ORCID Profile
0000-0003-3515-9129
Current Organisations
Fiona Stanley Hospital
,
Curtin University
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Publisher: Oxford University Press (OUP)
Date: 29-06-2020
DOI: 10.1093/JBCR/IRAA104
Abstract: Compression, a common treatment of choice for the management of edema, is one intervention that is applied with little objective understanding of the optimal parameters of application or efficacy in acute burn wounds. The aim of this study was to determine the effectiveness of different methods of compression for the management of hand edema following burn injury. The primary hypothesis tested was that in acute hand burn injury, the application of cohesive bandage will reduce edema faster than a generic compression glove. It is a randomized controlled study of 100 patients presenting with hand burn injury. Compression was randomized to one of the three methods of application: 1) spiral application of Coban to fingers, figure of eight to hand and wrist 2) pinch application of Coban to fingers, spiral application to hand and wrist or 3) a generic compression glove (control condition). Bioimpedance spectroscopy was used to measure hand volumes. Hand and wrist range of movement, pain scores, and QuickDASH were recorded. One hundred patients (68 males) demonstrated significant reductions in hand volumes, using all compression methods. Both methods of applying Coban resulted in significantly greater reductions in edema compared to the generic compression glove. Notwithstanding compression method, all range of movement measures improved, with significant improvement in thumb opposition (P = .046), hand span (P = .020), and wrist flexion (P = .020). QuickDASH decreased between sessions (P & .001). Different methods of applying Coban are superior to generic compression gloves for managing acute hand burn edema.
Publisher: Oxford University Press (OUP)
Date: 09-05-2020
DOI: 10.1093/JBCR/IRAA071
Abstract: The assessment of swelling following burn injury is complicated by the presence of wounds and dressings and due to patients experiencing significant pain and impaired movement. There remains a lack of sensitive objective measures for edema in patients presenting with hand burn injury. Bioimpedance spectroscopy (BIS) is a measure of body composition that has been demonstrated by our group to be reliable for measuring whole body and limb edema during resuscitation and to be sensitive to edema changes within healing wounds. The aim of this study was to determine the reliability and validity of BIS as a measure of edema following hand burn injury specifically. One hundred patients presenting with burn injury including a portion of a hand were recruited to this trial. Repeated measures of the hand were recorded using a novel application of BIS and in parallel with water displacement volumetry (WDV). The results were analyzed using mixed-effects regressions. Paired repeated measures were obtained for 195 hands, using four electrode configurations. BIS demonstrated high reliability in measuring hand BIS—Intraclass Correlation Coefficient 0.995 to 0.999 (95% CI 0.992–1.000) and sensitivity—Minimum Detectable Difference 0.74 to 3.86 Ω (0.09–0.48 Ω/cm). A strong correlation was shown with WDV, Pearson’s r = −0.831 to −0.798 (P & .001). BIS is a sensitive and reliable measure of edema following acute hand burn injury.
Publisher: Elsevier BV
Date: 2022
No related grants have been discovered for Dale Edwick.