Indian journal of burns最新文献

{"title":"Thermometry: A simple objective method for burn depth assessment","authors":"P. Agarwal, D. Sharma, Sudesh Wankhede, Lokesh Kumar Patel","doi":"10.4103/ijb.ijb_19_18","DOIUrl":"https://doi.org/10.4103/ijb.ijb_19_18","url":null,"abstract":"Introduction: Accurate assessment of burn wound depth is important because it determines the choice of treatment and prognosis. Clinical evaluation remains the most commonly used modality with its accuracy varies from 50% to 70%. This study was conducted to assess the accuracy and feasibility of burn wound depth using noninvasive noncontact technique using infrared thermometry. Materials and Methods: Fifteen patients' burn wounds depth was classified clinically into full-thickness, deep partial-thickness, or superficial partial-thickness burns. Thermometry was performed on 3rd day of burn injury using the handheld infrared thermometer. A punch biopsy was taken from all three areas (deep, deep-partial, and superficial-partial burns). A correlation between surface temperature and depth of burn by histopathology was done. Results: 12/15 patients total burn surface area (TBSA < 65%) survived and three patients (TBSA > 65%) died. In 11/12survivors, thermometry correctly predicted final burn depth. One of 12 burns superficial burn was wrongly assessed clinically as full thickness but was correctly classified by thermometry and healed within 21 days without surgery. 3/12 burns on clinical assessment thought to be superficial were deep; two were correctly predicted by thermometry. Conclusions: Handheld infrared thermometer can be used in conjunction with clinical examination to improve the efficacy of burn wound depth assessment.","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"18 1","pages":"72 - 76"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70741807","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":"Reconstruction of postburn crippled hands: A study of functional outcome","authors":"N. C. Hariharan, R. Sridhar, B. Sankari, V Valarmathy, Ebanesar Asirvatham, K. Geetha","doi":"10.4103/ijb.ijb_20_18","DOIUrl":"https://doi.org/10.4103/ijb.ijb_20_18","url":null,"abstract":"Introduction: In postburn survivors, quality of life depends on the functional ability of one's hands. However, restoring useful function in crippled hands is a formidable challenge. Understandably in such cases, there are no standardized rules regarding the sequence of release, the type of skin cover, the duration of immobilization by K wires, and the intensity of hand therapy. Patients and Methods: We formulated a protocol and evaluated the outcome for cases of severe contractures with a total loss of hand function and distorted hand architecture. It is a cross-sectional study of 10 consecutive patients and 14 hands operated in our department from January 2014 to June 2017. The patients were operated in two stages. At the first stage, contractures of the wrist, dorsum, and thumb web space were released. Extension contractures of the fingers and thumb were also released. During the second stage, the contractures of the palm, volar aspect of the fingers, and web spaces were released. In both the stages, the fingers were maintained in released position for 3 weeks by K wires and the raw areas were covered with split skin graft/skin flap. Results: Patients were assessed for the improvement of hand function by the disabilities of the arm, shoulder and hand (DASH) scores of the 10 patients operated, four returned to the original employment/school. Four found meaningful employment. Conclusion: The aim in crippled hands is to restore useful function in the least number of stages rather than improving the range of movement in individual joints. Maintaining the release achieved by surgery with K wires, coupled with aggressive therapy, prevent the recurrence of the contractures.","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"26 1","pages":"9 - 14"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70742425","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":"Exfoliative diseases of the integument and mucous membrane that mimic deep 2nd-degree burns with or without sepsis","authors":"K. Ramakrishnan, B. Ramachandran, K. Ravikumar, R. Ramkumar, V. Jayaraman, T. Mathivanan","doi":"10.4103/ijb.ijb_28_18","DOIUrl":"https://doi.org/10.4103/ijb.ijb_28_18","url":null,"abstract":"Introduction: Exfoliative skin diseases in children can mimic burns in many ways and require early diagnosis and management. Here we enumerate the different skin conditions with four case based examples and their management. Clinical Presentation: Varying degrees of skin involvement may be seen with severe involvement in DRESS syndrome and milder involvement in Stevens-Johnson syndrome. Management: The management of this exfoliative lesion is the application of collagen membrane to the wound as we treat burns. Although systemic symptoms can produce mortality (e.g., dress), collagen dressing heals the wound well with good epithelialization. Early and appropriate antibiotic therapy is mandatory. Conclusion: Careful attention to correct diagnosis, early intervention and use of collagen dressing have improved outcome in these children.","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"26 1","pages":"20 - 23"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70742797","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":"Oxidative stress in major thermal burns: Its implications and significance","authors":"R. Babu, M. Babu","doi":"10.4103/ijb.ijb_37_17","DOIUrl":"https://doi.org/10.4103/ijb.ijb_37_17","url":null,"abstract":"Introduction: Thermal burns could prove dreadful to humankind. The morbidity and mortality is the interplay of intraneous and extraneous factors. Multidisciplinary approach plays a cardinal role in managing this catastrophe. This study is carried out to analyze the oxidative stress in thermal burns, its implications in management, and the significance it carries with it. Materials and Methods: This prospective study was carried out in 30 patients from January 2016 to December 2016. Quantitative analysis of oxidative stress and total antioxidant capacity was done on postburn day 3 and every 5 days thereafter. Results: The quantitative oxidative stress level was high, and antioxidant capacity was low in patients who had higher percentage total body surface area burn and predominant deep burn with temporal analysis. The patterns were strikingly different in patients who had mortality with patients who survived. Discussion: Thermal burn releases reactive oxygen species which causes profound changes in internal and external milieu. This alters the physiological response to treatment and impresses on the morbidity and mortality of the patient. Conclusion: Thereby, it could be construed that oxidative stress along with tailored intervention, timing of treatment, and recalcitrant attitude to treatment methodology has a significant role in determining the outcome of burn patients.","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"26 1","pages":"38 - 43"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70743432","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":"Nanocrystalline silver gel versus conventional silver sulfadiazine cream as topical dressing for second-degree burn wound: A clinicopathological comparison","authors":"G. Dutta, Nandini Das, Abhishek Adhya, Kinkar Munian, B. Majumdar","doi":"10.4103/ijb.ijb_9_18","DOIUrl":"https://doi.org/10.4103/ijb.ijb_9_18","url":null,"abstract":"Background: The use of topical chemotherapy is fundamental to prevent infections thereby reducing local inflammation, pain and early healing in superficial, and deep dermal burns. Among the whole gamut, choice of topical agents became an important decisive factor. Silver sulfadiazine (SSD) cream has been an important part of burns management for many years. The major complications attributed to silver compounds are due to the complex or anion sulfadiazine, not the silver itself. With better understanding of the physical and chemical properties, nanocrystalline silver particles have emerged as the most studied material for burn wound dressing recently. Having in mind the difficulties experienced, the aim of the present study is to compare SSD with nanosilver (nano-Ag) gel dressing to treat second-degree burn wounds. Materials and Methods: Over a period of 24 months, a total of 90 cases were studied. 45 patients randomly included in each group, further divided into two subgroups depending on depth (superficial and deep) and involvement of total body surface area (10%–20% and >20%–30%) to minimize bias. Clinical, microbiological, and histological parameters were analyzed. Results: In NS group, significantly less pain observed throughout the study period in both superficial and deep dermal burn patient. Pseudomonas was the predominant flora. Nano-Ag gel was effective in controlling most of the microorganisms except Klebsiella and Proteus sp. Healthy granulation tissue appeared faster (P = 0.0009) in deep dermal burns in nano-Ag group and confirmed histologically. Overall wound healing was more satisfactory in nano-Ag group for both superficial and deep dermal wounds, clinically as well as by histological examination. Conclusions: Clinical and histological studies showed that nano-Ag gel has a positive impact on overall healing process of the patients and proved more beneficial for the management of partial thickness burn as compared to SSD.","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"26 1","pages":"29 - 37"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70744508","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":"Can removal of epidermis delay rejection of cadaveric dermis-only allograft? A proof of concept study","authors":"P. Agarwal, D. Sharma, A. Agarwal, L. Patel","doi":"10.4103/ijb.ijb_14_18","DOIUrl":"https://doi.org/10.4103/ijb.ijb_14_18","url":null,"abstract":"Background: Skin allograft, used as a biological dressing, is usually rejected after 2 weeks. Epidermis contains immunogenic cells and its removal reduces antigenicity of allograft and delays its rejection. Materials and Methods: This proof of concept observational study was conducted in 50 patients of deep burns and posttraumatic wounds to evaluate the biological response of cadaveric glycerol-preserved dermis-only allograft. The epidermis was removed surgically, and the endpoints of healing or graft rejection were compared with historical controls of full-thickness allografts. Results: Dermis-only allograft take was seen in 82% patients at 20 days; in 34% patients at 4 weeks and in 16% patients at 8 weeks. Conclusion: Surgical removal of epidermis from cadaver allograft reduces its antigenicity and enables its longer survival.","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"182 1","pages":"66 - 71"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70741128","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":"Burns management in India: The way ahead","authors":"A. Singh","doi":"10.4103/IJB.IJB_2_19","DOIUrl":"https://doi.org/10.4103/IJB.IJB_2_19","url":null,"abstract":"The problems of data collection in a country like ours are many: a. Multiplicity of treatment providers – Wide array of persons from plastic surgeons, surgeons, dermatologists, alternative medicine practitioners to Quacks are providing treatment to mild and moderate burns b. Absence of a robust health information system (HIS): Underdeveloped and developing countries often do not have the resources to invest in data collection and analysis.","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"26 1","pages":"3 - 5"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70742043","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":"The impact of first-day levels of serum proteins and lipids and their subsequent trends as prognostic indicators of burn mortality","authors":"Shobhit Gupta, S. Bhattacharya, P. Goyal","doi":"10.4103/ijb.ijb_4_18","DOIUrl":"https://doi.org/10.4103/ijb.ijb_4_18","url":null,"abstract":"Introduction: In severe burns, there is a profound systemic response that persists till the wounds heal. Since these physiological and metabolic derangements are dynamic over the clinical course of burns, it is expected that both trend of change and absolute values of the protein and lipid levels, to have a bearing on the prognosis and the ultimate outcome. Hence, this study was envisaged evaluate the prognostic value of these metabolic variables in burn patients. Materials and Methods: The study conducted on 100 adult patients of thermal burn (20% and 60% total body surface area). Serum albumin, globulin, total proteins, cholesterol and triglycerides (TGs) were estimated on alternate days starting from day till discharge or death. The 1st-day value and the trend of serial values throughout the clinical course were compared among nonsurvivors and survivors. Results: Mean serum values of albumin, globulin, and total protein on first-day of burns in survivor group were higher. Serum albumin levels of ≤2.1 g/dl at day one was a poor prognostic factor. The trend in the serum values of albumin, globulin, total protein, and cholesterol in survivor group was significantly positive and negative in nonsurvivors. Serum TGs, however, showed a nonsignificant negative trend in the survivors. Among the biochemical markers evaluated, most significant prognostic parameter was serum albumin, with maximum sensitivity and specificity. Conclusion: The cutoff values of proteins and trend of subsequent serial values can guide metabolic manipulations, albumin infusion, and dietary intake. In addition, these biochemical parameters merit inclusion in burn prognostic index scales.","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"26 1","pages":"48 - 54"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70743866","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":"Correlation of burn injury and family history of burns among patients hospitalized at a public hospital in Nairobi, Kenya: A case–control study","authors":"J. Wanjeri, M. Kinoti, T. Olewe","doi":"10.4103/ijb.ijb_8_18","DOIUrl":"https://doi.org/10.4103/ijb.ijb_8_18","url":null,"abstract":"Introduction: Burn injuries are physically and psychologically devastating types of trauma and are common among children especially in the home environment. They are more prevalent and are a public health problem in developing countries principally because of poor socioeconomic conditions. Effective prevention programs should be tailored for specific geographic locations and guided by the results of well-designed studies aimed at investigating local risk factors for burns. Studies targeting households can result in the identification of risk factors operating within family setups. Study Objective: To determine the association between occurrence of burn injury and family history of burns among patients hospitalized at a large hospital in a developing country in Africa. Methodology: This was age- and gender-matched case–control study comprising 202 patients admitted with burns (cases) and 202 nonsurgical patients (controls) admitted into the pediatric and medical wards. The study site was Kenyatta National Hospital, an 1800-bed national referral and teaching hospital in Kenya. The dependent variable was burn injury whereas the independent variables were family history of burn injury, history of hospitalization, and presence of a burn injury scar in the burnt family member. History of hospitalization following burn injury was termed as an indicator of severe burn injury having been sustained. Data Analytical Methods: The Chi-square test was used to identify the differences between the cases and control group variables, and logistic regression analysis and odds ratio were done to determine the relationship between the dependent and independent variables. Results: The male:female ratio was found to be 1:1, and burn injuries were found to be most common in the 0–4 years age bracket (n = 86, 42.6%), with the second most common age bracket being 20–40 years (n = 78, 38.6%). The injuries were mainly sustained in homes (n = 161, 80.9%) and the remainder at work (n = 15, 7.5%) and other places (n = 23, 11.6%). There was no significant difference between the two groups with regard to family history of burns (odds ratio [OR] = 0.689, 95% confidence interval [CI]: 0.443–1.073, P = 0.062) and presence of a burn scar in previously burnt family members (OR = 1.083, 95% CI: 0.308–3.805, P = 1.0). There was, however, a statistically significant higher incidence of postburn injury hospitalizations among the cases than the controls (OR = 2.354, 95% CI: 1.064–5.208, P = 0.033). Conclusion: Family history of burn injury with hospitalization of those affected is an indicator of households at a higher risk for burn injuries. More of the cases had history of hospitalization for burn injury among their family members, indicating that they had more risk factors operating within their environment, or their practices made them more prone to burn injuries. Identification of the specific risk factors involved is key in the prevention of burn injuries in homes.","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"26 1","pages":"24 - 28"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70744296","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":"Prevention of microstomia in patients having perioral burns","authors":"V. Puri, R. Shrotriya, Nikhil Ghubade, S. Kumail, S. Mayekar, Deepak Patil","doi":"10.4103/0971-653X.206702","DOIUrl":"https://doi.org/10.4103/0971-653X.206702","url":null,"abstract":"Facial burns are a common cause of morbidity in burn patients. Deep burns over lip and oral commissures heal with scarring resulting in microstomia which leads to eating difficulties, hygiene problems, and facial disfigurement frequently requiring surgical correction. Hence, the prevention of microstomia becomes an important part of management of perioral burns. Here, the authors discuss their experience in the prevention of microstomia in burn patients with perioral involvement.","PeriodicalId":13336,"journal":{"name":"Indian journal of burns","volume":"26 1","pages":"106 - 107"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70232808","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}