Cleon W. Goodwin

Banner North Colorado Medical Center

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Basil A. Pruitt

The University of Texas Health Science Center at San Antonio

Arthur D. Mason

United States Army Institute of Surgical Research

Leopoldo C. Cancio

United States Army Institute of Surgical Research

David J. Barillo

MRIGlobal

Jerome Finkelstein

NewYork–Presbyterian Hospital

Albert T. McManus

United States Army Institute of Surgical Research

Michael R. Madden

University of South Carolina

K Z Shirani

United States Army Institute of Surgical Research

D.W. Mozingo

Florida College

William F. McManus

Saint Anthony College of Nursing

Cooperative Institutions

The University of Texas Medical Branch at Galveston

102

Shriners Hospitals for Children - Galveston

United States Army Institute of Surgical Research

Harvard University

Cornell University

The University of Texas Southwestern Medical Center

Johns Hopkins University

Shriners Hospitals for Children - Erie

Massachusetts General Hospital

National Institutes of Health

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Burden of Burn: A Norm-Based Inquiry into the Influence of Burn Size and Distress on Recovery of Physical and Psychosocial Function

Journal of Burn Care & Rehabilitation (2005)

James A. Fauerbach Dennis C. Lezotte Rebecca Hills G. F. Cromes Karen Kowalske

This prospective, longitudinal study examined the influence of baseline physical and psychological burden on serial assessments of health-related quality of life among adults with major burns from three regional burn centers (n = 162). Physical burden groups were defined by % TBSA burned: <10%, 10% to 30%, or >30%. Psychological burden groups were defined by in-hospital distress using the Brief Symptom Inventory Global Severity Index T-score with scores of < 63 or > or = 63. Analyses compared groups across level of burden and with published normative data. Assessments reflected health and function (Short Form 36) during the month before burn, at discharge, and at 6 and 12 months after burn. Physical functioning was significantly more impaired and the rate of physical recovery slower among those with either large physical burden or large psychological burden. Notably, psychosocial functioning also was more impaired and the rate of psychosocial recovery slower among those with greater psychological burden. These results suggest that, in addition to aggressive wound closure, interventions that reduce in-hospital distress may accelerate both physical and psychosocial recovery.

10.1097/01.bcr.0000150216.87940.ac

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Citations (125)

Respiratory Care of the Burn Patient

Clinics in Plastic Surgery (1986)

Michael R. Madden Jerome Finkelstein Cleon W. Goodwin

Nasal cannula

Carbon monoxide poisoning

10.1016/s0094-1298(20)31614-x

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Citations (14)

A New Approach to the Experimental Measurement of Mean Tissue PO2

Advances in experimental medicine and biology (1976)

Robert Förster Cleon W. Goodwin Nobutomo Itada

Isotope dilution

Dilution

Tissue distribution

10.1007/978-1-4684-3273-2_6

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Citations (3)

The Relationship of Burnout, Stress, and Hardiness in Nurses in a Military Medical Center

Journal of Burn Care & Rehabilitation (1999)

Charlotte L. DePew M. C. GORDON Linda H. Yoder Cleon W. Goodwin

The purpose of this descriptive study was to determine whether the personality trait of hardiness is a predictor of burnout and whether it can buffer the effect of stress on burnout. Forty-nine registered nurses working in 7 special care units completed the Tedium Burnout Scale, the Nursing Stress Scale, and the Hardiness Test. Results indicate that burnout, stress, and hardiness had a significant relationship (P < .001). Hierarchical multiple regression analysis indicated that hardiness alone accounted for 35% of burnout variance (P < .05) and that the addition of stress had no effect. A previous study reported that burn unit nurses had the least burnout and greatest hardiness. However, in this study, nurses from the Burn Intensive Care Unit had the highest burnout and stress scores and the lowest hardiness scores of nurses from the 7 units. This study confirms findings by a previous study that hardiness is a predictor of burnout but is not a buffer in the stress-burnout relationship. To further understand burnout and hardiness, longitudinal and multisite studies that include burn units are recommended.

Hardiness (plants)

Burn out

10.1097/00004630-199920060-00016

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Citations (31)

Current Burn Treatment

Journal of Burn Care & Rehabilitation (1986)

Cleon W. Goodwin

10.1097/00004630-198603000-00042

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Citations (0)

Advanced Hemostatic Dressing Development Program: Animal Model Selection Criteria and Results of a Study of Nine Hemostatic Dressings in a Model of Severe Large Venous Hemorrhage and Hepatic Injury in Swine

Journal of Trauma and Acute Care Surgery (2003)

Anthony E. Pusateri Harold E. Modrow Richard Harris John B. Holcomb John R. Hess

Background An advanced hemostatic dressing is needed to augment current methods for the control of life-threatening hemorrhage. A systematic approach to the study of dressings is described. We studied the effects of nine hemostatic dressings on blood loss using a model of severe venous hemorrhage and hepatic injury in swine. Methods Swine were treated using one of nine hemostatic dressings. Dressings used the following primary active ingredients: microfibrillar collagen, oxidized cellulose, thrombin, fibrinogen, propyl gallate, aluminum sulfate, and fully acetylated poly-N-acetyl glucosamine. Standardized liver injuries were induced, dressings were applied, and resuscitation was initiated. Blood loss, hemostasis, and 60-minute survival were quantified. Results The American Red Cross hemostatic dressing (fibrinogen and thrombin) reduced (p < 0.01) posttreatment blood loss (366 mL; 95% confidence interval, 175–762 mL) and increased (p < 0.05) the percentage of animals in which hemostasis was attained (73%), compared with gauze controls (2,973 mL; 95% confidence interval, 1,414–6,102 mL and 0%, respectively). No other dressing was effective. The number of vessels lacerated was positively related to pretreatment blood loss and negatively related to hemostasis. Conclusion The hemorrhage model allowed differentiation among topical hemostatic agents for severe hemorrhage. The American Red Cross hemostatic dressing was effective and warrants further development.

Hemostatic Agent

Hemostatics

10.1097/01.ta.0000075336.92129.27

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Citations (150)

Burns Caused by Medical Therapy

Journal of Burn Care & Rehabilitation (2000)

David J. Barillo El Centro Coffey K Z Shirani Cleon W. Goodwin

Medical Therapy

10.1097/00004630-200021030-00016

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Citations (24)

Observations on the Risk of Resistance With the Extended Use of Vancomycin

Archives of Surgery (1998)

Albert T. McManus Cleon W. Goodwin Basil A. Pruitt

To document the risk of the development of vancomycin-resistant bacteria in a population of seriously burned patients during a 10-year period of common vancomycin hydrochloride use.Retrospective study.The US Army Institute of Surgical Research, Burn Center, Fort Sam Houston, Tex.Microbiology, infection, and antibiotic use records collected during the hospitalization of 2266 consecutively admitted seriously burned patients were reviewed. Vancomycin was the primary therapeutic agent used for gram-positive infections and was also used as a perioperative prophylactic antibiotic during burn wound excision. This policy was established prior to this review because of a high incidence of methicillin-resistant Staphylococcus aureus colonization and an anecdotal association of increased beta-lactam resistance in endemic gram-negative pathogens associated with the use of penicillinase-resistant penicillins and cephalosporins.Isolation of vancomycin-resistant enterococci (VRE) or other gram-positive organisms resistant to vancomycin.Examinations of 15 125 gram-positive isolates, including 957 enterococci, for in vitro sensitivity to vancomycin yielded 3 VRE isolates in 3 patients. Vancomycin was used prior to VRE isolation in one of these patients. Resistance was found in 3 other organisms (2 Corynebacterium species, 1 Lactobacillus species). Vancomycin was used prior to these isolations in 2 of 3 patients. None of the vancomycin-resistant organisms was associated with infection and all 6 patients survived. Vancomycin-resistant enterococci or other vancomycin-resistant gram-positive organisms were not found in 663 patients treated with vancomycin for documented gram-positive infections or in 1027 patients where perioperative vancomycin was used.Use of vancomycin as the primary therapeutic agent in seriously burned patients was not associated with increased risk of VRE isolation or VRE infection.

10.1001/archsurg.133.11.1207

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Citations (28)

ADRENAL HEMORRHAGES AND INFARCTION IN BURN PATIENT AUTOPSIES

Southern Medical Journal (1996)

Seung Hyun Kim Paulette Langlinais Cleon W. Goodwin John B. Ryan

10.1097/00007611-199610001-00206

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Effects of Burns on Inhalation Injury in Sheep: A 5-Day Study

Journal of Trauma and Acute Care Surgery (2002)

Osamu Tasaki Michael A. Dubick Cleon W. Goodwin Basil A. Pruitt

We have previously reported that infliction of thermal injury immediately after smoke exposure did not accentuate pulmonary dysfunction during the subsequent 48 h. The purpose of this study was to determine whether thermal injury would aggravate pulmonary dysfunction during a longer postinjury period of 5 days.Six sheep (G1) received 12 units of smoke inhalation injury (SII) alone; seven sheep (G2) received a 40% full-thickness scald burn immediately after SII. All sheep were resuscitated with lactated Ringer's solution for the first 48 h. After 48 h, animals were fed food and water ad libitum. Cardiopulmonary variables and blood gases were measured serially. At the end of the 5-day experimental period, VA/Q distribution was analyzed using the multiple inert gas elimination technique (MIGET). Lung wet to dry (W/D) weight ratios and malondialdehyde (MDA) concentrations were determined.Cardiac index in G2 significantly increased and remained higher compared with G1. There was no difference in A-aDO(2) between the two groups. There was also no difference between the two groups by MIGET study, or in terms of lung MDA and W/D weight ratios. None of the animals manifested symptoms of infection.Despite the difference in the hemodynamic changes induced by the addition of a 40% burn to smoke inhalation injury, pulmonary dysfunction was not accentuated during the 5-day study period in the absence of infection.

Smoke Inhalation Injury

Malondialdehyde

10.1097/00005373-200202000-00023

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Citations (18)