Securing an endotracheal tube for the patients with facial blistering due to burns is problematic. Unstable fixation may cause dislodging of the tube. Various improvements have been reported to overcome this problem. However, they are not considered practical, because all methods require a special instrument, which may be impossible to obtain in emergent situations. In this report, we present a simple and easy technique to directly secure an endotracheal tube to the maxilla. A 64-year-old man sustained a scaled burn involving 10% of the total body surface area to the face and both hands. He also had inhalation injury and underwent immediate intra-tracheal intubation at a nearby hospital. As the patient's face was covered with blisters, the fixation of the tube to the skin was unstable. Also, the patient had no teeth to fix the tube. Thus, we directly fixed the endotracheal tube to the maxilla. A drill hole was made in the alveolar process of the maxilla using a Kirschner wire and hand-hold drilling instrument, and a nylon line was threaded through the hole and tied around the endotracheal tube. The tube was anchored securely until extubation for seven days. We describe a simple method to secure an endotracheal tube to the maxilla in a toothless patient who sustained facial burn, without any special instruments. Our procedure may be a favorable option for such patients who require immediate oral intubation.
{"title":"Endotracheal tube anchoring to the maxilla in an edentulous patient with a facial burn","authors":"M. Fujioka, K. Fukui","doi":"10.4103/ijb.ijb_30_18","DOIUrl":"https://doi.org/10.4103/ijb.ijb_30_18","url":null,"abstract":"Securing an endotracheal tube for the patients with facial blistering due to burns is problematic. Unstable fixation may cause dislodging of the tube. Various improvements have been reported to overcome this problem. However, they are not considered practical, because all methods require a special instrument, which may be impossible to obtain in emergent situations. In this report, we present a simple and easy technique to directly secure an endotracheal tube to the maxilla. A 64-year-old man sustained a scaled burn involving 10% of the total body surface area to the face and both hands. He also had inhalation injury and underwent immediate intra-tracheal intubation at a nearby hospital. As the patient's face was covered with blisters, the fixation of the tube to the skin was unstable. Also, the patient had no teeth to fix the tube. Thus, we directly fixed the endotracheal tube to the maxilla. A drill hole was made in the alveolar process of the maxilla using a Kirschner wire and hand-hold drilling instrument, and a nylon line was threaded through the hole and tied around the endotracheal tube. The tube was anchored securely until extubation for seven days. We describe a simple method to secure an endotracheal tube to the maxilla in a toothless patient who sustained facial burn, without any special instruments. Our procedure may be a favorable option for such patients who require immediate oral intubation.","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"27 1","pages":"105 - 107"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70743202","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}
Inhaltion injury is one of the major determinants of the outcome, morbidity and mortality in burn patients. Early intervention to secure the airway in a suspected inhalation injury proves vital in the management and outcome of such patients. Failure to identify such cases will push the attending physicians into a vortex and the patients will succumb to the injury. High degree of suspicion and the ability to identify airway burns is a must for all physicians involved in the management of burn patients. Here we present a case of inhalation injury where airway management was delayed by a few hours due to technical and logistic issues, where in we had a very hard time securing the airway.
{"title":"Securing airway in a burn patient with inhalation injury – A narrow escape","authors":"Utsav Acharya, S. Bhandari","doi":"10.4103/ijb.ijb_16_19","DOIUrl":"https://doi.org/10.4103/ijb.ijb_16_19","url":null,"abstract":"Inhaltion injury is one of the major determinants of the outcome, morbidity and mortality in burn patients. Early intervention to secure the airway in a suspected inhalation injury proves vital in the management and outcome of such patients. Failure to identify such cases will push the attending physicians into a vortex and the patients will succumb to the injury. High degree of suspicion and the ability to identify airway burns is a must for all physicians involved in the management of burn patients. Here we present a case of inhalation injury where airway management was delayed by a few hours due to technical and logistic issues, where in we had a very hard time securing the airway.","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"27 1","pages":"102 - 104"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70741751","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}
Background: Electrical burn injuries result from accidental contact with exposed parts of electrical appliances, wiring, or lightning strikes. The purpose of this study was to analyze the mode of electric burn injuries occurring in the current technological world. Materials and Methods: A retrospective analysis of 3-year experience of electric burn injury case admitted in the burn unit of our institute was conducted from April 2016 to March 2019. Of the total 3983 patients, 914 patients were of electric burn injury. All age groups of patients were included, with exclusion of thermal, flame, and scald burn patients. We evaluated the variables according to age, sex, total burn surface area, injury type, and mode of injury. Results: Out of 914 cases, we had admitted 329 cases from February 2016 to August 2017 (Group 1) and 585 cases admitted from September 2017 to March 2019 (Group 2). Seven hundred sixty-nine cases were male and 145 were female. Group 1 had 187 cases in the age group of 40–59 years. While in Group 2, 226 cases were in the age group of 20–39 years. About 40.7% of the cases had electric burn due to working over electric pole in Group 1, while in Group 2, 19.65% cases had electric burn due to malfunctioning of appliances and 2.7% cases had smartphone electric burn injury. About 3.9% of the cases had electric burn due to working or taking selfies near electric train. Conclusion: In this technology era, the use of electric current in various appliances leads to increase the risk of electric burn injury, and these injuries can be prevented by education and safety measures to reduce the incidence of electrical injuries.
{"title":"Changing trends in electrical burn injury due to technology","authors":"G. Kalra, Amit Sharma, N. Rolekar","doi":"10.4103/ijb.ijb_22_19","DOIUrl":"https://doi.org/10.4103/ijb.ijb_22_19","url":null,"abstract":"Background: Electrical burn injuries result from accidental contact with exposed parts of electrical appliances, wiring, or lightning strikes. The purpose of this study was to analyze the mode of electric burn injuries occurring in the current technological world. Materials and Methods: A retrospective analysis of 3-year experience of electric burn injury case admitted in the burn unit of our institute was conducted from April 2016 to March 2019. Of the total 3983 patients, 914 patients were of electric burn injury. All age groups of patients were included, with exclusion of thermal, flame, and scald burn patients. We evaluated the variables according to age, sex, total burn surface area, injury type, and mode of injury. Results: Out of 914 cases, we had admitted 329 cases from February 2016 to August 2017 (Group 1) and 585 cases admitted from September 2017 to March 2019 (Group 2). Seven hundred sixty-nine cases were male and 145 were female. Group 1 had 187 cases in the age group of 40–59 years. While in Group 2, 226 cases were in the age group of 20–39 years. About 40.7% of the cases had electric burn due to working over electric pole in Group 1, while in Group 2, 19.65% cases had electric burn due to malfunctioning of appliances and 2.7% cases had smartphone electric burn injury. About 3.9% of the cases had electric burn due to working or taking selfies near electric train. Conclusion: In this technology era, the use of electric current in various appliances leads to increase the risk of electric burn injury, and these injuries can be prevented by education and safety measures to reduce the incidence of electrical injuries.","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"27 1","pages":"70 - 72"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70742063","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}
S. Nair, J. Oommen, V. Chandrabose, Hafiz Muhammed, Kader Kalathingal, A. Sivadasan, Subin Joseph, R. Pydi, Srivatsa M. Shet, S. Samantaray
Accidental burns is one of the most commonly encountered condition in our society. Women and children are often affected. The case being discussed is of a burn victim who had a series of unexpected and rare life-threatening complications. The child developed complications of actively bleeding duodenal stress ulcer, deep-vein thrombosis, and heparin-induced thrombocytopenia with thrombosis in addition to bacterial sepsis, during the hospital stay. All the complications that the child endured were unfortunate though not uncommon, and with the help of accurate diagnosis, treatment, and multidisciplinary team approach, we were able to save the child and enable him to lead a normal life.
{"title":"An unusual combination of complications in a pediatric burn patient with successful outcome","authors":"S. Nair, J. Oommen, V. Chandrabose, Hafiz Muhammed, Kader Kalathingal, A. Sivadasan, Subin Joseph, R. Pydi, Srivatsa M. Shet, S. Samantaray","doi":"10.4103/ijb.ijb_25_18","DOIUrl":"https://doi.org/10.4103/ijb.ijb_25_18","url":null,"abstract":"Accidental burns is one of the most commonly encountered condition in our society. Women and children are often affected. The case being discussed is of a burn victim who had a series of unexpected and rare life-threatening complications. The child developed complications of actively bleeding duodenal stress ulcer, deep-vein thrombosis, and heparin-induced thrombocytopenia with thrombosis in addition to bacterial sepsis, during the hospital stay. All the complications that the child endured were unfortunate though not uncommon, and with the help of accurate diagnosis, treatment, and multidisciplinary team approach, we were able to save the child and enable him to lead a normal life.","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"27 1","pages":"112 - 115"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70742495","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}
K. Ramakrishnan, B. Ramachandran, K. Ravikumar, Sulochana Putli, V. Jayaraman, Mathivanan, Ravi, Arumugam Ganamani, M. Babu
Introduction: Acinetobacter baumannii infection of a burn wound is a serious infection causing significant morbidity and mortality. Clinical Presentation: Acinetobacter can cause wound colonization, infection, invasive sepsis, and with or without septic shock. We present a series of five cases and management. Prompt medical and surgical treatments are essential to improve the outcome. Conclusion: Awareness of the presence of infection and detection of local sensitivity pattern of the organism will lead to initiation of the correct antibiotic.
{"title":"Management of Acinetobacter baumannii infection of burn wound with the evidence of sepsis","authors":"K. Ramakrishnan, B. Ramachandran, K. Ravikumar, Sulochana Putli, V. Jayaraman, Mathivanan, Ravi, Arumugam Ganamani, M. Babu","doi":"10.4103/ijb.ijb_12_19","DOIUrl":"https://doi.org/10.4103/ijb.ijb_12_19","url":null,"abstract":"Introduction: Acinetobacter baumannii infection of a burn wound is a serious infection causing significant morbidity and mortality. Clinical Presentation: Acinetobacter can cause wound colonization, infection, invasive sepsis, and with or without septic shock. We present a series of five cases and management. Prompt medical and surgical treatments are essential to improve the outcome. Conclusion: Awareness of the presence of infection and detection of local sensitivity pattern of the organism will lead to initiation of the correct antibiotic.","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"27 1","pages":"30 - 34"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70741253","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}
Samuel Sailo, S. Chenkual, Vanlalhlua Chawngthu, Richard Chawngthu
Introduction: The exact figure of burn injuries is still unavailable in many states of India. Some northeast Indian states with their unique social structure, hilly terrain, and practice of shifting (Jhum) cultivation the pattern of burn injuries in these states may be different. Materials and Methods: The burn records between March 2012 and April 2017 were retrospectively studied from all the district and private hospitals of the state. The demographic profiles, etiologies, delay in admission, percentage, and degrees of burn, hospital days, managements, and outcome on a single hill state of India were reviewed and analyzed. Results and Observations: The total number of patients studied was 450 with a mean age of 18.94 years. There were 281 male (62.4%), 168 female (37.3%), and one missing sex data, out of which 17 (4.2%) expired. Majority of the admission were in the winter season. The most common etiology was scald burn (55%). Suicidal intent was recorded in 8 patients (1.8%). The mean percentage of burn was 21.72%. Conclusion: The pattern of burn cases in the state showed marked variance from studies of other larger states of the country. Lifestyle modification, improving living standard, and active NGO participation seem to influence the low incidence of burn in the state.
{"title":"Burn scenario in a single North-Eastern State of India: A 5-year retrospective study","authors":"Samuel Sailo, S. Chenkual, Vanlalhlua Chawngthu, Richard Chawngthu","doi":"10.4103/ijb.ijb_23_18","DOIUrl":"https://doi.org/10.4103/ijb.ijb_23_18","url":null,"abstract":"Introduction: The exact figure of burn injuries is still unavailable in many states of India. Some northeast Indian states with their unique social structure, hilly terrain, and practice of shifting (Jhum) cultivation the pattern of burn injuries in these states may be different. Materials and Methods: The burn records between March 2012 and April 2017 were retrospectively studied from all the district and private hospitals of the state. The demographic profiles, etiologies, delay in admission, percentage, and degrees of burn, hospital days, managements, and outcome on a single hill state of India were reviewed and analyzed. Results and Observations: The total number of patients studied was 450 with a mean age of 18.94 years. There were 281 male (62.4%), 168 female (37.3%), and one missing sex data, out of which 17 (4.2%) expired. Majority of the admission were in the winter season. The most common etiology was scald burn (55%). Suicidal intent was recorded in 8 patients (1.8%). The mean percentage of burn was 21.72%. Conclusion: The pattern of burn cases in the state showed marked variance from studies of other larger states of the country. Lifestyle modification, improving living standard, and active NGO participation seem to influence the low incidence of burn in the state.","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"289 1","pages":"73 - 77"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70742077","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}
Aim: The aim is to study the role of infrared thermography in the assessment of burns wound treated with and without hyperbaric oxygen (HBO) therapy. Burn wound progression is assessed with clinical evaluation and infrared thermography for the patients subjected to HBO therapy with controls. Materials and Methods: This study was carried out in the plastic surgery department, from November 2018 to February 2019. A total of 21 patients with Burns were subjected to clinical evaluation and thermographic study. All patients were treated according to standard burns treatment protocol, and photographic data of clinical and thermographic imagings were sequentially recorded. These clinical and radiographic images were preserved for analysis. In 10 patients, HBO therapy was used as an adjunct for burns wound management and results were evaluated and rest of the patients was used as control. Results: Of 21 patients, with all patients' burns patients assessment done clinically and infrared thermography, 10 patients were subjected to hyperbaric therapy in random fashion and 11 patients were not subjected to HBO therapy. The duration of wound healing and wound progression to deeper planes were reduced in the patients subjected to hyperbaric therapy, which was evident both clinically and, by thermographic assessment. No complications were noted in patients subjected to HBO therapy. Conclusions: Infrared thermography can be used in association with clinical examination to assess the various types of burns wound and could be utilized for understanding the dynamic changes that happen in burns wound due to changes in the treatment protocol with evolving adjunct managements.
{"title":"Role of infrared thermography in the assessment of burn wounds treated with and without hyperbaric oxygen therapy","authors":"P. Korambayil, P. Ambookan, R. Karangath","doi":"10.4103/ijb.ijb_23_19","DOIUrl":"https://doi.org/10.4103/ijb.ijb_23_19","url":null,"abstract":"Aim: The aim is to study the role of infrared thermography in the assessment of burns wound treated with and without hyperbaric oxygen (HBO) therapy. Burn wound progression is assessed with clinical evaluation and infrared thermography for the patients subjected to HBO therapy with controls. Materials and Methods: This study was carried out in the plastic surgery department, from November 2018 to February 2019. A total of 21 patients with Burns were subjected to clinical evaluation and thermographic study. All patients were treated according to standard burns treatment protocol, and photographic data of clinical and thermographic imagings were sequentially recorded. These clinical and radiographic images were preserved for analysis. In 10 patients, HBO therapy was used as an adjunct for burns wound management and results were evaluated and rest of the patients was used as control. Results: Of 21 patients, with all patients' burns patients assessment done clinically and infrared thermography, 10 patients were subjected to hyperbaric therapy in random fashion and 11 patients were not subjected to HBO therapy. The duration of wound healing and wound progression to deeper planes were reduced in the patients subjected to hyperbaric therapy, which was evident both clinically and, by thermographic assessment. No complications were noted in patients subjected to HBO therapy. Conclusions: Infrared thermography can be used in association with clinical examination to assess the various types of burns wound and could be utilized for understanding the dynamic changes that happen in burns wound due to changes in the treatment protocol with evolving adjunct managements.","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"27 1","pages":"78 - 84"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70742107","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}
{"title":"Challenges in setting up a skin bank at GMC Nagpur","authors":"Surendra B. Patil","doi":"10.4103/ijb.ijb_29_19","DOIUrl":"https://doi.org/10.4103/ijb.ijb_29_19","url":null,"abstract":"","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"27 1","pages":"3 - 4"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70743164","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: There is a lacuna in our knowledge to objectively assess the progression of healing in an acute burn wound. Aim: This study aims to validate if a trend in changes of wound surface pH can be used as a reliable indicator to prognosticate wound healing in acute thermal burns. Materials and Methods: Hospital-based longitudinal observational study was conducted in the department of burns of a tertiary care center. One hundred and twenty-three patients with acute thermal burns in the age group of 15–60 years with total burn surface area between 30%–60% were included in the study. Surface pH of wound from a specific area of dimension 10×10 cm was measured on day 1, 3, 5, 7, 9, 11, 13, and 15 using HANNA HI 99181 pH meter and the trend of wound surface pH level changes over time was observed. Wound healing was clinically assessed by wound grading chart on day 7 and 15. Results: The trend of reducing pH values had a negative correlation coefficient of - 0.95 with improved wound healing, and the trend of increasing pH values had a positive correlation coefficient of 0.74 with deteriorating wound. This is statistically highly significant with P < 0.0001. Conclusion: The analysis showed that the trend of change in pH value over time has high statistical significance with wound healing in burns patients with reducing trend, i.e., toward slightly acidic pH being associated with better wound healing and increasing trend, i.e., toward alkalinity suggesting worsening of wounds. Hence, wound surface pH can be used as a reliable indicator to prognosticate wound healing in acute thermal burns.
{"title":"Surface pH and acute burn wound healing","authors":"T. Divakar, R. Srivastava","doi":"10.4103/ijb.ijb_19_19","DOIUrl":"https://doi.org/10.4103/ijb.ijb_19_19","url":null,"abstract":"Context: There is a lacuna in our knowledge to objectively assess the progression of healing in an acute burn wound. Aim: This study aims to validate if a trend in changes of wound surface pH can be used as a reliable indicator to prognosticate wound healing in acute thermal burns. Materials and Methods: Hospital-based longitudinal observational study was conducted in the department of burns of a tertiary care center. One hundred and twenty-three patients with acute thermal burns in the age group of 15–60 years with total burn surface area between 30%–60% were included in the study. Surface pH of wound from a specific area of dimension 10×10 cm was measured on day 1, 3, 5, 7, 9, 11, 13, and 15 using HANNA HI 99181 pH meter and the trend of wound surface pH level changes over time was observed. Wound healing was clinically assessed by wound grading chart on day 7 and 15. Results: The trend of reducing pH values had a negative correlation coefficient of - 0.95 with improved wound healing, and the trend of increasing pH values had a positive correlation coefficient of 0.74 with deteriorating wound. This is statistically highly significant with P < 0.0001. Conclusion: The analysis showed that the trend of change in pH value over time has high statistical significance with wound healing in burns patients with reducing trend, i.e., toward slightly acidic pH being associated with better wound healing and increasing trend, i.e., toward alkalinity suggesting worsening of wounds. Hence, wound surface pH can be used as a reliable indicator to prognosticate wound healing in acute thermal burns.","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"27 1","pages":"57 - 62"},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70741873","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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