In accordance with the principles laid down in its Constitution, the Mediterranean Bums Club organized the First International Training Course on Bums Management, held in Palermo from 5th to 9th June in the Lecture Hall of the Division of Plastic Surgery and Burns Therapy at Palermo Civic Hospital.
The Course was reserved to physicians, nurses, therapists, technicians, social workers, journalists and others concerned with bum problems. Participation in the course was free of change and the MBC also provided for the participants' board and lodging.
The President of the Course was S.W.A. Gunn. The Scientific Committee consisted of R. Bouayad Agha (Algeria), A. Brcic (Yugoslavia), M. Darghouti (Tunisia), J.D. loarmovich (Greece) and C. Swain (Malta), and the Coordinator was M. Masellis (MBC Secretary-General).
The lessons were given by a number of distinguished specialists in the field - physicians, nurses, journalists, psychologists, therapists, etc. The numerous topics covered every aspect of burn problems.
The first day was devoted to "Bums Prevention" in its various aspects and to "Acute Phase Management". R. Bouayad Agha gave a lesson on "L'6pidemiologie et la pr6vention des br~lures chez Fenfant", L. Rosemberg on "A comprehensive national burns prevention education programme", and M.M. Ferrara presented a videotape on "A prevention programme for bums in children". In the field of electrical bums P. Grasso gave a lesson on "Philosophy of a prevention programme of electrical accidents", M.M. Ferrara presented a videotape on "The prevention of electrical burns in everyday life", and F. Conte presented a videotape on "The prevention of electrical bums at work".
On the subject of the physiopathology of the bum disease the following lessons were given: Cl. Masse on "Les bases physiopathologiques du traitement des brûlures: thermiques, électriques, chimiques", A. Eldad on "Phosphor-us bums: pathophysiology and first aid, composition of various treatment modalities", L. Rosemberg on "Chemical and toxological bromine burns", A. Dayoub on "Chemical bums", A. Gliori on "Electrical bums: aethiopathogenesis and therapy", S. Joudgar on "Les brûlures électriques et leur traitement", and J. Marichy on "Intérêt des paramètres thermiques du brGl6".
The subject of fluid replacement was considered in six lessons by the following teachers: C. Swain on "The early management of bums: First Things First" , G. Magliacani on "Fluid therapy in the severely burned patient", J. loannovich on "Treatment of bums in the acute phase", J. Gabilondo on "Shock prevention in bums and fluid management", E. Brienza on "Personalized therapy in the severely burned patient", and M. Masellis on "Guidelines for a 'personalized resuscitatory therapy' in the extensively burned patient".
With regard to the prediction of bums mortality, J. Marichy gave a lesson on "Int6rêt prognostic des index de gravité", D. Rougé on "Sauvetage d'un très grand br616", and L. Rosemberg on "Algorithms in bum treatment".
The second day of the Course was taken up with the important chapter of "Bum Wound Care". The immunological aspect was considered by C. Echinard in his lesson on "Problèmes d'immunité chez le grand brûlé", J. Marichy on "Le rôle des protéines dans la phase aiguë de l'inflammation sur l'immunité des brû16s", G. Magliacani on "Infection and immunology in the severely burned patient", and P. Visentini on "The treatment of immune depression in the extensively burned patient".
Topical treatment was considered in its two aspects of escharectomy and skin replacement. Numerous lessons were given: C. Swain on "Bum wound care made easy", S. Roso on "Indications for escharectomy in the bum patient", M. Tafalla-Pena on "Escharectomy in the bum patient - State of the art - Indications and protocol", A. Brcic on "Technique of primary tangential excision", J.A. Banuelos on "Our experience in early escharectomies", J. Gabilondo on "Escharectomy: our practice in bums", P. Maviglio on "Chemical necrectomy", G. Sferrazza on "Surgical and chemical necrectomy", and D. Roug6 on "Laser et Brfilures".
On the topic of skin replacment D. Roug6 considered "La couverture des br-616s par homogreffes", D. Dioguardi "Topical treatment: skin replacement, skin culture", C. Echinard "L'utilisation des biomatériaux chez le brûlé", E. D'Alessio "Technical expedients in bums surgery", M. Tafalla-Pena "Skin culture in vitro", J.L. Foyatier "La culture d'&pider-me chez le grand brfil6", and A. Eldad "Skin culture: state of the art. Horizon for research".
The subject of hand bums was dealt with by D. Rougé in "Traitement en urgence de la main brûlée", M. Derfoufi in "Les aspects cliniques des séquelles des brûlures au niveau de la main - le traitement actuel et l'apport de la chirurgie plastique", and M. Kadry in "Early excision and grafting for bums of the hand".
Nutritional problems were reviewed by D. Barisoni in "Nutritional problems in bums", A. Gliori in "Lipid administration in the bum patient", and R. Vitale in "Metabolic monitoring in the extensively burned patient".
Seven lessons were devoted to reconstructive surgery in all its various aspects: S. Teich-Alasia lectured on "Considerations on current criteria in burn surgery", M. Darghouth on "Le traitement chirurgical des brûlures des enfants", R. Bouayad Agha on "La chirurgie reconstructive dans les brûlures du cou et des mains chez les enfants", S. Baux on "Traitement des retractions des plis de flexion des membres" and on "L'expansion cutanée chez le brûlé", M. Sobhi-Zaki on "Modem reconstructive techniques for the rehabilitation of the burned patient", and M. Taalat on "Reconstructive alternative procedures in post-bum contractures on the face, neck and hands".
The problem of rehabilitation in its psychological and functional aspects was considered by E. Brienza in a lesson on "Psychological problems in the bum patient", A. Mosca on "Model of integrated psychological therapy in the treatment of the burned patient", A. Brcic on "Rehabilitation procedures for burned patients", M. Amico on "A proposed rehabilitation programme for the prevention of bum sequelae", and F. Conte on "Guidelines for the functional recovery of the burned hand".
The third day of the course saw an interesting session consisting of lessons on the delicate problem of "Nurses and Nursing Care in Bums". Lessons were given by highly qualified nurses and physicians on four fundamental aspects of the problem: "Nurse education in burns", "Nurse staff organization", "Nursing care of the burned patient", and "Nursing support in the Bum Unit". Sister Scaraggi lectured on "The training of nursing staff in a Bums Centre", P. Pedemiana on "Staff organization in the Bum Unit", V. Cavallaro on "Staff organization in a Bum Unit operating theatre", A. Dayoub on "Nursing care of the burned patient", A. Quattrini on "Nursing care of the burned patient", F. Grezzani on "Respiratory assistance in inhalation bums - shock phase assistance", A.R. Palanque on "Le pansement chez le grand bi-616", G. Diez on "Nursing management at the Barcelona Bums Centre", and V. Basile on "Nursing management at the Palermo Bums Centre".
The delicate chapter of the "Organization of Bum Assistance" was the subject of a number of interesting lessons ranging from assistance to the bum patient on the spot with a lesson by R. Vitale on "First aid for bum victims at the accident site - Protocols for General Practitioners" to assistance in the general hospital with two lessons by 0. Bouzid on "Organisation des soins aux brûlés dans un hôpital non specialis6" and one by R. Vitale on "Protocols for assistance to bum patients in a non-specialized hospital".
J. loannovich, S. Teich-Alasia and G. Sferrazza considered assistance in specialized Centres, speaking respectively on "Bum facilities: our experience in the organization of a small Bums Unit", "Organization of a Centre for severely burned patients", and "Organization of a Bums Centre".
In accordance with the MBC's customary practice, the subject of "Fire Disaster" was amply dealt with. E. Cannata spoke on "Urban disaster", T. Corrigan on "Fire and bums in a public establishment", and L. Rosemberg recalled "The Bradford disaster".
With regard to the subject of Industrial Disasters, M. Masellis presented a videotape produced by the MBC entitled "Prevention of fire disasters in industry".
A. Eldad spoke on "War bums: epidemiology, trends, prophylaxis".
The topic "Management of Fire Disasters" was illustrated in its various aspects. Regarding medical rescue organization A. Eldad spoke on "Trainingthe hospital for the mass casualty event", J.A. Banuelos on "Medical rescue organization - our experience after two disasters". The problem of rescue services was considered by M. Fabbricatore, R. Guccione and M. Masellis, who presented an interesting paper entitled: "SIGOSEC: project for a computerized system for the optimal management of emergency aid in a catastrophe", by N. Salvato, who lectured on "Emergency: a hypothetical solution to an operative problem", and by A. Parisi and R. Guccione, who very competently described "An approach to psychological dynamics in the extensive bum patient. Notes for the work of a psychological support team in a bum disaster". The topic of fire disasters was concluded by two lessons on the coordination and planning of volunteer and other association, one by S.M. Costanzo on "Coordination and planning of volunteer groups in fire' disaster management", and the other by S. Asatinon on "The Italian Red Cross Voluntary Nurses Corps 'Auxiliary of the Armed Forces' in the management of burns disasters".
The course concluded with a series of lessons on a very topical subject: "Mass Information and International Support". F. Alfano gave an interesting lesson entitled "Analysis of the role of the mass media in their approach to bum accidents - Information and education for prevention". C. Nicolosi lectured on "Information in the event of fire disaster", and Y. Ayoub on "The role of the mass media in the field of bums". On the role of international organizations two up-to-date lessons were given by C.J. Romer, on "The role of WHO in disaster management", and by S.W.A. Gunn, President of the MBC, on "The international decade for natural disaster reduction".
A special keynote lecture, on "Chinese techniques for bum wound treatment", was given by Prof. Shi-Si-Xiang, Director of the Shanghai Bum Institute, Shanghai Second University, who was in Palermo to receive the 1989 G. Whitaker International Bums Prize.
Altogether participating in the course were 45 physicians, nurses, technicians, fire officers and civil defence workers from Algeria, France, Greece, Israel, Italy, Malta, Morocco, Syria, Tunisia and Turkey. All participants were issued with a certificate of attendance.
To conclude, the Course pin-pointed the state of the art in the sector of prevention, treatment and mobilization in bums. Fire disaster and its management were also considered in great detail in further discussions between the various teachers and between the teachers and the pupils attending the Course.