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The nutritional management of adult burn wound patients in South Africa
Thesis (MNutr (Human Nutrition))--University of Stellenbosch, 2007.
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| Other Authors: | |
| Format: | Thesis |
| Language: | English |
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Stellenbosch : University of Stellenbosch
2008
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| _version_ | 1867614039594500096 |
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| access_status_str | Open Access |
| author | Ellmer, Marlene |
| author2 | Blaauw, Renee |
| author_browse | Blaauw, Renee Ellmer, Marlene |
| author_facet | Blaauw, Renee Ellmer, Marlene |
| author_sort | Ellmer, Marlene |
| collection | Thesis |
| dc_rights_str_mv | University of Stellenbosch |
| description | Thesis (MNutr (Human Nutrition))--University of Stellenbosch, 2007. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/2755 |
| institution | Stellenbosch University (South Africa) |
| language | English |
| last_indexed | 2026-06-10T12:45:41.741Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2008 |
| publishDateRange | 2008 |
| publishDateSort | 2008 |
| publisher | Stellenbosch : University of Stellenbosch |
| publisherStr | Stellenbosch : University of Stellenbosch |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/2755 The nutritional management of adult burn wound patients in South Africa Ellmer, Marlene Blaauw, Renee Van der Merwe, Sulene University of Stellenbosch. Faculty of Health Sciences. Dept. of Interdisciplinary Health Sciences. Human Nutrition. Dissertations -- Nutrition Theses -- Nutrition Burns and scalds -- Patients -- Nutrition Burns and scalds -- Treatment -- Nutritional aspects Thesis (MNutr (Human Nutrition))--University of Stellenbosch, 2007. OBJECTIVE: The objectives of this study were to determine the nutritional practices used in burns units in South Africa and to compare them with the latest available literature in order to make appropriate recommendations for possible implementation. METHODS: Validated questionnaires were sent out to surgeons, dietitians and professional nurses working in burns units that complied with the inclusion criteria. Information on the units was obtained from an advertisement placed via email through ADSA. Non-random sampling was done and all the burns units were included in the study. Descriptive cross-sectional statistics were used to analyze the data. RESULTS: Twelve burns units were identified. Ten of the burns units’ health professionals (surgeons, dietitians and professional nurses) participated in the study. All the health professionals had experience in burned patients’ management judging by the average number of year’s experience. The average number of adult burned patients treated was 188 (58-350) and the mortality per year was 16% [Standard Deviation (SD) 6.4%] About half of the professionals indicated they used a protocol for the implementation of nutrition support. A degree of miscommunication was noted between the health professionals working in the units. Very few units (n=2) were able to perform wound excisions within 72 hours post-burn. All the dietitians used predictive equations when estimating energy requirements and the most popular formula remained the Curreri formula. Various different predictive equations were used. Even though most institutions indicated that micronutrient supplementation was routine practice, no standard regimen existed and supplementation varied significantly between units. The oral route, enteral route or a combination were used to feed patients with different degrees of burns, and the majority (60%) of the health professionals stated that they waited until oral diets were tolerated before enteral nutrition was stopped. The nasogastric enteral route remained the most popular route. Very few units used other feeding routes, and they would rather opt for TPN if nasogastric feeding should fail. The estimated nutritional requirements were met in 90% of patients in whom the feeding tube was successfully placed. From the results it appeared that dietitians were less confident regarding the use of immunonutrition in burned patients, in spite of the available literature. Anabolic agents were not very commonly used in South Africa, probably due to the high cost. Patients were not followed-up regularly by dietitians. CONCLUSION The results of this study indicated that despite the use of correct recommendations in certain instances there remained a definite degree of variation and uncertainty amongst health professionals. There also appeared to be poor communication between health professionals. The burns units in South Africa should use set standards for nutritional managements, obtain and implement strict feeding protocols and improve communication amongst the health professionals. 2008-03-26T10:51:16Z 2010-06-01T08:57:31Z 2008-03-26T10:51:16Z 2010-06-01T08:57:31Z 2007-12 Thesis http://hdl.handle.net/10019.1/2755 en University of Stellenbosch 1057920 bytes application/pdf application/pdf Stellenbosch : University of Stellenbosch |
| spellingShingle | Dissertations -- Nutrition Theses -- Nutrition Burns and scalds -- Patients -- Nutrition Burns and scalds -- Treatment -- Nutritional aspects Ellmer, Marlene The nutritional management of adult burn wound patients in South Africa |
| title | The nutritional management of adult burn wound patients in South Africa |
| title_full | The nutritional management of adult burn wound patients in South Africa |
| title_fullStr | The nutritional management of adult burn wound patients in South Africa |
| title_full_unstemmed | The nutritional management of adult burn wound patients in South Africa |
| title_short | The nutritional management of adult burn wound patients in South Africa |
| title_sort | nutritional management of adult burn wound patients in south africa |
| topic | Dissertations -- Nutrition Theses -- Nutrition Burns and scalds -- Patients -- Nutrition Burns and scalds -- Treatment -- Nutritional aspects |
| url | http://hdl.handle.net/10019.1/2755 |
| work_keys_str_mv | AT ellmermarlene thenutritionalmanagementofadultburnwoundpatientsinsouthafrica AT ellmermarlene nutritionalmanagementofadultburnwoundpatientsinsouthafrica |