The alexander surgical technique for the treatment of severe burns.

The extensive loss of skin in burned patients is a critical clinical condition, and the choice of an effective technique to cover and protect the damaged area has always been a challenge in the surgical field. Despite its wide clinical use, there is little data in the literature on using the Alexander technique to treat severe burns, while several studies have focused on alternative approaches. The present study aims to evaluate the effectiveness of the Alexander surgical technique on 117 patients with severe burns. The characteristics of the burned patients, factors related to etiology of burns as well as adverse prognostic factors and their incidence in discharged versus deceased patients were also taken into account. Finally, a comparison is made with an alternative surgical procedure described in the literature. Our results show a satisfactory level of survival for patients with severe burns surgically treated with the Alexander technique, accounting for 63% of all clinical cases reported here. This treatment is also less expensive and more rapid than the alternative approach we compared it with. The Alexander technique is a lifesaving method for the treatment of severe burns that provides a satisfactory chance of survival at lower cost than the alternative surgical procedure examined.

Une vaste perte de substance cutanée chez les brûlés détermine un état clinique critique, et le choix d'une technique efficace pour couvrir et protéger les zones détruites a toujours été un challenge chirurgical. Malgré sa large utilisation, il y a peu de références dans la littérature sur l'utilisation de la technique d'Alexander dans le traitement les brûlures graves, alors que différentes études insistent sur d'autres approches. Cette étude a pour but d'évaluer l'efficacité de la technique chirurgicale d'Alexander sur 117 patients présentant des brûlures graves. Les caractéristiques de ces brûlés (étiologie, facteurs pronostiques défavorables et leur incidence sur la sortie de l'hôpital) ont été prises en compte, comme celles des patients décédés. Enfin, la comparaison est faite avec les autres procédés alternatifs chirurgicaux décrits dans la littérature. Nos résultats montrent un taux satisfaisant de survie chez les patients présentant des brûlures graves traitées par la technique d'Alexander: 63% de tous les cas cliniques rassemblés ici. Le traitement est aussi moins cher et plus rapide que dans les techniques alternatives. La technique d'Alexander est une méthode de sauvetage pour le traitement des brûlures graves qui offre une chance satisfaisante de survie à un coût moindre que les autres techniques alternatives.

Introducing the advanced burn life support (ABLS) course in Italy.

Systematic education based on internationally standardized programs is a well-established practice in Italy, especially in the emergency health care system. However, until recently, a specific program to treat burns was not available to guide emergency physicians, nurses, or volunteers acting as first responders. In 2010, two national faculty members, acting as ABA observers, and one Italian course coordinator, trained and certified in the United States, conducted a week-long training program which fully certified 10 Italian instructors. Authorized ABLS provider courses were conducted in Italy between 2010 and 2012, including one organized prior to the 20th annual meeting of the Italian Society of Burns (SIUst). In order to increase the effectiveness and diffusion of the course in Italy, changes were approved by the ABA to accommodate societal differences, including the translation of the manual into Italian. The ABA has also approved the creation and publication of a bilingual ABLS Italian website for the purpose of promoting the ABLS course in Italy. In response to high demand, a second ABLS Instructor course was organized in 2012 and has been attended by physicians and nurses from several Italian burn centers. In the following discourse the experiences of the first 15 Italian ABLS courses will be discussed.

Quality of life impact as outcome in burns patients.

PURPOSE: Severe burns have not only physical but also psychological consequences both during and after hospitalisation. By identifying the mainly impaired areas of a patient's quality of life (QoL), specific psychological support programmes can be provided. The assessment of subjectively perceived QoL impairment can also provide an indicator of the outcome of the medical and psychological treatment. METHOD: This study used the Sickness Impact Profile (SIP) to investigate QoL in 30 burned patients after discharge and again three months' later. RESULTS: At the first assessment, both the physical and psychological dimensions were significantly impaired, although there was an improvement at the 3-month follow-up, particularly in the physical dimension. Data suggest that there are QoL areas that appear to be compromised in burn patients. Even after hospital discharge, the burn injury causes major limitations that extend well beyond the physical area and involve emotional, social and relational aspects. Nevertheless, most of the categories in the physical dimension tend to improve during follow-up and, three months after the first administration, the predominant limitations are in emotional behaviour and sleep and rest in the psychosocial dimension. The SIP score matched for depth and extent of burns show that females were in poorer health than males. At the first administration, gender-related differences were particularly marked in Ambulation (p = .005), Body Care and Movement (p = .004), Home Management (p = .013), Mobility (p = .011), Physical Dimension (p = .004) and the QoL general score (p = .031). Although all of these areas had improved by the time of the retest, the gender-related differences remained. The categories assessed with the Psychosocial Dimension of SIP did not correlate with the clinical parameters of the burn, whereas those pertaining to the Physical Dimension did. CONCLUSION: Multidisciplinary support for burn patients appears to be necessary even many months after hospital discharge.