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Volume XVIII |
Number 3 |
September 2005 |
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SUMMARIES
| 117 |
THE USABILITY OF HARRIS-BENEDICT AND CURRERI EQUATIONS IN NUTRITIONAL MANAGEMENT OF THERMAL INJURIES
(Spodaryk M. Kobylarz K. - Poland)
This part of the paper presents an analysis of ways of meeting the energy requirements of burn patients, the amount of which is calculated on the basis of commonly employed mathematical equations. It is however demonstrated that these equations are unusable in particular clinical situations. |
| 122 |
THE LOCAL TREATMENT OF BURNS WITH ANTIBIOTICS
(Napoli B., D'Arpa N., Masellis A., Masellis M. - Italy)
After presenting an analysis of the principal antiseptics used for the local treatment of burns, highlighting their toxicity and the limitations of their antibacterial effectiveness, we describe the therapeutic protocol used in our burns centre (where antibacterial treatment consists exclusively of antibiotics for both local and systemic use). We review the data regarding actual and predicted mortality, and mortality due to septicaemia during the years 2000-2003. |
| 127 |
BRULURE PAR FOUDRE. A PROPOS D'UNE OBSERVATION
(Mradmi W., Fassi-Fihri J., Mehaji G., Ezzoubi M., Diouri M., Bahechar N., Boukind E.H. - Maroc)
Aussi loin que l'on remonte dans la littérature, on retrouve des récits relatant des accidents consécutifs à la fulguration chez l'homme. La foudre était alors associée à la colère des dieux ou à la notion de châtiment. La fulguration correspond à un transfert d'énergie entre un cumulonimbus de charge négative et un objet de charge positive se trouvant au niveau du sol. Les lésions déterminées sont à la fois thermiques et électrothermiques. Bien que l'arrêt cardiorespiratoire soit une cause bien documentée de décès, la plupart des cas rapportés dans la littérature décrivent un éventail très disparate des séquelles qui surviennent suite à cet accident. Les Auteurs rapportent le cas d'un patient atteint par la foudre en insistant particulièrement sur les complications neurologiques qui sont survenues en cours d'évolution. Se basant sur cette observation et sur une revue de la littérature, les Auteurs soulignent que le pronostic des patients atteints par la foudre est plus favorable que généralement rapporté. |
| 130 |
DISEASES MIMICKING A BURN - OUTCOME AND TREATMENT
(Castana O., Makrodimou M., Michelakis D., Tsandoulas Z., Alexakis D. - Greece)
Burn care is not reserved uniquely to burns. Several diseases have the symptomatology, clinical presentation, complications, treatment requirements, and outcome of burns. Such diseases are: 1. Stevens-Johnson disease; 2. Lyell's syndrome; 3. bacterial fasciitis; 4. skin necrosis combined with coagulation disturbances; 5. pemphigoid; and 6. subacute cutaneous lupus erythematosus. |
| 133 |
EPIDERMAL KERATINOCYTES MAY HAVE AN IMPORTANT ROLE IN HYPERTROPHIC SCARRING PATHOGENESIS: AN IMMUNOHISTOCHEMICAL STUDY (USING P63 AND KI-67 STAINING)
(Edriss A.S., Mû?Èák J. - Czech Republic)
The role of epidermal keratinocytes in the early phase of normal unimpaired wound healing has been extensively studied. However, little is known of the cell biological process in the epidermis and the role of keratinocytes in hypertrophic scar formation. This study investigated the possible role of p63 in the early phase of hypertrophic scarring pathogenesis. Nine skin samples were taken from nine patients during plastic surgery operations, as follows: 1. six samples from patients who on account of thyroid disease or other reasons presented risk factors (RFs) for hypertrophic scarring; 2. one sample from a healthy young person (as control); and 3. one sample from the upper eyelid during blepharoplasty and one sample from an elderly patient during breast reduction. All the patients were women, and were followed up clinically for 12 months. Skin specimens were cultured and sectioned, and analysed by histology and immunohistochemistry. In normal skin, nuclear p63 was abundantly expressed by the basal cells, but expressed by very low levels of transient amplifying (TA) keratinocytes covering the surface. TA keratinocytes, immediately after their withdrawal from the stem cell compartment, reduced p63, even though they possessed a proliferative capacity. In some skin, samples with RFs possessed a high level of p63 expression - not only basal stem cells but also four to five rows of parabasal cells. Four of the six skin samples with RFs showed significant epidermal abnormalities through the expression of both p63 and ki-67. Staining for ki-67, a marker for cell proliferation, revealed more increase in the suprabasal than in the basal keratinocyte proliferation rate. These results suggest that the epidermal keratinocytes may have an important role in hypertrophic scarring pathogenesis, using paracrine or epithelial-mesenchymal signalling. At 3, 6, and 12 months post-operation this finding clinically appeared in four patients with RFs. |
| 140 |
THE REHABILITATION OF SEVERELY BURNED PATIENTS: PREVENTION AND TREATMENT OF SCARRING
(Arena D., Actis M.V. - Italy)
A detailed description, based on direct personal experience with burn patients, is provided of techniques for the prevention of scar contractures in various parts of the body. |
| 148 |
BURNS IN EPILEPTICS: EXPERIENCE FROM ENUGU, NIGERIA
(Jiburum B.C., Olaitan P.B., Otene C.I. - Nigeria)
We present burn injuries sustained by epileptics and managed in our burns centre over a period of 10 years. There were a total of 18 patients who sustained burns as a result of epileptic attacks during the study period. This constituted 3.7% of the 485 burn patients seen during the period. There were 10 males and 8 females. Sixteen of them (88.9%) were known epileptics, while two had their first seizures when they sustained the burn injuries. Only seven of the patients (38.9%) had attempted any form of treatment for epilepsy prior to the burn injuries - four of these were on native herbal medications while three had seen orthodox medical practitioners but did not comply with their medications. Sixteen of the patients (88.9%) had flame burns and two (11.1%) had scald injuries. The burn surface areas ranged between 5 and 80%, with a mean of 21.0%. Most of the injuries were full thickness, necessitating wound cover. One patient had amputation of the right hand digits, while another had an above-elbow amputation. We submit that sociocultural beliefs about epileptics and epilepsy constitute a significant problem in this group of patients in our environment. Education of the people will reduce burn injuries in such patients. |
| 151 |
THE APPLICATION OF COLLAGEN SHEET IN OPEN WOUND HEALING
(Lazovic G., Colic M., Grubor M., Jovanovic M. - Serbia and Montenegro)
The aim of this paper is describe the application of desamidated collagen as a biomaterial in order to evaluate the utility of collagen, particularly as a drug delivery device, as a haemostat, and as a wound cover. We also evaluated the utility of vitamin A, vitamin C, 50% glucose, and gentamicin locally applied onto the open wound. Any biomaterial should ensure non-toxicity to the biological environment where it is applied. We point out the utility of vitamin A, vitamin C, 50% glucose, and gentamicin locally applied onto the open wound with a biological covering. Collagen sheet is becoming evident in our ongoing studies. We are convinced that collagen sheets are very useful in first- and second-degree burns. The cost factor comes down and the pain associated with dressing can be avoided. Especially in children it is very useful since the trauma of dressing can be avoided.. |
| 157 |
ATTITUDE OF NURSES IN A BURN UNIT TO HIV/AIDS BURN PATIENTS
(Olaitan P.B.1, Olaitan J.O.2, Dairo M.D.3, Ogbonnaya I.S. - Nigeria)
The human immunodeficiency virus (HIV) and the acquired immunodeficiency syndrome (AIDS) have constituted a major challenge and concern worldwide. This is especially true among health workers who have to take care of such patients. This paper is aimed at studying the attitude to HIV/AID burn patients of nurses working in a burn unit. The work was carried out at the burns unit of the National Orthopaedics Hospital in Enugu, Nigeria. In a cross-sectional descriptive study, 125 questionnaires were distributed among nurses working in the burn unit. All the 120 nurses who responded were aware of HIV/AIDS: 80.8% of them believed that the prevalence was high, 93.3% that they could be infected while taking care of the patients, 91.5% that all burn patients should be screened for HIV, and 41.4% that their knowledge of the patients' HIV status would affect their professional duty to them; 31.1% would not want to dress the wounds of known HIV/AIDS burn patients. We conclude that there is a need to educate nurses and indeed all health care workers on adherence to universal precaution rather than routine screening for HIV of all burn patients as knowledge of the patients' HIV status may lead to discrimination against them. |
| 161 |
CASE PRESENTATION - RECONSTRUCTION OF THUMB DEFECT WITH NEUROVASCULAR CROSS-FINGER FLAP AFTER ELECTRICAL BURNS
(Terziqi H., Krysander L. - Kosova)
The advantages are underlined of the use of the neurovascular flap, as seen in a patient with injuries in all anatomical structures after electrical burns, with defect in the soft tissue together with tendon, vessel, and nerve injuries and necrosis of the distal phalanx of the thumb, with reference to the value of this technique in modern plastic and reconstructive surgery. |
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