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November 18, 2011

Severe Burns Among Pediatrics Can Heal With Fewer Treatments, New Study Finds


Here is a research finding that could improve the recovery experience for pediatric patients who have suffered severe burns.

In mid-October, a study was released by researchers at Children's Mercy Hospitals and Clinics in Kansas City, Missouri that says that fewer treatments are just as effective as the present standard of care given to children suffering from burns. The research was presented at the American Academy of Pediatrics National Conference and Exhibition in Boston.

"Given the risk of infection, dressings for burn patients need to be changed once or twice a day. This experience can be traumatic, especially for a young child," said Daniel Ostlie, M.D., director, Surgical Critical Care at Children's Mercy and lead investigator of the study. "If we can reduce this trauma just the slightest bit by eliminating one of the topical applications - with no major implications for outcome - we can make a significant improvement in the patient recovery experience."

In the randomized study, researchers compared the effectiveness of two burn therapies commonly used to facilitate the healing process: topical silver sulfadiazine, which is an antimicrobial treatment; and collagenase ointment, which is an enzyme therapy. While silver sulfadiazine is frequently used for its anti-bacterial properties, collagenase ointment is believed to shorten the healing time of burn wounds.

"For all of our burn patients, we want to avoid more invasive treatment, such as skin graft, because these add another layer of distress for the patient and the family," said Janine Pettiford, M.D., surgical scholar in the Department of Surgery at Children's Mercy and an author of the study. "Non-invasive topical therapies have proven to be effective, but no studies have demonstrated if one treatment is more effective than another in reducing the odds that the patient would need a skin graft."

Using a consistent intervention approach with both therapies, researchers found there was no difference in the need for skin grafting between the two therapies. Additionally, the cost difference between the therapies was insignificant.

Children's Mercy Hospitals and Clinics is one of the nation's top pediatric medical centers. The 314-bed hospital provides care for children from birth through the age of 18, and has been recognized by the American Nurses Credentialing Center with Magnet designation for excellence in nursing services, and ranked in U.S. News & World Report's "America's Best Children's Hospitals" listing for all 10 specialties the magazine ranks.

I you or someone you know does suffer a severe burn injury or a smoke inhalation injury, you should call Kramer & Pollack LLP in Mineola, New York so that the personal injury attorneys in that firm can determine whether another party has legal liability for injuries suffered, and if the injured party has a solid legal case.

November 2, 2011

How to Care for Your Burned Skin Following Hospital discharge (Part II)

After being discharged home from the hospital, a new phase of wound care starts at home. The new healing skin needs special care and consideration in which you play a major role.

Bathing: the first thing to be done before getting into a shower or a tub is to test the temperature of the water as your new skin is sensitive to extreme cold or extreme hot water and can be injured easily. Make sure that the area where bathing is taking place (shower or tub) is clean. Always look for signs and symptoms of infection of infection especially in children as they may not be able to speak. Gently wash with a clean soft towel instead of vigorously rubbing as this will lesson any discomfort associated with bathing. Use your medications as described before washing the wound if you have any open area. Continue to wash these area as directed according to the instructions that you have been given and with applying medication as directed.

Scarring: it's very difficult to tell how much scarring will be perminant in the beginnig. People vary in their tendency to scar, some people have a greater tendency to scar than others and it's difficult to determine how much scarring each patient will have as the amount is determend depending on the depth of the burn as well as individual basis. There are 2 types of scars, Keliod and hypertrophic scars.

A keloid scar is a type of scar that results in an overgrowth of tissue at the site of healed skin injury due to aggressive healing process. This type of scar grows and extends beyond the site of injury unlike hypertrophic scar. They occur as a result of the body's continuous production of collagen which is a fibrous protein after the healing of the wound. They often appear red or pink in color as compared to the surrounding normal skin. They are firm, rubbery lesions; they may appear shiny or as fibrous nodules. Keloid scars may be accompanied by severe itching, pain and may limit mobility if they are extensive. They may vary in size and some types may increase in size. They may occur anywhere on the body although some areas are more susceptible to form keloid scars such as the deltoid region. They occur more often in darker skinned patients.

A hypertrophic scar is an elevated scar that appears red, thick and raised as a lump on the skin, hypertrophic scars usually feel firm to the touch, and they may be sensitive to changes in temperature or texture. They don't grow beyond the injury site or incision (unlike a keloid scar which grows beyond the original site of the injury). Hypertrophic scars usually start to develop within weeks after the injury and often improve in appearance with time, which may take few years.
Treatment of scars is not easy, scars have the tendency to re-occur and multiple treatments may be required. Treatment may include compression garments, steriod injuction, cryotherapy, surgical therapy and laser surgery.

It's important to follow your doctor's instructions. if you have been prescribed compression garments, it is important to wear them for 23 hours a day (taken off only when bathing), as they can minimize scarring. If you were taught any exercises than you have to do them as they will minimize the scarring.

This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.

November 1, 2011

How to Care for Your Burned Skin Following Hospital discharge (Part I)

Wound care at home is one of the important factors in the continuation of wound healing. You may be discharged from the hospital with unhealed wound areas that still require wound care. Before being discharged, the social worker will have a meeting with you to discuss your discharge arrangement. According to your burn severity and your needs, you may be sent home or to a rehabilitaion facility were you will be provided with services according to your needs such as Physical therapy (PT), Occupational therapy (OT), and Speech therapy (ST).

Being discharged home after a lengthy hospital stay is one of the exciting moments for a burned victim. Your healing skin requires special attention and care. Some of the facts that you should pay attention to include:

  • Skin dryness: when the skin is burned, the oil producing glands in the skin (Sebaceous glands) will be damaged or destroyed and your skin will appear dry and scaly. Until the time some of these glands will begin functioning again, lubricants are needed. Avoid using lubricant that contains chemicals or alcohol as they may lead to skin irritation and blister formation. Use the lubricants as directed by your treating physician.
  • Blisters: blisters occur in grafted or healed skin. Bumping against objects, friction and rubbing with linen can cause blisters. As the new skin matures and thickens, the tendency to form blisters decreases. Contact your burn clinic or treating physician when blisters when blisters form to take instructions on how to take care of them.
  • Exposure to sun: you should protect your new skin from the effect of sunlight as the new skin is more sensitive and takes shorter time to burn. Direct contact with sunlight should be avoided at all times. Protection from sunburn can be done by: limiting exposure to sun specially in the peak hours (10am-3pm), Wearing sunscreens with a sun protective factor (SPF) of at least 30, Applying sunscreen 30 minutes prior to sun exposure (to allow skin to absorb it); sunscreen absorbs ultraviolet light reducing the amount that reaches the skin, Wear sunscreens when swimming in an outdoor pool, Wear hats, protective clothing and sunglasses with UV protection, Use lip balm with sunscreen to protect lips from burning, Look for shady areas, An ounce of prevention is worth a pound of cure.
  • Exposure to cold: the new skin is thinner and with time it will mature therefore it will be more sensitive to cold. When the weather is cold, slight numbness and tingling may be experienced especially in the feet and hands, this sensation will decrease with time. Wearing warm cloth and avoiding cold exposure help in decreasing the discomfort.
  • Itching: the new skin is dry and scaly due to the destruction of the oil producing glands which take time for some of these glands to function again. Itching is usually associated with healing, dry and scaly skin. Vigorous scratching should be avoided as this may lead to a break in the healing skin as well as a superadded infection. Use lubricants (mineral oil, lotions) as needed. Contact your physician in case of severe itching as he/she may prescribe medications for that purpose.
  • Skin discoloration: skin discoloration that may be noticed in the healing area is a result of the normal healing process. The color may vary from light to brown or even gray in color as the discoloration varies depending on the natural color of your skin. The time needed for the skin to return to its natural color depends on the severity of burn as it may take several months in superficial and some second degree burns while others may take a longer time, some skin discolorations may be permanent in severe burns such as third degree burns.
This information is not intended nor implied to be a substitute for professional medical advice; it should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Call 911 for all medical emergencies.