摘要:

Nausea and vomiting after a surgical procedure has a significant impact on a patient's hospital course. A perceived increased incidence of postoperative nausea and vomiting (PONV) in pediatric patients undergoing reconstructive scalp surgery had been clinically observed. A chart review to determine if a relationship existed between the surgical procedure and the incidence of PONV was conducted by selecting patients who were 5 to 12 years old and whose surgery fell between April 1995 and August 1995. Thirty-eight patients were evaluated for 46 procedures; 8 patients were evaluated for both insertion and removal of scalp expanders. No differences were identified between groups for previous history of PONV, length of anesthesia, or position during surgery. Data from the retrospective review suggested that pediatric patients with reconstructive surgeries of the scalp experienced PONV at 100% (24 procedures), whereas only 45% (10 procedures) of patients whose surgeries did not involve the scalp experienced PONV. In addition, despite significant earlier return of bowel sounds, episodes of PONV and time to oral intake were also increased in the group of patients whose operations involved the scalp. On the basis of these findings, a prospective study has been initiated to determine if changes in the perioperative protocol will improve patient outcomes and reduce the incidence of PONV. (J Burn Care Rehabil 1999;20:236–8)

ISSN:0273-8481    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Pressure garment use alters facial growth during rehabilitation after a facial burn injury. We previously studied 3 children with full facial burns and 3 children with partial facial burns who wore pressure garments for 1 year, and we found that maxillary horizontal growth and mandibular anterior-inferior growth are inhibited during the time of pressure garment use. The purpose of this follow-up study was to prospectively document skeletal and dental changes after pressure garment use was discontinued. We found that although the growth and development of the facial bones seem to return to normal, lasting changes remain. The use of pressure garments after skin grafting is still recommended. However, it is also recommended that an orthodontist be included in the team of burn care specialists for children with facial burns to monitor facial and dental development. Close attention to facial development during and after pressure garment use is necessary to maintain normal dental and facial relationships. (J Burn Care Rehabil 1999;20:239–49)

ISSN:0273-8481    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

A convergent postburn psychopharmacologic treatment for children for acute stress disorder (ASD) symptoms has not been established. Both the application of what has been learned through treatment of similar symptoms experienced by adults with posttraumatic stress disorder and the examination of safe treatment options for children led to the clinical decision to use imipramine for 25 pediatric patients with acute burns. The treatment histories of these patients were retrospectively reviewed to see if further exploration into the efficacy of imipramine was warranted. Eighty percent of the children experienced remission of hyperarousal symptoms (eg, trouble staying asleep, trouble falling asleep) and intrusive reexperiencing symptoms (eg, nightmares). Twelve percent of the children experienced a decrease in the frequency or intensity of ASD symptoms. Eight percent had no relief of ASD symptoms. Initial findings suggest that imipramine assists children who have postburn ASD symptoms by decreasing the hyperarousal and intrusive reexperiencing symptoms of ASD. (J Burn Care Rehabil 1999;20:250–8)

ISSN:0273-8481    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Skin tension is known to affect the amount of movement in normal skin and has been theorized to have a possible influence on burn scars. This study measured the directional variance in skin movement, which is related to this theory. Twenty adult female volunteers had 5 predetermined skin sites tested; these sites were on the ventral surface of the upper extremities (UE), from the shoulder to the wrist. A 1 kg axial traction force was randomly applied to each skin site in both proximal and distal directions. The skin was load-cycled 6 times before movement was measured with the use of a laser beam projection. Analysis was performed for each site, and pooled data was normalized for the entire UE. Distal skin movement was significantly greater than proximal movement at each of the 5 test sites and for the UE as a whole (P< .001). No significant differences were found among like-direction sites. Only subject height and length of UE correlated strongly (r= .88). This study demonstrates a difference in skin movement and discusses how these findings may relate to the theory that skin tension could be involved in burn scar contracture and hypertrophy. (J Burn Care Rehabil 1999;20:259–64)

ISSN:0273-8481    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Early coverage of deep burns of the elbow is vital to preserving the range of motion. Although various methods are used for coverage of this site, the brachioradialis muscle flap provides good coverage after débridement, with minimal donor site morbidity. (J Burn Care Rehabil 1999;20:265–6)

ISSN:0273-8481    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0273-8481    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:0273-8481    

出版商:OVID    

年代:1999

数据来源: OVID