Annals of Burns and Fire Disasters - vol. XX - n. 1 - March 2007 INTERNATIONAL ABSTRACTS
TREATMENT OF POST-OPERATIVE PAIN FOR BURN PATIENTS WITH INTRAVENOUS ANALGESIA IN CONTINUOUS PERFUSION USING ELASTOMERIC INFUSORSPost-operative pain in burn patients tends to be moderate or severe, and its treatment necessitates a combination of high-strength analgesics (opioids) with other opioids with different action mechanisms, according to the concept of multimodal analgesia. In this paper from Spain, the use is proposed of continuous intravenous analgesia with morphine, using elastomeric infusors at a fixed dose for the treatment of such pain. An assessment was made of its analgesic efficacy, side effects, and the level of satisfaction. Seventeen burn patients were given continuous intravenous analgesia during the post-operative period (morphine, 1 mg/h), using elastomeric infusors for a period of 24 h. Analgesic efficacy was analysed using the visual analogical scale (VAS) at different moments; side effects and the level of acceptance by the patient were also evaluated. A good analgesic effect was confirmed 2 h after the start of perfusion (VAS < 3). The side effects were similar to or less than those seen with the use of morphine in bolus or patient-controlled analgesia mechanisms, and in no case was treatment suspended. Patient acceptance level was good. This method thus indicated a high level of analgesic efficacy in the post-operative period. It is however important to note that lower results were obtained in the first hours of perfusion, and it is therefore proposed that a heavy initial dose of analgesics should be given when commencing. This was found to be an efficient method analgesic, easy to apply, and low-cost; its application could be extended to ambulatory treatment. García Barreiro J., Rodriguez A., Cal M., Alvarez A., Martelo Villar A. GLASS FRONT OF GAS FIRE PLACES: A CLEAR AND PRESENT DANGERGlass-fronted gas fires have become popular in many homes as a source of heat energy. However, the flames attract young children towards the hot glass plate, resulting in contact burns. This study from Wales considers the morbidity pattern of such injuries and preventive measures. A retrospective analysis of 35 children thus afflicted is presented. It is concluded that although glass-plate contact burns may be minor and superficial, they nevertheless affect a vital anatomical area, resulting in psychological distress for both child and parents. The authorities responsible should promote awareness campaigns and preventive measures. Naqui Z., Enoch S., Shah M.
MAJOR FULL-THICKNESS SKIN BURN INJURIES IN PREMATURE NEONATE TWINSThis paper from Lithuania considers burns in neonates following the use of pulse oximeters, electrodes, chemical disinfecting agents, and phototherapy blankets. Burn injuries in premature neonates are very rare and there have been no reports on major full skin thickness injuries. This case describes a pair of pre-term neonate male twins delivered at a Community Hospital. After delivery they were placed on water warmers for 15-20 min and then transported into incubators. The burn injuries (in respectively 20% and 14% TBSA) affected the dorsum, waist, and buttocks. The clinical and surgical procedures, which included skin grafts from the twins’ father, are presented. The grafted wounds were found to have epithelialized on day 18 post-surgery. It is concluded that in premature neonates relatively low temperatures may cause deep burn injuries. Rimdeika R., Bagdonas R. EPIDEMIOLOGY AND THERAPEUTIC ASPECTS OF BURN INJURIES IN SLOVAKIA (1993-2003)This paper from Slovakia analyses the epidemiology and latest trends in thermal injuries in that country since 1990. Statistics are presented originating from the two burn injury departments in Bratislava and Kosice. Conclusions are drawn and proposals are made to pursue the preventive measures that have contributed to the decrease of thermal injuries in Slovakia since 2000. Babík J., Sopko K., Orság J., Koller J. [The papers published in this issue of Acta Chirurgiae Plasticae (vol. 48, no. 2, 2006) were presented at the Symposium held in September 2005 on the occasion of the celebration of the 75th birthday of Professor Radana Königová, MD, PhD.] THE USE OF ARTIFICIAL SKIN IN PLASTIC SURGERY AND BURNSArtificial skin is able to restore the depth and elasticity of skin through restoration of the dermis, without any significant morbidity. This paper from Greece and the Czech Republic considers this aspect of plastic surgery in burn patients. It is possible to achieve permanent release of contractures and a pleasing contour, with satisfactory functional and cosmetic results. The advantages must however be counterbalanced against the requirement of meticulous surgical technique and intensive post-operative care, the waiting period, and the cost of the products used. Kritikos O., Tsoutsos D., Papadopoulos S., Zapadioti P., Tsagarakis M., Grabec P. OUR EXPERIENCE IN NUTRITION OF A BURNT CHILD TREATED WITH INTEGRA®A case history from the Czech Republic is presented, reporting how a 7-month-old girl - scalded in 26% TBSA by her mother when she was cooking goulash - received Integra® artificial skin applied in 16% TBSA after necrectomy. The nutritional parameters were monitored for 25 days, from the first necrectomy and application of Integra® until the first autotransplantation - while the other burned surfaces almost healed. The average protein and energy intake needed to achieve normal levels of monitored nutritional parameters was lower than that recommended by calculations for similarly burned children. Tymonová J., Crkvenjaš Z., Kadlčik M., Hladík M., Adámková M.
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