The year in burns 2008.
ABSTRACT For 2008, approximately 1200 original burn research articles were published in scientific journals using the English language. This article reviews those with the most impact on burn treatment according to the Editor of one of the major journals (Burns). As in the previous year's review, articles were divided into the following topic areas: epidemiology, wound characterisation, critical care physiology, inhalation injury, infection, metabolism and nutrition, psychological considerations, pain management, rehabilitation, and burn reconstruction. Each selected article is mentioned briefly with editorial comment.
- SourceAvailable from: Nancy E E Van Loey[show abstract] [hide abstract]
ABSTRACT: A sample of 90 persons who had been hospitalized for severe burns were interviewed 1-4 years after the incident. Current DSM-IV post-traumatic stress disorder (PTSD) was assessed with the Composite International Diagnostic Interview. Perceived attributed responsibility and related positive and negative emotional states were examined using a semi-structured interview. Findings showed that PTSD was established in 8% of the participants and partial PTSD in 13%. In a homogeneity analysis (HOMALS), PTSD was associated with the attribution of responsibility for the incident to impersonal relationships and with a negative emotional state. The absence of (partial) PTSD was associated with the attribution of responsibility to close relationships, internal and circumstance-related attribution of responsibility and neutral or forgiving feelings. In logit analyses, both emotional state as well as attributed responsibility are significantly related to (partial) PTSD. However, the model including emotional state showed to have the best fit. Although further research is needed, these results may indicate that professionals working in burn care should consider the emotional state in relation to perceived attribution of responsibility when considering PTSD. Promoting forgiveness may be a beneficial strategy in dealing with post-traumatic stress reactions.Burns: journal of the International Society for Burn Injuries 06/2008; 34(8):1082-9. · 1.95 Impact Factor
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ABSTRACT: Objective of the study is to investigate for the presence of fibrocytes, a leucocyte found at sites of injury with fibroblast-like properties, within pediatric burn wounds. Seventy 3 mm punch biopsies were taken from 53 burn wounds in 33 children between 7 months and 15 years of age at the time of planned operative debridement and grafting. After fixation and sectioning, immunohistochemistry (IHC) staining was performed for CD34, pro-collagen I, alpha smooth muscle actin, transforming growth factor beta1 and Leucocyte Specific Protein-1 (LSP-1). The presence of fibrocytes was confirmed by double immunofluorescence staining with antibodies to CD34 or LSP-1 with pro-collagen I. CD34 positive cells were present in all burn wound biopsies. Using IHC staining, in 18 patients cells positive for CD34 and pro-collagen I were identified; in 17 patients, cells positive for CD34 and alphaSMA and in 17 patients also cells positive for LSP-1 and pro-collagen I. Double immunofluorescence for CD34/pro-collagen I and LSP-1/pro-collagen I confirmed the presence of fibrocytes in specimens from 17 of 18 patients positive for these markers on IHC. Of the 17 patients whose burn wounds were complicated by hypertrophic scarring, fibrocytes were identified in 88% (n = 15) compared with 18% of those without hypertrophic scarring (P < .001). This study represents the first report of the presence of fibrocytes in acute pediatric burn wounds. These cells appear to be involved in the local response to burn wound injury and may correlate with the later development of hypertrophic burn wound scarring.Journal of burn care & research: official publication of the American Burn Association 07/2008; 29(4):619-26. · 1.54 Impact Factor
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ABSTRACT: The resuscitation of severe burn remains a controversial area within the burn care profession. There is ongoing debate as to what percentage burn is associated with a sufficient quality of life to support initial resuscitation efforts. We conducted a survey of delegates at the 39th Annual Meeting of the British Burns Association (2005), regarding attitudes towards resuscitation following major burns. Respondents were asked the maximum percentage total body surface area (TBSA) burn beyond which they would not wish to be resuscitated. They were also asked what maximum TBSA they perceived to be commensurate with an acceptable quality of life (QOL). One hundred and forty three of 300 delegates responded to the questionnaire. Thirty three percent of respondents would not wish to be resuscitated with 50-75% TBSA burns or greater. A further 35% would not wish to have life-sustaining intervention with 75-95% TBSA burns or greater. The remaining 32% indicated that they would not want resuscitation with TBSA burns>95%. Regardless of TBSA affected, 16% would not wish resuscitation if they had full thickness facial burns, a further 10% did not want resuscitation if both their hands and faces were affected. Our survey demonstrates the diversity of personal preference amongst burn care professionals. This would suggest that a unifying philosophy regarding the resuscitation of extensive burns will remain elusive.Burns 07/2008; 34(4):512-5. · 1.80 Impact Factor