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Volume IV

Number 3

September 1991

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SUMMARIES

151 THE ORGANIZATION OF MEDICAL RELIEF IN NUCLEAR DISASTERS
(Magliacani G. - Italy)
Nuclear disasters are predictable and they can therefore be prepared for. The particular dangers of this type of technological accident are nuclear radiation and contamination. The various stages of relief are described, together with the general principles on which relief must be based. The importance of preparedness is stressed. New developments in information sciences have improved communication and allow link-ups between central operational headquarters, rescue teams and outlying hospitals. Ten basic principles of planning are listed.
155 PRIORITIES IN NURSING CARE ON ADMISSION OF A SEVERELY BURNED PATIENT A STUDY OF TWO CASES
(Palanque A.R. - France)
An account is given of the nursing of two burn patients, one the victim of an electrical bum, the other a would~be suicide with petrol burns. The various stages of nursing care are described in great detail. It is suggested that nurses involved in this kind of work should have the specific title of "specialized burns nurses.
159 PLACE DE LA MICROCHIRLIRGIE DANS LE TRAITEMENT DES BRULURES
(Baudet J. - France)
L'Auteur décrit les avantages et les inconvénients de la microchirurgie dans le traitement des brúlures. 11 consi&re d'abord les transferts microchirurgicaux dans les brúlures aigués, avee les problérnes au niveau du site receveur et du site donneur, et ensuite les transferts mierochirurgicaux pour les séquelles des brúlures. 11 conclut avec des observations sur les transferts a visée esthétique et fonctionnelle.
161 POST- BURN HETEROTOPIC JOINT OSSIFICATIONS
(Virbicky B. - Czechoslovakia)
In a 10-year period 3322 burn in-patients were treated. Out of this number 68 patients developed heterotopic joint ossifications - either symptomless or limiting joint movement extent in various degrees up to ankylosis. The present work attempts to determine: a) causes which could lead to heterotopic ossifications; b) clinical signs in the period, of presupposed heterotopic ossifications; c) methods for detecting heterotopic ossification maturity prior to planned resection.
165 LE ROLE INFIRMIER DANS UN CENTRE DE BRULES SERVICE DU PR. COSTAGLIOLA-TOULOUSE
(Bernaras F., Palanque A.R. - France)
Les soins infirmiers en France sont régis par les décrets du 12 Mai 1981 (article 1: definition de la fonction d'infirmiére) et du 17 Mai 1984 modifié par les décrets du 30 Aoét 1988 et du 8 Octobre 1989 (article 1: définition des soins infirmiers; articles I A 7 : actes et actions relevant de la compétence de l'infirmi&e). Le réle du soignant West donc plus le reflet d'un ensemble d'activités, il représente aujourd'hui une ligne de conduite, un ensemble d'attitudes, de comportements requis pour soigner. C'est sous cet angle-ld que nous aborderons les soins aux brOlés. Pour conclure cet expok, on présente le vécu d'une équipe au travers de son expérience.
171 SUSPENSION OF BURNED LIMBS USING TRANSOSSEOUS PINS, AS EXPERIENCED BY THE NURSE AND THE PATIENT
(Palanque A.R. - France)
An unusual and controversial technique is described in which burned limbs are suspended by means of transosseous pins. The technique can be used for circumferential bums, bums of the posterior aspect of the limbs and bums of the thighs, perineum and buttocks. The use of the technique is described in 9 patients, together with the implications for both the patient and the nurses involved in patient monitoring. A comparison is made between the advantages and disadvantages of the technique.
174 APPLICATION OF A NEW CICATRIZATION DRESSING IN TREATING SECOND-DEGREE BURNS AND DONOR SITES
(Reig A., Tejerina C., Codina J., Hidalgo J., Mirabet V. - Spain)
A study is made of 46 patients, 20 with second-degree bums and the remaining 26 with graft donor sites. A comparison was made between a number of patients who received a new cicatrization dressing (Varihesive Gel Control) with habitual treatment (Opsite wound), and the remaining patients of the series who received only Variliesive Gel Control. The treated zone was examined every 24 hours; the dressing was only changed where necessary, as the result of complications. Mean cicatrization time using Variliesive Gel Control was 7.4 days among the second-degree burn patients, and 7.1 days for the donor sites; patients subjected to the habitual treatment presented a mean cicatrization time of 14.3 days in the case of second-degree burns, and of 13.8 days for the donor sites. In addition, complications were fewer when Variliesive Gel Control was applied.
177 AN EPIDEMIOLOGIC STUDY OF GUNPOWDER WOUNDS
(Tejerina C., Reig A., Codina J., Herrero J., Mirabet V. - Spain)
A retrospective epidemiologic study was made of patients with gunpowder bums admitted to our Bum Centre between I January 1988 and I January 199 1. During this three-year period 5679 patients were treated; of these, 443 (7.8%) required hospitalization. Gunpowder was the cause of the burns in 39 cases (8.8%). Mean patient age was 21.6 years (range, 8-54); 64. 1 % were aged between I I and 20. Mean bum extent involved 13.8% of the total body surface, predominantly second-degree deep and third-degree burns being the most common association. The hands were the region most commonly affected (82%), either isolatedly or in association with wounds elsewhere. The months of March, August and September are the times of year of greatest folklore activity in our region, and lead to the highest incidence of gunpowder bums. Three patients (7.7%) died as a result of their bums.
180 PLASTIC SURGERY RE-EDUCATION IN SEVERELY BURNED PATIENTS: FROM SURVIVAL TO QUALITY OF LIFE
(Caleffi E., Bocchi A., Toschi S., Papadia F. - Italy)
In major burns, surgical procedures have a rehabilitative perspective in each therapeutic step: first, early debridenient and coverage of the burned areas are necessary for a quicker recovery and to reduce complications; improper early management ol'burned areas is still the main cause of scar contractures and disability. Subsequently, an appropriate surgical approach is often necessary to improve the functional outcome and social reintegration. In a complete therapeutic approach to the burned patient, each surgical operation must be associated with conservative treatment, i.e. nutritional, immunological support in the early phases, and physiatric devices in the post-acute phases. In this way surgical steps can be reduced and complete rehabilitation be more effective.
186 LES REMEDES NON CHIRURGICAUX POUR LA REEDUCATION DU GRAND BRULE DANS LES DIFFERENTS STADES CLINIQUES
(Bocchi A., Caleffi E., Casa B., Ferraro F., Montacchini G. - Italy)
Dans ce travail les Auteurs prennent en considération les moyens rééducatifs non-chirurgicaux dans le traitement du patient brúlé. Aprés avoir décrit la physiopathologie du processus cicatriciel et les déficits fonctionnels du systérne respiratoire et locomoteur, i1s présentent les moyens, les étapes et les modalités de l'action rééducative á partir de la phase aigué jusquá la réadaptation du patient dans son contexte social et familial. Pour terniiner les Auteurs rernarquent I'importance d'une approche multidisciplinaire et intégrée au patient brulé, pour les problérnes complexes qu'il presente.
192 LES ASPECTS ANATOMOPATHOLOGIOLIES DES SEOLIELLES DE BRULLIRE
(Derfoufi M., Belmahi A. - Maroc)
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