About MBC
Mission, board, constitution, and activities of the Euro-Mediterranean Council for Burns and Fire Disasters
WHO Collaborating Centre
Since 1995 MBC has been an official WHO Collaborating Centre
NGO in Consultative Status of UN
MBC is NGO in Special Consultative Status with ECoSoC
International scientific participation
Meetings, conferences and symposia
Invitation for membership
Subscription and membership welcome
Contact us
For further information about the Council
Links
Sites of interest for Council
activities
linea_nera.jpg (4653 byte)

Volume XXXVII

Number 1

March 2024
linea_nera.jpg (4653 byte)

Summaries

3 STUDY OF THE RELATIONSHIP BETWEEN PATIENT DEMO- GRAPHICS, BURN ETIOLOGY, AND THE INCIDENCE OF BURN WOUND INFECTION IN TANTA UNIVERSITY BURN UNIT
(Sadaka M.S., Abdeldaim D.E.)
Burns are a worldwide major cause of injury. Burns result in damage to the skin and other organs, leading to open wounds, severe emotional and psychological complications, disability, and economic burden. In this article, we report our study of the relationship between patient demographics, burn etiology, and the incidence of burn wound infection. This study was conducted on 110 cases who presented with acute burns at the Burn Unit of the Plastic and Reconstructive Surgery Department at Tanta University Hospital, Egypt, in the period from January 2019 to January 2021. A prospective study was conducted, and the collected data were statistically analyzed regarding the different relationships between patient demographics, burn etiology, and the incidence of burn wound infection. In our study, most indoor burn injuries were scalds, most of which were accidental, while outdoor burns were mostly flame burns. Most burns in the 0-10 years age group were scalds, while in the other age groups, burns were mostly of the flame type. Females had significantly more frequent scald burns. The most important statistically significant prognostic risk factors for burn wound infection are TBSA of burn, depth of burn wound, and length of hospital stay.
10 AN ASSESSMENT OF THE FIRE SAFETY STANDARDS IN IRANIAN HOMES AND EQUIPMENT AS THEY RELATE TO FIRE ACCIDENTS
(Bagheri T., Forghani S.F., Hoveidamanesh S., Asgari M., Mahboubi O., Momeni M.)
Fire accidents and burns are one of the leading causes of death and disability worldwide. This study was conducted with the aim of studying the etiology of fire accidents as well as investigating the fire safety standards of both homes and equipment in Iran. Samples included patients with flame burns who consented to answer the questions. Questions covered five areas: patient demographics, epidemiological characteristics of burns, the fire safety status of the home, the fire safety status of the equipment, and the mechanism of the accident. In this study, the mean extent of the burns was 18.07 ± 14.29% of body surface area and was significantly related to the age grouping of the patients. The highest total body surface area (TBSA) was observed in patients between 19 to 39 years. The most common cause of flame injuries was gas explosions (36.81%). The interviews revealed that most of the houses were not equipped with smoke detectors or fire extinguishers. The extent of burns was significantly higher in patients living in unequipped homes (P = 0.047). Cooking equipment was often involved in the accidents (38.1%). Considering the low home fire safety and the role of equipment misuse and damaged equipment use in the occurrence of accidents, it seems that installing fire alarms and firefighting equipment, proper training on how to work with and maintain the equipment, using cooking and heating equipment correctly along with discontinuing use if damaged would all be effective and are highly suggestive to reduce fire injuries.
17 PEDIATRIC BURNS IN UNIVERSITY CLINICAL CENTRE OF KOSOVO FROM 2011-2015
(Duci SB, Bektashi EM, Zatriqi VK, Buja ZA, Hoxha ET, Rrusta DA)

The objective of this study was to describe the epidemiology of burn-related injuries in children <15 years in Kosovo, and compare incidence and cause of burns with our previous study conducted over the period 2005-2010 on children with burn injuries of the same age group. This was a retrospective study of pediatric patients (n=277) admitted to the University Clinical Centre of Kosovo between 1 January 2011 and 31 December 2015. We analyzed data on gender, age, cause, location, burn size (TBSA), depth of injury, seasonality, duration of hospitalization and treatment of burn-related injuries, collected from the medical records available in the archives of the University Clinical Centre of Pristina. The patients were categorized into three age groups: infants and toddlers (0-2 years), early childhood (3-6 years) and late childhood (7-15 years). Data were analyzed applying descriptive statistics, Chi-square. P-values less than 0.05 were considered significant. During the study period 2011-2015, in our population, burns in children were predominant in boys, with 166 cases (59.9%), while 111 patients were girls (40.1%). The incidence of extensive burns in childhood remains high, although we have seen a slight decrease compared to the previous 5-year study period.

23 BRÛLURES CHEZ LE DIABÉTIQUE: ÉTUDE ÉPIDÉMIOLOGIQUE, CLINIQUE ET PRONOSTIQUE
(Hachicha S., Mokline A., Ghedira S., Rahmouni M., Fraj H., Ben Saad M., Messadi A-A.)
Les brûlures sont fréquentes chez le diabétique et sont aggravées par les conséquences des complications spécifiques sur la cicatrisation et l’infection. L’objectif de cette étude est de décrire les caractéristiques des brûlures chez les diabétiques hospitalisés dans le service de réanimation des brûlés de Tunis durant 18 mois. Durant la période d’étude, 891 patients ont été hospitalisés dont 43 diabétiques (5%). L’âge moyen de nos patients était de 57 ans, avec une prédominance masculine (65%). Il s’agissait d’un diabète de type 2 dans 86% des cas et d’un diabète de type 1 dans 14% des cas. Des complications dégénératives ont été rapportées dans 10 cas (23%) à type de rétinopathie diabétique (n=6), de néphropathie diabétique (n=4) et de neuropathie diabétique (n=6). Les circonstances de brûlure étaient en rapport avec un accident domestique dans 2/3 des cas (76,7%). Il s’agissait de brûlures thermiques dans 83,7% des cas. Quatrevingt - six pour cent des patients ont décompensé leur diabète durant leur hospitalisation. Un sepsis a émaillé le cours évolutif des patients dans 55,8% des cas. Il ressort de cette étude que les facteurs de mauvais pronostic étaient : une hémoglobine glyquée >13%, une étendue des brûlures supérieure à 20% et un délai de consultation supérieur à 6 heures. La mortalité était de 18,6%
35 THE COMBINATION OF STROMAL VASCULAR FRACTION CELLS AND PLATELET-RICH PLASMA INCREASES FIBROBLAST GROWTH FACTOR 2 AND INSULIN-LIKE GROWTH FACTOR 1 IN FULL-THICKNESS BURNS IN ANIMAL MODEL
(Josh F., Soekamto T.H., Windura C.A., Lumalessil D.G.)
The previous study on the injection of SVFs in combination with PRP showed positive effect on the healing of deep dermal burns. We now seek to understand the effect on full thickness burns, as assessed by changes in serum FGF2, IGF1, epithelialization, and fibroblast count. Forty-eight Wistar rats were randomly divided into four groups: (1) rats with full thickness burns given a local injection of combined SVFs and PRP; (2) rats with burns given topical Vaseline; (3) rats with burns given a local injection of placebo; and (4) rats without burns. Primary data were measured according to the time of euthanasia (at the 8th hour, 4th day, 7th day, 14th day or 21st day). One-way ANOVA test followed by post hoc test were used. Epithelialization in rats who received SVFs and PRP was superior on days 7, 14 and 21 when compared to the other groups. The fibroblast count in rats who received SVFs and PRP showed significant difference on days 7 (p=0.022). Significant differences in serum FGF2 were observed on days 4, 7, 14 and 21 (p=0.003, p=0.001, p=0.024, p=0.038, respectively). A significant difference was also observed in serum IGF1 levels on days 7, 14 and 21 (p=0.043, p=0.003, p=0.045, respectively), and the combination of SVFs and PRP showed superior results compared to other groups. Injection of combined SVFs and PRP increases FGF2, IGF1, fibroblast count, and epithelialization.
38 BURNS DURING COVID-19 PANDEMIC: DEMOGRAPHICS, ETIOLOGICAL AND CLINICAL TRENDS IN 2021 AT THE NATIONAL BURN CARE CENTRE IN ISLAMABAD, PAKISTAN
(Rehan M., Iqbal T., Khan M.S., Tariq M.H., Khokhar O.K., Ain Q., Waheed U.)
The scarcity of data on burn-related injuries in Pakistan prompted this study. The study is specifically aimed at assessing the burn patients who were admitted to a national burn care center (BCC) in Pakistan. This single-center retrospective analysis was conducted for 12 months from January to December 2021. During this time period, 14,069 patients visited BCC with burn injuries of diverse natures while 613 of them were admitted. The patients’ information was abstracted from the hospital database. This information included age, sex, diagnosis, burn depth/degree, time of arrival, circumstances of burn injury, TBSA (total burn surface area), complications, outcome, and management plan. This information was shifted to Microsoft Office Excel Worksheet 2015 and then coded into the IBM Statistical Package for the Social Sciences (SPSS) version 24.0. Armonk, NY: IBM Corp. Of 14,069 patients, 613 were admitted to the burn care center, indicating an admission rate of 4.35%. Among these 613 patients, there was a high proportion of males (58.89%) and a mean age of 20.2±12.5 years. Most patients (40.4%) visited within the first hour after being burnt and flame burns were the most common (41.10%). Most patients were burnt due to accidents (97.7%). The mean length of hospital stay was 15.5 days. Flames were the main cause of burns among our cohort of patients. Most patients had a TBSA of >10% and generally had a second-degree burn, mostly in the pediatric population. An urgent appraisal of burn policies and related legislation is needed to halt the burn burden in the country.
45 ENZYMATIC DEBRIDEMENT COMPARED TO SURGICAL DEBRIDEMENT: A COST ANALYSIS IN A BURN UNIT IN SPAIN
(Ustarroz-Aguirre I., García-Lorenzo B., Acaiturri-Ayesta M.T., Gómez-Inhiesto E., Martin- Playa P.)
The standard care for burns is tangential surgical debridement and subsequent covering, but recently enzymatic debridement has appeared as an alternative. The objective of this study, using an individualised cost-per-patient information system, is to compare the cost per patient of these two alternatives and identify their main determining factors. A non-randomised, retrospective, observational study was carried out with 79 patients, 39 of whom were treated with surgical debridement. The average cost per patient for enzymatic debridement is lower, particularly due to a shorter length of stay of critical hospitalisation (13.7 vs. 18.9 days; €26,101 vs. €33,919), a decreased need for surgical procedures (0.45 vs. 1.28) and a shorter use of operating theatres (53 vs. 202 minutes; €904 vs. €3,000). Age, aetiology, evolution length and percentage TBSA are robust determinants of the cost of care for burn patients. The type of procedure does not appear to significantly affect the cost per patient.
53 ACUTE MANAGEMENT OF DEEP PERIORBITAL BURNS: A 10-YEAR REVIEW OF EXPERIENCE
(Kalinova K., Raycheva R., Petrova N., Uchikov P.)
Deep periorbital burns are an important issue mainly due to the presence of the eyes in the region, and the crucial importance of preservation of vision. There is no consensus regarding their treatment. A retrospective analysis of the treatment and outcome of 446 patients with deep burns of the periorbital region admitted to the Department of Burns and Plastic Surgery of St George’s University Hospital in Plovdiv, Bulgaria over 10 years was conducted. The study covers 446 patients, 162 female (36.5%) and 284 male (63.5%) aged from 5 months to 92 years. Deep periorbital burns accounted for 74.8% of hospitalized deep facial burns. Most frequent burn agents were hot liquids and flames. The mean total body surface area affected was 19.6% (min 0.5%, max 80.0%). Concomitant ocular pathology was diagnosed in 14% (n=63) of the patients. An early, staged and precise surgical approach was preferred, aimed at fast wound closure without sacrificing survived tissues. Follow up time ranged from 3 months to 5 years, median 37 months. Late ocular sequelae occurred in 7.4% (n=33) of the patients. There was no incidence of secondary corneal perforation or definitive loss of vision. Timely and adequate treatment during the acute period can minimize initial damage and late sequelae. Favor is given to the early, balanced surgical approach aimed at rapid wound closure between day 2 and 10 post burn. Preservation of vision is a determining factor for the significance of trauma and the effectiveness of treatment.
64 PLACE DES LAMBEAUX INGUINAUX ET DES EMPOCHEMENTS DANS LA PRISE EN CHARGE AIGUË DES BRÛLURES PROFONDES DU DORSUM DE MAIN: SÉRIE DE 6 CAS AU CENTRE DE TRAITEMENT DES BRÛLÉS DE LILLE
(Barry L., Guerre E., Jeanne M., Pasquesoone L.)
La prise en charge aiguë des brûlures profondes du dorsum de la main et des doigts représente un défi pour le chirurgien reconstructeur. En effet, l’exposition des structures ostéo-tendineuses nécessite souvent une couverture par lambeau dans un contexte où les lambeaux loco-régionaux ou libres ne sont pas toujours réalisables. La reconstruction a notamment pour objectif de préserver un maximum de longueur digitale, d’apporter des téguments souples, d’obtenir une sensibilité de protection et d’aboutir à une main fonctionnelle à 1 an. Nous rapportons ici une série de 8 brûlures profondes du dorsum de main. Six mains ont été couvertes par lambeaugreffe abdominal de Colson et 2 par lambeau inguinal pédiculé. Quatre patients sur six ont été revus en consultation, 1 patient a été perdu de vue et 1 patient est décédé. L’évaluation clinique a été réalisée par un chirurgien différent de l’opérateur. Les résultats fonctionnels sont très variables. Le délai de couverture est variable en fonction de la profondeur des lésions et de la gravité des patients. Le sevrage des lambeaux a eu lieu en moyenne à 30 jours. On retrouve un DASH score allant de 17.5 à 93/100 et des scores de total active motion (TAM) moyens à mauvais. Le résultat esthétique est satisfaisant avec un score de Vancouver de 4.5/13 en moyenne et une opinion générale du patient de 3.75/10 selon l’échelle POSAS. Lors de brûlures profondes du dorsum de la main et des doigts, les lambeaux locaux sont rarement possibles et les lambeaux loco-régionaux ne sont pas réalisables en cas d’atteinte associée du membre supérieur. Pour des surfaces moyennes à grandes, le lambeau inguinal pédiculé et l’empochement sont deux techniques fiables. Néanmoins, ils nécessitent une immobilisation relative du membre supérieur pourvoyeuse de raideur. La question de l’embrochage digital en position intrinsèque ou en rectitude n’est pas élucidée et ne semble pas prévenir les déformations secondaires. Il existe également une courbe d’apprentissage pour ces deux lambeaux, même si leur levée est réputée comme facile. Le lambeau de McGregor ou l’empochement peuvent être mis en balance avec les lambeaux libres. Cependant, la durée opératoire est longue, la technique chirurgicale est complexe, et les dommages vasculaires sont fréquents dans la population des patients brûlés. Bien qu’il y ait eu d’énormes progrès techniques depuis leurs descriptions, le lambeau inguinal pédiculé et l’empochement restent des alternatives à envisager dans la prise en charge aiguë des brûlures profondes du dorsum de main. Nous proposons dans cette présentation un algorithme d’aide à la prise en charge chirurgicale afin de situer ces deux techniques dans l’arsenal thérapeutique du chirurgien plasticien.
79 TRIPLE BARREL FREE FIBULA FLAP FOR STERNAL STABILIZATION: A CAS E R E PORT
(Cordoba T., Awaida C., Delisle É., Cordoba C., Odobescu A.)
Sternal non-union is a rare complication of median sternotomies following cardiac surgery. It results in sternal instability and is associated with a high rate of morbidity. Patients with sternal non-union usually complain of pain and sternal clicking with movement of the chest wall. Diagnosis is confirmed on computed tomography showing a gap between two sternal halves. Surgical correction of sternal instability is challenging. The key objective is to reconstruct a thoracic cage that allows for biomimesis and preserves normal physiologic cardiac and pulmonary functions all whilst achieving an aesthetically pleasing result. In this article, we describe a novel technique for sternal instability reconstruction using a triple-barrel vascularized free fibula flap fixed with rib titanium plates. This approach provides rigid long-lasting stability while preserving chest wall biomechanics.
83 MBC REPORT
85 SFB REPORT
86 International Abstract
linea_nera.jpg (4653 byte)
  Copyright ©2023 Euro-Mediterranean Council for Burns and Fire Disasters   This site has been realized and maintained by Informed Italia s.r.l.