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Volume V

Number 2

June 1992

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SUMMARIES

75 ELECTRICAL BURNS: A SURVEY OF 24 CASES
(Lochaitis A., Iliopoulou E., Poulikakos L.G., Asfour S. - Greece)
A study is made of a series of 24 patients who suffered low- and high-voltage electrical injuries during a 2-year period (1989-199 1). The complications and the methods of treatment are described. The strategy in the acute phase was that major traumas should never be closed or covered. Early coverage was feasible in minor injuries.
78 BRULURES ELECTRIOUES PAR ACCIDENT DU TRAVAIL A EDF: LINE REVUE DE 938 CAS SURVENUS DURANT LA DECENNIE 1980-1989
(Gourbiére E., Lambrozo J. - France)
Les auteurs présentent une ftude rétrospective de 938 cas de brélures électriques survenues parmi le personnel d'Eleetricité de France pendant une période de 10 ans. Les brélures &Iectriques représentent une faible part des accidents du travail A EDF mais elles se distinguent par leur gravité. Le taux de mortalité est de 2,9% et la fréquence des incapacit&s permanentes partielles parmi les surivivants est. é1evée (30,2%). Les causes habituelles des accidents sent des erreurs hurnaines.
86 ATRIAL FIBRILLATION FOLLOWING ELECTRICAL INJURY: A CASE REPORT
(Baruchin A.M., Reisin L., Basevich R. - Israel)
A case is reported of atrial fibrillation following electrical injury in a previously healthy 28-year-old man. After coming into contact with high-tension electrical current, the patient noted palpitation and electrical burns of his right upper extremity. An electrocardiographic diagnosis of atrial fibrillation was made in the emergency department. Although atrial fibrillation following electrical injury has rarely been reported in the literature, most cases of severe electrical injury probably warrant cardiac monitoring as a routine measure.
88 HYDROTHERAPY (BATH THERAPY) AS A TREATMENT OPTION IN BURNS
(Lochaitis A., Chalikitis S., Tzortzis C. - Greece)
Hydrotherapy means both immersion in a tub and showers in running warm water, provided these procedures contribute to the healing process. In our Department we use bath therapy starting on day 3-5 post-bum, when patients have overcome initial shock and their general condition has stabilized. In most cases nurses and physicians are present. The tub water is usually not salinized but sterilized, while ordinary (tap) water is used for showers. This study covering a total of 200 patients, over a period of 2 years (1989-1991), has the purpose of codifying the results of our long experience in this field, and stresses the adavantages and shortcomings of this method compared to other studies in the literature.
91 INFECTIONS IN BURN PATIENTS
(Reig A., Tejerina C., Codina J., Mirabet V. - Spain)
An epidemiological study is made of the infections in the 14é burn patients hospitalized in the Burn Center of La Fe Hospital (Valencia, Spain) in 1989. 5é (38.4%) patients suffered infection. Mean patient age was 32.1 years, and é2.5% were males. Mean hospital stay for the infected patients was 30 days. Mean bum extent was 22.3% TBSA. When burn extent exceeded 20% of the total surface, the infection rate increased to é5.3%. The association of deep second-degree and third-degree burns was predominantly related to infection. Electric current was the commonest aetiology associated with infection in these patients (55.5%). The burn bed was the most frequent direct cause of infection: alone or in association with other causes, it accounted for 89.2% of infections. Within the burn bed the most commonly isolated micro-organism in the first 24 hours was Staphylococcus epidermidis, with Staphylococcus aureus in the first week and Pseudomona aeruginosa after day 8. Of the 15 hospitalized patients who died in 1989, 9 had suffered infection; in 3% of cases infection was the cause of death.
96 HYDROCOLLOID DRESSINGS IN SMALL AND MEDIUM SPLIT-THICKNESS SKIN GRAFT DONOR SITES?
(Santamaria A.B., Oroz J., Pelay M.i., Castro J.A., Escudero F. - Spain)
There is currently little agreement among surgeons regarding the dressing of choice for split-thickness skin graft donor sites. This review examines experience in the treatment of 30 small and medium graft donor areas with a hydrocolloid dressing (COMFEEL (R)). The results show important advantages compared to traditional dressings.
100 THE TREATMENT OF EARLY AND LATE HAND CONTRACTURES FOLLOWING BURN INJURY (1978-1991)
(Antonopulos D., Danikas D., Dotsikas R, Nikolakopoulu G., Maurogiorgos C, Christophorou M. - Greece)
The results are presented of a retrospective study of various types of bums and scalds involving various levels of the hand and the digits. All cases from 1978 to 1991 were included. The patients were treated in a number of hospitals and private clinics in Greece. The causes of the contractures are evaluated, as also the type of primary treatment. Surgical correction of these complications was carried out with various techniques and splinting was necessary many times.
102 BURN SCAR CARCINOMA: CASE REPORTS AND REVIEW OF THE LITERATURE
(Xie Er-fan, Li A0 (Ngao), Wang Shi-liang, Kang Shao-yu, Cheng Guang-Xiu - People's Republic of China)
Marjolin's ulcer is defined as a malignant, ulcerating neoplasm occurring in cicatricial tissue, and is thought to be more aggressive than the other more common varieties of skin cancers. It has been reported in chronic scars of diverse origins. The following report describes two cases of burn scar carcinoma. A review is made of the literature pertaining to the mechanisms, paihological findings, clinical presentation, prognosis, prevention and treatment of this malignant degeneration of burn scars.
108 RECONSTRUCTIVE EVALUATIONS ON PLASTIC SURGERY FOR INJURIES AND MASSIVE TISSUE DEFECTS
(Belba G., Pepi G. - Albania)
The authors present their experience in the plastic surgical treatment of massive tissue injuries in the extremities. After a description of the results of 66 cases, the technical problems of treatment are discussed. Of special interest is the physiopathological division into three entities of the avulsed flap. The practical evaluation of flap vascularization creates premises for a more active surgical attitude, improving the general prognosis.
112 QUELLES SONT POUR NOUS LES TECHNIOUES OPERATOIRES LES PLUS ELECTIVES POUR LA RECONSTRUCTION D'UN DEFAUT CALCANEAIRE
(Belba G.J., Zhuka F, Pepi G. - Albania)
Par la présentation de trois cas cliniques, on discute sur les techniques opèratoires qu'on utilise pour la reconstruction ealcanèaire. En mettant 1'accent sur I'application des larnbeaux musculoècutanès les auteurs préentent en detail leurs indications.
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