Dissertations / Theses on the topic 'Burns and scalds Patients'
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Ellmer, Marlene. "The nutritional management of adult burn wound patients in South Africa." Thesis, Link to the online version, 2007. http://hdl.handle.net/10019/623.
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Lim, Kwai-tat Amanda. "Adjustment of patients with burns on face and hands." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1989. http://hub.hku.hk/bib/B29654063.
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GOOSEN, GERALDINE MAY. "BETA ENDORPHIN LEVELS IN BURNED PATIENTS." Diss., The University of Arizona, 1985. http://hdl.handle.net/10150/187950.
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Nursing activities directed at maintaining patient comfort incorporates time and energy. Nurses and researchers continue to search for adequate methods and information to quantify pain. The common mode of therapy is the administration of narcotics, which do not consistently relieve the pain described by traumatically injured patients. Discovery of endogenous opiates, such as β-endorphins, provided the potential for acquiring additional physiologic information regarding neuro-endocrine activities associated with pain. Consistent findings of concentrated β-endorphins in areas of the central nervous system previously identified as pain pathways prompted clinical researchers to determine β-endorphin levels in patients experiencing pain. The purposes of this investigation were to study β-endorphin levels in burn injured patients by describing: (1) the pattern of β-endorphin levels in burn injured patients during the first two weeks following injury, (2) the relationship between β-endorphin levels and the severity of the burn injury, (3) the relationship between analgesia taken by patients and the severity of the burn, and (4) the relationship between β-endorphin levels and the amount of analgesia given to the burn patient. Plasma samples for β-endorphin levels were obtained from 28 burned patients over a two-week interval. New England Nuclear ¹²⁵I β-Endorphin Kits were used to assay the plasma samples. In addition, information was tabulated from the patient's chart to complete the Burn Severity Index. Narcotic analgesia taken 24 hours before obtaining the blood sample were summarized and categorized according to the Equianalgesia Table. Descriptive and correlational statistics showed no significant relationships between β-endorphins over time, β-endorphins with burn severity, β-endorphins with the analgesia equivalency score, or burn severity with the analgesia equivalency scores. β-endorphin levels were elevated above normal in all 28 patients. Five patients displayed the anticipated declining pattern over the two-week interval post burn. Many erratic peaks and troughs in β-endorphin levels were observed with some peaks associated with clinical events. The findings of elevated β-endorphin levels have implications for nursing practice and provide stimulus for continued nursing research.
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Raven, Donna I. "Difference between calorie requirements of enterally fed trauma and burn patients and actual calories supplied." Virtual Press, 1998. http://liblink.bsu.edu/uhtbin/catkey/1101591.
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This study compared calorie needs, prescription and intake in enterally fed trauma and burn patients. Calorie needs of twenty-eight sequentially admitted patients were assessed by indirect calorimetry or by the Fick method. Caloric prescriptions were calculated from physicians orders. Following attainment of ordered goal rate, three day caloric intake was averaged. Caloric needs were not statistically different from caloric prescription. Caloric intake was significantly lower than caloric needs (p= 0.001). Intolerance and procedures were frequently cited reasons for withholding feedings. Results of this study suggest that trauma and burn patients may not receive the prescribed level of calories during the initial stage of enteral nutrition support.Department of Family and Consumer Sciences
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Ho, Wai-sze, and 何惠思. "An evidence-based guideline on using virtual reality analgesia for procedural pain in adult burn patients in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B44623471.
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Koon, Kamela Suzanne. "Relationship of Self-esteem in Pediatric Burn Patients to other Psychological and Physiological Parameters." Thesis, University of North Texas, 1992. https://digital.library.unt.edu/ark:/67531/metadc332822/.
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The purpose of this study was to evaluate post-burn adjustment in light of the self-esteem of child burn survivors. The study attempted to assess the viability of using a single, explicit self-report measure of self-esteem (Piers-Harris Children's Self-Concept Scale) as an index of post-burn adjustment. It appears that pediatric burn patients do not suffer a compromised self-concept secondary to the burn injury and, rather, are successful in incorporating their post-burn state, physically and psychologically, into a positive self-concept. It is suggested that evaluation of overall self-esteem incorporate a comprehensive picture of post-burn adjustment, based upon psychological and physiological parameters. Further research is justified and suggestions for future examinations are presented.
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Pillay, Rogini. "An exploration of burn survivors' experiences of pressure garment therapy at Tygerberg Academic Hospital." Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/86310.
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Thesis (MSc)--Stellenbosch University, 2014.ENGLISH ABSTRACT: Introduction: Pressure garment therapy (PGT) forms a significant part of burn rehabilitation. It is most commonly used to treat hypertrophic scars but the benefits of this intervention remain questionable. Adherence with this intervention also presents several challenges for the patient and clinician. Aim of the study: The aim of this study was to explore the experiences of adult burn survivors who participated in PGT during 2006 - 2010 at Tygerberg Academic Hospital (TAH). Methods: A phenomenological study design using qualitative research methods was implemented. Semi-structured interviews were conducted with eight burn survivors. The participants were chosen using purposive sampling methods. Thematic analysis was conducted using pre-determined themes from the literature as a starting point. Data was coded and categorised according to themes that emerged during data analysis. Results: The findings of the study revealed that several factors impacted on the participant’s experiences of pressure garment therapy. Factors related to the consequences of the burn injury included the participant’s loss of function, loss of participation, loss of self-confidence, financial dependence, emotional impact and impact on relationships. Factors related to pressure garment usage included physical effects, socio-emotional effects and the wearing schedule (which included maintenance and effort, adherence and time). Factors that contributed to adherence included support, inner strengths, knowledge, seeing a difference, seeing others, enablers to accessing the service and satisfaction with the service. Factors that contributed to non-adherence included lack of support, emotional turmoil and barriers to accessing the service. Participants made recommendations to improve the overall burn service at TAH. Conclusion: The findings of the study show that participants experienced PGT as a beneficial intervention. There were several complex factors that impacted the participants’ experiences of PGT. The most significant benefit as described by the participants was the improvements noted in scar appearance, whilst the main barrier was that the garments were cosmetically displeasing due to their colour.Recommendations: To adopt a person-centred approach to burn management, recommendations made include improvements needed within the occupational therapy service such as changing the colour of the garment material, the standardisation of the PGT treatment protocols and improving staff attitudes. Other recommendations include establishing a network for counselling services as well as an information pack for patients admitted to the burns unit.
AFRIKAANSE OPSOMMING: Drukklereterapie vorm ʼn belangrike deel van die rehabilitasie van brandwonde. Dit is die mees algemene behandeling vir hipertrofiese littekens, maar daar bestaan steeds twyfel aangaande die voordele van hierdie intervensie. Daar bestaan heelwat uitdagings, vir beide die terapeut en die pasiënt, om die behandelingsriglyne na te volg. Doel van die studie: Die doel van hierdie studie was om die ervarings van volwasse brandwond oorlewendes wat vanaf 2006 tot 2010 drukklereterapie by Tygerberg Akademiese Hospitaal ontvang het, te ondersoek. Metode: ʼn Fenomenologiese studie ontwerp is geimplïmenteer deur middel van kwalitatiewe navorsingsmetodes. Semi-gestruktureerde onderhoude is met agt brandwond oorlewendes gevoer. Die deelnemers is gekies deur doelgerigte steekproefneming metodes. Tematiese analise is uitgevoer met behulp van voorafbepaalde temas wat as beginpunt uit die literatuur geneem is. Data is gekodeer en gekategoriseer volgens temas wat na vore gekom het tydens data analise. Resultate: Die bevindings van die studie het aangedui dat verskeie faktore die deelnemers se ervarings van drukklereterapie beïnvloed het. Faktore wat met die gevolge van die brand beserings verband hou het die volgende ingesluit: verlies aan funksie, verlies aan deelname, verlies aan selfvertroue, finansiële afhanklikheid, emosionele impak en die impak op verhoudings. Die volgende faktore het verband gehou met die gebruik van drukklere: fisiese faktore, sosio-emosionele faktore en die dra skedule (dit sluit in onderhoud van die drukklere, moeite, volg van die dra skedule en tyd). Faktore wat bygedra het tot die navolging van die skedule het die volgende ingesluit: ondersteuning, innerlike krag, kennis, die sien van ʼn verskil, sien van ander, toegang tot die diens en tevredenheid met die diens. Die volgende faktore het bygedra tot nie-navolging: gebrek aan ondersteunning, emosionele verwarring en hindernisse tot toegang tot die diens. Deelnemers het aanbevelings gemaak om die brandwonde diens te verbeter. Slot: Die bevindings van die studie dui daarop dat die deelnemers drukklereterapie as ʼn voordelige intervensie ervaar het. Daar was verskeie komplekse faktore wat ʼn impak op drukklereterapie gehad het. Die grootste voordeel, soos beskryf deur deelnemers, was die verbetering in litteken voorkoms; terwyl die hoof hindernis was dat die drukklere kosmeties onaanvaarbaar was as gevolg van die kleur. Aanbevelings: Die volgende aanbevelings is gemaak om ʼn persoon-gesentreerde benadering tot brandwond behandeling te verseker: verbeterings benodig binne die arbeidsterapie diens, soos die verandering van die kleur van drukkleremateriaal, die standaardisering van drukklereterapie protokolle en die verbetering van personeel houdings. Ander aanbevelings sluit in ʼn netwerk vir beradingsdienste, sowel as ʼn inligtingspakket vir pasiente wat tot die brandwondeenheid toegelaat word.
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Tyack, Zephanie F. "Predictors of functional outcome in children at 6 months post-burn /." St. Lucia, Qld, 2001. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe16237.pdf.
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Ranucci, Melissa B. Guarnaccia Charles Anthony. "Self-inflicted and other-inflicted intentional burns versus unintentional burns a comparison study /." [Denton, Tex.] : University of North Texas, 2008. http://digital.library.unt.edu/permalink/meta-dc-9046.
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De, Ruiter Anne. "Traumatic burn injuries : mothering the acutely hospitalised adult child /." [St. Lucia, Qld.], 2005. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe19053.pdf.
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Pegg, Stuart Phillip. "Epidemiology of adult burn injuries in Queensland /." [St. Lucia, Qld.], 2005. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe19341.pdf.
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Talbert, Robert John. "Photoacoustic discrimination of viable and thermally coagulated blood for burn injury imaging." Diss., Columbia, Mo. : University of Missouri-Columbia, 2007. http://hdl.handle.net/10355/5081.
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Thesis (M.S.)--University of Missouri-Columbia, 2007.The entire dissertation/thesis text is included in the research.pdf file; the official abstract appears in the short.pdf file (which also appears in the research.pdf); a non-technical general description, or public abstract, appears in the public.pdf file. Title from title screen of research.pdf file (viewed on January 11, 2008) Includes bibliographical references.
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Ranucci, Melissa B. "Self-inflicted and other-inflicted intentional burns versus unintentional burns: A comparison study." Thesis, University of North Texas, 2008. https://digital.library.unt.edu/ark:/67531/metadc9046/.
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Burn injuries are associated with significant mortality and morbidity. Intentional burn injuries are not well understood, and warrant study to improve adjustment and outcomes. The present study examined group differences between intentional and unintentional burn injuries, comparing individuals with self-inflicted (SIB; n=109) and other-inflicted (OIB; n=109) burns to an unintentional burn (UB) group. Compared to UB, those with intentional (SIB, OIB) burn injuries were more likely to be young, female, unmarried, unemployed, abuse substances, and have positive alcohol/drug screens at hospital admission. Individuals with intentional burns report more psychological distress, lower quality of life in some areas, and lower life satisfaction. When SIB and OIB were examined individually, OIB were more likely to be African American compared to SIB and UB. OIB also had more anxiety and paranoia than UB. SIB was more likely than OIB and UB to have had medical problems or psychiatric disorders and treatment prior to the burn injury. Those with SIB were 3 times more likely than UB to die in the hospital even after controlling for age, severity of burn, and inhalation injuries. Moreover, the SIB group had high rates of suicidal ideation at discharge and follow-up. Treatment implications for burn treatment providers were discussed.
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Gu, Xiaozheng. "Computer simulation of microvascular exchange after thermal injury." Thesis, University of British Columbia, 1987. http://hdl.handle.net/2429/26703.
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A computer model is developed to study the fluid and protein redistribution after thermal injuries in rats. This model is derived by including the burned skin as a fourth compartment in the microvascular exchange model developed by Bert et al. [6].
The pathological changes that occur after thermal injuries are introduced into the burn model as perturbations. The simulations of short-term and long-term responses were then made in this four compartment (burn) model for two cases: 10% and 40% percent surface area burns. Appropriate ranges of the perturbations were estimated based on the available information in the literature. The perturbations for the 10% burn include: the plasma leak coefficient in the injured skin, the tissue pressure in the injured skin, the fluid exchange coefficients in the injured skin, the arterial capillary pressure in the injured skin and the lymph flow characteristics in the injured skin. The perturbations for the 40% burn include the perturbations for the 10% burn plus the plasma leak coefficients in the intact tissues, the fluid exchange coefficients in the intact tissues and the lymph flow characteristics in the intact tissues. The dynamic responses of the system using these perturbations were plotted. Comparisons between the simulation predictions and the experimental data were characterized in terms of sum-of-squares of differences between simulation results and experimental data.
Compared to the limited amount of data available in the literature, the burn model describes microvascular exchange after thermal injuries reasonably well. The work in this thesis could easily be extended to account for fluid resuscitation following a thermal injury in rats and, it is hoped that this approach might eventually be applied to the resuscitation management of burn patients.Applied Science, Faculty of
Chemical and Biological Engineering, Department of
Graduate
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Sands, Jaynie E. "A reflective analysis of burn wound care: The Australian burns nurse' perspective." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1996. https://ro.ecu.edu.au/theses/940.
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The purpose of this historiographical nursing study was to explore Australian Burn Wound Care from a nursing perspective, at two periods of time. It was the intention of the author to explore practices at the inception of specialised burns units, from the 1950's, presenting an historical perspective, and at the present time, May 1995. Eleven burns units across Australia participated in the study. There were 22 participants in the research sample. Each burns unit identified the first Charge Nurse (n =11) and the current Clinical Nurse Specialist (n =11), to be involved in the data collection process. The conceptual framework for this study incorporates the Reflective Cycle (Gibbs, 1988) succinctly incorporating the 'who', 'where', 'why', 'when' and 'what' aspects of the historical method of inquiry. An interview guide, used in conjunction with three photographs depicting burn wounds, provided interview structure for the data collection. A variety of historical data were gathered and analysed. These included scientific medical and nursing texts, foundation minutes, reports and conference papers of Australian and New Zealand Bums Association, to gain perspective of Australian Bum Wound Care. However, the data collated from 1950 to 1996 uncovered no written material on bum wound care. The information available was obtained exclusively from the indepth interviews. The data collated for the current perspective included hospital/ burns unit protocols and indepth interviews with key nursing personnel. A field trip facilitated the data collection, enabling semi-structured, audiotaped interviews in person and the opportunity to visit hospital libraries. The findings of the study have been organised to show bum wound care practices endorsed by Australian burns units, at the inception of specialised facilities, and at the present time.
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Leung, Tai-tei Betty, and 梁帶娣. "Evidence-based guideline on nanocrystalline silver (ACTICOAT) therapy for outpatient burn management." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B4658268X.
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Sabeh, Farideh. "Studies of the status of antioxidant enzymes and metabolites following burn injury, and the presence of antioxidant enzymes in the Aloe vera plant." Thesis, University of North Texas, 1995. https://digital.library.unt.edu/ark:/67531/metadc332708/.
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The effects of skin burn injury on the levels of oxidized and reduced glutthione, malondialdehyde, and on the activities of glutathione peroxidase, glutathione S-transferase, and glutathione reductase were determined in liver and lung of rabbit models, 24-h post-burn.
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Piazza-Waggoner, Carrie. "Burn prevention knowledge an assessment of restaurant servers /." Morgantown, W. Va. : [West Virginia University Libraries], 2001. http://etd.wvu.edu/templates/showETD.cfm?recnum=2128.
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Thesis (M.A.)--West Virginia University, 2001.Title from document title page. Document formatted into pages; contains v, 42 p. Vita. Includes abstract. Includes bibliographical references (p. 25-26).
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Steinvall, Ingrid. "Organ dysfunction among patients with major burns." Doctoral thesis, Linköpings universitet, Institutionen för klinisk och experimentell medicin, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-70061.
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The number of patients who are admitted for in-hospital care in Sweden because of burns is about 12/100,000, and only a small proportion of these have larger burns. Among them, and particularly among those who die in hospital, a condition referred to as “organ dysfunction” is common and an important factor in morbidity and mortality. The fact that the time of the initial event is known, and the magnitude of the insult is quantifiable, makes the burned patient ideal to be studied. In this doctoral thesis organ dysfunction and mortality were studied in a descriptive, prospective, exploratory study (no interventions or control groups) in patients admitted consecutively to a national burn centre in Sweden. The respiratory dysfunction that is seen after burns was found to be equally often the result of acute respiratory distress syndrome and inhalation injury. We found little support for the idea that this early dysfunction is caused by pneumonia, ventilator-induced lung injury, or sepsis. Acute kidney injury (AKI) was also common, and mortality was associated with severity. Importantly, renal dysfunction recovered among the patients who survived. Pulmonary dysfunction and systemic inflammatory response syndrome developed before the onset of AKI. Sepsis was a possible aggravating factor for AKI in 48% of 31 patients; but we could find no support for the idea that late AKI was mainly associated with sepsis. We found that older age (over 60 years), greater TBSA%, and respiratory dysfunction were associated with increased mortality, but there was no association between the overall mortality and sex. We also found that early transient liver dysfunction was common, and recorded early hepatic “hyper”- function among many young adults. Persistent low values indicating severe liver dysfunction were found among patients who eventually died. We conclude from this investigation that overall organ dysfunction is an early and common phenomenon among patients with severe burns. Our data suggest that the prognosis of organ dysfunction among these patients is good, and function recovers among most survivors. Multiple organ failure was, however, the main cause of death. The findings of the early onset in respiratory dysfunction and a delay in signs of sepsis are congruous with the gutlymphatic hypothesis for the development of organ dysfunction, and the idea of the lung as an inflammatory engine for its progression. We think that the early onset favours a syndrome in which organ dysfunction is induced by an inflammatory process mediated by the effect of the burn rather than being secondary to sepsis. Our data further suggest that clinical strategies to improve burn care further should be focused on early interventions, interesting examples of which include: selective decontamination of the gastrointestinal tract to prevent translocation of gut-derived toxic and inflammatory factors; optimisation of fluid replacement during the first 8 hours after injury by goal-directed resuscitation; and possible improvement in the fluid treatment given before admission.
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Roberts, Andrew T. "Aerosol delivery of mammalian cells for tissue engineering." Link to electronic thesis, 2003. http://www.wpi.edu/Pubs/ETD/Available/etd-0429103-192655.
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Ekvall, Klara. "Nursing care for patients with burns in Tanzania." Thesis, Röda Korsets Högskola, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:rkh:diva-86.
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Burns are common in low- and middle income countrie ssuch asTarzania and firerelated deaths are numerous in Africa compared to high income countries in Europe. The nurse's primary professional responsibility is to require nursing care to people. Nursing care for burned patients is important and demands knowledge. Nurses in Tanzania experience difficulties in their daily work in terms of heavy workload and lack of material. Transcultural nursing aims to see care, health and illness from a cultural perspective and the goal is to provide competent care to people in different cultures. The purpose of the study was to illuminate how nurses in Tanzania take care of patients with burns.The study was implemented at the hospital Kilimanjaro Christian Medical Centre in Moshi,Tanzania. A qualitative method was used;participating observations of nine nurses were carried out. The field notes were analyzed by content analysis and gradually two themes appeared; preventing infections and meeting the patient.The conclusion was that nursing care meant collaboration with the relatives, a calm and low stress atmosphere and concems about the patients' integrity. Difficulties experienced in the nurse's daily work were lack of time and material, but despite this the nurses wanted to improve the care of the burned patients in order to reduce the risk of infection. An interesting finding was that normally no contact was created between the nurse and the patient. Overall the lasting impression was that nursing care must be seen and understood in the cultural context.Röda Korsets sjuksköterskeförening stipendium 2010
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McGarry, Sarah. "Pediatric medical traumatic stress : the impact on children, parents and staff." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2013. https://ro.ecu.edu.au/theses/605.
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Burns are one of the most painful and traumatising injuries an individual can sustain and constitute a serious global health threat to children. Despite the magnitude of this public health problem, little research has examined the psychological burden of these injuries. This study used a mixed-methods approach to investigate the effect of paediatric medical trauma on children who have sustained a burn, their parents and the healthcare professionals caring for these patients. The paediatric medical traumatic stress model provided a theoretical framework for this study.
Firstly, this study aimed to gain an understanding of the lived experience of children who sustain a burn. Using phenomenology as a methodology, the first paper in this thesis provided an in-depth understanding of children’s perceptions, thoughts and feelings about the lived experience of sustaining a burn. The findings identified two phases of trauma that are central to the burn experience. The paper found that children experience ongoing trauma in addition to the initial trauma of sustaining the burn, resulting in a cumulative trauma experience. Six themes were identified in the data describing the child’s experience: ongoing recurrent trauma; return to normal activities; behavioural changes; scarring-the permanent reminder; family functioning and adaptation. The methodology of this research provided a voice for the child’s perspective of the burn experience and the findings can be used to inform clinical care at all stages of the burn journey.
The second paper, a cross-sectional study, aimed to investigate the impact of exposure to paediatric trauma on parents of children with a burn and to identify risk factors and relationships between psychological distress and resilience. The results indicated that parents experienced significantly more symptoms of post-traumatic stress disorder than a comparative population. Factors including having a daughter, witnessing the event, feeling helpless or having past traumatic experiences significantly influenced symptoms of psychological distress and resilience. Findings from this study highlight that health professionals should screen parents to identify those at greatest risk and provide effective evidence-based interventions aimed at improving resilience and reducing stress, as part of standard, routine care.
The aim of the third paper was to gain an understanding of the lived experience of parents of a child with a burn injury. Using a phenomenological, qualitative methodology allowed aspects of the parents’ experience not collected in standardised outcome measures to be identified, enabling triangulation with the quantitative results found in the second study. The findings demonstrated that the experience of parents reflected a journey that was represented by three phases: the event, the inpatient phase and the return to the community. Within the three phases, themes of external stressors, emotional and behavioural responses and coping strategies were identified. These findings can be used for the development of protocols to underpin a comprehensive information and social support management plan for families. This would complement the surgical and medical treatment plan, providing direction for comprehensive service delivery.
Children, parents and health professionals are interconnected in a professional relationship. The aim of the fourth paper was to investigate the effect of exposure to paediatric medical trauma on multidisciplinary teams and the relationships between psychological distress, resilience and coping skills. Health professionals experienced significantly more symptoms of psychological distress and less resilience than comparative groups. Non-productive coping was associated with adverse psychological outcomes and younger health professionals were more vulnerable to psychological distress than those aged 25 years and above. Findings from this study may assist in developing organisational systems to facilitate optimal mental health and coping strategies in health professionals, with the aim of the maintenance of a healthy workforce.
Overall findings from this research provide evidence for health professionals to optimise a holistic clinical service at all stages of the burn journey. These findings provide previously unknown knowledge about the impact of paediatric medical trauma on children, parents and health professionals within a paediatric hospital.
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Tian, Jun. "The effect of nano silver particles on cytokine expression and wound healing in an animal thermal injury model." Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B31051455.
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Carlsson, Anna. "Olycksfallsrisker i barnets hemmiljö : fokus på skållskador." Licentiate thesis, Malmö högskola, Institutionen för vårdvetenskap (VV), 2005. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-7378.
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Denna licentiatavhandling syftar till att beskriva barns (0-6 år) utsatthet för olycksfallsrisker i hemmiljön genom att fokusera på omfattningen av bränn- och skållskador, föräldrars uppfattningar om påverkande faktorer till olyckshändelser samt föräldrars uppgifter om egen följsamhet till olycksförebyggande råd och anvisningar. I barnhälsovården (BHV) ges råd och anvisningar kring olika åtgärder lämpliga i förhållande till barns utveckling. Dessa råd ges kontinuerligt och under barnens 6 första år. Innehållet i råden är reglerat i det basprogram som föräldrar till alla barn i Sverige erbjuds fram till skolstart. Få studier beskriver i vilken utsträckning föräldrar följer dessa råd och vilka faktorer som påverkar dels föräldrarnas följsamhet till råden dels faktorer som påverkar risken för barnolycksfall. I denna licentiatavhandling är exemplet skållskador (ΙΙ, ΙΙΙ) beskrivet som ett av flera möjliga olycksfall i hemmiljö som barn drabbas av.The overall aim of this licentiate thesis was to increase the knowledge about children’s (0–6 years old) exposure to accidents in the home environment through parents’ opinions about accidents and parents’ self-reported compliance with precautions. Data were collected from parents of 10-month-old children who answered a questionnaire. The questionnaire prompted responses related to parents’ background and socio-economic factors as well as questions about precautions they had taken to decrease hazards in their home. The questions focused on actions parents had taken upon receipt of preventive advice given to them during the eight-month Child Health Care nurse assessment. Thirty-two percent of the parents complied with less than half of the suggested precautions. Univariate odds ratios (OR) and 95% confidence intervals (95% C I) were calculated to investigate the associations between compliance and parents’ different background/socio-economic characteristics. The variables foreign born, low occupational level, 12 years’ education or less, rented housing and information provided at Child Health Care clinics proved to be statistically significant for the non-compliant group. Multiple logistic regression analysis was performed in order to adjust the estimated odds ratios for the influence of potential confounders such as parents’ nationality, educational and occupational level, place of information and habitation. After the adjustment the variable nationality and educational level stayed significant (Ι). Data in article ΙΙ were collected from medical records, in a retrospectively designed study. Burn-injured children (0–6 years old) consulting the University Hospital or the health centres (21) during 1998 and 2002 were included. Chi-squared test was used to analyse differences in nominal data and cross-tabulation was used to analyse the proportions between the characteristics of the injuries and sex, age and nationality. There were 148 burn injuries, 80% of which were scalds caused by hot liquid (71%) or hot food (29%). The majority were to boys between one and two years old. Children of foreign-born parents were more frequently affected and the extent of injuries often larger. The data collection method in article ΙΙΙ was tape-recorded interviews, analysed by content analysis, with parents of 20 children (0–6 years old) recently suffering from scalds. Parents told their perceptions about causes of the scalds. The analysis resulted in eight categories and two themes. One theme was ‘Deviation from the normal’, which could be when something unusual happened, such as a sudden visit by a friend or when a family member was tired, stressed or ill. The tiredness could be due to fever, a cold, other illnesses or mental stress. It could also be when something was broken in the kitchen and routines were changed. ‘Misjudgement of the child’s capacity’ was the other theme, which it concerned the children’s preventive capacity, rapidity and reach. It was hard for the parents to keep up with the fast development of the small children (9 months–2 years). The parents said that they often did not realise the child’s capacities until the accident occurred. Key words: accident, burns, child, compliance, intervention, prevention and scalds
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Sveen, Josefin. "Posttraumatic Stress and Cognitive Processes in Patients with Burns." Doctoral thesis, Uppsala universitet, Psykiatri, Akademiska sjukhuset, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-143169.
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A severe burn is one of the most traumatic injuries a person can experience. Posttraumatic stress disorder (PTSD) is relatively common after burns, and can be devastating for the individual’s possibilities for recovery. The principal aims were to gain knowledge regarding posttraumatic stress symptoms and cognitive processes after burn and to evaluate methods for assessing symptoms of PTSD up to one year after burn. The psychometric properties of a Swedish version of the Impact of Event Scale-Revised (IES-R) were examined. The results indicate that the IES-R is a valid screening instrument for measuring PTSD symptoms in patients with burns and it can be used during hospitalisation to identify resilient individuals. The pattern of PTSD symptoms over time was also investigated. Four distinct trajectories of PTSD symptoms were identified, i.e. four groups of patients with significantly different onsets and courses. The trajectories differed in the expected direction regarding several risk factors associated with PTSD symptoms. Several previously known risk factors for PTSD symptoms were also identified including burn severity, psychiatric history, previous life events, early psychological symptoms, neuroticism-related personality traits, avoidant coping and low social support. The risk factors correspond well with those reported in the international trauma literature, which strengthens the findings in this thesis. Finally, using the emotional Stroop task at one year post burn it was found that burn-specific attentional bias was common and associated with more previous life events, more perceived life threat, larger burns and higher levels of PTSD symptoms. In summary, there are individual differences in the development and course of PTSD symptoms after burn and attentional bias is a common cognitive phenomenon related to these symptoms. The findings also support the use of the IES-R as a screening instrument for PTSD symptoms in patients with burns.
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Osborne, Tyler Jerome. "Energy balance profile in acute small-moderate burns patients." Thesis, Osborne, Tyler Jerome (2019) Energy balance profile in acute small-moderate burns patients. Masters by Research thesis, Murdoch University, 2019. https://researchrepository.murdoch.edu.au/id/eprint/54765/.
Full textAbstract:
Background: Burns patients have been shown to exhibit a hyper-metabolic state of activity which can persist for up to two years post-burn. The relationship between total body surface area (TBSA) burned and resting metabolic rate (RMR) has been investigated in larger burns (≥20% TBSA), however not in small-moderate burns (≤15% TBSA). The majority of previous studies have looked at burns ≥ three months after the initial injury. This observational study examined acute effects of small-moderate burns (<15% TBSA) on RMR in burns patients using indirect calorimetry with the secondary aim to investigate the effects of surgery on RMR. Caloric intake was also recorded for comparison to RMR to determine energy balance.
Methods: 39 participants (32 male and 7 female) were included in this study via the inpatient burns ward at Fiona Stanley Hospital. Each patient was recruited upon admission to the ward with the day of the initial burn being considered as day 0. Data was collected on day four as able (± one day) and one day prior to and post-surgery as able.
Results: The pooled data bivariate correlation showed a significant weak relationship between RMR and TBSA (r=0.435, p=0.009), a significant relationship was also found between RMR and TBSA in males (r=0.634, p=0.001). Patients displayed a positive energy balance of 116kcal/day. The pre and post-surgery RMR data was found to be a non-significant change of -16kcal/day (t=-0.189, p=0.28).
Conclusion: This study demonstrated a moderate-strong correlation of RMR and TBSA in males for burns of ≤15% TBSA. The energy balance data showed an average difference of +116kcal/day aligning with the research showing that patients are fed conservatively during a burn injury.
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Myers, Trisha A. "Nurse practitioners in burn centers: an exploration of the developing role /." Click here to access thesis, 2006. http://www.georgiasouthern.edu/etd/archive/spring2006/trisha%5Fa%5Fmyers/myers%5Ftrisha%5Fa%5F200605%5Fmsn.pdf.
Full textAbstract:
Thesis (M.S.N.)--Georgia Southern University, 2006."A thesis submitted to the Graduate Faculty of Georgia Southern University in partial fulfillment of the requirements for the degree Master of Science" ETD. Includes bibliographical references (p. 54-58) and appendices.
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Tian, Jun, and 田軍. "The effect of nano silver particles on cytokine expression and wound healing in an animal thermal injury model." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2004. http://hub.hku.hk/bib/B31051455.
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Bäckström, Josefin. "Family Members of Patients with Burns : Experiences of a Distressful Episode." Doctoral thesis, Uppsala universitet, Psykiatri, Akademiska sjukhuset, 2013. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-208626.
Full textAbstract:
A severe burn is a trauma associated with long lasting consequences, not only for the survivor but also for the family. Although it is recognized that family members are central in providing social support for the patients, previous research has not focused extensively on this group. The aims of this thesis were to increase knowledge about psychological symptoms and health-related quality of life (HRQoL) in family members of patients with burns, as well as to explore their experiences of burn care and rehabilitation. The research questions were approached using quantitative and qualitative methods. The results showed that most family members demonstrate normal to mild levels of psychological symptoms, while one third demonstrate moderate to severe symptoms during care. The symptoms decreased over time and could be predicted to a certain degree by early symptoms. Further, family members’ report of HRQoL is similar to that of the general population. An improvement is seen over time and HRQoL could be predicted in part by earlier life events and psychological symptoms. Family members’ experiences were explored in an interview study. Qualitative content analysis revealed that the time in hospital is stressful, although there were experiences of a positive character. Family members might benefit from being cared for in a more individualized way. The communication between health care providers and the family members could be improved. Finally, a qualitative content analysis revealed that family members’ experiences and views concerning support is highly individual. There were experiences of sufficient support as well as lack of professional support. Treatment of family members should be modified according to personal circumstances, and it is important to actively include family members in the care process, both before and after discharge. In summary, being a family member of a burn survivor is a distressful experience, not only during care but in many cases also after discharge. The treatment of family members within burn care should be individualized. Some persons are more vulnerable than others and it might be possible to identify those in need of support while care is still ongoing.
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Wikehult, Björn. "Use of Healthcare, Perceived Health and Patient Satisfaction in Patients with Burns." Doctoral thesis, Uppsala University, Department of Surgical Sciences, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-9262.
Full textAbstract:
A severe burn is a trauma fraught with stress and pain and may change the entire course of life. This thesis focuses on care utilisation, care experiences and patient satisfaction after a severe burn.
The patients studied were treated at the Burn Unit at Uppsala University Hospital between 1980 and 2006. Burn-related health was examined using the Burn Specific Health Scale-Brief (BSHS-B), personality traits with the Swedish universities Scales of Personality (SSP), psychological symptoms using the Hospital Anxiety and Depression scale (HADS), symptoms of posttraumatic stress with the Impact of Event Scale-Revised (IES-R) and satisfaction with care using the Patient Satisfaction-Results and Quality (PS-RESKVA) questionnaire.
Those utilising care years after injury reported poorer functioning on three of the BSHS-B subscales. Personality traits had a greater impact on care utilisation than injury severity.
Social desirability was lower among care utilisers and was associated with burn-related health aspects.
The participants reported a low level of negative care experiences, the most common of which was Powerlessness.
Most patients were satisfied with care, more with quality of contact with the nursing staff, and less with treatment information. Multiple regressions showed that the BSHS-B Interpersonal relationships subscale was an independent variable related to all measured aspects of patient satisfaction. The highest adjusted R2 was 0.25.
In a prospective assessment with multiple regression analyses, Age and Education, the personality traits of Stress susceptibility, Trait irritability, Detachment and Social desirability, in addition to the post-traumatic stress symptoms Intrusion and Hyperarousal, were predictors of satisfaction with care. The highest adjusted R2 was 0.19.
The thesis has pointed out that interpersonal factors are related to care utilisation as well as satisfaction with care. However, satisfaction with care was only moderately associated with health and individual characteristics, which may imply that the care itself is of major importance.
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Weideman, Liezel. "An investigation into the antibacterial activities of medicinial plants traditionally used in the Eastern Cape to treat secondary skin infections associated with burn wounds." Thesis, Nelson Mandela Metropolitan University, 2005. http://hdl.handle.net/10948/172.
Full textAbstract:
Traditional medicine has a long history of being used for treating various ailments ranging in severity. Although traditional medicine has typically been the health care for the poorest levels of society, there is a worldwide growth in popularity. The growing popularity of traditional medicine, termed the green boom, may be ascribed to people taking a more holistic approach to maintain their health. Traditional medicine is widely used on a regular basis by 70% of South Africans. Various indigenous medicinal plants are used for the preparation of traditional herbal medicine. These plants are mostly indigenous to the regions were it is used. In this study four medicinal plants (Bulbine frutescens, Leonotis leounurus, Melianthus major & Zantedecshia aethiopica) that are traditionally used in the Eastern Cape region for treating burn wound infections, were collected for investigation. The in vitro antibacterial activity of these plants was tested against different bacterial strains of eight different bacteria. The bacteria used in this investigation included bacterial strains of four Gram-positive bacteria, S. aureus, methicillin-resistant S. aureus (MRSA), E. feacalis, S. pyogenes and four Gramnegative bacteria, P. aeruginosa, A. baumanii, K. pneumoniae and P. mirabilis. Traditional preparations as well as three different extracts (methanol, aqueous & acetone) of the plants were used for in vitro antibacterial activity testing. The microtitre plate assay and agar dilution assay were used for determining the antibacterial activity of the traditional preparations and plant extracts against the different bacterial strains. In the microtitre plate assay the antibacterial activity was tested using the bacterial growth indicator, INT and a microtitre plate spectrophotometer to determine the minimal inhibitory concentrations of the plant extracts and traditional preparations. The microtitre plate assay was used for testing the antibacterial activity of the plants against the bacterial strains of five bacteria, S. aureus, MRSA, P. aeruginosa, A. baumanii and K. pneumoniae. The bacterial strains of the three bacteria, S. pyogenes, E. feacalis and P. mirabilis were not compatible with the microtitre plate assay using INT and spectrophotometric readings to determine bacterial inhibition. Therefore the agar dilution assay were used as an alternative method for determining the MIC’s of the plant extracts against the bacterial strains of these bacteria. The initial plant extract concentration in the microtitre plate assay differed with the different plant extracts in the microtitre plate assay. Acetone followed by methanol extracted the highest plant extract concentrations with the different medicinal plants. M. major followed by L. leonurus produced the highest plant extract concentrations following extraction with the different extraction solvents. Consequently the acetone extract of M. major had the highest plant extract concentration before serial dilution in the microtitre plate assay. Uniform plant extract concentrations were tested in the agar dilution assay. The methanol extract followed by the acetone extract of the plants gave the highest antibacterial activity against the different bacterial strains. The extracts of M. major followed by L. leonurus inhibited the highest number of bacterial strains in the microtitre plate assay and the extracts of B. frutescens inhibited the lowest number of bacterial strains. The acetone and methanol extracts of M. major were the only extracts that displayed antibacterial activity in the agar dilution assay. The bacterial strains of P. mirabilis were the only bacteria that were inhibited using this method. The bacterial strains of S. pyogenes and E. feacalis were not inhibited at any of the plant extract concentrations in the agar dilution assay.
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Gardner, Glen G. "Development of a computer monitoring system to improve the management of severely burned patients." Thesis, University of Aberdeen, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.284325.
Full textAbstract:
Burn victims are treated using the exposure method in a specially designed intensive care room in which sterile air at a controlled temperature (25-38oC) is blown down on to the open wounds allowing them to dry and form an eschar. During this treatment, the patient's heat loss has to be maintained as low as possible to minimise thermal stress. This work involved the creation of an automated system to monitor patient heat loss, along with the development of a mathematical model to predict the optimum conditions for treatment. The monitoring system consists of a micro processor controlled interface board connected to an IBM PC which operates a multitasking operating system. The interface repetitively collects data from the monitoring equipment including an infra red camera, while the computer controls the rate of collection, calibration, storage and display of various environmental and physiological factors as well as the images obtained from the camera. The temperature distributions across burn wounds are complex and dependent on the depth and position of the wound as well as the time after injury The monitoring system allows the automatic collection of image data at regular intervals, with the sequence of images produced together with the environmental data recorded, being used in the calculation of body heat loss, and in the study of temperature changes during wound healing. A mathematical model has been developed, programmed and adapted to accurately model the responses of a group of 22 healthy subjects in the intensive care room over the range of ambient temperatures available. Further development was then made to enable the modelling of burned patients, with application to six patients studied in the room.
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Nogueira, Gláucia Regina [UNESP]. "Influência dos polimorfismos Taql e Bsml do gene do receptor de vitamina D no surgimento de infecção, tempo de internação e mortalidade em pacientes queimados." Universidade Estadual Paulista (UNESP), 2015. http://hdl.handle.net/11449/132033.
Full textAbstract:
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000848635.pdf: 388929 bytes, checksum: fb8a734b65143535639956be215b3641 (MD5)Introdução: Alguns estudos mostraram que o processo inflamatório está relacionado à gravidade da queimadura. Nesse contexto, a utilização de estratégias para modular essa hiper-resposta inflamatória é bastante atrativa. Nos últimos anos, a vitamina D tem se destacado por sua ação anti-inflamatória e pela modulação da resposta imunológica. Parte das ações da vitamina D é mediada pelo receptor nuclear da vitamina D (VDR). Estudos recentes mostram que polimorfismos do gene do receptor VDR pode influenciar a resposta à vitamina D. Objetivos: O objetivo deste estudo é avaliar a associação dos polimorfismos Taql e Bsml do gene VDR com o tempo de internação, o surgimento de infecção e a mortalidade em pacientes queimados. Casuística e métodos: Foram incluídos prospectivamente os pacientes queimados, com idade ≥ 18 anos, que internaram na enfermaria e na Unidade de Terapia Intensiva do Setor de Tratamento de Queimados do Hospital Estadual Bauru. Os pacientes foram incluídos no período de janeiro de 2013 a janeiro de 2014. Na admissão dos pacientes foram registrados dados demográficos e clínicos foram registrados. Amostras sanguíneas foram coletadas na admissão dos pacientes para dosagem bioquímica, de 25 (OH) vitamina D e determinação dos polimorfismos Taql e Bsml do gene VDR. Os pacientes foram acompanhados durante toda a internação e o surgimento de infecção, o tempo de internação e a mortalidade foram registrados. Para avaliar a associação dos polimorfismos com o tempo de internação utilizamos a análise de regressão linear simples e múltipla. Para avaliar a associação dos polimorfismos com o surgimento de infecção e mortalidade utilizamos a análise de regressão logística. O nível de significância adotado foi de 5%. Resultados: Foram avaliados 87 pacientes, mas em 7 deles, devido problemas técnicos, não foram avaliados os polimorfismos do receptor da vitamina D, Taql e Bsml, por isso...
Introduction: Some studies showed that the inflammatory process was related with severe burn injury. Thus, strategies for modulation of inflammatory response are of great interest. In the last years, vitamin D received attention due to its anti-inflammatory and immunomodulatory actions. Most of the actions of vitamin D are through its nuclear receptor (VDR). Recent studies showed that VDR gene polymorphisms could influence vitamin D response. Objective: The objective of this study is to evaluate the association of Taql and Bsml polymorphisms of VDR gene with length of hospital stay, infection development and mortality in burn patients. Methods: We prospectively evaluated burn patients, over the age of 18 years, admitted to the Burn Unit of Hospital Estadual Bauru. The patients were included from January 2013 to January 2014, after signing the written informed consent. Upon admission demographical and clinical data were recorded. Blood sample was collected for biochemical analysis, measure of serum 25(OH) vitamin D3 concentration, and Taql and Bsml polymorphisms determination. The patients were followed during hospital admission, and length of hospital stay, infection development and mortality were recorded. For association between length of hospital stay and VDR polymorphisms we used uni and multivariate linear regressions. For association between polymorphisms and infection development and mortality, uni and multiple logistic regressions were performed. Significance level was 5%. Results: We evaluated 87 patients, however 7 were excluded due to technical problems with VDR polymorphism evaluation. Thus, 80 patients were studied. Considering these patients 60% were male, and average age was 42.5 ± 16.1 years. Regarding the cause of burn 47.5% were caused by fire, 33,7% due to hot liquids, 15% caused by electricity and 3.8% due to other causes. The median of burn surface area was 8.0 (3.0-18.8)% and 47.5% were treated in intensive care ...
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Nogueira, Gláucia Regina. "Influência dos polimorfismos Taql e Bsml do gene do receptor de vitamina D no surgimento de infecção, tempo de internação e mortalidade em pacientes queimados /." Botucatu, 2015. http://hdl.handle.net/11449/132033.
Full textAbstract:
Orientador: Marcos Ferreira MinicucciCoorientador: Sandro José Conte
Banca: Marina Politi Okoshi
Banca: Daniela de Rezende Duarte Maksymczuk
Resumo: Introdução: Alguns estudos mostraram que o processo inflamatório está relacionado à gravidade da queimadura. Nesse contexto, a utilização de estratégias para modular essa hiper-resposta inflamatória é bastante atrativa. Nos últimos anos, a vitamina D tem se destacado por sua ação anti-inflamatória e pela modulação da resposta imunológica. Parte das ações da vitamina D é mediada pelo receptor nuclear da vitamina D (VDR). Estudos recentes mostram que polimorfismos do gene do receptor VDR pode influenciar a resposta à vitamina D. Objetivos: O objetivo deste estudo é avaliar a associação dos polimorfismos Taql e Bsml do gene VDR com o tempo de internação, o surgimento de infecção e a mortalidade em pacientes queimados. Casuística e métodos: Foram incluídos prospectivamente os pacientes queimados, com idade ≥ 18 anos, que internaram na enfermaria e na Unidade de Terapia Intensiva do Setor de Tratamento de Queimados do Hospital Estadual Bauru. Os pacientes foram incluídos no período de janeiro de 2013 a janeiro de 2014. Na admissão dos pacientes foram registrados dados demográficos e clínicos foram registrados. Amostras sanguíneas foram coletadas na admissão dos pacientes para dosagem bioquímica, de 25 (OH) vitamina D e determinação dos polimorfismos Taql e Bsml do gene VDR. Os pacientes foram acompanhados durante toda a internação e o surgimento de infecção, o tempo de internação e a mortalidade foram registrados. Para avaliar a associação dos polimorfismos com o tempo de internação utilizamos a análise de regressão linear simples e múltipla. Para avaliar a associação dos polimorfismos com o surgimento de infecção e mortalidade utilizamos a análise de regressão logística. O nível de significância adotado foi de 5%. Resultados: Foram avaliados 87 pacientes, mas em 7 deles, devido problemas técnicos, não foram avaliados os polimorfismos do receptor da vitamina D, Taql e Bsml, por isso...
Abstract: Introduction: Some studies showed that the inflammatory process was related with severe burn injury. Thus, strategies for modulation of inflammatory response are of great interest. In the last years, vitamin D received attention due to its anti-inflammatory and immunomodulatory actions. Most of the actions of vitamin D are through its nuclear receptor (VDR). Recent studies showed that VDR gene polymorphisms could influence vitamin D response. Objective: The objective of this study is to evaluate the association of Taql and Bsml polymorphisms of VDR gene with length of hospital stay, infection development and mortality in burn patients. Methods: We prospectively evaluated burn patients, over the age of 18 years, admitted to the Burn Unit of Hospital Estadual Bauru. The patients were included from January 2013 to January 2014, after signing the written informed consent. Upon admission demographical and clinical data were recorded. Blood sample was collected for biochemical analysis, measure of serum 25(OH) vitamin D3 concentration, and Taql and Bsml polymorphisms determination. The patients were followed during hospital admission, and length of hospital stay, infection development and mortality were recorded. For association between length of hospital stay and VDR polymorphisms we used uni and multivariate linear regressions. For association between polymorphisms and infection development and mortality, uni and multiple logistic regressions were performed. Significance level was 5%. Results: We evaluated 87 patients, however 7 were excluded due to technical problems with VDR polymorphism evaluation. Thus, 80 patients were studied. Considering these patients 60% were male, and average age was 42.5 ± 16.1 years. Regarding the cause of burn 47.5% were caused by fire, 33,7% due to hot liquids, 15% caused by electricity and 3.8% due to other causes. The median of burn surface area was 8.0 (3.0-18.8)% and 47.5% were treated in intensive care ...
Mestre
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Dawoud, Fakhry, Brian Thompson, and Shannon Castle. "ECMO Support for Pediatric Burn Patients: A Potential Life Saving Modality." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/asrf/2019/schedule/36.
Full textAbstract:
Extracorporeal membrane oxygenation (ECMO) has been used as life-saving support for children with varying causes of respiratory and/or cardiac failure. However, few studies have assessed the utility of ECMO as a viable treatment option in the setting of pediatric burn injury. We aim to examine the outcomes of pediatric burn patients requiring ECMO support by utilizing the Extracorporeal Life Support Organization (ELSO) registry in order to elucidate whether or not ECMO should be considered in this population.
A retrospective cohort study was conducted by querying the ELSO database for all pediatric patients (birth to less than 18 years) who were supported on ECMO with burn-associated cardiopulmonary failure between 1990 and 2016. ICD-9 codes 940–949.5 were utilized to identify patients with an associated burn injury. Venovenous ECMO was defined as any patient with only venous cannulas, including double-lumen venous cannulas. Venoarterial ECMO was defined as any patient with a venous and an arterial cannula, any patient originally supported on VA ECMO that was converted to venovenous, or any patient originally supported on venovenous that was converted to venoarterial ECMO. Oxygenation indices (OI) and complication rates were compared among survivors and non-survivors for both venovenous (VV) and venoarterial (VA) groups. Primary outcome variables were survival and non-survival to hospital discharge. Demographic and clinical data, along with pre-ECMO variables and ECMO complications, were analyzed for predictive mortality.
A total of 113 patients met inclusion criteria for the study. Overall survival to discharge was 52.2% (n=59) for the entire cohort. 73 patients were supported on VA ECMO, while 37 patients required VV ECMO support with a survival to discharge of 47.9% (n=35) and 62.2% (n=23), respectively. There was no statistical difference for median age (p=0.765), median weight (p=0.932), or median hours on ECMO (p=0.963) between survivors and non-survivors. Three patients did not have the type of cannulation identified but were listed as “other” in the ELSO registry. Patients requiring ECMO support for respiratory failure had a higher over-all survival (55.7%, n=97) compared to those requiring ECMO for cardiac failure (33.3%, n=6) or ECPR (30%, n=10). Patients who were supported on VV ECMO for respiratory failure had the best overall survival at 62.2% (n=37) and those cannulated to VA ECMO for respiratory failure had a survival of 51.7% (n=58). Patients supported on VA ECMO for cardiac failure or ECPR support had the same survival at 33.3% (n=6 and 9 respectively). Several factors were found to be significantly associated with mortality. Cardiac arrest prior to cannulation was associated with increased mortality with an odds ratio of 3.41 (95% CI 1.29-9.06, p=0.011). There was a trend for the use of nitric oxide prior to cannulation to be associated with a decrease in mortality with an odds ratio of 0.40 (95% CI 0.16-1.01, p=0.048)Following cannulation, complications including the need for inotropes (OR 2.64, 95% CI 1.24-5.65, p=0.011), presence of gastrointestinal hemorrhage (p=0.049), and hyperglycemia (glucose > 240mg/dL) (OR 3.42, 95% CI 1.13-10.38, p=0.024) were associated with increased mortality.
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Dyster-Aas, Johan. "Psychiatric History and Adaptation in Burn Injured Patients." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-7252.
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Maritz, David. "Aetiology and outcome of patients burned from 2003 to 2008 at the Tygerberg Hospital burns unit, Western Cape, SA." Master's thesis, University of Cape Town, 2013. http://hdl.handle.net/11427/2866.
Full textAbstract:
Rural to urban migration to major cities in South Africa continues to lead to the proliferation
of informal settlements. There is little recent published data on the epidemiology of adult
burns in the Western Cape, South Africa. The prediction of outcome in severe burns is
important to aid in clinical decision making, improve scarce resource allocation and allow
comparisons between different burn units. Age, burn size and the presence of inhalational
injury have been determined to be the most important factors in predicting mortality. There
is little published data on the outcome of severe burns in the Southern African region. A
retrospective review of patients on the Burn Unit database was undertaken, looking at
patients admitted to the Burn Unit between January 2003 and December 2008. This study
discusses the characteristics and outcome of patients who were treated at the Tygerberg
Burn unit. A total of 1908 patients were admitted to the burn unit during the 6 year period
under review. Most fatal injuries occurred in the 20 to 40 year age group. Injuries due to
shack fires and fuel stoves comprised 21% (399) of all admissions. Mortality due to these
injuries comprised 28% (137) of total mortality. Gas stoves accounted for 24% with kerosene
stoves accounting for 71% of injuries. The burn death rate in this study (25%) was found to
have increased dramatically from the last audit done from 1986 to 1995 in which a burn
death rate of 7.5% was observed. Reasons for this are explored. A stepwise logistic
regression analysis was done on the derivation cohort where age, gender, TBSA% and
presence of inhalational injury were identified as significant for predicting death. A mortality
prediction model is presented which was internally validated on the validation cohort. An
easy to use EXCEL calculator was created to estimate the probability of death.
Shack fires and injuries due to fuel stoves are a common reason for admission to the burn
unit and mostly involve young male individuals. Other research from the Southern African
region does not mention shack fires as a separate entity making it difficult to obtain an
accurate idea of the scale of the problem. Their injuries are severe with a high mortality. The
use of kerosene stoves are a major contributing factor. Recommendations include
enforceable legislation to promote safer stove design, research into safer bio fuels and
materials for building shacks as well promoting fire safety among schoolchildren in the
community. Further research is needed to determine the impact of HIV/AIDS on the outcome of acute burn injuries within the Southern African region. Further interventions are
needed to tackle this serious public health issue. A mortality prediction model is proposed
for use in the burn unit, but needs external validation before being adopted into clinical
practice. Further research is needed to improve data capturing in the burn unit.
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Horwitz, Ula Nadine. "Burned, banished or burnished a pilot study of a school reintegration programme." Thesis, Rhodes University, 1999. http://hdl.handle.net/10962/d1002504.
Full textAbstract:
It is the aim of this research to create a manual and programme for the reintegration of burn-injured primary-school learners in order to assist in their re-socialisation, and to act as a buffer against depression, conduct disorders, and academic lag. Additional aims of the programme included being resource-efficient, flexible, and compatible with Outcomes-Based Education (aBE) principles evidenced in Curriculum 2005. The final aim of the research involved designing the programme in order for teachers to be able to facilitate it. The manual and programme were evaluated through an embedded case study, encompassing a mildly disfigured burn-injured learner, his family, and his school environment by way of his class and teacher. The programme was found to be efficient in its use of resources, congruent with aBE principles, and engaging of the learners and teacher. Participation in the intervention seemed to afford the burn-injured learner with a buffer against depression, but did not prevent academic lag. Minimal teasing was encountered after the programme was implemented, which is contrary to the expected outcomes based on the literature available. Teacher facilitation was not achieved, however, numerous benefits were derived from the intervention for the majority of the participants.
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Pinheiro, Malone Santos. "Desenvolvimento, caracterização e efeito antimicrobiano e cicatrizante de membranas de bionanocompósito xantana:prata em modelo suíno." Pós-Graduação em Biotecnologia, 2013. https://ri.ufs.br/handle/riufs/3282.
Full textAbstract:
In recent years, advances in biotechnology has allowed the development of synthetic membranes associated with nanocomposites, which has shown promising results as dermal burns dressings. In this sense, silver nanoparticles (NPAg) has been the focus of interest because of their biological properties such as antimicrobial and antiinflammatory effect. The incorporation of NPAg in biological membranes of different natures, such as chitosan, polyester, polymethacrylate methyl and cellulose, has been
successfully tested in several biological models. The association between NPAg and polymers produced by the micro-organism presents important advantages, such as water solubility and lack of toxicity. Recently we developed a technique for producing NPAg associated with xanthan (GX), a biopolymer with potential application in various sectors of the petrochemical industry, food and pharmaceutical, through fermentation by Xanthomonas sp performed in the presence of silver nitrate. Therefore, this study aimed to develop, characterize and evaluate the potential antimicrobial and healing
membranes nanocomposite xanthan: silver on second-degree burns in the porcine model. Therefore, xanthan biocomposites: silver were used for fabrication of membranes (for casting process, which were subsequently characterized for thickness, mechanical properties (stress, strain, Young´s modulus) and the thermal profile (DSC, TG and DTG). Activity antimicrobial was tested against strains of Escherichia coli (ATCC 25922) and Staphylococcus aureus (ATCC 25923). analysis for tissue repair were made two dermal burns on the back nine male pigs breed Yorkshire (25 ± 5 kg), treated with Xanthan biosensor membrane: silver (XNPAg) with topical application of silver sulfadiazine 1% (SDZ). After eight, 18 and 30 days the wounds were examined macroscopically determined for each lesion area, and the animals euthanized for Microscopic study of the scar area observed that XNPAg membranes showed a
significant increase in the values of thickness (P <0.05), density (p <0.01) and Young´s modulus (p <0.001) and reduced strength strain (p <0.05) when compared to membranes of xanthan. Were revealed changes in the thermal profile of the two membranes suggesting the incorporation of silver nanoparticles in the polymer xanthan. XNPAg The membrane induced the formation of inhibition zones 9, 7 mm and
9.6 mm and death rate of 89% and 100% for Staphylococcus aureus and Escherichia coli respectively. Histological analysis showed quantitative and qualitative increase in the reaction granulation and best architectural arrangement of collagen fibers along the the healing process of wounds covered with membranes XNPAg. Could be concluded that the membranes nanocomposite xanthan:silver showed satisfactory mechanical properties for its handling, transportation and storage, as well as important
antimicrobial activity and pro-healing in dermal burns using porcine model.Nos últimos anos, os avanços na área da biotecnologia tem propiciado o desenvolvimento de membranas sintéticas associados à nanocompostos, que vem apresentando resultados promissores como curativos de queimaduras dérmicas. Nesse sentido, as nanopartículas de prata (NPAg) tem sido foco de interesse devido as suas propriedades biológicas como atividade antimicrobiana e efeito antiinflamatório. A incorporação de NPAg em membranas biológicas de diferentes naturezas, como quitosana, poliéster, polimetacrilato de metila e celulose, vem sendo testada com sucesso em diversos modelos biológicos. A associação entre NPAg e polímeros produzidos por microrganismo apresenta importantes vantagens, como solubilidade em água e ausência de toxicidade. Recentemente foi desenvolvida uma técnica de produção de NPAg associadas a goma xantana (GX), um biopolímero com aplicação potencial em vários setores da indústria petroquímica, alimentícia e farmacêutica, através de processo fermentativo realizado pela Xanthomonas sp na presença de nitrato de prata. Diante disso, o presente estudo teve como objetivo desenvolver, caracterizar e avaliar o potencial antimicrobiano e cicatrizante de membranas de bionanocompósito xantana:prata sobre queimaduras de segundo grau em modelo suíno. Para tanto, biocompósitos xantana:prata foram utilizadas para confecção de membranas (por casting process, que foram posteriormente caracterizadas quanto a espessura, propriedades mecânicas (tensão, deformação, módulo de Young) e perfil termoanalítico (DSC, TG e DTG). A atividade antimicrobiana foi avaliada frente a cepas de Escherichia coli (ATCC 25922) e Staphylococcus aureus (ATCC 25923). Para análise do reparo tecidual foram confeccionadas duas queimaduras dérmicas no dorso de nove suínos machos, da raça Yorkshire (25 ± 5 kg), tratadas com membrana de biocompósito xantana:prata (XNPAg) e com aplicação tópica da sulfadiazina de prata a 1% (SDZ). Após oito, 18 e 30 dias, as feridas foram analisadas macroscopicamente, determinada a área de cada lesão, e os animais eutanasiados para estudo microscópico da área cicatricial. Observou-se que as membranas XNPAg apresentaram aumento significativo nos valores de espessura (p<0,05), deformação (p<0,01) e módulo de Young (p<0,001), e redução da força de tensão (p<0,05) quando comparados a membranas de xantana. Foram evidenciadas alterações no perfil termoanalítico das duas membranas sugestivas da incorporação das nanopartículas de prata no polímero de xantana. As membrana XNPAg induziram a formação de halos de inibição de 9,7 mm e 9,6 mm e Taxa de letalidade de 89% e 100% para Staphylococcus aureus e Escherichia coli respectivamente. A análise histológica mostrou incremento quantitativo e qualitativo na reação de granulação, bem como melhor disposição arquitetural das fibras de colágeno ao longo do processo cicatricial das feridas cobertas com membranas XNPAg. Pôde-se concluir que as membranas de bionanocompóstico xantana:prata apresentaram propriedades mecânicas satisfatórias para sua manipulação, transporte e armazenamento, bem como importante atividade antimicrobiana e pró-cicatrizante em queimaduras dérmicas utilizando modelo suíno.
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Ferguson, Jon C. "Optimising the environment for treatment of patients with severe burns : the development and use of a computer-based monitoring system for heat transfer studies." Thesis, University of Aberdeen, 1991. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.303324.
Full textAbstract:
Many of the contributing factors to heat transfer from severely burned patients have been studied. This work involved experiments with a torso shaped phantom to determine local coefficients for mass and heat transfer in several environments including that used for actual patient treatment at Aberdeen Royal Infirmary. Studies on 24 burns patients treated in three Aberdeen hospitals between 1986 and 1990 were undertaken to gain a quantitative understanding of changes in burn wound permeability with elapsed time and environmental variables. Skin temperatures were also investigated. A parallel study was made to investigate ways of clinical monitoring patient heat transfer. A computer-based system was designed consisting of: a data-logger for obtaining surface, core and environmental temperatures and relative humidity, a method of logging patient weight change and integration of a remote thermographic camera for monitoring burn wound temperatures. A method for fast detailed display of thermographic data and patient information was accomplished on an inexpensive computer by a hardware modification of the display electronics and the extensive use of assembly code and look-up table techniques. Implementation of a simple graphical interface allowed burned areas on the image to be selected using a mouse and also simplified measurements made with a probe evaporimeter. Experiments with a database programe were made to determine the feasibility of storing all relevant patient data and performing whole body heat-transfer calculations from that data using the program's limited facilities for scientific calculation. The goal of this project was both to investigate methods for effectively monitoring patients in a clinical environment and to determine guide-lines for the environmental conditions consistent with patient thermo-neutrality when treated by exposure to downward flowing clean air. Significantly, heat transfer is dependent on burn wound size, requiring an air temperature of nearly 37oC when treating patients with partial and full thickness skin losses totalling more than 75% of the total body surface area, while small burns of 5% require a temperature of only 31-32oC.
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Ljungberg, Jessica, and Nassima Sangin. "Patienters upplevelser av det dagliga livet efter en brännskada." Thesis, Högskolan Kristianstad, Sektionen för Hälsa och Samhälle, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:hkr:diva-7873.
Full textAbstract:
Syfte: Syftet med studien är att belysa patienters upplevelser av det dagliga livet efter en brännskada. Bakgrund: Brännskador är ett trauma för både kropp och själ och är både ett fysiskt och psykiskt lidande. Patienterna lider av bland annat sömnsvårigheter, depression, ångest och klåda. En stor del av omvårdnaden är rehabilitering som hjälper patienten att återgå till vardagen. Hendersons omvårdnadsteori syftar till att sjuksköterskan ska hjälpa patienter att återfå oberoendet gällande sina grundläggande behov och kommer att användas vid tolkning av resultatet. Metod: Litteraturstudie utförd på ett systematiskt sätt, baserad på fem kvalitativa och sju kvantitativa vetenskapliga artiklar publicerade mellan åren 1995-2010. Resultat: Brännskador innebär både fysiska och psykiska förändringar i det dagliga livet. Resultatet är baserat på fyra kategorier; fysiska och psykiska begränsningar, vård och rehabilitering, det sociala livet och livskvalitet. Patienter upplevde bristande självförtroende, negativ påverkan på relationer, funktionshinder samt arbete och karriär, vilket kunde leda till depression och ångest. Diskussion: Rehabiliteringen var betydelsefull för patienternas tillfrisknande då det var viktigt att sjuksköterskan och anhöriga anpassade sig efter deras behov och få förståelse för den enskilda individen. Det kan vara en god idé att använda sig av Hendersons modell för att brännskadevården ska bli bättre och patienter ska klara av sin vardag på bästa sätt.Purpose: The purpose of the study is to highlight the daily life experience of patients after burn injury. Background: There is a physical and mental experience associated with burn injuries affecting both body and soul for patients which can be defined as trauma. The outcome of burn injuries can cause the patient to suffer from depression, anxiety and itching. Henderson’s care theory aims to support nurses to help patients to recover through rehabilitation so he/she can gain independency and return back to daily life. Henderson’s theory will be used to interpret the result. Method: Literature study used in a systematic way is based on five qualitative and seven quantitative articles published between 1995-2010. Result: Burn injuries have an effect on the physical and mental change in patients daily life. Result is based on four different categories: physical and mental limitations, care and rehabilitation, ability to socialize and quality of life. Patients experienced insufficient self-confidence, functional disability and negative affect on relationships and carrier which can be a driver for depression and anxiety. Discussion: Rehabilitation is crucial for the patient to recover and it is important that the nurse and relatives adapted according to the patients need. It is also important that understanding for the individual is set in mind to support the patient. It’s a good idea to use Henderson’s model to improve the care of patients after burn injury so they can manage their daily life in the best possible way.
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Stockman, A. "Signal analysis of physiological control : An investigation of blood pressure control and intercranial pressure in man with clinical applications for hypertensive skin burns and head injured patients." Thesis, University of Bradford, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.379868.
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Doi, Songila Maria da Silva Rocha. "Membrana amniótica descelularizada como substituto dérmico no processo de regeneração de queimaduras." Universidade Tecnológica Federal do Paraná, 2015. http://repositorio.utfpr.edu.br/jspui/handle/1/2017.
Full textAbstract:
A queimadura de 3º grau é um dos maiores traumas a que um ser humano pode ser submetido e em geral são as lesões mais frequentes na população mundial, tratando-se de um importante problema de saúde pública. Pensando neste problema, observou-se que a utilização da membrana amniótica (MA) pode ser o melhor tratamento que esses pacientes possam receber. Ela atua em benefício da epitelização, facilita a migração e a adesão das células epiteliais basais, a matriz estromal possui inibidores de proteases que previne a apoptose e restaura o fenótipo epitelial, antibacteriana do córion e âmnion, além de proteger a ferida e atuar na redução da dor. A descelularização, trata-se da retirada de todas as células e núcleo da MA utilizada, como forma de se evitar qualquer tipo de histoincompatibilidade. O presente trabalho teve como objetivo avaliar a eficácia do uso da membrana amniótica descelularizada (MAD) no tratamento de queimaduras de 3o grau em humanos, testada em ratos da linhagem Wistar. Trata-se de uma pesquisa descritiva, a qual investiga fundamentalmente a especificação e a disposição de dados acerca dos resultados obtidos a partir de um processo regenerativo de queimaduras utilizando-se a MAD. A amostra foi constituída de constituída por 20 ratos machos adultos da linhagem Wistar, dividida em 2 grupos (n=10): grupo controle (GC)–sem MA e grupo transplantado–com MA (TMAD). Os dois grupos foram submetidos a um processo padronizado de queimadura térmica, sendo retiradas duas amostras de tecido para análise, no 14º dia e no 30º dia. As amostras foram analisadas com o emprego de técnicas anatomopatológicas onde foram montadas em lâminas fragmentos de MA corados com solução Hematoxilina Eosina (HE) e, para análise histomorfométrica,as lâminas foram coradas com picro sirius red sob luz polarizada para verificação da descelularização e quantificação de colágeno do tipo I, II e III. As imagens foram quantificadas utilizando o programa Image Pro Plus®, versão 5.0 para Windows®. Os dados estatísticos foram analisados utilizando o programa computacional SSPS v.21.0. Observou-se um aumento significativo da quantificação de colágenos do tipo III no 14º dia no grupo TMAD em relação ao GC, do colágeno do tipo II no 14º e 30º dia comparado ao GC e do colágeno tipo I no 14º e 30º dia, mostrando que a utilização da MA foi eficaz no grupo TMAD. Concluiu-se que a MAD, aplicada topicamente, demonstrou eficácia no processo cicatricial em queimaduras de 3º grau. Esperava-se que a mesma promovesse a aceleração de cicatrização dos ferimentos, mas, o que se observou ao término do trabalho é que a MAD não só promoveu a cicatrização como foi mais eficiente no processo de regeneração dos tecidos lesados.3rd degree of burns are one of the greatest injury that a human being can be submitted and generally are the most frequent injuries in the world population, in the case of a major public health problem. Thinking this problem, it has been observed that the use of amniotic membrane (AM) may be the best treatment these patients can receive. It acts on behalf of epithelialization, facilitates migration and adhesion of basal epithelial cells, stromal matrix has protease inhibitors which prevent apoptosis and restores epithelial, antibacterial phenotype of the chorion and amnion, and protect the wound and act on reducing pain. The decellularization, it is the withdrawal of all cells and core AM used as a way to avoid any kind of histoincompatibility. This study aimed to evaluate the efficacy of the decellularized amniotic membrane (DAM) in the treatment of third degree burns in humans, tested in Wistar rats. It is a descriptive research which investigates mainly the specification and the arrangement of data on the results obtained from a regenerative process burns using DAM. The sample consisted of consisted of 20 Wistar adult male rats, divided into 2 groups (n = 10): control group (CG) - without MA, and group transplanted - with AM (TDAM). The two groups were submitted to a standard process of thermal burn, two samples being removed tissue for analysis on day 14 and day 30. Samples were analyzed with the use of pathological techniques which were mounted on slides DNA fragments stained with solution hematoxylin eosin (HE) for histomorphometric analysis, the slides were stained with picrosirius red under polarized light for verification of decellularization and quantifying collagen type I, II and III. Images were quantified using Image Pro Plus ®, version 5.0 for Windows. Statistical data were analyzed using the computer program SPSS v.21.0. There was a significant increase in type III collagen quantification on the 14th day in TDAM group compared to CG, type II collagen in the 14th and 30th day compared to the CG and type I collagen in the 14th and 30th day, showing that the use of MA were effective in TDAM group. It was concluded that the DAM, applied topically, has shown efficacy in the healing process in 3rd degree burns. It was expected that it would promote accelerated wound healing but which was observed at the end of work that MAD is not only promoted as the healing was more efficient the regeneration process of the damaged tissues.
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Gillies, Peter John. "Modulation of dermal microvascular endithelial cell responses to growth factors and haemostatic factors in the presence of vitronectin." Thesis, Queensland University of Technology, 2008. https://eprints.qut.edu.au/37176/1/Peter_Gillies_Thesis.pdf.
Full textAbstract:
In order to effect permanent closure in burns patients suffering from full thickness wounds, replacing their skin via split thickness autografting, is essential. Dermal substitutes in conjunction with widely meshed split thickness autografts (+/- cultured keratinocytes) reduce scarring at the donor and recipient sites of burns patients by reducing demand for autologous skin (both surface area and thickness), without compromising dermal delivery at the wound face. Tissue engineered products such as Integra consist of a dermal template which is rapidly remodelled to form a neodermis, at which time the temporary silicone outer layer is removed and replaced with autologous split thickness skin. Whilst provision of a thick tissue engineered dermis at full thickness burn sites reduces scarring, it is hampered by delays in vascularisation which results in clinical failure. The ultimate success of any skin graft product is dependent upon a number of basic factors including adherence, haemostasis and in the case of viable tissue grafts, success is ultimately dependent upon restoration of a normal blood supply, and hence this study. Ultimately, the goal of this research is to improve the therapeutic properties of tissue replacements, through impregnation with growth factors aimed at stimulating migration and proliferation of microvascular endothelial cells into the donor tissue post grafting. For the purpose of my masters, the aim was to evaluate the responsiveness of a dermal microvascular endothelial cell line to growth factors and haemostatic factors, in the presence of the glycoprotein vitronectin. Vitronectin formed the backbone for my hypothesis and research due to its association with both epithelial and, more specifically, endothelial migration and proliferation. Early work using a platform technology referred to as VitroGro (Tissue Therapies Ltd), which is comprised of vitronectin bound BP5/IGF-1, aided keratinocyte proliferation. I hypothesised that this result would translate to another epithelium - endothelium. VitroGro had no effect on endothelial proliferation or migration. Vitronectin increases the presence of Fibroblast Growth Factor (FGF) and Vascular Endothelial Growth Factor (VEGF) receptors, enhancing cell responsiveness to their respective ligands. So, although Human Microvascular Endothelial Cell line 1 (HMEC-1) VEGF receptor expression is generally low, it was hypothesised that exposure to vitronectin would up-regulate this receptor. HMEC-1 migration, but not proliferation, was enhanced by vitronectin bound VEGF, as well as vitronectin bound Epidermal Growth Factor (EGF), both of which could be used to stimulate microvascular endothelial cell migration for the purpose of transplantation. In addition to vitronectin's synergy with various growth factors, it has also been shown to play a role in haemostasis. Vitronectin binds thrombin-antithrombin III (TAT) to form a trimeric complex that takes on many of the attributes of vitronectin, such as heparin affinity, which results in its adherence to endothelium via heparan sulfate proteoglycans (HSP), followed by unaltered transcytosis through the endothelium, and ultimately its removal from the circulation. This has been documented as a mechanism designed to remove thrombin from the circulation. Equally, it could be argued that it is a mechanism for delivering vitronectin to the matrix. My results show that matrix-bound vitronectin dramatically alters the effect that conformationally altered antithrombin three (cATIII) has on proliferation of microvascular endothelial cells. cATIII stimulates HMEC-1 proliferation in the presence of matrix-bound vitronectin, as opposed to inhibiting proliferation in its absence. Binding vitronectin to tissues and organs prior to transplant, in the presence of cATIII, will have a profound effect on microvascular infiltration of the graft, by preventing occlusion of existing vessels whilst stimulating migration and proliferation of endothelium within the tissue.
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Grande, Karin Cristine. "Análise da energia utilizada por bisturi elétrico na ablação de tecido orgânico." Universidade Tecnológica Federal do Paraná, 2014. http://repositorio.utfpr.edu.br/jspui/handle/1/1150.
Full textAbstract:
A eletrocirurgia é uma técnica cirúrgica que utiliza o bisturi elétrico para a realização do corte, dessecação e coagulação do tecido orgânico, diminuindo dessa forma os riscos de hemorragia. O bisturi elétrico usa o processo da faiscância para a realização do trabalho. Esse processo provoca, entre outras coisas, o aquecimento da água intracelular e, consequentemente, o rompimento da célula do tecido. Embora se saiba a quantidade de energia entregue pelo bisturi elétrico, pouco se sabe sobre as parcelas de energia envolvidas nos vários fenômenos do processo eletrocirúrgico, principalmente no corte, onde as células sofrem ablação por vaporização. Com base neste problema, foi desenvolvida esta pesquisa, que teve o objetivo de determinar a energia necessária para o corte eletrocirúrgico, através dos parâmetros elétricos envolvidos e da energia utilizada para a vaporização da água do tecido orgânico. O método desenvolvido foi testado em três experimentos, com várias séries de cortes específicos em cada. Demonstrou-se que da energia total que é entregue pelo bisturi, menos de 10% é utilizada para o corte, ou especificamente, para a vaporização da água do tecido. O restante da energia acaba sendo utilizada em outros processos que começarão a ser analisados em outros trabalhos.Electrosurgery is a surgical technique that uses an electrosurgical device for cutting, drying (desiccation), and coagulation of organic tissue, thereby reducing the risk of bleeding. Electrosurgical device uses sparking phenomena for this purpose. This process causes heating of intracellular water and, consequently, the rupture of the cell in the organic tissue. Although the amount of energy delivered by the electrosurgical device is easy to know, little is known about the exactly amount of energy involved in the various phenomena of electrosurgical procedure, especially in cutting, where cells suffer ablation by vaporization Based on this was developed this research, which objective is to determine the energy required for the electrosurgical cutting through the electrical parameters involved and the energy used for the vaporization of water of organic tissue. The method developed was corted in three experiments, with a series of specific tests in each. It has been show that only about 10% of total energy is used for cutting, or specifically, for the vaporization of water of organic tissue. The rest of the energy is used in other processes that need more investigation to be understood.
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HSU, PO-TING, and 許博廷. "Construction a model to predict the important factors for the patients with burns and scald- Take the example of the database of the injury and scald centers at National Taiwan University." Thesis, 2018. http://ndltd.ncl.edu.tw/handle/5e9ema.
Full textAbstract:
碩士國立雲林科技大學
工業工程與管理系
106
In 2014, American Burn Association shows that there are four hundred and fifty thousand people sent to the emergency by the burns accident. Inside of these people, there were 3275 people died after the medical treatment. Moreover, Ministry of Health and Welfare in ROC present that there are 25600 people sent to the emergency by the burns accident and 128 people died because of the burns accident in 2015. On June 27, 2015, in the burs accident of Formosa Fun Coast party. The mortality rate is only 3 percent. We found out there are a huge different from the research before. The method which we had use before for evaluate the survival factors of the burns accident was to observe the wound situation or according to the infectious disease. Because the blood condition in human body has strong related with the survival probability, we put the blood factor into our prediction models for our research. We want to know if the factor we knew before is fit to the burs accident condition in Taiwan or there are others factor we do not notice in the past research. The most important thing is we collect the data at National Taiwan University Hospital Burns Center Information and use the way of backward cases history in our research. To be aimed at the dying factors of burns accident, we use the Random Forest Algorithm and Back Propagation Neural Network in our data mining method. The results show that the variables which used principal component analysis of Random Forest Diseases had better effect. Its area under the curve line of ROC models is 80.7 percent. The estimate of the mortality aspect is more accurately than the international burning mortality formula.
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Abu-Qamar, Ma'en Zaid. "Diabetes: the challenge in burns units." 2007. http://hdl.handle.net/2440/38942.
Full textAbstract:
People with diabetes are at a greater risk of burn injuries than those without diabetes. This stems from the epidemiological profiles of the conditions and the effects of morbidities associated with diabetes. Both conditions share some similarities in terms of metabolic alterations and suboptimal immune functions which may result in poor outcomes for patients. For that reason, it is reasonable to deduce that patients with diabetes are a challenging group to manage in burns units. However, this deduction should be taken cautiously because of lack of supporting evidence. Accordingly and after consulting with clinical experts, the research in this portfolio investigated the association between diabetes and burn injuries. In particular, two different aspects of this association were investigated in two individual quantitative and descriptive inquiries. The first was a case note review of patients hospitalised with a principal diagnosis of a foot burn injury in a large tertiary hospital in South Australia from 1999 to 2004. The second study investigated management of diabetes in burns units treating adults. This study is an e-mail survey of clinical leaders of burns units in Australia, New Zealand, Hong Kong and the United Kingdom. The clinical leaders were approached indirectly through key liaison persons in each identified unit. In the first study, outcomes for twelve subjects with and fifty-two without diabetes were described using descriptive and non-parametric statistics. In the second study, descriptive frequencies and content analysis were adopted to analyse twenty-nine responses from seventeen out of thirty burns units which participated in the study. Supporting findings in the literature, the first study showed that burn injuries among subjects with diabetes were mainly resulted from household devices. There were no statistically significant differences between subjects with and without diabetes in terms of size and depth of burn injuries and treatment received. In spite of this, there was a statistically significant association between diabetes and the experience of local post-burn complications and longer duration of hospitalisation. The second study indicated that more than twenty-five percent of the respondents believed that multidisciplinary centres should only occasionally be involved in the process of care. Participants reported that the individual profile of each patient plays a major role in determining the management of diabetes. Additionally, it was found that the insulin sliding scale was commonly used in the management of diabetes in burns units. The association between diabetes and a burn injury is a serious issue in terms of health and cost. This association need be addressed firstly and most importantly at the prevention level; secondly through proper management of both diabetes and burns.http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1285462
Thesis (D.Nurs.)--Population Health and Clinical Practice, 2007.
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Abu-Qamar, Ma'en Zaid. "Diabetes: the challenge in burns units." Thesis, 2007. http://hdl.handle.net/2440/38942.
Full textAbstract:
People with diabetes are at a greater risk of burn injuries than those without diabetes. This stems from the epidemiological profiles of the conditions and the effects of morbidities associated with diabetes. Both conditions share some similarities in terms of metabolic alterations and suboptimal immune functions which may result in poor outcomes for patients. For that reason, it is reasonable to deduce that patients with diabetes are a challenging group to manage in burns units.
However, this deduction should be taken cautiously because of lack of supporting evidence. Accordingly and after consulting with clinical experts, the research in this portfolio investigated the association between diabetes and burn injuries.
In particular, two different aspects of this association were investigated in two individual quantitative and descriptive inquiries. The first was a case note review of patients hospitalised with a principal diagnosis of a foot burn injury in a large tertiary hospital in South Australia from 1999 to 2004. The second study investigated management of diabetes in burns units treating adults. This study is an e-mail survey of clinical leaders of burns units in Australia, New Zealand, Hong Kong and the United Kingdom. The clinical leaders were approached indirectly through key liaison persons in each identified unit.
In the first study, outcomes for twelve subjects with and fifty-two without diabetes were described using descriptive and non-parametric statistics. In the second study, descriptive frequencies and content analysis were adopted to analyse twenty-nine responses from seventeen out of thirty burns units which participated in the study.
Supporting findings in the literature, the first study showed that burn injuries among subjects with diabetes were mainly resulted from household devices. There were no statistically significant differences between subjects with and without diabetes in terms of size and depth of burn injuries and treatment received. In spite of this, there was a statistically significant association between diabetes and the experience of local post-burn complications and longer duration of hospitalisation.
The second study indicated that more than twenty-five percent of the respondents believed that multidisciplinary centres should only occasionally be involved in the process of care. Participants reported that the individual profile of each patient plays a major role in determining the management of diabetes. Additionally, it was found that the insulin sliding scale was commonly used in the management of diabetes in burns units.
The association between diabetes and a burn injury is a serious issue in terms of health and cost. This association need be addressed firstly and most importantly at the prevention level; secondly through proper management of both diabetes and burns.Thesis (D.Nurs.)--Population Health and Clinical Practice, 2007.
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Mukarugwiza, Florence. "Characteristics and risk factors of burn injuries in Chuk/Rwanda." Thesis, 2009. http://hdl.handle.net/10413/250.
Full textAbstract:
Introduction: Bums are senous health problems associated with high mortality and
morbidity. Bum deaths include bums from residential fires and scalds, clothing bums,
industrial injuries, electrical injuries, among other sources of thermal energy.
Aim: The aim of the study was to identify risk factors and describe characteristics of
bum injuries in Rwanda. Ninety eight patients of all ages were selected and stratified by
age, sex, bum size, causes of bum, and province of residence. Most of the patients
(54.5%) were below the age of 12. Among children, 6% were aged between 0 and 11
months, 38% were aged between I and 5 years, 11% were between 13 and 21 years, 34%
were adult between 22 and 49 years, and 3% were senior persons of above 50 years. The
male population accounted for 55% of the total sample population, whereas the female
population accounted for 41 %.
Method: A quantitative retrospective descriptive survey was used in this study intended
at reporting the characteristics and risk factors of bums in Rwanda.
Results: The study finds a statistical correlation between gender and agent since 90% of
contact bums occurred among the female population, although more male persons were
affected by chemical bums (73%) in comparison to incidence among the female
population (27%). Scalds were the most common type ofbum among children of 0 to 5
years of age as well as among adults. Flame bums predominated in older children. Large bum size was the strongest predictor
of mortality. Among the twenty eight resultant deaths observed, twenty (71.4%) had a
TBSA> 20%. Bum patients from rural areas had a higher mortality rate compared to
patients that came from the urban context of the city of Kigali. The Southern Province
recorded the highest mortality rate (l00%) followed by the Northern Province (62.5%)
and the Eastern Province (45.4%). The city of Kigali has a mortality rate of 19%,
notwithstanding its high frequency rate in terms of hospital admission (34.7%).
Moreover, the study found that 25% of patients from the city of Kigali with major (more
than 20%) TBSA recovered without disability, while none (0%) from the rural areas
survived. Large bum size was the strongest predictor of mortality, followed by the rural
factor (residence), and by the presence of inhalation injury. Infants and young children
had the highest risk of death from bum injury. Bums smaller than 20% TBSA, without an
inhalation injury (such as small scald injuries), are occasionally lethal in bums for both
adults and children.
Conclusion: The consequences of fire and bum injuries are so large and potentially
devastating that efforts for their prevention should be proportionally much greater than
reflected in mortality statistics. Some individuals feel that large bums are a worse fate
than death (MacKenzie et al 1989). The scars of bum victims should remind us that
prevention of these injuries must have high priority and attention now than they have had
in the past.Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2009.
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Beder, Jefferson Brian. "Human keratinocyte culture and grafting techniques used in the treatment of extensive full thickness burn wounds and chronic leg ulcers." Thesis, 2016. http://hdl.handle.net/10539/20615.
Full textAbstract:
A dissertation submitted to the Faculty of Science University of the
Witwatersrand, Johannesburg for the Degree of Master of Science.
Johannesburg 19921. Beder, J.B. Thornley, A.L. and Veale.R, Human keratinocyte culture techniques using foetal, neonatal and adult keratinocytes with particular reference to extensive bum wounds. This paper was presented at the South African Burn Society Biannual Congress held at Berg en Dal, Kruger National Park, from 31 August to 1 September 1989. 2. Beder, J.B., Thornley, A.L. and Veale, R. Human keratinocyte culture techniques in extensive burn wounds. The Journal of Trauma and Emergency Medicine. 1990 Jan/Feb; 7 (1); 29-32. 3. Beder J.B. Cultured allografts. A letter appearing in the Continuing Medical Education Journal (CEM). 1990 Jan; 8(1): 48. 4. Beder, J.B. Problems and attempted solutions associated with the application of cultured epidermal grafts to full thickness burns in extensively burnt patients. This paper was presented in the form of a poster at the Association of Surgeons of South Africa Biannual Congress held in Bloemfontein from May 1-4 1990. 5. Beder, J.B., Thornley, A.L., Veale R., Kadwa, A.M., Scott, E. Healing chronic leg ulcers cultured keratinocyte allografts. This paper was presented at the annual Congress of The Surgical Research Society of Southern Africa held in Bloemfontein from 29 April to 1 May 1990. This paper was the runner-up for the best paper presented at the above congress. 6. The abstract of the paper mentioned in 5. above was published in the South African Journal of Surgery 1990 Sep; 28 (3): 123. 7. Beder, J.B., Healing full thickness burns with various types of cultured epidermal grafts - a comparative study. This paper was presented at the Z4th annual meeting of the British Burn Association held at the post-graduate centre, Stock Mandeville, Aylesbury, Bucks. England, United Kingdom, on the 10th May 1991. 8. Beder, J.B, J.B. A comparative study of various keratinocyte cell lines used in the synthesis of confluent stratified keratinocyte sheets. This paper was presented at the skin culture meeting, a satellite meeting of the 24th annual meeting of the British Burn Association, held at the post-graduate centre, Stoke-Mandeville, Aylesbury, Bucks, England, United Kingdom, on the 8th May 1991. 9. Beder, J.B. Healing chronic leg ulcers using cultured keratinocyte allografts. This paper was presented at the skin culture meeting of the British Burn Association held at the post-graduate centre, Stoke- Mandeville, Aylesbury, Bucks, England, United Kingdom on the 8th May 1991. 10. Beder, J.B., Thornley, A.L. and Veale, R. Healing chronic ulcers and other skin defects, using cultured keratinocyte allografts - including an assessment of their survival. Submitted for publication to the British Medical Journal. 11. Beder, J.B. The preparation and grafting of cultured epidermal sheets. Submitted for publication to the South African Journal of Surgery. 13. Beder, J.B., Thoenley, A.L. and Veale. R. Healing full thickness burns with cultured epidermal grafts - a comparative study. Submitted for publication to Transplantation.