Burns and Fire Disasters - vol. XII - n° 3 - September 1999
SUCCESSFUL UTILIZATION OF ECMO TO TREAT AN ADULT BURN PATIENT WITH ARDS
A case is presented of an adult who suffered
thermal burns and adult respiratory distress syndrome (ARDS) and was treated with
extracorporeal membrane oxygenation (ECMO). This is the first case reported of such a
patient who survived. The 26-yr-old man had sustained 12% thermal burns to the face and
anterior trunk, as well as inhalation injury which was detected bronchoscopically. As a
result of low oxygen saturation the patient required increasing F10, The parameters
measured indicated severe ARDS. The patient failed volume control ventilation. Pressure
ventilation was attempted but proved inadequate. The patient was thus transferred to a
hospital able to provide ECMO treatment, where he received venovenous ECMO. After six
week-, the patient was taken off all ventilatory support.
Patton M.L., Simone
M.R., Kraut J.D., Anderson H.L. 111, Haig L.R., jr
Burns, 24: 566-8, 1998
DEEP ELECTRICAL BURNS OF
THE CALVARIUM: EARLY OR DELAYED RECONSTRUCTION?
This article presents three cases of deep
high-energy electrical burns of the calvarium. All the patients suffered massive
electrical burns of the soft tissues of the head and underlying skull and they were all
successfully treated using specially tailored methods in each individual case. A
discussion is made of the surgical aspects involved, i.e. the timing of osteoneCrectomy,
reconstruction, and the choice of methods for the covering of the extensively denuded
Norkus T., Klebanovas L,
Vikgraitis S., Astrauskas T., GUlunas L, Rinakus R., Zobakas A.
Burns, 26: 569-72, 1998
SYNDROME IN A BURN PATIENT
Neuroleptic malignant syndrome (NMS) is an
occasionally encountered life-threatening complication of drug therapy, generally
developing as a reaction to the administration of certain drugs, e.g. butyrophenones
(Haloperidol), phenothiazines, and thioxanthenes. A 39-yr-old male with a 55% total body
surface area burn developed the syndrome. On post-burn day 31 his temperature was 108.4 'F
(42.2 'C). This high fever was reduced by the use of Dantrolene and Bromocripteme. In view
of this kind of case NMS should be included as part of the differential diagnosis
of fever in burn patients receiving medication known to cause the syndrome.
Still J., Friedman B., Law E, Deppe S.,
Epperly N., Orlet H.
Burns, 24: 573-5, 1998
POST-BURN CONTRACTURE OF WRIST WITH ILIZAROV METHOD
Post-burn contracture of the hand presents
difficult problems as joint deformities are invariably present in severe long-standing
A case is reported of severe post-burn contracture in a man aged 44 yr who had suffered
burns at the age of 6 months. He presented a history of recurrent ulceration and a
suspected Marjolin ulcer. The deformity was successfully corrected by means of gradual
distraction in an llizarov frame. This method appears to be superior to the plaster of
Paris cast and more versatile than other forms of external fixation.
Madhuri V., Dhanraj P.
Burns, 24: 577-8, 1998
BURN INJURIES FOLLOWING
EXPLOSIONS OF CAR HEATERS
Burns due to the explosion of hot coolant in the
heating unit of motor-vehicles are not uncommon and deserve special attention because of
the danger not only of the explosion itself but of the possible road accidents they can
lead to. Four such cases are described in which the overheating of the unit caused an
explosion. Because of the type of accident the body parts most exposed to injury are the
lower limbs, genitalia, and buttocks. Three of the four patients healed spontaneously with
the topical application of silver sulphadiazine cream.
Fulcurvishi K., Tanaka H.,
Maruyama J., Takahhashi H., Kitagishi H., Veshima U., Marayuma K., Sakata l.
Burns, 24: 581-3, 1998
IMPROVE DERMAL PERFUSION AFTER BURN INJURY
The aim of this study was to evaluate the effects
of the topical and systemic administration of amide local anaesthetics on dermal per~
fusion after deep partial-thickness burn injury in rats. It was found that the topical and
systemic administration of local anaesthetics prevented dermal ischaemia. The mechanism of
the action of the local anaesthetics could be by direct action on the vasculature or
indirect by inhibition of several mediators of the inflammatory cascade.
Rinsson A., Brofeldt B.F., Nellgdrd P., Tarnow
P., Cassuto J.
J. Burns Care Rehabil., 19: 50-6, 1998
URETHRAL FISTULA IN A PATIENT WITH BURNS
Urethrocutaneous fistula is a common complication
of peri-urethral abscess but spontaneous healing of the fistula is rare. Urethra fistula
has been reported after electric burns to the perineum. Such an unusual case is reported
in this article, concerning a 22-yr-old man who sustained 10% flame burns in the upper
extremities, lower abdomen, and perineum. A Foley catheter was placed, and marked oedema
was observed. On day 5 post-burn, a small laceration was noticed at the right side of the
penoscrotal junction. The resulting fistula needed surgical treatment. The oedematous
perineum in patients with burn injuries must be carefully managed in order to prevent
tearing at the penoscrotal junction.
Balakrishman C., Maralani S., Emanuele J.A.
J. Burn Care Rehabil., 19: 57-8, 1998
COVERAGE COMBINED WITH CULTURED EPITHELIAL AUTOGRAFTS - A NEW TECHNIQUE FOR TREATING THE
ELDERLY PATIENT WITH BURN INJURIES
The creation of split-thickness skin graft donor
sites in elderly patients with burn injuries may lead to associated morbidity. In view of
this danger, an attempt was made to minimize the donor site area and to maximize
autografts by means of a new technique using trilaminar harvesting of skin grafts with
dermolipectomy closure, and permanent coverage of the autograft layers obtained with
cultured epithelial autografts, in an 80-yr-old man with 15% TBSA burns in the lower
extremities and buttocks. All twelve meshed split-thickness grafts showed excellent take,
and the cultured epithelial autograft take was about 90%. The dermolipectomy sites healed
uneventfully. This procedure thus proved useful for the permanent closure of full- and
partial-thickness burns in an elderly patient.
Haith L.R., Moss B.E., Kraut J.D., Patton
M.L., Germain T.J.
J. Burn Care Rehabil., 19: 59-61, 1998
PILOT STUDY OF A UNIQUE
FILM DRESSING FOR THE TREATMENT OF DONOR SITE WOUNDS
This prospective, randomized, controlled pilot
study evaluated the clinical benefits of using the VENTEX Wound Dressing System (VWDS)
(The Kendall Co.) in the treatment of donor sites. One donor site was managed using VWDS,
while the other donor site on the same D.W.
patient was managed by the Authors' standard of care involving the use of Xerofonn gauze
(The Kendall Co.). The results are presented. The use of VWDS eliminated donor site pain
and accelerated reepithelialization compared with Xeroform gauze. No adverse reactions
were associated with the use of VWDS, which was however more complicated to apply and use.
No differences were observed the in scar quality of donor sites treated with these
Himel H.N., Ratliff C.R.,
Baruch L,D., Rodeheaver G.T.
J. Burn Care Rehab., 19: 62-5, 1998
A PROSPECTIVE ANALYSIS
OF SERUM VITAMIN K IN SEVERELY BURNED PAEDIATRIC PATIENTS
Burn patients may exhibit multiple risk factors
for the development of vitamin K deficiency. These include malabsorption, limited enteral
intake, antibiotic therapy, and multiple surgery. In order to evaluate serum vitamin K
values during the first 4 weeks post-burn, a prospective assessment of 48 burned children
was carried out at the Shriners Burns Institute, Cincinnati (USA). The findings presented
suggest that there is a relationship between coagulopathy and an intact functioning
gastrointestinal tract. The relative importance of dietary versus endogenous vitamin K
produced by intestinal bacteria still however remains to be clarified.
Jenkins M.E., Gottschlich M.M., Kopcha R.,
Khoury J., Warden
J. Burn Care Rehabil., 19: 75-81, 1998