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Rahim A, Asadollahi A, Mojadam M, Šparovec ED, Kashfi M, Nazari M. Psychometric Properties under EFA, CFA, Measurement Invariance, and IRT Models for Older Adults' First Aids Knowledge Scale among Iranian Grandparents: The Modified Scale. ScientificWorldJournal 2024; 2024:6208571. [PMID: 39224860 PMCID: PMC11368547 DOI: 10.1155/2024/6208571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Accepted: 08/08/2024] [Indexed: 09/04/2024] Open
Abstract
This research aims to create and evaluate an assessment tool termed Older Adults' First Aid Knowledge Scale, which measures the knowledge and attitude of Iranian grandparents about first aid. In accordance with COSIM guidelines, 485 individuals in southern Iran completed the instrument as part of a psychometric investigation. Rasch partial credit model (PCM), exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and receiver operating characteristic (ROC) analysis were used to analyze the results. The final version of OFAKS consisted of 18 items that were validated through EFA, CFA, and item response theory (IRT) analysis. All items showed measurement invariance and consecutive response groupings in the predictable order, and the instrument had strong internal consistency. Although Rasch's analysis demonstrated the significance of OFAKS, further investigations and testing in different settings are required to confirm the validity of the tool.
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Affiliation(s)
- Atefeh Rahim
- Students Research CommitteeShiraz University of Medical Sciences, Razi Ave., Shiraz, Iran
| | - Abdolrahim Asadollahi
- Department of GerontologySchool of HealthShiraz University of Medical Sciences, Razi Ave., Shiraz, Iran
- The Middle East Longevity Institute, Azmi Street, Abdo Center, P.O. Box: 618, Tripoli, Lebanon
| | - Mehdi Mojadam
- Health in Disasters and EmergenciesDepartment of Public HealthSchool of HealthAbadan University of Medical Sciences, Abadan, Iran
| | - Eva Dolenc Šparovec
- Public Health DivisionFaculty of Health SciencesUniversity of Ljubljana, Zdravstvena Pot 5, Ljubljana 1000, Slovenia
| | - Mansour Kashfi
- Department of Public HealthSchool of HealthShiraz University of Medical Sciences, Razi Ave., Shiraz, Iran
| | - Mahin Nazari
- Department of Health PromotionSchool of HealthShiraz University of Medical Sciences, Razi Ave., Shiraz, Iran
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Colston KPJ, Ede T, Mendl MT, Lecorps B. Cold therapy and pain relief after hot-iron disbudding in dairy calves. PLoS One 2024; 19:e0306889. [PMID: 38995898 PMCID: PMC11244798 DOI: 10.1371/journal.pone.0306889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 06/25/2024] [Indexed: 07/14/2024] Open
Abstract
Even when pain control is implemented, calves may experience pain for days after hot-iron disbudding. Whether calves seek pain relief post-disbudding offers a novel approach to assessing pain in these animals. By employing an approach-aversion paradigm, we explored the ability of cold therapy to provide immediate pain relief in disbudded calves. Calves were habituated to the manual placement of a cool or ambient pack on their forehead for a short duration simultaneous to milk reward consumption, prior to disbudding. Calves were then disbudded under local anaesthesia (procaine) and analgesia (meloxicam), and responses to the packs were observed over subsequent days. Individual calves were consistently exposed to either cool or ambient packs in different halves of a two-sided experimental pen, allowing for the testing of approach-aversion and conditioned place preference. We found calves approached milk rewards quicker and maintained contact for longer when receiving cold therapy compared to the ambient control. However, calves did not display any conditioned preference for the pen where they received the cool pack. These results add to the growing evidence of lasting pain following disbudding procedures and suggests that cold therapy provides some form of pain relief post-disbudding. Future studies should seek other ways to use cold therapy post-disbudding to reduce aversiveness and human involvement.
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Affiliation(s)
- Kane P. J. Colston
- Bristol Veterinary School, University of Bristol, Bristol, United Kingdom
| | - Thomas Ede
- Department of Clinical Studies, Swine Teaching and Research Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA, United States of America
| | - Michael T. Mendl
- Bristol Veterinary School, University of Bristol, Bristol, United Kingdom
| | - Benjamin Lecorps
- Bristol Veterinary School, University of Bristol, Bristol, United Kingdom
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3
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Elhussiny ME, Abuageelah BM, Alfaifi MH, Alshahrani MM, Alyami YM, Aljaber GT, Alghamdi HA, Banah AF, Albaraq MA, Alnaji OA, Majrashy AI, Alyami HM, Mahmoud SA, Alameer KM. Evaluating Burn First Aid Knowledge, Practices, and Confidence Levels Among the General Population in Aseer, Saudi Arabia. Cureus 2024; 16:e64760. [PMID: 39156337 PMCID: PMC11329290 DOI: 10.7759/cureus.64760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2024] [Indexed: 08/20/2024] Open
Abstract
Background and objectives Burns represents a significant public health issue globally and in Saudi Arabia, disproportionately affecting vulnerable groups. Prompt, evidence-based first aid improves outcomes. This study assessed burn first aid understanding, self-assurance, and information sources among Aseer Region residents. Methods A cross-sectional online survey was distributed to 386 individuals using a validated questionnaire, assessing understanding via a 10-item scale and confidence through Likert scales. Associations between variables were examined statistically. Results Most participants (85%; n=330) demonstrated poor first-aid comprehension, and only (1%; n=2) exhibited excellent knowledge. A history of burn exposure correlated with higher knowledge (p=0.039). The Internet was the primary information source (48%; n= 185). Confidence in assisting burn victims was generally low. Conclusions Significant gaps in foundational burn first aid knowledge were identified, necessitating targeted educational interventions disseminated via multiple modalities to strengthen emergency response and optimize outcomes in this region.
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Affiliation(s)
- Mohammed E Elhussiny
- Department of Histology, Faculty of Medicine, Al-Azhar University, Cairo, EGY
- Department of Histology, General Medicine Practice Program, Batterjee Medical College, Aseer, SAU
| | | | - Mona H Alfaifi
- General Medicine Practice Program, Batterjee Medical College, Aseer, SAU
| | | | - Yousef M Alyami
- General Medicine Practice Program, Batterjee Medical College, Aseer, SAU
| | - Ghade T Aljaber
- General Medicine Practice Program, Batterjee Medical College, Aseer, SAU
| | - Halima A Alghamdi
- General Medicine Practice Program, Batterjee Medical College, Aseer, SAU
| | - Alhanouf F Banah
- General Medicine Practice Program, Batterjee Medical College, Aseer, SAU
| | - Maryam A Albaraq
- General Medicine Practice Program, Batterjee Medical College, Aseer, SAU
| | - Ohud A Alnaji
- General Medicine Practice Program, Batterjee Medical College, Aseer, SAU
| | - Alya I Majrashy
- General Medicine Practice Program, Batterjee Medical College, Aseer, SAU
| | - Hamzah M Alyami
- General Medicine Practice Program, Batterjee Medical College, Aseer, SAU
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4
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Fu X, Hu G, Abker AM, Oh DH, Ma M, Fu X. A Novel Food Bore Protein Hydrogel with Silver Ions for Promoting Burn Wound Healing. Macromol Biosci 2024; 24:e2300520. [PMID: 38412873 DOI: 10.1002/mabi.202300520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/31/2024] [Indexed: 02/29/2024]
Abstract
Hydrogels have emerged as a promising option for treating local scald wounds due to their unique physical and chemical properties. This study aims to evaluate the efficacy of ovalbumin/gelatin composite hydrogels in repairing deep II-degree scald wounds using a mouse dorsal skin model. Trauma tissues collected at various time points are analyzed for total protein content, hydroxyproline content, histological features, and expression of relevant markers. The results reveal that the hydrogel accelerates the healing process of scalded wounds, which is 17.27% higher than the control group. The hydrogel treatment also effectively prevents wound enlargement and redness of the edges caused by infection during the initial stage of scalding. The total protein and hydroxyproline content of the treated wounds are significantly elevated. Additionally, the hydrogel up-regulates the expression of VEGF (a crucial angiogenic factor) and down-regulates CD68 (a macrophage marker). In summary, this study provides valuable insights into the potential of multifunctional protein-based hydrogels in wound healing.
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Affiliation(s)
- Xiaowen Fu
- National Research and Development Centre for Egg Processing, College of Food Science and Technology, Huazhong Agricultural University, Wuhan, Hubei, 430070, P. R. China
| | - Gan Hu
- National Research and Development Centre for Egg Processing, College of Food Science and Technology, Huazhong Agricultural University, Wuhan, Hubei, 430070, P. R. China
| | - Adil M Abker
- National Research and Development Centre for Egg Processing, College of Food Science and Technology, Huazhong Agricultural University, Wuhan, Hubei, 430070, P. R. China
- Institute for Agro-Industries, Industrial Research and Consultancy Centre (IRCC), Khartoum, 400076, Sudan
| | - Deog-Hwan Oh
- Department of Food Science and Biotechnology, College of Agriculture and Life Science, Kangwon National University, Chuncheon, 200701, South Korea
| | - Meihu Ma
- National Research and Development Centre for Egg Processing, College of Food Science and Technology, Huazhong Agricultural University, Wuhan, Hubei, 430070, P. R. China
| | - Xing Fu
- National Research and Development Centre for Egg Processing, College of Food Science and Technology, Huazhong Agricultural University, Wuhan, Hubei, 430070, P. R. China
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Ji S, Xiao S, Xia Z. Consensus on the treatment of second-degree burn wounds (2024 edition). BURNS & TRAUMA 2024; 12:tkad061. [PMID: 38343901 PMCID: PMC10858447 DOI: 10.1093/burnst/tkad061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/29/2023] [Accepted: 12/08/2023] [Indexed: 02/21/2024]
Abstract
Second-degree burns are the most common type of burn in clinical practice and hard to manage. Their treatment requires not only a consideration of the different outcomes that may arise from the dressing changes or surgical therapies themselves but also an evaluation of factors such as the burn site, patient age and burn area. Meanwhile, special attention should be given to the fact that there is no unified standard or specification for the diagnosis, classification, surgical procedure, and infection diagnosis and grading of second-degree burn wounds. This not only poses great challenges to the formulation of clinical treatment plans but also significantly affects the consistency of clinical studies. Moreover, currently, there are relatively few guidelines or expert consensus for the management of second-degree burn wounds, and no comprehensive and systematic guidelines or specifications for the treatment of second-degree burns have been formed. Therefore, we developed the Consensus on the Treatment of Second-Degree Burn Wounds (2024 edition), based on evidence-based medicine and expert opinion. This consensus provides specific recommendations on prehospital first aid, nonsurgical treatment, surgical treatment and infection treatment for second-degree burns. The current consensus generated a total of 58 recommendations, aiming to form a standardized clinical treatment plan.
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Affiliation(s)
- Shizhao Ji
- Correspondence: Shizhao Ji, ; Shichu Xiao, ; Zhaofan Xia,
| | - Shichu Xiao
- Correspondence: Shizhao Ji, ; Shichu Xiao, ; Zhaofan Xia,
| | - Zhaofan Xia
- Correspondence: Shizhao Ji, ; Shichu Xiao, ; Zhaofan Xia,
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Malhotra H, Sharma P, Kamal MA, Kaushik P, Rani N. Concise Review on Scientific Approaches to Burns and Scars. Curr Drug Saf 2024; 19:191-199. [PMID: 37165593 DOI: 10.2174/1574886318666230509143017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 02/06/2023] [Accepted: 02/16/2023] [Indexed: 05/12/2023]
Abstract
Burns are large open surgical lesions bathed in virulent pus that result in rupturing of the cutaneous membrane, which has serious consequences such as an extensive loss of proteins, and body fluids, increased chances of infections, and sometimes death. These can be classified based on their penetration levels, i.e., first-degree burns penetrating the epidermis, second-degree burns including both epidermis and dermis, third-degree burns to both layers including the hair follicular cells, sweat glands and various core tissues, fourth-degree burns to adipose tissue, fifth stage burns to muscles, and sixth stage burns to bones. Wound healing/wound repair is a very perplexing process in which the tissues of the affected/burnt area repairs themselves to attain their original form and functionality but develop a scar at the wound site. This article mainly focuses on the algorithms to differentiate various degrees of burns, general first aid approaches to burns and scars, the rationale of treatment of burns, basic mechanisms highlighting the healing processes in humans in terms of free from scar formation as well as with scar formation at their elementary levels including cellular as well as biochemical levels, utility, and progression of pre-clinical data to humans and finally approaches for the improvement of scar formation in man.
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Affiliation(s)
- Hitesh Malhotra
- Department of Pharmaceutical Science, Guru Gobind Singh College of Pharmacy, Yamuna Nagar (Haryana), India
| | - Prerna Sharma
- Department of Pharmaceutical Science, Guru Gobind Singh College of Pharmacy, Yamuna Nagar (Haryana), India
| | - Mohammad Amjad Kamal
- Institutes for Systems, Chengdu, Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, China
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka 1207, Bangladesh
- 4 Enzymoics, Novel Global Community Educational Foundation, 7 Peterlee place, Hebersham, NSW 2770, Australia
| | - Peeyush Kaushik
- Department of Pharmaceutical Science, Guru Gobind Singh College of Pharmacy, Yamuna Nagar (Haryana), India
| | - Nidhi Rani
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
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Fadel BA, Elwakil BH, Fawzy EE, Shaaban MM, Olama ZA. Nanoemulsion of Lavandula angustifolia Essential Oil/Gold Nanoparticles: Antibacterial Effect against Multidrug-Resistant Wound-Causing Bacteria. Molecules 2023; 28:6988. [PMID: 37836831 PMCID: PMC10574385 DOI: 10.3390/molecules28196988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/04/2023] [Accepted: 10/04/2023] [Indexed: 10/15/2023] Open
Abstract
Hospitalized patients are severely impacted by delayed wound healing. Recently, there has been a growing focus on enhancing wound healing using suitable dressings. Lavandula angustifolia essential oil (LEO) showed potential antibacterial, anti-inflammatory, and wound healing properties. However, the prepared gold nanoparticles possessed multifunctional properties. Consequently, the present investigation aimed to synthesize a novel nanosystem consisting of nano-Lavandula angustifolia essential oil and gold nanoparticles prepared through ultrasonic nanoemulsifying techniques in order to promote wound healing and combat bacterial infection. LEO showed potent antibacterial activity against Klebsiella pneumoniae, MRSA and Staphylococcus aureus with minimum inhibitory concentration (MIC) values of 32, 16 and 16 µg/mL, respectively, while exhibiting low activity against Proteus mirabilis. Interestingly, the newly formulated nano-gold/nano-Lavandula angustifolia penetrated the preformed P. mirabilis biofilm with a full eradication of the microbial cells, with MIC and MBEC (minimal biofilm eradication concentration) values reaching 8 and 16 µg/mL, respectively. The cytotoxic effect of the novel nanoformula was also assessed against WI-38 fibroblasts vero (normal) cells (IC50 = 0.089 mg/mL) while nano-gold and nano-Lavandula angustifolia showed higher results (IC50 = 0.529, and 0.209 mg/mL, respectively). Nano-gold/nano-Lavandula angustifolia formula possessed a powerful wound healing efficacy with a 96.78% wound closure. These findings revealed that nano-gold/nano-Lavandula angustifolia nanoemulsion can inhibit bacterial growth and accelerate the wound healing rate.
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Affiliation(s)
- Balqis A. Fadel
- Department of Botany & Microbiology, Faculty of Science, Alexandria University, Alexandria 21568, Egypt (E.E.F.)
| | - Bassma H. Elwakil
- Department of Medical Laboratory Technology, Faculty of Applied Health Sciences Technology, Pharos University in Alexandria, Alexandria 21526, Egypt
| | - Esraa E. Fawzy
- Department of Botany & Microbiology, Faculty of Science, Alexandria University, Alexandria 21568, Egypt (E.E.F.)
| | - Marwa M. Shaaban
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Alexandria University, Alexandria 21521, Egypt;
| | - Zakia A. Olama
- Department of Botany & Microbiology, Faculty of Science, Alexandria University, Alexandria 21568, Egypt (E.E.F.)
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Alhusayni MA, Alotaibi NM, Alshaer AA, Alnefaie A, Alotaibi MM, Albogami ARR, Juohari TB, Alnofaiey Y. Assessment of Awareness and Practices Related to Burn Injury First Aid Among the General Public: Cross-Sectional Study in Taif, Saudi Arabia. Cureus 2023; 15:e45912. [PMID: 37885549 PMCID: PMC10599189 DOI: 10.7759/cureus.45912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2023] [Indexed: 10/28/2023] Open
Abstract
Background Burn injuries can be highly traumatic and harmful, leading to significant mortality rates, extended hospital stays, deformity, and incapacity. In the long term, they may also result in rejection, social stigma, and psychiatric issues. This study aimed to estimate the awareness and practices related to burn injury first aid among the general public in Taif, Saudi Arabia. Methods This is an online cross-sectional survey in Taif, Saudi Arabia. An online self-administered questionnaire was distributed to the adult population, comprising individuals aged 18 years and older, of both genders, from June 2023 to August 2023. The questionnaire consisted of 24 questions divided into demographics and first aid for burns. The Scientific Research Ethics Committee at Taif University, Taif, Saudi Arabia, obtained the ethical approval for the study. Results A total of 531 individuals were included in the study. About half were male (58.4%) and in the age group of 22-29 years (52%). Out of that number, 24.1% were medical field students. About one-third of the respondents had participated in a burn training course (33.7%), and 73.8% reported experiencing a burn injury before, either to themselves or their family. Most respondents chose to treat the burn area using honey, and only 15.6% knew that they should administer water to a burn injury for 10 to 15 or >15 minutes. Most of the participants reported an excellent knowledge level (62.9%). Only 8.7% had an excellent practice level. The total knowledge and practice score was significantly associated with participation in the burn training course (P-value < 0.001 and 0.015, respectively). The work nature and prior experience with a burn injury were significantly associated with the knowledge scores (P-value=0.003, for both). Monthly income and the work nature also correlated with the practice total score (P-value=0.023 and <0.001, respectively). Conclusion Most participants had an excellent knowledge level, however, most of them reported poor or acceptable practice scores. It highlights the need for training sessions, awareness campaigns, and dissemination of evidence-based information to bridge the gap between knowledge and practice.
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Affiliation(s)
| | | | | | | | | | | | | | - Yasser Alnofaiey
- Department of Internal Medicine, College of Medicine, Taif University, Taif, SAU
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Farzan R, Parvizi A, Takasi P, Mollaei A, Karkhah S, Firooz M, Hosseini SJ, Haddadi S, Ghorbani Vajargah P. Caregivers' knowledge with burned children and related factors towards burn first aid: A systematic review. Int Wound J 2023; 20:2887-2897. [PMID: 36859701 PMCID: PMC10410335 DOI: 10.1111/iwj.14130] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/06/2023] [Accepted: 02/13/2023] [Indexed: 03/03/2023] Open
Abstract
This systematic review aimed to examine the caregivers' knowledge with burned children and related factors towards burn first aid. A comprehensive, systematic search was performed in different international electronic databases, such as Scopus, PubMed, Web of Science, and Persian electronic databases such as Iranmedex, and Scientific Information Database using keywords extracted from Medical Subject Headings such as "Knowledge", "First aid", "Caregiver", "Burn", and "Child" from the earliest to the December 1, 2022. The quality of the studies included in this systematic review was evaluated by using the appraisal tool for cross-sectional studies (AXIS tool). A total of 11 763 caregivers of children with burns were enrolled in 14 studies. Of the participants, 78.81% were female and 41.15% had a university education. The mean score of caregivers' knowledge with burned children towards burn first aid was 51.44 out of 100. The knowledge of caregivers of burned children towards burn first aid had a significant positive relationship with the level of education, first aid training, age of caregivers, history of burn, number of children, monthly income, social status, and attitude. In addition, caregivers' knowledge had a significant negative relationship with the number of children. Furthermore, there was a significant relationship between caregivers' knowledge and level of education, monthly income, smoking, and previous knowledge of first aid. The level of caregivers' knowledge with burned children towards burn first aid was moderate. Therefore, health managers and policymakers can improve the knowledge of caregivers of burned children towards burn first aid by creating suitable platforms for face-to-face training as well as online training using websites.
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Affiliation(s)
- Ramyar Farzan
- Department of Plastic & Reconstructive Surgery, School of MedicineGuilan University of Medical SciencesRashtIran
| | - Arman Parvizi
- Anesthesiology Research Center, Department of Anesthesiology, Alzahra HospitalGuilan University of Medical SciencesRashtIran
| | - Poorya Takasi
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Amirabbas Mollaei
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Samad Karkhah
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Mahbobeh Firooz
- Department of NursingEsfarayen Faculty of Medical SciencesEsfarayenIran
| | | | - Soudabeh Haddadi
- Anesthesiology Research Center, Department of Anesthesiology, Alzahra HospitalGuilan University of Medical SciencesRashtIran
| | - Pooyan Ghorbani Vajargah
- Anesthesiology Research Center, Department of Anesthesiology, Alzahra HospitalGuilan University of Medical SciencesRashtIran
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
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Alkhalifah KM, Almutairi F, Almohaimeed NS, Alhumaidan LS, Alsulaim L. Perception, Awareness, and Practices Related to Burn First Aid Among the General Population in Qassim Region, Saudi Arabia. Cureus 2023; 15:e45879. [PMID: 37885545 PMCID: PMC10598412 DOI: 10.7759/cureus.45879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/24/2023] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVES This study aims to assess the perception, awareness, and practices related to burn first aid among the general population in the Qassim region of Saudi Arabia. METHODS This is an observational, cross-sectional study that assesses perception, awareness, and practices related to burn first aid among the general population in the Qassim region of Saudi Arabia. The data was collected using questionnaires. The data was initially filtered and checked for completeness to rectify any errors or discrepancies. The Statistical Package for the Social Sciences (SPSS) version 24.0 (IBM SPSS Statistics, Armonk, NY, USA) was used for data analysis. The data was coded before entry into the software program. Descriptive statistics were applied, summarizing the data in terms of frequency and percentage. Chi-square tests were used for analyzing categorical variables and to determine the association between the groups, with significance set at a P-value of 0.05. RESULTS Of the participants, 72.8% had previous knowledge regarding burns' first aid management. Furthermore, 3% obtained knowledge and information about burn first aid from a certified course, while 21.1% obtained the information from the Internet. Of the respondents, 77.8% indicated that during the exposure to burn, they would remove accessories and clothes that covered the injured area. Of them, 79.4% noted that they would apply water to the injured area in case of exposure to burns. In addition, 61.9% of the respondents used honey as a home remedy to treat burns, and 30.1% used toothpaste to treat burns. CONCLUSION Of the general population in the Qassim region of Saudi Arabia, 72.8% had basic knowledge regarding burns' first aid management. The study found certified courses and the Internet to be the main sources of information and knowledge about burns' first aid management. The study found that clothes and accessories that covered the injured area should be removed when exposed to burns. In addition, cold water should be applied for a period of at least 10 minutes. The study found honey and toothpaste to be the most common home remedies used to treat burns. The use of pure honey is an accepted intervention in the treatment of burns due to its benefit in stimulating the rapid regeneration of tissues and decreasing incidences of scar formation. However, there are wrong beliefs about the use of toothpaste in cases of burns because it exacerbates the initial injury, making it even worse. There are significant differences in the perception, awareness, and practice of the general population according to their education level (P-value = 0.003) and employment (P-value = 0.007).
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Affiliation(s)
- Khalid M Alkhalifah
- Department of Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| | - Faisal Almutairi
- Department of Surgery, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| | - Nouf S Almohaimeed
- Department of Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| | - Lulwah S Alhumaidan
- Department of Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
| | - Lamees Alsulaim
- Department of Surgery, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
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11
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Muacevic A, Adler JR, Alsulymani B, Malaika L, Al-Rezqi M, Malaikah AA, Alqarni SH. Evaluation of Perception, Awareness, and Practices Related to Burns First Aid: Largest Cross-Sectional Study Among Non-Healthcare Providers in the Western Region of Saudi Arabia. Cureus 2023; 15:e33839. [PMID: 36819406 PMCID: PMC9931372 DOI: 10.7759/cureus.33839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2023] [Indexed: 01/19/2023] Open
Abstract
Introduction Burn injuries are among the most catastrophic public health issues because of the severe physical, functional, and psychological effects. Numerous studies have revealed that both developed and developing societies lack understanding about first aid for burns. This research sought to review and appraise perception, awareness, and practices of burn first aid among non-healthcare providers in Jeddah, Saudi Arabia, and whether they need an effective program. To the best of our knowledge, this is likely the first research conducted in Jeddah. Methodology We conducted a cross-sectional study in Jeddah, Saudi Arabia using a self-administered online questionnaire among non-healthcare providers in July 2022. The questionnaire was made up of 29 questions divided into two sections: demographics and first aid for burns. The Unit of Biomedical Ethics Research Committee at the Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia approved this study. Results This study included 575 participants. Males comprised 54.8% (315) and females 45.2% (260) of all respondents. A total of 443 respondents (77%) held a university diploma. All respondents had a mean burn knowledge score of 6.35±1.43 out of eight. Traditional medication was used on the burn by 484 people (84.2%). Antibiotic use in burn injuries was poorly understood as 453 (78.8%) of study participants agreed that antibiotics are beneficial in the case of burns, which is incorrect. Conclusion The level of first-aid practices for burn patients among non-healthcare workers was insufficient, and the use of traditional medicines and antibiotics in burn patients was excessive. The findings of this study should be carefully considered by various healthcare organizations.
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Hausen MDA, Melero AMG, Asami J, Ferreira LM, Gomes da Silva GB, Bissoli MCDA, Marcato VR, Nani BD, Rosalen PL, Alencar SMD, Botaro VR, Komatsu D, Senna A, Duek EADR. In vivo therapeutic evaluation of a cellulose acetate hydrogel cross linked with ethylenediaminetetraacetic-dianhydride containing propolis ethanolic-extract for treating burns. J BIOACT COMPAT POL 2022. [DOI: 10.1177/08839115221106869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
An increasing interest in regenerative medicine has been an approach with natural products used for assorted skin treatments. Propolis from Apis mellifera species of bees have shown high acceptance due to antimicrobial and anti-inflammatory properties. However, just a few propolis types presents stronger effects in controlling inflammation. The current work describes an organic propolis recently isolated, named as OP6, that presented strong anti-inflammatory influences in vivo when associated with EDTA cross-linked hydrogel, used as a curative device in second-degree burns in a murine model. We developed a cellulose acetate hydrogel cross-linked with ethylenediaminetetraacetic dianhydride (HAC-EDTA) as a polymeric matrix for a bandage based on an ethanolic extract of propolis at 15%, 30%, and 60% (w/v) for treating second-degree burns. In vivo studies were carried out in Wistar rats divided into three groups: negative control (only lesion), positive control (lesion with HAC-EDTA film), and treatment group (lesion with the HAC-EDTA + OP6 at 15%, 30%, and 60%). Each group was randomized and equally subdivided into two subgroups according to the period of bandage wearing (7 and 14 days). Previous work of this research group selected the propolis OP6 sample source as the best candidate for the in vivo study. HAC-EDTA + OP6 15%, 30%, and 60% films demonstrated a concentration-dependent release rate, with the highest amount of propolis released after tests (484.3 mg) by HAC-EDTA enriched with the highest concentrated extract of propolis. HAC-EDTA + OP6 films were efficient in preventing infections, promoting lesion retraction, and tissue regeneration. The HAC-EDTA + OP6 30% treatment was more efficient, revealing a reduced inflammatory process and stimulating skin regeneration. The designed HAC-EDTA + propolis films were shown as promising tools for second-degree burns treatment, accelerating healing process to a full recovery tissue repair after 14 days.
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Affiliation(s)
- Moema de Alencar Hausen
- Biomaterial’s Laboratory, Medicine and Health Sciences Faculty, Pontifical Catholic University of São Paulo (PUC/SP), Sorocaba, São Paulo, Brazil
| | - Anna Maria Gouvea Melero
- Department of Physics, Chemistry and Mathematics, Federal University of São Carlos (DFQM/UFSCAR), Sorocaba, São Paulo, Brazil
| | - Jessica Asami
- Biomaterial’s Laboratory, Medicine and Health Sciences Faculty, Pontifical Catholic University of São Paulo (PUC/SP), Sorocaba, São Paulo, Brazil
- Faculty of Mechanical Engineering, State University of Campinas (FEM/UNICAMP), São Paulo, Brazil
| | - Lucas Martins Ferreira
- Biomaterial’s Laboratory, Medicine and Health Sciences Faculty, Pontifical Catholic University of São Paulo (PUC/SP), Sorocaba, São Paulo, Brazil
| | - Guilherme Borges Gomes da Silva
- Biomaterial’s Laboratory, Medicine and Health Sciences Faculty, Pontifical Catholic University of São Paulo (PUC/SP), Sorocaba, São Paulo, Brazil
| | - Mariana Cesar de Azeredo Bissoli
- Biomaterial’s Laboratory, Medicine and Health Sciences Faculty, Pontifical Catholic University of São Paulo (PUC/SP), Sorocaba, São Paulo, Brazil
| | - Vanessa Rigoni Marcato
- Biomaterial’s Laboratory, Medicine and Health Sciences Faculty, Pontifical Catholic University of São Paulo (PUC/SP), Sorocaba, São Paulo, Brazil
| | - Bruno Dias Nani
- Piracicaba Dental School, University of Campinas (FOP/UNICAMP), Piracicaba, São Paulo, Brazil
| | - Pedro Luiz Rosalen
- Piracicaba Dental School, University of Campinas (FOP/UNICAMP), Piracicaba, São Paulo, Brazil
| | - Severino Matias de Alencar
- Luiz de Queiroz College of Agriculture, University of São Paulo (ESALQ/USP), Piracicaba, São Paulo, Brazil
| | - Vagner Roberto Botaro
- Department of Physics, Chemistry and Mathematics, Federal University of São Carlos (DFQM/UFSCAR), Sorocaba, São Paulo, Brazil
- Post-Graduation Program in Materials Science (PPGCM), Federal University of São Carlos (UFSCAR), Sorocaba, São Paulo, Brazil
| | - Daniel Komatsu
- Biomaterial’s Laboratory, Medicine and Health Sciences Faculty, Pontifical Catholic University of São Paulo (PUC/SP), Sorocaba, São Paulo, Brazil
| | - André Senna
- Department of Physics, Chemistry and Mathematics, Federal University of São Carlos (DFQM/UFSCAR), Sorocaba, São Paulo, Brazil
| | - Eliana Aparecida de Rezende Duek
- Biomaterial’s Laboratory, Medicine and Health Sciences Faculty, Pontifical Catholic University of São Paulo (PUC/SP), Sorocaba, São Paulo, Brazil
- Faculty of Mechanical Engineering, State University of Campinas (FEM/UNICAMP), São Paulo, Brazil
- Post-Graduation Program in Materials Science (PPGCM), Federal University of São Carlos (UFSCAR), Sorocaba, São Paulo, Brazil
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First Aid Willingness Questionnaire for Schoolchildren: An Exploratory Factor Analysis and Correlation Study. CHILDREN 2022; 9:children9070955. [PMID: 35883939 PMCID: PMC9321652 DOI: 10.3390/children9070955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 11/25/2022]
Abstract
The goal of this study was to explore the factor structure of the First Aid Willingness Questionnaire and determine its correlations and associations between sociodemographic and sport-related variables. A total of 413 adolescents participated in this study (mean age = 14.2 years). They consisted of 221 boys and 193 girls. Besides sociodemographic and sport-related questions, the First Aid Willingness Questionnaire was used to understand the student’s first aid attitudes. The exploratory factor analysis revealed a four-factor model. The first factor was named first aid willingness for peers, which includes willingness to help friends and family members. The second factor contained factors to help strangers; thus, it was named first aid willingness for strangers. The analysis revealed a third factor that assessed the students’ knowledge of first aid. The last factor contained the students’ negative emotions. The correlation between the factors showed that knowledge had a positive association with all the other factors. Adolescents’ willingness to help their peers was highly associated with helping strangers, but negative emotions had a negative correlation with helping unknown people. Sport-related variables were investigated to determine the effects on first aid attitudes. Even though sport seemed to increase first aid willingness, future studies need to explore its associations. We believe that a deeper understanding of this topic could help prevent serious injuries or death in emergencies.
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Griffin B, Cabilan C, Ayoub B, Xu H(G, Palmieri T, Kimble R, Singer Y. The effect of 20 minutes of cool running water first aid within three hours of thermal burn injury on patient outcomes: A systematic review and meta-analysis. Australas Emerg Care 2022; 25:367-376. [DOI: 10.1016/j.auec.2022.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/31/2022] [Accepted: 05/31/2022] [Indexed: 10/18/2022]
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15
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Bystander rescue and cute thermal injury teaching: training and ethical implications. Burns 2022; 48:737-743. [PMID: 35410698 DOI: 10.1016/j.burns.2022.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/11/2022] [Accepted: 03/22/2022] [Indexed: 12/15/2022]
Abstract
The clinical outcome after thermal injury depends significantly on bystander action at the scene of the initial burn. Bystander action may save life, by rescue or by extinguishing flames; or by reducing medical complications which lead to death from respiratory injury or from secondary infection. Best-practice first aid may reduce the need for skin grafting; and can modify the rate and quality of healing. However, before first aid can begin, rescue and control of the incident site is crucial to the outcome of thermal injury. Bystanders are faced with an inescapable decision whether to attempt a rescue (or not), and the decision to choose the best method for the extinguishment of flames. This is the "rescue phase", currently a relatively neglected theme. In 1981, the St. John Ambulance Association introduced the primacy of "D" for "Danger" in the pedagogic first aid mnemonic, now in its current form of DRSABCD. Most secondary threats to the victim and risks to the rescuer come from high-energy sources [such as flames], and most involve a repetition of the primary incident. Current doctrine teaches four elements of how best to act in the rescue phase of a casually suffering from thermal injury. These imperatives are: (a) Assess for danger (b) Use protection if a rescue is undertaken; (c) Train in techniques for extinguishing the flames of the burning casualty; and (d) Train in the methods of physical retrieval to a safe place - where the standard dictates of DRSABCD can continue.
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Moore C, Clover J, Gibson L. Evaluating parental knowledge of pediatric burns first aid in Ireland and the effectiveness of an educational intervention improving knowledge. Burns 2022; 48:672-682. [PMID: 34696953 DOI: 10.1016/j.burns.2021.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 04/15/2021] [Accepted: 05/24/2021] [Indexed: 12/15/2022]
Abstract
AIM Burns represent a large portion of injuries attending emergency departments each year, with children accounting for the biggest proportion. Appropriate first aid has been shown to help improve the outcome of burns, and decrease the need for surgical intervention. Several studies outside of Ireland demonstrate inadequate parental knowledge of burns first aid, but few evaluated interventions to improve knowledge. Consequently our aim was to assess parental/caregiver knowledge in Ireland, and determine if knowledge levels could be raised following a short educational video intervention. METHODS An educational video based on current European and British best practice guidelines was produced and shown to parents/caregivers waiting in the Pediatric Outpatients Department after a previously validated pre-intervention questionnaire was completed. A post intervention questionnaire was completed following the video. Questionnaires assessed demographics, previous experience and included scenarios to test parental knowledge. RESULTS 112 parents/caregivers (81.3% female (n = 91), 18.8% male (n = 21)) were questioned. Baseline knowledge was found to be poor overall, however this significantly improved with a simple educational video (pre-score 31.9%, post-test mean score knowledge 92.1%). Pre- and post-test scores showed a statistical significance (x2 = 71.117, P < 0.001, 95% CI).No other variables analysed were shown to be statistically significant predictors of pre- or post-test scores (all p > 0.05). CONCLUSION The study found poor parental knowledge of burns first aid in Ireland and shows the use of an educational video was effective in raising knowledge levels.
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Affiliation(s)
| | - James Clover
- University College Cork, Ireland; Cork University Hospital, Cork, Ireland.
| | - Louise Gibson
- University College Cork, Ireland; Cork University Hospital, Cork, Ireland.
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17
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A content analysis of scald first aid information on Chinese websites. Burns 2022; 48:585-594. [PMID: 34857414 DOI: 10.1016/j.burns.2021.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 06/18/2021] [Accepted: 07/14/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE With the rapid development of networks in China, the Internet has become an important source of first aid information for scalds. As a country with the largest population, there are a large number of scald cases every year in China. The content analysis of websites aimed to assess the accuracy and quality of the information on scalds available on Chinese websites. METHODS Using keywords related to scald in the most popular Chinese search engines, 19 sites were eventually selected for evaluation based on the inclusion and exclusion criteria. These websites were assessed on quality and content accuracy by using HONcode, DISCERN, and Patient Education Materials Assessment Tool (PEMAT) evaluation scales, and a modified evaluation system based on the system developed by J.D. Burgess. The evaluation was completed by a 5-person evaluation team. The subjective items were reviewed by five independent reviewers. The objective items were recorded by one reviewer, then another checked the results. RESULTS Using "scald first aid," "scald treatment," and "scald blister" to search on Baidu, Sougou, and Haosou, a total of 180 websites were recorded. According to the inclusion and exclusion criteria, 19 websites were obtained for assessment. Among them, 17 websites (89%) were established by commercial companies. Of the remaining two websites, one was created by a government agency and the other was created by a non-profit organization. The mean total HONcode score, DISCERN score, PEMAT (understandability) score, PEMAT (actionability) score, content accuracy score, and website quality score were 5.19 ± 1.09 out of 8; 52.63 ± 3.69 out of 80; 68%; 56%; 5.05 ± 1.47 out of 8; and 6.11 out of 12, respectively. The scores of the government agency website are better than that of commercial websites. CONCLUSION The websites established by government agencies and non-profit organizations are few, and most of the websites are established by commercial companies. Compared with the government agency website, these commercial websites contain many advertisements, and their website quality and accuracy need to be further improved.
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18
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Public awareness of first aid treatment in acute burns. JOURNAL OF SURGERY AND MEDICINE 2022. [DOI: 10.28982/josam.971375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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19
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Kamlungmak S, Nakpheng T, Kaewpaiboon S, Mudhar Bintang MAK, Prom-In S, Chunhachaichana C, Suwandecha T, Srichana T. Safety and Biocompatibility of Mupirocin Nanoparticle-Loaded Hydrogel on Burn Wound in Rat Model. Biol Pharm Bull 2021; 44:1707-1716. [PMID: 34719647 DOI: 10.1248/bpb.b21-00397] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Mupirocin nanoparticle-loaded hydrogel (MLH) was successfully developed. This study focused on the safety of cell lines and the biocompatibility of MLH for wound healing in rat models. MLH was assessed by an analysis of cytotoxicity and the secretion of inflammatory cytokines in cell lines. The cytocompatibility of MLH was compared with mupirocin ointment on full-thickness burn wounds in rats. The results indicated that MLH and blank hydrogel had no toxicity to human epidermal keratinocytes and human fibroblast cells. MLH inhibited lipopolysaccharide (LPS) activity in macrophage-like cells resulting in low nitric oxide production and reduced inflammatory cytokine production (interleukin (IL)-1β) compared with a positive control (LPS only). In burn wounds, MLH and hydrogel healed the wound better than the other groups determined by wound contraction, reduced secretion, and the generation of new blood vessels, as well as promotion of hair follicle cells. Better granulation tissue proliferation, less necrosis, and a lower degree of inflammation were found in the MLH and blank hydrogel than in the mupirocin ointment. The hydrogel group reduced the macrophages (CD68) on day 14 at the edge of the wound. On day 28, T cells (CD3), B cells (CD20), and CD68+ cells were concentrated in the deeper subcutaneous tissue. Additionally, the transforming growth factor β1 (TGF-β1) concentration and matrix prometalloproteinase-2/tissue inhibitor of metalloproteinases-2 ratio in the MLH and hydrogel groups were less than those in the other groups. The MLH formulation was safe and effective in burn wound healing. Therefore, MLH formulations are promising candidates for further evaluation in clinical trials.
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Affiliation(s)
- Sukanjana Kamlungmak
- Drug Delivery System Excellence Center, Prince of Songkla University.,Department of the Pharmaceutical Technology, Faculty of Pharmaceutical Sciences, Prince of Songkla University
| | - Titpawan Nakpheng
- Drug Delivery System Excellence Center, Prince of Songkla University
| | - Sunisa Kaewpaiboon
- Drug Delivery System Excellence Center, Prince of Songkla University.,Department of the Pharmaceutical Technology, Faculty of Pharmaceutical Sciences, Prince of Songkla University
| | - Muhammad Ali Khumaini Mudhar Bintang
- Drug Delivery System Excellence Center, Prince of Songkla University.,Department of the Pharmaceutical Technology, Faculty of Pharmaceutical Sciences, Prince of Songkla University
| | - Supattra Prom-In
- Department of the Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences, Prince of Songkla University
| | | | - Tan Suwandecha
- Department of Pharmacology, Faculty of Science, Prince of Songkla University
| | - Teerapol Srichana
- Drug Delivery System Excellence Center, Prince of Songkla University.,Department of the Pharmaceutical Technology, Faculty of Pharmaceutical Sciences, Prince of Songkla University
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20
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Progenitor Biological Bandages: An Authentic Swiss Tool for Safe Therapeutic Management of Burns, Ulcers, and Donor Site Grafts. Methods Mol Biol 2021; 2286:49-65. [PMID: 32572700 DOI: 10.1007/7651_2020_296] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
Clinical experience gathered over two decades around therapeutic use of primary human dermal progenitor fibroblasts in burn patient populations has been at the forefront of regenerative medicine in Switzerland. Relative technical simplicity, ease of extensive serial multitiered banking, and high stability are major advantages of such cell types, assorted to ease of safety and traceability demonstration. Stringent optimization of cell source selection and standardization of biobanking protocols enables the safe and efficient harnessing of the considerable allogenic therapeutic potential yielded by primary progenitor cells. Swiss legal and regulatory requirements have led to the procurement of fetal tissues within a devised Fetal Progenitor Cell Transplantation Program in the Lausanne University Hospital. Proprietary nonenzymatic isolation of primary musculoskeletal cell types and subsequent establishment of progeny tiered cell banks under cGMP standards have enabled safe and effective management of acute and chronic cutaneous affections in various patient populations. Direct off-the-freezer seeding of viable dermal progenitor fibroblasts on a CE marked equine collagen scaffold is the current standard for delivery of the therapeutic biological materials to patients suffering from extensive and deep burns. Diversification in the clinical indications and delivery methods for these progenitor cells has produced excellent results for treatment of persistent ulcers, autograft donor site wounds, or chronic cutaneous affections such as eczema. Herein we describe the standard operating procedures for preparation and therapeutic deployment of the progenitor biological bandages within our translational musculoskeletal regenerative medicine program, as they are routinely used as adjuvants in our Burn Center to treat critically ailing patients.
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21
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A pH-sensitive oxidized-dextran based double drug-loaded hydrogel with high antibacterial properties. Int J Biol Macromol 2021; 182:385-393. [PMID: 33798586 DOI: 10.1016/j.ijbiomac.2021.03.169] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/28/2021] [Accepted: 03/29/2021] [Indexed: 11/22/2022]
Abstract
Delayed healing or non-healing of wounds caused by bacterial infection is still a difficult medical problem. Nowadays, the topical application of antibiotics is a common treatment for infections. However, subinhibitory concentrations or high dose of antibiotics leads to the antibacterial effect counterproductive. So it's necessary to put forward an on-demand drug delivery to solve this tough issue. In this paper, a pH-responsive hydrogel was prepared by oxidized dextran (Dex-CHO), sulfadiazine (SD) and tobramycin (TOB). The hydrogel was designed by the environment in the early immature stage of biofilm (pH 5.0). Schiff bases can release drugs in slightly acidic environment. The hydrogel showed injectable, pH-sensitive drug release, and great biocompatibility. Released SD and TOB exhibited a synergistic effect therefore the hydrogel showed high antibacterial activity. This study provides an easy and promising strategy to develop smart hydrogels that aim at topical administration of antibiotics and come up with a new treatment of local bacterial infections.
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22
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Nanotechnology Development for Formulating Essential Oils in Wound Dressing Materials to Promote the Wound-Healing Process: A Review. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11041713] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Wound healing refers to the replacement of damaged tissue through strongly coordinated cellular events. The patient’s condition and different types of wounds complicate the already intricate healing process. Conventional wound dressing materials seem to be insufficient to facilitate and support this mechanism. Nanotechnology could provide the physicochemical properties and specific biological responses needed to promote the healing process. For nanoparticulate dressing design, growing interest has focused on natural biopolymers due to their biocompatibility and good adaptability to technological needs. Polysaccharides are the most common natural biopolymers used for wound-healing materials. In particular, alginate and chitosan polymers exhibit intrinsic antibacterial and anti-inflammatory effects, useful for guaranteeing efficient treatment. Recent studies highlight that several natural plant-derived molecules can influence healing stages. In particular, essential oils show excellent antibacterial, antifungal, antioxidant, and anti-inflammatory properties that can be amplified by combining them with nanotechnological strategies. This review summarizes recent studies concerning essential oils as active secondary compounds in polysaccharide-based wound dressings.
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Storey K, Kimble RM, Holbert MD. The Management of Burn Pain in a Pediatric Burns-Specialist Hospital. Paediatr Drugs 2021; 23:1-10. [PMID: 33447938 DOI: 10.1007/s40272-020-00434-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/10/2020] [Indexed: 10/22/2022]
Abstract
Appropriate pain management for children who have experienced an acute burn injury is critical to improve patient outcomes and reduce potential morbidities. With 60% of our patients being under the age of 4 years, pain management is crucial in reducing pain and anxiety in both patients and parents. It is imperative that appropriate pain relief is commenced from initial contact with healthcare workers as this will affect the success or failure of future wound procedures. Uncontrolled pain can negatively affect a patient, both short and long term. It may cause anticipatory anxiety for future medical procedures, increased pain and anxiety can decrease wound re-epithelialization which can lead to long-term consequences for growth and mobility, and increased pain can also influence the possibility of patients and families displaying signs of post-traumatic stress disorder. Pain management in the form of pharmaceuticals is imperative during burn wound treatment and should incorporate pain relief targeted at both background and procedural pain. It also requires a multimodal, individualized, and targeted approach combining both pharmaceutical and nonpharmaceutical techniques, including cold running water, multimodal distraction devices, hypnotherapy, and bubbles. We discuss the research and knowledge that our center has gained through treating pediatric patients with burns over the last 20 years.
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Affiliation(s)
- Kristen Storey
- Centre for Children's Burns and Trauma Research, Centre for Children's Health Research, South Brisbane, QLD, Australia. .,Pegg Leditschke Paediatric Burns Centre, The Queensland Children's Hospital, South Brisbane, QLD, Australia. .,Queensland University of Technology, Brisbane, QLD, Australia. .,Children's Health Queensland Hospital and Health Service, Queensland Children's Hospital, 501 Stanley Street, South Brisbane, QLD, 4101, Australia.
| | - Roy M Kimble
- Centre for Children's Burns and Trauma Research, Centre for Children's Health Research, South Brisbane, QLD, Australia.,Pegg Leditschke Paediatric Burns Centre, The Queensland Children's Hospital, South Brisbane, QLD, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Queensland University of Technology, Brisbane, QLD, Australia
| | - Maleea D Holbert
- Centre for Children's Burns and Trauma Research, Centre for Children's Health Research, South Brisbane, QLD, Australia.,Pegg Leditschke Paediatric Burns Centre, The Queensland Children's Hospital, South Brisbane, QLD, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
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24
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Management of Thermal Injuries in Donkeys: A Case Report. Animals (Basel) 2020; 10:ani10112131. [PMID: 33212805 PMCID: PMC7696336 DOI: 10.3390/ani10112131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 11/07/2020] [Accepted: 11/10/2020] [Indexed: 11/18/2022] Open
Abstract
Simple Summary Reports or descriptions of medical management of thermal injuries in donkeys is lacking. Four donkeys sustained burn injuries during the wildland–urban interface fire in Valparaiso, Chile, in 2014. The donkeys received first aid care at the scene of the fire, and then were hospitalized and treated for three months for thermal injuries, of various degrees of severity, in several body parts. The clinical findings and treatment of four of the donkeys are described in this paper. All donkeys recovered and were retired to an animal shelter. Abstract Burn injuries are uncommon in large animals and there are no reports of these injuries in donkeys. Burns cause local and systemic effects. Extensive thermal injuries can be challenging to manage and the extent of the burn surface affected will directly impact the severity of the illness and the prognosis. Burns are classified according to the depth of injury into four categories, from first-degree burns, and the least affect to fourth-degree burns, which are the more severely affected patients. This case report describes the medical management of four donkeys that sustained various degrees of external burn injuries during the wildland–urban interface fire in Valparaiso, Chile. The donkeys were treated topically for several weeks and closely monitor for inadequate nutritional intake. Water based topical medications are preferred in burn cases because they can be easily applied and removed without interfering with wound healing. Of note, the caloric demands of these cases can be achieved by increasing the amount of grain, adding fat (i.e., vegetable oil), and free-choice alfalfa hay. All donkeys recovered and were retired to an animal shelter.
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25
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Frear CC, Griffin B, Kimble R. Adequacy of cool running water first aid by healthcare professionals in the treatment of paediatric burns: A cross-sectional study of 4537 children. Emerg Med Australas 2020; 33:615-622. [PMID: 33191592 PMCID: PMC9292905 DOI: 10.1111/1742-6723.13686] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 10/23/2020] [Accepted: 10/28/2020] [Indexed: 11/27/2022]
Abstract
Objective To determine the adequacy of cool running water first aid provided by healthcare professionals in the early management of children with thermal burn injuries. Methods A cross‐sectional study was undertaken using a prospectively collected registry of children who presented with a thermal burn to the only major paediatric burns centre in Queensland, Australia, from January 2013 to December 2018. Main outcome measures included the type and duration of first aid administered by paramedics, general practitioners and emergency providers at local general hospitals and a children's hospital. In accordance with current Australian guidelines, adequate cooling was defined as 20 min of cool running water within 3 h of the injury. Results Of the 4537 children who presented to the paediatric burns centre, 3261 (71.9%) received adequate first aid, including 1502 (33.1%) at the scene of injury. Paramedics and general practitioners administered adequate cooling to 184 (25.0%) and 52 (24.2%) of their patients, respectively. ED clinicians adhered to guidelines in the treatment of 1019 (56.3%) children at general hospitals and 411 (76.0%) at the children's hospital. Among ED patients who presented with incomplete prior first aid, the risk of inadequate cooling was significantly greater for those transported via ambulance (P < 0.001). Conclusion Deficiencies remain in the cooling of paediatric burns patients at all levels of initial management. There is a need in the healthcare community for improved education regarding the parameters and clinical benefits of cool running water first aid.
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Affiliation(s)
- Cody C Frear
- Centre for Children's Burns and Trauma Research, Centre for Children's Health Research, Brisbane, Queensland, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Bronwyn Griffin
- Centre for Children's Burns and Trauma Research, Centre for Children's Health Research, Brisbane, Queensland, Australia.,School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Roy Kimble
- Centre for Children's Burns and Trauma Research, Centre for Children's Health Research, Brisbane, Queensland, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia.,Department of Paediatric Surgery, Urology, Burns and Trauma, Queensland Children's Hospital, Brisbane, Queensland, Australia
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26
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Mortada H, Malatani N, Aljaaly H. Knowledge & awareness of burn first aid among health-care workers in Saudi Arabia: Are health-care workers in need for an effective educational program? J Family Med Prim Care 2020; 9:4259-4264. [PMID: 33110842 PMCID: PMC7586629 DOI: 10.4103/jfmpc.jfmpc_811_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 06/14/2020] [Accepted: 07/03/2020] [Indexed: 11/10/2022] Open
Abstract
Objective: The objective of this study was to assess the level of awareness and knowledge of first aid for burns among healthcare workers in Saudi Arabia. Methods: We conducted a cross-sectional study between September 2 and December 5, 2019, via a self-administered online questionnaire among healthcare workers at a university hospital. The questionnaire comprised 24 questions divided into two sections pertaining to demographics and first aid for burns. This study was approved by the Research Ethics Committee. Results: We included 1,438 respondents in this study. Females comprised 68.2% (982) of the respondents. A total of 513 respondents (35.7%) were medical students. The mean burn knowledge score of all respondents was 8.07 ± 2.03 out of 13. Interestingly, 940 individuals (65.4%) used traditional medications on the burn area. Knowledge regarding antibiotic use in burn injuries was poor—1,199 (82.3%) study participants agreed that antibiotics are beneficial in the case of burns, which is a wrong act. The mean knowledge score was significantly different across groups of different ages, sexes, nationalities, marital statuses, and job positions (P < 0.001). Conclusion: The level of awareness of first aid for burn patients among healthcare workers was insufficient, and the unnecessary use of traditional medicines and antibiotics in burn patients being high. Moreover, this study confirmed the need for an effective educational program among healthcare workers.
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Affiliation(s)
- Hatan Mortada
- Department of Plastic Surgery and Burn Unit, King Saud Medical City, Riyadh, Saudi Arabia
| | - Nader Malatani
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hattan Aljaaly
- Division of Plastic and Reconstructive Surgery, Department of Surgery, King Abdulaziz University, Jeddah, Saudi Arabia
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Kilshaw AD, Jivan S. Smartphone apps on burns first aid: A review of the advice. Burns 2020; 47:171-174. [PMID: 33279340 DOI: 10.1016/j.burns.2020.04.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 03/16/2020] [Accepted: 04/11/2020] [Indexed: 11/18/2022]
Abstract
AIMS Many websites giving first aid advice are disappointingly inaccurate and at times dangerous in regard to burn injuries. With more patients relying on their smart phones to obtain online information the aim of this study was to compare first aid applications (apps) burn advice against those guidelines set by the British Burns Association (BBA). METHOD A content analysis of all freely available English written first aid apps from Google Play and the Apple Store was performed. The information was compared against BBA guidance which was split into 12 domains and scored appropriately. RESULTS 61 of the 103 first aid apps included in the study, had information on the treatment of burn injuries. The mean score for all apps was 3.3 out of 12. 85% of apps postulated the need to cool the burn. However, only 11% of apps stipulated the need for 20min of cooling, while 3% suggested the burn can be cooled up to 3h post injury. Disappointingly even apps produced by reputable first aid charities scored poorly. CONCLUSION Burns first aid is documented as being poorly given in the community. With easy access to the internet and specifically smart device apps, more needs to be done to improve burn first aid information online.
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Affiliation(s)
- Andrew David Kilshaw
- Department of Burns, Plastic and Reconstructive Surgery, Pinderfields General Hospital, Aberford Road, Wakefield WF14DG, UK.
| | - Sharmila Jivan
- Department of Burns, Plastic and Reconstructive Surgery, Pinderfields General Hospital, Aberford Road, Wakefield WF14DG, UK
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Outwater AH, Van Braekel T. Prehospital care of burn injuries in Africa: A review, 1990-2018. Burns 2019; 46:1737-1745. [PMID: 31785926 DOI: 10.1016/j.burns.2019.08.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 07/21/2019] [Accepted: 08/14/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Administration of appropriate first aid immediately after a burn injury is crucial to averting further harm to the victim, physically and psychologically. The aim of this review is to enable the design of better interventions by describing what is known about prehospital care of burn victims in Africa. RESULTS This review is based on 17 articles from 5 countries. For the purposes of the review, first responders are defined as those nearest the victim when a burn occurs. First responders include nonclinicians, most typically the mother of a young burn victim. Forty-five different substances, sometimes used in combination, are reported to have been applied to burn injuries: water, 15 food items (especially oils and egg), 14 pharmaceutical products, 9 traditional treatments, 5 minerals (petroleum products being the most common), and charcoal. Appropriate treatment, defined as the application of cool water for 10 min, was achieved about 0.5% of the time, most frequently in Cape Town, South Africa. Most victims do not have their wounds covered while they are transported to a health-care facility. Treatment delays are common. Pain management is hardly addressed. CONCLUSIONS Appropriate prehospital care for burn injury generally is not practiced in Africa. Yet best practices for prehospital care are affordable, available, and easily understood. The greatest risk factor for poor care is first responders' lack of knowledge. Awareness and education campaigns focusing on the lay public, as well as educational institutions for health workers, are urgently needed throughout the continent.
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Affiliation(s)
- Anne H Outwater
- Muhimbili University of Health and Allied Sciences, School of Nursing, PO Box 105211, Dar es Salaam, Tanzania.
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First aid management of paediatric burn and scald injuries in Southern Malawi: A mixed methods study. Burns 2019; 46:727-736. [PMID: 31732221 DOI: 10.1016/j.burns.2019.08.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 08/06/2019] [Accepted: 08/29/2019] [Indexed: 11/23/2022]
Abstract
BACKGROUND In sub-Saharan Africa, burn and scald injuries occur more commonly in children aged less than five years, than in any other age group, and carry a high lifetime morbidity. The optimal first aid at the time of injury includes the use of cool running water, which can reduce pain, scarring, and skin grafting. Data on the types of first aid used in Malawi is lacking, as is an in-depth understanding of the underlying factors which may influence this health behaviour. This study sought to: (a) document the types of first aid after paediatric burn and scald injuries in Southern Malawi; and (b) explore factors affecting the choice of first aid used. METHODS ANDFINDINGS We conducted a sequential explanatory mixed methods study. Quantitative analysis of a prospectively collected database of all patients aged less than 17 years admitted to the only burn unit in Southern Malawi was followed by thematic analysis of semi-structured interviews with 15 adults who had witnessed a paediatric burn or scald injury. 1326 patients aged less than 17 years were admitted to the Queen Elizabeth Central Hospital between July 2009 and December 2016. Median age was 3.0 years (IQR 1.9-5.0) and male to female ratio 1:0.9. The commonest cause of injury was hot liquid (45%), followed by open fire (31%) and porridge (12%). First aid was applied in 829 patients (69%), the commonest applications used were water (31%) and egg (21%). There was a statistically significant association between the type of first aid and secondary education of the father (p = 0.009) or mother (p = 0.036); however, the type of first aid used was more likely to be egg rather than water. Analysis of qualitative interviews identified four main themes: perceived roles and responsibilities within the community, drivers of individual behaviours, availability, and trust. Participants reported using eggs as a first aid treatment, as these were readily available and were seen to reduce the occurrence of blisters and prevent peeling of the skin. By comparison, there was a strong underlying fear of using water on burn injuries due to its association with peeling of the skin. Intergenerational learning appeared to play a strong role in influencing what is used at the time of injury, and mothers were the key source of this information. CONCLUSIONS This study provides the largest description of first aid use in sub-Saharan Africa, strengthening the evidence that remedies aside from water are commonly used and that higher parental education levels do not translate to increased use of water, but rather use of alternative treatments. Our qualitative findings allow improved understanding of how first aid for paediatric burns is perceived in rural Malawi communities, providing insight as to why certain first aid choices are made and the possible barriers and facilitators to the adoption of water as a first aid treatment.
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First aid is associated with improved outcomes in large body surface area burns. Burns 2019; 45:1743-1748. [PMID: 31606315 DOI: 10.1016/j.burns.2019.05.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 05/02/2019] [Accepted: 05/15/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Animal studies indicate treating burn injuries with running water (first aid) for 20 min up to 3 h after burn reduces healing time and scarring. We have previously demonstrated the benefits of first aid in minor burn injuries with respect to a reduction in wound depth, faster healing, and decreased skin grafting utilisation. The purpose of this cohort study was to assess the effect of first aid on clinical outcomes in large body surface area burn injuries (≥20%). METHODS Data was prospectively collected for patients with ≥20% TBSA burns from 2004- 2018. Multivariate regression analysis was used to determine the association of adequate first aid with 8 outcomes - mortality, total length of stay, total body surface area (TBSA), percentage/proportion of TBSA that was full thickness [PFTI], TBSA grafted, number of re-grafting sessions, intensive care admission, and intensive care length of stay. Adequate first aid was defined as the application of 20 min of cool, running tap water up to 3 h following the burn injury. FINDINGS 390 patients were identified. Adequate first aid was received in 35.6% (139) of patients. There was a trend towards a reduction in mortality (OR 0.37; 95% CI 0.12-1.13; P = 0.08). Patients who received adequate first aid had a statistically significant 9.8% reduction in TBSA (95% CI -13.6% to -6.1%; P < 0.0001) as well as a 12% lower PTFI compared to patients who received inadequate first aid (95% CI -19% to -4%; P < 0.01). Whilst there was no significant effect of adequate first aid on the TBSA grafted (P = 0.37), adequate first aid was associated with a significantly less number of re-grafting sessions (95% CI --0.29 to -0.08; P < 0.001). INTERPRETATION Adequate first aid with 20 min of running water is associated with improved outcomes in large burn injuries. Significant benefits are seen in a reduction in TBSA, proportion of the burn wound that is full thickness, as well as decreased re-grafting. This has significant patient and health system benefits and adds to the body of evidence supporting 20 min of cooling in burns care.
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Qing Y, Yongqiang X, Xiaoming F, Tuo S, Xiaona X, Yiheng H, Pengfei L, Xiaoyan H, Zhaofan X. First-aid knowledge regarding small area burns in children among 5814 caregivers: A questionnaire analysis. Burns 2019; 46:459-464. [PMID: 31481271 DOI: 10.1016/j.burns.2019.08.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 07/07/2019] [Accepted: 08/13/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND To assess caregivers'knowledge of first aid for small-area thermal burns in children, and reduce burns-induced morbidity and damage in children. METHODS The multi-stage cluster random sampling method was used to recruit school-age children from different kinds of schools. For each child, we selected only one caregiver as our study participant. First-aid knowledge regarding small area burns in children and choices of medical treatment were investigated in the manner of questionnaires. RESULTS The effective response rate of questionnaire was 99.4% (5814/5850). Folk remedies and daily necessities were chosen by 17.8% (1,036/5814) and 48.9% (2841/5814), respectively. 39.8% (2,312/5814) of caregivers knew all standard burn first aid measures. Moreover, the proportion of knowing all five measures among caregivers with undergraduate education was significantly higher than the figures among those with other educational levels. CONCLUSIONS Child caregivers had poor knowledge of first aid for small area burns in children. Only a few caregivers knew all five standard first aid measures for managing small area burns. Many non-scientific and inappropriate home remedies are still widely applied among Shanghai citizens. Our study results suggest relevant scientific evidence-informed measures should be more widely disseminated to the citizens.
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Affiliation(s)
- Yu Qing
- Department of Burn Surgery, Changhai Hospital, The Navy Military Medical University, Shanghai, 200433, China
| | - Xiao Yongqiang
- Department of Burn Surgery, Changhai Hospital, The Navy Military Medical University, Shanghai, 200433, China
| | - Fan Xiaoming
- Department of Burn Surgery, Changhai Hospital, The Navy Military Medical University, Shanghai, 200433, China
| | - Shen Tuo
- Department of Burn Surgery, Changhai Hospital, The Navy Military Medical University, Shanghai, 200433, China
| | - Xu Xiaona
- Department of Burn Surgery, Changhai Hospital, The Navy Military Medical University, Shanghai, 200433, China
| | - Huang Yiheng
- College of Pharmacy, Fudan University, Shanghai, China
| | - Luo Pengfei
- Department of Burn Surgery, Changhai Hospital, The Navy Military Medical University, Shanghai, 200433, China.
| | - Hu Xiaoyan
- Department of Burn Surgery, Changhai Hospital, The Navy Military Medical University, Shanghai, 200433, China.
| | - Xia Zhaofan
- Department of Burn Surgery, Changhai Hospital, The Navy Military Medical University, Shanghai, 200433, China.
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Griffin BR, Frear CC, Babl F, Oakley E, Kimble RM. Cool Running Water First Aid Decreases Skin Grafting Requirements in Pediatric Burns: A Cohort Study of Two Thousand Four Hundred Ninety-five Children. Ann Emerg Med 2019; 75:75-85. [PMID: 31474480 DOI: 10.1016/j.annemergmed.2019.06.028] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 06/11/2019] [Accepted: 06/27/2019] [Indexed: 10/26/2022]
Abstract
STUDY OBJECTIVE First-aid guidelines recommend the administration of cool running water in the early management of thermal injury. Our objective is to analyze the associations between first aid and skin-grafting requirements in children with burns. METHODS This cohort study used a prospectively collected registry of patients managed at a tertiary children's hospital. Multivariate logistic regression models were used to evaluate the relationship between first aid and the requirement for skin grafting. Secondary outcomes included time to re-epithelialization, wound depth, hospital admission and length of stay, and operating room interventions. Adequate first aid was defined as 20 minutes of cool running water within 3 hours of injury. RESULTS In our cohort of 2,495 children, 2,259 (90.6%) received first aid involving running water, but only 1,780 (71.3%) were given the adequate duration. A total of 236 children (9.5%) required grafting. The odds of grafting were decreased in the adequate first aid group (odds ratio [OR] 0.6; 95% confidence interval [CI] 0.4 to 0.8). The provision of adequate running water was further associated with reductions in full-thickness depth (OR 0.4; 95% CI 0.2 to 0.6), hospital admission (OR 0.7; 95% CI 0.3 to 0.9), and operating room interventions (OR 0.7; 95% CI 0.5 to 0.9), but not hospital length of stay (hazard ratio=0.9; 95% CI 0.7 to 1.2; P=.48). CONCLUSION Burn severity and clinical outcomes improved with the administration of cool running water. Adequate first aid must be prioritized by out-of-hospital and emergency medical services in the preliminary management of pediatric burns.
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Affiliation(s)
- Bronwyn R Griffin
- Queensland University of Technology Faculty of Health, Centre for Children's Burns and Trauma Research, South Brisbane, Queensland, Australia.
| | - Cody C Frear
- Queensland University of Technology Faculty of Health, Centre for Children's Burns and Trauma Research, South Brisbane, Queensland, Australia.
| | - Franz Babl
- Murdoch Children's Research Institute, Royal Children's Hospital, and Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Ed Oakley
- Murdoch Children's Research Institute, Royal Children's Hospital, and Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Roy M Kimble
- Queensland University of Technology Faculty of Health, Centre for Children's Burns and Trauma Research, South Brisbane, Queensland, Australia
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Guptarak M, Conway J, Stone TE, Fongkaew W, Settheekul S, Baxter E. Health Beliefs of Nurses in Northern Thailand: A Q-Methodology Study. J Transcult Nurs 2019; 31:350-359. [PMID: 31382839 DOI: 10.1177/1043659619865589] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Introduction: Northern Thailand has a distinct culture and set of health beliefs. Nurses' beliefs influence approaches to care affecting health care outcomes. This study explored the content, origin, and sociocultural influences on health beliefs of Northern Thai nurses and how they influence clinical practice and education. Method: Q-methodology was used in this study. Data were collected with interviews using Q-cards, Q-sort distribution board, and a semistructured interview guide. Results: Data were collected from 30 clinical nurses and 30 nurses working in academia. Q-factor analysis produced three factors accounting for 48% of variance: personal experience, Thai and Buddhist beliefs, and contemporary beliefs. Discussion: Participants who felt strongly rooted in their culture and beliefs were homogeneous in recognizing the need for evidence-based practice. Nurses aware of the nature and sources of their beliefs and those of patients are well-placed to balance maintenance of cultural traditions with the need to provide evidence-based practice.
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Affiliation(s)
- Marisa Guptarak
- Chiang Mai University Faculty of Nursing, Chiang Mai, Thailand
| | - Jane Conway
- University of New England, Armidale, New South Wales, Australia
| | | | | | | | - Emily Baxter
- University of New England, Armidale, New South Wales, Australia
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AlQahtani FA, Alanazi MA, Alanazi MK, Alshalhoub KS, Alfarhood AA, Ahmed SM. Knowledge and practices related to burn first aid among Majmaah community, Saudi Arabia. J Family Med Prim Care 2019; 8:594-598. [PMID: 30984679 PMCID: PMC6436272 DOI: 10.4103/jfmpc.jfmpc_382_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background: Burns in developing countries account for significant morbidity and mortality which have been shown by increasing burn first aid awareness. In general, flames, scalds, and contact burns are the most common causes, but in children scalds are the most common. Objectives: This study aims to assess the general knowledge and practices related to burn first aid among Majmaah community. Methods: This study is a cross-sectional study. Data were collected in 2018 using convenience sampling technique. Saudi men and women age 18 years and older living in Majmaah were included in the study. Data were collected from 390 males and females. The sample size was collected using precision formula. Data were encoded into Microsoft Excel worksheets and imported to Statistical Package for the Social Sciences (SPSS®) software for analysis. Results: A total of 390 individuals responded to the survey. Regarding the demographic data of the study participants, 49.2% were between 30 and 49 years old. Most of them were females (71.8%). Regarding burn first aid knowledge, 82.6% of the study participants knew that the first thing is to stop, drop, and roll when your clothes catch fire, 43.8% knew to apply cold water if hot oil spills on the hands, 41.0% knew that all burn injuries must be treated at hospital, whereas most of them 78.5% knew never to apply raw eggs or herbs to burn wounds. Conclusion: The knowledge of Majmaah community toward first aid is found to be low in spite of most of the respondents having a positive attitude toward first aid. The majority of the study participants (73.8%) were well-educated and had a bachelor's degree.
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Affiliation(s)
- Fahad Ali AlQahtani
- College of Medicine, Majmaah University, Al Majma'ah, Kingdom of Saudi Arabia
| | | | | | | | | | - Syed Meraj Ahmed
- Associate Professor, Department of Community Medicine and Epidemiology, College of Medicine, Majmaah University, Al Majma'ah, Kingdom of Saudi Arabia
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Bennett CV, Hollén L, Quinn-Scoggins HD, Emond A, Kemp AM. Feasibility of Safe-Tea: a parent-targeted intervention to prevent hot drink scalds in preschool children. Inj Prev 2019; 26:31-41. [PMID: 30765457 DOI: 10.1136/injuryprev-2018-042921] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 12/14/2018] [Accepted: 12/16/2018] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Despite the high prevalence of preventable hot drink scalds in preschool children, there is a paucity of research on effective prevention interventions and a serious need to improve parents' knowledge of first aid. This study investigates the feasibility of 'Safe-Tea', an innovative multifaceted community-based intervention delivered by early-years practitioners. METHODS 'Safe-Tea' was implemented at Childcare, Stay&Play and Home Visit settings in areas of deprivation in Cardiff, UK. A mixed-methods approach was used, including preintervention and postintervention parent questionnaires and focus groups with parents and practitioners to test the acceptability, practicality and ability of staff to deliver the intervention, and parents' knowledge and understanding. RESULTS Intervention materials, activities and messages were well received and understood by both parents and community practitioners. Interactive and visual methods of communication requiring little to no reading were most acceptable. Parents' understanding of the risk of hot drink scalds in preschool children and knowledge of appropriate first aid improved postintervention. Parents knew at baseline that they 'should' keep hot drinks out of reach. Focus group discussions after intervention revealed improved understanding of likelihood and severity of scald injury to children, which increased vigilance. Parents gained confidence to correct the behaviours of others at home and pass on first aid messages. CONCLUSION This feasibility study is a vital step towards the development of a robust, evidence-based behaviour change intervention model. Work is underway to refine intervention materials based on improvements suggested by parents, and test these more widely in communities across the UK.
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Affiliation(s)
- C Verity Bennett
- Division of Population Medicine, Cardiff University, Cardiff, UK
| | - Linda Hollén
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Alan Emond
- Centre for Academic Child Health, Bristol Medical School, University of Bristol, Bristol, UK
| | - Alison Mary Kemp
- Division of Population Medicine, Cardiff University, Cardiff, UK
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Brink C, Isaacs Q, Scriba MF, Nathire MEH, Rode H, Martinez R. Infant burns: A single institution retrospective review. Burns 2019; 45:1518-1527. [PMID: 30638666 DOI: 10.1016/j.burns.2018.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 10/10/2018] [Accepted: 11/08/2018] [Indexed: 12/15/2022]
Abstract
Thermal injuries amongst infants are common and a cause of significant mortality and morbidity in South Africa. This has been attributed to the lack of an enabling environment (poverty-related lack of safe living conditions) and the cognitive and physical developmental immaturity of infants, who depend on their surroundings and adults to keep them safe. This is a retrospective observational study of 548 infant admissions over 48 months. Infant was defined as children below 13 months of age. The 548 infants constituted 23% of all paediatric burn admissions of ages 0-12 years. Three hundred and fourteen were males (57%) and 234 (42.7%) females. The infants were divided in a pre-ambulatory group of 143 (26%) infants of 0-6 months and an ambulatory group of 7 months to 12 months consisting of 457 (83.3%). The total body surface area (TBSA) ranged from 2-65%. Seventy-six percent (417 infants) occurred in the home environment. Scalds accounted for 86% (471 infants) and 6% (33 infants) were as a result of flame burns. Non-accidental injuries accounted for 1.2%. The anatomical distributions varied between the pre-ambulatory and ambulatory groups. Conservative management was done in 397 (72.4%) and 101(18.4%) infants underwent surgery. Infection was suspected in 76 (13.5%) infants with positive blood cultures in 15(20%) of the 76. ICU care was received in 46 (8.3%) infants and 15 (32.6%) of these had inhalation injuries. Of the inhalation injuries 11(23.9%) infants underwent mechanical ventilation of an average of 4.4 days. Ventilator associated pneumonia was diagnosed in 8(17%) of the ventilated children. The mortality rate was 0.36%. The surgically treated patients acquired more complications than the conservatively treated group. Special treatment considerations should be considered in this paediatric sub-group.
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Affiliation(s)
- C Brink
- Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital and Faculty of Health Sciences, University of Cape Town, South Africa
| | - Q Isaacs
- Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital and Faculty of Health Sciences, University of Cape Town, South Africa
| | - M F Scriba
- Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital and Faculty of Health Sciences, University of Cape Town, South Africa
| | - M E H Nathire
- Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital and Faculty of Health Sciences, University of Cape Town, South Africa
| | - H Rode
- Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital and Faculty of Health Sciences, University of Cape Town, South Africa.
| | - R Martinez
- Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital and Faculty of Health Sciences, University of Cape Town, South Africa
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Holbert MD, Griffin BR, McPhail SM, Ware RS, Foster K, Bertoni DC, Kimble RM. Effectiveness of a hydrogel dressing as an analgesic adjunct to first aid for the treatment of acute paediatric thermal burn injuries: study protocol for a randomised controlled trial. Trials 2019; 20:13. [PMID: 30612585 PMCID: PMC6322255 DOI: 10.1186/s13063-018-3057-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 11/16/2018] [Indexed: 01/13/2023] Open
Abstract
Background Burns are a painful and traumatic experience, particularly in children. Reduced pain and anxiety positively influences re-epithelialisation rates in paediatric burn patients, however current literature fails to fully explain the effects of pain and anxiety and their links with wound healing. This study will determine if Burnaid® hydrogel dressing is an effective treatment for reducing pain in the acute period of a burn injury. It is hypothesised that a reduction in pain will then improve re-epithelialisation time in comparison to plastic wrap, which is standard practice at our institution — a metropolitan tertiary paediatric hospital located in Brisbane, Australia. Methods/design A randomised controlled trial will be conducted to assess the effectiveness of Burnaid® as an analgesic adjunct to cold running water first aid for the treatment of paediatric burns. Participants will include children aged between 0 and 16 years with an acute thermal burn injury (total burn surface area < 20%) presenting to the Department of Emergency within 24 h of the burn occurring. Participants will be randomised into one of two groups: (1) Burnaid® hydrogel (intervention arm) or (2) plastic wrap (control arm). Participants will also be stratified into one of two groups based on factors that influence pain intensity: (1) high pain risk or (2) low pain risk. High pain risk factors include foot burns, hot coal/ash/fire pit burns, burn area greater than 5%, and circumferential burns. The primary outcome is the intervention’s effect on reducing acute pain. Secondary outcomes include days to re-epithelialisation, pulse rate, temperature, salivary cortisol and α-amylase, anxiety, and cost-effectiveness. Sample size calculations have shown that 36 participants will be recruited into each group. Discussion This study will provide comprehensive data on the analgesic properties of Burnaid® as an adjunct to first aid for the treatment of acute paediatric thermal burns. If the intervention is effective in reducing pain, Burnaid® will be integrated as standard practice within the hospital’s Department of Emergency. This study replicates a real-world scenario in order to identify clinically significant analgesic and wound-healing effects. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12617001274369. Prospectively registered on 5 Sept 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-3057-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maleea D Holbert
- Centre for Children's Burns and Trauma Research, The University of Queensland, Brisbane, Australia. .,Pegg Leditschke Paediatric Burns Centre, Lady Cilento Children's Hospital, South Brisbane, Australia.
| | - Bronwyn R Griffin
- Centre for Children's Burns and Trauma Research, The University of Queensland, Brisbane, Australia.,Pegg Leditschke Paediatric Burns Centre, Lady Cilento Children's Hospital, South Brisbane, Australia.,School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - Steven M McPhail
- Centre for Functioning and Health Research, Metro South Health, Buranda, Australia.,School of Public Health & Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Kelly Foster
- Paediatric Emergency Research Unit, Children's Health Queensland, South Brisbane, Australia
| | - Demi C Bertoni
- Pegg Leditschke Paediatric Burns Centre, Lady Cilento Children's Hospital, South Brisbane, Australia
| | - Roy M Kimble
- Centre for Children's Burns and Trauma Research, The University of Queensland, Brisbane, Australia.,Pegg Leditschke Paediatric Burns Centre, Lady Cilento Children's Hospital, South Brisbane, Australia
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Topical treatment with a transient receptor potential ankyrin 1 (TRPA1) antagonist reduced nociception and inflammation in a thermal lesion model in rats. Eur J Pharm Sci 2018; 125:28-38. [DOI: 10.1016/j.ejps.2018.09.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 08/29/2018] [Accepted: 09/15/2018] [Indexed: 02/06/2023]
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Harish V, Tiwari N, Fisher OM, Li Z, Maitz PKM. First aid improves clinical outcomes in burn injuries: Evidence from a cohort study of 4918 patients. Burns 2018; 45:433-439. [PMID: 30337155 DOI: 10.1016/j.burns.2018.09.024] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 08/23/2018] [Accepted: 09/13/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Animal studies indicate treating burn injuries with running water (first aid) for 20min up to 3h post-burn reduces healing time and scarring. There is a lack of human data to support such a recommendation. The purpose of this cohort study was to assess the effect of first aid on clinical outcomes. METHODS Data was prospectively collected for patients with <10% total body surface area (TBSA) burns from 2007-2012. Multivariate regression analysis was used to determine the association of adequate first aid with four outcomes - wound depth, requirement for skin grafting, healing time (in non-grafted patients), and TBSA not grafted (in grafted patients). Adequate first aid was defined as the application of 20min of cool, running tap water up to 3h following the burn injury. FINDINGS 4918 patients were identified. Adequate first aid was received in 58.1% (2859) of patients. It was associated with a statistically significant reduction in burn wound depth (OR 1.39; 95% CI 1.24-1.55; P<0.001) but was not associated with a reduction in TBSA (P=0.86) or requirement for grafting (P=0.47). In patients not requiring grafting, those who received adequate first aid were healed on average 10% (HR 1.10; 95% CI 1.03-1.18; P<0.01) or 1.9 days faster (95% CI -2.9 to -0.9; P<0.001). Adequate first aid in patients requiring grafting was associated with a 15% increase in TBSA that was not grafted (0.27%; 95% CI 0.01-0.52; P=0.04). INTERPRETATION Adequate first aid with 20min of running water is associated with improved outcomes. Benefits are seen in a reduction in wound depth, faster healing, and decreased grafting requirements. This has significant patient and health system benefits, and calls for promotion of 20min of running water globally in burns care.
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Affiliation(s)
- Varun Harish
- Burns Unit, Concord Repatriation General Hospital, Sydney, Australia; ANZAC Research Institute, Concord Repatriation General Hospital, Sydney, Australia.
| | - Neha Tiwari
- Burns Unit, Concord Repatriation General Hospital, Sydney, Australia
| | - Oliver M Fisher
- Department of Surgery, St George Hospital, Sydney, Australia; Department of Surgery, University of Notre Dame School of Medicine, Australia
| | - Zhe Li
- Burns Unit, Concord Repatriation General Hospital, Sydney, Australia; ANZAC Research Institute, Concord Repatriation General Hospital, Sydney, Australia; University of Sydney, Sydney, Australia
| | - Peter K M Maitz
- Burns Unit, Concord Repatriation General Hospital, Sydney, Australia; ANZAC Research Institute, Concord Repatriation General Hospital, Sydney, Australia; University of Sydney, Sydney, Australia
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Bennett CV, Maguire S, Nuttall D, Lindberg DM, Moulton S, Bajaj L, Kemp AM, Mullen S. First aid for children's burns in the US and UK: An urgent call to establish and promote international standards. Burns 2018; 45:440-449. [PMID: 30266196 DOI: 10.1016/j.burns.2018.09.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 09/05/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Appropriate first aid can reduce the morbidity of burns, however, there are considerable variations between international first aid recommendations. We aim to identify, and compare first aid practices in children who present to Emergency Departments (ED) with a burn. METHODS A prospective cross-sectional study of 500 children (0-16 completed years) presenting with a burn to a paediatric ED in the UK (Cardiff) and the USA (Denver, Colorado), during 2015-2017. The proportion of children who had received some form of first aid and the quality of first aid were compared between cities. RESULTS Children attending hospital with a burn in Cardiff were 1.47 times more likely (RR 1.47; CI 1.36, 1.58), to have had some form of first aid than those in Denver. Denver patients were 4.7 time more likely to use a dressing and twice as likely to apply ointment/gel/aloe vera than the Cardiff cohort. First aid consistent with local recommendations was only administered to 26% (128/500) of children in Cardiff and 6% (31/500) in Denver. Potentially harmful first aid e.g. application of food, oil, toothpaste, shampoo or ice was applied to 5% of children in Cardiff and 10% in Denver. CONCLUSION A low number of children received optimal burns first aid, with potentially harmful methods applied in a considerable proportion of cases. There is an urgent need for internationally agreed, evidence-based burn first aid recommendations.
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Affiliation(s)
- C Verity Bennett
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, CF14 4YS, United Kingdom.
| | - Sabine Maguire
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, CF14 4YS, United Kingdom
| | - Diane Nuttall
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, CF14 4YS, United Kingdom
| | - Daniel M Lindberg
- Department of Emergency Medicine, Children's Hospital Colorado, United States
| | - Steven Moulton
- Division of Paediatric Surgery, Children's Hospital Colorado, United States; Department of Surgery, University of Colorado School of Medicine, United States
| | - Lalit Bajaj
- Department of Emergency Medicine, Children's Hospital Colorado, United States
| | - Alison M Kemp
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, CF14 4YS, United Kingdom
| | - Stephen Mullen
- Division of Population Medicine, School of Medicine, Cardiff University, Cardiff, CF14 4YS, United Kingdom; Paediatric Emergency Department, Royal Belfast Hospital for Sick Children, Falls Road, Belfast, BT12 6BA, United Kingdom
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Burn first aid knowledge and its determinants among general population of Rawalpindi. Eur J Trauma Emerg Surg 2018; 45:1121-1128. [PMID: 30167739 DOI: 10.1007/s00068-018-0996-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 08/20/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To assess the general knowledge and practices related to burn first aid treatment (BFAT) and to examine age, gender, socioeconomic status, education and previous history of exposure to burn (self/family member) as factors influencing burn first aid knowledge among the general population of Rawalpindi. STUDY DESIGN A cross-sectional, descriptive survey. PLACE AND DURATION OF STUDY Three major tertiary care hospitals of Rawalpindi, from August 2017 to May 2018. METHODOLOGY All consenting people ≥ 18 years of age, with or without a prior history of burn, accompanying patients to three major tertiary care centers of Rawalpindi were administered a pre-tested structured questionnaire. The questionnaire was divided into two sections; socio-demographic section and knowledge on BFAT. Those who were illiterate and could not fill the questionnaire were interviewed and their responses were marked by the researchers themselves. Data were analyzed using SPSS version 21. RESULTS A total of 400 participants comprising 205 (51.3%) males and 195 (48.8%) females with a mean age of 38 ± 10.3 years were included. The majority (58%) were educated up to 12th grade or higher. "Toothpaste" (47.5%) followed by "cool running water" (20.3%) were the two most frequently applied items following a burn injury. Only 8.8% respondents applied cold water for the ideal time duration. Overall, 83% of the participants provided correct answers for 25-50% of the survey questions. Socioeconomic and educational status of the participants had a significant association with burn first aid knowledge. CONCLUSION A significant limitation of knowledge regarding BFAT was seen among the general population of Rawalpindi.
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Abstract
Infrequent presentation of this patient group to emergency departments can cause stress and anxiety to front-line clinicians when they are faced with patients with a traumatic burn injury. Assessment relies on accurate evaluation of burn aetiology, size and depth, and initial management is directly responsible for patients' outcomes and quality of life. This is the second article in a two-part series that gives an overview of the minimum standard of care in burns first aid, and highlights the likely challenges in assessment of burn depth and size. The aim of the two articles is to enhance emergency clinicians' knowledge and confidence in burn management, and to build awareness of the life-changing implications of the initial clinical interventions in burn care.
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Affiliation(s)
- Kristina Stiles
- London and South East of England Burn Network, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, England
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Abstract
Although the overall incidence of and mortality rate associated with burn injury have decreased in recent decades, burns remain a significant source of morbidity and mortality in children. Children with major burns require emergent resuscitation. Resuscitation is similar to that for adults, including pain control, airway management, and administration of intravenous fluid. However, in pediatrics, fluid resuscitation is needed for burns greater than or equal to 15% of total body surface area (TBSA) compared with burns greater than or equal to 20% TBSA for adults. Unique to pediatrics is the additional assessment for non-accidental injury and accurate calculation of the percentage of total burned surface area (TBSA) in children with changing body proportions are crucial to determine resuscitation parameters, prognosis, and disposition.
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Affiliation(s)
- Ashley M Strobel
- Department of Emergency Medicine, University of Minnesota School of Medicine, Hennepin County Medical Center, University of Minnesota Masonic Children's Hospital, 701 South Park Avenue R2.123, Minneapolis, MN 55414, USA.
| | - Ryan Fey
- Department of Surgery, University of Minnesota School of Medicine, Hennepin County Medical Center, 701 South Park Avenue, Minneapolis, MN 55414, USA
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Sinha S, Yoon G, Shin W, Biernaskie JA, Nickerson D, Gabriel VA. Burn clinical trials: A systematic review of registration and publications. Burns 2018; 44:263-271. [DOI: 10.1016/j.burns.2017.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 09/28/2017] [Accepted: 11/02/2017] [Indexed: 10/18/2022]
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A 6-Year Case-Control Study of the Presentation and Clinical Sequelae for Noninflicted, Negligent, and Inflicted Pediatric Burns. J Burn Care Res 2018; 38:e101-e124. [PMID: 28009699 DOI: 10.1097/bcr.0000000000000408] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Inflicted burns are one of the leading causes of abuse-related fatalities in children. Between 30 and 60% of children accidentally returned to abusive homes suffer reabuse. Given the high chance for abuse recurrence and the associated morbidity/mortality, it is critical that inflicted burns are promptly identified to guide appropriate medical and child welfare management. Although previous studies proposed historical and mechanistic features using noncomparative or poorly powered data, this study utilized comparative data from a 6-year period (2009-2014) at a certified burn center along with expert analysis from Child Advocacy and Protective Services (CAPS) to provide higher level evidence supporting classical findings while elucidating new features with respect to burn severity and required interventions. A retrospective chart review of 408 pediatric burns was cross-referenced with the respective CAPS consultations to construct a multidisciplinary, deidentified database. The average age was 2.9 years (0.04-17 years) with 232 (57%) males and 330 (81%) African-Americans. CAPS investigations confirmed burn etiologies: noninflicted (346 [85%]), negligent (30 [7%]), and inflicted (32 [8%]). In comparing the three etiologies, statistical significance (P < .05) was observed for numerous variables including historical inconsistency, burn age, child welfare history, burn size and depth, distribution, concomitant injury rates, number of surgical interventions, infectious complications, and hospital length of stay. In addition to reaffirming classical features of abusive burns to fortify etiologic diagnoses, this study elucidated appreciable differences in burn severity, interventional sequelae, and burn-related complications, which will help guide medical and surgical interventions for future pediatric burn patients.
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Shannon F, Sasse A, Sheridan H, Heinrich M. Are identities oral? Understanding ethnobotanical knowledge after Irish independence (1937-1939). JOURNAL OF ETHNOBIOLOGY AND ETHNOMEDICINE 2017; 13:65. [PMID: 29162151 PMCID: PMC5699017 DOI: 10.1186/s13002-017-0189-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 10/31/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND The Schools' Folklore Scheme (1937-1939) was implemented at a pivotal time in Irelands' political history. It resulted in a body of ethnological information that is unique in terms of when, why and how it was collected. This material consists of over 700,000 pages of information, including ethnomedicinal and ethnobotanical traditions, reflecting an oral identity that spans generations and that in many cases was not documented in writing until the 1930s. The intention of this study is to highlight the importance of the Schools' Folklore Scheme and to demonstrate an ethnographic approach based on recollections of original participants of the scheme, to further understand the material in the collection and the impact it had on the participants. METHODS This study involves an analysis of both oral and archival data. Eleven semi-structured interviews with original participants of the scheme were carried out between April and September 2016. Their corresponding schools' archival contributions to the scheme were located, and ethnomedicinal information was analysed and compared with the participants' recollections. RESULTS The majority of participants' stated the scheme had a positive impact on them. Five participants' recalled collecting ethnomedicinal information, and there was a direct correlation between three of the participants' ethnomedicinal recollections and their entries in the archives. One third of all the ethnomedicinal entries analysed included the use of a plant. There were 191 plant mentions and 64 plant species named. CONCLUSIONS Contacting the original participants offers a novel approach of analysing this archival material. It provides a unique first-hand account of this historical initiative, an insight into how the scheme was implemented and how it impacted upon the children. The ethnomedicinal and ethnobotanical information provides an understanding of the medicinal practices in Ireland during the 1930s. The plant species that were both orally recalled by participants and documented in the archives are in keeping with key ethnomedicinal systems throughout the world.
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Affiliation(s)
- Fiona Shannon
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
- UCL School of Pharmacy, London, WC1N 1AX UK
| | - Astrid Sasse
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
| | - Helen Sheridan
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, Dublin, Ireland
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Herbert EW. Findings and strategies for treating horses injured in open range fires. EQUINE VET EDUC 2017. [DOI: 10.1111/eve.12806] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- E. W. Herbert
- Adelaide Plains Equine Clinic; Gawler South Australia Australia
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Read DJ, Tan SC, Ward L, McDermott K. Burns first aid treatment in remote Northern Australia. Burns 2017; 44:481-487. [PMID: 28811053 DOI: 10.1016/j.burns.2017.07.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 07/04/2017] [Accepted: 07/11/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND OBJECTIVE It is well demonstrated that adequate burns first aid treatment (BFAT) improves clinical outcomes for the injured but adequacy remains low in many studies. This study presents a twelve month assessment of the adequacy of burns first aid treatment for patients managed by the Burns Service, Royal Darwin Hospital (RDH). METHODS Prospective study design of all patients managed by the Burns Service, Royal Darwin Hospital. Data were collated from two sources; RDH Burns Registry, and the Burns Registry of Australia and New Zealand (BRANZ). Inclusion criterion was all patients managed by the Burns Service, Royal Darwin Hospital for the period 1 January 2014-31 December 2014. Variables collected and analysed include: demographics, burn mechanism, burn wound depth and adequacy of and circumstances around first aid. RESULTS Overall 310 cases were analysed. Most injuries involved adults (68%), 19% Indigenous persons and 70% of all patients had their burn injury occur in the urban region. Adequate BFAT occurred in 41% of cases. Adults, contact burns and those where the burn injury occurred in the remote regions were less likely to receive adequate BFAT. Indigenous persons were less likely to attempt any BFAT at all and when they did receive BFAT it was more likely applied by an emergency responder or health professional. CONCLUSION Overall adequacy of BFAT is low in the Top End of the Northern Territory. Remote dwellers and Indigenous persons are at increased risk of not applying or receiving adequate BFAT. The poor level of adequate BFAT demonstrated in this study suggests that the Top End community particularly remote and Indigenous persons would benefit from targeted BFAT education programs that are delivered in a culturally and linguistically appropriate fashion.
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Affiliation(s)
- David J Read
- National Critical Care and Trauma Response Centre, Royal Darwin Hospital, Northern Territory, Australia; Burns Service, Royal Darwin Hospital, Northern Territory, Australia.
| | - Swee Chin Tan
- Burns Service, Royal Darwin Hospital, Northern Territory, Australia.
| | - Linda Ward
- National Critical Care and Trauma Response Centre, Royal Darwin Hospital, Northern Territory, Australia; Menzies School of Health Research, Darwin, Northern Territory, Australia.
| | - Kathleen McDermott
- National Critical Care and Trauma Response Centre, Royal Darwin Hospital, Northern Territory, Australia.
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Nurmatov UB, Mullen S, Quinn-Scoggins H, Mann M, Kemp A. The effectiveness and cost-effectiveness of first aid interventions for burns given to caregivers of children: A systematic review. Burns 2017; 44:512-523. [PMID: 28784346 DOI: 10.1016/j.burns.2017.05.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 05/09/2017] [Accepted: 05/25/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVES the effectiveness and cost-effectiveness of burns first-aid educational interventions given to caregivers of children. METHODS Systematic review of eligible studies from seven databases, international journals, trials repositories and contacted international experts. RESULTS Of 985 potential studies, four met the inclusion criteria. All had high risk of bias and weak global rating. Two studies identified a statistically significant increase in knowledge after of a media campaign. King et al. (41.7% vs 63.2%, p<0.0001), Skinner et al. (59% vs 40%, p=0.004). Skinner et al. also identified fewer admissions (64.4% vs 35.8%, p<0.001) and surgical procedures (25.6% vs 11.4%, p<0.001). Kua et al. identified a significant improvement in caregiver's knowledge (22.9% vs 78.3%, 95% CI 49.2, 61.4) after face-to-face education intervention. Ozyazicioglu et al. evaluated the effect of a first-aid training program and showed a reduction in use of harmful traditional methods for burns in children (29% vs 16.1%, p<0.001). No data on cost-effectiveness was identified. CONCLUSION There is a paucity of high quality research in this field and considerable heterogeneity across the included studies. Delivery and content of interventions varied. However, studies showed a positive effect on knowledge. No study evaluated the direct effect of the intervention on first aid administration. High quality clinical trials are needed.
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Affiliation(s)
- Ulugbek B Nurmatov
- Division of Population Medicine, School of Medicine, Cardiff University, CF 14 4YS, Cardiff, Wales, UK.
| | - Stephen Mullen
- Paediatric Emergency Department, University Hospitals of Wales, CF 14 4XW, Cardiff, Wales, UK; The Scar Free Foundation Centre for Children's Burns Research, CF 14 4YS, Cardiff, Wales, UK.
| | - Harriet Quinn-Scoggins
- Division of Population Medicine, School of Medicine, Cardiff University, CF 14 4YS, Cardiff, Wales, UK; The Scar Free Foundation Centre for Children's Burns Research, CF 14 4YS, Cardiff, Wales, UK.
| | - Mala Mann
- Specialist Unit for Review Evidence, Cardiff University, CF 14 4YS, Cardiff, Wales, UK.
| | - Alison Kemp
- Division of Population Medicine, School of Medicine, Cardiff University, CF 14 4YS, Cardiff, Wales, UK; The Scar Free Foundation Centre for Children's Burns Research, CF 14 4YS, Cardiff, Wales, UK.
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Martin NA, Falder S. A review of the evidence for threshold of burn injury. Burns 2017; 43:1624-1639. [PMID: 28536038 DOI: 10.1016/j.burns.2017.04.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 03/05/2017] [Accepted: 04/02/2017] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Burn injury is common and depth is one measure of severity. Although the depth of burn injury is determined by many factors, the relationship between the temperature of the injurious agent and exposure duration, known as the time-temperature relationship, is widely accepted as one of the cornerstones of burn research. Moritz and Henriques first proposed this relationship in 1947 and their seminal work has been cited extensively. However, over the years, readers have misinterpreted their findings and incorporated misleading information about the time-temperature relationship into a wide range of industrial standards, burn prevention literature and medicolegal opinion. AIM The purpose of this paper is to present a critical review of the evidence that relates temperature and time to cell death and the depth of burn injury. These concepts are used by researchers, burn prevention strategists, burn care teams and child protection professionals involved in ascertaining how the mechanism of burning relates to the injury pattern and whether the injury is consistent with the history. REVIEW METHODS This review explores the robustness of the currently available evidence. The paper summarises the research from burn damage experimental work as well as bioheat transfer models and discusses the merits and limitations of these approaches. REVIEW FINDINGS There is broad agreement between in vitro and in vivo studies for superficial burns. There is clear evidence that the perception of pain in adult human skin occurs just above 43°C. When the basal layer of the epidermis reaches 44°C, burn injury occurs. For superficial dermal burns, the rate of tissue damage increases logarithmically with a linear increase in temperature. Beyond 70°C, rate of damage is so rapid that interpretation can be difficult. Depth of injury is also influenced by skin thickness, blood flow and cooling after injury. There is less clinical evidence for a time-temperature relationship for deep or subdermal burns. Bioheat transfer models are useful in research and becoming increasingly sophisticated but currently have limited practical use. Time-temperature relationships have not been established for burns in children's skin, although standards for domestic hot water suggest that the maximum temperature should be revised downward by 3-4°C to provide adequate burn protection for children. CONCLUSION Time-temperature relationships established for pain and superficial dermal burns in adult human skin have an extensive experimental modeling basis and reasonable clinical validation. However, time-temperature relationships for subdermal burns, full thickness burns and burn injury in children have limited clinical validation, being extrapolated from other data, and should be used with caution, particularly if presented during expert evidence.
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Affiliation(s)
- N A Martin
- St. Andrews Centre for Burns and Plastic Surgery, Broomfield Hospital, Chelmsford, Essex CM1 7ET, UK.
| | - S Falder
- Department of Burns and Plastic Surgery, Alder Hey Children's NHS Foundation Trust, Liverpool L12 2AP, UK.
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