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Volume VI |
Number 4 |
December 1993 |
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SUMMARIES
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ANALYSIS OF BURNED CHILDREN TREATED IN THE BURNS AND PLASTIC SURGERY CENTER, TRIPOLY LIBYA, IN THE YEAR 1992
(Zaidi M.M., Abusetta A., Brogowski K, Agrawal P.L., Franka M.R. - Libya)
Bum care in developing countries remains a challenge. A prospective study of 250 bumed children up to the age of 14 years admitted to the Bums and Plastic Surgery Center in Tripoli was carried out during the period 1-1-92 to 31-12-92. They were categorized into four age groups: 0-1 yr, 2-3 yr, 4-6 yr and 7-14 yr. In all age groups, scalding was the main cause of bum. In the same period, 1924 burned children were treated in our Out-patients Department. Admitted burned children represented about 48% of all bum patients admitted. Epidemiological data include age, sex, seasonal variation, family size, place of bum, time period between bum and admission to hospital, and the cause and mode of the bum. The relationships between mortality and age, cause of bum and extent of bum are discussed. The majority of bums occuffed in the home and in the presence of parents. Most of the bums occurred in the winter months from November to May. Most of the patients belonged to large families with more than three children. The male-female ratio in the age group 0-1 yr and 2-3 yr was 1.4: 1. There were 24 deaths (mortality rate 9.6%). The aim of this study is to implement an intense campaign to make parents aware of risk factors and to prevent them in order to reduce the number of bum accidents.
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| 224 |
EPIDEMIOLOGICAL ANALYSIS OF PATIENTS ADMITTED TO THE BURNS CENTRE IN VALENCIA DURING THE YEAR 1992
(Serna Ballester C., Terren Ruiz J., Pous Serrano S., Dolz Lago J.F., Calvo Medina V., Mirabet Ippolito V. - Spain)
We have performed a retrospective analysis of patients admitted to the Burns Centre of La Fe Hospital in Valencia (Spain) daring the year 1992 (152 cases, 110 men and 42 women). Regarding age, 38% of the patients were aged under 15 yr and 7.2% were over 60. The most frequent cause of burns was flame (49.3%), which caused both small and extensive wounds. The part of the body most frequently affected was the arm, so important in everyday work.
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| 229 |
HYPERCOAGULATION IN BURN PATIENTS - EFFICACY OF THROMBOEMBOLIC PROPHYLAXIS
(Arevalo Velasco A., Del Campo Balsa T, Gomez Bajo G.,* Cuesta Garcia V., Garcia Muhoz S., Lopez Pastor A., Fernandez-Chacon J.L., Fernandez-Pavon A., Garcia Torres V. - Spain)
Sixty-nine patients admitted to our hospital with bums, most commonly deep-dermal, of different extent and production mechanism were studied. Heparin prophylaxis was administered to all these patients, 18% with non-fractionated heparin (one dose every 12 hours) and 82% with low molecular weight heparin (Tedelparine-BoxoF). A coagulation study was performed on admission and 5, 10 and 30 days later. The results obtained support the existence of a state of hypercoagulation, due mainly to a decrease of antithrombin III to thrombogenic limits which tends to become normal as it evolves. We consider that this prophylaxis, administered even in the absence of thromboembolic disease, is positive.
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| 234 |
EFFICACY OF VARIOUS ALIMENTARY COMPOUNDS IN PROBE ENTERAL NUTRITION OF BURN PATIENTS
(Alexeev A.A., Saets T.L., Tarassov AN., Lavrov V.A., Melnikova TA. - Russia)
Alimentary compounds of natural homogenized products (Combustal, Russia) and mixtures of the formal diet group (Biosorbin-MCT Pfrimmer-Cabi/Germany and Fresubin/Germany) used for hyperalimentation of burn patients proved to be highly effective. The patients showed weight gain, decrease of tissue protein dissociation, inhibition of destructive processes, and activization of protein biosynthesis in the organism. In particular, Fresubin exerted a more pronounced influence upon activization of the anabolic processes; Combustal was more effective against dystrophic processes in muscle tissue; and Biosorbin/MCT drastically inhibited phospholipatic activity.
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| 240 |
TREATMENT OF SMALL DEEP DERMAL AND FULL-THICKNESS BURNS WITH A HYDROCOLLOID DRESSING
(Garcia Torres V., Gomez Bajo G., Herruzo Cabrera R. - Spain)
A study was undertaken to determine not only the effect of a hydrocolloid dressing on the healing of small deep dermal and full-thickness wounds but also its relation to other factors such as age, mechanism, localization and, especially, bacterial colonization/ infection. Fifty-five patients were studied in relation to subjective sensations (pain, discomfort, odour), epithelialization phenomena and relative rates, bacteriological surveillance by semiquantitative cultures, and sequelae.
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| 247 |
THE PHYSICOCHEMICAL CHARACTERISTICS OF KELOID COLLAGEN BEFORE AND AFTER CLINICAL TREATMENT WITH KENACORM A POLARIZING MICROSCOPICAL STUDY
(Chavrakov W., Mazgalova J. - Bulgaria)
Collagen structures of the keloids were studied by polarized light microscopy. The purpose of the investigation was to determine the histophysical characteristics of the collagenous fibrils before and after clinical treatment of keloids with Kenacort. The method of imbibition analysis was used. The total anisotropy of keloid collagen after the cure was measured and compared with the anisotropy of the collagen before treatment. An assessment of the rate of collagen rehydration was made by using total birefringence rates. It was found that the rate of collagen rehydration was faster in the group of treated keloids than in untreated lesions. Data for the histophysical state of the collagen were established. It is suggested that the variation of collagen rehydration could be explained by the alterations in the mucopolysaccharides of the ground substance. Two hypotheses for the explanation are put forward.
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| 253 |
EXPANSION TISSULAIRE ET REHABILITATION DES SEQUELLES DE BRULURES DE LA TETE ET DU COU
(Castide J.C., Ballanger A. - France)
Les auteurs décrivent la technique de l'expansion tissulaire et de la réhabilitation des séquelles de brûlures de la tête et du cou. En particulier ils prennent en considération les résultats obtenus chez 42 patients qui ont reçu 67 prothèses mises en place pour la reconstruction de la tête ou du cou. La moitié des patients présentaient des cicatrices du visage et du cou, plus du tiers présentaient une alopécie, trois patients ont bénificié d'une reconstruction complexe pour otoplastie et un patient pour rhinopoïèse. Les diverses prothèses sont décrites (forme et volume) et la technique opératoire. Enfin, les résultats sont présenteés, avec les rares complications: hématomes (3 cas), désunions mineures (6 cas). La reconstruction des séquelles de brûlure de la région cervico-céphalique à l'aide de l'expansion cutanée s'est révélée très positive et d'une grande utilité et les résultats sont favorables et bénéfiques à long terme.
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| 257 |
LES CICATRICES HYPERTROPHIQUES ET CHELOIDES DANS LES BRULURES: TRAITEMENT CHIRURGICAL
(Caleffi E, Bocchi A., Montacchini G., Papadia F. - Italy)
Les auteurs prennent en considération la formation et le traitement chirurgical de la cicatrice pathologique, qui est la complication la plus grave chez le patient brûlé. Ils décrivent les techniques chirurgicales - plastie en "Z", les greffes cutanées et les lambeaux - pour l'éliminer. L'expansion cutanée est très utile pour le chirurgien parce que cette méthode lui permet de disposer d'une quantité de peau suffisante de la même texture et coloration.
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| 264 |
THE CORRECTION OF THE INGUINAL-ABDOMINAL-GENITAL CONTRACTURE, WITH A CASE DESCRIPTION
(Belba GA - Albania)
Through the description of a case with inguinal, abdominal and genital contracture, the author discusses the role and function of cutaneous triangles, emphasizing their importance when the pathology involves some entire regions.
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| 267 |
LES PROBLEMES POSES PAR LE FRANCHISSEMENT DES FRONTIERES PAR DES PATIENTS ANONYMES LORS DE CATASTROPHES DE GRANDE AMPLEUR
(Fonrouge J.M. - France)
Dans le monde moderne l'homme a introduit un nombre considérable de facteurs de danger difficiles à contrôler qui peuvent exposer de plus en plus les populations aux effets néfastes d'incidents ou d'accidents technologiques, avec la possibilité d'un grand numéro de victimes qui poseraient un problème immédiat de prise en charge dans un seul pays. Une solution de ce problème consiste à transporter les victimes vers des Centres spécialisés des pays voisins. L'auteur considère les aspects juridiques du sujet et propose des solutions pour faciliter le franchissement des frontières par des patients anonymes victimes des catastrophes de grande ampleur. La complexité des divers problèmes montre combien les dispositions juridiques doivent être étudiées afin de permettre une organisation des secours adaptée face aux grandes catastrophes.
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