Background: Early excision and grafting has been the preferred method of managing major burns around the world since 1970. Considering the advances in health care and the development of new antibiotics over the past 5...Background: Early excision and grafting has been the preferred method of managing major burns around the world since 1970. Considering the advances in health care and the development of new antibiotics over the past 50 years, delayed grafting as a technique for the management of burns over 15%-20% of total body surface area (TBSA) could have comparable results to that of early excision. This study aims to highlight the outcomes of practicing delayed grafting in burn patients. Methods: A case series analysis was performed of 51 patients who were admitted to the burns unit in Sultan Qaboos Hospital Salalah with over 20% TBSA between January 2014 and December 2019. The patients received prophylactic antibiotics and silver sulphadiazine dressing until the burn eschar had completely separated, followed by grafting. Results: Two patients were lost during the entire duration of the study. The mortality rate was comparable to that of early excision, while the rate of hypertrophic scarring was lower than the range reported by other studies. Conclusion: In the management of patients with over 20% TBSA, delayed grafting after complete separation of eschar is still a valid technique.展开更多
<strong>Background: </strong>Burns is one of the most common and severe forms of trauma, as they cause an alteration in the protective barrier exerted by the skin. The objective of this work is to describe...<strong>Background: </strong>Burns is one of the most common and severe forms of trauma, as they cause an alteration in the protective barrier exerted by the skin. The objective of this work is to describe the bacterial pathogens that cause infections in the different body segments as well as to know the susceptibility in patients with burns during a period of two years. <strong>Methods:</strong> This study was conducted over a period of 2 years, January 2017 to January 2019. The analysis of the isolated microbiological agents was obtained from culture samples in different anatomic areas. The variables were measured in the general population and also by groups, considering: age, sex, TBSA with Wallace's rule of nine, anatomic area affected, type of burn, depth of burn, microorganism reported in cultures, antibiotics empirically administered and mortality rate. <strong>Results: </strong>Regardless of the anatomical segment studied, the most frequently isolated microorganism was <em>Pseudomonas aeruginosa</em>. <strong>Conclusions:</strong> Identification of the microorganisms that cause infection reduces the hospital stay, as well as the admission to the ICU. A fundamental research guideline is to pay more attention to the post-burn consequences, and the sequelae and functional limitations that it entails, since few since few studies focus on this aspect.展开更多
Burn injuries create severe pain and psychological distress that are highly variable between patients. Distinct types of pain during various stages of injury and recovery make treatment complex. Standard pharmacologic...Burn injuries create severe pain and psychological distress that are highly variable between patients. Distinct types of pain during various stages of injury and recovery make treatment complex. Standard pharmacological treatment of pain can have adverse effects and is not effective in treating anxiety and other psychological issues. Researchers have proposed that integrating clinical hypnosis as a complementary therapy can be highly beneficial to burn patients and their healthcare providers. The existing literature is reviewed and specific hypnosis techniques are discussed. Evidence exists indicating that adjunctive hypnosis is effective at reducing pain and procedural anxiety. Implementing a multidisciplinary burn care team that includes clinical hypnosis and focuses on the patients' psychological health as well as pain reduction is likely to result in faster healing and reduced distress for patients and caregivers alike.展开更多
【目的】探讨对烧伤重症监护病房(burn intensive care unit,BICU)重度烧伤患者实施临床护理路径的效果。【方法】以方便抽样的方法选取42例入住BICU的重度烧伤患者为对照组,按常规进行抢救、治疗和护理;58例入住BICU的重度烧伤患者为...【目的】探讨对烧伤重症监护病房(burn intensive care unit,BICU)重度烧伤患者实施临床护理路径的效果。【方法】以方便抽样的方法选取42例入住BICU的重度烧伤患者为对照组,按常规进行抢救、治疗和护理;58例入住BICU的重度烧伤患者为观察组,按制定好的临床护理路径进行护理。比较两组患者BICU入住时间、抗生素应用时间、住院费用、BICU并发症发生率、患者及家属满意度等指标。【结果】观察组患者BICU入住时间及抗生素应用时间少于对照组,住院费用低于对照组,创面脓毒症、导管败血症、应激性溃疡、肾功能不全等并发症的发生率低于对照组,患者满意度优于对照组,有统计学差异。【结论】应用临床护理路径对BICU重度烧伤患者实施护理,能减少患者入住BICU的时间,缩短抗生素使用时间,减少并发症的发生,提高患者及家属对护理工作的满意度,提高护理质量。展开更多
文摘Background: Early excision and grafting has been the preferred method of managing major burns around the world since 1970. Considering the advances in health care and the development of new antibiotics over the past 50 years, delayed grafting as a technique for the management of burns over 15%-20% of total body surface area (TBSA) could have comparable results to that of early excision. This study aims to highlight the outcomes of practicing delayed grafting in burn patients. Methods: A case series analysis was performed of 51 patients who were admitted to the burns unit in Sultan Qaboos Hospital Salalah with over 20% TBSA between January 2014 and December 2019. The patients received prophylactic antibiotics and silver sulphadiazine dressing until the burn eschar had completely separated, followed by grafting. Results: Two patients were lost during the entire duration of the study. The mortality rate was comparable to that of early excision, while the rate of hypertrophic scarring was lower than the range reported by other studies. Conclusion: In the management of patients with over 20% TBSA, delayed grafting after complete separation of eschar is still a valid technique.
文摘<strong>Background: </strong>Burns is one of the most common and severe forms of trauma, as they cause an alteration in the protective barrier exerted by the skin. The objective of this work is to describe the bacterial pathogens that cause infections in the different body segments as well as to know the susceptibility in patients with burns during a period of two years. <strong>Methods:</strong> This study was conducted over a period of 2 years, January 2017 to January 2019. The analysis of the isolated microbiological agents was obtained from culture samples in different anatomic areas. The variables were measured in the general population and also by groups, considering: age, sex, TBSA with Wallace's rule of nine, anatomic area affected, type of burn, depth of burn, microorganism reported in cultures, antibiotics empirically administered and mortality rate. <strong>Results: </strong>Regardless of the anatomical segment studied, the most frequently isolated microorganism was <em>Pseudomonas aeruginosa</em>. <strong>Conclusions:</strong> Identification of the microorganisms that cause infection reduces the hospital stay, as well as the admission to the ICU. A fundamental research guideline is to pay more attention to the post-burn consequences, and the sequelae and functional limitations that it entails, since few since few studies focus on this aspect.
文摘Burn injuries create severe pain and psychological distress that are highly variable between patients. Distinct types of pain during various stages of injury and recovery make treatment complex. Standard pharmacological treatment of pain can have adverse effects and is not effective in treating anxiety and other psychological issues. Researchers have proposed that integrating clinical hypnosis as a complementary therapy can be highly beneficial to burn patients and their healthcare providers. The existing literature is reviewed and specific hypnosis techniques are discussed. Evidence exists indicating that adjunctive hypnosis is effective at reducing pain and procedural anxiety. Implementing a multidisciplinary burn care team that includes clinical hypnosis and focuses on the patients' psychological health as well as pain reduction is likely to result in faster healing and reduced distress for patients and caregivers alike.
文摘【目的】探讨对烧伤重症监护病房(burn intensive care unit,BICU)重度烧伤患者实施临床护理路径的效果。【方法】以方便抽样的方法选取42例入住BICU的重度烧伤患者为对照组,按常规进行抢救、治疗和护理;58例入住BICU的重度烧伤患者为观察组,按制定好的临床护理路径进行护理。比较两组患者BICU入住时间、抗生素应用时间、住院费用、BICU并发症发生率、患者及家属满意度等指标。【结果】观察组患者BICU入住时间及抗生素应用时间少于对照组,住院费用低于对照组,创面脓毒症、导管败血症、应激性溃疡、肾功能不全等并发症的发生率低于对照组,患者满意度优于对照组,有统计学差异。【结论】应用临床护理路径对BICU重度烧伤患者实施护理,能减少患者入住BICU的时间,缩短抗生素使用时间,减少并发症的发生,提高患者及家属对护理工作的满意度,提高护理质量。
