Annals of the M.B.C. - vol. 1° - n° 1 - September 1987

INTERNATIONAL ABSTRACTS

THE USE OF OMIDERM IN A BURN UNIT

The use a new synthetic material OMIDERM (Omikron Scientific Ltd, Israel) for the temporary dressing of burn surfaces and skin donor sites is described. The lesions of 46 bum patients were divided into superficial dermal, deep dermal, full thickness, post-escharectomy and skin donor sites. Only the upper and lower limbs were treated with Omiderm. In each group the evolution of the wounds and final results are reported. Omiderm proved itself a very good dressing for donor sites and superficial dermal burns, and useful in the treatment of deep dermal burns, as it provides good protection of the wound against infection. Its advantages are provision of pain relief, protection against bactcrial contamination, reduction of fluid losses and i~s transparency, which permits inspection of the wound without removal of the dressing. Its disadvantage, are its poor elasticity and its inadequate permeability.

Cristofoli C, Lorenzini M. and Furlan S. Burns (1986) 12, (8), 587-591.

CHILDHOOD SCALDS IN BRISBANE

A 5-year study (1979-84) was carried out at the Royal Children's Hospital, Bri3bane, on children aged 0-12 years with burns injuries. Of the 333 children treated for scalds, 59.5% were boys and 40.5% girls (in some cases data were incomplete), 65.5% were under the age of 2, 46.6% between I and 2 years. The majority of these were boys. There was a higher proportion of girls in the older age-group. Most scalds affected only a small percentage of BSA, commonest areas being the arm and upper body. The most frequent time for scalds was between 4 p.m. and 7 p.m.. The commonest cause of scalds was hot water, followed by hot tea or milk. 85% c)f accidents occured in the home. The authors conclude, on the basis of their findings, that scald injuries may be prevented by educational programmes stressing the dangers to the land 2- year-old child, expecially in the kitchen and the bathroom, and at busy times of day (late afternoon and early evening).

Phillips W., Mahairas E., Hunt D. anl Pegg S.P. Burns (1986) 12, (5) 343-350.

The porpose of the paper was to gain further understanding of the long-lasting amenorrhea often observed in severely burned females. In particular the work studied the response of 8 amenorrhocic burned females to the luteinizing hormone-releasing hormone stimulation test. It was found, using this test, that post-bum amenorrhoea is not due to ovarian or pituitary affection but more likely to a hypothalamic or central disturbance, effection but more likely to a hypothalamic or central disturbance, effecting the cyclicity of godanotrophic hormones. The fact that pituitary responsiveness to LH-RH is intact in these patients is important in the treatment of amenorrhoea by the pulsatile administration of LH-RH, when the condition continues after the catabolic phase. Such treatment is now possible thanks to the development of a battery driven pump which administers this peptide in pulsatile rhythm similar to normal hateinizing hormone.

Mahmound A. El-Oteify, Hassan A.A., Shaahan M.M., Ghaneirnah S.A.
Egyptain Journal of Plastic & Reconstr. Surgery, Vol. 11 N. '87. 2, July

THE USE OF FIBRIN GLUE IN THE SURGICAL TREATMENT OF BURN PATIENTS

The authors describe their experience in the use of fibrin glue instead of common sutures for the application of free grafts on burned surfaces.
A total number of 33 patients were treated in this way, of whom 22 had extensive burns.
From an analysis of the results the authors conclude that the advantages of this method are: lower cost of the material; reduction in operating time; no suture stitches have to be removed after the grafts have taken. The authors notes that the grafts remained normally adherent after surgery and that the presence of the glue did not affect the attachment of the grafts. The infection rate was the same as with old methods.
Finally, the authors state that despite the numerous advantages offered by this new method, its use is not advisable in extensive burns, also because of the risks of trasmission of viral infecticns with the use of haemoderivatives.

Paldim E, Galla A.
Riv. It. Chir. Plastica (1-1986)

The authors have studied burn injuries occurring between Ist September 1982 and 3/st August 1983 in the municipatily of Copenhagen. Compared Social changes in Denmark and differences in the constitution of the population are discussed. Compared to a similar investigation carried out in 1974/75 there has been a 33% drop in the total numbe~- of burn injuries. There was a reduction in the number of accidents both at work and at home among males. Females continue to sustain their accidents mainly at home. The commonest cause of burning was scalding. The authors conclude their study with some statistical calculations on the basis of which they predict the number of burn accidents to be expected annually in Copenhagen.
It is also shown that preventive measures have eliminated or reduced the number of certain forms of accidents.

Lyngdorf P., Sorensen B. and Thomsen M. Burns (1986) 12, (8) 587-591.

An epidemiological study was carried out on burn patients admitted to the Copenhageii Burns Unit between Ist September 1982 and 31st August 1983 (75 patients in all).
Domestic burns and flame were the main causes of burns; children still have the highest burn rate together with an at-risk adult population group which is identified.
Stress is laid on the importance of further preventive measures.

Lyngdordf P. Burns (1986) 12, (7), 491-495.

A retrospective epidemiological siudy was carried out on 182 patients admitted to the Royal Brisbane Hospital with industrial burns over a 7-year period (1976-1983).
The characteristics of the population are analysed, together with % BSA, causes of the burns, complications and mortality. Compared to previous studies there was a drop in the percentage of industrial burn accidents from 31.5% to 18.5% of all burn accidents.
Although safety conditions have improved in industry in the last few years, there is still room for further extension of preventive measures.

Pegg S.P., Miller P.M., Sticklen EJ.and Stone W.J. Burns (1986) 12, (7) 484-490.

A series of games used in the occupational therapy of hand burns are described. All the games are individual and suitable for various intellectual levels; they are all easy to sterilize. The games not only help the patient from the motor point of view but also enable bim to escape mentally from the atmosphere of the Burns Centre and all that this implies.

Van Straten 0. Burns (1986) 12, (7), 521-525.

The results are analysed of a bacteriological study carried out on 156 burn patients between 1979 and 1984.
Staphylococcus aureus was the most frequently occurring microorganismi and the one that earliest infected burn areas. Pseudonomas aeruginosa appeared later and its presence was associated with that of other germs. Escherichia coli, proteus and other species appeared early only more rarely.
Death caused by sepsis during the bum illness was in this study due mainly to pseudonomas: about 30% of infections due to this germ were fatal and the presence of pseudonomas was in all cases the cause of a reduction in immune defences.
A study of sensitivity to chemotherapeutic agents showed a constant response to colimycin and tobramycin. The authors' conclusion is that the indiscriminate topical use of chemotherapeutic agents is not advisable without the support of antibiograms.

Boeciarelli G, Migliori E, Rava C., Gari M. and Biggini C.
Riv. Ital. Ch. Plast. 1 - 1986

Correccion de alopecias Postquemaduras de un tercio de cuero cabelludo. Caso clinico

A clinical case is presented of bum-related frontoparietal alopecia affecting a third of the scalp, wich was successfully treated using skin expandes.
Results were excellent and this technique is recommended for grave sequelai. following scalp burns and in any other type of alopecia.

Baena Montilla P., Safont Albert J., Montilla P.B. Cir. Plast. lbero-latino Americana Vol. XII n° 4 (1986)

Evaluaciones sanitarias de quemados graves: estudio retrospectivo ed un Centro Especializado de carâcter nacional, el Centro de Quemados y Chirurgia Plastica de la Cruz Roja

The initial therapy received by 61 patients with extensive burns admitted to the Madrid Red Cross Centre from various Spanish provinces was studied.
Only 8 patients (11%) received adequate care during transport. There is a need in Spain for greater sociosanitary education with regard to the initial therapy and the transport of the bum patient as well as for a modernization in extra-hospital emergency medicine.

Ortiz Garcia P.J., Ranget Velasco Carmen S.
Cir. Plast. Ibero-latino americana Vol. XI n° 3 (1985).