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Volume XVII |
Number 4 |
December 2004 |
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CONTENTS
| 173 |
ETUDE PROSPECTIVE DE L'EPIDEMIOLOGIE DES BRULURES DE L'ENFANT EN TUNISIE
(Messaadi A., Bousselmi K., Khorbi A., Chebil M., Oueslati S. - Tunisie)
L'insouciance du jeune âge associée à l'ignorance du risque exposent les enfants aux brûlures accidentelles. Ce travail prospectif analyse les caractéristiques épidémiologiques de 143 enfants consécutifs brûlés âgés de moins de 16 ans. Les brûlures sont thermiques dans 97,9% des cas et surviennent essentiellement à domicile (95,2%). Les liquides chauds représentent 64,3% des cas. La surface cutanée brûlée moyenne est de 8% avec des extrêmes de 1 à 90%. Quatorze pour cent ont nécessité une prise en charge hospitalière. Certains facteurs de risque ont été identifiés, à savoir la présence de l'enfant dans un environnement de préparation de repas et/ou l'utilisation à domicile du brazero et du Primus. Seulement 7% des enfants ont bénéficié du cooling d'où l'absolue nécessité de renforcer la prévention et les conduites positives telles que «stopper, tomber, rouler» ou refroidissement par l'eau de robinet. |
| 178 |
LES BRÛLURES ELECTRIQUES PAR BAS VOLTAGE A PROPOS DE 25 CAS
(Benazzou S., Ababou K., Siah R., Moussaoui A., Nouhi A., Ihrai H. - Maroc)
Les brûlures par bas voltage sont les brûlures électriques les plus fréquentes. Elles représentent 3% de l'ensemble des admissions du Service des Brûlés de l'Hôpital Militaire d'Instruction Mohamed V de Rabat (Maroc). Sur une période de 4 ans, nous rapportons une série de 25 patients victimes de brûlures électriques par bas voltage, dont le bilan lésionnel a mis le plus souvent en évidence une lésion localisée et isolée et dont la prise en charge thérapeutique a opté dans plus de 50% des cas à une excision greffe précoce avant le 5ème jour à visée fonctionnelle. |
| 181 |
EPIDEMIOLOGICAL AND THERAPEUTIC ASPECTS OF BURNS IN CHILDREN IN THE TERRITORY OF KOSOVO
(Arifi H., Zatriqi K.V., Zatriqi S., Ahmeti H., Muqaj S. - Kosovo)
This is a retrospective study of children admitted for burn trauma to the Department of Plastic and Reconstructive Surgery in Prishtina, Kosovo, in the period June 1999-June 2003. The burns treated were more frequent among males (59.9% of cases) and mostly involved children in the age group 0-6 yr (79.8%). Deep burns were present in 46.4% of the patients and superficial burns in 53.6% of hospitalized cases. Preschool children (age group, 0-6 yr) constituted 54.5% of the cases, predominantly with deep burns. Scalds were the commonest cause of deep burns (71% of cases). The mean duration of hospital stay was 18.1 days; in cases treated with early escharotomy the duration was 21.3 days, with late escharotomy, 40.8 days, and with conservative treatment, 18.8 days. Of the 124 patients with deep burns, 39.5% were treated surgically, while the remaining 60.5% were necessarily treated conservatively. Early complications occurred in deep burns in 47.6% of the cases, and late complications in 34.7%. The mortality rate was 2.6%. |
| 185 |
HIGH-TEMPERATURE CEMENT POWDER-RELATED BURN INJURIES IN CHINA
(Xiao-ming J., Dao-feng B., Tian-jie Z., Xin-long C. - People's Republic of China)
Cement is now widely used in the field of both civil and rural area engineering and in the construction industry in China. Cement powder-related burns have rarely been reported previously. We performed a retrospective study on cement powder-related burns treated in the 148th Hospital of PLA in China from April 1997 to March 2002. Twenty-six victims were analysed with special regard to common modes of injury, localization of cement exposure, preventive measures taken, and treatment, with complete records. Cement powder burns are injuries concerning professionals at the workplace as well as amateurs during do-it-yourself work. In all patients, no attempt had been made to protect the skin and 22 patients with inhalation injury had not received adequate respiratory protection. Full-thickness burns were reported in all cases. Surgery had to be performed to remove dead skin, and skin grafting was necessary for these patients. Eleven patients died of severe inhalation injury. Cement powder burns can be avoided by adequate skin protection and especially by respiratory protection. Although acute cement injuries may seem rare, prospective studies should be carried out for the correct estimation of prevalence. Product education and proper protection appear to be the best preventive measures. |
| 188 |
HYPERTENSIVE URGENCIES ASSOCIATED WITH MAJOR BURNS
(Nisanci M., Aksu M., Barcin C., Duman H., Sengezer M. - Ankara)
Despite the common occurrence of the complication in extensive body burns of hypertensive urgencies, which may even become true hypertensive emergencies during the treatment of paediatric burns, few data are available on hypertensive complications during the treatment of major burns in adults. To our knowledge, no article addressing the hypertensive urgencies that may occur during the treatment of burn injury in adults has been published in the literature. This article presents our clinical experience in the treatment of eight adult major burn patients who developed post-burn hypertensive urgency, and the clinical characteristics of the cases are discussed. Some possible physiological determinants are suggested for the increased systemic blood pressure in burn patients. We recommend antihypertensive drugs that restore vascular endothelium's vasoactive functions as the drug of choice in the treatment of hypertensive urgencies after major burns. |
| 193 |
THE USE OF HYALOMATRIX IN DEEP PAEDIATRIC BURNS
(Tamisani A.M. - Italy)
Burns therapy has gradually evolved over the last few years, and now we have at our disposal biotechnology and synthetic materials that are absolutely innovative. Hyaff is a new product composed of a hyaluronic acid ester; hyaluronic acid is a substance naturally occurring in the basal layer of the epidermis together with proliferating keratinocytes. For some three years in the Surgical Emergency Unit of the Giannina Gaslini Institute in Genoa we have been using Hyalomatrix in deep second- and third-degree burns. Hyaluronic acid certainly plays an important role in the processes leading to tissue repair: the inflammatory process, granulation tissue formation, and re-epithelialization. Hyaluronic acid is metabolized by the liver. On coming into contact with the exudate of the wounds, it jellifies, cleaning the wounds, softening the eschar, and obliging the collagenous fibres to permit good spontaneous healing. Hyalomatrix does not require daily medication, its removal is completely atraumatic, and it can remain on the wound for three or four days, depending on the seriousness of the case. |
| 197 |
EARLY MANAGEMENT OF THE BURNED AURICLE
(Kamal A., Kamel A.H., El Oteify M. - Egypt)
The auricle is frequently injured during thermal injury. Because it is covered by skin without any underlying subcutaneous tissue, it does not have significant insulation to protect the cartilaginous framework from subsequent deformity. This study was carried out on 30 patients with 40 burned auricles (age range, 7 months to 55 yr; mean age, 26 yr ± 12; 12 females and 8 males). The burn size ranged from 6 to 60% TBSA (mean, 23 ± 13%). All were admitted to the burns unit in Assiut University Hospital, Assiut, Egypt, during the period September 2000-September 2001. Statistical analysis and correlation of the patients' data were performed in order to understand the nature of burns involving the auricle, evaluate the results of various lines of treatment, determine the complications of the burned auricle, study changes that lead to chondritis, and consider its fate. |
| 201 |
COMPARATIVE STUDY OF AQUACEL AND SILVEROL TREATMENT IN BURNS
(Kogan L., Moldavsky M., Szvalb S., Govrin-Yehudain J. - Israel)
We conducted a prospective study of burns treatment by Aquacel, which is a representative of the new class of absorbent dressings, compared with treatment by Silverol, a customary preparation. The study focused on the ability of these preparations to control wound infection, relieve pain, and interact with the cellular substrate of the wound. Pain intensiveness during dressing change and a half-hour later was studied according to pain scores. The bacterial contamination and infection rate was controlled by wound culture and wound inspection. The cellular substrate of the wounds was studied during at every stage of wound healing by quantitative cell investigation of the imprints from the wound surface and exudate from the wound fixated in paraffin blocks. The cooling effect of Aquacel seems very effective in pain relief and superior to pain relief after Silverol application. In reaction to wound exudates, Aquacel forms a cohesive gel sheet that provides an analgesic effect also during treatment, making it easily removable during dressing change. Microbiological study of the wounds showed minor bacterial growth on the wound surface in the early stage of treatment. Comparative results of the cytological examination of wound healing in the two groups studied revealed some similarities and differences. |
| 208 |
SURGICAL PREVENTION OF SEQUELAE DURING BURN WOUND TREATMENT
(Hadjiiski O. - Bulgaria)
An operative approach is suggested for the plastic surgery coverage of burn wounds in anatomical areas liable to contractures with functional disorder during children's growth. The clinical material concerns 57 children aged 7 months to 13 years with sequelae after burns treatment. The application of full-thickness skin grafts and the rotation of skin flaps from an adjacent location are advantageous in split-skin grafts, which are easily influenced by fibrosis from the burn wound surface. |
| 212 |
COMPTE RENDU DE VOYAGE A HO CHI MINH VILLE (VIETNAM) MISSION SEQUELLES DE BRULURES ENFANTS DU 14 AU 21 MARS 2003
(Costagliola M. - France) |
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