Necessidades humanas básicas e sociais na assistência de enfermagem a pessoa atendida em Unidades de Tratamento ao Queimado: um estudo integrativo

Objective: To identify the empirical indicators of basic and social human needs found in nursing care for people treated in Burn Treatment Units. Materials and Method: Descriptive, cross-sectional and exploratory study of the integrative literature review type. After applying inclusion and exclusion criteria, 16 of the 265 articles identified made up the sample. The data collected were inserted in spreadsheets for descriptive statistical analysis and inferences, analyzed using the Microsoft Office Excel 2010 program and the Statistical Package for the Social Sciences (SPSS) version 20.0 software. The distribution of empirical indicators was carried out, which were later discussed based on scientific productions in the area.Results: The search resulted in the identification of 113 empirical indicators, 89 corresponding to psychobiological needs, 21 to psychosocial needs and 03 to psycho-spiritual needs. The needs that most presented empirical indicators were Need for Vascular Regulation (n=18) and Need for Oxygenation (n=16). However, the Need for Emotional Security showed more frequent indicators.Conclusion: The burn, in addition to affecting physical integrity, also affects emotional aspects, contributing to changes in mental integrity. The existence of few studies with the theme highlights the need for scientific production related to the theme, in order to contribute to human and holistic nursing practice. Objetivo: Identificar los indicadores empíricos de las necesidades humanas básicas y sociales que se encuentran en la atención de enfermería a las personas tratadas en las Unidades de Tratamiento de Quemaduras.Materiales y Método: Estudio descriptivo, transversal y exploratorio del tipo revisión integradora de literatura. Se identificaron 265 artículos, seleccionándose, tras el uso de los criterios de inclusión y exclusión, 16 estudios. Los datos recogidos se ingresaron en hojas de trabajo para el análisis estadístico descriptivo y de inferencia, analizándolos utilizando Microsoft Office Excel 2010 y el software Statistical Package for the Social Sciences (SPSS) versión 20.0. La distribución de indicadores empíricos se realizó, los cuales se discutieron basándose en producciones científicas en el área.Resultados: La búsqueda resultó en la identificación de 113 indicadores empíricos en total, 89 correspondientes a necesidades psicobiológicas, 21 a necesidades psicosociales y 03 a necesidades psico-espirituales. Las necesidades que más presentaron indicadores empíricos fueron Necesidad de regulación vascular (n=18) y Necesidad de oxigenación (n=16). Sin embargo, la necesidad de seguridad emocional mostró indicadores más frecuentes.Conclusión: Se encontró que la quemadura, además de afectar la integridad física, también afecta los aspectos emocionales, contribuyendo a los cambios en la integridad mental. La existencia de pocos estudios con el tema resalta la necesidad de producción científica relacionada con el tema, con el fin de contribuir a la práctica de la enfermería humana y holística. Objetivo: Identificar os indicadores empíricos das necessidades humanas básicas e sociais encontrados na assistência de enfermagem à pessoa atendida em Unidades de Tratamento ao Queimado. Materiais e Método: Estudo descritivo, transversal e exploratório do tipo revisão integrativa da literatura. Foram identificados 265 artigos, que após os critérios de inclusão e exclusão, 16 estudos compuseram a amostra. Os dados coletados foram inseridos em planilhas para análises estatísticas descritivas e inferências, analisados utilizando o programa Microsoft Office Excel 2010 e o software Statistical Package for Social Sciences (SPSS) versão 20.0. Foi realizada a distribuição dos indicadores empíricos e, posteriormente, discutidos a partir de produções científicas da área. Resultados: A busca resultou na identificação de 113 indicadores empíricos no total, sendo 89 correspondendo às necessidades psicobiológicas, 21 às necessidades psicossociais e 03, às necessidades psicoespirituais. As necessidades que mais apresentaram indicadores empíricos foram Necessidade de Regulação Vascular (n=18) e Necessidade de Oxigenação (n=16). No entanto, a Necessidade de Segurança Emocional apresentou indicadores mais frequentes. Conclusão: Constatou-se que a queimadura além de afetar a integridade física atinge, também, aspectos emocionais, contribuindo para alterações da sua integridade mental. A existência de poucos estudos com a temática evidencia a necessidade da produção científica relacionada ao tema, a fim de contribuir para a prática humana e holística de enfermagem.

Use of Acellular Dermal Matrix in Reconstructive Surgery: A Review

In recent decades, tissue engineering advances have led to more skin substitutes becoming available. Acellular dermal matrix, initially developed for use in the treatment of full-thickness burns, is made by removing the cellular components from the dermis collected from donated bodies or animals. This class of scaffold is used to replace skin and soft tissue deficiencies in a variety of fields, including breast reconstruction, abdominal wall reconstruction, and burn treatment. Herein, we provide a detailed review of the clinical applications of acellular dermal matrix.

A Review of Cold Atmospheric Pressure Plasmas for Trauma and Acute Care

Despite the high overall survival rates of severely injured military and civilian personnel requiring trauma and acute care, the challenges of treating infections and healing-resistant wounds have grown. Exposure to unknown environmental pathogens at the wound, including parasites and antibiotic resistant microorganisms, hinders timely and effective treatment using traditional techniques. Cold atmospheric pressure plasma (CAPP) provides a promising biophysical tool to address these issues by applying physically created modalities that cannot be circumvented by bioresistance to inactivate microorganisms and enhance wound healing. CAPPs generate charged particles and numerous reactive oxygen species (ROS) and reactive nitrogen species (RNS) that act on biological cells and tissues, often through plasma membrane interactions. This review fills a gap in the plasma medicine literature by specifically focusing on applying CAPPs for acute trauma, such as surgery, wound treatment, and disinfection. After briefly highlighting the areas of opportunity for improving acute trauma treatment and the fundamentals of CAPP generation, this review details emerging applications of CAPPs for enhanced wound healing, burn treatment, transdermal delivery, and surgical applications. We also discuss CAPP optimization through novel device design and synergistic combination with traditional treatment technologies to transition this biophysical technology to the battlefield and acute care settings.

Tilapia skin: technological advance in the treatment of burns?

Introduction: Burn is one of the greatest aggressions the body can suffer. The approach varies according to the degree of the burn, since the use of chlorhexidine, silver sulfadiazine, debridement of necrotic tissue, biosynthetic dressings and artificial skins. However, these latter two have high costs, so several studies have emerged with the objective of seeking more viable options, such as the use of Nile Tilapia skin in burns, due to its healing properties. That said, the present article has as a guide question: Is this new method, in fact, a technological advance as important for the treatment of burned patients as it appears to be? Objective: To analyze the use of Nile Tilapia skin in patients with burn injuries, as well as to compare with other pre-established techniques. Methods: This is an integrative bibliographic review with a qualitative approach. Data were collected through PubMed databases and Virtual Health Library (VHL), from 2015 to 2020. Results: The articles indicate a good prognosis to the use of Nile Tilapia skin in relation to the other options in force for the treatment of burns, with a significant advantage in reducing the number of dressings required, for better adhesion to the wound. Moreover, it presents microscopic characteristics similar to human skin, such as high tensile strength and breakage extension, reducing reepithelialization time and pain intensity, as well as reducing treatment costs. Conclusion: In view of the findings of the literature reported in the present review, it is concluded that studies with nile tilapia skin proves to be a revolutionary modality with benefits in the treatment of patients with superficial and deep skin lesions. Therefore, the researchers concluded, answering the guide question, that the new method is, yes, an important advance in the field of burn treatment, because it's employability is confirmed, besides demonstrating an advantage over some of the main preexisting alternatives.

Functional Hydrogel Dressings for Treatment of Burn Wounds

The therapy of burns is a challenging clinical issue. Burns are long-term injuries, and numerous patients suffer from chronic pain. Burn treatment includes management, infection control, wound debridement and escharotomy, dressing coverage, skin transplantation, and the use of skin substitutes. The future of advanced care of burn wounds lies in the development of “active dressings”. Hydrogel dressings have been employed universally to accelerate wound healing based on their unique properties to overcome the limitations of existing treatment methods. This review briefly introduces the advantages of hydrogel dressings and discusses the development of new hydrogel dressings for wound healing along with skin regeneration. Further, the treatment strategies for burns, ranging from external to clinical, are reviewed, and the functional classifications of hydrogel dressings along with their clinical value for burns are discussed.

Electrospun Fibers Loaded with Natural Bioactive Compounds as a Biomedical System for Skin Burn Treatment. A Review

Burns are a major threat to public health and the economy due to their costly and laborious treatment and high susceptibility to infection. Efforts have been made recently to investigate natural bioactive compounds with potential use in wound healing. The importance lies in the capacities that these compounds could possess both in infection control by common and resistant microorganisms, as well as in the regeneration of the affected tissues, having in both cases low adverse effects. However, some bioactive molecules are chemically unstable, poorly soluble, and susceptible to oxidative degradation or have low bioavailability. Therefore, developing new technologies for an efficient treatment of wound healing poses a real challenge. In this context, electrospun nanofibers have gained increasing research interest because bioactive molecules can be easily loaded within the nanofiber, resulting in optimal burst control and enhanced drug stability. Additionally, the nanofibers can mimic the extracellular collagen matrix, providing a suitable highly porous structural support for growing cells that facilitate and accelerate skin burns healing. This review gives an overview of the current state of electrospun fibers loaded with natural bioactive compounds as a biomedical system for skin burn treatment.

The legacy of fire: long-term changes to the forest understory from periodic burns in a New England oak-hickory forest

Background Over the last century, fire exclusion has caused dramatic structural and compositional changes to southern New England forests, highlighting the need to reintroduce fires into the historically pyrogenic landscape to study the response. We investigated the effects of a single overstory thinning and midstory removal to create an open oak-hickory woodland structure, followed by repeated prescribed burns. We hypothesized that burning would create greater floristic diversity comprising fire-tolerant woody regeneration and shade-intolerant herbaceous flora. We followed shifts in plant structure, composition, and diversity over a 23-year period, using a before-after-control-impact design with data collected once prior to burning and twice after burn treatments had begun and with soil samples collected after nearly 20 years of burning. Results We observed a dense ingrowth of saplings on unburned plots that were largely absent from burned plots and a shift in midstory composition to favor mesic sweet birch (Betula lenta L.) in the unburned treatment, as opposed to the hickories (Carya Nutt. spp.) and oaks (Quercus L. spp.) that dominated the burned treatment. Burning resulted in a significantly greater density, richness, Shannon diversity, and evenness of understory vegetation (forbs, shrubs, tree seedlings). These four measures remained high on burned plots, despite a decrease in both floristic diversity and evenness on unburned plots and a reduction in unburned site-level richness. Understory composition varied significantly by year and burn treatment, with unburned plots largely characterized by shade-tolerant species while burned plots showed an enhanced abundance of heliophilic plants. Conclusions Our results suggest that periodic burning increases nutrient microsite heterogeneity and periodically maintains greater understory light, both of which in turn increase understory plant density and diversity and cause a shift in understory composition. This study shows that repeated prescribed burns in an open New England woodland have lasting structural and compositional effects capable of restoring pre-settlement, pyrogenic vegetation patterns.

Polymer-Based Nanotherapeutics for Burn Wounds

: Burn wounds are complex and intricate injuries that have become a common cause of trauma leading to significant mortality and morbidity every year. Dressings are applied to burn wounds with the aim of promoting wound healing, preventing burn infection and restoring skin function. The dressing protects the injury and contributes to recovery of dermal and epidermal tissues. Polymer-based nanotherapeutics are increasingly being exploited as burn wound dressings. Natural polymers such as cellulose, chitin, alginate, collagen, gelatin and synthetic polymers like poly (lactic-co-glycolic acid), polycaprolactone, polyethylene glycol, and polyvinyl alcohol are being obtained as nanofibers by nanotechnological approaches like electrospinning and have shown wound healing and re-epithelialization properties. Their biocompatibility, biodegradability, sound mechanical properties and unique structures provide optimal microenvironment for cell proliferation, differentiation, and migration contributing to burn wound healing. The polymeric nanofibers mimic collagen fibers present in extracellular matrix and their high porosity and surface area to volume ratio enable increased interaction and sustained release of therapeutics at the site of thermal injury. This review is an attempt to compile all recent advances in the use of polymer-based nanotherapeutics for burn wounds. The various natural and synthetic polymers used have been discussed comprehensively and approaches being employed have been reported. With immense research effort that is currently being invested in this field and development of proper characterization and regulatory framework, future progress in burn treatment is expected to occur. Moreover, appropriate preclinical and clinical research will provide evidence for the great potential that polymer-based nanotherapeutics hold in the management of burn wounds.

Experience of using vacuum therapy in the burn department

Relevance. Indications, application techniques and contraindications for the use of vacuum therapy in surgery and orthopedics are formulated in clinical guidelines and are generally available. Indications for the use of a vacuum in patients with severe burns are scattered and depend on personal experience and preferences of the medical staff, and not on objective reasons.Intention. To analyze the results of using Negative Pressure Wound Therapy (NPWT) in patients of burn departments.Methodology. The study included 56 patients treated with local negative pressure in the Department of thermal injuries of the Saint-Petersburg institute of emergency care named after I.I. Dzhanelidze in 2017–2020. Statistical data processing was performed using Microsoft Office Excel 2007 and IBM SPSS 20.0 using descriptive and non-parametric statistics.Results and their Discussion. The frequency of using VAC-therapy in patients with burn injuries was 0.8 % (56 of 6764). The most common reasons for hospitalization of patients were contact injuries – 20 (36 %) and flame burns – 18 (32 %). The main indications for NPWT were stimulation of granulation formation – 21 (38 %), control of wound infection – 20 (36 %), and temporary wound closure after early excisions or atypical amputations – 11 (20 %). The main contraindications to the use of the method were cognitive disorders or impaired consciousness. The primary complication was the depressurization of the dressings, which we encountered in 9 cases (16 %). The expected results of vacuum therapy were achieved in 49 patients (88 %).Conclusion. Local negative pressure is relatively rarely used in burn treatment. A positive effect from the use of NPWT can be expected in the control of wound infections and in the preparation of wounds for skin grafting. The prospects for the introduction of the method can be considered its application in the treatment of partial-thickness burns and additional fixation of skin grafts. To objectify the choice of modes and duration of vacuum therapy in burned patients, it is necessary to conduct further multicenter studies with the preparation of clinical guidelines.