No abstract

Many medical students now have contact with patients from the very beginning of their course and the increasing numbers of medical students means that more and more patients will be exposed to students during their medical treatment. This paper presents the attitudes of 281 patients towards medical students encountered in a primary or secondary care setting. Particular attention is paid to consent, types of procedures undertaken and the title given to the medical student. The study showed that the likelihood of patients agreeing to be involved in medical education depended on the patient, the student and the procedure being undertaken. Recommendations have been made to the university on the basis of the results with the aim of maximizing patient involvement and satisfaction in order to further medical student education.

BackgroundIt is commonly accepted that burns taking longer than 3 weeks to heal have a much higher rate of hypertrophic scarring than those which heal more quickly. However, some of our patients develop hypertrophic scars despite healing within this 3-week period.MethodsWe performed a prospective study of 383 paediatric burns treated non-operatively at a regional burns centre over a 2-year period from May 2011 to April 2013. Scar assessment was performed by a senior burns therapist using the Vancouver Scar Scale.ResultsOverall rates of hypertrophic scarring were 17.2%. Time to healing was the strongest predictor of developing hypertrophic scarring, and the earliest hypertrophic scar developed in a patient who was healed after 8 days. The risk of hypertrophic scarring was multiplied by 1.138 for every additional day taken for the burn wound to heal. There was a trend towards higher rates of hypertrophic scarring in non-white skin types but this did not reach statistical significance.ConclusionsThe risk of hypertrophic scarring increases with every day and, therefore, every effort should be made to get the wound healed as quickly as possible, even within the traditional 3-week period usually allowed for healing. We believe that the traditional dogma of aiming for healing within 3 weeks is overly simplistic and should be abandoned: in paediatric burns, every day counts.Trial registrationNot applicable.

This study showed significant improvements in patient-assessed mobility, softness, and appearance. Collagen and elastic fibrin were present in all specimens, nerve fiber regeneration was limited to the mid- or lower reticular dermis, and adnexal structures were absent. The typical wrinkled appearance of mature Integra reconstruction cannot be said to be entirely due to a lack of elastic fibers.