Annals of Burns and Fire Disasters - vol. XVIII - n. 4 - December 2005 INTERNATIONAL ABSTRACTS
ÉTUDE COMPARATIVE DE LA SENSIBILITÉ AUX ANTIBIOTIQUES DES PRINCIPALES BACTÉRIES ISOLÉES DANS UN SERVICE DE REANIMATION DES BRŰLÉS DURANT DEUX PÉRIODES: 1992-1995 ET 2000-2003The purpose of this study was to compare the bacteriological profile and the antibiotic susceptibility of the main bacterial isolates in burn patients hospitalized in our intensive care burn department over two 4-yr periods (period 1, January 1992-December 1995; period 2, January 2000-December 2003). In the first of the two periods, bacteraemia and cutaneous infections were mainly due to Staphylococcus aureus. Acinetobacter baumanni has been isolated in our burn department only since 1994 and is currently (period 2) the main agent responsible for bacteraemia. Pseudomonas aeruginosa was the commonest isolate from cutaneous burn swabs in the second period. The survey of antibiotic susceptibility evolution showed an overall global increase of germ resistance to the antibiotics usually prescribed. Messadi A.A., Thabet T., Bouselmi B., Oueslati S., Ben Redjeb S. INHALATION TRAUMA IN BURNS, CYTOLOGY, AND BIOCHEMICAL FINDINGSIn a pilot study (conducted in the Czech Republic) we followed a group of patients for the cytological and biochemical changes due to lavage in the upper and lower respiratory system. The patients included presented respiratory burns confirmed by bronchoscopy and skiagraphy. We divided the patients on the basis of their lung injury scores. We obtained values in our sample group between intubation and the last swab (before extubation). We list the risk factors, probability of survival, and lung histology results in the patients who died. Brož L., Valová M., Vajtr D., Adámek T., Tomášová H., Mociková H. TREATMENT OF SCAR CONTRACTURES IN THE JOINTS, USING IMMEDIATE PERI-OPERATIVE REDUCTION TECHNIQUE AND SKIN GRAFTSerious sequelae due to scar retraction, affecting limb articulations, require that specialized attention should be paid to the immediate treatment of burn patients (early tangential excision and skin grafting). In this study from Brazil the importance of the surgical treatment of scar retraction is stressed, the aim being to restore motor function to patients using a very simple technique. Scar resection with peri-operative reduction associated with skin grafting and/or Z-plasty led to total functional recovery in patients subjected to this procedure, and later sequelae did not depend on the surgical procedure. Del Pino Roxo C. COHORT OF BURNED IN-PATIENTS - MORTALITY PREDICTION AND THE SEASONALITY OF BURNSIn Brazil studies on prognosis and the possible seasonality of burns are rare. We followed a cohort of 923 burned in-patients admitted to our burns unit between January 1993 and December 1996. In a subgroup of these patients, we used logistic regression to study the best model to predict mortality. The hospital mortality rate was 5%, the causes being related in decreasing order of frequency to inhalation injury, body surface area burned, and age. The commonest cause was thermal lesions (mainly flame). The months from June to September had the highest rate of burns, possibly because of low air humidity. It is thus possible to make some predictions regarding the possibility of burn patient hospital mortality in this part of Brazil. Beraldo P.S.S., Nunes L.G.N., Ramos M.F.G. AIRWAY BURN INJURIESThis paper from Brazil considers the literature on airway burn injuries and describes the approach to their treatment. The importance is stressed of early diagnosis and of the incidence of possibly serious complications. The signs and symptoms that may indicate inhalation injury are reviewed. Diagnostic methods are described, as well as treatment. Carbon monoxide poisoning is responsible for most deaths in fires. Tostes M.L.F. KETAMINE REDUCES MORTALITY OF SEVERELY BURNED RATS, WHEN COMPARED TO MIDAZOLAM PLUS FENTAMYLKetamine’s anti-inflammatory properties can have protective effects, as seen in animal models of septic shock and endotoxaemia, and it has elicited the heat-shock response (HSR) in experimental studies. HSR reduced mortality after severe burns in rats. This study from Brazil tested the possibility that ketamine could be protective in experimental burns and generate the HSR. Male Fischer rats (120 in all) were randomly divided into five groups. The rats in the first group (n = 20) were sham-anaesthetized. In the second group (n = 20), the animals were anaesthetized with ketamine and shaved. In the third group (n = 20), the rats were anaesthetized with midazolam plus fentanyl and shaved. In the fourth group (n = 30), they were anaesthetized with ketamine, shaved, and submitted to 29% body surface third-degree burns using a brass bar. In the last group (n = 30), they were anaesthetized with midazolam plus fentanyl, shaved, and submitted to 29% body surface third-degree burns using a brass bar. Mortality rates were measured on days 1, 5, 7, 10, 15, and 25. Liver and lung samples were collected from all groups for heat-shock protein 70 (HSP70) detection. No animals in the first, second, and third groups died. Animals anaesthetized with ketamine showed significantly less mortality than animals anaesthetized with midazolam plus fentanyl, from day 2 to day 10 (p < 0.01, Fischer’s exact test) and from day 10 to day 25 (p < 0.05). HSP70 was found to be positive in the lungs of animals from all groups, with no differences between them, and was not found in any of the liver samples. Mortality was thus significantly less in ketamine-anaesthetized burned rats than in burned animals anaesthetized with midazolam plus fentanyl. Ketamine did not elicit the HSR in this model of experimental burn and thus its protective effects were not shown to be mediated through this mechanism. Meyer T.N., Lázaro da Silva A.
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