medline Industries, Inc, Mundelein, IL). Because the standard of care is to change dressings daily, our study focused in on weekly dressing changes as a cost-containment issue. Sprague-Dawley rats received a standard contact burn (20% TBSA). On day 3, the wound was excised and infected with Pseudomonas aeruginosa and Staphylococcus aureus at 5.0 x 10 cfu/ml. The animals were divided into four groups (n = 5 each group): untreated control, Acticoat group, Silvasorb group, and Silverlon group. The dressings remained on the wounds for 10 days when the wounds were quantitatively assessed. Mean wound counts of the control ranged from 1.2 x 10(5) to 6.5 x 10(5) for P. aeruginosa and S. aureus, respectively. Acticoat dressing counts for both organisms were 0 and 1.8 x 10(3) (median alpha); Silvasorb was 0 and 6.3 x 10(3) and Silverlon was 1.5 x 10(4) x 7.4 x 10(4) (median), Acticoat and Silvasorb were both significantly lower (P < .05) than the control for P. aeruginosa, and Acticoat was significantly lower (P < .05) than the control for S. aureus. Although counts for Silvasorb (M) appear significantly lower than the controls for S. aureus, the numbers were not sufficient to be significant. However, Silverlon did achieve a slight significance. These preliminary data suggest that weekly dressing changes with these new silver dressings are feasible and economically and medically congruous.","PeriodicalId":22626,"journal":{"name":"The Journal of burn care & rehabilitation","volume":"26 1","pages":"53-6"},"PeriodicalIF":0.0,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.bcr.0000150298.57472.26","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24895932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 69

Late outcomes in adult survivors of toxic epidermal necrolysis after treatment in a burn center. 在烧伤中心治疗后中毒性表皮坏死松解成年幸存者的晚期结局。

The Journal of burn care & rehabilitation Pub Date : 2005-01-01 DOI: 10.1097/01.bcr.0000150215.78220.79

Julia Haber, Wilma Hopman, Manuel Gomez, Robert Cartotto

{"title":"Late outcomes in adult survivors of toxic epidermal necrolysis after treatment in a burn center.","authors":"Julia Haber, Wilma Hopman, Manuel Gomez, Robert Cartotto","doi":"10.1097/01.bcr.0000150215.78220.79","DOIUrl":"https://doi.org/10.1097/01.bcr.0000150215.78220.79","url":null,"abstract":"Despite improved survival after burn center treatment for patients with toxic epidermal necrolysis (TEN), little is known about the overall long-term outcomes in these patients. In this work we sought to analyze late outcomes in survivors of TEN who were treated in our burn center. Subjects completed a questionnaire that included the RAND 36-Item Health Survey (SF-36) and the Dermatology Life Quality Index. Subjects were examined, when possible, and completed the Functional Independence Measure. Scores on the SF-36 were compared with age- and sex-matched National normative data. All results are presented as the mean +/- SD. Of 35 adults admitted with TEN between January 1, 1995, and January 6, 2003, 10 have died in hospital, 4 have died since discharge, and 8 have been lost to follow-up, leaving a study population of 13 subjects (age 45 +/- 18 years with initial %TBSA involvement 65 +/- 29). Follow-up occurred at 38 +/- 27 months after discharge. The most common ophthalmic problems were chronic photosensitivity (54%) and dry eyes (31%). The Dermatology Life Quality Index (maximum-worst score = 30) was 9 +/- 10. SF-36 scores were significantly lower than in the age- and sex-matched normal population across all domains except mental health. The Functional Independence Measure score (maximum-best score = 126) was 123 +/- 4. Survivors of TEN demonstrate a high level of independent function in activities of daily living, but numerous complications of TEN significantly impair their overall quality of life, emphasizing the need for long-term follow-up.","PeriodicalId":22626,"journal":{"name":"The Journal of burn care & rehabilitation","volume":"26 1","pages":"33-41"},"PeriodicalIF":0.0,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.bcr.0000150215.78220.79","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24895987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 95

Bronchoalveolar lavage in diagnosis of ventilator-associated pneumonia in patients with burns. 支气管肺泡灌洗对烧伤患者呼吸机相关性肺炎的诊断价值。

The Journal of burn care & rehabilitation Pub Date : 2005-01-01 DOI: 10.1097/01.bcr.0000150305.25484.1a

Wendy L Wahl, Karla S Ahrns, Mary-Margaret Brandt, Stephen A Rowe, Mark R Hemmila, Saman Arbabi

{"title":"Bronchoalveolar lavage in diagnosis of ventilator-associated pneumonia in patients with burns.","authors":"Wendy L Wahl, Karla S Ahrns, Mary-Margaret Brandt, Stephen A Rowe, Mark R Hemmila, Saman Arbabi","doi":"10.1097/01.bcr.0000150305.25484.1a","DOIUrl":"https://doi.org/10.1097/01.bcr.0000150305.25484.1a","url":null,"abstract":"Ventilator-associated pneumonia (VAP) remains a major cause of morbidity and mortality for patients with burns. In nonburn populations, bronchoalveolar lavage (BAL) excludes other pathology such as systemic inflammatory response syndrome. We hypothesized that BAL would decrease our false-positive VAP rate. All ventilated patients with burn injury who were admitted to our institution from July 2000 through June 2003 were included. After June 2001, BAL was used to make the diagnosis of VAP, with > or =10(4) organisms considered a positive result. Fifty patients met criteria for VAP, 21 in the pre-BAL period and 29 in the BAL period. Six patients (21%) in the BAL group had quantitative cultures <10(4) and were not treated. The outcomes for these patients were not different than those treated for VAP. There were no differences in age, TBSA size, antibiotic use, or ventilator days for the pre-BAL or BAL groups, although the pneumonia rate was lower for the BAL time period. The use of BAL eliminated the unnecessary antibiotic treatment of 21% of patients in the BAL time period and was associated with a lower rate of VAP.","PeriodicalId":22626,"journal":{"name":"The Journal of burn care & rehabilitation","volume":"26 1","pages":"57-61"},"PeriodicalIF":0.0,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.bcr.0000150305.25484.1a","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24895931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 30

Burden of burn: a norm-based inquiry into the influence of burn size and distress on recovery of physical and psychosocial function. 烧伤负担:一项基于规范的调查烧伤大小和痛苦对身体和心理功能恢复的影响。

The Journal of burn care & rehabilitation Pub Date : 2005-01-01 DOI: 10.1097/01.bcr.0000150216.87940.ac

James A Fauerbach, Dennis Lezotte, Rebecca A Hills, G Fred Cromes, Karen Kowalske, Barbara J de Lateur, Cleon W Goodwin, Patricia Blakeney, David N Herndon, Shelley A Wiechman, Loren H Engrav, David R Patterson

{"title":"Burden of burn: a norm-based inquiry into the influence of burn size and distress on recovery of physical and psychosocial function.","authors":"James A Fauerbach, Dennis Lezotte, Rebecca A Hills, G Fred Cromes, Karen Kowalske, Barbara J de Lateur, Cleon W Goodwin, Patricia Blakeney, David N Herndon, Shelley A Wiechman, Loren H Engrav, David R Patterson","doi":"10.1097/01.bcr.0000150216.87940.ac","DOIUrl":"https://doi.org/10.1097/01.bcr.0000150216.87940.ac","url":null,"abstract":"This prospective, longitudinal study examined the influence of baseline physical and psychological burden on serial assessments of health-related quality of life among adults with major burns from three regional burn centers (n = 162). Physical burden groups were defined by % TBSA burned: <10%, 10% to 30%, or >30%. Psychological burden groups were defined by in-hospital distress using the Brief Symptom Inventory Global Severity Index T-score with scores of < 63 or > or = 63. Analyses compared groups across level of burden and with published normative data. Assessments reflected health and function (Short Form 36) during the month before burn, at discharge, and at 6 and 12 months after burn. Physical functioning was significantly more impaired and the rate of physical recovery slower among those with either large physical burden or large psychological burden. Notably, psychosocial functioning also was more impaired and the rate of psychosocial recovery slower among those with greater psychological burden. These results suggest that, in addition to aggressive wound closure, interventions that reduce in-hospital distress may accelerate both physical and psychosocial recovery.","PeriodicalId":22626,"journal":{"name":"The Journal of burn care & rehabilitation","volume":"26 1","pages":"21-32"},"PeriodicalIF":0.0,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.bcr.0000150216.87940.ac","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24895986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 111

Successful management of adult smoke inhalation with extracorporeal membrane oxygenation. 体外膜氧合对成人烟雾吸入的成功治疗。

The Journal of burn care & rehabilitation Pub Date : 2005-01-01 DOI: 10.1097/01.bcr.0000150303.15345.79

James T Thompson, Joseph A Molnar, Michael H Hines, Michael C Chang, Thomas Pranikoff

{"title":"Successful management of adult smoke inhalation with extracorporeal membrane oxygenation.","authors":"James T Thompson, Joseph A Molnar, Michael H Hines, Michael C Chang, Thomas Pranikoff","doi":"10.1097/01.bcr.0000150303.15345.79","DOIUrl":"https://doi.org/10.1097/01.bcr.0000150303.15345.79","url":null,"abstract":"Pulmonary complications remain one of the leading causes of mortality in patients with burns. We report two cases of adult patients with thermal and inhalation injuries who were placed on extracorporeal membrane oxygenation (ECMO) and survived. Patient 1 was a 42-year-old male who suffered 15% TBSA and a severe inhalation injury requiring intubation upon arrival to the emergency department. Patient 2 was a 24-year-old female in a house fire who received 20%TBSA and was noted to be in respiratory distress and intubated on the scene by the paramedic team. Three days after admission, patient 1 developed severe respiratory failure. He decompensated, despite maximum conventional management, and was placed on ECMO. After 300 hours of ECMO, his pulmonary function had improved, and he was decannulated. Patient 2 also developed severe refractory respiratory failure and was placed on ECMO. She was decannulated 288 hours later. Both patients were discharged home shortly afterwards and have managed well. ECMO should be considered when patients are facing a respiratory death from inhalation injury on conventional mechanical ventilation.","PeriodicalId":22626,"journal":{"name":"The Journal of burn care & rehabilitation","volume":"26 1","pages":"62-6"},"PeriodicalIF":0.0,"publicationDate":"2005-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/01.bcr.0000150303.15345.79","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"24895933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 29

A seven-year burn unit experience in Kayseri, Turkey: 1996 to 2002. 1996年至2002年在土耳其开塞利烧伤科工作7年。

The Journal of burn care & rehabilitation Pub Date : 2005-01-01 DOI: 10.1097/01.bcr.0000150301.80601.95

Atilla Coruh, Galip K Gunay, Aliye Esmaoglu

引用次数: 22

Role of the gastrointestinal tract in burn sepsis. 胃肠道在烧伤败血症中的作用。

The Journal of burn care & rehabilitation Pub Date : 2005-01-01 DOI: 10.1097/01.bcr.0000150212.21651.79

Ankush Gosain, Richard L Gamelli

引用次数: 93