{"title":"Acute Management of Deep Periorbital Burns: A 10-Year Review of Experience.","authors":"K Kalinova, R Raycheva, N Petrova, P Uchikov","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Deep periorbital burns are an important issue mainly due to the presence of the eyes in the region, and the crucial importance of preservation of vision. There is no consensus regarding their treatment. A retrospective analysis of the treatment and outcome of 446 patients with deep burns of the periorbital region admitted to the Department of Burns and Plastic Surgery of St George's University Hospital in Plovdiv, Bulgaria over 10 years was conducted. The study covers 446 patients, 162 female (36.5%) and 284 male (63.5%) aged from 5 months to 92 years. Deep periorbital burns accounted for 74.8% of hospitalized deep facial burns. Most frequent burn agents were hot liquids and flames. The mean total body surface area affected was 19.6% (min 0.5%, max 80.0%). Concomitant ocular pathology was diagnosed in 14% (n=63) of the patients. An early, staged and precise surgical approach was preferred, aimed at fast wound closure without sacrificing survived tissues. Follow up time ranged from 3 months to 5 years, median 37 months. Late ocular sequelae occurred in 7.4% (n=33) of the patients. There was no incidence of secondary corneal perforation or definitive loss of vision. Timely and adequate treatment during the acute period can minimize initial damage and late sequelae. Favor is given to the early, balanced surgical approach aimed at rapid wound closure between day 2 and 10 post burn. Preservation of vision is a determining factor for the significance of trauma and the effectiveness of treatment.</p>","PeriodicalId":93873,"journal":{"name":"Annals of burns and fire disasters","volume":"37 1","pages":"53-63"},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11041892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861272","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}
S Hachicha, A Mokline, S Ghedira, M Rahmouni, H Fraj, M Ben Saad, A-A Messadi
{"title":"[Burns and Diabetes Mellitus: Epidemiology, Clinical Presentation and Prognosis].","authors":"S Hachicha, A Mokline, S Ghedira, M Rahmouni, H Fraj, M Ben Saad, A-A Messadi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Burns in diabetics are quite frequent and serious in relation to diabetic neuropathy, which is common in this population, delaying healing and predisposing to the risk of infection. The objective of this study was to describe the characteristics of burns in diabetics hospitalized at the CTB of Tunis over 18 months. During the study period, 891 patients were hospitalized, including 43 diabetics (5%). The average age of our patients was 57 years old with a male predominance (65%). Type 2 diabetes was present in 86% of cases and type 1 diabetes in 14% of cases. Degenerative complications were reported in 10 cases (23%), such as diabetic retinopathy (n=6), diabetic nephropathy (n=4) and diabetic neuropathy (n=6). The circumstances of burns were related to a domestic accident in 2/3 of the cases (76.7%). Thermal burns were involved in 83.7% of cases. 86% of the patients had decompensated their diabetes during their hospitalization. Sepsis marked the evolution of the patients in 55.8% of cases. In our study, poor prognostic factors were: a glycosylated haemoglobin > 13%, an extent of burns greater than 20%, and a delay in consultation greater than 6 hours. The mortality rate was 18.6%.</p>","PeriodicalId":93873,"journal":{"name":"Annals of burns and fire disasters","volume":"37 1","pages":"23-27"},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11041885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861144","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":"The Combination of Stromal Vascular Fraction Cells and Platelet-Rich Plasma Increases Fibroblast Growth Factor 2 and Insulin-Like Growth Factor 1 in Full-Thickness Burns in Animal Model.","authors":"F Josh, T H Soekamto, C A Windura, D G Lumalessil","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The previous study on the injection of SVFs in combination with PRP showed positive effect on the healing of deep dermal burns. We now seek to understand the effect on full thickness burns, as assessed by changes in serum FGF2, IGF1, epithelialization, and fibroblast count. Forty-eight Wistar rats were randomly divided into four groups: (1) rats with full thickness burns given a local injection of combined SVFs and PRP; (2) rats with burns given topical Vaseline; (3) rats with burns given a local injection of placebo; and (4) rats without burns. Primary data were measured according to the time of euthanasia (at the 8th hour, 4th day, 7th day, 14th day or 21st day). One-way ANOVA test followed by post hoc test were used. Epithelialization in rats who received SVFs and PRP was superior on days 7, 14 and 21 when compared to the other groups. The fibroblast count in rats who received SVFs and PRP showed significant difference on days 7 (p=0.022). Significant differences in serum FGF2 were observed on days 4, 7, 14 and 21 (p=0.003, p=0.001, p=0.024, p=0.038, respectively). A significant difference was also observed in serum IGF1 levels on days 7, 14 and 21 (p=0.043, p=0.003, p=0.045, respectively), and the combination of SVFs and PRP showed superior results compared to other groups. Injection of combined SVFs and PRP increases FGF2, IGF1, fibroblast count, and epithelialization.</p>","PeriodicalId":93873,"journal":{"name":"Annals of burns and fire disasters","volume":"37 1","pages":"35-44"},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11041884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873816","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}
T Cordoba, C Awaida, É Delisle, C Cordoba, A Odobescu
{"title":"Triple Barrel Free Fibula Flap for Sternal Stabilization: A Case Report.","authors":"T Cordoba, C Awaida, É Delisle, C Cordoba, A Odobescu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Sternal non-union is a rare complication of median sternotomies following cardiac surgery. It results in sternal instability and is associated with a high rate of morbidity. Patients with sternal non-union usually complain of pain and sternal clicking with movement of the chest wall. Diagnosis is confirmed on computed tomography showing a gap between two sternal halves. Surgical correction of sternal instability is challenging. The key objective is to reconstruct a thoracic cage that allows for biomimesis and preserves normal physiologic cardiac and pulmonary functions all whilst achieving an aesthetically pleasing result. In this article, we describe a novel technique for sternal instability reconstruction using a triple-barrel vascularized free fibula flap fixed with rib titanium plates. This approach provides rigid long-lasting stability while preserving chest wall biomechanics.</p>","PeriodicalId":93873,"journal":{"name":"Annals of burns and fire disasters","volume":"37 1","pages":"79-82"},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11042043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867888","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 of the Relationship Between Patient Demographics, Burn Etiology, and the Incidence of Burn Wound Infection in Tanta University Burn Unit.","authors":"M S Sadaka, D E Abdeldaim","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Burns are a worldwide major cause of injury. Burns result in damage to the skin and other organs, leading to open wounds, severe emotional and psychological complications, disability, and economic burden. In this article, we report our study of the relationship between patient demographics, burn etiology, and the incidence of burn wound infection. This study was conducted on 110 cases who presented with acute burns at the Burn Unit of the Plastic and Reconstructive Surgery Department at Tanta University Hospital, Egypt, in the period from January 2019 to January 2021. A prospective study was conducted, and the collected data were statistically analyzed regarding the different relationships between patient demographics, burn etiology, and the incidence of burn wound infection. In our study, most indoor burn injuries were scalds, most of which were accidental, while outdoor burns were mostly flame burns. Most burns in the 0-10 years age group were scalds, while in the other age groups, burns were mostly of the flame type. Females had significantly more frequent scald burns. The most important statistically significant prognostic risk factors for burn wound infection are TBSA of burn, depth of burn wound, and length of hospital stay.</p>","PeriodicalId":93873,"journal":{"name":"Annals of burns and fire disasters","volume":"37 1","pages":"3-9"},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11041824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861906","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":"[The Place of Groin, Colson and McGregor Flaps in the Acute Care of Deep Burns to the Hand Dorsum : A Series of 6 Cases In Lille's Burn Centre].","authors":"L Barry, E Guerre, M Jeanne, L Pasquesoone","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The acute management of deep burns to the dorsum of the hand and fingers represents a challenge for the reconstructive surgeon. The exposure of osteo-tendinous structures often requires flap coverage, in a context where loco-regional or free flaps are not always feasible. The aims of reconstruction are to preserve a maximum of digital length, provide supple tissue, obtain protective sensitivity, and achieve a functional hand at 1 year. We report here on a series of 8 deep burns to the dorsum of the hand. Six hands were covered by Colson abdominal flap-graft and two by pedicled inguinal flap. Four out of 6 patients were reviewed in consultation, 1 patient was lost to follow-up, and 1 patient died. Clinical evaluation was performed by a surgeon other than the operator. Functional results are highly variable. Coverage time varies according to lesion depth and patient severity. Flap weaning took place at an average of 30 days. DASH scores ranged from 17.5 to 93/100, with average to poor total active motion (TAM) scores. The aesthetic result was satisfactory, with a Vancouver score of 4.5/13 on average, and an overall patient opinion of 3.75/10 on the POSAS scale. For deep burns to the dorsum of the hand and fingers, local flaps are rarely possible, and loco-regional flaps are not feasible in cases of associated upper limb damage. For medium to large surface areas, pedicled inguinal flaps and pocketing are two reliable techniques. Nevertheless, they require relative immobilization of the upper limb, which leads to stiffness. The question of digital pinning in the intrinsic or straight position remains unresolved, and does not appear to prevent secondary deformities. There is also a learning curve for these two flaps, even though they are reputed to be easy to lift. McGregor's flap or pocketing can be weighed against free flaps. However, the operating time is long, the surgical technique is complex, and vascular damage is common in the burn patient population. Although there have been enormous technical advances since their descriptions, the pedicled inguinal flap and pocketing remain alternatives to be considered in the acute management of deep burns to the dorsum of the hand. In this presentation, we propose a surgical management algorithm to situate these two techniques in the plastic surgeon's therapeutic armament.</p>","PeriodicalId":93873,"journal":{"name":"Annals of burns and fire disasters","volume":"37 1","pages":"64-78"},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11041980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873777","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}
T Bagheri, S F Forghani, S Hoveidamanesh, M Asgari, O Mahboubi, M Momeni
{"title":"An Assessment of the Fire Safety Standards in Iranian Homes and Equipment As They Relate to Fire Accidents.","authors":"T Bagheri, S F Forghani, S Hoveidamanesh, M Asgari, O Mahboubi, M Momeni","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Fire accidents and burns are one of the leading causes of death and disability worldwide. This study was conducted with the aim of studying the etiology of fire accidents as well as investigating the fire safety standards of both homes and equipment in Iran. Samples included patients with flame burns who consented to answer the questions. Questions covered five areas: patient demographics, epidemiological characteristics of burns, the fire safety status of the home, the fire safety status of the equipment, and the mechanism of the accident. In this study, the mean extent of the burns was 18.07 ± 14.29% of body surface area and was significantly related to the age grouping of the patients. The highest total body surface area (TBSA) was observed in patients between 19 to 39 years. The most common cause of flame injuries was gas explosions (36.81%). The interviews revealed that most of the houses were not equipped with smoke detectors or fire extinguishers. The extent of burns was significantly higher in patients living in unequipped homes (P = 0.047). Cooking equipment was often involved in the accidents (38.1%). Considering the low home fire safety and the role of equipment misuse and damaged equipment use in the occurrence of accidents, it seems that installing fire alarms and firefighting equipment, proper training on how to work with and maintain the equipment, using cooking and heating equipment correctly along with discontinuing use if damaged would all be effective and are highly suggestive to reduce fire injuries.</p>","PeriodicalId":93873,"journal":{"name":"Annals of burns and fire disasters","volume":"37 1","pages":"10-16"},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11042041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869649","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}
S B Duci, E M Bektashi, V K Zatriqi, Z A Buja, E T Hoxha, D A Rrusta
{"title":"Pediatric Burns in University Clinical Centre of Kosovo From 2011-2015.","authors":"S B Duci, E M Bektashi, V K Zatriqi, Z A Buja, E T Hoxha, D A Rrusta","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":93873,"journal":{"name":"Annals of burns and fire disasters","volume":"37 1","pages":"17-22"},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11042038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869374","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}
M Rehan, T Iqbal, M S Khan, M H Tariq, O K Khokhar, Q Ain, U Waheed
{"title":"Burns During Covid-19 Pandemic: Demographics, Etiological and Clinical Trends in 2021 at the National Burn Care Centre in Islamabad, Pakistan.","authors":"M Rehan, T Iqbal, M S Khan, M H Tariq, O K Khokhar, Q Ain, U Waheed","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":93873,"journal":{"name":"Annals of burns and fire disasters","volume":"37 1","pages":"28-34"},"PeriodicalIF":0.0,"publicationDate":"2024-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11042046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873425","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":"Assessment of Small Paediatric Burns: A Coin-Based System.","authors":"J J Wilson, L Awad, K Allison","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":93873,"journal":{"name":"Annals of burns and fire disasters","volume":"36 4","pages":"276-280"},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11041877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861840","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}