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Lam N, Hung N, Khanh N. Cost Analysis and Influencing Factors Amongst Severe Burn Patients. ANNALS OF BURNS AND FIRE DISASTERS 2023; 36:183-188. [PMID: 38680437 PMCID: PMC11041904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 07/03/2022] [Indexed: 05/01/2024]
Abstract
This study analyzed the structure and determined the factors affecting the cost of treatment of severe burns patients. The results showed that the average total costs for a patient was 3275.9 USD. The daily cost of hospitalization was 113.3 USD, the treatment cost for 1% burn surface area was 109.5 USD with the highest proportion for medication and consumable medical equipment (43.2%), followed by surgery and procedures (30.2%). The treatment costs increased with increasing age, burn extent and deep burn area (p < .05) and were significantly higher in the group of patients with inhalation injury, electrical burns and in non-survivors (p < .01). Multivariate regression analysis found that burn extent, deep burn area and inhalation injury independently influenced the treatment cost of burn patients.
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Affiliation(s)
- N.N. Lam
- Le Huu Trac National Burn Hospital, Viet Nam
- Medical Military University, Viet Nam
| | - N.T. Hung
- Le Huu Trac National Burn Hospital, Viet Nam
- Medical Military University, Viet Nam
| | - N.N. Khanh
- Hanoi - Amsterdam High School for the Gifted, Viet Nam
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2
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King B, Cancio LC, Jeng JC. Military Burn Care and Burn Disasters. Surg Clin North Am 2023; 103:529-538. [PMID: 37149388 DOI: 10.1016/j.suc.2023.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Mass-casualty incidents can occur because of natural disasters; industrial accidents; or intentional attacks against civilian, police, or in case of combat, military forces. Depending on scale and type of incident, burn casualties often with a variety of concomitant injuries can be anticipated. The treatment of life-threatening traumatic injuries should take precedent but the stabilization, triage, and follow-on care of these patients will require local, state, and often regional coordination and support.
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Affiliation(s)
- Booker King
- North Carolina Jaycee Burn Center, University of North Carolina Chapel Hill, Burnett Womack Building, Campus Box 7206, Chapel Hill, NC 27599-7206, USA
| | - Leopoldo C Cancio
- U.S. Army Burn Center, U.S. Army Institute of Surgical Research, Fort Sam Houston, San Antonio, TX 78234-6315, USA
| | - James C Jeng
- University of California Irvine, 3800 West Chapman Avenue, Suite 6200, Orange, CA 92868, USA.
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The Hidden Costs of War: Healthcare Utilization Among Individuals Sustaining Combat-related Trauma (2007-2018). Ann Surg 2023; 277:159-164. [PMID: 33651722 DOI: 10.1097/sla.0000000000004844] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We sought to evaluate long-term healthcare requirements of American military servicemembers with combat-related injuries. SUMMARY OF BACKGROUND DATA US military conflicts since 2001 have produced the most combat casualties since Vietnam. Long-term consequences on healthcare utilization and associated costs remain unknown. METHODS We identified servicemembers who were treated for combat-related injuries between 2007 and 2011. Controls consisted of active-duty servicemembers injured in the civilian sector, without any history of combat-related trauma, matched (1:1) on year of injury, biologic sex injury severity, and age at time of injury. Surveillance was performed through 2018. Total annual healthcare expenditures were evaluated overall and then as expenditures in the first year after injury and for subsequent years. Negative binomial regression was used to identify the adjusted influence of combat injury on healthcare costs. RESULTS The combat-injured cohort consisted of 3981 individuals and we identified 3979 controls. Total healthcare utilization during the follow-up period resulted in median costs of $142,214 (IQR $61,428, $323,060) per combat-injured servicemember as compared to $50,741 (IQR $26,669, $104,134) among controls. Median expenditures, adjusted for duration of follow-up, for the combat-injured were $45,211 (IQR $18,698, $105,437). In adjusted analysis, overall costs were 30% higher (1.30; 95% confidence interval: 1.23, 1.37) for combat-injured personnel. CONCLUSION This investigation represents the longest continuous observation of healthcare utilization among individuals after combat injury and the first to assess costs. Expenditures were 30% higher for individuals injured as a result of combat-related trauma when compared to those injured in the civilian sector.
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Developing a Delphi-Based Comprehensive Core Set from the International Classification of Functioning, Disability, and Health Framework for the Rehabilitation of Patients with Burn Injuries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18083970. [PMID: 33918802 PMCID: PMC8068789 DOI: 10.3390/ijerph18083970] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/05/2021] [Accepted: 04/07/2021] [Indexed: 02/04/2023]
Abstract
Burn injuries cause disability and functional limitations in daily living. In a 2015 fire explosion in Taiwan, 499 young people sustained burn injuries. The construction of an effective and comprehensive rehabilitation program that enables patients to regain their previous function is imperative. The International Classification of Functioning, Disability, and Health (ICF) includes multiple dimensions that can contribute to meeting this goal. An ICF core set was developed in this study for Taiwanese patients with burns. A consensus process using three rounds of the Delphi technique was employed. A multidisciplinary team of 30 experts from various institutions was formed. The questionnaire used in this study comprised 162 ICF second-level categories relevant to burn injuries. A 5-point Likert scale was used, and participants assigned a weight to the effect of each category on daily activities after burns. The consensus among ratings was assessed using Spearman's ρ and semi-interquartile range indices. The core set for post-acute SCI was developed from categories that attained a mean score of ≥4.0 in the third round of the Delphi exercise. The core ICF set contained 68 categories. Of these, 19 comprised the component of body functions, 5 comprised body structures, 37 comprised activities and participation, and 7 comprised environmental factors. This preliminary core set offers a comprehensive system for disability assessment and verification following burn injury. The core set provides information for effective rehabilitation strategy setting for patients with burns. Further feasibility and validation studies are required in the future.
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Ma H, Tung KY, Tsai SL, Neil DL, Lin YY, Yen HT, Lin KL, Cheng YT, Kao SC, Lin MN, Dai NT, Perng CK, Wang TG, Tai HC, Chen LR, Tuan YC, Lin CH. Assessment and determinants of global outcomes among 445 mass-casualty burn survivors: A 2-year retrospective cohort study in Taiwan. Burns 2020; 46:1444-1457. [PMID: 32499049 DOI: 10.1016/j.burns.2020.02.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 02/12/2020] [Accepted: 02/15/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE To study outcomes among survivors of the mass-casualty powder explosion on 27 June 2015, at Formosa Fun Coast Waterpark, New Taipei City, Taiwan. METHODS Using retrospective data on Taiwanese survivors, we analyzed prehospital management, burns assessment and prognosis, functional recovery, and medical costs, followed-up through 30 June 2017. We related outcomes to burn extent, categorized according to the percentages of total body surface area with second/third-degree burns (%TBSA) or autologous split-thickness skin grafts (%STSG), and an investigational scale: f{SASG} = (%TBSA + %STSG)/2, stratified by %STSG. Analyses included casualty dispersal, comparisons between %TBSA, %STSG and f{SASG}, and their relationships with length of hospitalization, times to rehabilitation and social/school re-entry, physical/mental disability, and medical costs. We also investigated how burn scars restricting joint mobility affected rehabilitation duration. RESULTS 445 hospitalized casualties (excluding 16 foreigners, 23 with 0% TBSA and 15 fatalities) aged 12-38 years, had mean TBSA of 41.1%. Hospitalization and functional recovery durations correlated with %TBSA, %STSG and f{SASG} - mean length of stay per %TBSA was 1.5 days; more numerous burn scar contractures prolonged rehabilitation. Females had worse burns than males, longer hospitalization and rehabilitation, and later school/social re-entry; at follow-up, 62.3% versus 37.7% had disabilities and 57.7% versus 42.3% suffered mental trauma (all p ≤ 0.001). Disabilities affecting 225/227 people were skin-related; 34 were severely disabled but 193 had mild/moderate impairments. The prevalence of stress-related and mood disorders increased with burn extent. Treatment costs (mean USD-equivalents ∼$48,977/patient, ∼$1192/%TBSA) increased with burn severity; however, the highest %TBSA, %STSG and f{SASG} categories accounted for <10% of total costs, whereas TBSA 41-80% accounted for 73.2%. CONCLUSIONS Besides %TBSA, skin-graft requirements and burn scar contractures are complementary determinants of medium/long-term outcomes. We recommend further elucidation of factors that influence burn survivors' recovery, long-term physical and mental well-being, and quality of life.
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Affiliation(s)
- Hsu Ma
- Division of Plastic Surgery, Department of Surgery, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Rd., Taipei 11217, Taiwan; Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, 325, Sec. 2, Chenggong Rd., Taipei 11490, Taiwan; School of Medicine, National Yang Ming University, 155, Sec. 2, Linong St., Taipei 112, Taiwan
| | - Kwang-Yi Tung
- Department of Surgery, MacKay Memorial Hospital, 92, Sec. 2, Zhongshan N. Rd., Taipei 10449, Taiwan
| | - Shu-Ling Tsai
- National Health Insurance Administration, 140, Sec. 3, Hsinyi Rd., Taipei 10634, Taiwan
| | - David L Neil
- Full Universe Integrated Marketing Ltd., 4F, 417 Ruiguang Rd., Taipei 11492, Taiwan
| | - Yun-Yi Lin
- Department of Physical Medicine & Rehabilitation, National Taiwan University Hospital, 7 Zhongshan S. Rd., Taipei 100, Taiwan; Burn Rehabilitation & Post-acute Care Center, New Taipei City Hospital, 198 Yingshi Rd., New Taipei City 220, Taiwan; Institute of Health Policy and Management, National Taiwan University, 17 Xu-Zhou Rd., Taipei 100, Taiwan
| | - Hung-Tsang Yen
- Department of Emergency Medicine, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Rd., Taipei 11217, Taiwan; Institute of Emergency and Critical Care Medicine, National Yang Ming University, 155, Sec. 2, Linong St., Taipei 112, Taiwan
| | - Kao-Li Lin
- Department of Health, New Taipei City Government, 192-1 Ying-Shi Rd., New Taipei City 22006, Taiwan
| | - Yi-Ting Cheng
- Department of Health, New Taipei City Government, 192-1 Ying-Shi Rd., New Taipei City 22006, Taiwan
| | - Shu-Chen Kao
- Department of Health, New Taipei City Government, 192-1 Ying-Shi Rd., New Taipei City 22006, Taiwan
| | - Mei-Na Lin
- Department of Health, New Taipei City Government, 192-1 Ying-Shi Rd., New Taipei City 22006, Taiwan
| | - Niann-Tzyy Dai
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, 325, Sec. 2, Chenggong Rd., Taipei 11490, Taiwan
| | - Cherng-Kang Perng
- Division of Plastic Surgery, Department of Surgery, Taipei Veterans General Hospital, 201, Sec. 2, Shih-Pai Rd., Taipei 11217, Taiwan; School of Medicine, National Yang Ming University, 155, Sec. 2, Linong St., Taipei 112, Taiwan
| | - Tyng-Guey Wang
- Department of Physical Medicine & Rehabilitation, National Taiwan University Hospital, 7 Zhongshan S. Rd., Taipei 100, Taiwan
| | - Hao-Chih Tai
- Division of Plastic Surgery, National Taiwan University Hospital, 7 Zhongshan S. Rd., Taipei 100, Taiwan
| | - Li-Ru Chen
- Department of Physical Medicine and Rehabilitation, MacKay Memorial Hospital, 92, Sec. 2, Zhongshan N. Rd., Taipei 10449, Taiwan
| | - Yung-Chang Tuan
- Ansin Psychiatric Clinic, 132, Sec. 3, Chongxin Rd., New Taipei City 241, Taiwan
| | - Chi-Hung Lin
- Department of Health, New Taipei City Government, 192-1 Ying-Shi Rd., New Taipei City 22006, Taiwan; Institute of Microbiology and Immunology, National Yang Ming University, 155, Sec. 2, Linong St., Taipei 112, Taiwan; Department of Biological Science and Technology, National Chiao-Tung University, 1001 University Rd., Hsinchu 300, Taiwan; Cancer Progression Research Center, National Yang Ming University, 155, Sec. 2, Linong St., Taipei 112, Taiwan.
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Yu TC, Zhang X, Smiell J, Zhou H, Tan R, Böing E, Tan H. Healthcare resource utilization, treatment patterns, and cost of care among patients with thermal burns and inpatient autografting in two large privately insured populations in the United States. Burns 2020; 46:825-835. [DOI: 10.1016/j.burns.2019.10.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 09/24/2019] [Accepted: 10/26/2019] [Indexed: 01/15/2023]
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Lowin J, Winfield T, Price P, Anderson P, Potokar T. Estimating the cost impact of dressing choice in the context of a mass burns casualty event. ANNALS OF BURNS AND FIRE DISASTERS 2019; 32:222-226. [PMID: 32313537 PMCID: PMC7155402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 09/10/2019] [Indexed: 06/11/2023]
Abstract
Mass casualty burn events (MCBs) require intense and complex management. Silver-infused longer use dressings might help optimise management of burns in an MCB setting. We developed a model estimating the impact of dressing choice in the context of an MCB. The model was developed in Excel in collaboration with experienced emergency response clinicians. The model compares use of silver-infused dressings with use of traditional dressings in patients with partial thickness burns covering 30% of their body. Costs were estimated from a UK perspective as a proxy for a funded emergency response team and limited to cost of dressings, bandages, padding, analgesia and staff time. Expected patient costs and resource use were summarised over an acute 2-week intervention period and extrapolated to estimate possible time savings in a hypothetical MCB. Per patient costs were estimated at £2,002 (silver) and £1,124 (traditional) (a daily additional spend of £63). Per patient staff time was estimated at 864 minutes (silver) and 1,200 minutes (traditional) (a daily time saving of 24 minutes). Multiplying up to a possible MCB population of 20 could result in a saving equivalent to 9 staff shifts over the 2-week intervention period. The model was sensitive to type of silver dressing, frequency of dressing change and staff costs. We found increased costs through use of silver dressings but time savings that might help optimise burns management in an MCB. Exploring the balance between costs and staff time might help future MCB response preparation.
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Affiliation(s)
- J. Lowin
- Swansea Centre for Health Economics, Swansea University, Swansea, UK
| | - T. Winfield
- Swansea Centre for Health Economics, Swansea University, Swansea, UK
| | - P. Price
- Centre for Global Burn Injury Policy & Research, Swansea University, Swansea, UK
| | - P. Anderson
- Swansea Centre for Health Economics, Swansea University, Swansea, UK
| | - T. Potokar
- Centre for Global Burn Injury Policy & Research, Swansea University, Swansea, UK
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8
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Wang TH, Yeh YH, Pu C. Excess mortality reduction given a "reduce patient mortality at all costs" scenario for mass burn casualties. Burns 2019; 45:1477-1482. [PMID: 31056205 DOI: 10.1016/j.burns.2019.04.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 02/21/2019] [Accepted: 04/08/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The aim of this study was to estimate the effect on medical resource use and mortality of full financial support from the government for treatment costs after a mass burn casualty event in Taiwan. METHODS All patients with burn injuries from the event were included (n = 483). Each burn patient from this incident was matched to a separate burn patient identified from the National Health Insurance database. Medical care usage and mortality were compared between groups at 1-, 3-, 6-, 9-, and 12-month intervals. RESULTS Regarding outpatient expenditure, burn patients from the mass casualty event had significantly higher levels of medical expenditure compared with their control counterparts at all intervals and levels of medical institution. For inpatient expenditure, patients from the mass casualty event only had higher expenditure for the first month, and excess procedures used by these patients mainly consisted of nonvital procedures such as rehabilitation training. The mortality rate was only slightly lower for this group of burn patients compared with their control counterparts. CONCLUSIONS Full financial support by the government in terms of medical treatment may engender only marginal additional benefits in terms of mortality if burn treatment procedures are already well established in the country.
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Affiliation(s)
- Tsung-Hsi Wang
- Ministry of Health and Welfare, 18F. No. 488, Sec. 6, Zhongxiao E. Rd., Nangang Dist., Taipei, Taiwan; Department of Public Health, School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei, 112, Taiwan.
| | - Yu-Hua Yeh
- Department of Public Health, School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei, 112, Taiwan.
| | - Christy Pu
- Department of Public Health, School of Medicine, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Taipei, 112, Taiwan.
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Stone Ii R, Natesan S, Kowalczewski CJ, Mangum LH, Clay NE, Clohessy RM, Carlsson AH, Tassin DH, Chan RK, Rizzo JA, Christy RJ. Advancements in Regenerative Strategies Through the Continuum of Burn Care. Front Pharmacol 2018; 9:672. [PMID: 30038569 PMCID: PMC6046385 DOI: 10.3389/fphar.2018.00672] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 06/05/2018] [Indexed: 01/09/2023] Open
Abstract
Burns are caused by several mechanisms including flame, scald, chemical, electrical, and ionizing and non-ionizing radiation. Approximately half a million burn cases are registered annually, of which 40 thousand patients are hospitalized and receive definitive treatment. Burn care is very resource intensive as the treatment regimens and length of hospitalization are substantial. Burn wounds are classified based on depth as superficial (first degree), partial-thickness (second degree), or full-thickness (third degree), which determines the treatment necessary for successful healing. The goal of burn wound care is to fully restore the barrier function of the tissue as quickly as possible while minimizing infection, scarring, and contracture. The aim of this review is to highlight how tissue engineering and regenerative medicine strategies are being used to address the unique challenges of burn wound healing and define the current gaps in care for both partial- and full-thickness burn injuries. This review will present the current standard of care (SOC) and provide information on various treatment options that have been tested pre-clinically or are currently in clinical trials. Due to the complexity of burn wound healing compared to other skin injuries, burn specific treatment regimens must be developed. Recently, tissue engineering and regenerative medicine strategies have been developed to improve skin regeneration that can restore normal skin physiology and limit adverse outcomes, such as infection, delayed re-epithelialization, and scarring. Our emphasis will be centered on how current clinical and pre-clinical research of pharmacological agents, biomaterials, and cellular-based therapies can be applied throughout the continuum of burn care by targeting the stages of wound healing: hemostasis, inflammation, cell proliferation, and matrix remodeling.
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Affiliation(s)
- Randolph Stone Ii
- Combat Trauma and Burn Injury Research, US Army Institute of Surgical Research San Antonio, TX, United States
| | - Shanmugasundaram Natesan
- Combat Trauma and Burn Injury Research, US Army Institute of Surgical Research San Antonio, TX, United States
| | - Christine J Kowalczewski
- Combat Trauma and Burn Injury Research, US Army Institute of Surgical Research San Antonio, TX, United States
| | - Lauren H Mangum
- Combat Trauma and Burn Injury Research, US Army Institute of Surgical Research San Antonio, TX, United States.,Extremity Trauma and Regenerative Medicine, US Army Institute of Surgical Research San Antonio, TX, United States
| | - Nicholas E Clay
- Combat Trauma and Burn Injury Research, US Army Institute of Surgical Research San Antonio, TX, United States
| | - Ryan M Clohessy
- Combat Trauma and Burn Injury Research, US Army Institute of Surgical Research San Antonio, TX, United States
| | - Anders H Carlsson
- Dental and Craniofacial Trauma Research, US Army Institute of Surgical Research San Antonio, TX, United States
| | - David H Tassin
- Dental and Craniofacial Trauma Research, US Army Institute of Surgical Research San Antonio, TX, United States
| | - Rodney K Chan
- Dental and Craniofacial Trauma Research, US Army Institute of Surgical Research San Antonio, TX, United States
| | - Julie A Rizzo
- Burn Flight Team, US Army Institute of Surgical Research San Antonio, TX, United States
| | - Robert J Christy
- Combat Trauma and Burn Injury Research, US Army Institute of Surgical Research San Antonio, TX, United States
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10
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Razavi S, Partoazar A, Takzaree N, Fasihi-Ramandi M, Bahador A, Darvishi MH. Silver sulfadiazine nanoethogel for burn healing: characterization and investigation of its in vivo effects. Nanomedicine (Lond) 2018; 13:1319-1331. [DOI: 10.2217/nnm-2017-0385] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Nanoethosomal formulation containing silver sulfadiazine (SSD) was used to reduce bacterial burden and healing time in burn injuries. Materials & methods: Ethosomal formulations were characterized for their size, ζ-potential, morphology, drug encapsulation efficiency and in vitro release kinetics of SSD. Results: The optimized nanoethosomal suspension with a size of 206.7 ± 1.18, and ζ-potential value of -67.3 ± 0.45 mV exhibited a high SSD encapsulation efficiency (92.03 ± 0.79%). Results of antimicrobial tests indicated SSD-loaded ethosome formulation led to a significant reduction of colony number. Histopathological results demonstrated a wound contraction rate of 96.83% for the group treated with SSD ethosomal gel while untreated group showed 59.41%. Conclusion: The SSD ethogels promotes the therapeutic effect of SSD for burn treatment.
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Affiliation(s)
- Seyedehhamideh Razavi
- Nanobiotechnology Research Centre, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Alireza Partoazar
- Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasrin Takzaree
- Anatomy Department, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Fasihi-Ramandi
- Molecular Biology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Abas Bahador
- Department of Microbiology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad H Darvishi
- Nanobiotechnology Research Centre, Baqiyatallah University of Medical Sciences, Tehran, Iran
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11
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Ordoñez CA, Manzano Nunez R, Parra MW, Herrera JP, Naranjo MP, Escobar SS, Badiel M, Morales M, Cevallos C, Bayona JG, Sanchez AI, Puyana JC, García AF. Analysis of combat casualties admitted to the emergency department during the negotiation of the comprehensive Colombian process of peace. COLOMBIA MEDICA (CALI, COLOMBIA) 2017; 48:155-160. [PMID: 29662256 PMCID: PMC5896721 DOI: 10.25100/cm.v43i4.3389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Aim: Our objective was to describe the variations in casualties admitted to the emergency department during the period of the negotiation of the comprehensive peace agreement in Colombia between 2011 and 2016. Methods: A retrospective study of all hostile military casualties managed at a regional Level I trauma center from January 2011 to December 2016. Patients were subsequently divided into two groups: those seen before the declaration of the process of peace truce (November 2012) and those after (negotiation period). Variables were compared with respect to periods Results: A total of 448 hostile casualties were registered. There was a gradual decline in the number of admissions to the emergency department during the negotiation period. The number of soldiers suffering blast and rifle injuries also decreased over this period. In 2012 there were nearly 150 hostile casualties' admissions to the ER. This number decreased to 84, 63, 32 and 6 in 2013, 2014, 2015 and 2016 respectively. Both, the proportion of patients with an ISS ≥9 and admitted to the intensive care unit were significantly higher in the period before peace negotiation. From August to December/2016 no admissions of war casualties were registered. Conclusion: We describe a series of soldiers wounded in combat that were admitted to the emergency department before and during the negotiation of the Colombian process of peace. Overall, we found a trend toward a decrease in the number of casualties admitted to the emergency department possibly in part, as a result of the period of peace negotiation.
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Affiliation(s)
- Carlos A Ordoñez
- Division of Trauma and Acute Care Surgery. Fundación Valle del Lili. Cali, Colombia.,Universidad del Valle, Cali, Colombia
| | - Ramiro Manzano Nunez
- Division of Trauma and Acute Care Surgery. Fundación Valle del Lili. Cali, Colombia.,Clinical Research Center. Fundación Valle del Lili. Cali, Colombia
| | | | - Juan Pablo Herrera
- Department of Surgery, Brigham & Women's Hospital. Boston, Massachusetts. USA
| | | | | | | | | | | | - Juan G Bayona
- Clinical Research Center. Fundación Valle del Lili. Cali, Colombia
| | | | | | - Alberto F García
- Division of Trauma and Acute Care Surgery. Fundación Valle del Lili. Cali, Colombia.,Universidad del Valle, Cali, Colombia
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Tseng HM, Shih WM, Shen YC, Ho LH, Wu CF. Work Stress, Resilience, and Professional Quality of Life Among Nurses Caring for Mass Burn Casualty Patients After Formosa Color Dust Explosion. J Burn Care Res 2017; 39:798-804. [DOI: 10.1093/jbcr/irx053] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Hsu-Min Tseng
- Department of Healthcare Management, Chang Gung University, Taoyuan City, Taiwan
- Medical Education Research Centre, Linkou Chang Gung Memorial Hospital, Taoyuan City, Taiwan
| | - Whei-Mei Shih
- Graduate Institute of Health Care, Chang Gung University of Science and Technology, Taoyuan City, Taiwan
- Department of Rheumatology, Linkou Chang Gung Memorial Hospital
| | - Yung-Chao Shen
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan City, Taiwan
| | - Lun-Hui Ho
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan City, Taiwan
| | - Chu-Fang Wu
- Department of Nursing, Linkou Chang Gung Memorial Hospital, Taoyuan City, Taiwan
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