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Volume XV |
Number 3 |
September 2002 |
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SUMMARIES
| 110 |
BRULURES DOMESTIQUES MORTELLES: ETUDE MEDICO-LEGALE RETROSPECTIVE A PROPOS DE 28 CAS
(Razik H., Benyaich H., Chaouki O., Chbani A., Louahlia S. - Maroc)
Durant l'année 2000 l'Institut Médico-légal du CH Ibn Rochd a compté 33 cas de brûlures mortelles, dont 84,8% sont des accidents domestiques. Toutes les tranches d'âges sont touchées, avec les deux extrêmes de 3 mois et 76 ans. Les victimes sont souvent de bas niveau socio-économique et culturel et présentent fréquemment une surface corporelle brûlée supérieure à 60%. La bouteille de gaz de butane de 3 kg a été le chef de file des agents causals. La mortalité était essentiellement en rapport avec un choc septique. Dans notre contexte la prévention reste le meilleur moyen de lutte - elle doit tenir en compte les traditions et les conditions socio-économiques locales. |
| 113 |
BURNS IN PREGNANCY: A TEN-YEAR REVIEW OF ADMITTED PATIENTS
(El-Gallal A.R.S., Yousef S.M. - Libya)
Thirty-one pregnant women admitted to the Burns Unit based at Aljala Hospital in Benghazi (Libya) with thermal injuries (mostly domestic accidents) over a ten-year period (1992-2001) were studied retrospectively. There were eight patients had minor injuries, fifteen with moderate injuries, and the remaining eight patients presented serious major burns. Eight patients had other associated co-morbid problems. Six patients were in the first trimester of pregnancy, eight in the second, and 17 in the third. Seven patients with major burns died, while 20 patients with moderate and minor burns required skin grafting procedures in the course of their burn management. Fourteen patients with minor and moderate injuries gave birth to normal healthy babies; only five were by caesarean section. In this study, we present the Benghazi Burn Unit's last ten years' experience in the management of burned pregnant patients. We conclude that dealing with such cases is still difficult, and consideration must be given to prevention. |
| 116 |
COMPARISON OF SILVER SULPHADIAZINE 1 PER CENT, MUPIROCIN 2 PER CENT, AND FUSIDIC ACID 2 PER CENT FOR TOPICAL ANTIBACTERIAL EFFECT IN METHICILLIN-RESISTANT STAPHYLOCOCCI-INFECTED FULL-SKIN-THICKNESS RAT BURN WOUNDS
(Acikel C., Oncul O., Ulkur E., Bayram I., Celikoz B., Cavuslu S. - Turkey)
Silver sulphadiazine 1 per cent, mupirocin 2 per cent, and fusidic acid 2 per cent were compared to assess the antibacterial effect of once daily application on experimental rat 15 per cent full-skin-thickness burn wounds seeded 24 h earlier with 108 standard strain of methicillin-resistant staphylococci. The quantitative counts of the seeded organism in burn eschar and subjacent muscle were determined on day 7 post-burn, in addition to the cultures of blood and lung biopsies. All tested topical agents were equally effective against methicillin-resistant Staphylococcus aureus in reducing local burn wound bacterial count and preventing systemic infection. |
| 120 |
THE EFFECT OF MOIST EXPOSED BURN OINTMENT ON MAINTAINING A PHYSIOLOGICAL MOIST ENVIRONMENT IN TREATING BURN WOUND
(Er-fan Xie, Rong-xiang Xu, Cheng-chuan Wang, Zhi-biao Pu, Hong-bin Liusup, Li-guo Zhou, Cheng-ru Chao, Zhao-xing Sang, Fang Dong, Jun-lan Ge - People's Republic of China)
Objective: To investigate the effect of moist exposed burn ointment (MEBO) on the maintenance of a physiological moist environment in burn wound treatment. Methodat: A rabbit model with deep-second degree burn wound was used in this study. Observations were conducted at 0 hours (before burn), at 0.5, 6, 24, 48, 72 hours and 7 days post-burn, and after wound healing. Water evaporation, gross appearance, pathological changes, and the healing time of burn wounds treated with MEBO were studied, and the findings were compared with those of burn wounds treated respectively with either Vaseline or conventional dry exposed therapy. Results: It was found that water evaporation in MEBO-treated wounds was similar to that in normal skin and significantly less than that in wounds treated with dry exposed therapy (p < 0.01). MEBO did not obstruct proper water evaporation from wound as Vaseline did (p < 0.01). MEBO-treated wounds retained good breathing properties and adequate drainage and healed faster than dry exposed wounds. The difference was statistically very significant (p < 0.01). Conclusion: MEBO provided burn wounds with a physiological moist environment that promoted tissue regeneration and wound repair. |
| 125 |
ASSESSMENT OF THE ROLE OF ARTIFICIAL NUTRITION IN THE MANAGEMENT OF CRITICALLY ILL BURN PATIENTS
(Saleh Y., Radwan S., Mohamed M. - Egypt)
This study considering the effects of artificial nutrition in burn patients was carried out in 15 females and 25 males admitted to a burns unit in Egypt between January 2000 and January 2001. The burn surface was 25-50% and the patients' age ranged from 15 to 50 yr. All the patients received standard resuscitation measures during the first 48 h. On day 3, the patients were divided into two groups. One group received ordinary enteral nutrition plus artificial nutrition through a peripheral vein, while the other control group received only enteral nutrition. Each group was considered with regard to anthropometric measurements and laboratory analyses. The group receiving artificial nutrition was found to have excellent results, compared with the other group that received only enteral nutrition - body weight was maintained or slightly increased, while in the other group body weight markedly decreased. There was an increase in S. proteins, S. albumin, and S. transferrin in the first group. It is concluded that artificial nutrition can play an important role in the management of critically ill burn patients, in addition to the oral route, improving patient immunity and healing capacity, reducing the infection rate, and decreasing hospital stay. |
| 132 |
PERI-OPERATIVE HYPOTHERMIA IN BURN PATIENTS SUBJECTED TO NON-EXTENSIVE SURGICAL PROCEDURES
(Ramos G.E., Resta M., Patiño O., Bolgiani A.N., Prezzavento G., Grillo R.,Chacón Pazmiño G., Benaim F., Rutan R.L. - Argentina)
Burn patients are especially susceptible to hypothermia. The purpose of this study was to determine the incidence, risk factors, and sequelae of intra-operative hypothermia in our burn population. This prospective observational study was conducted between May 1998 and February 1999. During that time, fourteen burn patients (body surface area [BSA] burned, 10-64%) underwent 66 operative debridements of 1-15% BSA. The patients experienced hypothermia (core temperature, ± 36 °C) in 13 of the 66 procedures (19.7%). The hypothermia was mild in all cases (35.2 ± 0.3 °C; mean ± SD). BSA, age, and surgical room temperature were identified as risk factors for hypothermia, but not the duration of surgery. Bleeding time was longer in hypothermic patients, but without clinical consequences. |
| 138 |
TISSUE EXPANSION IN THE RECONSTRUCTION OF BURNS SEQUELAE
(Barroso M. da Luz Ferreira - Portugal)
Tissue expansion is an important and valuable addition to the reconstructive armamentarium of plastic and reconstructive surgeons. It is a safe technique and can be used successfully for the rehabilitation of selected burn victims. It allows the creation of skin that maintains all the skin characteristics in the area (sensation, texture, colour, and hair follicles) with minimal or no donor site sequelae. It can be accomplished on an out-patient basis under local or general anaesthesia, depending on the area involved and the patient's condition. |
| 142 |
RECONSTRUCTION OF THE BURNED BREAST
(Hafezi F., Boddouhi N., Nouhi A.H. - Iran)
Thermal injury to the anterior chest wall in adolescent female patients may cause severe disfigurement of the breasts. Direct damage to the breast bud can lead to complete lack of breast development, and even if the breast bud is spared the breast mound will be compressed under the scarred skin of the chest wall. In this article, we report the cases of patients who underwent surgery for burned breast. In 20 patients who had moderate to severe burn scars, we released the breast tissue and used thick split-thickness skin graft for reconstruction. In three patients with milder deformities, the inferior pedicle technique was used. We believe that repeated scar revision and grafting in the growing adolescent is mandatory for normal breast mound growth. In milder forms, the inferior pedicle method gives an acceptable appearance and offers consistent and reliable results in burned breasts. |
| 145 |
PRESERVATION OF HUMAN SKIN: VIABILITY CRITERIA
(Vasiliev A.V., Kiseliov I.V., Ivanov A.A., Fedorov D.N., Smirnov S.V., Terskikh V.V. - Moscow)
The aim of this study was to evaluate the initial viability of cadaver skin that was sufficient for the cryopreservation of viable grafts. We also studied the effect of cryopreservation on the pre-graft viability of skin on the basis of the viability of isolated keratinocytes. Various methods of evaluation of skin viability were compared: trypan blue exclusion, incorporation of labelled leucine, and growth of isolated keratinocytes in culture. The histology of the skin samples was also assessed. The results presented show the correlation between trypan blue counts and the capacity of epidermal keratinocytes to grow in culture. We suggest that within certain limits of trypan blue counts, cadaver skin retains viability sufficient for the cryopreservation of viable grafts. We also found that short-term banking is possible in clinics at about -70 °C. |
| 151 |
THE ROLE OF THE OCCUPATIONAL THERAPIST IN THE TREATMENT OF BURNS
(Petiot J. - France)
The author of this paper, an occupational therapist working in France, presents a concise account of his work with burned children and outlines some of its main aspects, including the use of pressure garments and special corrective apparatus. The aims and methods of occupational therapy are briefly summarized, with reference to the successive phases of treatment. |
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