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Volume V |
Number 1 |
March 1992 |
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SUMMARIES
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THE INFLUENCE OF THE ANCIENT MEDITERRANEAN CIVILIZATION ON THE DEVELOPMENT OF HUMAN CULTURES
(Poiycratis G.S. - Greece)
An account is given of the contributions made to Mediterranean culture by all the peoples that have populated the various countries, at different moments of history.
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EPIDEMIOLOGIE DES BRULURES DE L'ENFANT EN MILIEU TOGOLAIS
(Ahouangbevi A., James K., Ayite A. - Togo)
L'étude retrospective de 1285 dossiers d'enfants de 0 A 15 ans, soign&s dans le service des brélés A Lomé (Togo) de 1980 a 1989, a permis de savoir que: les brOlures de 1'enfant sont tr&s fréquentes en milieu africain; le sexe masculin (5é,7% des cas) est plus atteint que le sexe féminin (43,3% des cas); les brfilures thermiques sont de loin les plus fréquentes, avec plus de 9é% des cas; on ne note pas de brfilures chimiques ni electriques, bien que 42% de nos brul&s proviennent de la zone urbaine de Lomé; les brOlures sont souvent du second degre superficiel et peu kenclues; la guérison est souvent rapide par exposition A I'air des surfaces brulées; la prévention de ces brélures passe par lWucation des m&res surtout dans les zones rurales de notre pays.
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EPIDEMIOLOGY AND PREVENTION OF BURNS AT GERIATRIC AGE
(D'Arpa N., Napoli B., Masellis M. - Italy)
With a view to prevention, an investigation was made of the circumstances, the modalities and the lesive agents responsible for burns to elderly patients admitted to hospital during the period 1975-1991. The factors to be considered in the preparation of a prevention campaign are indicated and suggestions are given as to how the campaign can be developed.
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BURNS IN CHILDHOOD - A TEN-YEAR EXPERIENCE IN MANAGEMENT
(Tryfonas G., Gavopoulos S., Limas C., Z¡outis l., Violaki A., Klokkaris A., Fragos E., Grigoriadis G. - Greece)
During the period from 1981-1990, 281 patients were hospitalized in our clinic, 174 males and 107 females. The age ranged from 2 days to 14 years. In 72% of cases the bums were of second degree and in 28% they were of third degree. The patients were divided into two groups, according to age and burned area. The method of choice was the undressed one. Autografts were used in 76 cases. Homografts, after histocompatibility determination, were used in 4 cases because of the extensive burned area (60-75%). There were 3 deaths and the mean in-patient time was 28 days.
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COMPARATIVE STUDY OF BURN PATIENTS AFTER TREATMENT WITH MORE AGGRESSIVE SURGICAL TECHNIOUES IN WOUND CARE
(Luengo Matos S., Herruzo Cabrera R., Garcia Torres V., Fernandez Arjona M., Rey Calero J. - Spain)
All 1367 patients admitted to a Bums Centre during the period 1971-1986 were considered retrospectively on the basis of the treatment administered in two sub-periods, before and after January 1982, when modifications in therapy were introduced (more aggressive surgery, more antibiotic prophylaxis, more parenteral feeding, different topical treatment). The comparison between the results showed better evolution of the bum disease in the second sub-period, as measured by a number of parameters.
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GRAND BRULE: OLIELLE PLACE RESTE-T- IL A L'HOMOGREFFE CUTANEE EN 1991?
(Micheau Ph., RougLé R, Bodnar M., Conil J.M., Laguerre L., Calot JR, Favarel H., Brouchet A., Gaudy E, Costagliola M. - France)
En un an et demi 142 brélés ont Repris en charge par le centre des brfilés de Toulouse. 17 dentre eux ont bénéfici& d'une couverture par homogreffe cutan&e conserv&e cadavérique. Cette population est définie: pour 10 d'entre eux, il s'agit de sujets jeunes, grands brélés (U BS > 150). "L'excision-homogreffe" vaste ( > 20% surface), pr&coce (avant J5), répétée (2 è 5 fois en 15 jours) vise A obtervir, d&s la 3e semaine, un recouvrement total. Les autogreffes - conjointes ou secondaires - permettent d'obtenir une couverture totale dans le 21 ou 31 mois. Pour 7 d'entre eux, il s'agit de bt-é1és de surface réduite (10 A 30%) mais de "malades a risque", Agés (5 avaient plus de 70 ans), on infectés, dénutris, vus tardivement (2 d'entre eux ont été requs au-delA de la k semaine). Chez ces brWs une couverture temporaire de 2 sernaines par homogreffes a permis de transformer état local et général autorisant une autogreffe secondaire. Les "tests" d'efficacité de cette stratégie chirurgicale sont représentés par la stabilité clinique, biologique, et surtout par I'abaissement de la mortalité (2 morts sur les 7 morts "attendus"). L'homogreffe garde en 1991, dans notre pratique, une place privilégiée, irremplaqable, dans toutes les situations locales difficiles voire insolubles chez le grand bré1é.
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ELECTRICAL BURNS IN SOUTH-WEST GREECE - EXPERIENCE IN THE LAST THREE YEARS
(Christoforou M., Antonopoulos D., Danikas D., Nikolakopoulou G., Dotsikas R., Maurogiorgos C., Vasiliou D., Partheni W., Skarpetas D. - Greece)
Over a period of 3 years, 21 patients aged 2-75 years with various types of electrical burns were admitted and treated as -emergenties in the Department of Plastic and Reconstructive Surgery at St. Andrew's General Hospital in Patras, Greece. Ten patients developed complications in the cardiovascular, renal and central nervous systems. The various steps of treatment, in collaboration with other specialities in our hospital, and the reconstructive procedures are presented.
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CIRCUMFERENTIAL ELECTRIC BURNS OF THE RING FINGER
(Baruchin A.M. - Israel)
Two patients sustained circumferential burns to the fingers associated with metal rings. In both cases the patients sustained a deep partial -thickness burn when their rings shorted the battery of a vehicle. Our treatment regimen was entirely on an out-patient basis and consisted of multiple daily washing, instruction in home physical therapy, and repeated clinical examinations.
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HISTOPATHOLOGICAL CHANCES IN THE EXPANDED HUMAN SCALP
(Hegazy M., Shalby H.A., El-Khalifa M., Ayad H., Ghoraba H. - Egypt)
Histopathological changes of the expanded human scalp in 10 children aged 2.5 - 12 years old are described. A correlation of the clinical observations during and after the procedure of expansion with the histological changes is reported. These changes were found to be present up to six months after removal of the expanders. Long-term studies, up to two years, are recommended to evaluate the effect of expansion on the histology and functions of the scalp.
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POUR UNE APPROCHE PSYCHOLOGIOUE DES SOINS AUX PATIENTS BRULES
(Beren¡-Marzouk B. - France)
Brulure et brfflé dépendent étroitement des concepts qui président aux objectifs des services et de la faqon dont les soins sont compris par ceux qui les dispensent autant que par ceux qui les recoivent. Les pertes psychiques et la valeur éminernment compensatoire des soins et de I'hospitalisation sont des étapes déstructurantes/strUcturantes que le braIé traverse cornme autant d'épreuves dont it peut sortir différent mais plus fort, ou alors différent mais arnoindri. C'est pourquoi il nous sernble pertinent que les équipes soient en mesure d'étre autant d 1'écoute de leurs propres limites qu'A celles des patients dont elles prennent soin. Dans un cadre aussi extra-ordinaire que Fhospitatisation pour brOlures graves, on doit mesurer l'importance des enjeux d'une stratégie d'accompagnement psychologique du patient et des équipes.
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STRUCTURAL ASPECTS IN A BURN UNIT: PROPOSAL OF EXPANDING MODELS
(Magliacani C., Teich Alasia S., Bormioli M., Stella M., Musci F., Holmes J. - Italy)
This article reviews criteria for the construction of Bum Centres, with particular regard to the prevention and control of infection. The functional distribution of space within the hospital building and the types and characteristics of air-conditioning systems are analysed in detail. It is pointed out in the conclusion that, apart from structural criteria and surgical and nutritional treatment, the conscientious respect of hygiene norms is of the highest importance.
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THE SCIENTIFIC BASIS OF DISASTER MEDICINE
(Gunn S.W.A., Masellis M. - Italy)
A new discipline needs a sound scientific base, technical underpinning, proper conceptual framework and organized management. In disaster medicine all the medical and multisectoral aspects of emergency management are essential if disaster preparedness and response are to be more efficient and more effective. The authors outline 10 principles as a scientific base to the newly evolving discipline of disaster medicine.
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