Rowley-Conwy G.,Burn Unit
Nursing standard (Royal College of Nursing (Great Britain) : 1987) | Year: 2013
Patients with major burns require specialist care in burn centres, taking into account the complex systemic response to a burn injury, avoidance of complications, specialist wound care and supportive multidisciplinary management. Occasionally, these patients may be managed in other settings, such as emergency departments or general intensive care units and ward areas, for example after an explosion or major disaster. Therefore, general nurses require an understanding of patients' complex needs, and should be aware of the latest developments in burn care and up-to-date evidence to ensure best practice.
Rowley-Conwy G.,Burn Unit
Nursing standard (Royal College of Nursing (Great Britain) : 1987) | Year: 2012
Many patients with minor burns can be cared for in the emergency department or community setting, but clinicians must be confident in assessing and managing a burn injury to ensure the best possible outcome. This article defines a minor burn, reviews burn assessment and considers aspects of nursing management that optimise minor burn care.
Costa-de-Oliveira S.,University of Porto |
Miranda I.M.,University of Porto |
Silva R.M.,University of Porto |
E Silva A.P.,University of Porto |
And 5 more authors.
Antimicrobial Agents and Chemotherapy | Year: 2011
This is the first case report of Candida glabrata-disseminated candidiasis describing the acquisition of echinocandin resistance following anidulafungin treatment. The initial isolates recovered were susceptible to echinocandins. However, during 27 days of anidulafungin treatment, two resistant strains were isolated (from the blood and peritoneal fluid). The resistant peritoneal fluid isolate exhibited a Ser663Pro mutation in position 1987 of FKS2 HS1 (hot spot 1), whereas the resistant blood isolate displayed a phenylalanine deletion (Phe659). Copyright © 2011, American Society for Microbiology. All Rights Reserved.
Harvey L.A.,University of New South Wales |
Connolley S.,NSW Agency for Clinical InnovationNSW |
Harvey J.G.,Burn Unit
Burns | Year: 2015
To combat the risk of nightwear burns a mandatory standard regulating the design, flammability and labelling requirements of children's nightwear was introduced in Australia in 1987. This population-based study examined the trends, characteristics and causes of clothing-related burns to inform a review of the current standard, and to facilitate the development of targeted prevention strategies. Clothing-related burns for 1998-2013 were identified from hospitalisation data for all hospitals in NSW and detailed information regarding circumstance of injury from a burn data registry. To investigate percentage annual change (PAC) in trends negative binomial regression analysis was performed. There were 541 hospitalisations for clothing-related burns, 18% were nightwear-related and 82% were for other clothing. All clothing burns decreased by an estimated 4% per year (95% CI -6.2 to -2.1). Nightwear-related burns decreased by a significantly higher rate (PAC -7.4%; 95% CI -12.5 to -2.1) than other clothing (PAC -2.5%; 95%CI -4.7 to -0.1). Exposure to open heat source (campfire/bonfire) was the most common cause, followed by cooking. Of factors known to be associated with clothing burns, accelerant use was reported in 27% of cases, cigarettes 17%, loose skirt or dress 8%, and angle grinders in 6% of cases. Hospitalisations for clothing burns are relatively uncommon in NSW and rates, particularly of nightwear burns, have decreased over the last 15 years. Strategies for continued reduction of these injuries include increasing the scope of the current clothing standard or developing new standards to include all children's clothing and adult nightwear, and increasing community awareness of the risk associated with open heat sources, accelerant use and loose clothing. © 2014 Elsevier Ltd and ISBI. All rights reserved.
Lee H.,Burn Unit
Burns | Year: 2012
Introduction: The lack of autograft donor sites with major burns provides the impetus to develop innovative solutions due to the difficulty of wound closure. Autograft donor sites are particularly limited in patients with burns involving over 50% total body surface area (TBSA). The introduction of cultured epithelial cell autografts offers a potential solution to assist in wound closure. The objective of this study was the assessment of clinical results after sprayed application of the cultured epithelial autograft (CEA, Keraheal™, Seoul, Korea, MCTT) suspension onto the wounds of extensively burned patients. Materials and methods: This retrospective clinical audit of major burn patients (n = 16) describes the use of CEA which was combined with 6:1 meshed expansion grafts in those with the burn over 40% TBSA in our hospital between the period of August 2007 and January 2010. The burn patients included 12 males and 4 females with a mean age 41.5 and a burn area of 51.3 ± 3.1% TBSA (30-70%; median: 50.5%) and a mean third burn area of 32.5 ± 3.0% TBSA (median 34.0%). Results: The take rates were 37.6%, 68.0% and 90.0% on average at 2, 4 and 8 weeks after treatment with the suspension, respectively, and the transplantation of the cultured cells was applied to full-thickness burns, with the coverage of a skin area of 497.5 cm 2 per 1 ml of the cultured cells. For clinical follow-up, 12 patients were observed for 21.5 months on average, with a maximum follow-up period of 39 months. Six patients were excluded from the surveillance because two died during hospitalisation and the other four were impossible to trace. Conclusion: The use of a sprayed cultured epithelial cell autograft (Keraheal™) in treating a full-thickness skin wound in severely burned patients results in favourable quality of scars and also good potential to save lives by providing epidermal cover. © 2012 Elsevier Ltd and ISBI.