Context: Burn injuries are one of the most common health issues of the universe. Burn injuries in hand are very frequent, and in spite of appearance that the expanse of the hand represents < 3% of the total body surface area (TBSA) on each hand, burn injury may have major significance on the quality of the life of an individual. Although the studies have shown the association of burn with either functional, motor, or sensory functions, no such study was found which evaluated and related all the three aspects of hand function, i.e., sensory, motor, and functional activities. Subjects and Methods: Individuals aged between 18 to 60 years satisfying the examination process were included for the study. Two groups were allocated, including 10 burned hand patients and 10 controlled subjects. All the 20 subjects were examined for sensory, motor, and functional abilities. Pain, temperature, and 2-point discrimination sensitivities were tested; motor functions were tested using Strickland method, Kleinert method, and Jamar hand dynamometer, and functional impairment was tested using Michigan Hand Questionnaire (MHQ). Statistical Analysis Used: The descriptive data was analyzed using Microsoft Excel and Spearman's rank correlation test was applied using IBM SPSS Statistics for Windows, Version 16.0. Armonk, NY: IBM Corp.” Result: TBSA was significantly related to the pain perceived on the Visual analog scale (VAS) (r = 0.509; P < 0.05). Significant correlation was seen with MHQ work (r = 0.611; P < 0.05), MHQ esthetics (r = 0.788; P < 0.05), and MHQ satisfaction (r = 0.654; P < 0.05) in relation to TBSA. Degree of burn was significantly related to the pain perceived on VAS (r = 0.907, P < 0.05), pain sensation, temperature, and 2-point discrimination (r = 0.59, P < 0.05). Significant correlation was seen with grip strength (r = 0.77, P < 0.05) and further, index finger flexion (r = 0.866), middle finger flexion (r = 0.949), ring finger flexion (r = 0.909), and little finger flexion (r = 0.910) were significantly related (P < 0.05) to degree of burn. MHQ was significantly related (P < 0.05) to degree of burn in terms of overall hand function (r = 0.836), ADL (r = 0.825), work (r = 0.790), pain (r = 0.574), esthetics (r = 0.86), and satisfaction (r = 0.884) in relation to degree of burn. Conclusion: TBSA was significantly co-related with pain in terms of sensory function and showed significant relationship with functional abilities in terms of work, esthetic, and satisfaction. Degree of burn significantly related to the pain, temperature, and 2-point discrimination in terms of sensory abilities, grip strength, Strickland method, and Kleinert method in terms of motor abilities and MHQ in terms of functional capabilities. It also indicates that there was a statistically significant difference in sensory, motor, and functional abilities of the hand that were decreased in patients compared with the control group.
{"title":"Association between sensory, motor, and functional abilities among burned hand patients","authors":"H. Kaushik, Pragya Kumar, J. Kaur","doi":"10.4103/ijb.ijb_26_19","DOIUrl":"https://doi.org/10.4103/ijb.ijb_26_19","url":null,"abstract":"Context: Burn injuries are one of the most common health issues of the universe. Burn injuries in hand are very frequent, and in spite of appearance that the expanse of the hand represents < 3% of the total body surface area (TBSA) on each hand, burn injury may have major significance on the quality of the life of an individual. Although the studies have shown the association of burn with either functional, motor, or sensory functions, no such study was found which evaluated and related all the three aspects of hand function, i.e., sensory, motor, and functional activities. Subjects and Methods: Individuals aged between 18 to 60 years satisfying the examination process were included for the study. Two groups were allocated, including 10 burned hand patients and 10 controlled subjects. All the 20 subjects were examined for sensory, motor, and functional abilities. Pain, temperature, and 2-point discrimination sensitivities were tested; motor functions were tested using Strickland method, Kleinert method, and Jamar hand dynamometer, and functional impairment was tested using Michigan Hand Questionnaire (MHQ). Statistical Analysis Used: The descriptive data was analyzed using Microsoft Excel and Spearman's rank correlation test was applied using IBM SPSS Statistics for Windows, Version 16.0. Armonk, NY: IBM Corp.” Result: TBSA was significantly related to the pain perceived on the Visual analog scale (VAS) (r = 0.509; P < 0.05). Significant correlation was seen with MHQ work (r = 0.611; P < 0.05), MHQ esthetics (r = 0.788; P < 0.05), and MHQ satisfaction (r = 0.654; P < 0.05) in relation to TBSA. Degree of burn was significantly related to the pain perceived on VAS (r = 0.907, P < 0.05), pain sensation, temperature, and 2-point discrimination (r = 0.59, P < 0.05). Significant correlation was seen with grip strength (r = 0.77, P < 0.05) and further, index finger flexion (r = 0.866), middle finger flexion (r = 0.949), ring finger flexion (r = 0.909), and little finger flexion (r = 0.910) were significantly related (P < 0.05) to degree of burn. MHQ was significantly related (P < 0.05) to degree of burn in terms of overall hand function (r = 0.836), ADL (r = 0.825), work (r = 0.790), pain (r = 0.574), esthetics (r = 0.86), and satisfaction (r = 0.884) in relation to degree of burn. Conclusion: TBSA was significantly co-related with pain in terms of sensory function and showed significant relationship with functional abilities in terms of work, esthetic, and satisfaction. Degree of burn significantly related to the pain, temperature, and 2-point discrimination in terms of sensory abilities, grip strength, Strickland method, and Kleinert method in terms of motor abilities and MHQ in terms of functional capabilities. It also indicates that there was a statistically significant difference in sensory, motor, and functional abilities of the hand that were decreased in patients compared with the control group.","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"28 1","pages":"24 - 28"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41473996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Srikanth Vasudevan, S. Nagireddy, A. Chandrappa, Y. Anantheshwar, R. Batth, Harish Kablian, Dinkar Sreekumar
Objective: The objective of this study was to compare the effectiveness of bupivacaine-soaked gauze dressing and conventional dressing for pain relief in patients requiring split-thickness skin graft for reconstruction of various defects. Methodology: Fifty patients requiring split-thickness skin grafting for various soft-tissue defects were divided into two groups with 25 patients in each group. In Group A, skin graft donor site dressing was kept moist with 10 mL/100 cm2 of 0.25% bupivacaine solution-soaked gauze, and in Group B, dressing was moistened with the same amount of normal saline-soaked gauze. Outcome was measured by comparing pain scores and calculating rescue analgesia requirements in the two groups in the first 24 h. Significance was determined by comparing analgesia-sparing effect of each dressing using Chi-square test. Results: In Group A, 1 out of 25 (4%) patients required rescue analgesia. In Group B, 23 out of 25 (92%) patients required rescue analgesia (P < 0.0001). There was 96% effectiveness of bupivacaine-soaked dressing while only 8% effectiveness of conventional dressing. Conclusion: Bupivacaine-soaked dressing should be considered as a potent alternative to traditional saline dressings for the skin graft donor site.
{"title":"A prospective study on efficacy of topical bupivacaine in split skin grafting donor site in immediate postoperative pain relief","authors":"Srikanth Vasudevan, S. Nagireddy, A. Chandrappa, Y. Anantheshwar, R. Batth, Harish Kablian, Dinkar Sreekumar","doi":"10.4103/ijb.ijb_2_20","DOIUrl":"https://doi.org/10.4103/ijb.ijb_2_20","url":null,"abstract":"Objective: The objective of this study was to compare the effectiveness of bupivacaine-soaked gauze dressing and conventional dressing for pain relief in patients requiring split-thickness skin graft for reconstruction of various defects. Methodology: Fifty patients requiring split-thickness skin grafting for various soft-tissue defects were divided into two groups with 25 patients in each group. In Group A, skin graft donor site dressing was kept moist with 10 mL/100 cm2 of 0.25% bupivacaine solution-soaked gauze, and in Group B, dressing was moistened with the same amount of normal saline-soaked gauze. Outcome was measured by comparing pain scores and calculating rescue analgesia requirements in the two groups in the first 24 h. Significance was determined by comparing analgesia-sparing effect of each dressing using Chi-square test. Results: In Group A, 1 out of 25 (4%) patients required rescue analgesia. In Group B, 23 out of 25 (92%) patients required rescue analgesia (P < 0.0001). There was 96% effectiveness of bupivacaine-soaked dressing while only 8% effectiveness of conventional dressing. Conclusion: Bupivacaine-soaked dressing should be considered as a potent alternative to traditional saline dressings for the skin graft donor site.","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"28 1","pages":"18 - 23"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49657604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: One of the most common burn sequels is postburn contracture (PBC) neck. These contractures affect the patient significantly causing both functional limitations and distorted aesthetic appearance. Therefore, the reconstruction of the head-and-neck area is a challenge for surgeons to restore not only the function but also to improve the esthetic appearance. Materials and Methods: We conducted a tertiary hospital-based prospective study in 12 patients with cases of severe PBC that underwent split-thickness skin graft (SSG) cover as a treatment modality and evaluated the results after the operative procedure in terms of function and appearance of the neck and its complications. Result of the function evaluated with respect to the range of extension movement of the neck –good 120°or more, fair 90°–120°, and bad <90°. Esthetic appearance evaluations were done on the patient's opinion with consideration of color match; maintenance of contour of the neck is good, fair, and not acceptable. Observation and Results: In our study, nine of cases were of thermal burn. All cases were presented with flexion contracture neck, while in seven cases were presented with 0° extensions of the neck. The neck contracture was released in two cases by excision of the scar and in rest of cases by incision methods. The defect was resurfaced with an unmeshed sheet of SSG in six cases, while in six of cases, the defect was resurfaced with a combination of an unmeshed and meshed sheet of SSG. Good functional recovery in terms of extension of the neck >120° in nine cases and fair esthetic appearance in eight cases and good in four cases. Conclusions: The excision of all scar tissue is possible only in few cases, but the incision releases were required in the majority of severe neck contractures. The STS grafting is a simple, reliable, and safe operation. Sheets of unmeshed SSG in the neck and lower face resulted in better postoperative neck function, the cosmetic appearance in terms of color match, and cervicomental angle.
{"title":"The postburn severe flexion contracture neck correction with split-thickness skin graft: Our experience","authors":"A. Bhatnagar, Anupama Singh","doi":"10.4103/ijb.ijb_12_20","DOIUrl":"https://doi.org/10.4103/ijb.ijb_12_20","url":null,"abstract":"Introduction: One of the most common burn sequels is postburn contracture (PBC) neck. These contractures affect the patient significantly causing both functional limitations and distorted aesthetic appearance. Therefore, the reconstruction of the head-and-neck area is a challenge for surgeons to restore not only the function but also to improve the esthetic appearance. Materials and Methods: We conducted a tertiary hospital-based prospective study in 12 patients with cases of severe PBC that underwent split-thickness skin graft (SSG) cover as a treatment modality and evaluated the results after the operative procedure in terms of function and appearance of the neck and its complications. Result of the function evaluated with respect to the range of extension movement of the neck –good 120°or more, fair 90°–120°, and bad <90°. Esthetic appearance evaluations were done on the patient's opinion with consideration of color match; maintenance of contour of the neck is good, fair, and not acceptable. Observation and Results: In our study, nine of cases were of thermal burn. All cases were presented with flexion contracture neck, while in seven cases were presented with 0° extensions of the neck. The neck contracture was released in two cases by excision of the scar and in rest of cases by incision methods. The defect was resurfaced with an unmeshed sheet of SSG in six cases, while in six of cases, the defect was resurfaced with a combination of an unmeshed and meshed sheet of SSG. Good functional recovery in terms of extension of the neck >120° in nine cases and fair esthetic appearance in eight cases and good in four cases. Conclusions: The excision of all scar tissue is possible only in few cases, but the incision releases were required in the majority of severe neck contractures. The STS grafting is a simple, reliable, and safe operation. Sheets of unmeshed SSG in the neck and lower face resulted in better postoperative neck function, the cosmetic appearance in terms of color match, and cervicomental angle.","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"28 1","pages":"36 - 43"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46746640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-01-01DOI: 10.4103/0971-653X.316584
Shalabh Kumar
Burns is a serious health problem in our country. Burn management is a complex and resource intensive process and requires a dedicated multidisciplinary team working in coordination in all the aspects of burn care simultaneously. Most burn patients get treated by the general practitioner primarily and then referred to higher centers. Specialized burn centers are few in number, and affordable care is hard to find other than government run institutions. A lot of research has been done in the fields of burn resuscitation, nutrition, synthetic and biologic dressings, and surgical management of burn wounds, etc., and several advances have been made, but most institutes managing burns are restricted by their availability of resources and high patient load and hence adopt their own protocols based on their patient characteristics, resources, and experience in treating burns. Here, I have shared a few tips and wisdom I have gained in the management of burns based on my experience of almost 30 years in treating burns at a government run tertiary burn care center. Despite all efforts, severe burns are still associated with very high morbidity and mortality and so a concerted effort needs to be made at the national as well as grass root level to raise the awareness and education regarding burns safety and prevention of burns.
{"title":"Tips in the management of burns","authors":"Shalabh Kumar","doi":"10.4103/0971-653X.316584","DOIUrl":"https://doi.org/10.4103/0971-653X.316584","url":null,"abstract":"Burns is a serious health problem in our country. Burn management is a complex and resource intensive process and requires a dedicated multidisciplinary team working in coordination in all the aspects of burn care simultaneously. Most burn patients get treated by the general practitioner primarily and then referred to higher centers. Specialized burn centers are few in number, and affordable care is hard to find other than government run institutions. A lot of research has been done in the fields of burn resuscitation, nutrition, synthetic and biologic dressings, and surgical management of burn wounds, etc., and several advances have been made, but most institutes managing burns are restricted by their availability of resources and high patient load and hence adopt their own protocols based on their patient characteristics, resources, and experience in treating burns. Here, I have shared a few tips and wisdom I have gained in the management of burns based on my experience of almost 30 years in treating burns at a government run tertiary burn care center. Despite all efforts, severe burns are still associated with very high morbidity and mortality and so a concerted effort needs to be made at the national as well as grass root level to raise the awareness and education regarding burns safety and prevention of burns.","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"28 1","pages":"4 - 6"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44689025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: It is a standard practice to cover the burn wounds with skin grafts at the earliest. Deficiency of donor skin seriously limits timely cover of extensive burns. Studies have shown that these autologous cells enhance the wound-healing process by reducing the time needed for the host cells to invade the wound tissue and by early synthesis of new skin this technique of enzymatically digesting small skin grafts, centrifuging the suspended cells and spraying the epidermal cells over burn raw areas may allow early healing. Aims and Objective: The aim of this study is to assess feasibility and role of epidermal cell suspension as wound cover in burns. Materials and Methods: This study was conducted at the burn center of a tertiary Hospital in India over a period of 1 year. Patients with postburn raw areas were included. Similar size two sites were identified in the patients. On one site cell suspension was applied, while other areas were managed with conventional dressings. Small piece of split-skin graft (SSG) was used to make cell suspension. Under anesthesia, required size of SSG was harvested from healthy donor site. Trypsinization of graft was done; epidermis was separated from the dermis. The epidermis was cut into tiny pieces, and patient's serum was added and centrifuged. Epidermal cell suspension was made, and viability of cells is confirmed using an inverted microscope. Meanwhile, the wound is thoroughly cleaned by soda bicarbonate solution. The freshly prepared keratinocytes suspension was applied on day 1, 3, and 5. Similar standard dressing protocol was followed on the control side. Wound assessment was done based on the percentage of reepithelization on the 7th and 14th day. Results: Twenty-eight patients (18 males and 10 females with a mean age of 34 years) were included the study. Cell suspension was sprayed on 4735 cm2 area. Wound size reduced to 2247 cm2 and 923 cm2 on the 10th and 14th day, respectively. While, at control site wound reduced to 3882 cm2 and 2134 cm2 on the 7th and 14th day, respectively. The difference in cell suspension and control treated area was found to be significant. Conclusion: Keratinocytes cell suspension is feasible in burns and improves the healing of wounds. However, larger studies are required to standardize and validate its use in major burns.
{"title":"Use of epidermal cell suspension in burns wound management: A pilot study","authors":"B. Mishra, V. Singh, C. Arora","doi":"10.4103/ijb.ijb_4_20","DOIUrl":"https://doi.org/10.4103/ijb.ijb_4_20","url":null,"abstract":"Introduction: It is a standard practice to cover the burn wounds with skin grafts at the earliest. Deficiency of donor skin seriously limits timely cover of extensive burns. Studies have shown that these autologous cells enhance the wound-healing process by reducing the time needed for the host cells to invade the wound tissue and by early synthesis of new skin this technique of enzymatically digesting small skin grafts, centrifuging the suspended cells and spraying the epidermal cells over burn raw areas may allow early healing. Aims and Objective: The aim of this study is to assess feasibility and role of epidermal cell suspension as wound cover in burns. Materials and Methods: This study was conducted at the burn center of a tertiary Hospital in India over a period of 1 year. Patients with postburn raw areas were included. Similar size two sites were identified in the patients. On one site cell suspension was applied, while other areas were managed with conventional dressings. Small piece of split-skin graft (SSG) was used to make cell suspension. Under anesthesia, required size of SSG was harvested from healthy donor site. Trypsinization of graft was done; epidermis was separated from the dermis. The epidermis was cut into tiny pieces, and patient's serum was added and centrifuged. Epidermal cell suspension was made, and viability of cells is confirmed using an inverted microscope. Meanwhile, the wound is thoroughly cleaned by soda bicarbonate solution. The freshly prepared keratinocytes suspension was applied on day 1, 3, and 5. Similar standard dressing protocol was followed on the control side. Wound assessment was done based on the percentage of reepithelization on the 7th and 14th day. Results: Twenty-eight patients (18 males and 10 females with a mean age of 34 years) were included the study. Cell suspension was sprayed on 4735 cm2 area. Wound size reduced to 2247 cm2 and 923 cm2 on the 10th and 14th day, respectively. While, at control site wound reduced to 3882 cm2 and 2134 cm2 on the 7th and 14th day, respectively. The difference in cell suspension and control treated area was found to be significant. Conclusion: Keratinocytes cell suspension is feasible in burns and improves the healing of wounds. However, larger studies are required to standardize and validate its use in major burns.","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"28 1","pages":"69 - 73"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49179711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Axillary postburn scar contracture is a challenging problem to the reconstructive surgeon owing to the wide range of abduction that should be achieved. The aim of this study is to highlight the various management options used in managing axillary contractures in our hospital and to minimize the complications commonly encountered. Aims and Objective: The aim and objective of this study is (1) to evaluate different options for postburn axillary contracture treatment, (2) the functional outcome of different treatment methods, and (3) late squeals of treatment. Materials and Methods: It is a prospective study which was conducted at the department of plastic surgery. Axillary contracture was released and resurfaced using split skin graft and/or with different types of flaps, including the Single Z plasty, Multiple Z plasty, Five flap plasty, Local fasciocuteneous flap, Propeller flap, and Parascapular flap. Results: Eighteen patients were operated. Surgical treatment included split-thickness skin graft in five cases, square flap in three cases and square flap with split thickness graft in two cases, Multipe Z-plasties in two cases and Multipe Z plasty with split-thickness graft in one case, Parascapular flaps with split thickness graft in two cases, while five flap plasty in three cases. Conclusion: Mean degree of abduction is maintain or increased in follow-up (after 6 month) is Square flap, Multiple Z plasty, five flap plasty, and Parascapular flap. Mean degree of abduction is decreased in split thickness graft in follow-up (after 6 month).
{"title":"Comparing different modalities of managing postburn axillary contracture","authors":"Arshadullah Khan, Vivek Ambedkar, R. Maurya","doi":"10.4103/ijb.ijb_14_19","DOIUrl":"https://doi.org/10.4103/ijb.ijb_14_19","url":null,"abstract":"Introduction: Axillary postburn scar contracture is a challenging problem to the reconstructive surgeon owing to the wide range of abduction that should be achieved. The aim of this study is to highlight the various management options used in managing axillary contractures in our hospital and to minimize the complications commonly encountered. Aims and Objective: The aim and objective of this study is (1) to evaluate different options for postburn axillary contracture treatment, (2) the functional outcome of different treatment methods, and (3) late squeals of treatment. Materials and Methods: It is a prospective study which was conducted at the department of plastic surgery. Axillary contracture was released and resurfaced using split skin graft and/or with different types of flaps, including the Single Z plasty, Multiple Z plasty, Five flap plasty, Local fasciocuteneous flap, Propeller flap, and Parascapular flap. Results: Eighteen patients were operated. Surgical treatment included split-thickness skin graft in five cases, square flap in three cases and square flap with split thickness graft in two cases, Multipe Z-plasties in two cases and Multipe Z plasty with split-thickness graft in one case, Parascapular flaps with split thickness graft in two cases, while five flap plasty in three cases. Conclusion: Mean degree of abduction is maintain or increased in follow-up (after 6 month) is Square flap, Multiple Z plasty, five flap plasty, and Parascapular flap. Mean degree of abduction is decreased in split thickness graft in follow-up (after 6 month).","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"28 1","pages":"63 - 68"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46414113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Saurabh Tiwari, Manish Jain, Satyendra Kumar, A. Varshney, Sudhir Kumar
Background: Burns are a serious global public health concern. In India, every year, a substantial proportion of mortality and morbidity occurs due to burn injuries (1.4 lakh and 2.4 lakh, respectively). Burn injuries lead a significant medical, social, and psychological problem along with severe economic loss to individual and nation. A sociodemographic profile of burn patients is essential for the planning of program for the prevention of burns. The present study was conducted to study the sociodemographic profile of burn patients of Bundelkhand. Materials and Methods: Two hundred and fifty burn patients admitted consecutively between March 2018 and September 2018 in the burns unit of Maharani Laxmi Bai Medical College and Hospital, Jhansi, India, (Uttar Pradesh) were included in the present study. Sociodemographic data were obtained by the questionnaire as well as through the interview of patients and attendants. Results: The most affected age group, gender, and religion were 21–30 years (37.60%), female, (51.2%) and Hindus (92%), respectively. The common place of burn was home (88.4%) and maximum patients (75.2%) belonged to the rural areas. The floor cooking was most preferred method used for cooking (83.2%), and majority of patients were wearing synthetic clothes at the time of injury (51.2%). Psychiatric illness and suicidal tendency were present in only 6.8% of the patients. Regarding socioeconomic status, most of the patients (70.8%) belonged to the upper lower class. Thermal burns, electrical burns, and other (filigree and chemical) burns were more common in the married population, whereas scald was more common in unmarried population. Conclusion: All types of major burns were commonly occurred in the rural population, and they had poor educational and socioeconomic status. The incidence of burn injuries was mainly accidental in nature. Floor cooking is prevalent in Bundelkhand.
{"title":"Sociodemographic profile of burn patients at a tertiary care hospital of Bundelkhand region of India","authors":"Saurabh Tiwari, Manish Jain, Satyendra Kumar, A. Varshney, Sudhir Kumar","doi":"10.4103/ijb.ijb_18_20","DOIUrl":"https://doi.org/10.4103/ijb.ijb_18_20","url":null,"abstract":"Background: Burns are a serious global public health concern. In India, every year, a substantial proportion of mortality and morbidity occurs due to burn injuries (1.4 lakh and 2.4 lakh, respectively). Burn injuries lead a significant medical, social, and psychological problem along with severe economic loss to individual and nation. A sociodemographic profile of burn patients is essential for the planning of program for the prevention of burns. The present study was conducted to study the sociodemographic profile of burn patients of Bundelkhand. Materials and Methods: Two hundred and fifty burn patients admitted consecutively between March 2018 and September 2018 in the burns unit of Maharani Laxmi Bai Medical College and Hospital, Jhansi, India, (Uttar Pradesh) were included in the present study. Sociodemographic data were obtained by the questionnaire as well as through the interview of patients and attendants. Results: The most affected age group, gender, and religion were 21–30 years (37.60%), female, (51.2%) and Hindus (92%), respectively. The common place of burn was home (88.4%) and maximum patients (75.2%) belonged to the rural areas. The floor cooking was most preferred method used for cooking (83.2%), and majority of patients were wearing synthetic clothes at the time of injury (51.2%). Psychiatric illness and suicidal tendency were present in only 6.8% of the patients. Regarding socioeconomic status, most of the patients (70.8%) belonged to the upper lower class. Thermal burns, electrical burns, and other (filigree and chemical) burns were more common in the married population, whereas scald was more common in unmarried population. Conclusion: All types of major burns were commonly occurred in the rural population, and they had poor educational and socioeconomic status. The incidence of burn injuries was mainly accidental in nature. Floor cooking is prevalent in Bundelkhand.","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"28 1","pages":"84 - 88"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49622302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Context: Burns is a condition associated with high mortality and morbidity. Nutrition plays an important role in the recovery of these patients. Amino acid glutamine is an important energy substrate for immune cells and for the intestinal epithelium. Glutamine is the preferred respiratory fuel for both lymphocytes and enterocytes. It stimulates the immune system and prevents catabolism. Aim: This study is aimed at determining if oral supplementation of glutamine can improve the outcome in patients with severe burns. Materials and Methods: It is a randomized controlled study. Patients of severe burns (30%–50%) were randomized into two groups. The first group was started on enteral nutrition but without glutamine supplementation. The second group received enteral nutrition with glutamine supplementation. All patients were followed up for a period of 1 month from the day of burns. Blood culture, wound culture, blood counts, and serum total proteins were done once every week for all patients. Statistical Analysis: Student's t-test was used to analyze the quantitative and Chi-square test was used to measure the qualitative data. Results: One hundred and two patients were included in the study, of which 49 were in Group 1 and 53 patients in Group 2. The mean percentage of burns in the two groups was comparable at 40.71% and 41.72%, respectively. Total leukocyte counts, mean duration of hospital stay, and mortality rates did not show any statistically significant difference between the two groups. However, serum protein levels showed a significant increase in the glutamine-supplemented group from the 3rd week onward. Wound infection rates were also lower in the glutamine-supplemented group, i.e., 19.5% vs. 2.1% by the 4th week. Conclusion: Glutamine supplementation has shown to enhance serum protein levels and hence improve nutritional status of these patients. It is also useful for its immunomodulatory effects, thus reducing burn wound infection, as shown by lesser number of burn wound culture positivity rates.
{"title":"Effects of early enteral glutamine supplementation on the outcome of severe burns: A randomized control study","authors":"S. Arora, Chandni Shankar","doi":"10.4103/ijb.ijb_31_19","DOIUrl":"https://doi.org/10.4103/ijb.ijb_31_19","url":null,"abstract":"Context: Burns is a condition associated with high mortality and morbidity. Nutrition plays an important role in the recovery of these patients. Amino acid glutamine is an important energy substrate for immune cells and for the intestinal epithelium. Glutamine is the preferred respiratory fuel for both lymphocytes and enterocytes. It stimulates the immune system and prevents catabolism. Aim: This study is aimed at determining if oral supplementation of glutamine can improve the outcome in patients with severe burns. Materials and Methods: It is a randomized controlled study. Patients of severe burns (30%–50%) were randomized into two groups. The first group was started on enteral nutrition but without glutamine supplementation. The second group received enteral nutrition with glutamine supplementation. All patients were followed up for a period of 1 month from the day of burns. Blood culture, wound culture, blood counts, and serum total proteins were done once every week for all patients. Statistical Analysis: Student's t-test was used to analyze the quantitative and Chi-square test was used to measure the qualitative data. Results: One hundred and two patients were included in the study, of which 49 were in Group 1 and 53 patients in Group 2. The mean percentage of burns in the two groups was comparable at 40.71% and 41.72%, respectively. Total leukocyte counts, mean duration of hospital stay, and mortality rates did not show any statistically significant difference between the two groups. However, serum protein levels showed a significant increase in the glutamine-supplemented group from the 3rd week onward. Wound infection rates were also lower in the glutamine-supplemented group, i.e., 19.5% vs. 2.1% by the 4th week. Conclusion: Glutamine supplementation has shown to enhance serum protein levels and hence improve nutritional status of these patients. It is also useful for its immunomodulatory effects, thus reducing burn wound infection, as shown by lesser number of burn wound culture positivity rates.","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"28 1","pages":"57 - 62"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42212847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mostafa Dahmardehi, A. Ahmadabadi, Majid Khadem-Rezaiyan, Farhang Safarnejad, Tayyeb Ghadimi, H. Otaghvar
Background: The appropriateness of the wound bed for autograft transplantation is routinely evaluated based on the surgeon's judgment, which might not be reliable in some situations. Therefore, this study was designed to evaluate the association between wound pH, wound temperature, and wound culture results with autograft taking. Materials and Methods: In this prospective, cross-sectional study, the body core temperature, wound pH, and local wound temperature at the beginning of operation and after burn wound excision were measured in 50 patients with burn wounds. Swab culture specimen was obtained from the burn wound after dressing removal and after the completion of wound excision. Autograft taking was evaluated on days 3 and 7 postoperative. Results: There was a statistically significant reverse association between autograft taking on day 3 and wound pH at the beginning of operation (P = 0.016). Besides, there was a statistically significant association between core body temperature and autograft taking on days 3 (P = 0.035) and 7 (P = 0.002). However, there was no significant association between local wound temperature and autograft taking. A positive result for wound culture after excision, even when the colony count was <102, was significantly associated with autograft taking on days 3 and 7. Conclusions: Wound pH measurement after dressing removal in the operation room may be a simple and available modality to evaluate the appropriateness of burn wound for skin autografting.
{"title":"Wound pH and autograft taking in burn wounds: An experimental study","authors":"Mostafa Dahmardehi, A. Ahmadabadi, Majid Khadem-Rezaiyan, Farhang Safarnejad, Tayyeb Ghadimi, H. Otaghvar","doi":"10.4103/ijb.ijb_17_20","DOIUrl":"https://doi.org/10.4103/ijb.ijb_17_20","url":null,"abstract":"Background: The appropriateness of the wound bed for autograft transplantation is routinely evaluated based on the surgeon's judgment, which might not be reliable in some situations. Therefore, this study was designed to evaluate the association between wound pH, wound temperature, and wound culture results with autograft taking. Materials and Methods: In this prospective, cross-sectional study, the body core temperature, wound pH, and local wound temperature at the beginning of operation and after burn wound excision were measured in 50 patients with burn wounds. Swab culture specimen was obtained from the burn wound after dressing removal and after the completion of wound excision. Autograft taking was evaluated on days 3 and 7 postoperative. Results: There was a statistically significant reverse association between autograft taking on day 3 and wound pH at the beginning of operation (P = 0.016). Besides, there was a statistically significant association between core body temperature and autograft taking on days 3 (P = 0.035) and 7 (P = 0.002). However, there was no significant association between local wound temperature and autograft taking. A positive result for wound culture after excision, even when the colony count was <102, was significantly associated with autograft taking on days 3 and 7. Conclusions: Wound pH measurement after dressing removal in the operation room may be a simple and available modality to evaluate the appropriateness of burn wound for skin autografting.","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"28 1","pages":"89 - 93"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45342883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Arumugam, H. Walia, Bhagyashri Talele, S. Sharma
Burn injuries, especially electrical burns, can lead to significant soft-tissue damage. A delayed sequela of both electric burn and firecracker injury is arterial rupture. The initial phase is characterized by occlusion of small vessels. Large vessels are prone to aneurysm formation due to medial necrosis. This can result in unanticipated bleeding, which can lead to loss of the limb or even be life-threatening. We are presenting here two cases treated in our burns department for electrical burns and firecracker injury involving the lower limbs. Both these patients presented with delayed vascular complications, which were successfully managed and limbs salvaged. We are presenting these cases to emphasize that timely intervention leads to better outcomes.
{"title":"Arterial rupture: A delayed sequela of burn injury","authors":"P. Arumugam, H. Walia, Bhagyashri Talele, S. Sharma","doi":"10.4103/ijb.ijb_13_20","DOIUrl":"https://doi.org/10.4103/ijb.ijb_13_20","url":null,"abstract":"Burn injuries, especially electrical burns, can lead to significant soft-tissue damage. A delayed sequela of both electric burn and firecracker injury is arterial rupture. The initial phase is characterized by occlusion of small vessels. Large vessels are prone to aneurysm formation due to medial necrosis. This can result in unanticipated bleeding, which can lead to loss of the limb or even be life-threatening. We are presenting here two cases treated in our burns department for electrical burns and firecracker injury involving the lower limbs. Both these patients presented with delayed vascular complications, which were successfully managed and limbs salvaged. We are presenting these cases to emphasize that timely intervention leads to better outcomes.","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"28 1","pages":"98 - 100"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42254671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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