International Journal of Burns and Trauma最新文献

{"title":"Safety and effectiveness of micropigmentation skin grafting using the Meek method.","authors":"Diana Rafieezadeh, Mohammadjavad Abbaspour","doi":"10.62347/HFPU3214","DOIUrl":"10.62347/HFPU3214","url":null,"abstract":"<p><p>The management of complex burn injuries has evolved significantly, with various surgical techniques developed to improve outcomes. This review examines the evolution of these methods, focusing particularly on mesh grafting and the Meek technique. While mesh grafting is effective, it poses challenges such as limited graft coverage and a high demand for autologous skin. In contrast, the Meek technique, a specialized method reintroduced in 1993, offers notable advantages for extensive burns by achieving higher skin expansion ratios of up to 1:9 and reducing the need for large donor sites. The Meek technique uses a meshing device to create tiny perforations in small skin grafts, facilitating their expansion to cover larger wound areas and improving healing outcomes. Recent studies highlight its effectiveness across various burn severities and age groups, especially when combined with Cultured Epithelial Autografts (CEA). Additionally, bioengineering advancements like Biobrane offer temporary skin substitutes to aid burn wound healing in pediatric cases, though they ultimately require replacement with autografts. While the Meek technique presents certain challenges, such as a 6-day delay before applying allografts, it remains a robust alternative to traditional methods. Clinical experience indicates that the Meek technique, particularly when combined with CEA, can achieve superior results for severe burns compared to conventional mesh grafting. This review emphasizes the Meek technique's potential as a valuable tool in burn wound management, offering a promising approach for improving patient outcomes in complex burn injuries.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":"14 6","pages":"107-114"},"PeriodicalIF":1.4,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029969","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":"Ideal burn resuscitation: a step toward resolving the dilemma in acute flame burn management.","authors":"Muhammad Shais Khan, Tariq Iqbal, Muhammad Rehan, Muhammad Hassaan Tariq, Qurra Tul Ain, Shifa Khan, Muhammad Ibrahim, Ali Mujtaba, Masooma Mubashir Chatha","doi":"10.62347/SQKU5090","DOIUrl":"10.62347/SQKU5090","url":null,"abstract":"<p><p>Following severe burns, the predominant concern is significant fluid loss, for which balanced crystalloid solutions are widely recommended as the primary intravenous resuscitation fluids. However, current literature lacks a clear distinction among various buffered crystalloid types that might be most effective in the early resuscitation of burn patients. This retrospective study was conducted to identify the optimal resuscitation fluid for major burns and to assess the clinical outcomes associated with isotonic crystalloid solutions compared to hypotonic crystalloids, specifically in terms of urinary output, acid-base balance, and electrolyte stability. Conducted over one year at the Burn Care Center of the Pakistan Institute of Medical Sciences in Islamabad, the study involved 132 patients who were divided equally into two groups, each with 66 patients. Group A received isotonic crystalloids, while Group B was administered hypotonic crystalloids. The mean pre-infusion levels of sodium, potassium, bicarbonate, and pH were identical across both groups. Following infusion, sodium and chloride levels remained within normal ranges in the isotonic group. Among children under 12 years of age, none in the isotonic group exhibited a urine output below 1 ml/kg/h, while 22.7% of those in the hypotonic group had urine output below this threshold. In patients over 12 years, only one individual in the isotonic group presented a urine output of less than 0.5 ml/kg/h, compared to 19.7% of those in the hypotonic group. These findings indicate that isotonic crystalloids are superior to hypotonic crystalloids, demonstrating improved urinary output and better serum electrolyte balance in patients with severe burns.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":"14 6","pages":"133-141"},"PeriodicalIF":1.4,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751552/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143029933","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":"Study on the application of deep learning artificial intelligence techniques in the diagnosis of nasal bone fracture.","authors":"Siyi Wang, Jing Fei, Yuehua Liu, Ying Huang, Leiji Li","doi":"10.62347/VCJP9652","DOIUrl":"10.62347/VCJP9652","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the identification of nasal bone fractures and their clinical diagnostic significance for three-dimensional (3D) reconstruction of maxillofacial computed tomography (CT) images by applying artificial intelligence (AI) with deep learning (DL).</p><p><strong>Methods: </strong>CT maxillofacial 3D reconstruction images of 39 patients with normal nasal bone and 43 patients with nasal bone fracture were retrospectively analysed, and a total of 247 images were obtained in three directions: the orthostatic, left lateral and right lateral positions. The CT scan images of all patients were reviewed by two senior specialists to confirm the presence or absence of nasal fractures. Binary classification prediction was performed using the YOLOX detection model + GhostNetv2 classification model with a DL algorithm. Accuracy, sensitivity, and specificity were used to evaluate the efficacy of the AI model. Manual independent review, and AI model-assisted manual independent review were used to identify nasal fractures.</p><p><strong>Results: </strong>Compared with those of manual independent detection, the accuracy, sensitivity, and specificity of AI-assisted film reading improved between junior and senior physicians. The differences were statistically significant (<i>P</i><0.05), and all were higher than manual independent detection.</p><p><strong>Conclusions: </strong>Based on deep learning methods, an artificial intelligence model can be used to assist in the diagnosis of nasal bone fractures, which helps to promote the practical clinical application of deep learning methods.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":"14 6","pages":"125-132"},"PeriodicalIF":1.4,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11751554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030015","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":"Concurrent avulsion of posterior cruciate ligament and semimembranosus: a case-based discussion and literature review.","authors":"Prasoon Kumar, Sameer Aggarwal, Gaurav Gupta, Siddhartha Sharma, Ankit Dadra, Vijay Goni","doi":"10.62347/FZKH6176","DOIUrl":"10.62347/FZKH6176","url":null,"abstract":"<p><p>A 30-year-old male sustained a road traffic accident and presented to our trauma centre with injuries to his pelvis and right knee. Radiology showed closed fractures of the right posterior wall and posterior column of the acetabulum and PCL bony avulsion with posteromedial tibial plateau osteochondral fracture, without any distal neurovascular deficit. He was managed with surgical intervention for both injuries. His hip and knee healed well with a good functional range of motion at 12 months of follow-up. The aim of highlighting this case is that it underscores the rarity of concurrent PCL and semimembranosus (SM) avulsion injuries, emphasizing the importance of comprehensive evaluation and tailored surgical management. Utilizing CT imaging proves instrumental in identifying the associated posteromedial osteochondral fragment. Successful reduction and posterior buttressing of the fragment are crucial for stability against vertical shear forces and subsequent union.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":"14 5","pages":"101-106"},"PeriodicalIF":1.4,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11579402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711373","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":"Autologous non-vascularized fibula with compression plating in the management of aseptic complex non-union of long bones.","authors":"Latif Zafar Jilani, Yasir Salam Siddiqui, Abdul Qayyum Khan, Mohammad Istiyak","doi":"10.62347/DQLS6083","DOIUrl":"10.62347/DQLS6083","url":null,"abstract":"<p><strong>Background: </strong>The surgical treatment of non-union of long bones are challenging especially when bones are osteoporotic or there is a large bone gap due to repeated surgeries and implant failures. Plate with intramedullary fibula provides a stable construct as fibula acts as a second implant with better anchorage and high pull-out strength. The aim of our study is to present our experience of treating complex non-union of long bones using compression plating (LCP_s/DCP_s) in combination with autologous non-vascularized fibular graft (ANVFG).</p><p><strong>Material and methods: </strong>10 cases of complex non-union of long bones (tibia, femur, humerus) treated with debridement, decortication followed by intramedullary fibular strut grafting and rigid osteosynthesis by LCP_s/DCP_s were included in this study. DASH score and LEFS score was used for upper limb and lower limb functional assessment.</p><p><strong>Results: </strong>All patients had clinico-radiological union with a mean time of 11.4 months. Pre-operative mean DASH and LEFS score was 45.9±2.1 and 20.6±2.03 At the last follow-up, mean DASH and LEFS score was 19.8±1.1 and 60.6±2.6.</p><p><strong>Conclusion: </strong>Compression plating with ANVFG is a viable option for treating complex non-union of long bones. Intramedullary fibula acting as a second implant provides mechanical stability and support biological healing with its osteogenic property at the non-union site.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":"14 4","pages":"75-83"},"PeriodicalIF":1.4,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11411171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298171","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":"Malignant peripheral nerve sheath tumour presenting as pathological fracture of proximal femur in neurofibromatosis type-1: a case report with brief literature search.","authors":"Mohd Hadi Aziz, Yasir Salam Siddiqui, Mohd Owais Ansari, Ahmad Masood Aziz, Adnan Anwer, Asad Khan, Mohd Julfiqar, Mohd Adnan, Mohammad Ibran","doi":"10.62347/IGKP3358","DOIUrl":"10.62347/IGKP3358","url":null,"abstract":"<p><p>Neurofibromas, in association with NF-1, can undergo a malignant transformation, giving rise to Malignant peripheral nerve sheath tumours (MPNSTs), a relatively rare entity. Clinically, it presents with non-specific symptoms like pain and numbness, distinguishing it from other nerve lesions difficult. There is a lack of data on the occurrence of MPNST in NF-1 in children and adults, and distant metastasis to the brain and bones is reported only in a few cases. In this case report, we present the unusual presentation of MPNST with metastasis to the proximal femur and liver in a patient with NF-1 and its management. Patients and clinicians should be made aware of the relatively high risk of MPNST in NF-1, which is characterized by pain and rapid growth, and regular follow-up is needed for NF-1 patients for early diagnosis of malignant transformation. So, this case report is presented to enhance the understanding and awareness regarding this rare presentation.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":"14 4","pages":"90-95"},"PeriodicalIF":1.4,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11411172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298175","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":"Evaluation of pain associated with the application of burn dressings.","authors":"Connor L Kenney, Catherine R Thorpe, Steven G Schauer, Mahdi Haq, James K Aden, Julie A Rizzo","doi":"10.62347/RBJC6006","DOIUrl":"10.62347/RBJC6006","url":null,"abstract":"<p><strong>Introduction: </strong>Topical wound care after burn injury has revolutionized burn care. Dressings and topical solutions provide broad-spectrum antimicrobial coverage to prevent wound infection, be easy to apply and remove, and promote wound healing. A wide variety of dressings are available for providers to choose from based on wound characteristics. An additional factor to consider when making that decision is any pain associated with applying the dressing and frequency of dressing changes.</p><p><strong>Methodology: </strong>This retrospective study aimed to examine the daily and maximum pain reported by patients and daily opioid consumption to determine if there are any differences among commonly used dressings including 5% sulfamylon solution (SMS), manuka honey, negative-pressure wound therapy (NPWT), silver sulfadiazine, and silver nylon.</p><p><strong>Results: </strong>This study demonstrated that silver sulfadiazine had lower mean daily pain scores compared only to manuka honey as well as lower maximum scores when compared to all other dressings except silver nylon. Furthermore, the choice of dressing did not have an overwhelming effect on the amount of opioids consumed by patients during their hospital stay with manuka honey having less opioid consumption when compared to only 5% SMS and NPWT only.</p><p><strong>Conculsion: </strong>Further studies are needed with additional validated pain assessment tools and clinically relevant endpoints to fully elucidate the impact of burn dressings and other topical wound care options on pain.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":"14 4","pages":"84-89"},"PeriodicalIF":1.4,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11411175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298174","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 outcome of ultrasound guided vs. fluoroscopy guided hydrodilatation in adhesive capsulitis: a prospective study.","authors":"Mehtab Ahmad, Mohammad Jesan Khan, Mohd Hadi Aziz, Rida Fatima, Mohd Adnan, Adnan Anwer, Asad Khan, Shivank Khurana, Syed Mohd Shoaib, Faisal Harun","doi":"10.62347/YHQM4422","DOIUrl":"10.62347/YHQM4422","url":null,"abstract":"<p><strong>Background: </strong>The incidence of adhesive capsulitis varies from 2-5% in the general population to 20% in people with diabetes. One of the most effective treatment methods is hydrodilatation, which can be done under US-guidance or Fluoroscopic guidance. However, the clinical effectiveness of US-guided injections in comparison to fluoroscopy-guided injections is still debatable. The possibility of severe side effects, the expense, and the time required to carry out this minimally invasive procedure highlight how crucial it is for patients to have a precise intra-articular injection. This study aims to compare the effectiveness of Ultrasound-guided vs. Fluoroscopic guided hydrodilatation for patients with adhesive capsulitis.</p><p><strong>Methods: </strong>Sixty-four patients were randomly selected for hydrodilatation using any one of the techniques. The patients were evaluated for clinical improvements using the visual analog scale (VAS), oxford shoulder score (OSS), and range of motion (ROM).</p><p><strong>Results: </strong>The US-guided group experienced more pain reduction than the fluoroscopy group within the first four weeks (P < 0.001). The increase in ROM was much more significant in the US-guided group for the first 8 weeks. Improvement in Abduction and External rotation was much more significant (P < 0.001) in the first 4 weeks after hydrodilatation in the US-guided group. The improvement in ROM was maintained on long-term follow-up (mean 24 months), with 45 out of 64 (70.3%) reporting a normal or near normal ROM. On assessing the Oxford shoulder score improvements, the US-guided group's score significantly increased after the first week (P = 0.003), but the fluoroscopy-guided group's score increased after the second week. On comparison between the two groups, the amount of score improvement was more significant in the US-guided group than in the fluoroscopy-guided group in the first 4 weeks (P < 0.001).</p><p><strong>Conclusion: </strong>US-guided technique for intra-articular injection for patients with adhesive capsulitis provided a quicker pain reduction and a larger improvement in range of motion and overall shoulder functions.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":"14 4","pages":"65-74"},"PeriodicalIF":1.4,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11411173/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298173","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":"Combined awake videolaryngo-bronchoscopy intubation with HFNC preoxygenation for predicted difficult airway in a patient with post-burn mentosternal scar contracture.","authors":"Pasquale Rinaldi, Francesco Coletta, Maria Elena Porcelli, Giovanna Lauro, Francesca Schettino, Antonio Tomasello, Romolo Villani","doi":"10.62347/JNPY4151","DOIUrl":"10.62347/JNPY4151","url":null,"abstract":"<p><p>Airway management and safety remain a difficult challenge during reconstructive surgery in patients with extensive post-burn mentosternal scar contractures. Current guidelines do not recommend the use of direct laryngoscopy for predicted difficult airway because of the risk of intubation failure and airway emergencies: the consequences of wrong decisions can be fatal, and the patient is at serious risk. At present, video-laryngoscopy is the most commonly used technique for routine orotracheal intubation. Awake tracheal intubation with fibro-bronchoscopy also remains a valid option when possible, ensuring the patient's spontaneous breathing during the procedure. However, when videolaryngoscopy is used in combination with this method, the efficiency of these devices can be increased, and a better result can be achieved. We report a case of successful management of a predicted difficult airway with combined video laryngo-bronchoscopy in an awake patient with post-burn neck scar contractures.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":"14 4","pages":"96-100"},"PeriodicalIF":1.4,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11411174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298172","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":"Management of post-traumatic ankle deformities in children.","authors":"Yasir Salam Siddiqui, Mohd Julfiqar, Mohd Hadi Aziz, Mazhar Abbas, Adnan Anwer, Asad Khan, Mohd Owais Ansari, Mohd Adnan, Syed Mohd Shoaib, Mohammad Ibran","doi":"10.62347/UDGF6452","DOIUrl":"10.62347/UDGF6452","url":null,"abstract":"<p><p>The objective of this clinical appraisal was to assess the clinical-radiological results of ankle deformity correction secondary to physeal injury, utilizing the methods based on the age of the child, site & severity of the deformity, remaining growth potential, condition of the soft tissue envelop and integrity of neurovascular status. Fifteen subjects ≤ 16 years of age, with angular deformities of the ankle secondary to physeal injury, were included. Deformities secondary to infection and pathological fractures were excluded. Demographic data, type of injury, treatment method, and follow-up were recorded from the case files. Treatment categories included osteotomies for acute correction (> 10 years) and growth modulation (≤ 10 years). Male to female ratio was 7:8, with an average age of 11.8 ± 2.31 years (range 9-16 years). The right and left ratio was 7:8. Mean duration of follow-up was 1 year and 4 months. Gradual deformity correction was done in 2 cases utilizing the principle of growth modulation, while acute correction by osteotomy was done in 13 cases. The average pre-operative ankle deformity was 20.8 ± 3.11 degrees (Range -25 to 24 degrees). Radiological union was attained at a mean of 11 weeks (8-24). Nine patients achieved neutral ankle alignment. The mean residual varus was 2.3°, and the valgus was 4°. There was a statistically significant improvement of the AOFAS score by 17 points from a mean pre-operative score of 57 (44-84) to 74 (56-100) points at the final follow-up (<i>p</i>-value < 0.001). The average pre-operative shortening was 2.36 ± 0.21 cm, which was completely corrected in 9 individuals. Management of angular deformities around the ankle calls attention to correcting the resultant angular deformity and/or limb length disparity, utilizing acute or gradual correction. A successful outcome depends on early recognition and patient-specific treatment of paediatric ankle fracture patterns. Correlating the results of our study with the available literature, we feel that both acute or gradual correction for angular deformities around the ankle is a feasible solution as long as principles of deformity correction are adhered to. Techniques for salvaging and restoring the viability of injured physeal plate warrant additional research.</p>","PeriodicalId":45488,"journal":{"name":"International Journal of Burns and Trauma","volume":"14 3","pages":"48-57"},"PeriodicalIF":1.4,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634952","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}