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Full-thickness burns
Abstracts
type. Its relationship to 'primary brain stem damage' in head injury. Brain 100, 489. Brain scanners The first two authors are neurosurgeons, the second two were in a firm of management consultants. They explore in considerable detail the financial implications of making more computerized scanners available, having already shown that they much reduce dependence on neuroradiological services and how they would add to the precision and confidence of diagnosis of intracranial lesions in the larger general hospitals that look after the victims of cerebral damage. They do this by taking the existing neurological and related services of one of the London regions for reference and then calculating the costs of altering them in four different ways. Their conclusions are that scanners should be more generally available, particularly for head injuries, and that the reduced call for conventional neuroradiological investigations would enable existing services to be made available to a larger population. The consideration is comprehensive, but experience of other supposed means of achieving economies may leave one requiring something more than arguments. Bartlett J. R., Neil-Dwyer G., Banham J. M. M. et al. (1978) Evaluating cost-effectiveness of diagnostic equipment: the brain scanner case. Br. Med. J. 2, 815.
This paper is based on the use of the equipment in 571 cases. When the intracranial investigations that were carried out in addition to the scanner were compared with the number that would have been carried out had the scanner not been available, the reduction considerably exceeded what had been expected, most of all after injury of the head. The authors discuss the possibility of making scanners available in district general hospitals and so freeing neuroradiological services to be used for much larger catchment areas than at present. Bartlett J. R. and Neil-Dwyer G. (1978) Clinical study of the EMI scanner: implications for the provision of neuroradiological services. Br. Med. J. 2, 813. Burns Burns in adolescents Much can be done to alleviate the fears and anxieties of young burned persons if they are sympathetically questioned about them so that specific advice can be given about certain acts of conduct, about dress and about physical activities as well as an indication of what further treatment may be required to deal with scarfing and its effect on development. Clarke A. M. and Martin H. L. (1978) The effects of previous thermal injury on adolescents. Burns 5, 101. Healed burns in controlled environments Patients scarred by burns were tested in controlled
85
environments. They tolerated heat better than cold. Even with 45 per cent burns the remaining normal skin was able to produce enough sweat to keep the core temperature normal whe,,n the environment was hot. Burned skin reacted more slowly than unburned to changes in surrounding temperature and the core temperature fell slightly in the cold. Palmer B., Jacobson S., Maim L. et al. (1978) Patients with healed major burns in hot and cold environments. Burns 5, 79. Education of burned child During the first few weeks after burning there is little that can be done to maintain a child's education, but a teacher can do a great deal for the morale of the child and may also be able to provide interesting pastimes. Collaboration between the hospital and the school teachers can do much to maintain the progress and position in the class in the case of prolonged absence from school. Read E. (1978) The education of the burned child in hospital. Burns 5, 94. Full-thickness burns The preparation of proteolytic enzymes studied successfully dissolved burned skin, but could be painful. The authors recommend that its use be confined to the l" treatment of full-thickness burns of not more than l0 per cent of the body's surface, when sloughing is delayed and to decompress limbs encircled by unyielding burnt tissues. Levick P. L., Brough M. D., Vasilescu C. T. et al. (1978) Treatment of full-thickness burns with Travase. Burns 4, 28 I. N e w topical agent The agent studied was hydrophilic beads of dextran polymer which soaked up wound discharge without becoming dry and exerting the splinting effect of a crust or scab. It was applied to 130 hands of 80 persons who had suffered dermal and deep dermal burns. The hands were treated in plastic bags and the Debrisan was soaked off and replaced when all the beads had become soaked and gelatinous, which was as often as 4 times a day in some cases. This was not a controlled trial, but the results suggest that the early and continued movements that were possible promoted suppleness of the fingers. Arturson G., Hakelius L., Jacobsson S. et al. (1978) A new topical agent (Debrisan) for the early treatment of the burned hand. Burns 4, 225. H a n d injuries Hand deformities and snake bites Over the past 25 years, 219 patients were referred to the hospitals in Galveston, Texas with poisonous snake bites. Almost all the snakes belonged to the
type. Its relationship to 'primary brain stem damage' in head injury. Brain 100, 489. Brain scanners The first two authors are neurosurgeons, the second two were in a firm of management consultants. They explore in considerable detail the financial implications of making more computerized scanners available, having already shown that they much reduce dependence on neuroradiological services and how they would add to the precision and confidence of diagnosis of intracranial lesions in the larger general hospitals that look after the victims of cerebral damage. They do this by taking the existing neurological and related services of one of the London regions for reference and then calculating the costs of altering them in four different ways. Their conclusions are that scanners should be more generally available, particularly for head injuries, and that the reduced call for conventional neuroradiological investigations would enable existing services to be made available to a larger population. The consideration is comprehensive, but experience of other supposed means of achieving economies may leave one requiring something more than arguments. Bartlett J. R., Neil-Dwyer G., Banham J. M. M. et al. (1978) Evaluating cost-effectiveness of diagnostic equipment: the brain scanner case. Br. Med. J. 2, 815.
This paper is based on the use of the equipment in 571 cases. When the intracranial investigations that were carried out in addition to the scanner were compared with the number that would have been carried out had the scanner not been available, the reduction considerably exceeded what had been expected, most of all after injury of the head. The authors discuss the possibility of making scanners available in district general hospitals and so freeing neuroradiological services to be used for much larger catchment areas than at present. Bartlett J. R. and Neil-Dwyer G. (1978) Clinical study of the EMI scanner: implications for the provision of neuroradiological services. Br. Med. J. 2, 813. Burns Burns in adolescents Much can be done to alleviate the fears and anxieties of young burned persons if they are sympathetically questioned about them so that specific advice can be given about certain acts of conduct, about dress and about physical activities as well as an indication of what further treatment may be required to deal with scarfing and its effect on development. Clarke A. M. and Martin H. L. (1978) The effects of previous thermal injury on adolescents. Burns 5, 101. Healed burns in controlled environments Patients scarred by burns were tested in controlled
85
environments. They tolerated heat better than cold. Even with 45 per cent burns the remaining normal skin was able to produce enough sweat to keep the core temperature normal whe,,n the environment was hot. Burned skin reacted more slowly than unburned to changes in surrounding temperature and the core temperature fell slightly in the cold. Palmer B., Jacobson S., Maim L. et al. (1978) Patients with healed major burns in hot and cold environments. Burns 5, 79. Education of burned child During the first few weeks after burning there is little that can be done to maintain a child's education, but a teacher can do a great deal for the morale of the child and may also be able to provide interesting pastimes. Collaboration between the hospital and the school teachers can do much to maintain the progress and position in the class in the case of prolonged absence from school. Read E. (1978) The education of the burned child in hospital. Burns 5, 94. Full-thickness burns The preparation of proteolytic enzymes studied successfully dissolved burned skin, but could be painful. The authors recommend that its use be confined to the l" treatment of full-thickness burns of not more than l0 per cent of the body's surface, when sloughing is delayed and to decompress limbs encircled by unyielding burnt tissues. Levick P. L., Brough M. D., Vasilescu C. T. et al. (1978) Treatment of full-thickness burns with Travase. Burns 4, 28 I. N e w topical agent The agent studied was hydrophilic beads of dextran polymer which soaked up wound discharge without becoming dry and exerting the splinting effect of a crust or scab. It was applied to 130 hands of 80 persons who had suffered dermal and deep dermal burns. The hands were treated in plastic bags and the Debrisan was soaked off and replaced when all the beads had become soaked and gelatinous, which was as often as 4 times a day in some cases. This was not a controlled trial, but the results suggest that the early and continued movements that were possible promoted suppleness of the fingers. Arturson G., Hakelius L., Jacobsson S. et al. (1978) A new topical agent (Debrisan) for the early treatment of the burned hand. Burns 4, 225. H a n d injuries Hand deformities and snake bites Over the past 25 years, 219 patients were referred to the hospitals in Galveston, Texas with poisonous snake bites. Almost all the snakes belonged to the