Randomized, Paired-Site Comparison of Autologous Engineered Skin Substitutes and Split-Thickness Skin Graft for Closure of Extensive, Full-Thickness Burns.

Stable closure of full-thickness burn wounds remains a limitation to recovery from burns of greater than 50% of the total body surface area (TBSA). Hypothetically, engineered skin substitutes (ESS) consisting of autologous keratinocytes and fibroblasts attached to collagen-based scaffolds may reduce requirements for donor skin, and decrease mortality. ESS were prepared from split-thickness skin biopsies collected after enrollment of 16 pediatric burn patients into an approved study protocol.

A performance improvement initiative to determine the impact of increasing the time interval between changing centrally placed intravascular catheters.

Existing practice guidelines designed to minimize invasive catheter infections and insertion-related complications in general intensive care unit patients are difficult to apply to the burn population. Burn-specific guidelines for optimal frequency for catheter exchange do not exist, and great variation exists among institutions. Previously, the authors' practice was to follow a new site insertion at 48 hours by an exchange over a guidewire, which was followed 48 hours later by a second guidewire exchange (48h group).

Amish burn ointment and burdock leaf dressings: assessments of antimicrobial and cytotoxic activities.

Amish burn wound ointment (ABO) contains honey, lanolin, oils, glycerin, bees wax, and other natural additives. Although there are many anecdotal reports that this ointment covered with a burdock leaf (BL) dressing promotes burn wound healing, little scientific testing of this treatment has occurred. The goal of this study was to evaluate in vitro some of the components of this treatment modality for antimicrobial and cytotoxic activities.

Multicenter testing of a burn prevention teaching tool for Amish children.

Burn prevention is not taught in Amish schools despite significant cultural risks for burn injuries related to scalds, ignition of clothing, and ignition of highly flammable materials. A culturally appropriate and acceptable burn prevention teaching tool was previously developed and pilot-tested in one Amish school. The purpose of this study was to perform further evaluation of this burn prevention teaching tool for Amish children.

Pilot testing of a burn prevention teaching tool for Amish children.

Burn prevention education for Amish children is warranted as there are unique risks associated with the Amish lifestyle. Specific educational opportunities are related to scalds, ignition of clothing, and ignition of highly flammable materials. A culturally sensitive burn prevention teaching tool, consisting of a magnetic storyboard, burn safety curriculum, and tests, was developed with the cooperation of one Old Order Amish community.

Development of a burn prevention teaching tool for Amish children.

Although there are inherent risks for burn injury associated with the Amish lifestyle, burn prevention is not taught in Amish schools. The purpose of this study was to develop a burn prevention teaching tool for Amish children. An anonymous parental survey was designed to explore the content and acceptability of a teaching tool within an Old Order Amish community.

Pharmacokinetics of colistin in an adolescent boy with extensive burn injury.

Multidrug resistance in Gram-negative bacteria has led to a resurgence in colistin use. No pharmacokinetic data exist for burn patients. A 17-year-old boy suffered a 71% TBSA full-thickness burn with deep necrosis and compartment syndrome.

Is there an increased risk of burns to Amish children?

The purpose of this study was to examine the incidence, causes, and demographics of burn injuries in Amish children, treated at a pediatric burn center located in close proximity to the Midwestern Amish country. After Institutional Review Board approval, we used our TRACS Burn Registry to identify burn injuries in Amish and non-Amish children. We then compared the groups formed by gender and culture.

Pain management competency evidenced by a survey of pediatric nurses' knowledge and attitudes.

Nurses' knowledge and attitudes about pain management affect their capability to attend to children in pain. A modified version of the Pediatric Nurses' Knowledge and Attitude Survey (PNKAS--Manworren and Shriners Hospitals for Children Version, 2002) was used to evaluate nursing competency to manage pain at eight pediatric hospitals. A convenience sample of 295 nurses attained a mean individual test score of 74% correct.

Pediatric nurses' knowledge and attitudes survey regarding pain: a competency tool modification.

Nurses' knowledge and attitudes about pain affect their ability to manage patients' pain. A mechanism was sought to evaluate nursing competency in pain management at eight pediatric hospitals. Several pain survey tools were reviewed, considering the patient population around which they were designed, the basis for survey content, and format.

Prophylactic intravenous immune globulin and polymixin B decrease the incidence of septic episodes and hospital length of stay in severely burned children.

After burn shock resuscitation, serum gamma globulin levels decrease well below normal before slowly recovering over the course of 1 to 2 months. During this period, patients are vulnerable to further insult as a result of this immunocompromise. We hypothesized that intravenous immune globulin and subtherapeutic polymixin B (IVIG-B) could decrease the incidence and/or severity of sepsis after major thermal injury.

Cultured skin substitutes reduce donor skin harvesting for closure of excised, full-thickness burns.

Objective: Comparison of cultured skin substitutes (CSS) and split-thickness skin autograft (AG) was performed to assess whether donor-site harvesting can be reduced quantitatively and whether functional and cosmetic outcome is similar qualitatively in the treatment of patients with massive cutaneous burns.

Summary Background Data: Cultured skin substitutes consisting of collagen-glycosaminoglycan substrates populated with autologous fibroblasts and keratinocytes have been shown to close full-thickness skin wounds in preclinical and clinical studies with acceptable functional and cosmetic results.

Methods: Qualitative outcome was compared between CSS and AG in 45 patients on an ordinal scale (0, worst; 10, best) with primary analyses at postoperative day 28 and after about 1 year for erythema, pigmentation, pliability, raised scar, epithelial blistering, and surface texture.