Medicine and Health Sciences Commons^™

Pharmacological Efficacy Of Aloe Vera In Wound Healing: A Narrative Review, Sandra Viviana Aparicio Salcedo, Brian Steven Carranza Aldana, Sayuri Anayca Chávez Salas, Leslie Solanth Quispe Tinco, Carlos Abel Palomino Zevallos, Ariana Nicole Peralta Medina, Juana Mónica Robles Esquerre

Revista de la Facultad de Medicina Humana

Aloe Vera has different therapeutic effects, including wound healing. The aim of this review is to determine the potential efficacy of topical use of Aloe Vera in skin wound healing. A bibliographic search of preclinical and clinical studies from 1999 to 2020 was carried out, which included the therapeutic use of Aloe vera in the healing of: burns, surgical wounds, lactation disorders, anal fissure and anal fistula; in the databases of the VHL Regional Portal, PubMed and Google Scholar. It was obtained that the topical administration of Aloe vera was effective in the healing of the mentioned wounds by mainly …

Assessing Disparities In Culturally Competent Care In Ethnic Burn Patients, Min Kang

Nursing | Student Research Posters

One of the most debilitating injuries one can suffer is a burn. It is even worse when certain individuals can not access the high quality care such as immigrants. With immigration rates increasing over the last several decades, these populations often lack the proper medical care that they deserve. The overarching theme in this population is that they face challenges in attaining positive patient outcomes due to cultural differences.

• Lack of Culturally Competent Care in Burn Care
• Addressing Cultural Safety and Quality of Care in Burn Injury Management
• Analyzing Disparities in Access to Culturally Competent Burn care

Contracture Management For Acute Burn Injury Patients, Brianna Paige Pestrosky

Graduate Theses, Dissertations, and Problem Reports

Background: The Occupational Therapists working within the burn unit at West Penn Hospital assess and treat patients utilizing the biomechanical approach FOR, as well as the support from MOHO and PEOP. The patients seen within the burn unit encompass a variety of injuries and occupational deficits that require an individualized and holistic approach to care.

Purpose: The purpose of the contracture management project is to provide an interdisciplinary approach to improve carryover and patient care within and out of the hospital.

Theoretical framework: The contracture management project is guided using the biomechanical frame of reference as well as supporting constructs …

Advocating For The Role Of Occupational Therapy In The Burn Population, Jordan Faircloth, Keisa Boykin

Fall 2023 Virtual OTD Capstone Symposium

In 2018, around 450,000 individuals in the United States (U.S.) suffered from severe burn injuries (ABA, 2018). The largest burn center in the U.S. is the Joseph M. Still Burn Center at Doctors Hospital, located in Augusta, Georgia. This location is where the capstone experience was completed. Individuals who suffer from severe burns are at risk for developing contractures. Scar contractures can impact an individual during ADL participation, limiting their independence and causing a disruption in daily routine, habits, and roles (Oosterwijk et al., 2017). Five main components of scar management focus on compression gear, sun protection, appropriate positioning/splinting to …

Maximizing Wound Coverage In Full-Thickness Skin Defects: A Randomized-Controlled Trial Of Autologous Skin Cell Suspension And Widely Meshed Autograft Versus Standard Autografting, Sharon Henry, Steven Mapula, Mark Grevious, Kevin N. Foster, Herbert Phelan, Jeffrey Shupp, Rodney Chan, David Harrington, Neil Mashruwala, David A. Brown, Haaris Mir, George Singer, Alfredo Cordova, Lisa Rae, Theresa Chin, Lourdes Castanon, Derek Bell, William Hughes, Joseph A. Molnar

Department of Surgery Faculty Papers

BACKGROUND: Traumatic insults, infection, and surgical procedures can leave skin defects that are not amenable to primary closure. Split-thickness skin grafting (STSG) is frequently used to achieve closure of these wounds. Although effective, STSG can be associated with donor site morbidity, compounding the burden of illness in patients undergoing soft tissue reconstruction procedures. With an expansion ratio of 1:80, autologous skin cell suspension (ASCS) has been demonstrated to significantly decrease donor skin requirements compared with traditional STSG in burn injuries. We hypothesized that the clinical performance of ASCS would be similar for soft tissue reconstruction of nonburn wounds.

METHODS: A …

Physical And Psychological Impacts Of Burn Injuries On The Pediatric Population And Their Families: An Occupational Therapy Perspective, Sadie E. Anderson

Occupational Therapy Capstone Presentations

Background: Due to the curious nature of the pediatric population, burns are a common and leading cause of non-fatal and fatal injuries among children. Following these injuries, the impacts extend beyond the physical impairments that occur and often result in long-term psychological impacts for the child and their families. With a holistic approach to care, occupational therapy is fully equipped to aid in the mitigating of these impacts. Method: Through advanced clinical practice and the development of various questionnaires, occupational therapy interventions were explored and integrated to facilitate functional outcomes and improve mental health care. Results: With the provision of …

Improving The Psychosocial Effects Of A Burn Injury, Leila Young

Nursing | Student Research Posters

Burn injuries are an existing risk factor of social impairment. The main priority of care for a burn patient includes the focus on pain management and wound care. However, scarce research has been studied on how to improve the psychological adjustment of burn victims. There is limited availability of evidenced based practice that is related to promoting a healthy social life after a burn. Without interventions to help re-engage burn victims with society, they will turn to negative coping mechanisms such as avoidance, isolation and distancing. The goal of this study is to enhance the social interaction of burn survivors …

A Prospective Study For An Alternative Probe Site For Pulse Oximetry Measurement In Male Patients With Severe Burn Trauma: Penile Shaft, Yeşi̇m Andiran Şenayli, Gülsen Keski̇n, Mi̇ne Akin, Ati̇lla Şenayli, Rabi̇a Ata, Gökhan Demi̇rtaş, Emrah Şenel

Turkish Journal of Medical Sciences

Background/aim: Authors widely use pulse oximetry in clinical monitoring of heart rate (HR) and peripheral oxygen saturation (SpO2) by attachment to the fingers; however, there can be a need for an alternative attachment site, especially for burned patients. We investigate the availability of a pulse oximeter probe attached to the penile shaft as an alternative site in pediatric male patients if all extremities became unavailable for pulse oximetry measurement due to severe burn and/or trauma. Materials and methods: We designed a prospective comparative study in a training and research hospital. After local ethical committee approval, pediatric male cases eligible for …

Meta-Analysis Of Prognostic Indicators In Burned Patients, Fawzy Ahmed Hamza, Khallad Mohamed Abd Elfattah Sholkamy, Omar Mohamed Saad Abd Elfattah

Al-Azhar International Medical Journal

Background: The chance of death after a burn injury is considerable.There is a dearth of recent epidemiological data on burn injury and mortality rates in Egypt. Objective: This study used meta-analysis to look at the prognostic markers in burn victims. Materials and Methods: This was a meta-analysis, and articles from PubMed, PLOS, and Clarivate - Scopus were searched for relevant material.To retrieve articles from the previous ten years, we used a variety of search engines, including EKB. A total of 20 studies were included 6 were retrospective studies, 1 case series, 1 case control, 1 cross sectional and 1 prospective …

Increased Incidence Of Suspected Smoke Inhalation During The Coronavirus Disease 2019 Pandemic: A National Database Study, Theodore E Habarth-Morales, Arturo J. Rios Diaz, Emily Isch, Shreyas Chandragiri, Lucy Qi, Rose Ni, Edward J. Caterson

Student Papers, Posters & Projects

The COVID-19 pandemic has forced many Americans to adapt their daily routines. In 2020, there was a significant increase in house fires according to the National Fire Prevention Association (NFPA). The objective of this study was to characterize the changes in suspected smoke inhalations (SSIs) during the first year of the pandemic in the National Emergency Medical Services Information System (NEMSIS). The NEMSIS database was queried for all EMS transports captured between 2017 and 2020. Differences in the incidences of SSIs and fire dispatches in 2020 were estimated using Poisson regression models. There was a 13.4% increase in the incidence …

Delirium In Hospitalised Adults With Acute Burns – A Systematic Review, Guy H.M Stanley, Angus R.J Barber, Aoife M. O'Brien, Cheryl Hamill, Glenn Boardman, Cody C. Frear, Dale W. Edgar, Hannah Seymour, Fiona M. Wood

IHR Papers and Journal Articles

Introduction: Delirium is a potentially modifiable, acutely altered mental state, commonly characterised as a hospital-acquired complication. Studies of adult inpatients with acute burns with and without delirium identify causative risks related to the injury or treatment and outcomes related to the patient and healthcare system. We compare patients with and without delirium, providing a high-level quantitative synthesis of delirium risks and outcomes to inform guidelines and future research.

Methods: A systematic review, meta-analysis and GRADE evaluation of risks and outcomes associated with delirium in adults with acute burns was conducted using PRISMA guidelines and PROSPERO protocol CRD42021283055. The Newcastle-Ottawa Scale …

A Study On Post-Burn Healing: Optimising Scar Outcome Through The Use Of A Silicone-Based Film-Forming Wound Dressing, Fiona Poelchow

Theses

Introduction

The development of scarring is a normal physiological response during burn wound healing for any except the most trivial of injuries. Burn scarring can cause considerable functional and psychological anguish in burn survivors. Prolonged wound healing has been shown to affect scarring outcomes. Superficial cutaneous wound injuries carry a risk of scarring and altered pigmentation after the wound has healed. The primary aim of this study was to explore the effects of topical silicone on the rate of wound healing in superficial wounds. Secondary aims included investigation of scar and pain outcomes.

Methods

This thesis presents two studies which …

Nerve Impairment In Burn Injuries, Taylor A. Kowalske

Department of Occupational Therapy Entry-Level Capstone Projects

No abstract provided.

Enteral Nutrition Protocol For Pediatric Burn Patients: A Quality Improvement Initiative, Margaret Tepe

Doctoral Projects

Objective: This quality improvement project was conducted to determine the efficacy of an enteral feeding protocol to improve nutrition supplementation in pediatric burn patients.

Methods: Non-ICU patients with >10% total burn surface area requiring enteral nutrition supplementation were fed within 12 hours of admission or with the first sedated dressing change, whichever took place first. Pre (n = 3) and post (n = 5) implementation of the enteral feeding protocol data were obtained. Data were collected via chart audit and survey.

Results: Patients and nurses had similar characteristics; and nurses had similar nutrition practices. Total intake of calories (93.8%) and …

Seasonal Impact In Admissions And Burn Profiles In A Desert Burn Unit, Syed F. Saquib, Joseph T. Carroll, Paul J. Chestovich

Surgery Faculty Publications

In much of the world, pattern of burn injuries can vary depending on the season. This study examines the seasonal impact of admissions, acuity, mortality, and resource utilization at an accredited burn center located in a desert climate. It is a retrospective analysis of patients admitted from March 1, 2014 to February 28, 2019 for acute burns. Patients were categorized into four groups according to each season based on their date of admission: Spring (March, April, May), Summer (June, July, August), Fall (September, October, November), and Winter (December, January, February).

A total of 1519 patients were included. 1016 were male …

Foot Ulcers Associated With External Trauma Among People With Diabetes: An Integrative Review Of The Origin Of Trauma And Outcomes, Ma-En Zaid Abu-Qamar, Vivien Kemp, Lisa Whitehead

Research outputs 2014 to 2021

Background

Foot ulcers are common among people with diabetes. These ulcers are caused by a number of factors including trauma. To date, research findings on the origin of external trauma and the outcome of foot ulcers resulting from an external trauma have not been summarised.

Objective

To examine the origin of external trauma that contribute to the development of foot ulcers among people with diabetes and the outcome of such ulcers.

Design

An integrative review.

Settings

Hospital/community.

Participants

Patients with diabetes and foot ulcer.

Method

The Joanna Briggs framework was used to underpin this integrative review. Six different databases (CINAHL …

The Efficacy Of Resistance Training In Addition To Usual Care For Adults With Acute Burn Injury: A Randomised Controlled Trial, Paul M. Gittings, Benedict M. Wand, Dana A. Hince, Tiffany L. Grisbrook, Fiona M. Wood, Dale W. Edgar

Physiotherapy Papers and Journal Articles

Resistance training immediately after a burn injury has not been investigated previously. This randomised, controlled trial assessed the impact of resistance training on quality of life plus a number of physical, functional and safety outcomes in adults with a burn injury. Patients were randomly assigned to receive, in addition to standard physiotherapy, four weeks of high intensity resistance training (RTG) or sham resistance training (CG) three days per week, commenced within 72h of the burn injury. Outcome data was collected at six weeks, three and six months after burn injury. Quality of life at 6 months was the primary endpoint. …

Quantification Of The Negative Impact Of Sedation And Inotropic Support On Achieving Early Mobility In Burn Patients In Icu: A Single Center Observational Study, Lauren Bright, Lisa Van Der Lee, Dana Hince, Fiona M. Wood, Dale W. Edgar

IHR Papers and Journal Articles

Introduction: Early rehabilitation for burns survivors in the intensive care unit (ICU) is arguably more challenging than the general population. Early achievement of functional verticality milestones (FVMs) has the potential to ameliorate the detrimental effects of bed rest and immobility observed in ICU patients and reduce healthcare costs. However, the time to achieving FVMs after burn injury is influenced by factors such as sedation practices, cardiovascular stability, mechanical ventilation, acute skin reconstruction and length of stay (LOS) during the acute intensive care period.

Objectives/Aims: The aims of this study were to identify the association between early achievement of FVMs and …

Clinical Trials Of 3d Printing Splints To Avoid Contracture Development In Burned Children, Ati̇lla Şenayli, Güven Çankaya, Can İhsan Öztorun, Hakan Oflaz, Emrah Şenel

Turkish Journal of Medical Sciences

Background/aim: We evaluated the feasibility of producing splints with 3D printer technology to prevent contractures in burned children in our clinical prospective study. Materials and methods: After approvals, children with burns greater than 2nd degree were included in the study. Age, sex, burn percentages, printing time, filament types, number of filament trials, splint suitability, patient and doctor comments, preclinical trials' significances and financial impact were evaluated statistically. Results: Seventy-six trials were conducted on 18 patients. Fourteen of the patients were male and 4 are female. Average ages of boys and girls were 5 and 3, respectively. Burn percentage was 36.9 …

A Systematic Review Of Epidemiological Patterns And Proposed Interventions To Address Pediatric Burns In Nigeria, Srikanta Banerjee, Constance Shumba

School of Nursing & Midwifery, East Africa

Background: Unintentional injuries from burns comprise a significant proportion of public health morbidity in Nigeria. In order to understand the type and impact of burns on youth in Low-and-Middle-Income countries, the epidemiology of burns must be adequately assessed.

Methods: This review describes the epidemiological patterns of burn occurrences in the pediatric populations and pro- poses interventions using the Haddon Matrix to address injuries in specific populations in Nigeria. A literature search was conducted using the Proquest, CINAHL, and PubMed databases at the Johns Hopkins University library (January 1, 1990 to August 14, 2018), on burns or thermal injury …

An Examination Of The Night Burn Clinic Transition To Nurse Practitioner Coverage, Kevin J. Maxwell Dnp, Fnp-Bc

Dissertations

Background/Significance: Burns are dynamic, evolving wounds requiring prompt attention and treatment (Morgan et al., 2018). Many studies have been conducted comparing physician outcomes to those of APNs showing no difference (McCleery, Christensen, Peterson, Humphrey, & Helfand, 2011; Naylor & Kurtzman, 2010; Pioro et al., 2001; Roche, Gardner, & Jack, 2017; Spetz, Skillman, & Andrilla, 2017). Time delays which allow for progression of the injury have a negative impact on patient outcomes. Any pathway allowing for quicker review of the burn by a burn specialist should be welcomed (Kelly et al., 2013). APNs can augment physician efforts and expand access to …

Innovative Treatment Of Burn Wounds With Banana Leaf Dressing: A Case Report, Kanakadurga Poduri, Brian Tucker, Pritesh Patel

Physical Medicine & Rehabilitation

No abstract provided.

Outcomes Of Resistance Exercise Training In Adults With Acute Burn Injury, Paul M. Gittings

Theses

Decreased quality-of-life and impairments in physical function, muscle strength and muscle volume are known complications of a burn injury. As such, rehabilitation is an important aspect of the burn care journey. Rehabilitation of burn injury is currently hampered by a lack of tools to reliably measure muscle strength and lower limb function, as well as an incomplete understanding of the effect of resistance training after a burn injury. Specifically, there is currently no data on the safety or efficacy of resistance training immediately after a burn injury.

The series of studies presented in this thesis aimed to: 1) systematically review …

The Importance Of Telehealth In The Implementation Of Best Practice In Paediatric Burn Management By Non-Burn Specialist Clinicians, Tania Mcwilliams

Theses: Doctorates and Masters

Introduction: Burns are a leading cause of injury worldwide, yet the initial assessment and management of patients following burn injury is often performed by non-burn specialist clinicians. Using the Gilbert Behaviour Engineering Model as a framework, strategies were introduced to support these clinicians. A better understanding was needed, however, of the effectiveness of these strategies, and the experiences of clinicians who provide this initial care.

Aims: This study aims to contribute new knowledge related to paediatric burn care through the evaluation of a state-wide burns telehealth program in Western Australia; specifically, develop a deeper and more relevant understanding of a …

Special Considerations In Pediatric Burn Patients Regarding Drug Dosage And Administration, Kelsey Lindsley, Maureen Moynihan, Angela Chu, Kristen Yaeger, Karen L. Kier

Pharmacy and Wellness Review

Pediatric burn patients are a high-risk patient population to treat. These patients have altered physiologic function as a result of the burn injury, in addition to their smaller size and developing bodies. This creates unique challenges during treatment. Accommodations for these patients are made through unique drug dosages and routes of administration. When treating pediatric burn patients, properly assessing and treating pain promptly and effectively is of utmost importance. Nurses who utilize accurate and appropriate pain assessment scales will provide the best treatment of pain. Proper assessment allows the patient to receive the correct analgesic regime, ensuring a faster and …

Acute Surgical Vs. Non-Surgical Management For Ocular And Peri-Ocular Burns: Oculoplastic Systematic Review And Meta-Analysis, Kevin Klifto, Ala Elhelali, Caresse Gurno, Stella Seal, Mohammed Asif, C Scott Hultman

Research Day

Burn related injury to the face involving the structures of the eyes, eyelids, eyelashes, and/or eyebrows could result in multiple reconstructive procedures to improve functional and cosmetic outcomes, and correct complications following poor acute phase management. This systematic review and meta-analysis compared 272 surgical to 535 non-surgical interventions within one month of patients suffering burn-related injuries to 465 eyes, 253 eyelids, 90 eyelashes, and 0 eyebrows and evaluated associated outcomes and complications. The PubMed, EMBASE, Cochrane Library, Web of Science, and Scopus databases were systematically and independently searched. Patient and clinical characteristics, surgical and medical interventions, outcomes and complications were …

Illicit Substance Use Effects On Burn Related Reconstruction Patient Outcomes And Complications Following Hospital Admission: Systematic Review And Meta-Analysis, Kevin Klifto, Pragna N. Shetty, Benjamin R. Slavin, Caresse F. Gurno, Stella M. Seal, Mohammed Asif, Scott Hultman

Research Day

Patients suffering from burn-related injuries admitted to the hospital concurrent illicit substance use are believed to be at an increased risk of poor outcomes and the development of complications following burn reconstruction, however data varies within the literature and remains controversial. This systematic review and meta-analysis compared outcomes and complications from studies during the years 1986 to 2017 between 15653 burn patients admitted to the hospital with substance use alcohol use reported by a positive toxicology screen (amphetamines, barbiturates, benzodiazepines, cannabinoids, cocaine, methadone, codeine/morphine, PCP, LSD, inhalants, solvents, aerosols, legal highs), or the patient on hospital admission to 299543 burn …

Nicotine And Smoking Effects On Burn Related Reconstruction Patient Outcomes And Complications Following Hospital Admission: Systematic Review And Meta-Analysis, Kevin Klifto, Pragna Shetty, Ben Slavin, Caresse Gurno, Stella Seal, Mohammed Asif, C Scott Hultman

Research Day

Patients suffering from burn-related injuries admitted to the hospital concurrently using nicotine and/or smoke are believed to be at an increased risk of poor outcomes and the development of complications following burn reconstruction, however data varies within the literature and remains controversial. This systematic review and meta-analysis compared outcomes and complications from studies during the years 1986 to 2018 between 8568 burn patients admitted to the hospital who use nicotine and/or smoke to 299543 burn patients admitted who do not use nicotine and/or smoke. The PubMed, EMBASE, Cochrane Library, and Web of Science databases were systematically and independently searched. Clinical …

Alcohol Use Effects On Burn Related Reconstruction Patient Outcomes And Complications Following Hospital Admission: Systematic Review And Meta-Analysis, Kevin Klifto, Pragna Shetty, Ben Slavin, Caresse Gurno, Stella Seal, Mohammed Asif, C Scott Hultman

Research Day

Patients suffering from burn-related injuries admitted to the hospital concurrently consuming alcohol are believed to be at an increased risk of poor outcomes and the development of complications following burn reconstruction, however data varies within the literature and remains controversial. This systematic review and meta-analysis compared outcomes and complications from studies during the years 1958 to 2018 between 813 burn patients admitted to the hospital with alcohol use reported by a positive blood alcohol concentration (BAC), intoxication, or the patient on admission to 299543 burn patients admitted who were not consuming alcohol. The PubMed, EMBASE, Cochrane Library, and Web of …

Is Music Therapy Intervention Effective In Decreasing Pain After Standard Wound Care In Hospitalized Burn Patients?, Lindsay King

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective evidence based medicine review is to determine whether or not music therapy intervention is effective in decreasing pain after standard wound care in hospitalized burn patients.

STUDY DESIGN: Systematic review compiling data from three randomized controlled trials in 2016, all in the English language.

DATA SOURCES: After a thorough search of PubMed and Cochrane, three pertinent studies were found to include in this review. The selected studies were evaluated to assess the effectiveness of music therapy in decreasing pain after wound care in hospitalized burn patients.

OUTCOMES MEASURED: Decrease in pain symptoms were measured …