In this study, the outcome of treatment with Flammacerium in burn patients is studied. The retrospective study involved patients with acute burns admitted to the Burn Centre of Martini Hospital, Groningen, The Netherlands, between 2009 and 2014. The outcome parameters were mortality, complications (noninfectious and infectious), need of surgery, and length of stay. The group of patients consisted of 853 patients, of which 554 were male (64.9%). There were 23 patients with a total burn size of 40% TBSA or more (2.7%). In total, 13 of the 853 patients (1.5%) died, and none of them were children (<16 years). The overall mortality in the group of patient with burns >40% TBSA was 30.4%. In the elderly group (>70 years), the mortality rate was 6.3%. Treatment with Flammacerium is applicable in all thermal burn patients. Especially children, elderly patients, and patients with severe burns can benefit from a more conservative treatment with Flammacerium whereby the first operation can be postponed until the patient is stabilized and in which the wounds can be covered directly with skin transplants.
In this study, the outcome of treatment with Flammacerium in burn patients is studied. The retrospective study involved patients with acute burns admitted to the Burn Centre of Martini Hospital, Groningen, The Netherlands, between 2009 and 2014. The outcome parameters were mortality, complications (noninfectious and infectious), need of surgery, and length of stay. The group of patients consisted of 853 patients, of which 554 were male (64.9%). There were 23 patients with a total burn size of 40% TBSA or more (2.7%). In total, 13 of the 853 patients (1.5%) died, and none of them were children (<16 years). The overall mortality in the group of patient with burns >40% TBSA was 30.4%. In the elderly group (>70 years), the mortality rate was 6.3%. Treatment with Flammacerium is applicable in all thermal burn patients. Especially children, elderly patients, and patients with severe burns can benefit from a more conservative treatment with Flammacerium whereby the first operation can be postponed until the patient is stabilized and in which the wounds can be covered directly with skin transplants.
Introduction: In March 2014, the New South Wales (NSW) Government (Australia) announced the NSW Integrated Care Strategy. In response, a family-centred, population-based, integrated care initiative for vulnerable families and their children in Sydney, Australia was developed. The initiative was called Healthy Homes and Neighbourhoods. A realist translational social epidemiology programme of research and collaborative design is at the foundation of its evaluation. Theory and Method: The UK Medical Research Council (MRC) Framework for evaluating complex health interventions was adapted. This has four components, namely 1) development, 2) feasibility/piloting, 3) evaluation and 4) implementation. We adapted the Framework to include: critical realist, theory driven, and continuous improvement approaches. The modified Framework underpins this research and evaluation protocol for Healthy Homes and Neighbourhoods. Discussion: The NSW Health Monitoring and Evaluation Framework did not make provisions for assessment of the programme layers of context, or the effect of programme mechanism at each level. We therefore developed a multilevel approach that uses mixed-method research to examine not only outcomes, but also what is working for whom and why.
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