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Prevention is by far the best strategy to minimise the burden of burns and smoke inhalation injuries on public health. However, it is inevitable that some injuries will occur despite the best attempts to prevent them. We must, therefore, optimise treatment in order to restore individuals to the best possible condition. Previous experience has shown that a wide range of specialties, many of which are...
Numerous experimental studies have shown several benefits of treating burns by the immediate application of cool water. In this study of 695 children with burns, treated in the National Burn Institute (NBI), Hanoi, Vietnam, patients were assessed on admission according to first aid measures at the time of injury, i.e. the removal of the cause and immediate cooling with cold water. A total of 33% of...
Toxic shock syndrome (TSS) is a rare but serious complication of burns in children. Symptoms usually start within 3 days of the burn injury and even children with minor burns can be susceptible. Prompt diagnosis and rapid treatment is crucial in limiting the morbidity associated with this condition. We report here a 19-month-old child with a 2% scald who developed TSS following cessation of a 5-day...
The epidemiology of burns and smoke inhalation in secondary care, for the population (1.6 million) of the four U.K. health authorities of Lancashire and South Cumbria is presented. Using health authority data from 1997 to 1999, it was found that 925 patients were admitted to hospital with either a primary diagnosis of burns or a primary diagnosis of smoke inhalation, in which 66% were male and 34%...
This retrospective analysis of burn patients and victims of other forms of trauma from Ribeirao Preto and nearby cities admitted to hospitals in the city of Ribeirao Preto, Sao Paulo, Brazil, was carried out to determine the frequency of injuries of all types in order to identify the extent of the problem of burns relative to other forms of trauma. Data concerning 921 patients with burns and 60,344...
The success of treatment of childhood burns is critically dependent on how well the initial management is performed. In this case series of 695 children with burns transferred to the National Burn Institute (NBI) in Hanoi from peripheral hospitals, the initial management of each patient was assessed for the following initial management measures: removal of the cause and immediate cooling with water...
Background: Clinical studies document correlation of serum lactate and base deficit with mortality in trauma and sepsis. No study of the prognostic value of these two serum markers has been reported in burn injury.Methods: Resuscitation data from 49 patients admitted to the adult Burn ICU were analyzed. Lactate and base deficit were analyzed upon admission and every 2h during the initial 48h after...
Patients with extensive burn injuries frequently require supplemental tube feeds in order to maintain caloric balance. Conventionally, nutrition is supplied via a naso-gastric tube (NGT). However, NGTs cause discomfort and numerous complications have been described, particularly following prolonged use.An alternative route to the gastro-intestinal tract comprises the percutaneous endoscopic gastrostomy...
Although dermal substitution is a main topic of current wound healing research, there is a paucity of clinical trials with a long-term clinical and histopathological evaluation. A clinical trial was conducted to perform an intra-individual comparison of conventional treatment (split-thickness autograft) to a collagen/elastin dermal substitute in combination with an autograft. Promising results with...
Vancomycin-resistant enterococci (VRE) are multi-resistant micro-organisms that have emerged as important nosocomial pathogens during the last decade. Emergence of this organism has been blamed mainly on the increased and inappropriate use of antibiotics, in particular, the cephalosporins and the glycopeptide, vancomycin. Burns patients are highly vulnerable to acquiring VRE infections, being both...
Introduction: In any system of burn care, first-aid, packaging and transportation of the burn injured patient from outside of hospital is a most important contribution to the successful management and outcome.This study aimed to assess the current initial care of burn patients given by the statutory ambulance services and then compare this to a survey of opinions among the plastic surgery and burns...
Inappropriate treatment of axillary burns frequently results in adduction contractures. In this clinical study we have reviewed 32 patients with different types of axillary post-burn adduction contractures.We have used a variety of surgical treatments for reconstruction of axillary contracture releasing defects such as simple grafting, Z-plasties and locally pedicled flaps. Among these alternatives,...
Objective: To explore the role of Ca 2+ in the damage to myocardial mitochondrial respiratory function in the early stage after severe burns. Methods: An experimental model of 30%TBSA full-thickness skin scalding was reproduced in rats. Myocardial mitochondria were isolated from control and burned rats in the 1st, 3rd, 6th, 12th and 24th hour post-burn. The mitochondrial respiratory function,...
Blood samples of 200 patients with thermal injuries were drawn apparently to determine the trend of the cholinesterase activity. In relation to the severity of the injury, a characteristic decrease was noted during the first days after admission. A recovery to normal values was achieved in all survivors (150 patients) after a proportionate period of time, but in the group of non-survivors (50 patients),...
The authors in a prospective descriptive study, via a demographic questionnaire, semi-structured interview and/or psychological autopsy examined 318 cases of self-burning in Mazandaran, Iran during 3 years. The average age was 27 years and 83% of them were female. Most of them were married, home makers and with high school education. Sixty-two percent had an impulsive suicidal intention. The major...
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