Annals of the MBC - vol. 3 - n' 1 -
INTERNATIONAL TRAINING COURSE MANAGEMENT OF BURNS
was held f rorn 5th to 9th June 1989
in PALERMO, ITALY
Organized by MBC
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
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
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
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
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
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
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
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
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
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.