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Sofar SM, Wazqar DY, Syam NM. Effect of a Nurse-Led Rehabilitation Program: A Quasi-Experimental Study Examining Functional Outcomes in Patients With Hand Burns. Rehabil Nurs 2024; 49:44-56. [PMID: 38289181 DOI: 10.1097/rnj.0000000000000453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
PURPOSE The model of early rehabilitation for people with burns is still relatively novel in developing countries such as Egypt. The study examined the effect of a nurse-led rehabilitation program on functional outcomes in patients with severe hand burns. DESIGN A quasi-experimental design was used in this study. METHODS The study was completed in the burn unit of a teaching university hospital in Alexandria, Egypt, with a convenience sample of 80 patients with severe hand burns. Participants were consecutively assigned to one of two groups: control ( n = 40), which received only routine hospital care and clinical interventions, or intervention ( n = 40), which received routine hospital care and clinical interventions and a 4-week nurse-led rehabilitation program (health education including audiovisual aids and burn rehabilitation education booklet, social support, and hand rehabilitation exercises). To assess functional outcomes, both groups were given pre- and posttests of the Disabilities of the Arm, Shoulder and Hand outcome and the Hand Motor Function Observational Checklist questionnaires. Descriptive and inferential statistics were conducted. RESULTS Functional outcomes were significantly improved in the intervention participants compared to the control participants ( t = 5.710, p < .001). The differences in index scores between the two groups were statistically significant ( p < .001). CLINICAL RELEVANCE The study provides information for burn rehabilitation nurses in developing countries to develop and test early interventions that improve functional outcomes in this population. CONCLUSIONS A 4-week nurse-led program may be a beneficial intervention for improving functional outcomes in adult patients with severe hand burns who are undergoing rehabilitation.
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Affiliation(s)
- Samah Mahmoud Sofar
- Medical Surgical Nursing Department, Faculty of Nursing, Alexandria University, Egypt
| | - Dhuha Youssef Wazqar
- Department of Medical Surgical Nursing, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Narges Mohammed Syam
- Medical Surgical Nursing Department, Faculty of Nursing, Alexandria University, Egypt
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Postoiu RL, Onose G. Research on the possibilities of a therapeutic approach through physical interventions with Laser MLS (Multiwave Locked System) in post-combustion pathology (burns and severe burns). BALNEO AND PRM RESEARCH JOURNAL 2022. [DOI: 10.12680/balneo.2022.532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Abstract:
Introduction. Depending on their severity, most of the burns are "particularly disabling injuries", which is why a constant improvement of current therapeutic interventions is necessary [1]. The patient describes the severe burn as the "ultimate agony" placing an important responsibility on the medical staff to achieve a satisfactory level of recovery and reintegration into society [2]. "Burns negatively influence the main aspects of life", but also the quality of life [3]. Laser therapy has stood out in recent years in stimulating the healing process of burn patients [4]. The role of this study is to highlight the therapeutic effects of the MLS LASER in the case of burns and severe burns.
Methods. We previously carried out a systematic review of the related literature through the method of filtering and selecting profile documentary material, widely used and accepted at the international level: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Thus, we searched, using contextually, combinations/syntaxes of search keywords in the following international databases: Elsevier, PubMed, PMC, PEDro, articles published in English in ISI indexed journals Web of Knowledge/Science, during 01.01.2021-31.12.2021.
Results and discussion. Seven of the selected articles have been included in our systematic literature review. The evolution of burn injuries materialized through improvements, will hopefully be achievable, both through direct observation and through the favorable dynamic progress of the scores of the quantification scales used: (VSS – Vancouver Scar Scale, VAS – Visual Analogue Scale, 5-D ITCH Scale, according to the model of the American Spinal Injury Association Impairment Scale – AIS - for sensitivity disorders, 3-step scale, ROM – Range of motion, MMT – Manual Muscle Test Scale, The Barthel Index, FIM – Functional Independence Measure scale, ADL, Timed up and go test, Walk Speed, Berg Balance Scale, Six-Minutes Walk Test). If it will be possible, sufficiently sustained medium/long-term follow-up of the cases included in our doctoral research will also be measured by the frequency of readmissions.
Conclusions. Through this research, which is part of the doctoral study, we hope to be able to deepen aspects related to both the still existing limits and the identifiable possibilities for optimizing the conceptual and practical approach to patients with such pathologies.
Keywords: Burns, MLS LASER, Burn wound, Burn Rehabilitation, Multiwave Locked System.
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Affiliation(s)
- Ruxandra Luciana Postoiu
- Faculty of Medicine – „Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania 2. Neuromuscular Clinic Division – Teaching Emergency Hospital „Bagdasar-Arseni”, Bucha-rest, Romania
| | - Gelu Onose
- Faculty of Medicine – „Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania 2. Neuromuscular Clinic Division – Teaching Emergency Hospital „Bagdasar-Arseni”, Bucha-rest, Romania
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Jing Q, Xing Y, Duan M, Guo P, Cai W, Gao Q, Gao R, Ji L, Lu J. Study on the Rehabilitation Therapist Estimation Under Institutional Perspective by Applying the Workload Indicators of Staffing Needs in the Aging Context. Front Public Health 2022; 10:929675. [PMID: 35784252 PMCID: PMC9244688 DOI: 10.3389/fpubh.2022.929675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 05/26/2022] [Indexed: 11/29/2022] Open
Abstract
Background The need for rehabilitation therapy has increased dramatically with the aging of the population, the prevalence of non-communicable diseases, and the increase in the number of disabilities. Rehabilitation therapists are crucial to provide high quality rehabilitation therapy; however, there is a significant shortage of these professionals in China. One of the effective strategies to address this challenge is using the norm of the workforce for rehabilitation therapy, which is an index for assessing the personnel required in a facility. This research aimed to create a rehabilitation therapist-required norm under institutional perspective in Shandong Province, China, based on the Workload Indicators of Staffing Needs (WISN) method, which was created by the World Health Organization (WHO) in 1998 to analyse staff utilization at various levels of the health care system. Methods We conducted descriptive and quantitative research from October to November 2020 in the rehabilitation department of a tertiary hospital in Weifang City, China. Focus groups, online interviews, and document reviews were conducted to gather data and calculations of the WISN method performed. Results Admission assessment, pre-treatment evaluation, rehabilitation therapy, post-treatment evaluation, and health education for patients were identified as the main priority group activities. Interviews and analysis of documents summarized five factors related to rehabilitation therapists' health service activities. In this study, the annual working time of each therapist was 1,776 h per year. The WISN method calculations showed that the norm of rehabilitation therapists in this tertiary hospital was 23 therapists. As the department had 13 therapists, there was a shortage of 10 therapists based on the WISN calculation, with a ratio of 0.57, which represented the actual compared to the ideal number of therapists. Conclusion Workload pressure was high for therapists in this tertiary hospital. This model revealed a demand for ten more therapists in the rehabilitation department. The WISN method can help hospital administrators in therapist workforce monitoring, including in regard to therapists. Therefore, the WISN method should be embraced as part of hospital human resource planning and recruitment strategies to meet increasing rehabilitation needs.
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Affiliation(s)
- Qi Jing
- School of Management, Weifang Medical University, Weifang, China
- China Rehabilitation and Health Institute, Weifang Medical University, Weifang, China
- School of Public Health/China Research Center on Disability Issues, Fudan University, Shanghai, China
| | - Yang Xing
- Weifang People's Hospital, Weifang, China
| | - Mingxue Duan
- School of Public Health, Weifang Medical University, Weifang, China
| | - Peiwu Guo
- Weifang People's Hospital, Weifang, China
| | - Weiqin Cai
- School of Management, Weifang Medical University, Weifang, China
- China Rehabilitation and Health Institute, Weifang Medical University, Weifang, China
| | - Qianqian Gao
- School of Management, Weifang Medical University, Weifang, China
- China Rehabilitation and Health Institute, Weifang Medical University, Weifang, China
| | - Runguo Gao
- School of Public Health, Weifang Medical University, Weifang, China
| | - Lihong Ji
- China Rehabilitation and Health Institute, Weifang Medical University, Weifang, China
- School of Public Health, Weifang Medical University, Weifang, China
| | - Jun Lu
- China Rehabilitation and Health Institute, Weifang Medical University, Weifang, China
- School of Public Health/China Research Center on Disability Issues, Fudan University, Shanghai, China
- *Correspondence: Jun Lu
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Zhou L, Zhou YQ, Yang L, Ma SY. Secondary injuries caused by ill-suited rehabilitation treatments: Five case reports. World J Clin Cases 2021; 9:7786-7797. [PMID: 34621828 PMCID: PMC8462254 DOI: 10.12998/wjcc.v9.i26.7786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 05/31/2021] [Accepted: 08/03/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Increasing attention is being given to burn rehabilitation, and an increasing number of burn patients are undergoing rehabilitation. However, little attention has been given to secondary injuries caused by ill-suited rehabilitation practices. Patients, especially those in undeveloped countries, sustain injuries due to inadequate burn rehabilitation practices and the nonstandard implementation of rehabilitation treatments.
CASE SUMMARY This study reports 5 cases of secondary injuries caused by ill-suited burn rehabilitation practices in our institute, including first web space contracture caused by a single orthosis treatment, finger deformity caused by improper compression therapy with a self-adhering bandage, developmental impairment of the affected limb caused by continuous improper compression therapy, and fracture caused by overly intensive rehabilitation exercise.
CONCLUSION More attention should be given to burn rehabilitation to reduce the incidence of secondary injuries caused by ill-suited rehabilitation practices. Burn rehabilitation system should include specialized hospitals (burn rehabilitation centers), community hospitals, and family rehabilitation clinics. Precise instruments and equipment, accurate measurement methods, objective monitoring indicators and standardized guidelines and recommendations will help improve the quality of burn rehabilitation. Additionally, more attention should be given to burn rehabilitation in children.
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Affiliation(s)
- Ling Zhou
- Institute of Burn Research, Southwest Hospital, State Key Laboratory of Trauma, Burns and Combined Injury, The Army Medical University, Chongqing 400038, China
| | - Ya-Qin Zhou
- Institute of Burn Research, Southwest Hospital, State Key Laboratory of Trauma, Burns and Combined Injury, The Army Medical University, Chongqing 400038, China
| | - Lei Yang
- Institute of Burn Research, Southwest Hospital, State Key Laboratory of Trauma, Burns and Combined Injury, The Army Medical University, Chongqing 400038, China
| | - Si-Yuan Ma
- Institute of Burn Research, Southwest Hospital, State Key Laboratory of Trauma, Burns and Combined Injury, The Army Medical University, Chongqing 400038, China
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Yang X, Xiao Y, Zhong C, Shu F, Xiao S, Zheng Y, Xia Z. ABT-263 Reduces Hypertrophic Scars by Targeting Apoptosis of Myofibroblasts. Front Pharmacol 2021; 11:615505. [PMID: 33519480 PMCID: PMC7840494 DOI: 10.3389/fphar.2020.615505] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 11/24/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Inhibiting proliferation and inducing apoptosis of myofibroblasts is becoming one of the promising and effective ways to treat hypertrophic scar. ABT-263, as an orally bioavailable BCL-2 family inhibitor, has showed great antitumor characteristics by targeting tumor cell apoptosis. The objective of this study was to explore whether ABT-263 could target apoptosis of overactivated myofibroblasts in hypertrophic scar. Methods: In vivo, we used ABT-263 to treat scars in a rabbit ear scar model. Photographs and ultrasound examination were taken weekly, and scars were harvested on day 42 for further Masson trichrome staining. In vitro, the expression levels of BCL-2 family members, including prosurvival proteins, activators, and effectors, were detected systematically in hypertrophic scar tissues and adjacent normal skin tissues, as well as in human hypertrophic scar fibroblasts (HSFs) and human normal dermal fibroblasts (HFBs). The roles of ABT-263 in apoptosis and proliferation of HSFs and HFBs were determined by annexin V/PI assay, CCK-8 kit, and cell cycle analysis. Mitochondrial membrane potential was evaluated by JC-1 staining and the expression of type I/III collagen and α-SMA was measured by PCR, western blotting, and immunofluorescence staining. Furthermore, immunoprecipitation was performed to explore the potential mechanism. Results: In vivo, ABT-263 could significantly improve the scar appearance and collagen arrangement, decrease scar elevation index (SEI), and induce cell apoptosis. In vitro, the expression levels of BCL-2, BCL-XL, and BIM were significantly higher in scar tissues and HSFs than those in normal skin tissues and HFBs. ABT-263 selectively induced HSFs apoptosis by releasing BIM from binding with prosurvival proteins. Moreover, ABT-263 inhibited HSFs proliferation and reduced the expression of α-SMA and type I/III collagen in a concentration- and time- dependent manner. Conclusion: HSFs showed increased mitochondrial priming with higher level of proapoptotic activator BIM and were primed to death. ABT-263 showed great therapeutic ability in the treatment of hypertrophic scar by targeting HSFs.
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Affiliation(s)
- Xiaolan Yang
- Department of Burn Surgery, Changhai Hospital, Naval Medical University, Shanghai, China.,Fujian Burn Institute, Fujian Medical University Union Hospital, Fuzhou, China.,Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai, China.,Quanzhou First Hospital Affiliated to Fujian Medical University, Fujian, China
| | - Yongqiang Xiao
- Department of Burn Surgery, Changhai Hospital, Naval Medical University, Shanghai, China.,Department of Burn and Plastic Surgery, The 970th Hospital of People's Liberation Army, Yantai, China
| | - Chenjian Zhong
- Department of Burn Surgery, Changhai Hospital, Naval Medical University, Shanghai, China.,Fujian Burn Institute, Fujian Medical University Union Hospital, Fuzhou, China
| | - Futing Shu
- Department of Burn Surgery, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Shichu Xiao
- Department of Burn Surgery, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Yongjun Zheng
- Department of Burn Surgery, Changhai Hospital, Naval Medical University, Shanghai, China
| | - Zhaofan Xia
- Department of Burn Surgery, Changhai Hospital, Naval Medical University, Shanghai, China.,Fujian Burn Institute, Fujian Medical University Union Hospital, Fuzhou, China.,Research Unit of Key Techniques for Treatment of Burns and Combined Burns and Trauma Injury, Chinese Academy of Medical Sciences, Shanghai, China
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Qian W, Wang S, Wang Y, Zhang X, Liu M, Zhan R, Huang Y, He W, Luo G. Epidemiological and clinical characteristics of burns in the older person: a seven-year retrospective analysis of 693 cases at a burn center in south-west China. BURNS & TRAUMA 2020; 8:tkz005. [PMID: 32346542 PMCID: PMC7175758 DOI: 10.1093/burnst/tkz005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 07/15/2019] [Indexed: 01/16/2023]
Abstract
Background Burns are one of the major traumas that may affect older individuals. The purpose of this study was to investigate the epidemiological and clinical characteristics of geriatric burns at a major center in south-west China. Methods This retrospective study was conducted at the Institute of Burn Research, Southwest Hospital of Army Medical University between 2010 and 2016, and the data collected from medical records included admission date, age, gender, premorbid disease, burn etiology, injured anatomical location, burn area and depth, inhalation injury, number of surgeries, length of stay (LOS), clinical outcome, and medical cost. Results Of the 693 older burn patients included, 60.75% were male and 56.85% were aged 60–69 years. Burns peaked in December–March and June. Flame was the most common cause of burns, making up 51.95% of all cases, and also dominated in the burn patients aged 60–69 years. Limbs were the most common anatomical sites of burns (69.41%), and the median total body surface area (TBSA) was 5% (interquartile range [IQR]: 2%–15%). The percentage of the patients who underwent surgeries and number of surgeries significantly increased in the cases of contact burns, younger age and full-thickness burns. Six deaths resulted in a mortality of 0.9%. The median LOS was 16 days (IQR: 8–29 days), and the main risk factors were more surgeries, better outcomes, and full-thickness burns. The median cost was 20,228 CNY (IQR: 10,457– 46,581.5 CNY), and major risk factors included longer LOS, larger TBSA, and more surgeries. Furthermore, compared to the earlier data from our center, the proportion of older adults among all burns (7.50% vs. 4.15%), proportion of flame burns (51.95% vs. 33.90%), and mean age (69.05 years vs. 65.10 years) were significantly higher, while the proportion of premorbidities (16.9% vs. 83.9%), mortality (0.9% vs. 7.5%) and median TBSA (5% vs. 21%) were significantly lower. Conclusions This study suggested that closer attention should be paid to prevent burn injuries in older people aged 60–69 years, especially males, regarding incidents in the summer and winter, and flame burns. Moreover, tailored intervention strategies based on related risk factors should be under special consideration.
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Affiliation(s)
- Wei Qian
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Song Wang
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Yangping Wang
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Xiaorong Zhang
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Mian Liu
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Rixing Zhan
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Yong Huang
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Weifeng He
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
| | - Gaoxing Luo
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing 400038, China
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Subrata SA. A concept analysis of burn care in nursing. Scand J Caring Sci 2020; 35:75-85. [PMID: 32319697 DOI: 10.1111/scs.12847] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 03/04/2020] [Accepted: 03/11/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Burn is a life-threatening injury that requires long-term treatment and concomitant hospital stay. Relevant clinical studies in burns have been accomplished and published in the literature. However, none of these studies reported the concept analysis of burn care in nursing. Therefore, analysing the concept of burn care acts as an imperative strategy to provide comprehensive management of burn injury. OBJECTIVE The study aims to describe the concept of burn care in nursing. METHOD Walker and Avant's method (2013) was used to achieve the objective of the study. FINDINGS A model of burn care in nursing was generated that consists of assessment and diagnosis, intervention and evaluation. In addition, the biopsychosocial model developed by George L. Engel (1977) was also integrated to examine how these aspects play a significant role in burn care. CONCLUSION Implementing the concept of burn care will improve the quality of nursing care, cosmetic outcomes and vice versa, reduce the comorbidities on burn injury.
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Affiliation(s)
- Sumarno A Subrata
- Philosophy Program in Nursing, International and Collaborative Program with Foreign University Program, Mahidol University, Phaya Thai, Thailand.,Department of Nursing and Wound Research Center, Faculty of Health Sciences, Universitas Muhammadiyah Magelang, Magelang, Indonesia
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Tan J, Chen J, Zhou J, Song H, Deng H, Ao M, Luo G, Wu J. Joint contractures in severe burn patients with early rehabilitation intervention in one of the largest burn intensive care unit in China: a descriptive analysis. BURNS & TRAUMA 2019; 7:17. [PMID: 31139664 PMCID: PMC6526598 DOI: 10.1186/s41038-019-0151-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 03/22/2019] [Indexed: 01/17/2023]
Abstract
Background Joint contracture is the major clinical complication in burn patients, especially, the severe burn patients. This study aimed to investigate the number and severity of joint contractures in patients with burns affecting greater than or equal to 50% of the total body surface area (TBSA) undergoing early rehabilitation in a burn intensive care unit (BICU). Methods We analyzed burn patients with burns affecting greater than or equal to 50% of the TBSA admitted to a BICU who received early rehabilitation within 7 days post-injury from January 2011 to December 2015. Demographic and medical information was collected. The range of motion (ROM) of different joints was measured 1 month post-admission. Spearman’s correlation coefficient and logistic regression analysis was used to determine predictors of the presence and severity of contractures. Result The average affected TBSA of the included burn patients was 67.4%, and the average length of stay in the BICU was 46.2 ± 28.8 days. One hundred and one of 108 burn patients (93.5%) developed at least one joint contracture. The ROM in 67.9% of the affected joints was mildly limited. The majority of contractures in severe burn patients were mild (37.7%) or moderate (33.2%). The wrist was the most commonly affected joint (18.2%), followed by the shoulder, ankle, hip, knee, and elbow. A predictor of the presence of contractures was the length of hospital stay (p = 0.049). The severe contracture was related to the area of full-thickness burns, the strict bed rest time, and the duration of rehabilitation in BICU. The length of rehabilitation stay (days) in patients with moderate contracture is 54.5% longer than that in severe contracture (p = 0.024) Conclusion During the long stay in BICU, the length of rehabilitation stay in a BICU could decrease the severity of contractures from severe to moderate in the patients with equal to 50% of the TBSA. Hence, this research reveals the important role of early rehabilitation interventions in severe burn patients. Electronic supplementary material The online version of this article (10.1186/s41038-019-0151-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jianglin Tan
- 1Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injuries, Chongqing Key Laboratory for Disease Proteomics, Southwest Hospital, Third Military (Army) Medical University, Chongqing, 400038 China
| | - Jian Chen
- 1Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injuries, Chongqing Key Laboratory for Disease Proteomics, Southwest Hospital, Third Military (Army) Medical University, Chongqing, 400038 China
| | - Junyi Zhou
- 1Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injuries, Chongqing Key Laboratory for Disease Proteomics, Southwest Hospital, Third Military (Army) Medical University, Chongqing, 400038 China
| | - Huapei Song
- 1Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injuries, Chongqing Key Laboratory for Disease Proteomics, Southwest Hospital, Third Military (Army) Medical University, Chongqing, 400038 China
| | - Huan Deng
- 1Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injuries, Chongqing Key Laboratory for Disease Proteomics, Southwest Hospital, Third Military (Army) Medical University, Chongqing, 400038 China
| | - Ming Ao
- 1Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injuries, Chongqing Key Laboratory for Disease Proteomics, Southwest Hospital, Third Military (Army) Medical University, Chongqing, 400038 China
| | - Gaoxing Luo
- 1Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injuries, Chongqing Key Laboratory for Disease Proteomics, Southwest Hospital, Third Military (Army) Medical University, Chongqing, 400038 China
| | - Jun Wu
- 1Institute of Burn Research, State Key Laboratory of Trauma, Burns and Combined Injuries, Chongqing Key Laboratory for Disease Proteomics, Southwest Hospital, Third Military (Army) Medical University, Chongqing, 400038 China.,2Department of Burns, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080 China
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Ren Z, Zhang P, Wang H, Wang H. Qualitative research investigating the mental health care service gap in Chinese burn injury patients. BMC Health Serv Res 2018; 18:902. [PMID: 30486854 PMCID: PMC6263539 DOI: 10.1186/s12913-018-3724-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 11/16/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Psychological disturbances are prevalent in people with burn injuries; however, psychological services are rarely accessiblepost-burn injury in China. The objective of this qualitative study was to explore and conceptualize the obstacles to delivering mental health care in burn injury patients. METHODS The researchers used a grounded theory research approach to interview sixteen burn injury patients, five nurses, four rehabilitation therapists, five medical doctors, and eight caregivers regarding their experiences with current health care services and barriers. RESULTS An explorative model was generated from the data, and the relationships among the categories were identified. People's beliefs, knowledge, socioeconomic status, cultural understanding of mental health, and social stigma appear to play key roles in the public health approach to post-burn health promotion and post-burn psychosocial interventions. CONCLUSION The model proposed in our research highlights the need to focus on the underlying social, economic, and cultural determinants of mental health care. The underlying social determinants of the mental health care gap that is responsible for the ill-prepared health care must be addressed.
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Affiliation(s)
- Zhengjia Ren
- Department of Clinical Psychology, The First Affiliated Hospital to Army Medical University (Third Military Medical University), Chongqing, China
| | - PeiChao Zhang
- Research Center for Modern Psychology, Wuhan University, Wuhan, China
| | - HongTao Wang
- Department of Burn and Cutaneous Surgery, Burn Centre of the People Liberation Army, The First Affiliated Hospital of Air Force Medical University, Xi’an, China
| | - Hongyan Wang
- Department of Cadre Ward, Navy General Hospital, Beijing, 100048 China
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Li H, Zhou J, Peng Y, Zhang J, Peng X, Luo Q, Yuan Z, Yan H, Peng D, He W, Wang F, Liang G, Huang Y, Wu J, Luo G. The progress of Chinese burn medicine from the Third Military Medical University-in memory of its pioneer, Professor Li Ao. BURNS & TRAUMA 2017; 5:16. [PMID: 28573147 PMCID: PMC5450149 DOI: 10.1186/s41038-017-0082-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 05/12/2017] [Indexed: 12/30/2022]
Abstract
Professor Li Ao was one of the founders of Chinese burn medicine and one of the most renowned doctors and researchers of burns in China. He established one of the Chinese earliest special departments for burns at Third Military Medical University (TMMU) in 1958. To memorialize Professor Li Ao on his 100th birthday in 2017 and introduce our extensive experience, it is our honor to briefly review the development and achievement of the Chinese burn medicine from TMMU. The epidemiology and outcomes of admitted burn patients since 1958 were reviewed. Furthermore, main achievements of basic and clinical research for the past roughly 60 years were presented. These achievements mainly included the Chinese Rule of Nine, fluid resuscitation protocol, experience in inhalation injury, wound treatment strategies, prevention and treatment of burn infections, nutrition therapy, organ support therapies, and rehabilitation. The progress shaped and enriched modern Chinese burn medicine and promoted the development of world burn medicine.
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Affiliation(s)
- Haisheng Li
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Junyi Zhou
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Yizhi Peng
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Jiaping Zhang
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Xi Peng
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Qizhi Luo
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Zhiqiang Yuan
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Hong Yan
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Daizhi Peng
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Weifeng He
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Fengjun Wang
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Guangping Liang
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Yuesheng Huang
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Jun Wu
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
| | - Gaoxing Luo
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Gaotanyan Street no.29, Shapingba District, Chongqing, 400038 China
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Li H, Wang S, Tan J, Zhou J, Wu J, Luo G. Epidemiology of pediatric burns in southwest China from 2011 to 2015. Burns 2017; 43:1306-1317. [PMID: 28372828 DOI: 10.1016/j.burns.2017.03.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 03/06/2017] [Accepted: 03/08/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Burns are a major form of injury in children worldwide. This study aimed to investigate the epidemiology, outcome, cost and risk factors of pediatric burns in southwest China. METHODS This retrospective study was performed at the Institute of Burn Research of the Third Military Medical University from 2011 to 2015. Data, including demographic, injury-related, and clinical data and patient outcome, were collected from medical records. RESULTS A total of 2478 children with burns (58.03% boys), accounting for 39.2% of total burn patients, were included. The average age of the burn patients was 2.86±2.86years, and most patients (85.55%) were under five years old. The incidence of burns peaked in January, February and May. Scald burns were the most frequent (79.06%), followed by flame burns (14.0%) and electrical burns (3.35%). Limbs were the most common burn sites (69.73%), and the average total body surface area (TBSA) was 11.57±11.61%. The percentage of children who underwent operations and the number of operations were significantly increased in cases of electrical burns, the older-age group, a larger TBSA and full-thickness burns. Six deaths were recorded, yielding a mortality of 0.24%. The median length of stay and cost were 14days and 9541 CNY, respectively, and the major risk factors for length of stay and cost were the TBSA, number of operations, full-thickness burns and outcome. CONCLUSIONS In southwest China, among children under five years old, scald and flame burns should become the key prevention target, and future prevention strategies should be based on related risk factors.
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Affiliation(s)
- Haisheng Li
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Song Wang
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Jianglin Tan
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Junyi Zhou
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Jun Wu
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Gaoxing Luo
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Southwest Hospital, Third Military Medical University, Chongqing, China.
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12
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Chiwaridzo M, Zinyando VJ, Dambi JM, Kaseke F, Munambah N, Mudawarima T. Perspectives of caregivers towards physiotherapy treatment for children with burns in Harare, Zimbabwe: A cross-sectional study. BURNS & TRAUMA 2016; 4:31. [PMID: 27981055 PMCID: PMC5134272 DOI: 10.1186/s41038-016-0057-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 07/19/2016] [Indexed: 12/02/2022]
Abstract
Background Physiotherapy is an integral part of treatment for paediatric burns. In Zimbabwe, children are admitted in paediatric burn unit with their caregivers, who play important roles such as providing explanation and obtaining cooperation of the child during physiotherapy, which is often uncomfortable or painful to the patient. The aim of this study was to determine the perspectives of caregivers towards physiotherapy interventions administered to hospitalized children at central hospitals in Harare, Zimbabwe. Methods A descriptive cross-sectional study was conducted using self-administered questionnaires. The study was carried out at two large central hospitals (Parirenyatwa Hospital and Harare Central Hospital). The study targeted all the caregivers of children below the age of 12 years with a diagnosis of burns, irrespective of severity or area affected, who were admitted in the two paediatric burn units. Of the 34 caregivers eligible to participate, 31 (91.1 %) questionnaires had complete data and were analysed. The analyses were done using Statistica version 12.0. Results The median age of the caregivers was 28 years (IQR = 24–33 years). Female caregivers constituted 90.3 % of the sample. The majority of the caregivers (n = 26, 83.9 %) were biological mothers to the hospitalised child. The majority of children (n = 20, 64.5 %) hospitalised were between 0 and 4 years. The commonest cause of burns was scalding (n = 19, 61.2 %). The burns were mainly in the upper extremities (n = 11, 35.5 %). Physiotherapy for the burns was mainly active and passive joint range of motion exercises (n = 30, 96.8 %). The caregivers’ perceptions towards physiotherapy were mainly positive (n = 20, 64.5 %) indicating that physiotherapy plays an important role in burn management. Of the 21 caregivers given a ward exercise programme, 13 (61.9 %) were not compliant. Conclusions Caregivers’ perspectives towards physiotherapy were largely positive and are similar to those found in other studies. The majority of the caregivers indicated that physiotherapy was important in the overall management of burns leading to proper healing of the wounds without complications.
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Affiliation(s)
- Matthew Chiwaridzo
- Department of Rehabilitation, College of Health Sciences, University of Zimbabwe, P.O Box A178, Avondale, Harare, Zimbabwe
| | | | - Jermaine Matewu Dambi
- Department of Rehabilitation, College of Health Sciences, University of Zimbabwe, P.O Box A178, Avondale, Harare, Zimbabwe
| | - Farayi Kaseke
- Department of Rehabilitation, College of Health Sciences, University of Zimbabwe, P.O Box A178, Avondale, Harare, Zimbabwe
| | - Nyaradzai Munambah
- Department of Rehabilitation, College of Health Sciences, University of Zimbabwe, P.O Box A178, Avondale, Harare, Zimbabwe
| | - Tapfuma Mudawarima
- Department of Rehabilitation, Harare Central Hospital, P.O Box ST 14, Southerton, Harare, Zimbabwe
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Li-Tsang CWP. "Scarless world or scar-less world": expedition on new perspectives on management of post-burn hypertrophic scar. BURNS & TRAUMA 2016; 4:22. [PMID: 27574691 PMCID: PMC4964259 DOI: 10.1186/s41038-016-0049-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 05/11/2016] [Indexed: 12/24/2022]
Affiliation(s)
- Cecilia W P Li-Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom Hong Kong, China
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