Annals of burns and fire disasters最新文献

The objective of this study was to describe the epidemiology of burn-related injuries in children <15 years in Kosovo, and compare incidence and cause of burns with our previous study conducted over the period 2005-2010 on children with burn injuries of the same age group. This was a retrospective study of pediatric patients (n=277) admitted to the University Clinical Centre of Kosovo between 1 January 2011 and 31 December 2015. We analyzed data on gender, age, cause, location, burn size (TBSA), depth of injury, seasonality, duration of hospitalization and treatment of burn-related injuries, collected from the medical records available in the archives of the University Clinical Centre of Pristina. The patients were categorized into three age groups: infants and toddlers (0-2 years), early childhood (3-6 years) and late childhood (7-15 years). Data were analyzed applying descriptive statistics, Chi-square. P-values less than 0.05 were considered significant. During the study period 2011-2015, in our population, burns in children were predominant in boys, with 166 cases (59.9%), while 111 patients were girls (40.1%). The incidence of extensive burns in childhood remains high, although we have seen a slight decrease compared to the previous 5-year study period.

The scarcity of data on burn-related injuries in Pakistan prompted this study. The study is specifically aimed at assessing the burn patients who were admitted to a national burn care center (BCC) in Pakistan. This single-center retrospective analysis was conducted for 12 months from January to December 2021. During this time period, 14,069 patients visited BCC with burn injuries of diverse natures while 613 of them were admitted. The patients' information was abstracted from the hospital database. This information included age, sex, diagnosis, burn depth/degree, time of arrival, circumstances of burn injury, TBSA (total burn surface area), complications, outcome, and management plan. This information was shifted to Microsoft Office Excel Worksheet 2015 and then coded into the IBM Statistical Package for the Social Sciences (SPSS) version 24.0. Armonk, NY: IBM Corp. Of 14,069 patients, 613 were admitted to the burn care center, indicating an admission rate of 4.35%. Among these 613 patients, there was a high proportion of males (58.89%) and a mean age of 20.2±12.5 years. Most patients (40.4%) visited within the first hour after being burnt and flame burns were the most common (41.10%). Most patients were burnt due to accidents (97.7%). The mean length of hospital stay was 15.5 days. Flames were the main cause of burns among our cohort of patients. Most patients had a TBSA of >10% and generally had a second-degree burn, mostly in the pediatric population. An urgent appraisal of burn policies and related legislation is needed to halt the burn burden in the country.

A review of paediatric burns in our burns facility in the United Kingdom demonstrated variable accuracy of size, and a majority documented as <1% total body surface area (TBSA). Accurate assessment is important for medical records, clinical management and non-accidental injuries. We propose to assess burn size with a coin-based system, where small burns are described by single/multiple sterling coins. Participants were asked about their confidence in evaluating small paediatric burns. Participants were given ten scenarios which included photographs of paediatric patients with small burns. They were asked to assess burn size in their normal manner (TBSA, measurement) and with a coin-based system. The 'burns' were drawn on children based on a given coin size and percentage so that the accuracy of the participant's answer was quantifiable. Participants provided qualitative feedback in a questionnaire on the coin-based system. Thirty nurses and medical staff of varying seniority actively involved in referral/management of paediatric burns took part, creating over 300 responses. In preliminary questions, 66% of participants did not feel confident in estimating paediatric burns and 83% needed to refer to a paediatric burns chart. Accuracy of burn size using TBSA and the coin-based system was 45% and 67%, respectively. The majority (97%) stated estimating size was easier, and 93% found it more accurate. A total of 87% found communication between colleagues easier. Results highlight the improved assessment of small burns in our hospital using a coin-based approach in comparison to TBSA, and could facilitate accurate communication between health care professionals.

Although the burden of traumatic lower limb amputation (TLLA) has been well described when it concerns the adult population, there is an evident scarcity in literature concerning this matter in the pediatric population. Our objective is to review the surgical burden and long-term outcome of lower limb amputation among pediatric trauma victims who have experienced lower extremity amputation as the result of an accident or injury. A PICO format was utilized. The population of interest includes only children and adolescents suffering TTLA. The generation of data to be reviewed was executed using MEDLINE and PUBMED. Altogether, all data that includes trauma in the pediatric population in the timeframe 1949-2019 was revised and yielded 13 observational studies. This systematic review includes statistical comparisons between the group of interest of this review and the adult population. Other comparisons include those between the different sources. Our outcomes include a consistent pattern. This consistency between different studies was opposed by certain contradictions. Disparity between the different reviewed studies was displayed in terms of the distribution of the most cited complications of TLLA among different sources and the frequency of additional surgery. The dichotomy in the results of the reviewed studies highlights a gap in the data relevant to TLLA in the pediatric population. In addition to the discrepancies in the available literature, the significant physio-anatomical differences between the pediatric and the adult populations which are relevant to TLLA highlight a requirement for further studies regarding TTLA in the pediatric age group.

Burns are frequent lesions, often leading to serious functional or even life-threatening sequelae. Their care poses a problem in the countries of the South due to the lack of specialized centres. Through this study, we would like to share our experience. This was a descriptive retrospective study carried out over 36 months on 24 patients treated and followed up in the department for burn sequelae involving a limb. Functional results were classified as excellent, good, fairly good, fair and poor. Aesthetically, they have been categorized into satisfactory, unsatisfactory and poor. We recorded 1480 patients who underwent surgery, 24 of whom were operated on after burns. We noted a female predominance (sex ratio of 1.6) with an average age of 24.2 years (range 16-40). Domestic accidents (n=19) were the main circumstance of occurrence and there was a preponderance of thermal burns by flame (n=21). Twenty people were treated in the first year after burn with excellent, good and fair results in 10, 9 and 4 cases respectively. Burns can cause significant functional sequelae, the management of which requires specialized nursing staff. Training of caregivers oriented towards burn care without forgetting the related means remains a key element to minimizing the occurrence of these sequelae.

The explosion of headphones is a rare incident, not reported in the literature, and is responsible for serious burns involving functional and aesthetic consequences with a major psychological impact. We report here the case of a young boy in order to raise awareness in the population and draw attention to these risks.

Burn injury is one of the most concerning issues in the health industry. Globally, mortality and morbidity rates associated with burn injuries and their sequelae are exceptionally high. This study aims to determine the mortality rate of burn injury patients after the closure of the burn trauma unit at Dr. Hasan Sadikin Hospital, Bandung, Indonesia. This research is a descriptive-analytic study with a cross-sectional approach. The population in this study are burn injury patients treated at Dr. Hasan Sadikin Hospital during April 2021-September 2021. The inclusion criteria for this study were adult (TBSA >20%) and pediatric (TBSA >10%) patients with severe burn injury. The subjects included in this study were 76 patients and were divided into two groups, patients treated in the burn unit (n=27) and in the non-burn unit (n=49). The number of deaths in a non-burn unit (n=24; 48.97%) was higher compared to patients treated in a burn unit (n=6; 22.22%). There is a significant relationship between the type of care unit and the burn injury mortality rate, as indicated by a p value of 0.022 and an odds ratio (OR) of 3.36.

The combination of platelet-rich plasma (PRP) and stromal vascular fraction cells (SVFs) was beneficial in accelerating wound healing. This study aims to assess the effect of this combination in balancing the inflammatory process to accelerate burn healing. Thirty eligible Wistar rats were used in this study to establish a deep dermal degree burn wound model. They were randomly divided into four groups: locally injected with the combination of SVFs and PRP (n=9), vaseline (n=9), placebo (n=9), and healthy Wistar rats group (n=3), as treatment group, positive control group, negative control group and healthy control group, respectively. The burn wound tissue was excised from three separated sacrificed rats (8, 24 and 48 hours) to examine polymorphonuclear (PMN) and lymphocyte counts through the standard hematoxylin-eosin procedure and for cyclooxygenase2 (COX-2) expression through the immunohistochemical procedure. The highest PMN, lymphocyte cell count, and COX 2 expression were found at 8 hours in the local injection with the PRP combination SVF group (28,555±11,237, 8,111±3,218, and 4,666±2,309, respectively, p <0.05 except for COX 2). The regression analysis results showed that local injection of a combination of PRP and SVF could reduce PMN cells by 1.068 times, lymphocytes by 1.786 times, and COX 2 by 1.853 times greater than topical application with vaseline. The combined injection of PRP and SVF effectively heals deep burns by acutely increasing the PMN cell and lymphocyte count, and COX 2 expression. Conversely, the treatment decreased the PMN cell and lymphocyte count but not the COX 2 expression in the sub-acute phase of wound healing.

The elderly population is on the increase globally according to the current global demographic changes and is more vulnerable to burn injuries. Despite recent advances in burn care, the outcome of burns in the elderly has only marginally improved when compared with children and younger adults. The objective of this study was to determine the patterns and outcomes of burns in the elderly and eventually proffer prevention strategies. A retrospective review of all the elderly (65 years and older) burn patients managed at the Burn Centre of National Orthopaedic Hospital Igbobi Lagos (NOHIL) between January 2015 and December 2019 was performed. The socio-demographic data, clinical information surrounding the burn injury and management were extracted from the medical records, analyzed and presented. A total of 21 patients were included in this study, with a male to female ratio of 1:1.1. Flame burns represented the commonest cause of burns (85.7%) and the majority had pre-injury comorbidities (57.1%). All the patients with %TBSA of less than 40% were successfully managed and discharged while death occurred in all the patients with %TBSA of 40% and above, with a mortality rate of 11.1%. This study provided an epidemiological profile of elderly burn patients in Nigeria. One in five burn admissions is elderly, with flame burns being the major cause of burns. Most of the burns occurred indoors and were related to cooking activities. Prevention strategies were recommended to improve home safety and make the home a safer place for the elderly.

Minimally invasive surgery is becoming the standard of care across surgical subspecialties. Several new "minimally invasive" options for burn debridement and autografting exist. Enzymatic bromelain-based debridement (BBD) and autologous skin cell spray (ASCS) have independently proven to reduce the rate of split-thickness skin grafting (STSG) and decrease donor site size when grafting is performed. There is a paucity in the literature regarding the combination of these two therapies. The purpose of this study is to characterize a cohort of patients treated with both BBD and ASCS and qualitatively compare data to expected outcomes without these therapies. This retrospective study of a single academic burn center's experience using BBD and ASCS together included 13 patients with a total burn surface area (TBSA) from 1-30% and all had >50% deep partial thickness. All patients received BBD and ASCS. Deeper burns additionally received STSG with ASCS overspray. Median burn size was 14% TBSA (IQR:5.45,20), donor site size was 225 sq cm (IQR:28.5,556.5), and ratio of donor site area to total treatment area of 0.082 (IQR: 0.039, 0.241) was observed. Median observed length of stay (LOS) was 19 days (IQR:10,27), expected LOS was 15.4 days, and O/E ratio 1.06. Donor sites in both groups of patients were much smaller than expected versus treatment with conventional meshed STSG alone and length of stay is lower than expected based on burn size. An emphasis on expenses and scar development will guide future studies into the patient subset and wound features that are best for this combination treatment.