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Volume III |
Number 2 |
June 1990 |
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SUMMARIES
| 75 |
THE USE OF SALICYLATE VASELINE IN THE DEBRIDEMENT OF BURNS
(Maviglio R, Mavilio D., De Donno G., Rume D. - Italy)
Although surgical escharectomy is the generally accepted method of choice for the elimination of bum eschars, particular conditions may exist when this technique is not possible. It is therefore necessary, in order to avoid the risk of septic complications, to remove the eschar by other means. Salicylate vaseline was used for this purpose in over 500 patients over a period of 15 years with good results. This ointment has no limitations, and it also has the advantage of being easy to apply, apart from being inexpensive and easy to prepare.
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| 79 |
SEPARATION OF THE ESCHAR
(Dayoub A. - Syria)
The are two main ways of removing the eschar that forms after third-degree bums: spontaneous separation (including removal by medication) and surgical separation. Both methods are equally valid in clinical practice, and neither is to be preferred to the other as a matte r of principle. The two techniques are described.
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| 84 |
FOREARM FASCIOCUTANEOUS FLAPS FOR COVERAGE OF DEFECTS AROUND THE ELBOW
(Osman OR, Houtah A.M. - Egypt)
This work details our experience in 9 patients with contracted elbow, for reconstruction of the defects after release of bum cicatrix, utilizing a proximally based forearm fasciocutaneous flap. The results were promising, with regain of full range of movements in a short post-operative period.
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| 87 |
LES SÉOUELLES DE LA BROLURE: SIGNE INEFFAÇABLE DU PASSAGE DE LA MALADIE SUR LE CORPS ET SUR LA PERSONNE
(Mosca K., Amico W., Masellis M. - Italy)
Dans la civilisation technologique occidentale l'image du corps est construite par rapport à la culture d'origine et à la conception de l'homme caractéristique de cette civilisation. L'idée de la beauté dans le monde occidental se heur-te à l'oeuvre du chirurgien plastique pour ce qui concerne la correction des séquelles des brûlures. La maladie "brûlure" en général et les séquelles des brûlures en particulier créent un nouveau rapport entre corps et culture. En effet, dans notre civilisation il semble difficile d'accepter n'importe quelle division entre corps et culture, parce que les imperfections bouleversent l'équilibre construit entre les deux parts. La découverte d'une nouvelle expressivité du corps qui puisse aussi embrasser l'imperfection c'est une condition essentielle pour la création d'une nouvelle culture de la corporéité que l'on peut utiliser pour exprimer les potentialités du corps non seulement esthétiques mais aussi éthiques.
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| 90 |
POUR UNE RÉPARATION PRÉCOCE DES BRÛLURES ÉLECTRIOUES: INTÉRÊT DU CONCEPT DE LESIONS TISSULAIRES EXTENSIVES
(Rouge D., Escourrou G., Laguerre J., Conil J.M., Micheau Ph., Laffitte F., Chavoin J.P., Costagliola M. - France)
Sur la base d'une étude retrospective des cas de brûlures électro-thermiques traitées dans une Unité des Grands Brûlés sur une période de 4 ans, les Auteurs ont mené une étude prospective pour tenter de mieux cerner les lésions provoquées par ce type de brûlure. Ils décrivent les six patients inclus dans l'étude, avec le protocole chirurgical et le protocole anatomo-pathologique, et les résultats. Ils ont trouvé qu'une meilleure définition lésionelle de la brûlure électrique permet de comprendre que c'est une lésion constituée de deux parties, une nécrose centrale tissulaire définitive et un halo ischémique évolutif périphérique à cette nécrose possédant un grading de lésions vasculaires dégressif. Le traitement dépend du caractère de ces lésions.
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| 95 |
TOLERANCE AND COMPLICATIONS OF EARLY ENTERAL NUTRITION IN BURNS
(loannovich J., Llakakos Th., Panayotou P., Mantas N., Alexakis D. - Greece)
Total enteral nutrition (TEN) following bum injuries has been used in clinical practice only in the past two years, and there is still some scepticism about its validity. It is widely believed that TEN should commence only after the 3rd day post-burn, because of the danger of paralytic ileus. A study was carried out to evaluate the tolerance of early TEN after bum lesions and to investigate its clinical and biochemical side effects. In three groups of patients (total number 13, average age 45 yrs, T13SA 20-75%), TEN was initiated respectively in the first hours post-burn, on the first day post-burn, and between the 2nd and the 5th day post-bum. The results obtained showed that TEN was satisfactorily tolerated, without major gastric or intestinal side effects or irreversible side etTects on the hepatic tissue. All side effects were mild and were resolved without difficulty. Morbidity was low because of the improvement in the patients' general conditions, the absence of upper G.I. tract bleeding and the reduction in septicaemia. Mortality was also significantly reduced. The TEN technique can therefore be said to be well tolerated, irrespective of the time of its initiation.
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| 100 |
MICROSURGICAL TREATMENT IN ACUTE BURNS AND THEIR SEQUELAE
(Lorenzini M., Cristofoli C., Governa M., Rigotti G., Barisoni D. - Italy)
The development of microsurgery techniques over the past years has enabled us to obtain striking results in difficult cases which were not easily treated years ago. In burns therapy microsurgery has introduced a new philosophy of therapeutical approach, both in the acute phase and in the treatment of sequelae. The Authors present the experience of the Verona Burns Centre, Italy, with these innovative techniques, showing possible applications and describing cases. The results are excellent, but it is stressed that the patients have to be carefully selected. An analysis is made of the advantages that these methods can ofFer in comparison to traditional techniques.
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| 104 |
FOREST FIRES: TYPOLOGY, PREVENTION, AND PROTECTION OF FIRE-FIGHTERS
(Bovio G. - Italy)
After a brief introduction that underlines the extent and gravity of the problem of forest fires, a description is made of the kinds of forest fires that may actually occur in the Mediterranean area. The nature of the particular forest environment is closely related to the characteristics of the fire-front. Precautions to control the fire involve environmental modifications that must be planned with a view both to maximizing the possibilities of extinction and to guaranteeing the safety of the fire-fighting squads. A distinction is made between the kind of fire that can be attacked directly and indirectly. Particular reference is made to firebreaks, where fire-fighting squads can take up their positions. An account is given of the temperatures that have to be faced in the vicinity of the fire, as also of the protective clothing that must be worn. If adequate safety is to be guaranteed many dangers have to be considered, the most serious of which is burns.
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| 109 |
THE ROLE OF THE PORTUGUESE AIR FORCE IN CIVIL DEFENCE
(Dias J.M.E. - Portugal)
After some general observations about how the Armed Forces may be useful in the event of a fire disaster, the specific role of the Portuguese Air Force is described. Detailed recommendations are made regarding evacuation of burn patients by air.
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| 112 |
THE MANAGEMENT OF BURN INJURIES IN MASS CASUALTIES
(Reda Mabrouk AM. - Cairo)
Suggestions are made for the management of bum injuries in the event of mass casualties. The causes of mass burns are considered and methods for sorting described, together with progressive steps in therapy. The experience of an actual occurrence of mass bums casualties is recorded. This was result of a military engagement, and the main cause of the bums was napalm.
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| 114 |
EARLY NEUROLOGICAL COMPLICATIONS IN ELECTRICAL BURNS
(Haberal M., Bayraktar U., OztOrk S., Oner 1, Bilgin N. - Turkey)
It was observed that high-tension electrical burns rnay cause major damage to the neural system, even in the absence of severe tissue injury. A description is given of three such patients, who suffered variously from loss of sensation, myelopathy, a paraplegia-like syndrome and neuropraxia. It is therefore advisable to perform a thorough neurological examination in patients with electrical burns, even if they do not present severe tissue injury, in order to prevent later complications.
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| 116 |
STATISTICAL AND EPIDEMIOLOGICAL DATA OF 800 BURN PATIENTS IN A S-YEAR PERIOD
(lliopoulou E, Lohaitis A., Poulikakos L., Bei A., - Greece)
This study is an analysis of statistical and epidemiological data in a series of 800 bum patients hospitalized in the period 1983-1987. The parameters recorded and studied were: 1) number of admissions; 2) classification according to sex, age, extent and thickness of burns and causative agent; 3) outcome of the burn disease, as well as the mortality rate in various groups, depending on the extent of the burn and the age of patients. The results stress that male burn patients outnumber female by 2.11, despite women's slight preponderance in the general population (1:1.03), and that the largest group of patients comprises those with minor bums (290 patients with 10%. 292 with 20% T13SA) and who are comparatively younger (103 cases in the group of 20-30 years, 166 cases in the group of 30-40 years). The data coincide with those presented by loannovich and al., excluding the fact that our Department treats patients over 15 years of age. The mortality rate has decreased in all groups, but is still no less than 11.7%. The ratio of men to women who died of burns was L4: 1.
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