International Journal of Burns and Trauma最新文献

{"title":"The role of matrix metalloproteinase-9 and its inhibitor TIMP-1 in burn injury: a systematic review.","authors":"Chinmay Sharma,&nbsp;Geoffrey P Dobson,&nbsp;Lisa M Davenport,&nbsp;Jodie L Morris,&nbsp;Hayley L Letson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Matrix metalloproteinase-9 (MMP-9) and its endogenous inhibitor, tissue inhibitor of metalloproteinase-1 (TIMP-1), are key mediators of acute inflammation and regulators of the wound healing process. The aim of this systematic review was to determine the local and systemic involvement of the MMP-9/TIMP-1 system following burn injury. Two databases (Scopus and MEDLINE) were searched for all studies reporting MMP-9 and/or TIMP-1 after burn injury. Based on our eligibility criteria, we reviewed 24 studies involving 508 burns patients in 11 clinical studies and 367 animals in 13 preclinical studies. Local, systemic, and peripheral gene expression, protein levels and activity of MMP-9 and TIMP-1 were assessed. Increased MMP-9 was reported at the site of injury early after burn trauma in all studies, and remained elevated in non-healing wounds. Increased TIMP-1 expression in burn wounds occurred later than MMP-9, and was persistent in hypertrophic burn scars. Similar to local expression, systemic MMP-9 and TIMP-1 concentrations were significantly elevated after burn injury in response to upregulation of proinflammatory cytokines. While no association was found between systemic MMP-9 concentration and extent of injury or outcome, serum or plasma TIMP-1 showed good correlation with survival and burn severity. This review also found evidence of the MMP-9/TIMP-1 system contributing to secondary tissue damage distant from the burn site, including burn-associated musculoskeletal damage and acute lung injury. In addition, increased MMP-9 synthesis and activity in the brain after peripheral burn may lead to blood-brain barrier dysfunction and cerebral edema, a significant contributor to mortality. This systematic review provides an overview of the available evidence of the role of MMP-9 and TIMP-1 in burn injury pathophysiology and finds that TIMP-1 may be a promising biomarker in outcome prognostication of burns patients. Large-scale studies of both pediatric and adult burns patients with increased female representation and repeated sampling are recommended to validate the reliability of TIMP-1 as a prognostic marker following burn injury.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2021-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8449144/pdf/ijbt0011-0275.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39443703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aesthetic-functional reconstruction of dental fracture and its impact on the psychosocial aspect.","authors":"Sandra Meyfarth,&nbsp;Críscilla Marquiotti da Silva,&nbsp;Leonardo Santos Antunes,&nbsp;Lívia Azeredo Alves Antunes","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Traumatic dental injury (TDI) constitutes a public health concern. This injury occurs mainly in anterior teeth and brings disadvantageous psychosocial consequences that affect adolescents, as well as impairing their speech and eating habits. A healthy smile and facial aesthetic have an influence on social interaction, especially in the way individuals are seen, felt, and perceived by other people. Therefore, this paper aimed to report a dental trauma injury and its impact on the Oral Health-Related Quality of Life (OHRQoL). A 14-years old boy was referred to a Dental Trauma Care Program in a Brazilian Public University after falling from his own height. The patient had a crown fracture involving enamel and dentin without pulp exposure in the upper left central incisor. The oral rehabilitation was performed by using a composite resin associated with the silicone guide technique. Taking into account the integrality of the patient, the OHRQoL was assessed before and after the rehabilitation treatment with the application of the Brazilian version of the Child Perceptions Questionnaire (CPQ11-14)-Impact Short Form (ISF: 16). TDI in the anterior tooth had a negative impact on the social wellbeing of this adolescent. After the oral rehabilitation, the patient showed improvement on OHRQoL demonstrating autonomy and self-confidence in his reintegration into the social environment.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2021-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8449145/pdf/ijbt0011-0328.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39444175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burn care strategy in the covid-19 pandemic: a narrative review study.","authors":"Fatemeh Delfani,&nbsp;Mahnaz Shoghi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic has changed the world and intensified health management in many parts of the world. Sensitivity in burn patients' care and prevalence of COVID-19 have a major impact on this group's healthcare system and infection control strategies. The purpose of this study is to review burn care strategies during the COVID-19 outbreak.</p><p><strong>Materials and methods: </strong>The present study is a narrative review study. In writing this paper, to access information, the keywords of Coronavirus, COVID-19, burn, strategy, care, and SARS were used. Due to the emergence of COVID disease, searches in Science Direct, PubMed, Scopus, Web of Science, Google Scholar, SID, Magiran, Springer, and Elsevier databases were performed without time limit. Research articles were purposefully selected and approved to be investigated based on the criteria for entering the research. A total of 14 articles had a full text related to the research scope. The researchers used qualitative content analysis to analyze the data. Data analysis was conducted as a comprehensive review of articles, qualitative conclusions, and results.</p><p><strong>Results: </strong>In this study, 14 articles related to burn care strategies in the COVID-19 epidemic were selected. Their results were reviewed in two areas of staff care strategies and burn patients during the COVID-19 outbreak. Findings indicate that appropriate prevention and protection strategies and measures should be followed to prevent the transmission of the COVID-19 virus to burn care professionals. In addition, burn patient care strategies were proposed in two levels of minor and moderate to severe burns, so that patients with burns receive adequate burn care during the COVID-19 outbreak.</p><p><strong>Conclusion: </strong>Implementation of staff and burn patient care strategies during the COVID-19 pandemic is essential to treat burn patients and prevent the spread of the COVID virus.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2021-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8449152/pdf/ijbt0011-0289.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39443704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physicians based emergency medical services for the management of burn injuries in trauma centers of the center region of Saudi Arabia: evaluation of physicians' knowledge and experience.","authors":"Homaidan T Alhomaidan,&nbsp;Zafar Rasheed,&nbsp;Manal M Alsudais,&nbsp;Asma M AlMutairi,&nbsp;Khawlah A Alzaben,&nbsp;Sara M AlMutairi,&nbsp;Lamees I Alissa,&nbsp;Adel M Widyan,&nbsp;Abdullah S Alkhamiss,&nbsp;Sharifa K Alduraibi,&nbsp;Waleed Al Abdulmonem","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Medical services at trauma centers regularly encounter severe burn patients but prehospital care of these patients in Saudi Arabia is comparatively unexplored. This study evaluates the knowledge and experience of physicians working in trauma centers of Qassim province of Saudi Arabia for the management of patients with burn injuries.</p><p><strong>Methods: </strong>This is a cross sectional study performed on 204 physicians working in the trauma centers of Qassim province. Physicians' knowledge and experience were assessed via administration of validated questionnaires and the data were analyzed using SPSS software.</p><p><strong>Results: </strong>Among total studied physicians, only 35.3% and 24.0% gave the right answer to the question on the diagnosis of burn skin in depth/extent for adults and pediatric patients, respectively. Importantly, 93.6% physicians responded correctly for first aid treatment. For the parkland concept, 62.2% responded correctly, however, only 22.5% understand the colloid fluid concept. The 74% physicians knew the methods of fluid revival for mass burn injuries and about half of studied physicians showed right knowledge for intubation for breathing for mass burn injuries. Only 47.5% physicians understand the concept of electrolyte disorder.</p><p><strong>Conclusions: </strong>This is the first study from the central region of Saudi Arabia that analyzed the knowledge and experience of physicians working in trauma centers for the management of patients with burn injuries. Overall data showed that ~60% physicians working in trauma centers have knowledge for handling the patients with burn injuries but the rest needed counseling, therefore proper training sessions for them are needed for management of burn patients.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8310865/pdf/ijbt0011-0184.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39266072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paraffin wax bath therapy versus therapeutic ultrasound in management of post burn contractures of small joints of hand.","authors":"Hafiz Muddassir Riaz,&nbsp;Saeed Ashraf Cheema","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Burn injury may result in psychological and physical disability. Post-burn contractures, a poor outcome of the wound healing process, may limit the movement at the joints and impair the quality of life of the survivors. To compare outcomes of paraffin wax bath therapy and therapeutic ultrasound in post-burn contractures of small joints of the hand; eighty patients with post-burn contractures were enrolled in this study. Patients were divided into two groups; group I (n=40) was treated with ultrasound therapy and group II (n=40) with paraffin wax bath therapy, while stretching exercises & protocols for massage of the burn scar contracture were the same for both groups. The study participants were assessed for passive range of motion (P-ROM) for the extension at inter-phalangeal (IP) joints of the involved finger at the first contact session and the end of the 8th week of the treatment. The mean age of the patients was 25.62 years in Group-I and 24.67 years in group II. Group-I had 29 (72.5%) males and 11 (27.5%) females and group-II had 37 (92.5%) males and 37.5%) females. After 8 weeks of treatment, Group-I displayed improvement in range of motion with a mean increase of 4.97 ± <i>SD</i> 0.94 degrees while Group-II showed a mean increase of 9.37 ± <i>SD</i> 4.41 degrees with <i>P</i> value of <0.005. Paraffin wax therapy with stretching exercises and massage were more effective as compared to ultrasound therapy with stretching exercises and massage for the management of post-burn contractures of small joints of the hand.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8310878/pdf/ijbt0011-0245.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39273882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The pruritus severity scale-a novel tool to assess itch in burns patients.","authors":"Suzanne M Beecher,&nbsp;Ronan Hill,&nbsp;Laura Kearney,&nbsp;Jemima Dorairaj,&nbsp;Arun Kumar,&nbsp;Anthony James Clover","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Pruritus assessment is difficult due to the varying subjective nature of the experience. There have been several validated tools described to quantify the severity of itch, however these tools fail to provide a comprehensive assessment or are too cumbersome and therefore lack usability. Our novel burn assessment tool, <i>\"The Pruritus Severity Scale\"</i> (PSS) allows for accurate quantification of itch components. The aim of this study was to assess its use in the burns population.</p><p><strong>Methods: </strong>A prospective observational study was conducted on all patients over five years of age with a burn injury over a six month period. Patients underwent subjective evaluation of their itch as determined by two validated scores, the Visual Analogue Scale (VAS) and the Itch Man scale (IMS) and in addition to the PSS. The pruritus severity scale was correlated with the previously validated scoring methods using bi-variate correlations.</p><p><strong>Results: </strong>Twenty-two patients were included in the study. The most common cause of injury was due to flame burn. The mean total body surface area was 6.5% (range: 1-26%). Both the IMS and the VAS positively correlated well with the PSS. The Spearman Coefficient for the PSS vs IMS was 0.81, R² = 0.65 (P<0.05). The Spearman Coefficient for the PSS vs VAS was 0.87 (R² = 0.76 (P<0.01)). There is a positive linear relationship between our novel scoring methods and the currently validated methods, indicating its validity as a burn assessment too.</p><p><strong>Conclusion: </strong>The Pruritus Severity Scale was shown to be an accurate, objective tool that was able to effectively record the patient's experience of itch. We believe that this novel score is quick, easy to use and allows for more comprehensive assessment than other short assessment tools.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8310874/pdf/ijbt0011-0156.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39266068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Bacterial surgical site infection in traumatic patients undergoing orthopedic surgeries: a cross-sectional study.","authors":"Mehdi Motififard,&nbsp;Mehdi Teimouri,&nbsp;Kiana Shirani,&nbsp;Saeed Hatami,&nbsp;Mahila Yadegari","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background and objective: </strong>Infection at the surgical site is one of the most common postoperative complications. Due to the high prevalence of orthopedic surgery site infection, epidemiologic studies that evaluate the frequency distribution of bacterial infection and related risk factors seem crucial. In the present study, we aimed to investigate and evaluate the prevalence of bacterial infections in traumatic operated patients.</p><p><strong>Methods: </strong>This is a cross-sectional study that was performed in 2011-2020 on all trauma cases with closed fractures re-admitted to the traumatic referral hospital due to surgical site infection after orthopedic surgeries. Data regarding surgical site culture and antibiogram and the most effective antibiotics were also collected from medical documents of patients.</p><p><strong>Results: </strong>During this study, 5950 people underwent traumatic closed fracture surgeries, of which 238 (4%) were readmitted due to infection. Data of 157 patients were analyzed and showed that the most common site of infection was knee in 46 patients (29.3%). Data also showed that gram-positive bacteria were detected in 55 patients (56.7%) while gram-negative micro-organisms were found in 42 patients (43.3%). Based on the statistical analysis, vancomycin was the most effective antibiotic in staphylococcus infections. There was also a significantly higher risks of bacterial surgical site infection for tibial injury (OR = 1.18, P < 0.001), knee injury (OR = 1.50, P < 0.001), presence of Staphylococcus (OR = 1.50, P < 0.001) and also Enterobacter (OR = 1.50, P < 0.001) both in the crude and adjusted models.</p><p><strong>Conclusion: </strong>The prevalence rate of infection was 4% and the most common bacteria was Staphylococcus aureus. Vancomycin was also the most effective antibiotic in patients. We suggest that more studies should be conducted on the use of prophylactic antibiotics.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8310873/pdf/ijbt0011-0191.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39273875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case study demonstrating tolerance of the gut to large volumes of enteral fluids as a complement to IV fluid resuscitation in burn shock.","authors":"Emily W Baird,&nbsp;Colleen M Reid,&nbsp;Leopoldo C Cancio,&nbsp;Jennifer M Gurney,&nbsp;David M Burmeister","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Appropriate intravenous fluid resuscitation has improved early post burn outcomes. However, clinical and pre-clinical evidence suggests that enteral or oral resuscitation may complement intravenous fluid administration. While this strategy is often discussed in the context of resource-limited settings, its implementation could reduce overall IV fluid requirements and simplify management during routine care. Conversely, concerns about this strategy have been raised over impaired gut perfusion and function leading to adverse effects. We present a case of an 82-year-old man with a total burn size of 14% who was encouraged to ingest the oral rehydration solution Drip Drop® starting 7 hours post-burn. In the ensuing 17 hours he consumed over 5 L of oral rehydration solution, which was nearly 1 L more than the total amount of IV fluids he received. There were no adverse gastrointestinal side effects. This demonstrates tolerance of a significant volume of voluntary oral fluids in combination with IV resuscitation. Clinical trials are warranted.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8310868/pdf/ijbt0011-0202.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39273877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally invasive approach supported by the use of mouthguard in the treatment of sport-related root fracture: a case report.","authors":"Vania Gomes Moraes,&nbsp;Ludmila Silva Guimaraes,&nbsp;Erlange Andrade Borges Silva,&nbsp;Livia Azeredo Alves Antunes,&nbsp;Romulo Franchini,&nbsp;Leonardo Santos Antunes","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>All sporting activities have an associated risk of orofacial injuries that can affect the oral health-related quality of life (OHRQoL). A custom-made mouthguard can be used as an adjuvant treatment for faster recovery of an athlete to resume sporting activities. This case report described a minimally invasive approach by use of mouthguard for treating sport-related root fracture and its impact on OHRQoL. In a dental trauma care program, the patient was treated by repositioning the coronary portion and the confection of a splint. It was opted to not realize the endodontic treatment and the patient was inserted in a rigorous clinical and radiographic follow-up. A custom-made mouthguard was made, which allowed for the immediate return of athletes to practicing sports. The athlete's OHRQoL was negatively impacted by dental trauma, but the treatment proposed was associated with the use of custom-made mouthguards. After 2 years, the absence of radiographical lesions and a positive response to sensibility tests were observed. The success of the minimally invasive approach was attributed to immediate conduct following dental trauma, the implementation of follow-up, and associated with the use of custom-made mouthguard.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8310876/pdf/ijbt0011-0226.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39273880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective analysis of calcium levels in pediatric trauma patients.","authors":"Brian G Cornelius, Daniel Clark, Ben Williams, Anna Rogers, Andreea Popa, Phillip Kilgore, Urska Cvek, Marjan Trutschl, Kevin Boykin, Angela Cornelius","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Traumatic injury is a major cause of morbidity and mortality in pediatric patients. Hemorrhage is a known but treatable component of these outcomes. Evidence exists that major trauma patients are at high risk for hypocalcemia but the rate of pediatric occurrence is not documented. The purpose of this study was to determine the incidence of hypocalcemia in pediatric trauma patients, as well as to investigate any correlation between hypocalcemia and the need for transfusion and operative intervention. After IRB approval a retrospective analysis was conducted of all pediatric trauma patients seen in our Adult Level One, Pediatric Level Two trauma center. Significance testing for mortality was performed using Pearson's χ² test. For the remaining numeric variables, association was determined one-way analysis of variance (when comparing all classes) or Welch's two-sample t-test (when comparing subsets based on calcium or mortality). In any event, significance was determined using α=0.05. A total of 2,928 patients were identified, 1623 were excluded, primarily due to incomplete data. Patients were predominantly male following blunt trauma. Initial calcium levels were 8.73 mg/dL, 95% CI [4-10.9] and 8.97 mg/dL, 95% CI [6.42-13.1] when correcting for albumin levels. Acute declines were noted when comparing initial and corrected serum calcium levels in patients requiring transfusion (7.99 mg/dL and 8.72 mg/dL) and operative intervention (8.54 mg/dL and 8.91 mg/dL). 456 (34.9%) patients required operative intervention, 138 (10.6%) required transfusion and 29 (2.2%) required massive transfusion. Patients in our cohort arrived with calcium values on the low end of normal, with a trend towards hypocalcemia if operative intervention or blood transfusion was required. This has been previously associated with increased mortality. Patients requiring operative intervention and transfusion are at increased risk for hypocalcemia and recognition of this potential is key for improved outcomes.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2021-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8310872/pdf/ijbt0011-0267.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39266430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}