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Outcome Of Burn Care

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Outcome Of Burn Care

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Author : Laura Pompermaier
language : en
Publisher: Linköping University Electronic Press
Release Date : 2017-11-09

Outcome Of Burn Care written by Laura Pompermaier and has been published by Linköping University Electronic Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017-11-09 with categories.

Background: Despite the improvements in burn care during the last decades, burns remain catastrophic for the patients and a challenge for the care-givers. The early outcome of burn care is to assess its quality and to improve it, but the crucial outcome is mortality, which is the main focus of this thesis. In particular, I address questions about mortality that have arisen from working with burned patients and that can have clinical consequences: the impact of pre- existing medical conditions; long-term survival; the causes of unexpected deaths; and the possible differences between sexes in the provision of resources. Patients with burns share the fact that the time of their injury is known, its severity can be quantified from the size of the burn, and the care is relatively standardised. The analysis of outcome among burned patients treated at a single burn centre may therefore be of general value to others who treat burns. Methods: We retrospectively analysed data that had been collected prospectively (the burn unit database) from patients with burns admitted consecutively to a national burn centre in Sweden during the last 25 years. Results: Age and percentage of total body surface area burned (TBSA %) affected the in- hospital mortality, whereas pre-existing medical conditions did not influence the prediction of outcome (Paper I). After discharge, both age and the presence of full thickness burns reduced the long-term survival, whereas the extent of the burn (TBSA %) did not (Paper II). Most patients with moderate burns who die in hospital despite a good prognosis, die for reasons other than the burn (Paper III). Previously, it has been shown that sex is not an independent factor for mortality during burn care; in this thesis we show that the sex of the patients did not affect the number of medical interventions given either (Paper IV). Conclusion: The addition of “coexisting condition” to a mortality model based on age and size of burn does not improve its predictive value; rather, the factor “age” is sufficient to adjust for comorbidity in the assessment of a burn and its outcome (Paper I). If patients with burns survive, the long-term prognosis is good. The effect of age is the one that governs survival, whereas the effect of the extent of the burn ends when the patient is discharged (Paper II). The in-hospital mortality during burn care is low, but some patients die for reasons other than the actual burn (Paper III). In a centre where the mortality is independent of the sex of the patient, the provision of medical interventions is also equal between men and women (Paper IV). Questa tesi tratta del rischio di morte in seguito ad ustioni ed affronta, con approccio scientifico, alcune domande sollevate frequentemente da pazienti e da addetti ai lavori. In particolare: a presenza di altre malattie a prescindere dall´ustione (diabete, nefropatie, alcolismo, etc.) peggiora la prognosi del paziente?L´essere sopravvissuto ad un´ustione riduce l´aspettativa di vita dopo la dimissione dall´ospedale?Qual è la causa di morte in quei (rari) pazienti che muoiono con ustioni di modesta entità?Il sesso del paziente influenza le cure prestate durante il ricovero ed, in tal caso, qual è l´effetto sulla prognosi? Spesso avevamo risposto a questi interrogativi di interesse clinico basandoci sull´esperienza o su luoghi comuni accettati acriticamente. Con questa tesi abbiamo cercato con metodo scientifico delle risposte di valore generale, analizzando i dati raccolti durante l´ultimo ventennio sui pazienti ricoverati a causa di traumi termici al Centro Nazionale Grandi Ustioni dell´Università di Linköping. In Svezia, come negli altri paesi a reddito medio-alto, il tasso di mortalità in seguito ad ustioni è diminuito notevolmente negli ultimi anni, tuttavia l´obbiettivo principale tra gli addetti ai lavori rimane quello di diminuire ulteriormente la mortalità. L´identificazione precoce di pazienti ad alto rischio di morte fornisce un mezzo utile per migliorarne la prognosi. A tale proposito sono stati sviluppati numerosi modelli matematici in grado di calcolare la probabilità di morte in seguito ad ustioni, basati principalmente sull`età del paziente e sull´ estensione dell´ustione. Infatti, è intuitivamente comprensibile che il rischio di morire aumenti con l´età del paziente e la gravità dell´ustione. Nel nostro primo studio abbiamo aggiunto ad un modello prognostico basato su età e superficie corporea ustionata informazioni sulle malattie già presenti nel paziente prima dell`ustione. Contrariamente a quanto ipotizzato, la presenza di altre malattie negli ustionati non ne aumenta la probabilità di morte. Nel nostro secondo studio abbiamo seguito i pazienti sopravvissuti all´ustione dopo la dimissione dal nostro Centro ed abbiano dimostrato che l´ustione in se´ non ne accorcia la vita ne´a breve termine (nei 30 giorni seguenti la dimissione), ne´a lungo termine. È piuttosto inusuale che pazienti con ustioni di modesta gravitá muioiano durante il ricovero ospedaliero. Nel nostro terzo studio abbiamo dimostrato che la principale cause di morte tra questi pazienti non è correlata all´ustione in se´, ma ad altre patologie indipendenti dal trauma termico, quali l´ictus o l´infarto miocardico. A livello internazionale è stato ampiamente documentato un impari impiego delle cure mediche tra i sessi, a discapito delle donne. Questa disparità riguarda principalmente la diversa allocazione delle risorse terapeutiche, ma ha conseguenze negative sul´esito finale della cura. Studi provenienti da diversi centri per la terapia delle grandi ustioni (USA, Australia, India) hanno dimostrato che il rischio di morte in ospedale è maggiore per le pazienti femmine. In contrasto con questo, una precedente ricerca svolta presso il nostro centro non ha mostrato alcuna differenza nella sopravvivenza tra uomini e donne. Anche tra i pazienti della terapia intensiva generale svedese la mortalità è simile per entrambi i sessi, nonostante gli uomini ricevano più trattamenti rispetto alle donne. Questa osservazione apre le porte ad un´ovvia domanda, e cioè: se le donne ricevessero le stesse attenzioni degli uomini morirebbero esse su scala minore? In linea con i risultati riguardanti la mortalità precedentemente pubblicati dal nostro centro, col nostro quarto studio abbiamo dimostrato che non esiste alcuna disparità tra i sessi nella distribuzione delle risorse. In sintesi, con questa tesi abbiamo dimostrato che: i fattori che maggiormente influenzano la prognosi in caso di ustione sono l'età del paziente e l´area corporea ustionata; la presenza di altre patologie non aumenta significativamente il rischio di morte.L´essere sopravvissutto ad un´ustione non riduce l´aspettativa di vita dopo la dimissione dall´ospedale.Una percentuale non indifferente delle morti che si verificano durante il periodo di cura per ustioni di modesta gravità è causata da fattori indipendenti dall´ustione stessa.Uomini e donne nel nostro centro ricevono equo trattamento. La prognosi per donne e uomini ricoverati nel nostro centro è la stessa. Riteniamo che i risultati presentati in questa tesi dovrebbero essere tenuti in considerazione nella terapia dei pazienti ustionati: il trattamento attivo dovrebbe essere offerto a chiunque abbia una ragionevole possibilità di sopravvivenza, calcolata sulla base dell´età e della gravità dell´ustione. Una volta guariti da un´ustione l´aspettativa di vita è buona. Non va scordato che, tra i pazienti che muoiono in seguito ad un´ustione, le cause di morte potrebbero essere dovute a patologie di altra natura. Non si evidenziano differenze nelle mortalitá, lí dove venga offerto uguale trattamento a uomini e donne.

Handbook Of Burns Volume 1

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Author : Marc G. Jeschke
language : en
Publisher: Springer Nature
Release Date : 2019-10-29

Handbook Of Burns Volume 1 written by Marc G. Jeschke and has been published by Springer Nature this book supported file pdf, txt, epub, kindle and other format this book has been release on 2019-10-29 with Medical categories.

The second edition of this volume provides updated information on acute burn treatment. It also discusses genomic responses to burns and novel techniques in this area. Divided into four topical parts, this book provides insights into the history, epidemiology, prevention of burns, as well as initial and pre-hospital management of burns, acute burn care and therapy, and non-thermal burns. All chapters have been edited by leading world authorities on burn care and offer readers a broad overview of the techniques and outcomes in this area. Please also have a look at "Handbook of Burns Volume 2 - Reconstruction and Rehabilitation 2nd edition".

Total Burn Care

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Author : David N. Herndon
language : en
Publisher: Saunders
Release Date : 2012

Total Burn Care written by David N. Herndon and has been published by Saunders this book supported file pdf, txt, epub, kindle and other format this book has been release on 2012 with Medical categories.

Total Burn Care guides you in providing optimal burn care and maximizing recovery, from resuscitation through reconstruction to rehabilitation! Using an integrated, "team" approach, leading authority David N. Herndon, MD, FACS helps you meet the clinical, physical, psychological, and social needs of every patient. With Total Burn Care, you'll offer effective burn management every step of the way! Effectively manage burn patients from their initial presentation through long-term rehabilitation. Devise successful integrated treatment programs for different groups of patients, such as elderly and pediatric patients. Browse the complete contents of Total Burn Care online and download images, tables, figures, PowerPoint presentations, procedural videos, and more at www.expertconsult.com! Decrease mortality from massive burns by applying the latest advances in resuscitation, infection control, early coverage of the burn, and management of smoke inhalation and injury. Enhance burn patients' reintegration into society through expanded sections on reconstructive surgery (with an emphasis on early reconstruction), rehabilitation, occupational and physical therapy, respiratory therapy, and ventilator management.

Burn Care And Treatment

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Author : Marc G. Jeschke
language : en
Publisher: Springer Nature
Release Date : 2020-12-21

Burn Care And Treatment written by Marc G. Jeschke and has been published by Springer Nature this book supported file pdf, txt, epub, kindle and other format this book has been release on 2020-12-21 with Medical categories.

The second edition of this practical guide offers a comprehensive summary of the most important and most immediate therapeutic approaches in the assessment and treatment of burn injuries. Taking into account age-specific needs in pediatric, adult, and elderly burn patients, several chapters on key issues – such as pre-hospital treatment, wound care and infection control, burn nursing, critical care, burn reconstructive surgery and rehabilitation for burn victims – have now been updated. In addition, the book has been supplemented with the latest information on fluid resuscitation, organ support for burn patients, necrotizing soft tissue infections, and TEN/SJS. Written in a concise manner, the updated edition of this book provides essential guidelines for optimal care to improve patient outcomes, and thus will be a valuable reference resource for physicians, surgeons, residents, nurses, and other burn care providers.

Burn Care And Therapy

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Author : Gretchen J. Carrougher
language : en
Publisher:
Release Date : 1998

Burn Care And Therapy written by Gretchen J. Carrougher and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1998 with Burn care teams categories.

BURN CARE AND THERAPY provides a comprehensive analysis of the care and treatment of burns. Beginning with Physiologic Response to Cutaneous Burn Injury and ending with Burn Prevention, the book is divided into 21 chapters that chronologically follow the care provided throughout the burn continuum. Authored by burn experts in their areas of specialty, a collaborative approach is used. Nursing care is presented through each phase of care while integrating medical management. The text is heavily illustrated and a color insert is included to accurately showcase the stages of burn care and healing. A quick reference guide highlighting common nursing and medical burn care facts and figures is provided free with the purchase of the book.TOC: * A collaborative approach demonstrates how a burn care team manages burn care and therapy. * Nursing care is included with each phase of burn care. * Each chapter focuses on every phase of burn treatment from transport to discharge. A final chapter addresses prevention and community planning for burn education. * More than 200 illustrations (45 in full color), including a 16-page color insert, assist the burn professional in determining the extent of the burn wound. * An entire chapter dedicated to pain heavily addresses assessment, treatment, and pharmacokinetics to help the burn care team assess the pain agents that most effectively manage pain. * Sample critical paths are provided for each chapter for guidance in developing a collaborative approach to burn care. * Diagnostic findings and patient management as it relates to nursing care is discussed within the context of the burn patient continuum.

Burns

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Author : Robert L. Sheridan
language : en
Publisher: CRC Press
Release Date : 2011-10-30

Burns written by Robert L. Sheridan and has been published by CRC Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2011-10-30 with Medical categories.

This book emphasizes the fundamental surgical, medical and related procedures involved in each stage of burn care, thus enabling the reader to focus on the essentials, and ensure the best outcome for patients. Chapters range from burn physiology, initial care and resuscitation, to wound evaluation and surgical management, respiratory and critical care, rehabilitation, reconstruction and aftercare. The book’s concise visual approach will appeal to all professionals caring for burn patients in acute or recovery phases.

Burn Care For General Surgeons And General Practitioners

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Author : David G. Greenhalgh
language : en
Publisher: Springer
Release Date : 2016-04-12

Burn Care For General Surgeons And General Practitioners written by David G. Greenhalgh and has been published by Springer this book supported file pdf, txt, epub, kindle and other format this book has been release on 2016-04-12 with Medical categories.

This textbook on burn care is focused specifically on the needs of a surgeon. It provides a “how to do” text that presents the practical strategies for initial resuscitation, skin grafting, burn-specific critical care and ultimately guide the surgeon for the best outcomes for the burn surgeon. It provides the reader with basic pathophysiology but avoids a detailed review of the molecular science of burns. Guidelines for basic care with the chapters covering the timeline used for each patient spanning from initial resuscitation (ABCs) to managing their re-socialization are provided. The text covers the key components to the initial management of the burn patient including airway, breathing and circulation. The reader is introduced to the metabolic changes of a major burn and how nutrition and pharmacologic manipulation affects these systemic effects of a burn injury. The management of burn sepsis as well as the basic concepts of wound healing of the different depths and severity of burns are covered. Another chapter covers the basic techniques of skin grafting, rehabilitation and reconstruction with a focus to optimize the cosmetic and functional outcome of the burn. Special chapters cover management of outpatient burns and pediatric injuries. Special burns – electrical, chemical, cold injuries and finally the treatment of other diseases that lead to massive skin loss are covered. Special considerations for pain, scar management, psychosocial recovery, intentional burns, burn prevention and disaster preparation complete the text. Burn Care for General Surgeons and General Practitioners provides a reference for general and plastic surgeons who are planning a career in burns. The textbook will also be a straightforward resource for the general or plastic surgeon who takes care of burns as part of their practice.

Total Burn Care

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Author : David N. Herndon
language : en
Publisher: Elsevier Health Sciences
Release Date : 2012-06-15

Total Burn Care written by David N. Herndon and has been published by Elsevier Health Sciences this book supported file pdf, txt, epub, kindle and other format this book has been release on 2012-06-15 with Medical categories.

Total Burn Care

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Author : David N. Herndon
language : en
Publisher: Elsevier Health Sciences
Release Date : 2017-10-10

Recent advances in research have resulted in tremendous changes in burn management. Stay fully up to date with the new edition of Total Burn Care, by leading authority Dr. David N. Herndon. Detailed procedural guidelines walk you through every step of the process, from resuscitation through reconstruction and rehabilitation. Everyone on the burn care team, including general and plastic surgeons, intensivists, anesthestists, and nurses, will benefit from this integrated, multidisciplinary guide to safe and effective burn management. Discusses infection control, early burn coverage, occupational physical exercise, respiratory therapy, and ventilator management. Summarizes key points at the beginning of each chapter for quick reference. Uses an integrated, team approach to help you meet the clinical, physical, psychological, and social needs of every patient. Offers expert guidance on early reconstructive surgery and rehabilitation, with new content on improved surgical techniques. Provides access to 15+ procedural operative videos and PowerPoint presentations on topics ranging from alopecia and anesthesia to radiation and treatment of infection – ideal for teaching and presenting. Covers special populations such as elderly and pediatric patients, and includes a new chapter on burns in pregnancy. Expert ConsultTM eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, and references from the book on a variety of devices.

Total Burn Care

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Author : David N. Herndon
language : en
Publisher: Elsevier Health Sciences
Release Date : 2007

Using an integrated, "team" approach, leading authority David N. Herndon, MD, FACS explains how to meet the clinical, physical, psychological, and social needs of every burn patient - and thus achieve optimal recovery and rehabilitation. The 3rd Edition of this definitive reference covers all of the latest advances in the treatment of burns...features new a full-color layout with new color illustrations and clinical photographs. Compiled and edited by one of the world's leading authorities on the management of patients with burns. Discusses the management of burn patients from their initial presentation through long-term rehabilitation. Addresses the clinical, physical, and social needs of the burn patient and emphasizes a multi-faceted, "team approach" to treatment. Covers how to devise integrated treatment programs for different groups of patients, such as elderly and pediatric patients. Uses color illustrations and clinical photographs throughout for the first time-incorporating the illustrative strengths of Barret & Herndon's Color Atlas of Burn Care to provide you with a single source of definitive guidance on diagnosis and management. Presents new chapters on barotrauma and inhalation injury - the tissue bank - the role of exercise - and the use of dermal templates and burn scar resurfacing. Offers fresh perspectives from more than 50% new authors. With more than 100 additional contributing experts

Outcome Of Burn Care

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