|
 |
Volume IV |
Number 4 |
December 1991 |
|
|
SUMMARIES
| 215 |
THERMAL AGENT DISASTER AND BURN DISASTER: DEFINITION, DAMAGE, ASSESSMENT AND RELIEF OPERATION
(Masellis M., Gunn S.W.A. - Italy)
A distinction is made between thermal agent disasters and bum disasters, and their respective consequences. The management of each kind of disaster is described. Operative proposals are made, and the phases of immediate care, first aid and organized relief are considered. It is stressed that it is important to organize specific training programmes for persons of all levels and for physicians and paramedical staff. It is also important to prepare mobilization plans for specific means and structures.
|
| 219 |
BURNS AS A RESULT OF VIOLENCE AND SELF-INFLICTED INJURY
(Lochaitis A., ]liopoulou E, Parker J.M., Poniros N., Panayiotaki D. - Greece)
The relationship between accidental bums and those resulting from acts of violence has so far interested the medical world almost exclusively when the number of victims was large, as in the Circus Niteroi fire in Brazil in 1965, the fire in Los Alfaques in 1978 with 210 victims, or when it has been the result of terrorist action (Cooper et al. 1983), such as the bomb incidents in Northern Ireland and Great Britain. The relationship between accidental and self-inflicted bums has been well documented in psychiatric literature (Jacobsen et al., 1984; Snaith, 1987), where the emphasis was naturally on the state of the patient prior to the attempt rather than on the effect of the type and course of the bum. In this paper an epidemiological analysis of these two groups of bums is presented as encountered in our unit. Factors recorded and taken into consideration were as follows: age, sex, family status, financial status, educational level, medical history, the reason and cause of the bum, its extent, depth and location as well as treatment and complications. The outcome and social problems appearing during the burn course were also considered as well as several points of interest arising from the comparison of the two groups.
|
| 222 |
BRULURE PAR ACIDE SULFURIOUE ET VITRIOLAGE: DEUX LESIONS POUR UN MEME PRODUIT
(Bodnar M., RougO R., Grolleau J.L., Conil J.M., Laguerre L., Favarel H., Brouchet A., Nicoulet B., Micheau R., Gavroy J.P., Costagliola M. - France)
Les auteurs décrivent cinq cas de brûlure par acide sulfurique. Ils prennent en considération le mécanisme lésionnel de l'acide sulfurique et les complications qui peuvent se produire. Ils concluent en proposant des traitements.
|
| 226 |
TRACHEOTOMIE CHEZ LE GRAND BRULE: 4 ANNEES D'EXPERIENCE
(Favarel H., Laguerre J., Conil J.M., Rougé R., Bouchet A., Costagliola M. - France)
Chez le grand brûlé, nécessitant une assistance respiratoire prolongée, notre stratégie thérapeutique privilégie la trachéotomie même en zone brûlée. Cette étude reprend 45 cas et analyse les indications et les complications immédiates et secondaires selon que la trachéotomie est effectuée en zone brûlée ou non brûlée, en les comparant aux données de la littérature. Devant l'absence de différence significative entre les deux séries et le faible taux de complications, les auteurs considèrent que la brûlure cervicale n'est pas un obstacle à la trachéotomie.
|
| 234 |
TREATMENT OF DONOR SITES OF SKIN GRAFTS OF PARTIAL THICKNESS WITH HYDROCOLLOID DRESSINGS
(Valero J., Comellas M., Alvarez A., Badran J., Vazquez Barro A., Moledo E. - Spain)
In this paper we report our experience with the use of a hydrocolloid dressing. The healing time that attributed to classical treatments and comfort and handling were good. The most important drawbacks we found were the post-operative exudate leak and the bad appearance and smell of the wound until the site is cleaned. We believe that the dressing tested is useful in treating the donor sites of skin grafts.
|
| 238 |
OUR EXPERIENCE WITH A HYROCOLLOID DRESSING (COMFEEL) IN THE MANAGEMENT OF DONOR SITES
(De La Cruz-Ferrer L.I., Mena-Yago A., Benito-Ruiz J., Baena-Montilla P., Navarro-Monzonis A., Chamorro-Hernandez J.J. - Spain)
A trial was made of the new dressing Comfee~' on 100 skin donor sites. The following parameters were evaluated: epithelialization time, pain, case of use, and complications. Comfeel was found to be very satisfactory as it reduced epithelialization time, was comfortable for the patient, and required few dressing changes. The slight extra expense was outweighed by the advantages.
|
| 243 |
EVALUATION OF EMPIRICAL ANTIBIOTIC TREATMENT IN SEPSIS IN THE BURN PATIENT WITH CEPTAZIDIME-AMINOGLYCOSIDE ASSOCIATION
(Lenguas F., Herruzo R., Pintado R., Denia R., Mariscal F., Silva MJ. - Spain)
An empiric antibiotic treatment was made with th i rd-gene ration cephalosporins (ceptazidime-aminoglycoside), in 18 critical burns patients with clinical sepsis without bacteriological confirmation; the evaluation of plasmatic levels and M.I.C. (minimum inhibitory concentration) of ceptazidime was made. The successes and failures of the this dual antibiotic treatment, the high incidence of sepsis by Staphylococcus epidermidis in relation to Pseudomonas aerugmosa (20%), and the selection of resistances to aminoglycosides and beta-lactam antibiotics were discussed. We recommend treatment with aminoglycoside-vancomycin antibiotic in the case of existence of sepsis without bacteriological confirmation.
|
| 248 |
THE TREATMENT OF TIBIAL OSTEOMYELITIS FOLLOWING BURN INJURIES
(Gabilondo F.J., Torrero J.V., Llop M. - Spain)
The tibial osteomyelitis, underlying ulcers of the lower third of the leg in serious bums cases poses, after survival of the acute episode, a two-sided problem: (i) the cleansing of the bone of the affected and isolated zone which is the cause and location of the osteomyelitis, resistant to conventional treatment, and (ii) the covering of the ulcer in a zone which with difficulty provides soft parts, aggravated by the fact that the extremities are covered with grafts in patients with bad cutaneous covering and few donor zones. This accumulation of circumstances can be resolved by providing a cutaneous covering of good quality with its own vascularization from another area which closes the defect, not only of the ulcer but also of the larger zone of the cleansing of the bone in the alIceted area. To do this, we used a free skin flap with its vascular pedicle connected to the posterior tibial artery outside the zone of the pathology.
|
| 251 |
TUMOURS OF THE UPPER LIMB AND BURN SCARS. CASE REPORTS
(Napoli B., D'Arpa N., Conte F., Masellis M. - Italy)
After a brief description of the actiopathogenesis of carcinoma occurring in burn scars, some such cases are presented that were observed in the upper limb. It is concluded that these tumours can be avoided by preventive treatment of unstable scars.
|
| 255 |
TWO SEVERE FACIAL BURN SCAR PATIENTS WITH LAGOPHTHALMOS LEFT UNTREATED OVER A LONG PERIOD OF TIME
(Yano K., Hata Y. - Japan)
Two cases are described of patients with bum lagophthalmos left untreated for a long period. Skin grafting was performed in both cases and the results are described.
|
|