International Journal of Burns and Trauma最新文献

{"title":"Evaluation of silver sulfadiazine 1%-cerium nitrate 2.2% cream efficacy and safety in moderate to severe burn patients: a single-blind randomized clinical trial.","authors":"Emad Molaei, Hedyieh Karbasforooshan, Ali Ahmadabadi, Mohammadreza Abbaspour, Seyed Hasan Tavoosi, Majid Khadem-Rezaeian, Ali Molaei, Sepideh Elyasi","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Burn injury is a major global health crisis. Topical antimicrobials such as silver sulfadiazine (SSD) are commonly used for superficial burn wounds. SSD has a broad-spectrum antimicrobial activity and also anti-inflammatory property, but also suffers from some limitations. Therefore, some studies suggest to add cerium nitrate (CN) to SSD, as an immunomodulatory and tanning agent with antitoxic properties, but its effect on patients' mortality, length of hospital stay, and bacterial colonization is contraversial.</p><p><strong>Objectives: </strong>In this research, we evaluated the efficacy and safety of SSD 1%+CN 2.2% cream in patients with moderate to severe burn.</p><p><strong>Material and methods: </strong>Twenty-two patients who fulfilled the inclusion criteria randomly were assigned to the intervention (n=7) or control (n=15) group and received SSD 1%+CN 2.2% or SSD cream 1% respectively, once daily until the complete re-epithelization or prepration of the burned skin for grafting. Intesity of pain, re-epithelialization time, required interventions, laboratory and clinical findings and final outcome were recorded.</p><p><strong>Results: </strong>There was no significant difference in re-epithelialization time between the treatment and control groups (P>0.05). The same findings were reported about the required interventions and laboratory and clinical parameters. However, the final outcome and the pain score on third day were significantly better in the treatment group (P=0.017). On the other hand, all patients in the treatment group needed graft surgery.</p><p><strong>Conclusion: </strong>Use of SSD 1%+CN 2.2% cream did not significantly improve re-epithelization time or infection occurrence and patients' pain, but also increased graft surgery rate in comparison with SDD 1% cream in moderate to severe burns.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10658154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138463457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes in necrotizing soft tissue infections are worse in rural versus urban Montana: a 10-year single center retrospective review.","authors":"Gordon M Riha,&nbsp;Michael S Englehart,&nbsp;Benjamin T Carter,&nbsp;Manoj Pathak,&nbsp;Simon J Thompson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Time to definitive surgical debridement has been recognized as a predictor for morbidity and mortality in necrotizing soft-tissue infections (NSTI). Rural patients are at particular risk due to limited local resources, decreased access to care, and prolonged transport times. The aim of the current study was to examine the outcomes of NSTI requiring surgical treatment in a previously non-described setting. This retrospective study (2010-2020) from a single tertiary care center in Montana reviewed patients ≥18 years old with a NSTI via ICD9/10 codes. Rural-Urban Continuum Codes (RUCC; characterizing counties by population size) were used to distinguish urban versus rural counties. Race (White and American Indian/Alaskan Native (AI/AN)) was self-described. Qualitative and quantitative comparisons between groups were determined using the appropriate two-tailed statistical tests. An aggregate of 177 patients was identified. Mean age in AI/AN was significantly lower (<i>P</i><0.0001) compared to White patients with no preexisting condition delineation. NSTI demonstrated an elevated incidence in both rural areas and AI/AN patients. Diabetes was also significantly higher (<i>P</i>=0.0073) in rural versus urban patients. Both rural and AI/AN patients faced extended travel distance for treatment. AI/AN patients had a significantly different infection location than White. Furthermore, polymicrobial species were significantly more prevalent in AI/AN patients. Morbidities (defined as septic shock and/or amputation) were significantly higher in AI/AN patients and rural environments (<i>P</i><0.01). There was no significant difference in all-cause mortality between respective groups. The state of Montana presents unique challenges to optimizing NSTI treatment due to excessive distances to regional tertiary care facilities. This delay in treatment can lead to increased morbidity.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10509540/pdf/ijbt0013-0173.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41180226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early ambulation and good outcomes after using combined nail plate construct for fixation of distal femoral fractures: a retrospective series of 14 cases.","authors":"Mostafa Aly Elabd,&nbsp;Ahmed Nageeb Mahmoud,&nbsp;Elzaher Hassan Elzaher,&nbsp;Muhammad Elsayed Kamel","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Combined nail/plate technique is a relatively novel method for surgically managing distal femur fractures. It was supposed to allow for early weight bearing and achieve adequate fixation that allow for good bone healing. This study aims to describe our single institution experience of treating distal femur fractures using the combined nail/plate technique.</p><p><strong>Methodology: </strong>This is a retrospective study of 14 cases who had AO/OTA fractures 33A_C that were managed with this technique. Patients mean age was 67.6 years and all of them had either obvious osteopenia/osteoporosis or comminuted fractures.</p><p><strong>Results: </strong>With early postoperative weight bearing, after a mean follow up of 13.2 months, all the patients were able to return to preinjury activity level. None of the cases were revised for union related problems. Adequate bone healing was noticed after a mean of 16.8 weeks postoperatively. At the final follow up, the mean Oxford knee score was 42 (range 34-46).</p><p><strong>Conclusion: </strong>The combined nail/plate technique provides adequate fixation method that allows for early weight bearing and good functional outcomes. More studies, ideally comparative are needed to properly assess the cost benefit of this technique compared to other techniques.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10509538/pdf/ijbt0013-0166.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41152667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid development of squamous cell carcinoma at a split-thickness skin graft donor site.","authors":"Andrew P Bain,&nbsp;Kareem R AbdelFattah,&nbsp;Audra T Clark","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The development of a Marjolin ulcer at the site of a split-thickness skin graft donor site is exceptionally rare. Here we describe the rapid development of squamous cell carcinoma at a split-thickness skin graft donor site in the setting of severe burn. We present a case of a 52-year-old male with no past medical history who presented with a 24% total body surface area burn caused by a flash flame. Four months after his initial excision and grafting, he presented for revision of a burn scar with an additional complaint of a rapidly developing skin lesion at his donor site, which arose over 2 weeks. The lesion was excised <i>en bloc</i> and found to be invasive squamous cell carcinoma. There are 5 previous cases of squamous cell carcinoma development at the site of split-thickness skin harvest in the setting of severe burn. While the typical Marjolin ulcer has a latency period of up to 30 years, lesions that arise in split-thickness skin graft donor sites appear to have a rapid onset of weeks to months. Squamous cell carcinoma at the site of split-thickness skin grafting is an uncommon but important sequelae of burn care.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10509539/pdf/ijbt0013-0182.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41152668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative evaluation of putty index and custom template for direct composite restoration of uncomplicated crown fractures in permanent anterior teeth.","authors":"Ishrat Siddiqui,&nbsp;Vijay Prakash Mathur,&nbsp;Nitesh Tewari,&nbsp;Veena Jain,&nbsp;Kalpana Bansal,&nbsp;Rahul Morankar","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to compare and evaluate Putty Index and Custom Template Technique for Direct Composite restoration of uncomplicated crown fractures in permanent anterior teeth.</p><p><strong>Material and methods: </strong>A total of 100 teeth were randomly allocated to the respective groups, n=49 in Group I and n=51 in Group II. Composite build up using Putty Index technique in Group I and vacuum formed Custom Template in Group II was done followed by finishing and polishing of the restoration. The restorations were scored using Modified USPHS criteria by two blinded and calibrated evaluators at baseline, 6 months and 12 months followed by Spectrophotometric evaluation. The clinical chair side time was recorded using digital clock.</p><p><strong>Results: </strong>No statistically significant difference was seen between ITT and PP analysis among the two groups at 6 months and 12 months follow-up. Mean time chair side time taken for Group I was 20 minutes and for 24.4 minutes for Group II which was statistically significant (P=0.00). No statistically significant change was seen in the colour of the restoration at 6 months (P=0.45) and 12 months (P=1.00) using spectrophotometer.</p><p><strong>Conclusion: </strong>Custom Template technique and Putty Index technique showed no statistically significant difference in terms of clinical evaluation at baseline, 6 months and 12 months except for postoperative sensitivity.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10509537/pdf/ijbt0013-0156.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41137289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A single institution case series of ReCell^® use in treating pediatric burns.","authors":"Samantha Jane Wala,&nbsp;Kelli Patterson,&nbsp;Steven Scoville,&nbsp;Shruthi Srinivas,&nbsp;Dana Noffsinger,&nbsp;Renata Fabia,&nbsp;Rajan K Thakkar,&nbsp;Dana M Schwartz","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Thermal injury has a significant impact on disability and morbidity in pediatric patients. Challenges in caring for pediatric burn patients include limited donor sites for large total body surface area (TBSA) burn as well as optimization of wound management for long term growth and cosmesis. ReCell^® technology produces autologous skin cell suspensions from minimal donor split-thickness skin samples, allowing for expanded coverage using minimal donor skin. Most literature on outcomes reports on adult patients.</p><p><strong>Objective: </strong>We present the largest to-date retrospective review of ReCell^® technology use in pediatric patients at a single pediatric burn center.</p><p><strong>Method: </strong>Patients were treated at a quaternary care, free-standing, American Burn Association verified Pediatric Burn Center. A retrospective chart review was performed from September 2019 to March 2022, during which time twenty-one pediatric burn patients had been treated with ReCell^® technology. Patient information was collected, including demographics, hospital course, burn wound characteristics, number of ReCell^® applications, adjunct procedures, complications, healing time, Vancouver scar scale measurements, and follow-up. A descriptive analysis was performed, and medians were reported.</p><p><strong>Results: </strong>Median TBSA burn on initial presentation was 31% (ranging 4%-86%). The majority of patients (95.2%) had placement of a dermal substrate prior to ReCell^® application. Four patients did not receive split thickness skin grafting with their ReCell^® treatment. The median time between date of burn injury and first ReCell^® application was 18 days (ranging 5-43 days). The number of ReCell^® applications ranged from 1-4 per patient. Median time until wound was classified as healed was 81 days (ranging 39-573 days). The median maximum Vancouver scar scale measurement per patient at time healed was 8, ranging from 3-14. Five patients who received skin grafts had graft loss and three of these patients had graft loss from areas with ReCell^®.</p><p><strong>Conclusion: </strong>ReCell^® technology provides an additional method for wound coverage, either on its own or in conjunction with split thickness skin grafting, and is safe and effective in pediatric patients.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10195214/pdf/ijbt0013-0078.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9506565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A debriding gel in the treatment of post-trauma, non-healing lesions.","authors":"Michel He Hermans","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Topical desiccation agent (TDA) is an acidic species in a gel with a potent hygroscopic action. When in contact with (water in) biofilm and necrosis, rapid desiccation occurs, with the dehydrated tissues typically sloughing off in 1-3 days. This allows for quick granulation tissue formation which is an essential step for healing by secondary intention or as wound bed preparation for grafting.</p><p><strong>Methods: </strong>A series of nine non-healing, post-trauma lesions on the lower leg were treated with TDA, followed by treatment of the lesion with vaseline gauze.</p><p><strong>Results: </strong>The average age of the patients was 77.0 years and the lesions had been in existence for 5.6 months on average. The average size of the lesion was 15.9 cm². Complete granulation of all lesions was reached in an average of 34.1 days while the time to complete reepithelialization averaged, 69.8 days (data from one outlier removed). There were no adverse events.</p><p><strong>Conclusion: </strong>These data suggest TDA treatment is an effective and efficient way to debride lesions, and to prepare them for healing by secondary intention or for grafting.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10349327/pdf/ijbt0013-0136.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9822068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sacrococcygeal chordoma-illustrative cases and our experience.","authors":"Sandeep K Yadav,&nbsp;Kishor Kunal,&nbsp;Prabodh Kantiwal,&nbsp;Rajesh Kumar Rajnish,&nbsp;Abhay Elhence,&nbsp;Saurbh Gupta","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Chordoma is an uncommon malignant bone tumour of low metastatic potential, the commonest site of which being sacrum. We intend to report two cases of giant sacrococcygeal chordoma managed surgically. The first patient presented with natal cleft swelling since past 3 years which on examination had a size of 12*10*14 and was mildly tender, non reducible, non pulsatile and non fluctuant. The swelling had a variegated surface and extended from sacral region till 2 cm above anal verge. The second patient presented with low backache with radiation to the left lower limbs along with numbness in posterior aspect of left thigh. Physical examination in the second patient was near similar to that in first case except the decreased perianal sensation with otherwise normal neurology in the second patient. The imaging and histopathology was consistent with sacroccocygeal chordoma in both cases. Both patients underwent wide margin resection with preservation of both S2 and right S3 roots. Effective management of sacrococcygeal chordoma requires early diagnosis, accurate preoperative staging, definitive and adequate surgical resection with proved tumour-free cut margins while in those declining surgery, radiotherapy can be considered as an alternative.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10349324/pdf/ijbt0013-0110.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9827849","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does the residual displacement of pelvic ring affect the functional outcome in pelvic ring injures?","authors":"Mohak Kataria,&nbsp;Sameer Aggarwal,&nbsp;Vikas Bachhal,&nbsp;Karan Jindal,&nbsp;Ajay Appajigowda","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Purpose: </strong>The effects of residual displacement on the functional outcome of the patient are not distinctly known and the acceptability criteria of residual displacement of the pelvic ring remain disputed. The purpose of this study is to evaluate the effect of residual displacement on functional outcome in pelvic ring injuries.</p><p><strong>Materials and methods: </strong>A total of 49 patients with pelvic ring injuries (both operative and non-operative) were followed up for six months. Anteroposterior (AP), Vertical and rotational displacements were measured at admission, after surgery and at six months. Resultant displacement (vector addition of AP and vertical displacement) was taken for comparison. Displacement was graded as excellent, good, fair and poor according to Matta's criteria. Functional outcome assessment was done at six months using Majeed score. Work adjusted Majeed score was calculated for non-working patients by taking the percentage score.</p><p><strong>Results: </strong>We compared the means of residual displacement with functional outcome (Excellent/Good/Fair) and found that there was no significant difference between the groups in operative (P=0.33) or non-operative patients (P=0.09). This showed that patients with relatively higher residual displacement also had satisfactory functional outcomes. The functional outcomes were compared after dividing the residual displacement into 2 groups: <10 mm and >10 mm and no significant difference was found in outcomes for either operative or non-operative patients.</p><p><strong>Conclusion: </strong>Up to 10 mm of residual displacement is acceptable in pelvic ring injuries. More prospective studies with a longer follow up are needed for determination of correlation between reduction and functional outcome.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10195215/pdf/ijbt0013-0044.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9557448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Grisel's syndrome and Down syndrome: a case report.","authors":"Ramin Shayan-Moghadam,&nbsp;Mohammadhasan Sharafi,&nbsp;Philippe Violas,&nbsp;Mohammad Hossein Nabian,&nbsp;Saeed Reza Mehrpour","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Grisel's syndrome is a non-traumatic subluxation of the atlantoaxial joint following an inflammatory process in the upper respiratory tract. Patients with Down syndrome have higher risks of developing atlantoaxial instability. This issue is mainly due to low muscle tone, loose ligaments, and alterations to the bone in patients with Down syndrome. Accompaniment of Grisel's syndrome and Down syndrome was not perused in recent investigations. To our knowledge, only one case of Grisel's syndrome in an adult patient with Down syndrome has been reported. In this study, we present a case of Grisel syndrome in a 7-year-old boy with Down syndrome following lymphadenitis. A 7-year-old boy with Down syndrome was admitted to the orthopedic ward of Shariati hospital with a possible diagnosis of Grisel's syndrome and treated with mento-occipital traction for ten days. In this case report, we represent a child with Down syndrome with Grisel's syndrome for the first time. We also imitated a simple and applicable non-surgical treatment for Grisel's syndrome.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10195222/pdf/ijbt0013-0094.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9506558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}