Sodium butyrate protects against severe burn-induced remote acute lung injury in rats.

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Xun Liang

Full Text Available High-mobility group box 1 protein (HMGB1, a ubiquitous nuclear protein, drives proinflammatory responses when released extracellularly. It plays a key role as a distal mediator in the development of acute lung injury (ALI. Sodium butyrate, an inhibitor of histone deacetylase, has been demonstrated to inhibit HMGB1 expression. This study investigates the effect of sodium butyrate on burn-induced lung injury. Sprague-Dawley rats were divided into three groups: 1 sham group, sham burn treatment; 2 burn group, third-degree burns over 30% total body surface area (TBSA with lactated Ringer's solution for resuscitation; 3 burn plus sodium butyrate group, third-degree burns over 30% TBSA with lactated Ringer's solution containing sodium butyrate for resuscitation. The burned animals were sacrificed at 12, 24, and 48 h after burn injury. Lung injury was assessed in terms of histologic changes and wet weight to dry weight (W/D ratio. Tumor necrosis factor (TNF-α and interleukin (IL-8 protein concentrations in bronchoalveolar lavage fluid (BALF and serum were measured by enzyme-linked immunosorbent assay, and HMGB1 expression in the lung was determined by Western blot analysis. Pulmonary myeloperoxidase (MPO activity and malondialdehyde (MDA concentration were measured to reflect neutrophil infiltration and oxidative stress in the lung, respectively. As a result, sodium butyrate significantly inhibited the HMGB1 expressions in the lungs, reduced the lung W/D ratio, and improved the pulmonary histologic changes induced by burn trauma. Furthermore, sodium butyrate administration decreased the TNF-α and IL-8 concentrations in BALF and serum, suppressed MPO activity, and reduced the MDA content in the lungs after severe burn. These results suggest that sodium butyrate attenuates inflammatory responses, neutrophil infiltration, and oxidative stress in the lungs, and protects against remote ALI induced by severe burn, which is associated with inhibiting HMGB1

Emergency service admissions of patients with burn injury

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Sadiye Yolcu

2013-09-01

Full Text Available Objective: In this study, we aimed to investigate the propertiesof burn injured patients who admitted to our hospitalemergency service.Methods: Patients were detected from the hospital recordsof emergency service during six months period andwere divided into five groups according to their ages (60 years. Age, gender totalbody surface area (TBSA, mechanism of injury and theoutcome of emergency evaluation were recorded.Results: Totally 111619 patients admitted to our emergencyservice between 01.07.2011 and 31.12.2011. Duringsix months, 2349 males and 1960 females totally4309 patients were burn injured patients. 1773 patientswere between 0-10 years, 1083 patients were 11-20years, 735 patients were between 21 and 40, 361 patientswere between 41 and 60 and 357 patients were over 60years. Most of the patients were treated in the emergencyservice (90.1%. 0-10% TBSA patients constituted 94.2%.This ratio for burn area >40% was 0.6%. Hot liquid burn(vapored water, milk etc. was 60.2%. There was a significantrelation between mechanism of burn injury andage groups (p<0.05. No corrosive and sunburn injuriesdetermined in females. Age groups were related with hospitalization(p<0.05. The highest intensive care unit admissionwas found in the 0-10 age group (1.3%.Conclusion: Emergency service is the first admission departmentof burn injury patients. Knowing the propertiesof burn injury patients, would help hard-working emergencydoctors in triage of these patients. Also, reportingthe data of emergency service burn injury patients wouldbe helpful for further studies. J Clin Exp Invest 2013; 4(3: 285-288Key words: Burn injury, emergency service, total body surface area

Pediatric soup scald burn injury: etiology and prevention.

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Palmieri, Tina L; Alderson, Tyrone S; Ison, Dahlia; O'Mara, Michael S; Sharma, Raj; Bubba, Anthony; Coombs, Elena; Greenhalgh, David G

2008-01-01

One of the leading causes of scald burn injury in children is from hot soup, particularly prepackaged instant soups. The purpose of this study was to determine the demographic, socioeconomic, and situational factors that contribute to the incidence of scald burns in children. A 20-item questionnaire was given to the caregiver of children who were treated for scald burn injury at a pediatric burn center from July 2006 to March 2007. Questions included demographics (child age, gender, siblings, ethnicity), socioeconomic status (income, education), factors contributing to the injury (type of soup, child supervision, type of container), and location of injury. The mean age of the 78 children sustaining burn injury and completing the survey was 4.8 +/- 0.6 years. The majority of patients were girls (51%), and the most frequently involved ethnic group was Hispanic (44%). Households had a mean of 3.0 +/- 0.3 children in residence, and an income of less than $29,000/year (59%). The highest educational level achieved was high school for 73% of the parents. Prepackaged soup (65%) with a narrow base heated directly in the original container (46%) using the microwave (51%) was implicated in the majority of burns. Soup scald burns, especially from prepackaged instant soups, appear to predominate in lower income families with multiple children. The majority of injuries occur when the caregiver heats the soup in the original container using the microwave. Prevention of these types of injuries will require a two-pronged approach: educating families with multiple children and changing the soup packaging.

Thermal burn and electrical injuries among electric utility workers, 1995-2004.

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Fordyce, Tiffani A; Kelsh, Michael; Lu, Elizabeth T; Sahl, Jack D; Yager, Janice W

2007-03-01

This study describes the occurrence of work-related injuries from thermal-, electrical- and chemical-burns among electric utility workers. We describe injury trends by occupation, body part injured, age, sex, and circumstances surrounding the injury. This analysis includes all thermal, electric, and chemical injuries included in the Electric Power Research Institute (EPRI) Occupational Health and Safety Database (OHSD). There were a total of 872 thermal burn and electric shock injuries representing 3.7% of all injuries, but accounting for nearly 13% of all medical claim costs, second only to the medical costs associated with sprain- and strain-related injuries (38% of all injuries). The majority of burns involved less than 1 day off of work. The head, hands, and other upper extremities were the body parts most frequently injured by burns or electric shocks. For this industry, electric-related burns accounted for the largest percentage of burn injuries, 399 injuries (45.8%), followed by thermal/heat burns, 345 injuries (39.6%), and chemical burns, 51 injuries (5.8%). These injuries also represented a disproportionate number of fatalities; of the 24 deaths recorded in the database, contact with electric current or with temperature extremes was the source of seven of the fatalities. High-risk occupations included welders, line workers, electricians, meter readers, mechanics, maintenance workers, and plant and equipment operators.

Epidemiology of burn injuries in Mekele Town, Northern Ethiopia: A ...

African Journals Online (AJOL)

Introduction: Epidemiological study on burn injuries and exploration of the risk factors in different settings is important for effective intervention. Very little is known about burn injuries in Ethiopia. Objectives: The aims of this study were to assess the annual incidence of burn injuries and to describe the local knowledge about ...

Factors related to child maltreatment in children presenting with burn injuries.

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Wibbenmeyer, Lucy; Liao, Junlin; Heard, Jason; Kealey, Lyn; Kealey, Gerald; Oral, Resmiye

2014-01-01

The underpinnings of maltreatment in children presenting with burn injuries are necessary to discern as detection and prevention rest on a clear delineation of factors associated with maltreatment. Inaccurate identification of child victims can result in perpetuation of the maltreatment and its attendant neuropsychological sequela. The authors sought to determine factors associated with maltreatment in children presenting with burn injuries, which would guide the burn team in assessing the likelihood of maltreatment. All consenting children admitted with burn injuries were surveyed regarding their injury mechanism and current sociodemographic status. Suspicious injuries were referred by the burn team to the multidisciplinary review team (MRT). The MRT reported injuries with signs of physical abuse, supervision neglect, neglect of other basic needs, or sexual abuse. These children constituted the cases in our study. Variables related to maltreatment were entered into stepwise logistic regression to identify independent predicting variables. Pmaltreatment. Risk factors related to suspicions of maltreatment included: young age, large burns, tap water injury, immersion lines, delay in care, absence of a two-parent family (unconventional family structure), young parents, inconsistent history, and injury pattern. In this single-center prospective study, the authors identified several factors that, when present in injuries with initial suspicion of maltreatment, should trigger a child maltreatment workup. Burn clinicians have an important role as advocates for children and their families. It is important to continue to further the knowledge of maltreatment detection and prevention among children presenting with burn injuries.

Increased serum concentrations of soluble ST2 predict mortality after burn injury.

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Hacker, Stefan; Dieplinger, Benjamin; Werba, Gregor; Nickl, Stefanie; Roth, Georg A; Krenn, Claus G; Mueller, Thomas; Ankersmit, Hendrik J; Haider, Thomas

2018-06-27

Large burn injuries induce a systemic response in affected patients. Soluble ST2 (sST2) acts as a decoy receptor for interleukin-33 (IL-33) and has immunosuppressive effects. sST2 has been described previously as a prognostic serum marker. Our aim was to evaluate serum concentrations of sST2 and IL-33 after thermal injury and elucidate whether sST2 is associated with mortality in these patients. We included 32 burn patients (total body surface area [TBSA] >10%) admitted to our burn intensive care unit and compared them to eight healthy probands. Serum concentrations of sST2 and IL-33 were measured serially using an enzyme-linked immunosorbent assay (ELISA) technique. The mean TBSA was 32.5%±19.6%. Six patients (18.8%) died during the hospital stay. Serum analyses showed significantly increased concentrations of sST2 and reduced concentrations of IL-33 in burn patients compared to healthy controls. In our study cohort, higher serum concentrations of sST2 were a strong independent predictor of mortality. Burn injuries cause an increment of sST2 serum concentrations with a concomitant reduction of IL-33. Higher concentrations of sST2 are associated with increased in-hospital mortality in burn patients.

The effect of smoking status on burn inhalation injury mortality.

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Knowlin, Laquanda; Stanford, Lindsay; Cairns, Bruce; Charles, Anthony

2017-05-01

Three factors that effect burn mortality are age, total body surface of burn (TBSA), and inhalation injury. Of the three, inhalation injury is the strongest predictor of mortality thus its inclusion in the revised Baux score (age+TBSA+17* (inhalation injury, 1=yes, 0=no)). However, the weighted contribution of specific comorbidities such as smoker status on mortality has traditionally not been accounted for nor studied in this subset of burn patients. We therefore sought to examine the impact of current tobacco and/or marijuana smoking in patients with inhalation injury. A retrospective analysis of patients admitted to a regional burn center from 2002 to 2012. Independent variables analyzed included basic demographics, burn mechanism, presence of inhalation injury, TBSA, pre-existing comorbidities, and smoker status. Bivariate analysis was performed and logistic regression modeling using significant variables was utilized to estimate odds of mortality. There were a total of 7640 patients over the study period. 7% (n=580) of the burn cohort with inhalation injury were included in this study. In-hospital burn mortality for inhalation injury patients was 23%. Current smokers (20%) included cigarette smokers and marijuana users, 19% and 3%, respectively. Preexisting respiratory disease (17%) was present in 36% of smokers compared to 13% of non-smokers (psmoke inhalation injury. Future prospective studies in human and/or animal models are needed to confirm these findings. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Myosin Light Chain Kinase Mediates Intestinal Barrier Disruption following Burn Injury

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Chen, Chuanli; Wang, Pei; Su, Qin; Wang, Shiliang; Wang, Fengjun

2012-01-01

Background Severe burn injury results in the loss of intestinal barrier function, however, the underlying mechanism remains unclear. Myosin light chain (MLC) phosphorylation mediated by MLC kinase (MLCK) is critical to the pathophysiological regulation of intestinal barrier function. We hypothesized that the MLCK-dependent MLC phosphorylation mediates the regulation of intestinal barrier function following burn injury, and that MLCK inhibition attenuates the burn-induced intestinal barrier disfunction. Methodology/Principal Findings Male balb/c mice were assigned randomly to either sham burn (control) or 30% total body surface area (TBSA) full thickness burn without or with intraperitoneal injection of ML-9 (2 mg/kg), an MLCK inhibitor. In vivo intestinal permeability to fluorescein isothiocyanate (FITC)-dextran was measured. Intestinal mucosa injury was assessed histologically. Tight junction proteins ZO-1, occludin and claudin-1 was analyzed by immunofluorescent assay. Expression of MLCK and phosphorylated MLC in ileal mucosa was assessed by Western blot. Intestinal permeability was increased significantly after burn injury, which was accompanied by mucosa injury, tight junction protein alterations, and increase of both MLCK and MLC phosphorylation. Treatment with ML-9 attenuated the burn-caused increase of intestinal permeability, mucosa injury, tight junction protein alterations, and decreased MLC phosphorylation, but not MLCK expression. Conclusions/Significance The MLCK-dependent MLC phosphorylation mediates intestinal epithelial barrier dysfunction after severe burn injury. It is suggested that MLCK-dependent MLC phosphorylation may be a critical target for the therapeutic treatment of intestinal epithelial barrier disruption after severe burn injury. PMID:22529961

Barriers to return to work after burn injuries.

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Esselman, Peter C; Askay, Shelley Wiechman; Carrougher, Gretchen J; Lezotte, Dennis C; Holavanahalli, Radha K; Magyar-Russell, Gina; Fauerbach, James A; Engrav, Loren H

2007-12-01

To identify barriers to return to work after burn injury as identified by the patient. A cohort study with telephone interview up to 1 year. Hospital-based burn centers at 3 national sites. Hospitalized patients (N=154) meeting the American Burn Association criteria for major burn injury, employed at least 20 hours a week at the time of injury, and with access to a telephone after discharge. Patients were contacted via telephone every 2 weeks up to 4 months, then monthly up to 1 year after discharge. A return to work survey was used to identify barriers that prevented patients from returning to work. A graphic rating scale determined the impact of each barrier. By 1 year, 79.7% of patients returned to work. Physical and wound issues were barriers early after discharge. Although physical abilities continued to be a significant barrier up to 1 year, working conditions (temperature, humidity, safety) and psychosocial factors (nightmares, flashbacks, appearance concerns) became important issues in those with long-term disability. The majority of patients return to work after a burn injury. Although physical and work conditions are important barriers, psychosocial issues need to be evaluated and treated to optimize return to work.

Trauma mechanisms and injury patterns in pediatric burn patients.

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Moehrlen, Theres; Szucs, Thomas; Landolt, Markus A; Meuli, Martin; Schiestl, Clemens; Moehrlen, Ueli

2018-03-01

The objective of this study was to evaluate the frequency, severity, exact patterns and mechanisms of burn injuries in children. The patient records of children with acute burns admitted to the University Children's Hospital of Zurich were retrospectively reviewed over an 11year period. The age group with the highest risk, were children under the age of five (69%). Boys were overrepresented in all age groups, but the gender imbalance increased with age. Infants and toddlers were mainly injured by scalds and contact burns. Conversely, almost three quarters of injuries over the age of 9 were caused by flame. The majority of scald injuries was a result of pulling down hot liquids. The typical distribution of this accident scenario involved mainly the face, trunk and arms. More than half of all flame injuries occurred due to fire accelerants. 55% of children were passively involved while other children throwing flammable substances into a fire. Most of these injuries involved the face and arms. This study shows that burn etiology is age dependent. Additionally, our results demonstrate the diversity of burn accidents and their resulting injuries. These findings may help better specify target groups and subjects for prevention. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Study of Alterations in Lipid Profile After Burn Injury.

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Dr.Asha Khubchandani

2017-06-01

Full Text Available Introduction: After burn injury, changes in lipid profile occur in body. Dyslipidemia after burn injury is one of the important alterations. Objective: To check alterations in lipid profile after burn injury. Materials and Method: It was cross sectional study which was carried out on 250 burns patients of both sex, with an age group of 18-45 years, and varying burns percentage of 20-80% of total body surface area (TBSA. Serum cholesterol, serum LDL, serum HDL and serum triglyceride level were measured on XL-640 fully-auto biochemical analyser. Serum LDL and HDL were measured by Accelerator Selective Detergent Method. Serum cholesterol and triglyceride were measured by Trindor’s method. Results: Results showed decrease in serum cholesterol, serum LDL and serum HDL, while increase in serum triglyceride level in burns patients compared to normal subjects. Conclusion: This study clearly showed the importance of measuring serum cholesterol, TG, LDL and HDL in burn patients and targeting changes that occur in their levels along the burns course, which may have beneficial effect in protection from organ damage, increasing survival rates and improving burn outcome.

Myosin light chain kinase mediates intestinal barrier disruption following burn injury.

Directory of Open Access Journals (Sweden)

Chuanli Chen

Full Text Available BACKGROUND: Severe burn injury results in the loss of intestinal barrier function, however, the underlying mechanism remains unclear. Myosin light chain (MLC phosphorylation mediated by MLC kinase (MLCK is critical to the pathophysiological regulation of intestinal barrier function. We hypothesized that the MLCK-dependent MLC phosphorylation mediates the regulation of intestinal barrier function following burn injury, and that MLCK inhibition attenuates the burn-induced intestinal barrier disfunction. METHODOLOGY/PRINCIPAL FINDINGS: Male balb/c mice were assigned randomly to either sham burn (control or 30% total body surface area (TBSA full thickness burn without or with intraperitoneal injection of ML-9 (2 mg/kg, an MLCK inhibitor. In vivo intestinal permeability to fluorescein isothiocyanate (FITC-dextran was measured. Intestinal mucosa injury was assessed histologically. Tight junction proteins ZO-1, occludin and claudin-1 was analyzed by immunofluorescent assay. Expression of MLCK and phosphorylated MLC in ileal mucosa was assessed by Western blot. Intestinal permeability was increased significantly after burn injury, which was accompanied by mucosa injury, tight junction protein alterations, and increase of both MLCK and MLC phosphorylation. Treatment with ML-9 attenuated the burn-caused increase of intestinal permeability, mucosa injury, tight junction protein alterations, and decreased MLC phosphorylation, but not MLCK expression. CONCLUSIONS/SIGNIFICANCE: The MLCK-dependent MLC phosphorylation mediates intestinal epithelial barrier dysfunction after severe burn injury. It is suggested that MLCK-dependent MLC phosphorylation may be a critical target for the therapeutic treatment of intestinal epithelial barrier disruption after severe burn injury.

Development of Metabolic Indicators of Burn Injury: Very Low Density Lipoprotein (VLDL and Acetoacetate Are Highly Correlated to Severity of Burn Injury in Rats

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Maria-Louisa Izamis

2012-07-01

Full Text Available Hypermetabolism is a significant sequela to severe trauma such as burns, as well as critical illnesses such as cancer. It persists in parallel to, or beyond, the original pathology for many months as an often-fatal comorbidity. Currently, diagnosis is based solely on clinical observations of increased energy expenditure, severe muscle wasting and progressive organ dysfunction. In order to identify the minimum number of necessary variables, and to develop a rat model of burn injury-induced hypermetabolism, we utilized data mining approaches to identify the metabolic variables that strongly correlate to the severity of injury. A clustering-based algorithm was introduced into a regression model of the extent of burn injury. As a result, a neural network model which employs VLDL and acetoacetate levels was demonstrated to predict the extent of burn injury with 88% accuracy in the rat model. The physiological importance of the identified variables in the context of hypermetabolism, and necessary steps in extension of this preliminary model to a clinically utilizable index of severity of burn injury are outlined.

The Impact of Legislation on Gas Can- and Mattress-Related Burn Injuries.

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Kellogg, Levi; Butcher, Brandon; Peek-Asa, Corinne; Wibbenmeyer, Lucy

2018-01-01

Burn prevention program success requires thorough evaluation of intervention outcomes. The impact of 2 engineering-specific burn prevention regulations, the Children's Gasoline Burn Prevention Act and the Standard for the Flammability of Mattress Sets, will be assessed. Records from 1997 to 2015 within the Consumer Product Safety Commission's (CPSC) National Electronic Injury Surveillance System (NEISS) were reviewed. After identifying gas can- and mattress-involved burn injuries, injury incidence was estimated by utilizing survey sampling weights associated with each record. Logistic regression, incorporating estimated injury incidence and adjusting for gender and age, was performed to test for change in injury risk following these regulations. Within NEISS, there were 493 burns involving gas cans, yielding an estimated 19,339 injuries (95% confidence interval [CI], 15,781-22,896) during the 19-year study period. The odds of a gas can burn injury after legislation decreased by 67% for children younger than 5 years (odds ratio [OR], 0.33; 95% CI, 0.16-0.66; P = 0.0018). There was no significant change in risk for persons 5 years and older (OR, 1.07; 95% CI, 0.80-1.41; P = 0.66). During the same time, there were 219 NEISS burns involving mattresses, yielding an estimated 6864 injuries (95% CI, 5071-8658). The odds of a mattress burn injury following legislation enactment decreased by 31% for all ages (OR, 0.69; 95% CI, 0.51-0.94; P = 0.02). Both regulations decreased the odds of injury in their target populations. This study demonstrates that passive interventions involving engineering standards remain a powerful tool for burn prevention and should be the focus of future efforts to improve burn care.

Inducible satellite cell depletion attenuates skeletal muscle regrowth following a scald-burn injury.

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Finnerty, Celeste C; McKenna, Colleen F; Cambias, Lauren A; Brightwell, Camille R; Prasai, Anesh; Wang, Ye; El Ayadi, Amina; Herndon, David N; Suman, Oscar E; Fry, Christopher S

2017-11-01

Severe burns result in significant skeletal muscle cachexia that impedes recovery. Activity of satellite cells, skeletal muscle stem cells, is altered following a burn injury and likely hinders regrowth of muscle. Severe burn injury induces satellite cell proliferation and fusion into myofibres with greater activity in muscles proximal to the injury site. Conditional depletion of satellite cells attenuates recovery of myofibre area and volume following a scald burn injury in mice. Skeletal muscle regrowth following a burn injury requires satellite cell activity, underscoring the therapeutic potential of satellite cells in the prevention of prolonged frailty in burn survivors. Severe burns result in profound skeletal muscle atrophy; persistent muscle atrophy and weakness are major complications that hamper recovery from burn injury. Many factors contribute to the erosion of muscle mass following burn trauma, and we have previously shown concurrent activation and apoptosis of muscle satellite cells following a burn injury in paediatric patients. To determine the necessity of satellite cells during muscle recovery following a burn injury, we utilized a genetically modified mouse model (Pax7 CreER -DTA) that allows for the conditional depletion of satellite cells in skeletal muscle. Additionally, mice were provided 5-ethynyl-2'-deoxyuridine to determine satellite cell proliferation, activation and fusion. Juvenile satellite cell-wild-type (SC-WT) and satellite cell-depleted (SC-Dep) mice (8 weeks of age) were randomized to sham or burn injury consisting of a dorsal scald burn injury covering 30% of total body surface area. Both hindlimb and dorsal muscles were studied at 7, 14 and 21 days post-burn. SC-Dep mice had >93% depletion of satellite cells compared to SC-WT (P satellite cell proliferation and fusion. Depletion of satellite cells impaired post-burn recovery of both muscle fibre cross-sectional area and volume (P satellite cells in the aetiology of lean

Impact of Work-Related Burn Injury on Social Reintegration Outcomes: A Life Impact Burn Recovery Evaluation (LIBRE) Study.

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Schneider, Jeffrey C; Shie, Vivian L; Espinoza, Leda F; Shapiro, Gabriel D; Lee, Austin; Acton, Amy; Marino, Molly; Jette, Alan; Kazis, Lewis E; Ryan, Colleen M

2017-11-26

To examine differences in long-term social reintegration outcomes for burn survivors with and without work-related injuries. Cross-sectional survey. Community-dwelling burn survivors. Burn survivors (N=601) aged ≥18 years with injuries to ≥5% total body surface area or burns to critical areas (hands, feet, face, or genitals). Not applicable. The Life Impact Burn Recovery Evaluation Profile was used to examine the following previously validated 6 scale scores of social participation: Family and Friends, Social Interactions, Social Activities, Work and Employment, Romantic Relationships, and Sexual Relationships. Older participants, those who were married, and men were more likely to be burned at work (Preintegration outcomes than those without work-related injuries. Identification of those at higher risk for work reintegration challenges after burn injury may enable survivors, providers, employers, and insurers to better use appropriate resources to promote and target optimal employment outcomes. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Combination of Radiation and Burn Injury Alters FDG Uptake in Mice

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Carter, Edward A.; Winter, David; Tolman, Crystal; Paul, Kasie; Hamrahi, Victoria; Tompkins, Ronald; Fischman, Alan J.

2012-01-01

Radiation exposure and burn injury have both been shown to alter glucose utilization in vivo. The present study was designed to study the effect of burn injury combined with radiation exposure, on glucose metabolism in mice using [18F] Fluorodeoxyglucose (18FDG). Groups of male mice weighing approximately 30g were studied. Group 1 was irradiated with a 137Cs source (9 Gy). Group 2 received full thickness burn injury on 25% total body surface area followed by resuscitated with saline (2mL, IP). Group 3 received radiation followed 10 minutes later by burn injury. Group 4 were sham treated controls. After treatment, the mice were fasted for 23 hours and then injected (IV) with 50 µCi of 18FDG. One hour post injection, the mice were sacrificed and biodistribution was measured. Positive blood cultures were observed in all groups of animals compared to the shams. Increased mortality was observed after 6 days in the burn plus radiated group as compared to the other groups. Radiation and burn treatments separately or in combination produced major changes in 18FDG uptake by many tissues. In the heart, brown adipose tissue (BAT) and spleen, radiation plus burn produced a much greater increase (p<0.0001) in 18FDG accumulation than either treatment separately. All three treatments produced moderate decreases in 18FDG accumulation (p<0.01) in the brain and gonads. Burn injury, but not irradiation, increased 18FDG accumulation in skeletal muscle; however the combination of burn plus radiation decreased 18FDG accumulation in skeletal muscle. This model may be useful for understanding the effects of burns + irradiation injury on glucose metabolism and in developing treatments for victims of injuries produced by the combination of burn plus irradiation. PMID:23143615

Does inhalation injury predict mortality in burns patients or require redefinition?

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Youngmin Kim

Full Text Available Inhalation injury is known to be an important factor in predicting mortality in burns patients. However, the diagnosis is complicated by the heterogeneous presentation and inability to determine the severity of inhalation injury. The purpose of this study was to identify clinical features of inhalation injury that affect mortality and the values that could predict the outcome more precisely in burns patients with inhalation injury. This retrospective observational study included 676 burns patients who were over 18 years of age and hospitalized in the Burns Intensive Care Unit between January 2012 and December 2015. We analyzed variables that are already known to be prognostic factors (age, percentage of total body surface area (%TBSA burned, and inhalation injury and factors associated with inhalation injury (carboxyhemoglobin and PaO2/FiO2 [PF] ratio by univariate and multivariate logistic regression. Age group (odds ratio [OR] 1.069, p<0.001, %TBSA burned (OR 1.100, p<0.001, and mechanical ventilation (OR 3.774, p<0.001 were identified to be significant predictive factors. The findings for presence of inhalation injury, PF ratio, and carboxyhemoglobin were not statistically significant in multivariate logistic regression. Being in the upper inhalation group, the lower inhalation group, and having a PF ratio <100 were identified to be significant predictors only in univariate logistic regression analysis (OR 4.438, p<0.001; OR 2.379, p<0.001; and OR 2.765, p<0.001, respectively. History and physical findings are not appropriate for diagnosis of inhalation injury and do not predict mortality. Mechanical ventilation should be recognized as a risk factor for mortality in burns patients with inhalation injury.

Hypertonic lactated saline resuscitation reduces the risk of abdominal compartment syndrome in severely burned patients.

Science.gov (United States)

Oda, Jun; Ueyama, Masashi; Yamashita, Katsuyuki; Inoue, Takuya; Noborio, Mitsuhiro; Ode, Yasumasa; Aoki, Yoshiki; Sugimoto, Hisashi

2006-01-01

Secondary abdominal compartment syndrome is a lethal complication after resuscitation from burn shock. Hypertonic lactated saline (HLS) infusion reduces early fluid requirements in burn shock, but the effects of HLS on intraabdominal pressure have not been clarified. Patients admitted to our burn unit between 2002 and 2004 with burns > or =40% of the total body surface area without severe inhalation injury were entered into a fluid resuscitation protocol using HLS (n = 14) or lactated Ringer's solution (n = 22). Urine output was monitored hourly with a goal of 0.5 to 1.0 mL/kg per hour. Hemodynamic parameters, blood gas analysis, intrabladder pressure as an indicator of intraabdominal pressure (IAP), and the peak inspiratory pressure were recorded. Pulmonary compliance and the abdominal perfusion pressure were also calculated. In the HLS group, the amount of intravenous fluid volume needed to maintain adequate urine output was less at 3.1 +/- 0.9 versus 5.2 +/- 1.2 mL/24 h per kg per percentage of total body surface area, and the peak IAP and peak inspiratory pressure at 24 hours after injury were significantly lower than those in the lactated Ringer's group. Two of 14 patients (14%) in the HLS group and 11 of 22 patients (50%) developed IAH within 20.8 +/- 7.2 hours after injury. In patients with severe burn injury, a large intravenous fluid volume decreases abdominal perfusion during the resuscitative period because of increased IAP. Our data suggest that HLS resuscitation could reduce the risk of secondary abdominal compartment syndrome with lower fluid load in burn shock patients.

A closer look at burn injuries and epilepsy in a developing world ...

African Journals Online (AJOL)

Background: Burn injuries in South Africa result in significant morbidity and mortality, and specific vulnerable groups of patients are at increased risk of sustaining a burn injury. Epileptic patients are one such vulnerable group. The spectrum of burn injuries sustained by epileptic patients in a South African township and the ...

Stress disorder and PTSD after burn injuries: a prospective study of predictors of PTSD at Sina Burn Center, Iran

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Sadeghi-Bazargani H

2011-07-01

Full Text Available Homayoun Sadeghi-Bazargani1, Hemmat Maghsoudi2, Mohsen Soudmand-Niri3, Fatemeh Ranjbar4, Hossein Mashadi-Abdollahi51Neuroscience Research Center, Statistics and Epidemiology Department, School of Health and Nutrition, 2Department of Surgery, 3School of Psychology, 4Department of Psychiatry, 5National Public Health Management Centre, Tabriz University of Medical Sciences, Tabriz, IranBackground: A burn injury can be a traumatic experience with tremendous social, physical, and psychological consequences. The aim of this study was to investigate the existence of post-traumatic stress disorder (PTSD and predictors of PTSD Checklist score initially and 3 months after injury in burns victims admitted to the Sina Burn Center in north-west Iran.Methods: This prospective study examined adult patients aged 16–65 years with unintentional burns. The PTSD Checklist was used to screen for PTSD.Results: Flame burns constituted 49.4% of all burns. Mean PTSD score was 23.8 ± 14.7 early in the hospitalization period and increased to 24.2 ± 14.3, 3 months after the burn injury. Twenty percent of victims 2 weeks into treatment had a positive PTSD screening test, and this figure increased to 31.5% after 3 months. The likelihood of developing a positive PTSD screening test increased significantly after 3 months (P < 0.01. Using multivariate regression analysis, factors independently predicting PTSD score were found to be age, gender, and percentage of total body surface area burned.Conclusion: PTSD was a problem in the population studied and should be managed appropriately after hospital admission due to burn injury. Male gender, younger age, and higher total body surface area burned may predict a higher PTSD score after burn injury. Keywords: post-traumatic stress disorder, burn injury, predictors, Iran

Burn injury during long-term oxygen therapy in Denmark and Sweden

DEFF Research Database (Denmark)

Tanash, Hanan A; Ringbaek, Thomas; Huss, Fredrik

2017-01-01

% confidence interval [CI], 126-225) vs 85 (95% CI, 44-148) per 100,000 person-years; rate ratio 2.0 (95% CI, 1.0-4.1). The risk remained higher after adjustment for gender, age, and diagnosis in multivariate Cox regression, hazard ratio 1.8 (95% CI, 1.0-3.5). Thirty-day mortality after burn injury was 8......BACKGROUND: Long-term oxygen therapy (LTOT) increases life expectancy in patients with COPD and severe hypoxemia. Smoking is the main cause of burn injury during LTOT. Policy regarding smoking while on LTOT varies between countries. In this study, we compare the incidence of burn injury...... end point was burn injury during LTOT. RESULTS: A total of 23,741 patients received LTOT in Denmark and 7,754 patients in Sweden. Most patients started LTOT due to COPD, both in Sweden (74%) and in Denmark (62%). The rate of burn injury while on LTOT was higher in Denmark than in Sweden; 170 (95...

Treadmills: a preventable source of pediatric friction burn injuries.

Science.gov (United States)

Maguiña, Pirko; Palmieri, Tina L; Greenhalgh, David G

2004-01-01

Treadmills are a burn risk for children. A child's hand can get trapped in the conveyor belt, causing friction burns to the underlying tissue. The purpose of this retrospective study was to review the characteristics and treatment of treadmill-related burns in children from 1998 to 2002. Ten patients, at a mean age of 3.4 years, sustained injuries associated with treadmill use. Trapping of the hand between the conveyor belt and the base was the most frequent injury mechanism. Burn location was predominantly on fingers and palms. Four patients required operative intervention. All patients required specialized wound care as well as scar management and occupational therapy. Treadmills pose a danger to children. Current safety devices are ineffective for preventing serious hand injuries in children. New design modifications and public awareness are needed to improve child safety.

Burn-injury affects gut-associated lymphoid tissues derived CD4+ T cells.

Science.gov (United States)

Fazal, Nadeem; Shelip, Alla; Alzahrani, Alhusain J

2013-01-01

After scald burn-injury, the intestinal immune system responds to maintain immune balance. In this regard CD4+T cells in Gut-Associated Lymphoid Tissues (GALT), like mesenteric lymph nodes (MLN) and Peyer's patches (PP) respond to avoid immune suppression following major injury such as burn. Therefore, we hypothesized that the gut CD4+T cells become dysfunctional and turn the immune homeostasis towards depression of CD4+ T cell-mediated adaptive immune responses. In the current study we show down regulation of mucosal CD4+ T cell proliferation, IL-2 production and cell surface marker expression of mucosal CD4+ T cells moving towards suppressive-type. Acute burn-injury lead to up-regulation of regulatory marker (CD25+), down regulation of adhesion (CD62L, CD11a) and homing receptor (CD49d) expression, and up-regulation of negative co-stimulatory (CTLA-4) molecule. Moreover, CD4+CD25+ T cells of intestinal origin showed resistance to spontaneous as well as induced apoptosis that may contribute to suppression of effector CD4+ T cells. Furthermore, gut CD4+CD25+ T cells obtained from burn-injured animals were able to down-regulate naïve CD4+ T cell proliferation following adoptive transfer of burn-injured CD4+CD25+ T cells into sham control animals, without any significant effect on cell surface activation markers. Together, these data demonstrate that the intestinal CD4+ T cells evolve a strategy to promote suppressive CD4+ T cell effector responses, as evidenced by enhanced CD4+CD25+ T cells, up-regulated CTLA-4 expression, reduced IL-2 production, tendency towards diminished apoptosis of suppressive CD4+ T cells, and thus lose their natural ability to regulate immune homeostasis following acute burn-injury and prevent immune paralysis.

Temperature threshold for burn injury: an oximeter safety study.

Science.gov (United States)

Greenhalgh, David G; Lawless, Mary Beth; Chew, Bradford B; Crone, Willem A; Fein, Michael E; Palmieri, Tina L

2004-01-01

Pulse oximeters have become essential devices for evaluating and monitoring patient oxygenation. The probe emits a small amount of heat into the skin in the process of signal detection. Regulations set by the Food and Drug Administration currently limit the maximum allowable temperature of an oximeter probe to 41 degrees C. As a result of the prolonged exposure of extremities to these devices, we sought to determine the actual temperature threshold for burn injury in patients. Eighteen patients undergoing surgery for removal of redundant skin (abdominoplasty, breast reduction) consented to the application of a temperature-controlled custom probe with four light-emitting diodes that had temperatures set randomly at the expected threshold for burn injury (42.5 degrees C, 43 degrees C, 43.5 degrees C, and 44 degrees C). The probe was left in place for 8 hours (or less if significant pain was noted). The sites covered by the probes were then checked for signs of injury. On the next day, the redundant skin was removed as a scheduled procedure, and histopathology was performed to detect the extent of burn injury. The study was approved by the local institutional research board. Two patients were excluded because of technical problems with the probe, one of whom had the probe turned off because of pain. The only observed sign of injury was either erythema or a superficial blister that was usually unobservable or slightly red at operation. These subtle signs of a burn were noted in one patient at 43 degrees C, four at 43.5 degrees C, and nine at 44 degrees C. No burns were noted in two patients. Minimal or no signs of injury frequently were noted by histopathology. Pulse oximeter probes are safe up to a temperature of 43 degrees C for at least 8 hours in well-perfused skin. Above that temperature, there is a risk of burn injury. Performing temperature threshold tests in redundant skin that is planned for excision is a potential method for testing the safety of devices or

Changes in intracellular K+ concentration and action potential of myocardiocytes in early stage of radiation, burn and combined radiation-burn injuries in rats

International Nuclear Information System (INIS)

Li Min; Xiao Jiasi; Yan Shuzhi; Wan Zibin

1996-01-01

K + -ISME and micro electrode were used respectively to measure the [K + ] i concentration and action potential in ventricular papillary myocardiocytes of 92 Wistar rats, which were divided into four groups: normal rats (group C), and rats receiving radiation (group R), burn (group B) and combined radiation-burn (group RB), and undergoing measurement 1,3,8 and 24 hours after respective treatment. It was found that (1) [K + ] i was reduced in groups B and RB (especially in group B), but there was no change in group R; (2) RP, APA and V max were all decreased in three injured groups; (3) APD 50 and APD 90 were shortened obviously in group B, but were prolonged in both groups R and RB (especially in group R). These results suggest that (1) radiation injury diminishes Na + inflow and K + outflow; (2) burn diminishes Na + inflow and accelerates K + outflow; (3) combined radiation-burn injury is not a simple addition of radiation and burn effects

Music therapy for children with severe burn injury

OpenAIRE

Edwards, Jane

1998-01-01

peer-reviewed Music therapy for children with severe burns is a developing field of practice and research interest in pediatric music therapy. The following article presents an overview of the nature of severe burn injury and provides a rationale for the use of music therapy in the Burn Unit. The application of song writing techniques to address needs of children receiving care for severe burns in a hospital setting is presented.

Raoultella planticola bacteremia-induced fatal septic shock following burn injury.

Science.gov (United States)

Yumoto, Tetsuya; Naito, Hiromichi; Ihoriya, Hiromi; Tsukahara, Kohei; Ota, Tomoyuki; Watanabe, Toshiyuki; Nakao, Atsunori

2018-05-04

Raoultella planticola, a Gram-negative, aerobic bacillus commonly isolated from soil and water, rarely causes invasive infections in humans. Septic shock from R. planticola after burn injury has not been previously reported. A 79-year-old male was admitted to the emergency intensive care unit after extensive flame burn injury. He accidently caught fire while burning trash and plunged into a nearby tank filled with contaminated rainwater to extinguish the fire. The patient developed septic shock on day 10. The blood culture detected R. planticola, which was identified using the VITEK-2 biochemical identification system. Although appropriate antibiotic treatment was continued, the patient died on day 12. Clinicians should be aware of fatal infections in patients with burn injury complicated by exposure to contaminated water.

Neuronal Plasticity Associated with Burn Injury and Its Relevance for Perception and Management of Pain in Burn Patients

Directory of Open Access Journals (Sweden)

Terence J Coderre

2000-01-01

Full Text Available Through the introduction of the gate control theory and various subsequent works, Ronald Melzack has inspired many investigators worldwide to realize two important facts about pain. First, incoming pain messages are subject to both negative and positive modulation, which significantly affect its perception. Second, the progression of knowledge about the basic mechanisms underlying persistent and chronic pain is critically dependent on the increased understanding of the complexity of the symptoms experienced by pain patients. The present paper examines these two very important issues in an effort to understand better the mechanisms that underlie the pain suffered by burn patients. The physiological responses to burn injury involve many different mediators and mechanisms, all of which contribute to pain perception and development of neuronal plasticity underlying short and long term changes in pain sensitivity. While experimental burn injuries in humans and animals are typically well controlled and mild, in burn victims, the severity is much more variable, and clinical care involves repeated traumas and manipulations of the injured sites. Recurrent inputs from damaged and redamaged tissue impinge on a nervous system that becomes an active participant in the initiation of changes in sensory perception and maintenance of long term sensory disturbances. Recently acquired experimental evidence on postburn hyperalgesia, central hyperexcitability and changes in opioid sensitivity provides strong support that burn patients need an analgesic approach aimed at preventing or reducing the 'neural' memory of pain, including the use of more than one treatment modality. Burn injuries offer a unique opportunity to combine experimental and clinical research to understand pain mechanisms better. Over the years, Ronald Melzack has insisted that one of the most laudable enterprises in research is to span the gap between these two often separate worlds.

Work-related burn injuries in Ontario, Canada: a follow-up 10-year retrospective study

Science.gov (United States)

Clouatre, Elsa; Gomez, Manuel; Banfield, Joanne; Jeschke, Marc G

2013-01-01

Work-related burn injuries contribute to a quarter of all burn injuries in USA. In 2009, the provincial Workplace Safety and Insurance Board reported 64,824 work-related injuries that resulted in time-lost, 1188 injuries (2%) were a result of burns. There have been two previous studies performed at a regional burn centre (1984-1990 and 1998-2000) looking at incidence and characteristics of work-related burns. There was no significant change between these two groups. The purpose of this study was to identify the recent pattern of work-related burns from 2001 to 2010 and to compare it to the previous studies. During the study period, 1427 patients were admitted for an acute injury to the regional burn centre. Of these, 330 were due to a work-related incident (23%). The mean age of patients was 40.5±11.9 years, 95% were male. The mean total body surface area burn was 11.9±16.2%. The most common mechanism of burn injury was flame (32.7%) followed by electrical (27%) and scald (19.7%), inhalation injury was present in 4.8% of patients and the mortality was 1.8%. Our study has shown that there has been a significant decrease in the incidence in work-related burns treated at the regional burn centre (23.1%, vs. 28.2% vs. 30.2% pburns have now become the leading cause of injury, there was a significant reduction in inhalation injury (4.8% vs. 23% vs. 14.8%, pburns, improvement in burn care, and that prevention strategies may have been more effective. PMID:23352030

Quantifying Risk Factors for Long-Term Sleep Problems After Burn Injury in Young Adults.

Science.gov (United States)

Lee, Austin F; Ryan, Colleen M; Schneider, Jeffrey C; Kazis, Lewis E; Li, Nien Chen; Rose, Mary; Liang, Matthew H; Wang, Chao; Palmieri, Tina; Meyer, Walter J; Pidcock, Frank S; Reilly, Debra; Sheridan, Robert L; Tompkins, Ronald G

Restorative sleep is an important component of quality of life. Disturbances in sleep after burn injury were reported but all based on uncontrolled or nonstandardized data. The occurrence and the effect of long-term sleep problems in young adult burn survivors have not been well defined. This 5-year (2003-2008) prospective multicenter longitudinal study included adults with burn injuries ages 19 to 30 years who completed the Young Adult Burn Outcome Questionnaire (YABOQ) up to 36 months after injury. The items measured 15 patient-reported outcomes including physical, psychological, and social statuses and symptoms such as itch and pain. Scores of these 15 YABOQ outcome domains were standardized to a mean of 50 and a SD of 10 based on an age-matched nonburned reference group of young adults. Sleep quality was assessed using the item 'How satisfied are you now with your sleep,' rated by a 5-point Likert scale. Patients responding with very and somewhat dissatisfied were classified as having sleep dissatisfaction and the remaining as less or not dissatisfied. The associations between sleep dissatisfaction (yes/no) and YABOQ outcome domains were analyzed longitudinally using mixed-effect generalized linear models, adjusted for %TBSA burned, age, gender, and race. Generalized estimating equations were used to take into account correlated error resulting from repeated surveys on each patient over time. One hundred and fifty-two burn survivors participated in the YABOQ survey at baseline and during the follow-up who had at least one survey with a response to the sleep item. Among them, sleep dissatisfaction was twice as prevalent (76/152, 50%) when compared with the nonburned reference group (29/112, 26%). The likelihood of a burn survivor being dissatisfied with sleep was reduced over time after the burn injury. Sleep dissatisfaction following burns was significantly associated, in a dose-dependent manner, with increasing burn size (P = .001). Better sleep was associated

Aerobic exercise capacity after burn injury in children and adolescentsin the Netherlands

NARCIS (Netherlands)

Disseldorp, Laurien; van Brussel, Marco; Takken, Tim; Beerthuizen, Gerard I,J.M; van der Woude, Lucas; Mouton, Leonora J.; Nieuwenhuis, Marianne; Mouton, Leonora J.

2015-01-01

Abstract Purpose: Burn injuries have a major impact on the patient’s physical and psychological functioning. The consequences can, especially for pediatric burns, persist long after the injury. Loss of physical fitness after burns seems logical, considering inflammatory and stress responses and a

Effect of Fireworks Laws on Pediatric Fireworks-Related Burn Injuries.

Science.gov (United States)

Myers, John; Lehna, Carlee

Changes in U.S. fireworks laws have allowed younger children to purchase fireworks. In addition, the changes have allowed individuals to purchase more powerful fireworks. The purpose of this study is to examine the epidemiology of pediatric firework-related burn injuries among a nationally representative sample of the United States for the years 2006 to 2012. We examined inpatient admissions for pediatric firework-related burn patients from 2006 to 2012 using the nationwide inpatient sample and examined emergency department admissions using the nationwide emergency department sample. Both data sources are part of the Healthcare Cost and Utilization Project. Trajectories over time were evaluated. A total of 3193 injuries represented an estimated 90,257 firework-related injuries treated in the United States from 2006 to 2012. A majority of injuries were managed in the emergency department (n = 2008, 62.9%). The incidence generally increased over time; increasing from 4.28 per 100,000 population in 2006 to 5.12 per 100,000 population in 2012, P = .019. However, the proportion of injuries requiring inpatient admission (28.9% in 2006 to 50.0% in 2012, P fireworks laws may have had a modest effect on incidence of related injuries and the age of purchaser. However, it has had a dramatic effect on the severity of the related injuries, resulting in more inpatient admissions and longer length of stay in the hospital. Preventative methods should be taken to reduce the rate and severity of firework-related injuries among U.S. youths.

Properties and Types of Significant Thermal Skin Burn Injuries

Science.gov (United States)

2018-02-01

The deep burn category includes deep second, deep third and deep fourth-degree burns. Table 2: Burn Classification and Injury Outcome ( Rice ...Subcutaneous tissue  Entire dermis destroyed  No to low pain due to nerve destruction  Waxy white to leathery gray to charred black skin  Dry...Richard R.L. (2009) Rehabilitation of the Burned Hand. Hand Clinics, 25, 529- 541 Rice P.L. & Orgill, D.P. (2015).Classification of burns. (Ed

[Burn injuries to military personnel during the Six Day War].

Science.gov (United States)

Dreyfuss, U Y

2000-05-01

About 2500 soldiers were injured during the Six Day War (June 1967) of whom 115 suffered from burns. In 34 of them 15% or more of their body surface was involved and 11 died. Typical features of these burn cases were supplementary injuries, a high rate of infection, and long periods of hospitalization. Prophylactic antibiotics were not useful. The general condition of many deteriorated during the first week after injury, indicating the importance of treating severe burns in specialized facilities.

Myelo-erythroid commitment after burn injury is under β-adrenergic control via MafB regulation.

Science.gov (United States)

Hasan, Shirin; Johnson, Nicholas B; Mosier, Michael J; Shankar, Ravi; Conrad, Peggie; Szilagyi, Andrea; Gamelli, Richard L; Muthumalaiappan, Kuzhali

2017-03-01

Severely injured burn patients receive multiple blood transfusions for anemia of critical illness despite the adverse consequences. One limiting factor to consider alternate treatment strategies is the lack of a reliable test platform to study molecular mechanisms of impaired erythropoiesis. This study illustrates how conditions resulting in a high catecholamine microenvironment such as burns can instigate myelo-erythroid reprioritization influenced by β-adrenergic stimulation leading to anemia. In a mouse model of scald burn injury, we observed, along with a threefold increase in bone marrow LSK cells (lin neg Sca1 + cKit + ), that the myeloid shift is accompanied with a significant reduction in megakaryocyte erythrocyte progenitors (MEPs). β-Blocker administration (propranolol) for 6 days after burn, not only reduced the number of LSKs and MafB + cells in multipotent progenitors, but also influenced myelo-erythroid bifurcation by increasing the MEPs and reducing the granulocyte monocyte progenitors in the bone marrow of burn mice. Furthermore, similar results were observed in burn patients' peripheral blood mononuclear cell-derived ex vivo culture system, demonstrating that commitment stage of erythropoiesis is impaired in burn patients and intervention with propranolol (nonselective β1,2-adrenergic blocker) increases MEPs. Also, MafB + cells that were significantly increased following standard burn care could be mitigated when propranolol was administered to burn patients, establishing the mechanistic regulation of erythroid commitment by myeloid regulatory transcription factor MafB. Overall, results demonstrate that β-adrenergic blockers following burn injury can redirect the hematopoietic commitment toward erythroid lineage by lowering MafB expression in multipotent progenitors and be of potential therapeutic value to increase erythropoietin responsiveness in burn patients. Copyright © 2017 the American Physiological Society.

Burn injury suppresses human dermal dendritic cell and Langerhans cell function

NARCIS (Netherlands)

van den Berg, Linda M.; de Jong, Marein A. W. P.; Witte, Lot de; Ulrich, Magda M. W.; Geijtenbeek, Teunis B. H.

2011-01-01

Human skin contains epidermal Langerhans cells (LCs) and dermal dendritic cells (DCs) that are key players in induction of adaptive immunity upon infection. After major burn injury, suppressed adaptive immunity has been observed in patients. Here we demonstrate that burn injury affects adaptive

Effects of different components of serum after radiation, burn and combined radiation-burn injury on inward rectifier potassium channel of myocardial cells

International Nuclear Information System (INIS)

Ye Benlan; Cheng Tianmin; Xiao Jiasi

1997-01-01

Objective: To study the effects of different components of serum in rats inflicted with radiation, burn and combined radiation-burn injury on inward rectifier potassium channel of cultured myocardial cells. Method: Using patch clamp method to study the action of single ion channel. Results: The low molecular and lipid components of serum after different injuries models could all activate the inward rectifier potassium channel in cultured myocardial cells. The components of serum after combined radiation-burn injury showed the most significant effect, and the way of this effect was different from that from single injury. Conclusion: The serum components post injury altered the electric characteristic of myocardial cells, which may play a role in the combined effect of depressed cardiac function after combined radiation-burn injury

Burning more than calories: treadmill friction injuries in children.

LENUS (Irish Health Repository)

Davidson, C C

2012-02-01

Treadmill injuries in young children are a serious but little documented problem. Friction burns occur when the hands come into contact with the moving belt resulting in deep burns that often require hospital admission and surgery. The aim of this study was to assess the nature and prevalence of injuries sustained and to highlight treadmill friction burns as a public health issue previously undocumented in Ireland. A retrospective chart review from January 2006 until March 2008 was performed and functional outcome was assessed by the modified Michigan Hand Outcomes Questionnaire. Eight girls and four boys from one year and seven months to seven years and five months were treated. Eight children required admission to hospital and to date three have required surgery for their injuries. This is a new and increasing problem in Ireland which must be highlighted.

Effects of Burn Injury on Markers of Hypermetabolism in Rats

OpenAIRE

Izamis, Maria-Louisa; Uygun, Korkut; Uygun, Basak; Yarmush, Martin L.; Berthiaume, François

2009-01-01

The basic metrics of hypermetabolism have not been thoroughly characterized in rat burn injury models. We examined three models expected to differ in sensitivity to burn injury to identify that which group(s) exhibited the most clinically relevant metabolic response. Six and 12 weeks old male CD (6 week mCD and 12 week mCD) rats, and 12 weeks old female Fischer (12 week fFI) rats received a 20% total body surface area burn, followed by saline resuscitation. Activity, core body temperature, he...

Adenosine triphosphate hydrolysis reduces neutrophil infiltration and necrosis in partial-thickness scald burns in mice.

Science.gov (United States)

Bayliss, Jill; Delarosa, Sara; Wu, Jianfeng; Peterson, Jonathan R; Eboda, Oluwatobi N; Su, Grace L; Hemmila, Mark; Krebsbach, Paul H; Cederna, Paul S; Wang, Stewart C; Xi, Chuanwu; Levi, Benjamin

2014-01-01

Extracellular adenosine triphosphate (ATP), present in thermally injured tissue, modulates the inflammatory response and causes significant tissue damage. The authors hypothesize that neutrophil infiltration and ensuing tissue necrosis would be mitigated by removing ATP-dependent signaling at the burn site. Mice were subjected to 30% TBSA partial-thickness scald burn by dorsal skin immersion in a water bath at 60 or 20°C (nonburn controls). In the treatment arm, an ATP hydrolyzing enzyme, apyrase, was applied directly to the site immediately after injury. Skin was harvested after 24 hours and 5 days for hematoxylin and eosin stain, elastase, and Ki-67 staining. Tumor necrosis factor (TNF)-α and interferon (IFN)-β expression were measured through quantitative real-time polymerase chain reaction. At 24 hours, the amount of neutrophil infiltration was different between the burn and burn + apyrase groups (P burn group at 24 hours and 5 days. TNF-α and IFN-β expression at 24 hours in the apyrase group was lower than in the burn group (P burn site allays the neutrophil response to thermal injury and reduces tissue necrosis. This decrease in inflammation and tissue necrosis is at least partially because of TNF-α and IFN-β signaling. Apyrase could be used as topical inflammatory regulators to quell the injury caused by inflammation.

Changes of some immune functions in combined radiation-burn injury in rats

International Nuclear Information System (INIS)

Yan Yongtang; Ran Xinze; Wei Shuqing

1991-01-01

The characteristics of some immune functions in radiation injury (6 Gy), burn injury (15%, III deg) and combined radiation-burn injury (CRBI) were studied in rats. The results showed that the functions of splenocytes and thymocytes in radiation injury group (RIG) were depressed more markedly 24-72 h after injury. The degree of thymocyte depression in burn injury group (BIG) was significantly lower than that in RIG and recovered more easily. The characteristics of the CRBI effects were as follows: (1) The combined depression effect on thymocytes in CRBI as compared with that in RIG was deeper and the recovery was slower. (2) The depression course of splenocytes was similar to that in RIG, but the depression degree in the early stage was significantly more heavy than that in RIG. (3) In the later stage of CRBI the level of recovery of T H cells was significantly lower than that in RIG. (4) Eschar-excision plus skin grafting at 24 h after combined injury was helpful for the recovery of thymocyte and splenocytes function. The results showed that the depression and recovery of immune functions in combined injury were closely related to the wound of burn

Current knowledge of burn injury first aid practices and applied traditional remedies: a nationwide survey.

Science.gov (United States)

Kattan, Abdullah E; AlShomer, Feras; Alhujayri, Abdulaziz K; Addar, Abdullah; Aljerian, Albaraa

2016-01-01

Burn first aid awareness has been shown to reduce morbidity and mortality. We present a report on the knowledge and practices of the Saudi population with regard to burn first aid and the application of traditional remedies. An internet-based survey was conducted to assess the public's knowledge on first aid practices and home remedies applied for burn injuries among Saudi adults. A total of 2758 individuals responded to the survey. There were 1178 (42.7 %) respondents who had previously received burn first aid information. One thousand five hundred fifty respondents had a history of burn exposure in which burn injury first aid was applied as follows: 1118 (72.1 %) removed clothing and accessories from the injured area; water was applied by 990 (63.9 %); among those who applied water, 877 (88.6 %) applied cold water; and only 57 (5.8 %) did so for more than 15 min. Wrapping the burn area was performed by 526 (33.9 %), and 985 (63.5 %) sought medical assistance. When it comes to traditional remedies, 2134 (77.4 %) knew of and/or implemented these remedies as first aid or to treat burns. Honey and toothpaste were the commonest among these remedies with 1491 (69.9 %) and 1147 (53.7 %), respectively. This was associated with female gender ( r  = 0.87, P  first aid. Proper burn first aid is a simple, cheap, and accessible means of managing burns initially. Although the majority of the respondents were university graduates (51.1 %), knowledge and implementation of burn first aid was very poor. Major healthcare agencies should review and promote a consistent guideline for burn first aid in an effort to tackle and minimize the effect of this grave injury.

Analgesic effects of dexamethasone in burn injury

DEFF Research Database (Denmark)

Werner, Mads U; Lassen, Birgit Vibeke; Kehlet, Henrik

2002-01-01

and secondary hyperalgesia. RESULTS: The burn injury induced significant increases in erythema (P burn did not differ between dexamethasone and placebo treatments (P >.6). There were no significant......BACKGROUND AND OBJECTIVES: Glucocorticoids are well-known adjuvant analgesics in certain chronic pain states. There is, however, a paucity of data on their analgesic efficacy in acute pain. Therefore, the aim of the study was to examine the analgesic effects of dexamethasone in a validated burn...... model of acute inflammatory pain in humans. METHODS: Twenty-two volunteers were investigated in a double-blind, randomized, placebo-controlled cross-over study. Intravenous dexamethasone 8 mg or placebo was administered on 2 separate study days. Two hours after drug administration, a first-degree burn...

Images of God used by self-injurious burn patients.

Science.gov (United States)

Grossoehme, D H; Springer, L S

1999-08-01

Suicide by burning and other forms of self-injurious behaviors which involve burning are sometimes considered to have religious overtones. The ritual death of widows upon their husband's funeral pyre is closely associated with Hindu beliefs. Buddhists have used self-immolation as a form of protest. The Judaeo-Christian traditions have imagery of fire as cleansing and purifying; there is also secular imagery associating fire with images of condemnation and evil. Previous studies have described religiosity as a common theme among survivors. The present study describes the ways in which persons who inflicted self-injurious behaviors through burning, including attempted suicide, imagine the Divinity and use religious language to give meaning to their experience.

Early postoperative alterations of ventilation parameters after tracheostomy in major burn injuries

Directory of Open Access Journals (Sweden)

Mailänder, Peter

2010-01-01

Full Text Available Purpose: In patients with major burn injuries mechanical ventilation is often required for longer periods. Tracheostomy (TS plays an integral role in airway management. We investigated the effect of TS on ventilation parameters within 8 hours after TS. Materials: A retrospective analysis of severely burned patients admitted to the burn unit of a German University Hospital was performed. Ventilation parameters 8 hours before and after TS were registered. Results: A retrospective analysis of 20 patients which received surgical TS was performed. Mean age was 52±19 years. Mean abbreviated burned severity index (ABSI was 8.3±2.2. A mechanical ventilation was required for 14.3±4.8 days. TS was performed on day 7±4. Inspiratory oxygen concentration (FiO2 (p<0.001, peak inspiratory pressure (p<0.001, positive end-expiratory pressure (p=0.003 and pulmonary resistance (p<0.001 were reduced significantly after TS. The arterial partial pressure of oxygen/FiO2-ratio increased significantly after TS (p<0.001. Conclusions: We demonstrate that TS reduces invasiveness of ventilation in severely burned patients and by this can optimize lung protective ventilation strategy.

Effects of abdominal lavage fluid from rats with radiation injury and combined radiation-burn injury on growth of hematopoietic progenitor cells

International Nuclear Information System (INIS)

Su, Y.-P.; Cheng, T.-M.; Guo, C.-H.; Liu, X.-H.; Qu, J.-F.

2003-01-01

Full text: Objective: To observe the effects of abdominal lavage fluid from rats with radiation injury, burn injury and combined radiation-burn injury on growth of hematopoietic progenitor cells. Methods Rats were irradiated with a single dose of 12 Gy γ-ray of 60Co, combined with 30% of total body surface area (TBSA) generated under a 5 KW bromo-tungsten lamp for 25 s. Lavage fluid from the peritoneum was collected 3, 12, 24, 48 and 72 hours after injury. Then the lavage fluid was added to the culture media of erythrocyte progenitor cells (CFU-E, BFE-E) or of granulocyte-macrophage progenitor cells (CFU-GM) at 40 mg/ml final concentration. Results The formed clones of CFU-E, BFU-E and CFU-GM of the lavage fluid from rats with radiation injury or combined radiation-burn injury at 3h, 12h, 24h, 48h and 72h time points were significantly higher than those from normal. They reached their peaks at 24h after injury (215.7%, 202.3%, or 241.2% from burned rats and 188.1%, 202.3% or 204.6% from rats inflected with combined radiation-burn injury as compared with those from normal rats). However, few CFU-E, BFU-E or CFU-GM clones were found after addition of lavage fluid from irradiated rats. Conclusion Peritoneal lavage fluid from rats with burn injury or combined radiation-burn injury enhances the growth of erythrocytes and granulocyte progenitor cells. On the contrary, the lavage fluid from irradiated rats shows inhibitory effects

Capacity of bone marrow colony forming unit-fibroblasts in vitro from mice with combined radiation-burn injury

International Nuclear Information System (INIS)

Chen Xinghua; Luo Chengji; Guo Chaohua; Wang Ping

1999-01-01

Objective: To investigate the capacity of bone marrow colony forming unit-fibroblasts (CFU-F) from mice with combined radiation-burn injury. Methods: Mice were treated with 5.0 Gy γ-ray radiation alone, 15% total body surface area (TBSA) III degree burn alone or combined radiation-burn. The numbers of CFU-Fs were assayed by Dexter's method. Results: The numbers of CFU-Fs from mice with radiation and combined radiation-burn injury were significantly decreased, compared with those of controls and mice with burn injury alone (P<0.05-0.01). conclusion: The results reveal that the repairing process of bone marrow stromal cells from mice with radiation injury and combined radiation-burn injury is slow, and the combined radiation-burn injury inflicted on the stromal cells possesses the characteristic of radiation injury

Acute pavement burns: a unique subset of burn injuries: a five-year review of resource use and cost impact.

Science.gov (United States)

Silver, Andrew G; Dunford, Gerrit M; Zamboni, William A; Baynosa, Richard C

2015-01-01

This study focuses on the hospital care of a rare subset of burn injuries caused by contact with environmentally heated pavement, to further understand the required use of resources. This article aims to show that pavement burns are typically more severe than their flame/scald counterparts. A retrospective review of patients admitted to the burn center with injuries suffered from contact with hot pavement was performed. Patients were stratified on the presence or absence of altered mental status (AMS) and additional inciting factors. A representative sample of similarly sized flame and scald wounds treated in the same time period was compiled for comparison. Those with pavement burns had a significantly greater requirement for operative intervention, repetitive debridements, overall cost/percent burned, and lengthier hospital stays than those with flame/scald burns. Pavement burn victims with AMS were significantly more likely to require an operation, a greater cost/percent burned, and longer hospital stays than those without AMS. Pavement burns are significantly worse than similarly sized scald/flame burns with regards to length of stay and total hospital costs, and the necessity of initial and repetitive operative intervention. These discrepancies are even greater in patients with AMS as a concomitant inciting factor. It is apparent that these wounds often continue to deepen during a patient's stay, likely because of continued pressure on the wounds while recumbent. As such, this article highly recommends pressure off-loading beds and more aggressive debridement in the treatment of these unique injuries.

Summer camps for children with burn injuries: a literature review.

Science.gov (United States)

Maslow, Gary R; Lobato, Debra

2010-01-01

The first summer camps for children with burn injuries started over 25 years ago, and as of 2008, there were 60 camps worldwide. This review examines the literature on summer pediatric burn camps. The authors describe common characteristics of burn camp structure, activities, and staffing and then examine the scientific evidence regarding the effect of burn camp programs on campers and camp staff volunteers. A search of Pubmed and Psychinfo databases from 1970 to 2008 for articles related to pediatric burn summer camps identified 17 articles, of which 13 fit the inclusion criteria. Existing literature consists primarily of qualitative studies, suggesting that burn camp can decrease camper isolation, improve self-esteem, and promote coping and social skills. Studies examining volunteer staff at burn camp have consistently found that there are both personal and professional benefits. Quantitative studies of self-esteem have yielded equivocal results. No studies have examined safety or the effect of burn camp on medical or rehabilitation outcomes. For the past 25 years, pediatric summer camps for children with burn injuries have played an important rehabilitation role and provided a strong community that benefits both campers and staff. Future research using more rigorous research methods and examining a broader range of outcomes (eg, safety and medical/rehabilitation outcomes) is recommended.

How to Help a Person with a Serious Burn Injury

Science.gov (United States)

... How To Help A Person With A Serious Burn Injury Wellness For Parents Professionals Caregivers Printable Version ... volunteer to help out! Kathy Edwards is a burn survivor and professor in the Department of Communication ...

Safety and potential anticoagulant effects of nebulised heparin in burns patients with inhalational injury at Singapore General Hospital Burns Centre.

Science.gov (United States)

Yip, Lian Yee; Lim, Yen Fang; Chan, Hong Ngee

2011-11-01

Nebulised heparin, N-acetylcysteine (NAC) and salbutamol were shown to decrease reintubation rates, incidence of atelectasis and mortality in paediatric patients and reduce lung injury scores in adult burns patients with inhalational lung injury (ILI). Nebulised heparin, NAC and salbutamol treatment protocol was introduced in Singapore General Hospital (SGH) Burns Centre in 2006. However, safety data on the use of nebulised heparin and NAC for burns patients with ILI is not well established. In this study, we investigated the safety and potential anticoagulant effects of nebulised heparin in burns patients with ILI. A retrospective study with historical control was conducted. The treatment group consisted of 52 mechanically ventilated adult patients, with a diagnosis of ILI as confirmed by bronchoscopy, admitted to burn intensive care unit (BICU) from the year 2006 to 2009. The group was treated with nebulised heparin, NAC and salbutamol. The control group consists of 11 mechanically ventilated BICU ILI patients treated from year 2001 to 2005 before protocol initiation. Blood coagulation indices (prothrombin time (PT), activated partial thromboplastin time (APTT) and platelet count) were monitored and bleeding incidences were assessed. Blood coagulation indices did not suggest an increase risk of bleeding with nebulised heparin. The APTT, PT and platelet count followed a similar trend for both groups over 7 days. No clinically significant increase in bleeding risk was found to be associated with nebulised heparin. Nebulised heparin was not found to potentiate the risk of bleeding in burns patients with ILI. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

Epidemiology of burn injuries in South-Eastern Iran: A retrospective study

International Nuclear Information System (INIS)

Moghaddam, A.A.; Baghbanian, A.; Dogoonchi, M.; Roudi, M.M.

2013-01-01

Objective: To explore the epidemiology of burn injuries in Zahedan, Southeastern Iran. Methods: A retrospective review of 730 medical records, of burnt patients, for a period of two years was done. Pre-designed data recording forms were used to collect data. The SPSS-15 was used to analyze data. Results: Overall, 713 medical records were analyzed: two-thirds (62.0%) were fire-related and one-third related to scalds (33.1%). Intentional self-harm injuries accounted for 14.3% of all admissions. A significant difference existed between patients' age or sex and the causes of burns (P<0.001). Burns more than 60% closely correlated with death rate and hospital stay (P<0.001). Conclusion: Lack of the necessary, socio-economic infrastructure, language and cultural barriers, low level of literacy, flammability of women's clothes and unsafe application/design of stove and heaters are likely to contribute to the high frequency of burn injuries in this area. (author)

Individual-level predictors of inpatient childhood burn injuries: a case–control study

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Homayoun Sadeghi-Bazargani

2016-03-01

Full Text Available Abstract Background Burn injuries are considered one of the most preventable public health issue among children; however, are a cause of significant morbidity and mortality in Iran. The aim of this study was to assess individual-level predictors of severe burn injuries among children leading to hospitalization, in East Azerbaijan Province, in North-West of Iran. Methods The study was conducted through a hospital based case–control design involving 281 burn victims and 273 hospital-based controls who were frequency matched on age, gender and urbanity. Both bivariate and multivariate methods were used to analyze the data. Results Mean age of the participants was 40.5 months (95 % CI: 37–44 with the majority of burns occurring at ages between 2 months-13.9 years. It was demonstrated that with increase in the caregiver’s age there was a decrease in the odds of burn injuries (OR = 0.94, 95 % CI: 0.92-0.97. According to the multivariate logistic regression there were independent factors associated with burn injuries including childhood ADHD (OR = 2.82, 95 % CI: 1.68 - 4.76, child’s age (OR = 0.73, 95%CI: 0.67 - 0.80, flammability of clothing (OR = 1.60, 95 % CI: 1.12 - 2.28, daily length of watching television (OR = 1.31, 95 % CI: 1.06 - 1.61, playing outdoors (OR = 1.32, 95 % CI: 1.16 - 1.50 and increment in the economic status (OR = 1.37, 95 % CI: 1.18 - 1.60. Conclusion Major risk predictors of burn injuries among the Iranian population included childhood ADHD, child’s age, watching television, playing outdoors, high economic status and flammable clothing.

Severe burn injuries caused by bioethanol-design fireplaces-an overview on recreational fire threats.

Science.gov (United States)

Kraemer, Robert; Knobloch, Karsten; Lorenzen, Johan; Breuing, Karl H; Koennecker, Soeren; Rennekampff, Hans-Oliver; Vogt, Peter M

2011-01-01

Commercially available bioethanol-fueled fireplaces have become increasingly popular additions for interior home decoration in Europe and more recently in the United States. These fireplaces are advertised as smokeless, ecologically friendly, and do not require professional installation, formal gas lines, or venting. Although manufacturers and businesses promote their safety, recent presentations of injuries have alerted the authors to the relevant danger bioethanol fireplaces can pose for the incautious user. Are bioethanol fireplaces going to become the future threat in domestic burn accidents beside common barbeque burns? A Medline literature search on barbeque and domestic fireplace accidents was performed to compare and stratify the injury patterns reported and to identify a risk profile for contemporary bioethanol-fueled fireplaces. To exemplify, two representative clinical cases of severe burn accidents caused by bioethanol-fueled fireplaces, both treated in the burn unit of the authors, are being presented. Design fireplaces are being recognized as an increasing source of fuel and fire-related danger in the home. This risk may be underestimated by the uninformed customer, resulting in severe burn injuries. Because bioethanol-fueled fireplaces have become more commonplace, they may overtake barbecue-related injury as the most common domestic burn injury.

Socio-Economic And Psychological Implications Of Burn Injury In ...

African Journals Online (AJOL)

Burn is a global problem with a magnitude of chains of psychological effects on surviving victims and socio economic implications for the individual, the immediate family and the society at large. This paper seeks to highlight the major consequences of burn injuries in the Nigerian society. There is a growing evidence of ...

Examining the Correlation between Objective Injury Parameters, Personality Traits and Adjustment Measures among Burn Victims

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Josef Mordechai Haik

2015-03-01

Full Text Available Background: Burn victims experience immense physical and mental hardship during their process of rehabilitation and regaining functionality. We examined different objective burn related factors as well as psychological ones, in the form of personality traits, that may affect the rehabilitation process and its outcome. Objective: To assess the influence and correlation of specific personality traits and objective injury related parameters on the adjustment of burn victims post-injury. Methods: 62 male patients admitted to our burn unit due to burn injuries were compared with 36 healthy male individuals by use of questionnaires to assess each group's psychological adjustment parameters. Multivariate and hierarchical regression analysis was conducted to identify differences between the groups. Results: A significant negative correlation was found between the objective burn injury severity (e.g. TBSA and burn depth and the adjustment of burn victims (p<0.05, p<0.001, table 3. Moreover, patients more severely injured tend to be more neurotic (p<0.001, and less extroverted and agreeable (p<0.01, table 4. Conclusions: Extroverted burn victims tend to adjust better to their post-injury life while the neurotic patients tend to have difficulties adjusting. This finding may suggest new tools for early identification of maladjustment-prone patients and therefore provide them with better psychological support in a more dedicated manner.

Acute Kidney Injury: It's not just the 'big' burns.

Science.gov (United States)

Kimmel, L A; Wilson, S; Walker, R G; Singer, Y; Cleland, H

2018-02-01

Acute Kidney Injury (AKI) complicates the management of at least 25% of patients with severe burns and is associated with long term complications. Most research focuses on the patients with more severe burns, and whether the same factors are associated with the development of AKI in patients with burns between 10 and 19% total body surface area (TBSA) is unknown. The aims of this study were to examine the incidence of, and factors associated with, the development of AKI in patients with %TBSA≥10, as well as the relationship with hospital metrics such as length of stay (LOS). Retrospective medical record review of consecutive burns patients admitted to The Alfred Hospital, the major adult burns centre in Victoria, Australia. Demographic and injury details were recorded. Factors associated with AKI were determined using multiple logistic regression. Between 2010 and June 2014, 300 patients were admitted with burn injury and data on 267 patients was available for analysis. Median age was 54.5 years with 78% being male. Median %TBSA was 15 (IQR 12, 20). The AKI incidence, as measured by the RIFLE criteria, was 22.5%, including 15% (27/184) in patients with %TBSA 10-19. Factors associated with AKI included increasing age and %TBSA (OR 1.05 p<0.001) as well as increased surgeries (p<0.041) and a cardiac comorbidity (p<0.01). All patients with renal comorbidity developed AKI. In the %TBSA 10-19 cohort, only increasing age (OR 1.05 p<0.001) was associated with AKI. After accounting for confounding factors, the probability of discharge from hospital in Non-AKI group was greater than for the AKI patients at all time points (P<0.001). This is the first study to show an association between patients with %TBSA 10-19 and AKI. Given the association between AKI and complications, prospective research is needed to further understand AKI in burns with the aim of risk reduction. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Consensus of the Surgical Treatment of Burn Injuries in Belgium

OpenAIRE

BRUSSELAERS, NELE; Lafaire, C; Ortiz, S; Jacquemin, D; Monstrey, Stan

2008-01-01

On the occasion of the twentieth anniversary of the 'Belgian Association of Burn Injuries' an inventory was made of all surgical techniques used in the five largest Belgian burn centres in order to draw up a consensus document. A questionnaire covering the whole treatment of severely burned patients was sent to the surgeons of each burn unit, ranging, from emergency treatment, through diagnostic techniques, burn surgery and post-healing treatment (scars, contractures). During the past decade,...

Intraluminal Flagellin Differentially Contributes to Gut Dysbiosis and Systemic Inflammation following Burn Injury.

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Logan Grimes

Full Text Available Burn injury is associated with a loss of gut barrier function, resulting in systemic dissemination of gut-derived bacteria and their products. The bacterial protein and TLR5 agonist, flagellin, induces non-specific innate immune responses. Because we detected flagellin in the serum of burn patients, we investigated whether gut-derived flagellin was a primary or secondary contributor to intestinal dysfunction and systemic inflammation following burn injury. The apical surface of polarized human intestinal epithelial cells (IECs, Caco-2BBe, were exposed to 50 or 500 ng of purified flagellin and 1 x 105 of an intestinal E. coli (EC isolate as follows: 1 flagellin added 30 min prior to EC, 2 flagellin and EC added simultaneously, or 3 EC added 30 min prior to flagellin. Our results showed that luminal flagellin and EC modulated each other's biological actions, which influenced their ability to induce basolateral secretion of inflammatory cytokines and subsequent translocation of bacteria and their products. A low dose of flagellin accompanied by an enteric EC in the lumen, tempered inflammation in a dose- and time-dependent manner. However, higher doses of flagellin acted synergistically with EC to induce both intestinal and systemic inflammation that compromised barrier integrity, increasing systemic inflammation following burn injury, a process we have termed flagellemia. In a murine model of burn injury we found that oral gavage of flagellin (1 μg/mouse significantly affected the gut microbiome after burn injury. In these mice, flagellin disseminated out of the intestine into the serum and to distal organs (mesenteric lymph nodes and lungs where it induced secretion of monocyte chemoattractant protein (MCP-1 and CXCL1/KC (mouse equivalent of human IL-8 at 24 and 48h post-burn. Our results illustrated that gut-derived flagellin alone or accompanied by a non-pathogenic enteric EC strain can function as an initiator of luminal and systemic

Risks for skin and other cancers up to 25 years after burn injuries

DEFF Research Database (Denmark)

Mellemkjaer, Lene; Hölmich, Lisbet R; Gridley, Gloria

2006-01-01

BACKGROUND: Malignant degeneration of chronic ulcers such as nonhealed burn wounds has been described in the literature, but this phenomenon has never been quantified in an epidemiologic study. We investigated the risks for skin and other cancers among patients with a prior burn. METHODS: We...... with that in the general population of Denmark. RESULTS: Patients with burn had 139 skin cancers, with 189 expected, yielding a standardized incidence ratio of 0.7 (95% confidence interval = 0.6-0.9). This reduced risk was due mainly to deficits of basal cell carcinoma and malignant melanoma, whereas the number...... of squamous cell carcinomas observed was close to expected. We saw no consistent increases in risk for skin cancer in the subgroups of patients with the most severe injuries or with the longest periods of follow up. CONCLUSIONS: The tendency to malignant degeneration of burn scars, described in previous...

Household related predictors of burn injuries in an Iranian population: a case–control study

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Sadeghi-Bazargani Homayoun

2012-05-01

Full Text Available Abstract Background To prevent burn injuries it is vital to have sound information on predictors of its occurrence in different settings. Ardabil Province is the coldest province of Iran with high burden of burn injuries. The aim of this study was to determine the household related predictors of unintentional burns in Ardabil Province located at North-West of Iran. Methods The study was conducted through a hospital based case–control design. 239 burn victims as well as 246 hospital-based controls were enrolled. Both bivariate and multivariate analysis methods were used. Results Males comprised 55.2% of all the study subjects. Mean age of the participants was 21.8 years (95% CI: 19.17-24.4. The economic ability of the households was associated with risk of burn injuries. Multivariate conditional logistic regression results showed the following variables to be independent factors associated with burn injuries. Using non-conventional pipe-less air heaters instead of conventional piped kerosene- or gas-burning heaters (Odds ratio: 1.98, 95% CI: 1.1-3.6. Common use of picnic gas-stove for cooking at home (odds ratio = 1.6, 95%CI: 1–2.4. Using electric samovars instead of other types of samovars (Odds ratio = 0.3, 95% CI: 0.1-1. Using samovars lacking the national standard authorization mark (Odds ratio = 2.2, 95% CI: 1.4-3.6. Conclusion Using some types of specific heating or cooking appliances, and unsafe use of conventional appliances were major risk predictors of burn injuries in this population.

Electrical Burn Causing a Unique Pattern of Neurological Injury

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Nathan R. Schaefer, BExSc, MBBS (Hons

2015-04-01

Full Text Available Summary: Neurological involvement is not uncommon in patients who sustain electrical injury. The exact mechanism of nervous system damage following electrical trauma is not fully understood. The gamut of possible neurologic manifestations following electrical injury is diverse. This case report describes a young man with a unique pattern of neurological injury following an electrical burn. The combination of brachial plexopathy, partial Horner’s syndrome, and phrenic nerve palsy secondary to electrical injury has not been previously described in the literature.

Is there a threshold age and burn size associated with poor outcomes in the elderly after burn injury?

Science.gov (United States)

Jeschke, Marc G; Pinto, Ruxandra; Costford, Sheila R.; Amini-Nik, Saeid

2016-01-01

Elderly burn care represents a vast challenge. The elderly are one of the most susceptible populations to burn injuries, but also one of the fastest growing demographics, indicating a substantial increase in patient numbers in the near future. Despite the need and importance of elderly burn care, survival of elderly burn patients is poor. Additionally, little is known about the responses of elderly patients after burn. One central question that has not been answered is what age defines an elderly patient. The current study was conducted to determine whether there is a cut-off age for elderly burn patients that is correlated with an increased risk for mortality and to determine the burn size in modern burn care that is associated with increased mortality. To answer these questions, we applied appropriate statistical analyses to the Ross Tilley Burn Centre and the Inflammatory and Host Response to Injury databases. We could not find a clear cut-off age that differentiates or predicts between survival and death. Risk of death increased linearly with increasing age. Additionally, we found that the LD50 decreases from 45% total body surface area (TBSA) to 25% TBSA from the age of 55 years to the age of 70 years, indicating that even small burns lead to poor outcome in the elderly. We therefore concluded that age is not an ideal to predictor of burn outcome, but we strongly suggest that burn care providers be aware that if an elderly patient sustains even a 25% TBSA burn, the risk of mortality is 50% despite the implementation of modern protocolized burn care. PMID:26803373

Implications for would healing of patient age and time elapsed since burn injury.

Science.gov (United States)

Mountford, E M; Blight, A; Cheshire, I M

1995-01-01

To determine the relationship between growth potential in culture and the age of the patient, skin biopsies were obtained from over 60 patients of varying ages. The relationship between the length of time elapsed since burn injury and growth potential was also examined, using biopsies obtained from patients with burns during their treatment. Keratinocytes were extracted from biopsies and assessed for colony-forming ability by standard methods. Repeated subculture of cells was undertaken to determine the reproductive capacity of cells in vitro. Age had no effect on the colony-forming ability of keratinocytes in primary culture; however age did affect the total number of generations achieved by these cells. The growth potential of keratinocytes from patients with severe burns showed considerable variation according to the amount of time which had elapsed since the injury. This was most apparent around one week post-burn. These results need to be investigated further to understand their clinical implications. The study provides an insight into the influence of age and physiological response on the wound healing process in burn injuries.

Effect of Malva sylvestris cream on burn injury and wounds in rats

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Ebrahim Nasiri

2015-06-01

Full Text Available Objectives: Burn injury is one of the most health-threatening problems in the world. Malva sylvestris (M. sylvestris flowershave a high mucilage content and are used as a remedy for cut wound and dermal infected wounds in Iranian folklore Medicine. The purpose of this study was to investigate the effect of M. sylvestris cream on the second degree burn injury in rats. Materials and Methods: Five groups of 10 rats per group were burned with hot metal plate. Animals were administrated divided as control, normal saline, standard silver sulfadiazine 1% (SSD, 5% M. sylvestris, and 10% M. sylvestris into separate groups. Wound area, percentage of wound contraction, and histological and bacteriological assessments were evaluated. Results: Wound sizes were not significantly different among groups on 1st and 3rd days after burn injury, while they were significantly different among groups after 7th day post-burn injury. The average areas of wounds on the 15th day were 7.5±2.9, 6.7±2, 10.5±1.6, 4.7±2, and 4.5±2 cm2 for base cream, normal saline, SSD, 5% M. sylvestris, and 10% M. sylvestris, respectively. The results of histology exhibited well-formed horizontally-oriented collagen fibers in MS topical treatment groups. Microorganisms existed in the SSD group were most probably Staphilococcus epidermitis and for NS group were staphylococcus saprophiteccus. Conclusion: M. sylvestris cream improved histological changes of tissue components in the process of healing when compared with SSD cream. Therefore, it can be used as a topical treatment agent for burn wound.

78 FR 57486 - Eligibility of Disabled Veterans and Members of the Armed Forces With Severe Burn Injuries for...

Science.gov (United States)

2013-09-19

... Members of the Armed Forces With Severe Burn Injuries for Financial Assistance in the Purchase of an... ``severe burn injury (as determined pursuant to regulations prescribed by the Secretary)'' as one of the... severe burn injuries, the Chairman of the Senate Committee on Veterans' Affairs explained that, ``[d]ue...

77 FR 66419 - Eligibility of Disabled Veterans and Members of the Armed Forces With Severe Burn Injuries for...

Science.gov (United States)

2012-11-05

... Members of the Armed Forces With Severe Burn Injuries for Financial Assistance in the Purchase of an... the Armed Forces with Severe Burn Injuries for Financial Assistance in the Purchase of an Automobile... (U.S.C.), by reformatting the statute and adding ``severe burn injury (as determined pursuant to...

77 FR 70389 - Eligibility of Disabled Veterans and Members of the Armed Forces With Severe Burn Injuries for...

Science.gov (United States)

2012-11-26

... Members of the Armed Forces With Severe Burn Injuries for Financial Assistance in the Purchase of an... reformatting the statute and adding ``severe burn injury (as determined pursuant to regulations prescribed by...)(iv), VA proposes to amend 38 CFR 3.808 to define the term ``severe burn injury.'' In the proposed...

Primary observation on adherent function of bone marrow stromal cells in mice post combined radiation-burn injury

International Nuclear Information System (INIS)

Chen Xinghua; Luo Chengji; Guo Chaohua; Wang Ping; Deng Xuecai

1999-01-01

Objective: To investigate the adherent function of bone marrow stromal cells in hematopoietic inductive microenvironment post combined radiation-burn injury. Methods: The expression of cell adhesion molecules including vascular cell adhesion molecule-1 (VCAM-1), fibro-connection (Fn), laminin (Ln) and collagen type IV (Col IV) on bone marrow stromal cells cultured in vitro was detected by flow cytometry and the binding capacity of bone marrow mononuclear cells to stromal cell adherence layer was tested by cell binding assay and cell binding blocking assay respectively from mice treated with 5.0 Gy γ-ray 15% of total body surface area (TBSA), third-degree burn injury and combined irradiation-burn injury, respectively. Results: 1. The expression levels of molecules mentioned above in burn-injured mice were the highest. The molecules levels in control mice were greater than those in radiation-injured mice, which were lower than those in mice with combined radiation-burn injury. 2. The binding capacity of stromal cell adherence layer in burn-injured mice was greater than that in control mice, and significantly increased from 3 to 7 days post injury as compared with that in controls, radiation-injured mice and combined radiation-burn-injured mice, respectively (P < 0.05-0.01). Contrarily, the capacity of binding in the radiation-injured and combined radiation-burn-injured mice was the lowest from 3 to 7 days post injury. 3. The binding rate of bone marrow mononuclear cells to stromal cell adherence layer descended in different degrees after pre-treatment with monoclonal antibodies directed to VCAM-1, Fn, Ln, or Col IV respectively or VCAM-1 combined with anti-Fn, anti-Ln or anti-Col IV, respectively, in stromal cell adherence layer. Conclusion: The damage of cell adherent function for bone marrow hematopoietic inductive microenvironment post combined radiation-burn injury might be one of the important factors in hematopoietic disorder in combined radiation-burn injury

Firework injuries presenting to a national burn's unit.

Science.gov (United States)

Jones, D; Lee, W; Rea, S; Donnell, M O; Eadie, P A

2004-09-01

The sale to the general public of fireworks is illegal in Ireland. However, many fireworks are readily available on the black market from illegal traders. The number of firework injuries presenting to our unit during the three week run-up to Hallowe'en October 2001 was recorded. In addition, each patient was contacted to determine how the fireworks were obtained, the average amount of money spent, and the level of adult supervision present at the time of injury. A total of 19 patients presented, 18 from the local catchment area, with a mean age of 16 yrs (range 5-46 yrs). Thirteen patients required admission. Sixteen patients sustained hand injuries including burns, and three sustained burns to other body areas. The amount of money spent varied between adults and children, the average amount among the paediatric group was Euro 2-4, but Euro 45 in the adult group. None were willing to identify the local source of their fireworks, but most fireworks originated in Northern Ireland. This small review highlights an ongoing problem in Ireland; fireworks are illegal, yet they are easily and cheaply available without quality or safety controls. Our public awareness campaign has failed to reach its target audience, and the illegal traders who sell these often inferior products are seldom charged. Children and adults will continue to sustain serious injuries as a result.

The burning issues of motor vehicle radiator scald injuries revisited - a fresh review and changing prevention strategies.

Science.gov (United States)

Patel, J N; Tan, A; Frew, Q; Dziewulski, P

2016-12-31

A preventable subgroup of burn injuries is scalds sustained from motor vehicle radiators. This study was to determine changes in trends in epidemiology of such injuries and to discuss whether current and other prevention efforts proposed previously require reinforcement. We conducted a retrospective study (February 2007-August 2015) of all motor vehicle-related burn referrals to our regional burns service. 68 cases of motor vehicle radiator burns were identified. Male to female ratio was 65:3. Mean age was 35.1 (range = 9-71). Most cases occurred in the summer months (22/68 = 32.4%). 65 cases (95.6%) involved car radiators. 66% of injuries resulted from actively removing the pressure cap of an overheated radiator in the motor vehicle. Mean total burn surface area (%TBSA) was 2.1% (range = 0.5- 11%). The depths of burn injuries were mostly superficial partial thickness. Face, chest and upper limbs were the most common sites of injury. Mean healing time was 14.2 days (range = 4-60). Following the introduction of safety measures by vehicle manufacturers, motor vehicle radiator burns in this era are mostly minor injuries and can be potentially managed conservatively as an outpatient. This contrasts with findings from previous studies over a decade ago of larger, more significant injuries requiring admission and surgery. Whilst manufacturers have installed safety measures into the design of radiator caps, our findings suggest that re-educating the public to allow a period of cooling prior to opening caps should be reinforced.

Peripheral antinociceptive effects of morphine after burn injury

DEFF Research Database (Denmark)

Møiniche, S; Dahl, J B; Kehlet, H

1993-01-01

In a double-blind study, 2 mg of morphine in saline, or saline only, was given subcutaneously into a second-degree bilateral leg-burn injury in 12 volunteers. Heat-pain thresholds and pressure-pain thresholds were significantly increased by local morphine administration. These results confirm...

Design of a cross-sectional study on physical fitness and physical activity in children and adolescents after burn injury

NARCIS (Netherlands)

Disseldorp, Laurien M.; Mouton, Leonora J.; Takken, Tim; Van Brussel, Marco; Beerthuizen, Gerard I. J. M.; Van der Woude, Lucas H. V.; Nieuwenhuis, Marianne K.

2012-01-01

Background: Burn injuries have a major impact on the patient's physical and psychological functioning. The consequences can, especially in pediatric burns, persist long after the injury. A decrease in physical fitness seems logical as people survive burn injuries after an often extensive period of

Validation of the Community Integration Questionnaire in the adult burn injury population.

Science.gov (United States)

Gerrard, Paul; Kazis, Lewis E; Ryan, Colleen M; Shie, Vivian L; Holavanahalli, Radha; Lee, Austin; Jette, Alan; Fauerbach, James A; Esselman, Peter; Herndon, David; Schneider, Jeffrey C

2015-11-01

With improved survival, long-term effects of burn injuries on quality of life, particularly community integration, are important outcomes. This study aims to assess the Community Integration Questionnaire's psychometric properties in the adult burn population. Data were obtained from a multicenter longitudinal data set of burn survivors. The psychometric properties of the Community Integration Questionnaire (n = 492) were examined. The questionnaire items were evaluated for clinical and substantive relevance; validation procedures were conducted on different samples of the population; construct validity was assessed using exploratory factor analysis; internal consistency reliability was examined using Cronbach's α statistics; and item response theory was applied to the final models. The CIQ-15 was reduced by two questions to form the CIQ-13, with a two-factor structure, interpreted as self/family care and social integration. Item response theory testing suggests that Factor 2 captures a wider range of community integration levels. Cronbach's α was 0.80 for Factor 1, 0.77 for Factor 2, and 0.79 for the test as a whole. The CIQ-13 demonstrates validity and reliability in the adult burn survivor population addressing issues of self/family care and social integration. This instrument is useful in future research of community reintegration outcomes in the burn population.

Ustioni da fuoco / Burn injuries / Les brûlures

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Liliana Copertino

2008-04-01

Full Text Available Severe burn injuries require high specialistic treatment. Burn injuries are common in disasters and war scenarios, so war medicine has been fundamental to improve treatment protocols for burn patients..Burn injuries are classified according to the etiopathogenetic agent (physical, chemical or radiation, that determines different anatomoisthologic aspects.An estimation of the depth and extension are fundamental for defining the gravity of the burn. Critical burn patients have to be transported in specialistic Centers. There they are treated by multispecialistic teams from the resuscitation phase to the reconstructive surgery and specialist rehabilitation.. This process can continue for two years with the objective to return patients to a quiet normal life. Les brûlures sont des lésions traumatiques qui requièrent un traitement spécialisé. Lors de catastrophes et de guerres, les brûlures sont des lésions très fréquentes et la médecine de guerre a contribué à faire avancer la science de manière importante, dans le traitement de cette pathologie.Les brûlures sont classées en fonction de l'agent étiopathogénique (agents physiques, chimiques ou radiations dont le mécanisme d'action qui provoque la lésion cause des aspects anatomohistologiques caractéristiques.Pour définir la sévérité d'une brûlure, il est aussi fondamental d'éstimer l'extension de la surface corporelle et la profondeur de l'épiderme, et éventuellement du derme, atteints. Les patients gravement brûlés doivent être hospitalisés dans des Centres Spécialisés où des équipes multispécialistes les suivent de la phase initiale de la réanimation aux phases de chirurgie reconstructive et au processus de réhabilitation. Ces dernières phases peuvent se prolonger pendant les deux années suivant le traumatisme avant qu'une réintégration dans une vie sociale acceptable ne puisse être faite.

Stigma perspective of siblings of children with a major childhood burn injury.

Science.gov (United States)

Lehna, Carlee

2013-10-01

To understand the stigma perspective of siblings of children with major burn injury. A mixed method, qualitative-dominant study was conducted. The life story method was used for the qualitative portion. Only narratives from those family members describing the sibling's appearance change were used (N = 18 participants). Stigma experienced by siblings was first described by parents or noninjured siblings; they described how the sibling with changed appearance was stared at, ridiculed, or teased when they entered a new social situation. Only when specifically asked did the children with burn injury talk about their problems, saying, "This always happens when I go somewhere new." Children with changed appearance focused on normalizing their lives in a positive way. Oftentimes, it was a parent or noninjured sibling who would describe manifestations of stigma and ways they tried to protect the child with burn injury. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.

Evaluation of burn injuries related to liquefied petroleum gas.

Science.gov (United States)

Tarim, Mehmet Akin

2014-01-01

Liquefied petroleum gas (LPG) is a fuel that is widely used for domestic, agricultural, and industrial purposes. LPG is also commonly used in restaurants, industries, and cars; however, the home continues to be the main site for accidents. In Turkey, the increased usage of LPG as a cooking or heating fuel has resulted in many burn injuries from LPG mishaps. Between January 2000 and June 2011, 56 LPG-burned patients were compared with 112 flame-burned patients. There were no significant differences with respect to the mean age, sex, hospitalization time, and mortality in both groups. In the LPG-caused burn cases, 41 burns (73.2%) occurred at home, seven (12.5) were work-related mishaps, and eight (14.3) were associated with car accidents. The majority of the LPG burns (82%, 46 patients) resulted from a gas leak, and 18% of them were related to the failure to close LPG tubes in the patients' kitchens (10 patients). Burns to the face and neck (82 vs 67%, P = .039) and upper (62 vs 23%, P = .000) and lower (70 vs 45%, P = .002) extremities were significantly higher in LPG-caused burn cases than flame-burned cases. General awareness regarding the risk of LPG and first aid for burns appears to be lacking. The LPG delivery system should be standardized throughout countries that widely use LPG.

The Western Australia Population-based Burn Injury Project: Using record linkage to examine long-term effects of burn injury

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Janine Duke

2017-04-01

Both minor and severe burns were associated with increased long-term cardiovascular and musculoskeletal morbidity and mortality. These results identify treatment needs for burn patients for a prolonged time after discharge. Further research that links primary care and pharmaceutical data is required to facilitate identification of at-risk patients and appropriate treatment pathways to reduce post-burn morbidity.

Camphor burns of the palm and non-suicidal self-injury: An uncommonly reported, but socially relevant issue

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Ravi Kumar Chittoria

2014-01-01

Full Text Available Camphor is a waxy white sublimating chemical derived from natural as well as synthetic sources and widely used in various communities worldwide for a number of medicinal, culinary, and religious reasons. Camphor is burnt as an offering to God in many religious communities. We report three incidences of self inflicted injury from burning camphor on the palm resulting in full thickness burns. Non-suicidal self-injury is socially unacceptable destruction or alteration of body tissue when there is no suicidal intent or pervasive developmental disorder and we have explored an association between this and burn injury. This report also highlights the unique social and cultural pattern of this burn injury and the importance of psycho-therapeautic help for these victims.

Scar formation following excisional and burn injuries in a red Duroc pig model.

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Blackstone, Britani N; Kim, Jayne Y; McFarland, Kevin L; Sen, Chandan K; Supp, Dorothy M; Bailey, J Kevin; Powell, Heather M

2017-08-01

Scar research is challenging because rodents do not naturally form excessive scars, and burn depth, size, and location cannot be controlled in human longitudinal studies. The female, red Duroc pig model has been shown to form robust scars with biological and anatomical similarities to human hypertrophic scars. To more closely mimic the mode of injury, recreate the complex chemical milieu of the burn wound environment and enhance scar development, an animal model of excessive burn-induced scarring was developed and compared with the more commonly used model, which involves excisional wounds created via dermatome. Standardized, full-thickness thermal wounds were created on the dorsum of female, red Duroc pigs. Wounds for the dermatome model were created using two different total dermatome settings: ∼1.5 mm and ≥ 1.9 mm. Results from analysis over 150 days showed that burn wounds healed at much slower rate and contracted more significantly than dermatome wounds of both settings. The burn scars were hairless, had mixed pigmentation, and displayed fourfold and twofold greater excess erythema values, respectively, compared with ∼1.5 mm and ≥ 1.9 mm deep dermatome injuries. Burn scars were less elastic, less pliable, and weaker than scars resulting from excisional injuries. Decorin and versican gene expression levels were elevated in the burn group at day 150 compared with both dermatome groups. In addition, transforming growth factor-beta 1 was significantly up-regulated in the burn group vs. the ∼1.5 mm deep dermatome group at all time points, and expression remained significantly elevated vs. both dermatome groups at day 150. Compared with scars from dermatome wounds, the burn scar model described here demonstrates greater similarity to human hypertrophic scar. Thus, this burn scar model may provide an improved platform for studying the pathophysiology of burn-related hypertrophic scarring, investigating current anti-scar therapies, and development of

Sibling experiences after a major childhood burn injury.

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Lehna, Carlee

2010-01-01

The purpose of this research project was to understand, primarily from the sibling perspective, the effect of a child's major burn injury on his or her sibling. A mixed method qualitative dominant design was implemented using the life story method for the qualitative portion. Additionally, the Sibling Relationship Questionnaire -Revised (SRQ-R) was used as a structured interview guide and for calculating scoring data to explore sibling relationship factors of warmth/closeness, rivalry, conflict, and relative status/power. Participants from 22 family cases (one or multiple family members) and 40 individuals were interviewed. To capture impact on the family over time, interviews began a minimum of two years post-burn. The central thematic pattern for the sibling relationship in families having a child with a major burn injury was that of normalization. Two components of normalization were described: areas of normalization and the process of adjustment. Areas of normalization were found in play and other activities, in school and work, and in family relations with siblings. The process of adjustment was varied and often gradual, involved school and work re-entry, and in some instances, seemed to change life perspective. Clinical implications in providing family-centered care can focus on promoting normalization by assessing and supporting siblings who may only be occasionally seen in the hospital or clinic.

The burning issues of motor vehicle radiator scald injuries revisited – a fresh review and changing prevention strategies

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Patel, J.N.; Tan, A.; Frew, Q.; Dziewulski, P.

2016-01-01

Summary A preventable subgroup of burn injuries is scalds sustained from motor vehicle radiators. This study was to determine changes in trends in epidemiology of such injuries and to discuss whether current and other prevention efforts proposed previously require reinforcement. We conducted a retrospective study (February 2007-August 2015) of all motor vehicle-related burn referrals to our regional burns service. 68 cases of motor vehicle radiator burns were identified. Male to female ratio was 65:3. Mean age was 35.1 (range = 9-71). Most cases occurred in the summer months (22/68 = 32.4%). 65 cases (95.6%) involved car radiators. 66% of injuries resulted from actively removing the pressure cap of an overheated radiator in the motor vehicle. Mean total burn surface area (%TBSA) was 2.1% (range = 0.5- 11%). The depths of burn injuries were mostly superficial partial thickness. Face, chest and upper limbs were the most common sites of injury. Mean healing time was 14.2 days (range = 4-60). Following the introduction of safety measures by vehicle manufacturers, motor vehicle radiator burns in this era are mostly minor injuries and can be potentially managed conservatively as an outpatient. This contrasts with findings from previous studies over a decade ago of larger, more significant injuries requiring admission and surgery. Whilst manufacturers have installed safety measures into the design of radiator caps, our findings suggest that re-educating the public to allow a period of cooling prior to opening caps should be reinforced. PMID:28289357

Brain hemorrhage after electrical burn injury: Case report and probable mechanism

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Axayacalt, Gutierrez Aceves Guillermo; Alejandro, Ceja Espinosa; Marcos, Rios Alanis; Inocencio, Ruiz Flores Milton; Alfredo, Herrera Gonzalez Jose

2016-01-01

Background: High-voltage electric injury may induce lesion in different organs. In addition to the local tissue damage, electrical injuries may lead to neurological deficits, musculoskeletal damage, and cardiovascular injury. Severe vascular damage may occur making the blood vessels involved prone to thrombosis and spontaneous rupture. Case Description: Here, we present the case of a 39-year-old male who suffered an electrical burn with high tension wire causing intracranial bleeding. He ...

Perceived social support among patients with burn injuries: A perspective from the developing world.

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Waqas, Ahmed; Turk, Marvee; Naveed, Sadiq; Amin, Atif; Kiwanuka, Harriet; Shafique, Neha; Chaudhry, Muhammad Ashraf

2018-02-01

Social support is among the most well-established predictors of post-burn psychopathology after burn. Despite a disproportionately large burden of burns in the developing world, the nature of social support among burn patients in this context remains elusive. We, therefore, seek to investigate social support and its biopsychosocial determinants among patients with burn injuries in Pakistan. A cross-sectional study of 343 patients presenting with burn injuries at four teaching hospitals in the Punjab province of Pakistan was conducted. Patient evaluation consisted of a multi-part survey of demographic status, clinical features, and social support as measured by the validated Urdu translation of the Multidimensional Scale of Perceived Social Support (MSPSS). Multiple regression analysis was performed to evaluate associations between patient characteristics and MSPSS score. Mean overall MSPSS score was 57.64 (std dev 13.57). Notable positive predictors of social support include male gender, Punjabi ethnicity, burn surface area, and ego resiliency. Our study reveals a troubling pattern of inadequate social support among certain subgroups of Pakistani burn patients. Addressing these inequities in the provision of social support must be prioritized as part of the global burn care agenda. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Effects of combined radiation-burn injury on survival rate of allogeneic skin grafts and immune reaction in rats

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Ran Xinze; Yan Yongtang; Cheng Tianmin; Li Yuan; Wei Shuqing

1996-01-01

The effects of combined radiation-burn injury on survival rate of allogeneic skin grafts and immune reaction were studied in rats with combined injury of 3-8 Gy 60 Co γ-ray irradiation plus 15% total body surface area full thickness burn induced by exposure to a 5 kw bromotungsten lamp. The allogeneic skin was transplanted 24 hours after injury. It was found that all the skin grafts failed to survive in 10 days and the immune reaction significantly increased in the early stage of burn injury. But the immune reaction was obviously suppressed by the combined radiation-burn injury. The survival rates of skin grafts were 20% and 30% in the combined injury of burn plus 3 and 4 Gy irradiation respectively. When the radiation doses increased to 5,6 and 8 Gy, the survival rates elevated to 69%, 88% and 100% respectively (in the group of 8 Gy, bone marrow transplantation was conducted before receiving skin graft). At day 30 post-transplantation the survival rates were still 36%, 42% and 100% respectively. Compared with burn group, there was a significant difference in survival rate when the radiation doses were higher than 5 Gy. These results indicate that the survival rate of the allogeneic skin graft increases concurrently with the increase in radiation dose and decreases with the elapse of the post-transplantation time

Design of a cross-sectional study on physical fitness and physical activity in children and adolescents after burn injury

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Disseldorp Laurien M

2012-12-01

Full Text Available Abstract Background Burn injuries have a major impact on the patient’s physical and psychological functioning. The consequences can, especially in pediatric burns, persist long after the injury. A decrease in physical fitness seems logical as people survive burn injuries after an often extensive period of decreased activity and an increased demand of proteins leading to catabolism, especially of muscle mass. However, knowledge on the possibly affected levels of physical fitness in children and adolescents after burn injury is limited and pertains only to children with major burns. The current multidimensional study aims to determine the level of physical fitness, the level of physical activity, health-related quality of life and perceived fatigue in children after a burn injury. Furthermore, interrelations between those levels will be explored, as well as associations with burn characteristics. Methods/design Children and adolescents in the age range of 6 up to and including 18 years are invited to participate in this cross-sectional descriptive study if they have been admitted to one of the three Dutch burn centers between 6 months and 5 years ago with a burn injury involving at least 10% of the total body surface area and/or were hospitalized ≥ 6 weeks. Physical fitness assessments will take place in a mobile exercise lab. Quantitative measures of cardiorespiratory endurance, muscular strength, body composition and flexibility will be obtained. Outcomes will be compared with Dutch reference values. Physical activity, health-related quality of life and fatigue will be assessed using accelerometry and age-specific questionnaires. Discussion The findings of the current study will contribute to a better understanding of the long-term consequences of burn injury in children and adolescents after burns. The results can guide rehabilitation to facilitate a timely and optimal physical recovery. Trial registration The study is registered in

Firework injuries at a major trauma and burn center: A five-year prospective study.

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Wang, Cheng; Zhao, Ran; Du, Wei-Li; Ning, Fang-Gang; Zhang, Guo-An

2014-03-01

In China, fireworks are an integral part of the celebration of the annual Spring Festival, but the number of injuries associated with their private use seen in emergency rooms increases dramatically. To raise awareness and help guide future prevention practices in this city, we investigated the epidemiology of firework-related injuries presented at our trauma and burn center in Beijing during the Spring Festivals of 2007-2011. Patients were interviewed using a pre-coded questionnaire to elicit information regarding age, gender, causes, injured body part, type of injury, diagnosis, and disposition. From 2007 to 2011, during the Spring Festivals 734 patients with fire-work related injuries were seen at our trauma and burn center in Beijing, the median patients of the five year were 140(136-150). The mean age of the patients was 26±15.3 years (range, 1-95 years). Of the 734 patients, the highest proportion of injuries were the 5-14 year-old age group The majority of the patients were male (87.9%), the overall male:female ratio was 7.41:1, and males were predominant in all age groups. For all 5 years, the incidence of firework-related injuries during the Spring Festival Holidays peaked specifically on the first, fifth, and last days, respectively. Injuries were mainly due to improper handling (415/610, 68.0%) or setting off illegal fireworks (195/610, 32.0%). The most frequently injured body parts were the hands and fingers (32.0%), head or face except eyes (28.3%), and trunk (22.4%). Burns were the most common type of injury (65.7%), most of the burned patients (437/453) were between 1% and 10%, and the most common region burned were hands and fingers (218/754). Contusions or lacerations were the second common type of injury (34.3%). Most of the patients (642, 87.5%) were treated and released, while 37 (5%) were treated and transferred, and 55 (7.5%) were admitted for advanced treatment. The private use of fireworks during the Spring Festival Holidays is associated

Burn prevention in Zambia: a targeted epidemiological approach.

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Heard, Jason P; Latenser, Barbara A; Liao, Junlin

2013-01-01

The aim of this study is to assess primary burn prevention knowledge in a rural Zambian population that is disproportionately burdened by burn injuries. A 10-question survey was completed by youths, and a 15-question survey was completed by adults. The survey was available in both English and Nyanja. The surveys were designed to test their knowledge in common causes, first aid, and emergency measures regarding burn injuries. Logistic regression analysis was used to explore relationships between burn knowledge, age, school, and socioeconomic variables. A burn prevention coloring book, based on previous local epidemiological data, was also distributed to 800 school age youths. Five hundred fifty youths and 39 adults completed the survey. The most significant results show knowledge deficits in common causes of burns, first aid treatment of a burn injury, and what to do in the event of clothing catching fire. Younger children were more likely to do worse than older children. The adults performed better than the youths, but still lack fundamental burn prevention and treatment knowledge. Primary burn prevention data from the youths and adults surveyed demonstrate a clear need for burn prevention and treatment education in this population. In a country where effective and sustainable burn care is lacking, burn prevention may be a better investment to reduce burn injury than large investments in healthcare resources.

First aid practices, beliefs, and sources of information among caregivers regarding paediatric burn injuries in Harare, Zimbabwe: A cross-sectional study.

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Chirongoma, Farai; Chengetanai, Samson; Tadyanemhandu, Cathrine

2017-06-01

While burns take seconds to occur, injuries incurred result in pain and undesirable long term effects that might take a lifetime to overcome. The study was carried out to determine the measures of first aid delivered by caregivers after a burn injury and sources of the information. A cross- sectional study was carried out over a period of 3 months at two central hospitals in Harare. A questionnaire was administered to the caregivers of children within the age group of 0-60 months admitted in burns wards to elicit information on the circumstances of the burn injury and the first aid methods which were administered. Out of the 50 children who were recruited, 54.0% were females and the mean age was 29.5 months (SD= 15.5). After the burn injury 30(60.0%) of the caregivers, cooled the burn injury with cold running water whilst some caregivers also applied eggs, margarine and some traditional herbs as first aid. The other practices reported by the caregivers included use of urine and crushed cockroaches after burn injury in 40 (80.0%) whilst 20 (40.0%) reported used aloe vera gel after a burn injury. About half of the caregivers got first aid information mainly from family members and very few indicated that the information was obtained from mass media, 3 (6.0%). The first aid measures used by the majority of caregivers were either incomplete or inadequate. Although some caregivers had adequate knowledge of what to do after an injury, there still was widespread use of alternatives therapies in burn management.

Use of Essential Oils Following Traumatic Burn Injury: A Case Study.

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Jopke, Kathleen; Sanders, Heather; White-Traut, Rosemary

Hospital admissions related to burn injury reach 40,000 annually. Patients who experience extensive burns require longer hospital stays and are at increased risk for infection and hospital acquired conditions. This comparative case study is a two patient matched case control design that follows the hospital course of two children who experienced burn injuries. For one of these patients, with the consent of the child's parents, the grandmother treated her granddaughter with essential oils. Essential oils have the potential to inhibit microbial growth, support treatment of wounds, and facilitate healing. However, there have been no large scale studies on essential oils. Data for the two cases were retrieved from the electronic medical record at a Midwestern Pediatric Hospital. Retrieved data included burn site description, treatment for burns, number of days on the ventilator, white blood cell count, length of hospital stay, number of ICU days, infections diagnosed by positive culture and pain ratings. While the goals for treatment were the same for both children, the child who received only standard care was diagnosed with two blood stream infections and four hospital acquired conditions while the child who received supplemental treatment with essential oils did not develop any blood stream infections, was diagnosed with one hospital acquired condition, was in the PICU one day less, and had a four day shorter length of hospital stay. While these case findings are intriguing, research is needed to expand understanding of the role of essential oils in the treatment of burns. Copyright © 2017 Elsevier Inc. All rights reserved.

Children with Burn Injury Have Impaired Cardiac Output during Submaximal Exercise.

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Rivas, Eric; Herndon, David N; Beck, Kenneth C; Suman, Oscar E

2017-10-01

Burn trauma damages resting cardiac function; however, it is currently unknown if the cardiovascular response to exercise is likewise impaired. We tested the hypothesis that, in children, burn injury lowers cardiac output (Q˙) and stroke volume (SV) during submaximal exercise. Five children with 49% ± 4% total body surface area (BSA) burned (two female, 11.7 ± 1 yr, 40.4 ± 18 kg, 141.1 ± 9 cm) and eight similar nonburned controls (five female, 12.5 ± 2 yr, 58.0 ± 17 kg, 147.3 ± 12 cm) with comparable exercise capacity (peak oxygen consumption [peak V˙O2]: 31.9 ± 11 vs 36.8 ± 8 mL O2·kg·min, P = 0.39) participated. The exercise protocol entailed a preexercise (pre-EX) rest period followed by 3-min exercise stages at 20 W and 50 W. V˙O2, HR, Q˙ (via nonrebreathing), SV (Q˙/HR), and arteriovenous O2 difference ([a-v]O2diff, Q˙/ V˙O2) were the primary outcome variables. Using a 2-way factorial ANOVA (group [G] × exercise [EX]), we found that Q˙ was approximately 27% lower in the burned than the nonburned group at 20 W of exercise (burned 5.7 ± 1.0 vs nonburned: 7.9 ± 1.8 L·min) and 50 W of exercise (burned 6.9 ± 1.6 vs nonburned 9.2 ± 3.2 L·min) (G-EX interaction, P = 0.012). SV did not change from rest to exercise in burned children but increased by approximately 24% in the nonburned group (main effect for EX, P = 0.046). Neither [a-v] O2diff nor V˙O2 differed between groups at rest or exercise, but HR response to exercise was reduced in the burn group (G-EX interaction, P = 0.004). When normalized to BSA, SV (index) was similar between groups; however, Q˙ (index) remained attenuated in the burned group (G-EX interaction, P exercise. Further investigation of hemodynamic function during exercise will provide insights important for cardiovascular rehabilitation in burned children.

Predictive role of arterial carboxyhemoglobin concentrations in ovine burn and smoke inhalation-induced lung injury.

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Lange, Matthias; Cox, Robert A; Enkhbaatar, Perenlei; Whorton, Elbert B; Nakano, Yoshimitsu; Hamahata, Atsumori; Jonkam, Collette; Esechie, Aimalohi; von Borzyskowski, Sanna; Traber, Lillian D; Traber, Daniel L

2011-05-01

Inhalation injury frequently occurs in burn patients and contributes to the morbidity and mortality of these injuries. Arterial carboxyhemoglobin has been proposed as an indicator of the severity of inhalation injury; however, the interrelation between arterial carboxyhemoglobin and histological alterations has not yet been investigated. Chronically instrumented sheep were subjected to a third degree burn of 40% of the total body surface area and inhalation of 48 breaths of cotton smoke. Carboxyhemoglobin was measured immediately after injury and correlated to clinical parameters of pulmonary function as well as histopathology scores from lung tissue harvested 24 hours after the injury. The injury was associated with a significant decline in pulmonary oxygenation and increases in pulmonary shunting, lung lymph flow, wet/dry weight ratio, congestion score, edema score, inflammation score, and airway obstruction scores. Carboxyhemoglobin was negatively correlated to pulmonary oxygenation and positively correlated to pulmonary shunting, lung lymph flow, and lung wet/dry weight ratio. No significant correlations could be detected between carboxyhemoglobin and histopathology scores and airway obstruction scores. Arterial carboxyhemoglobin in sheep with combined burn and inhalation injury are correlated with the degree of pulmonary failure and edema formation, but not with certain histological alterations including airway obstruction scores.

Using acute kidney injury severity and scoring systems to predict outcome in patients with burn injury

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George Kuo

2016-12-01

Conclusion: Our results revealed that AKI stage has considerable discriminative power for predicting mortality. Compared with other prognostic models, AKI stage is easier to use to assess outcome in patients with severe burn injury.

Brain hemorrhage after electrical burn injury: Case report and probable mechanism.

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Axayacalt, Gutierrez Aceves Guillermo; Alejandro, Ceja Espinosa; Marcos, Rios Alanis; Inocencio, Ruiz Flores Milton; Alfredo, Herrera Gonzalez Jose

2016-01-01

High-voltage electric injury may induce lesion in different organs. In addition to the local tissue damage, electrical injuries may lead to neurological deficits, musculoskeletal damage, and cardiovascular injury. Severe vascular damage may occur making the blood vessels involved prone to thrombosis and spontaneous rupture. Here, we present the case of a 39-year-old male who suffered an electrical burn with high tension wire causing intracranial bleeding. He presented with an electrical burn in the parietal area (entry zone) and the left forearm (exit zone). The head tomography scan revealed an intraparenchimatous bleeding in the left parietal area. In this case, the electric way was the scalp, cranial bone, blood vessels and brain, upper limb muscle, and skin. The damage was different according to the dielectric property in each tissue. The injury was in the scalp, cerebral blood vessel, skeletal muscle, and upper limb skin. The main damage was in brain's blood vessels because of the dielectric and geometric features that lead to bleeding, high temperature, and gas delivering. This is a report of a patient with an electric brain injury that can be useful to elucidate the behavior of the high voltage electrical current flow into the nervous system.

Retrospective analysis of patients with burn injury treated in a burn center in Turkey during the Syrian civil war.

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Yuce, Yucel; Acar, Hakan A; Erkal, Kutlu H; Arditi, Nur B

2017-01-01

To report the management of burn injuries that occured in the Syria civil war, which were referred to our burn center. Methods: Forty-three patients with burns, injured in the civil war in Syria and whom were referred to Dr. Lütfi Kırdar Kartal Educating and Training Hospital Burn Centre of İstanbul, Turkey between 2011-2015 were analyzed in a retrospective study. Results: Most of our patients were in major burn classification (93%; 40/43) and most of them had burns greater than 15% total on body surface area. Most of them were admitted to our center late after first management at centers with improper conditions and in cultures of these patients unusual and resistant strains specific to the battlefield were produced. Conclusion: Immediate transfer of the patients from the scene of incidence to burn centers ensures early treatment, this factor may be effective on the outcome of these patients.

Retrospective analysis of patients with burn injury treated in a burn center in Turkey during the Syrian civil war

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Yucel Yuce

2017-01-01

Full Text Available Objectives: To report the management of burn injuries that occured in the Syria civil war, which were referred to our burn center. Methods: Forty-three patients with burns, injured in the civil war in Syria and whom were referred to Dr. Lütfi Kırdar Kartal Educating and Training Hospital Burn Centre of İstanbul, Turkey between 2011-2015 were analyzed in a retrospective study. Results: Most of our patients were in major burn classification (93%; 40/43 and most of them had burns >15% total on body surface area. Most of them were admitted to our center late after first management at centers with improper conditions and in cultures of these patients unusual and resistant strains specific to the battlefield were produced. Conclusion: Immediate transfer of the patients from the scene of incidence to burn centers ensures early treatment, this factor may be effective on the outcome of these patients.

No correlation between initial arterial carboxyhemoglobin level and degree of lung injury following ovine burn and smoke inhalation.

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Lange, Matthias; Cox, Robert A; Traber, Daniel L; Hamahata, Atsumori; Nakano, Yoshimitsu; Traber, Lillian D; Enkhbaatar, Perenlei

2014-04-01

Fire victims often suffer from burn injury and concomitant inhalation trauma, the latter significantly contributing to the morbidity and mortality in these patients. Measurement of blood carboxyhemoglobin levels has been proposed as a diagnostic marker to verify and, perhaps, quantify the degree of lung injury following inhalation trauma. However, this correlation has not yet been sufficiently validated. A total of 77 chronically instrumented sheep received sham injury, smoke inhalation injury, or combined burn and inhalation trauma following an established protocol. Arterial carboxyhemoglobin concentrations were determined directly after injury and correlated to several clinical and histopathological determinants of lung injury that were detected 48 hours post-injury. The injury induced severe impairment of pulmonary gas exchange and increases in transvascular fluid flux, lung water content, and airway obstruction scores. No significant correlations were detected between initial carboxyhemoglobin levels and all measured clinical and histopathological determinants of lung injury. In conclusion, the amount of arterial carboxyhemoglobin concentration cannot predict the degree of lung injury at 48 hours after ovine burn and smoke inhalation trauma.

The Effect of Lithospermum officinale, Silver Sulfadiazine and Alpha Ointments in Healing of Burn Wound Injuries in Rat.

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Mohtasham Amiri, Zahra; Tanideh, Nader; Seddighi, Anahita; Mokhtari, Maral; Amini, Masood; Shakouri Partovi, Alborz; Manafi, Amir; Hashemi, Seyedeh Sara; Mehrabani, Davood

2017-09-01

Burn is the most devastating condition in emergency medicine leading to chronic disabilities. This study aimed to compare the effect of Lithospermum officinale , silver sulfadiazine and alpha ointments on healing of burn wounds in rat. Ninety-five rats were divided into 5 groups. Group 1 just underwent burn injury, and groups 2-5 received alpha ointment, silver sulfadiazine (SSD), gel base and L. officinale extract, respectively. A hot plate was used for induction of a standard 3 rd degree burn wound. Burn wounds were macroscopically and microscopically evaluated on days 7 th , 14 th and 21 st after burn induction. A decrease in the number of inflammatory cells was noted when L. officinale and SSD were applied while the most inflammatory response was seen after administration of alpha ointment. The number of macrophages alone decreased after burn injury, while the frequency was the most when L. officinale and alpha ointment were applied. Re-epithelialization, angiogenesis and formation of granulation tissue were the best in relation to L. officinale and alpha ointment while, the worst results belonged to burn injury group and SSD regarding granulation tissue formation. Considering histological assessment, the best results were observed for scoring of inflammation, re-epithelialization, angiogenesis, formation of granulation tissue and number of macrophage when L. officinale and alpha ointment were used after burn injury. It can be concluded that topical application of L. officinale as a non-toxic, inexpensive and easy to produce herbal can lead to a rapid epithelialization and wound healing and these findings can be added to the literature on burn wound healing.

Improving burn care and preventing burns by establishing a burn database in Ukraine.

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Fuzaylov, Gennadiy; Murthy, Sushila; Dunaev, Alexander; Savchyn, Vasyl; Knittel, Justin; Zabolotina, Olga; Dylewski, Maggie L; Driscoll, Daniel N

2014-08-01

Burns are a challenge for trauma care and a contribution to the surgical burden. The former Soviet republic of Ukraine has a foundation for burn care; however data concerning burns in Ukraine has historically been scant. The objective of this paper was to compare a new burn database to identify problems and implement improvements in burn care and prevention in this country. Retrospective analyses of demographic and clinical data of burn patients including Tukey's post hoc test, analysis of variance, and chi square analyses, and Fisher's exact test were used. Data were compared to the American Burn Association (ABA) burn repository. This study included 1752 thermally injured patients treated in 20 hospitals including Specialized Burn Unit in Municipal Hospital #8 Lviv, Lviv province in Ukraine. Scald burns were the primary etiology of burns injuries (70%) and burns were more common among children less than five years of age (34%). Length of stay, mechanical ventilation use, infection rates, and morbidity increased with greater burn size. Mortality was significantly related to burn size, inhalation injury, age, and length of stay. Wound infections were associated with burn size and older age. Compared to ABA data, Ukrainian patients had double the length of stay and a higher rate of wound infections (16% vs. 2.4%). We created one of the first burn databases from a region of the former Soviet Union in an effort to bring attention to burn injury and improve burn care. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

Pain and anxiety experiences of South African adult burn injury patients during physiotherapy management

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L.D. Morris

2010-01-01

Full Text Available A dequate management of procedural pain during physiotherapy management plays an important role in building a trusting relationship betweenthe burn victim and the physiotherapist, and in ensuring desirable functional outcomes. However, the burn pain management regimens currently utilized inburn units, primarily consist of traditional pharmacologic analgesics which areassociated with numerous side-effects and alone are often reported as inadequateto alleviate procedural pain, warranting safer and effective adjunct therapies.Prior to the introduction and implementation of adjunct therapies into a developing world, it is imperative that the current situation in a burn unit, in terms of whether or not the pain management regimens in place are adequate, is first assessed, due to cost concerns. The following short report exemplifies the pain and anxiety experiences of a small number of burn injury patients during physiotherapy at the Tygerberg Hospital adult burn unit, South A frica.  It was hypothesized that the results of this study would underpin whether adult burn injury patients in a developing countryrequire adjunct therapies during physiotherapy management to supplement traditional pharmacologic analgesics inmanaging their procedural pain and subsequent anxiety.

Change in catalase and peroxidase activity in rat blood in case of combined burn and radiation injury

International Nuclear Information System (INIS)

Abramova, L.P.; Simonova, L.N.

1982-01-01

The peroxidase activity of blood and catalase activity were studied in white rats, subjected to whole-body X-irradiation with the dose 129 mC/kg and burn injury (20% of body surface) of 3A-3B degree and also combined burn and radiation injury. It is established that catalase activity was decreased in all groups and at all terms of the investigation. The changes in the blood peroxide activity were of phase character and normalized only by 14th day. The peroxide activity restores to intact level only by 30th day in animals with burn and radiation injury, that testifies to heavier course of the desease and to protracted character of recovery processes

Effect of auto-skin grafting on bacterial infection of wound in rats inflicted with combined radiation-burn injury

International Nuclear Information System (INIS)

Ran Xinze; Yan Yongtang; Wei Shuqing

1992-01-01

Rats were exposed to 6 Gy whole body γ-ray irradiation from a 60 Co source followed by light radiation burn (15% TBSA, full thickness burn) from a 5 kw bromo-tungsten lamp. The effect of auto-skin grafting on invasive bacterial infection of wound in the rats with combined radiation-burn injury was studied, In the control group inflicted with combined radiation-burn injury but without skin grafting, bacteria were found on and in the eschars at 24th hour after injury, and in the subeschar tissue on 3rd day. Tremendous bacterial multiplication occurred from 7th to 15th day, and the amount of bacteria in the internal organs increased along with the increase of subeschar infection. At the same time, no bacterial infection was found in internal organs in auto-skin grafted group at 24th hour after injury. The results show that skin grafting can decrease or prevent bacterial infection in both subeschar tissue and internal organs

Post-traumatic stress disorder in patients with acute burn injury

International Nuclear Information System (INIS)

Ibran, E.; Adil, S.E.R.; Rao, M.H.

2013-01-01

Objective: To determine the risk of PTSD in patients with acute burn incidents. Method: This was an observational prospective cross-sectional study conducted in admitted patients in Burns Ward of Civil Hospital, Karachi during a period of 6 months from January 1 to June 30, 2011. Data was collected through questionnaire having socio demographic variables and the Impact of Event-Scale (IES-R) was used to determine the risk of PTSD. Results: Out of 145 patients, 12 (77.3%) were at risk of PTSD with 75 (66.9%) males and 37 (33%) females. Out of these 112 cases, 50% belonged to age group 16-29 years. All burn patients with more than 60% total body surface area (TBSA) involved in injury were at risk. Conclusion: The study reports an astronomic number of burns patients with PTSD risk. PTSD drastically affects the quality of life. The earlier this disorder is diagnosed and assessed; better chances are there for enhanced treatment and better recovery. (author)

Pediatric scalds: do cooking-related burns have a higher injury burden?

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Bachier, Marielena; Hammond, Sarah E; Williams, Regan; Jancelewicz, Timothy; Feliz, Alexander

2015-11-01

Pediatric scald burns result in frequent emergency room visits and hospitalizations. We investigated whether cooking-related burns produce greater morbidity requiring more extensive care than noncooking burns. We performed a 6-y review at our free-standing children's hospital. Children aged cooking versus noncooking burns. The Mann-Whitney U test, a chi-square test, and the negative binomial were used to compare continuous, categorical, and count data between groups. Bivariate analysis was performed to identify risk factors among patients with adverse outcomes. We identified 308 patients; 262 (85%) cooking and 46 (15%) noncooking burns. Most patients were African-American males, with public insurance, and a median age of 2 y. Cooking burns preferentially occurred over the head, neck, and upper body; noncooking burns were distributed over the lower body (P  0.11). In subgroup analysis, semisolid and grease burns resulted in increased rates of wound contractures and/or limited mobility when compared with noncooking burns (P = 0.05 and P = 0.008, respectively). Patients with complications were more likely to have third degree burns and required more consults, longer hospitalization, and more surgical debridements and clinic visits. Most accidental scald burns occurred in young children during food preparation. Greater long-term morbidity was found in patients with semisolid and grease burns. This subset of children has a higher injury burden and requires extensive care in the acute and long-term setting. Copyright © 2015 Elsevier Inc. All rights reserved.

Single Hind Limb Burn Injury to Mice Alters NF Kappa B (NF-κB) Expression and [18F] 2-Fluoro-2-Deoxy-d-Glucose (FDG) Uptake

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Carter, Edward A.; Hamrahi, Victoria; Paul, Kasie; Bonab, Ali A.; Jung, Walter; Tompkins, Ronald G.; Fischman, Alan J.

2014-01-01

Burn trauma to the extremities can produce marked systemic effects in mice1, 6, 7. Burn injury to the dorsal surface of mice is also associated with changes in glucose metabolism (18FDG uptake) by brown adipose tissue (BAT) and NF-κB activity in a number of tissues including skeletal muscle. This study examined the effect of a single hindlimb burn in mice on 18FDG uptake by in vivo, NF-κB activity in vivo, and blood flow determined by laser Doppler techniques. Male mice NF-κB luciferase reporter mice (28 grams- 30 grams, male) were anesthetized, both legs were shaven, and the right leg was subjected to scald injury by immersion in 90°C water for 5 seconds. Sham treated animals were used as controls. Each burned and sham mouse was resuscitated with saline (2 ml, IP). The individual animals were placed in wire bottom cages with no food and free access to water. 24 hrs later, the animals were imaged with Laser Doppler for measurements of blood flow in the hind limb. The animals were then injected unanesthetized with 50 µCi of FDG or luciferin (1.0 mg), I.V. via tail vein. Five minutes after luciferin injection, NF-kB mice were studied by bioluminescence imaging with a CCD camera. One hour after 18FDG injection the animals were euthanized with carbon dioxide overdose and 18FDG biodistribution was measured. Tissues were also analyzed for NF-κB luciferase activity. The scalding procedure used here produced a full thickness burn injury to the leg with sharp margins. 18FDG uptake by the burned leg was lower than in the contralateral limb. Similarly luciferase activity and blood flow in the burned leg were lower than in the contralateral leg. 18FDG uptake by BAT and heart was increased, while brain was decreased. In conclusion, the present study suggests that burn injury to a single leg reduced 18FDG uptake by skeletal muscle but increased 18FDG uptake by BAT. The injury to the leg reduced NF-κB expression as compared to the contralateral leg and the uninjured

Burn injury triggered dysfunction in dendritic cell response to TLR9 activation and resulted in skewed T cell functions.

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Haitao Shen

Full Text Available Severe trauma such as burn injury is often associated with a systemic inflammatory syndrome characterized by a hyperactive innate immune response and suppressed adaptive immune function. Dendritic cells (DCs, which sense pathogens via their Toll-like receptors (TLRs, play a pivotal role in protecting the host against infections. The effect of burn injury on TLR-mediated DC function is a debated topic and the mechanism controlling the purported immunosuppressive response remains to be elucidated. Here we examined the effects of burn injury on splenic conventional DC (cDC and plasmacytoid DC (pDC responses to TLR9 activation. We demonstrate that, following burn trauma, splenic cDCs' cytokine production profile in response to TLR9 activation became anti-inflammatory dominant, with high production of IL-10 (>50% increase and low production of IL-6, TNF-α and IL-12p70 (∼25-60% reduction. CD4+ T cells activated by these cDCs were defective in producing Th1 and Th17 cytokines. Furthermore, burn injury had a more accentuated effect on pDCs than on cDCs. Following TLR9 activation, pDCs displayed an immature phenotype with an impaired ability to secrete pro-inflammatory cytokines (IFN-α, IL-6 and TNF-α and to activate T cell proliferation. Moreover, cDCs and pDCs from burn-injured mice had low transcript levels of TLR9 and several key molecules of the TLR signaling pathway. Although hyperactive innate immune response has been associated with severe injury, our data show to the contrary that DCs, as a key player in the innate immune system, had impaired TLR9 reactivity, an anti-inflammatory phenotype, and a dysfunctional T cell-priming ability. We conclude that burn injury induced impairments in DC immunobiology resulting in suppression of adaptive immune response. Targeted DC immunotherapies to promote their ability in triggering T cell immunity may represent a strategy to improve immune defenses against infection following burn injury.

Injury-related fear-avoidance and symptoms of posttraumatic stress in parents of children with burns.

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Willebrand, M; Sveen, J

2016-03-01

Parents of children with burns experience a range of psychological reactions and symptoms, and parents' health is known to impact children's health. So far, there is little research into potential mechanisms that maintain parents' symptoms. The aim was to investigate parental injury-related fear-avoidance, and its associations with injury severity and health measures. Parents (n=107) of children aged 0.4-18 years that sustained burns 0.1-9.0 years previously completed questionnaires on fear-avoidance, posttraumatic stress, and health of the child. Analyses showed that the average level of fear-avoidance was low and positively associated with measures of injury severity and parents' symptoms of posttraumatic stress, and negatively associated with parents' ratings of their child's health. In two separate multiple regressions with parents' symptoms of PTSD and the child's health as dependent variables, fear-avoidance made the largest contribution in both models while injury severity was non-significant. Results were not related to comorbid conditions of the child, scarring, or parent-related socio-demographic variables. In summary, injury-related fear-avoidance is more likely among parents whose children sustain more severe burns. In turn, fear-avoidance contributes significantly to parents' symptoms of PTSD and to poorer health ratings regarding the child, irrespective of injury severity or child comorbidity. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

From traditional biochemical signals to molecular markers for detection of sepsis after burn injuries.

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Muñoz, Balam; Suárez-Sánchez, Rocío; Hernández-Hernández, Oscar; Franco-Cendejas, Rafael; Cortés, Hernán; Magaña, Jonathan J

2018-05-22

Sepsis is a life-threatening organ-dysfunction condition caused by a dysregulated response to an infectious condition that can cause complications in patients with major trauma. Burns are one of the most destructive forms of trauma; despite the improvements in medical care, infections remain an important cause of burn injury-related mortality and morbidity, and complicated sepsis predisposes patients to diverse complications such as organ failure, lengthening of hospital stays, and increased costs. Accurate diagnosis and early treatment of sepsis may have a beneficial impact on clinical outcome of burn-injured patients. In this review, we offer a comprehensive description of the current and traditional markers used as indicative of sepsis in burned patients. However, although these are markers of the inflammatory post-burn response, they usually fail to predict sepsis in severely burned patients due to that they do not reflect the severity of the infection. Identification and measurement of biomarkers in early stages of infection is important in order to provide timely response and effective treatment of burned patients. Therefore, we compiled important experimental evidence, demonstrating novel biomarkers, including molecular markers such as genomic DNA variations, alterations of transcriptome profiling (mRNA, miRNAs, lncRNAs and circRNAs), epigenetic markers, and advances in proteomics and metabolomics. Finally, this review summarizes next-generation technologies for the identification of markers for detection of sepsis after burn injuries. Copyright © 2018 Elsevier Ltd and ISBI. All rights reserved.

The effectiveness of using pictures in teaching young children about burn injury accidents.

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Liu, Hsueh-Fen; Lin, Fang-Suey; Chang, Chien-Ju

2015-11-01

This study utilized the "story grammar" approach (Stein and Glenn, 1979) to analyze the within-corpus differences in recounting of sixty 6- and 7-year-old children, specifically whether illustrations (5-factor accident sequence) were or were not resorted to as a means to assist their narration of a home accident in which a child received a burn injury from hot soup. Our investigation revealed that the message presentation strategy "combining oral and pictures" better helped young children to memorize the story content (sequence of events leading to the burn injury) than "oral only." Specifically, the content of "the dangerous objects that caused the injury", "the unsafe actions that people involved took", and "how the people involved felt about the severity of the accident" differed significantly between the two groups. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Young Children's Acute Stress After a Burn Injury: Disentangling the Role of Injury Severity and Parental Acute Stress.

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Haag, Ann-Christin; Landolt, Markus A

2017-09-01

Although injury severity and parental stress are strong predictors of posttraumatic adjustment in young children after burns, little is known about the interplay of these variables. This study aimed at clarifying mediation processes between injury severity and mother's, father's, and young child's acute stress. Structural equation modeling was used to examine the relationships between injury severity and parental and child acute stress. Parents of 138 burn-injured children (ages 1-4 years) completed standardized questionnaires on average 19 days postinjury. Sixteen children (11.7%) met Diagnostic and Statistical Manual of Mental Disorders, 5th edition, preschool criteria for posttraumatic stress disorder (excluding time criterion). The model revealed a significant mediation of maternal acute stress, with the effect of injury severity on a child's acute stress mediated by maternal acute stress. Paternal acute stress failed to serve as a mediating variable. Our findings confirm mothers' crucial role in the posttraumatic adjustment of young children. Clinically, mothers' acute stress should be monitored. © The Author 2017. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Genitalia burn: accident or violence? Concerns that transcend injury treatment

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Ana Lúcia Ferreira

2014-06-01

Full Text Available OBJECTIVE: To describe a case of genital burn which raised the suspicion of maltreatment (sexual abuse and neglect by lack of supervision.CASE DESCRIPTION: An infant was taken to the Emergency Room of a pediatric hospital with an extensive burn in the vulva and perineum. The mother claimed the burn had been caused by a sodium-hydroxide-based product. However, the injury severity led to the suspicion of sexual abuse, which was then ruled out by a multidisciplinary team, based on the consistent report by the mother. Besides, the lesion type matched those caused by the chemical agent involved in the accident and the family context was evaluated and considered adequate. The patient had a favorable outcome and was discharged after four days of hospitalization. Outpatient follow-up during six months after the accident enabled the team to rule out neglect by lack of supervision.COMMENTS: Accidents and violence are frequent causes of physical injuries in children, and the differential diagnosis between them can be a challenge for healthcare workers, especially in rare clinical conditions involving patients who cannot speak for themselves. The involvement of a multidisciplinary trained team helps to have an adequate approach, ensuring child protection and developing a bond with the family; the latter is essential for a continued patient follow-up.

Application of silver sulfadiazine cream with early surgical intervention in patients suffering from combined burn-blast injury facial tattoos.

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Ebrahimi, Ali; Kalantar Motamedi, Mohammad Hosein

2012-01-01

Severe combined burn-blast injury is a great challenge to surgical teams due to its high mortality. It also results in unsightly traumatic tattoos. The aims of these case reports were to clarify the clinical characteristic of the dynamite explosion burn-blast facial injuries and discuss appropriate management of these patients. We report two patients suffering from facial burn-blast injury following dynamite explosion in which after primary stabilization, silver sulfadiazine cream was applied to the wounds and 12 hours later the wounds were cleaned under general anesthesia with vigorous saline solution irrigation and brushing. The foreign particles were meticulously removed from wounds and simultaneous repairing of defects was done with nylon 6-0 sutures. We conclude application of silver sulfadiazine cream on facial burn-blast injury tattoos several hours before surgical removal of particles is highly efficacious in facilitating particle removal and attaining a good result following surgical intervention, and primary repair. Treatment of combined burn-blast tattoos is different from other types of tattoos not associated with burns. Debridement and removal of foreign particles under general anesthesia from skin immediately and primary reconstruction of wounds is essential. We recommend application of the topical agent silver sulfadiazine to wounds about 12 hours before surgical intervention.

The Effect of Burn Injury on Serum Concentrations of Sclerostin and FGF23

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Klein, Gordon L; Herndon, David N; Le, Phuong T; Andersen, Clark R; Benjamin, Debra; Rosen, Clifford J

2015-01-01

Severe burn injury results in acute bone resorption followed by an adynamic state, most likely due to changes brought about by the inflammatory and glucocorticoid responses to the injury. There is a consequent increase in annual extrapolated fracture incidence in children. While osteoblasts have been reported to disappear from the bone surface and stem cell differentiation into osteoblasts is impaired, the effect of burns on osteocyte function is unknown. We measured serum concentrations of two osteocyte proteins, sclerostin and fibroblast growth factor (FGF)-23 between 6–60 days post-burn in pediatric patients, ages 5–18 years who had participated in a randomized controlled double-blind study of acute administration of pamidronate to prevent the resorptive bone loss. While FGF-23 was undetectable in all samples, the plot of sclerostin concentration versus time post-burn yielded a statistically significant difference between slopes, −2.5 in the placebo control group and +3.5 in the group receiving pamidronate, p=0.016 by ANCOVA. The FGF23 data suggest that osteocytes may be apoptotic, although the sclerostin data may indicate partial preservation of osteocyte function in subjects receiving pamidronate or an ectopic source of sclerostin. PMID:25922302

Bone Loss in the Acute Stage Following Burn Injury - Original Investigation

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Berrin Leblebici

2007-06-01

Full Text Available Aim: The purpose of this study was to determine whether a bone loss occurs during acute period following burn injury or not, and to investigate the effects of various parameters on it. Materials and Methods: This study was conducted on 19 patients, ages between 20 and 50, who had a burn injury with more than %20 of Total Body Surface Area (TBSA. We recorded the patients’ burn cause, localization, percantage, ambulation and functional status. At the end of the first month, we measured bone mıneral densıty of total L1-L4 vertebrae, left distal forearm, left total femur, in all patients. A Z score less than –1 was accepted to be the indicator of bone loss. Results: The mean age of the patients (14 male and 5 female was 33.09±11.61. We found a Z score less then -1 in 68.4% of left distal forearm, 21.1% of left total femur and 36.8% of total L1-L4 vertabrae measurements. There were no significant correlations between TBSA, Functional Ambulatıon Scale and Functional Independence Measure, and Z scores. Conclusion: There is a reduction in Bone Mineral Density in patıents wıth moderate/severe burn ınjuries in the acute period which is not correlated wıth neither TBSA nor functional status. (From the World of Osteoporosis 2007;13:33-6

Treatment with gelsolin reduces brain inflammation and apoptotic signaling in mice following thermal injury.

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Zhang, Qing-Hong; Chen, Qi; Kang, Jia-Rui; Liu, Chen; Dong, Ning; Zhu, Xiao-Mei; Sheng, Zhi-Yong; Yao, Yong-Ming

2011-09-21

Burn survivors develop long-term cognitive impairment with increased inflammation and apoptosis in the brain. Gelsolin, an actin-binding protein with capping and severing activities, plays a crucial role in the septic response. We investigated if gelsolin infusion could attenuate neural damage in burned mice. Mice with 15% total body surface area burns were injected intravenously with bovine serum albumin as placebo (2 mg/kg), or with low (2 mg/kg) or high doses (20 mg/kg) of gelsolin. Samples were harvested at 8, 24, 48 and 72 hours postburn. The immune function of splenic T cells was analyzed. Cerebral pathology was examined by hematoxylin/eosin staining, while activated glial cells and infiltrating leukocytes were detected by immunohistochemistry. Cerebral cytokine mRNAs were further assessed by quantitative real-time PCR, while apoptosis was evaluated by caspase-3. Neural damage was determined using enzyme-linked immunosorbent assay of neuron-specific enolase (NSE) and soluble protein-100 (S-100). Finally, cerebral phospho-ERK expression was measured by western blot. Gelsolin significantly improved the outcomes of mice following major burns in a dose-dependent manner. The survival rate was improved by high dose gelsolin treatment compared with the placebo group (56.67% vs. 30%). Although there was no significant improvement in outcome in mice receiving low dose gelsolin (30%), survival time was prolonged against the placebo control (43.1 ± 4.5 h vs. 35.5 ± 5.0 h; P Burn-induced T cell suppression was greatly alleviated by high dose gelsolin treatment. Concurrently, cerebral abnormalities were greatly ameliorated as shown by reduced NSE and S-100 content of brain, decreased cytokine mRNA expressions, suppressed microglial activation, and enhanced infiltration of CD11b+ and CD45+ cells into the brain. Furthermore, the elevated caspase-3 activity seen following burn injury was remarkably reduced by high dose gelsolin treatment along with down-regulation of

[Combined burn trauma in the array of modern civilian and combat burns].

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Ivchenko, E V; Borisov, D N; Golota, A S; Krassiĭ, A B; Rusev, I T

2015-02-01

The current article positions the combined burn and non-burn injuries in the general array of civilian and combat burns. For that purpose the official state statistics and scientific medical publications, domestic as well as foreign, have been analyzed. It has been shown that in peace time the combined burn/trauma injuries are infrequent. But the same type of injury becomes routine especially among the civilian population in the conditions of the modern so called "hybrid war". And the medical service should be prepared for it.

High tidal volume decreases adult respiratory distress syndrome, atelectasis, and ventilator days compared with low tidal volume in pediatric burned patients with inhalation injury.

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Sousse, Linda E; Herndon, David N; Andersen, Clark R; Ali, Arham; Benjamin, Nicole C; Granchi, Thomas; Suman, Oscar E; Mlcak, Ronald P

2015-04-01

Inhalation injury, which is among the causes of acute lung injury and acute respiratory distress syndrome (ARDS), continues to represent a significant source of mortality in burned patients. Inhalation injury often requires mechanical ventilation, but the ideal tidal volume strategy is not clearly defined in burned pediatric patients. The aim of this study was to determine the effects of low and high tidal volume on the number of ventilator days, ventilation pressures, and incidence of atelectasis, pneumonia, and ARDS in pediatric burned patients with inhalation injury within 1 year post burn injury. From 1986 to 2014, inhalation injury was diagnosed by bronchoscopy in pediatric burned patients (n = 932). Patients were divided into 3 groups: unventilated (n = 241), high tidal volume (HTV, 15 ± 3 mL/kg, n = 190), and low tidal volume (LTV, 9 ± 3 mL/kg, n = 501). High tidal volume was associated with significantly decreased ventilator days (p tidal volume significantly decreases ventilator days and the incidence of both atelectasis and ARDS compared with low tidal volume in pediatric burned patients with inhalation injury. Therefore, the use of HTV may interrupt sequences leading to lung injury in our patient population. Copyright © 2015 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Forty-Year Follow-up of Full-Thickness Skin Graft After Thermal Burn Injury to the Volar Hand.

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Weeks, Dexter; Kasdan, Morton L; Wilhelmi, Bradon J

2016-01-01

The hands are commonly affected in severe thermal burn injuries. Resulting contractures lead to significant loss of function. Burn contracture release and skin grafting are necessary to restore hand function. We report a case in which surgical reconstruction of a volar hand burn was performed with full-thickness skin grafting. The patient had a 40-year follow-up to assess the function and cosmesis of the repaired hand. We report a case in which a 15-month-old boy presented after receiving third-degree burns to the left volar hand, including the flexural aspects of the index, long, and ring fingers by placing it on a hot kitchen stove burner. The patient subsequently underwent scar contracture release and full-thickness skin grafting. Eleven years after reconstruction, further contractures developed associated with the patient's growth, which were reconstructed with repeat full-thickness skin graft from the inguinal region. No recurrence was witnessed afterward and 40 years after initial injury, the patient maintains full activities of daily living and use of his hand in his occupation. There is debate regarding the superiority of split-thickness versus full-thickness grafts during reconstruction. Our case strengthens the argument for durability of a full-thickness skin graft following thermal burn injury.

The Clinical Significance of the MIF Homolog D-Dopachrome Tautomerase (MIF-2) and its Circulating Receptor (sCD74) in Burn Injury

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Kim, Bong-Sung; Stoppe, Christian; Grieb, Gerrit; Leng, Lin; Sauler, Maor; Assis, David; Simons, David; Boecker, Arne Hendrick; Schulte, Wibke; Piecychna, Marta; Hager, Stephan; Bernhagen, Jürgen; Pallua, Norbert; Bucala, Richard

2016-01-01

Background We reported earlier that the cytokine macrophage migration inhibitory factor (MIF) is a potential biomarker in burn injury. In the present study, we investigated the clinical significance in severely burned patients of expression levels the newly discovered MIF family member D-dopachrome tautomerase (DDT or MIF-2) and their common soluble receptor CD74 (sCD74). Methods DDT and sCD74 serum levels were measured 20 severely burned patients and 20 controls. Serum levels were correlated to the abbreviated burn severity index (ABSI) and TBSA followed by receiver operating characteristic (ROC) analysis. Data were supported by gene expression dataset analysis of 31 burn patients and 28 healthy controls. Results CD74 and DDT were increased in burn patients. Furthermore, CD74 and DDT also were elevated in septic non-survivors when compared to survivors. Serum levels of DDT showed a positive correlation with the ABSI and TBSA in the early stage after burn injury, and the predictive character of DDT was strongest at 24 hrs. Serum levels of CD74 only correlated with the ABSI five days post-injury. Conclusions DDT may assist in the monitoring of clinical outcome and prediction of sepsis during the early post-burn period. sCD74 and MIF, by contrast, have limited value as an early predictor of death due to their delayed response to burn injury. PMID:27209369

Burn-related factors affecting anxiety, depression and self-esteem in burn patients: an exploratory study.

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Jain, M; Khadilkar, N; De Sousa, A

2017-03-31

Burns are physically, psychologically and economically challenging injuries, and the factors leading to them are many and under-studied. The aim of the current study was to assess level of anxiety, depression and self-esteem in burn patients, and look at various burn-related variables that affect them. This cross-sectional study included 100 patients with burn injuries admitted to a tertiary care private hospital in an urban metropolis in India. The patients were assessed for anxiety, depression and self-esteem using the Hamilton anxiety rating scale, Hamilton depression rating scale and Rosenberg self-esteem scale respectively. Assessment was carried out within 2-8 weeks of injury following medical stabilization. The data was tabulated and statistically analyzed. The study sample was predominantly male (54%), married (69%), with a mean age of 34.1 ± 10.8 years. Accidental burns (94%) were the most common modality of injury. The majority (46%) suffered burns involving 20-59% total body surface area (TBSA), and facial burns were present (57%). No significant association was found between TBSA and anxiety, depression or self-esteem, and the same was true for facial burns. Deep burns, however, were significantly associated with anxiety (p=0.03) and depression (p=0.0002). High rates of anxiety and depression are associated with burn injuries and related to burn depth. Adjustment and recovery in these patients depends on various other factors like the patient's psychological status, nature/extent of the injury and ensuing medical care. Further research is warranted to reveal the magnitude and predictors of psychological problems in burn patients.

Initial evaluation and management of the critical burn patient.

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Vivó, C; Galeiras, R; del Caz, Ma D P

2016-01-01

The major improvement in burn therapy is likely to focus on the early management of hemodynamic and respiratory failures in combination with an aggressive and early surgical excision and skin grafting for full-thickness burns. Immediate burn care by first care providers is important and can vastly alter outcomes, and it can significantly limit burn progression and depth. The goal of prehospital care should be to cease the burning process as well as prevent future complications and secondary injuries for burn shock. Identifying burn patients appropriate for immediate or subacute transfer is an important step in reducing morbidity and mortality. Delays in transport to Burn Unit should be minimized. The emergency management follows the principles of the Advanced Trauma Life Support Guidelines for assessment and stabilization of airway, breathing, circulation, disability, exposure and environment control. All patients with suspected inhalation injury must be removed from the enclosure as soon as possible, and immediately administer high-flow oxygen. Any patient with stridor, shortness of breath, facial burns, singed nasal hairs, cough, soot in the oral cavity, and history of being in a fire in an enclosed space should be strongly considered for early intubation. Fibroscopy may also be useful if airway damage is suspected and to assess known lung damage. Secondary evaluation following admission to the Burn Unit of a burned patient suffering a severe thermal injury includes continuation of respiratory support and management and treatment of inhalation injury, fluid resuscitation and cardiovascular stabilization, pain control and management of burn wound. Copyright © 2015 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

Effect of blood transfusion and skin grafting on rats with combined radiation-burn injury

International Nuclear Information System (INIS)

Yan Yongtang; Ran Xinze; Wei Shuqing

1990-01-01

The therapeutic effect of escharectomy and skin grafting at different times on rats with combined radiation-burn injuries (5 Gy total body irradiation plus flash radiation from a 5 kW bromotungstenic lamp to induce a 15% TBSA full thickness burn on back) treated with blood transfusion (BT) were studied. The treatment with BT and escharectomy plus skin grafting at 24, 48, and 72 h after injury showed significant therapeutic effects. In these treated groups, early recovery of WBC counts, the granulocytes and total lymphocytes, T, B-cells, bone marrow cells or CFU-F counts were evident within 30 days after injury. The 30-day survival rates of the skin grafts in the group treated with BT and skin grafting at 24 h after injury was 80%, in the group with skin grafting alone was 50%, while all the skin grafts sloughted within 30 days when the grafting was performed 48 and 72 h after injury. The 30-day survival rate of the recipients treated with skin grafting plus BT was higher than that of the animals with skin grafting alone. The results showed that satisfactory results were achieved with BT plus escharectomy and skin grafting within 24 h after injury, while skin grafting performed at 48 or 72 h after injury was ineffective for the survival of skin grafts

The role of the nurse in the rehabilitation of patients with radical changes in body image due to burn injuries.

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Aacovou, I

2005-06-30

Burn injuries are among the most serious causes of radical changes in body image. The subject of body image and self-image is essential in rehabilitation, and the nurse must be aware of the issues related to these concepts and take them seriously into account in drafting out the nursing programme. This paper defines certain key words related to body image and discusses the social context of body image. Burn injuries are considered in relation to the way each of these affects the patient's body image. The aim of nursing is defined and the nurse's role in cases of severe changes in body image due to burn injuries is discussed.

Improved Survival of Patients With Extensive Burns: Trends in Patient Characteristics and Mortality Among Burn Patients in a Tertiary Care Burn Facility, 2004-2013.

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Strassle, Paula D; Williams, Felicia N; Napravnik, Sonia; van Duin, David; Weber, David J; Charles, Anthony; Cairns, Bruce A; Jones, Samuel W

Classic determinants of burn mortality are age, burn size, and the presence of inhalation injury. Our objective was to describe temporal trends in patient and burn characteristics, inpatient mortality, and the relationship between these characteristics and inpatient mortality over time. All patients aged 18 years or older and admitted with burn injury, including inhalation injury only, between 2004 and 2013 were included. Adjusted Cox proportional hazards regression models were used to estimate the relationship between admit year and inpatient mortality. A total of 5540 patients were admitted between 2004 and 2013. Significant differences in sex, race/ethnicity, burn mechanisms, TBSA, inhalation injury, and inpatient mortality were observed across calendar years. Patients admitted between 2011 and 2013 were more likely to be women, non-Hispanic Caucasian, with smaller burn size, and less likely to have an inhalation injury, in comparison with patients admitted from 2004 to 2010. After controlling for patient demographics, burn mechanisms, and differential lengths of stay, no calendar year trends in inpatient mortality were detected. However, a significant decrease in inpatient mortality was observed among patients with extensive burns (≥75% TBSA) in more recent calendar years. This large, tertiary care referral burn center has maintained low inpatient mortality rates among burn patients over the past 10 years. While observed decreases in mortality during this time are largely due to changes in patient and burn characteristics, survival among patients with extensive burns has improved.

Seawater immersion aggravates burn-associated lung injury and inflammatory and oxidative-stress responses.

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Ma, Jun; Wang, Ying; Wu, Qi; Chen, Xiaowei; Wang, Jiahan; Yang, Lei

2017-08-01

With the increasing frequency of marine development activities and local wars at sea, the incidence of scald burns in marine accidents or wars has been increasing yearly. Various studies have indicated that immersion in seawater has a systemic impact on some organs of animals or humans with burn. Thus, for burn/scald injuries after immersion in seawater, it is desirable to study the effects and mechanisms of action on important organs. In the present study, we aimed to investigate the effect of immersion in seawater on lung injury, inflammatory and oxidative-stress responses in scalded rats. The structural damage to lungs was detected by hematoxylin and eosin staining and the results showed that seawater immersion aggravated structural lung injury in scalded rats. The expression of HMGB1 in lung tissues was detected by immunohistochemical analysis and the results showed that seawater immersion increased HMGB1 expression in lung tissues of scalded rats. Apoptosis in lung tissues was detected by terminal deoxynucleotidyl transfer-mediated dUTP nick end-labeling (TUNEL) staining and the results showed that seawater immersion increased apoptosis rate in lung tissues of scalded rats. In addition, the expression levels of TNF-α, IL-6, IL-8, SOD, and MDA in serum were analyzed by enzyme-linked immunosorbent assays (ELISAs) and the results showed that seawater immersion induced secretion of proinflammatory factors (TNF-α, IL-6, and IL-8), increased MDA protein level, and suppressed SOD activity in the serum of scalded rats. Furthermore, measurement of plasma volume and pH showed that seawater immersion decreased plasma volume and pH value. Overall, the results indicated that all effects induced by immersion in seawater in scalded rats are more pronounced than those induced by freshwater. In conclusion, seawater immersion may aggravate lung injury and enhance inflammatory and oxidative-stress responses after burn. Copyright © 2017 Elsevier Ltd and ISBI. All rights

Lawn mower-related burns.

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Still, J; Orlet, H; Law, E; Gertler, C

2000-01-01

Lawn mower-related injuries are fairly common and are usually caused by the mower blades. Burns may also be associated with the use of power lawn mowers. We describe 27 lawn mower-related burn injuries of 24 male patients and 3 female patients. Three of the patients with burn injuries were children. Burn sizes ranged from 1% to 99% of the total body surface area (mean, 18.1%). Two of the patients died. The hospital stay ranged from 1 day to 45 days. Twenty-six injuries involved gasoline, which is frequently associated with refueling accidents. Safety measures should involve keeping children away from lawn mowers that are being used. The proper use and storage of gasoline is stressed.

Pediatric Burns in the Bedouin Population in Southern Israel

Directory of Open Access Journals (Sweden)

Arnon D. Cohen

2007-01-01

Full Text Available Burn trauma is an important public health concern, with increased risk for burns in children. A cross-sectional study was performed to describe the epidemiological characteristics and risk factors for burns in hospitalized Bedouin children in Soroka University Medical Center during the years 2001–2002. In a population of 558 hospitalized burn-injured patients, 282 Bedouin children were identified. Two hundred and sixty five patients (94.0% had burns involving less than 20% of the body surface area. Cause of the burns was scald in 190 patients (67.4%, fire in 80 patients (28.4%, chemical in 8 patients (2.8%, and explosion in 2 patients (0.7%. Two female patients (0.7% aged 11 and 17 years died of their burns that were caused by fire. The mean length of hospitalization was 9.8 days. Pediatric burn injury has become a significant public health problem in the Bedouin population of the Negev. To reduce the burden of burn injury, it is necessary to increase current efforts in prevention of burns.

Phoenix Society for Burn Survivors

Science.gov (United States)

... in 2018! Learn More For Loved Ones A burn injury doesn't just impact the survivor. Families ... to support longterm recovery, improve the quality of burn care, and prevent burn injury. Explore articles on ...

A burn prevention program as a long-term investment: trends in burn injuries among Jews and Bedouin children in Israel.

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Shani, E; Bahar-Fuchs, S A; Abu-Hammad, I; Friger, M; Rosenberg, L

2000-03-01

In order to broaden our long-term intervention efforts in elementary schools in Israel (underway since 1988) and to set priorities for further population-specific actions, we compared the pattern of burn injuries among two age groups (0-4; 5-14) of two ethnic groups of Jews and Bedouins admitted to a regional hospital between 1986 and 1995 (n = 1050). The findings indicated a significant downward trend, though somewhat nonlinear, in burn admissions among the older age groups. A relatively less favorable trend was observed for the younger age groups. Consistently across years, burn rates in the younger group of Bedouin children were the highest. For the 10-year period, a significant season by ethnic group variation in burn admissions was observed, with a peak in the spring and in the wintertime for the Jews and Bedouins, respectively. A significant trend of decrease, mostly among older children, in average lengths of hospital stay, was also evident. Yet, regardless of age group and across years, Bedouin children stayed longer in the hospital than Jewish children. The overall leading causes of injury (for 1992-1995) were hot liquids (69%), fire (17%), chemicals (9.5%) and contact (2%). In our view, there is a need to address at-risk populations through environmental, community and family-oriented interventions and to venture beyond the pathogenic factors to the investigation of the salutary factors of health under diverse life conditions.

Burn injury reveals altered phenotype in mannan-binding lectin-deficient mice

DEFF Research Database (Denmark)

Møller-Kristensen, Mette; Hamblin, Michael R; Thiel, Steffen

2007-01-01

Burn injury destroys skin, the second largest innate immune organ in the body, and triggers chaotic immune and inflammatory responses. The pattern recognition molecule, mannan-binding lectin (MBL), plays an important role in the first-line host defense against infectious agents. MBL initiates...... the lectin complement pathway and acts as an opsonin. Recent studies suggest that MBL also modulates inflammatory responses. We report that local responses after burn in MBL null mice differ from those found in wild-type (WT) mice in the following important biological markers: spontaneous eschar separation......, thinned epidermis and dermis, upregulation of soluble factors including cytokines, chemokines, cell adhesion molecules, a growth factor-binding protein, and matrix metalloproteinases. Mice lacking C1q, C4, or C3 did not show the lack of eschar separation seen in MBL null-burn phenotype. These findings...

Changing patterns in electrical burn injuries in a developing country: should prevention programs focus on the rural population?

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Patil, Surendra B; Khare, Nishant Anil; Jaiswal, Sumeet; Jain, Arvind; Chitranshi, Anurag; Math, Mahantesh

2010-01-01

In the developing world, the incidence of electrical injuries has increased in the past few years. This study attempts to identify the causative and demographic risk factors that can help in formulating a targeted prevention program. The study was conducted prospectively and retrospectively from 2004 to 2009. Eighty-four consecutive patients with electrical burn injuries were analyzed for their demographic profile, age, sex, occupation, rural-urban distribution, mode of injury, and place of injury. The patients were asked to fill out a questionnaire regarding their awareness about electrical burn injuries, and the results were tabulated. The age of presentation ranged from 3 to 61 years. The most frequently affected age group was the second decade of life (33.3%). Of 84 patients studied, 71 were male and 13 female. Fifty-nine patients were from the urban area, while 25 were from the surrounding rural area. Students including children and adolescents were the most common affected single group (22.5%). Contact with live wire or contact with an object that was in contact with a live wire (secondary contact) accounted for 43 of 84 cases (51%). Home was the most common location where injury occurred (51.2%). Twenty-one of 59 cases (35.6%) reported from the urban area and 3 of 25 cases (12%) from the rural area had specific knowledge about prevention of electrical burn injury. Forty-one patients (69.4%) from the urban area and 22 (88%) from the rural area believed that adequate information regarding electrical burn injury was not available. Thirty-six patients (61%) from the urban area and 24 (96%) from the rural area believed that they would have behaved differently if the information had been available. The authors recommend that prevention programs should be modified to cater to the specific needs of the younger age groups and the rural population.

CLINICAL STUDY OF ELECTRICAL BURNS AMONG ALL BURNS CASES- 3 YEARS’ EXPERIENCE

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Nagabathula Durga Prasad

2017-08-01

Full Text Available BACKGROUND With the advances in technology, electrical injuries are becoming more common and are the leading cause of work-related traumatic death. One third of all electrical traumas and most high-voltage injuries are job related and more than 50% of these injuries result from power line contact. The management of the major burn injury represents a significant challenge to every member of the burns team. Most of electrical burns present with gangrene of toes and limbs with eschar over body parts. Their presentation is mostly due to contact with high-voltage electricity at their work places. MATERIALS AND METHODS A retrospective study was made to study the clinico-social profile of patients suffering electric burns admitted into Department of General Surgery. RESULTS 92 cases were evaluated and studied. Majority of patients developed gangrene of limbs and toes. Amputations and skin grafting was done. Most patients who suffered electric burns were males of age group 21 to 40 years. All cases are accidental and mostly occurred at work places. Most electric burns are high-voltage based and caused deep burns. Major complications like acute renal failure and septicaemia were encountered. Most of them suffered 16 to 30% burns. Most commonly isolated organism from wounds is pseudomonas. Most of them suffered a hospital stay of 1 to 2 months. CONCLUSION Electric burns are a burden to the society. Prevention is the best way to deal with them. Electricity-based employees have to be trained properly regarding safety measures to be taken. General education of public regarding safety measures can prevent electrical burn injuries.

A Smartphone App and Cloud-Based Consultation System for Burn Injury Emergency Care.

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Lee A Wallis

Full Text Available Each year more than 10 million people worldwide are burned severely enough to require medical attention, with clinical outcomes noticeably worse in resource poor settings. Expert clinical advice on acute injuries can play a determinant role and there is a need for novel approaches that allow for timely access to advice. We developed an interactive mobile phone application that enables transfer of both patient data and pictures of a wound from the point-of-care to a remote burns expert who, in turn, provides advice back.The application is an integrated clinical decision support system that includes a mobile phone application and server software running in a cloud environment. The client application is installed on a smartphone and structured patient data and photographs can be captured in a protocol driven manner. The user can indicate the specific injured body surface(s through a touchscreen interface and an integrated calculator estimates the total body surface area that the burn injury affects. Predefined standardised care advice including total fluid requirement is provided immediately by the software and the case data are relayed to a cloud server. A text message is automatically sent to a burn expert on call who then can access the cloud server with the smartphone app or a web browser, review the case and pictures, and respond with both structured and personalized advice to the health care professional at the point-of-care.In this article, we present the design of the smartphone and the server application alongside the type of structured patient data collected together with the pictures taken at point-of-care. We report on how the application will be introduced at point-of-care and how its clinical impact will be evaluated prior to roll out. Challenges, strengths and limitations of the system are identified that may help materialising or hinder the expected outcome to provide a solution for remote consultation on burns that can be

A Smartphone App and Cloud-Based Consultation System for Burn Injury Emergency Care.

Science.gov (United States)

Wallis, Lee A; Fleming, Julian; Hasselberg, Marie; Laflamme, Lucie; Lundin, Johan

2016-01-01

Each year more than 10 million people worldwide are burned severely enough to require medical attention, with clinical outcomes noticeably worse in resource poor settings. Expert clinical advice on acute injuries can play a determinant role and there is a need for novel approaches that allow for timely access to advice. We developed an interactive mobile phone application that enables transfer of both patient data and pictures of a wound from the point-of-care to a remote burns expert who, in turn, provides advice back. The application is an integrated clinical decision support system that includes a mobile phone application and server software running in a cloud environment. The client application is installed on a smartphone and structured patient data and photographs can be captured in a protocol driven manner. The user can indicate the specific injured body surface(s) through a touchscreen interface and an integrated calculator estimates the total body surface area that the burn injury affects. Predefined standardised care advice including total fluid requirement is provided immediately by the software and the case data are relayed to a cloud server. A text message is automatically sent to a burn expert on call who then can access the cloud server with the smartphone app or a web browser, review the case and pictures, and respond with both structured and personalized advice to the health care professional at the point-of-care. In this article, we present the design of the smartphone and the server application alongside the type of structured patient data collected together with the pictures taken at point-of-care. We report on how the application will be introduced at point-of-care and how its clinical impact will be evaluated prior to roll out. Challenges, strengths and limitations of the system are identified that may help materialising or hinder the expected outcome to provide a solution for remote consultation on burns that can be integrated into routine

Factors influencing psychological, social and health outcomes after major burn injuries in adults: cohort study protocol.

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Druery, Martha; Newcombe, Peter A; Cameron, Cate M; Lipman, Jeffrey

2017-06-17

The goal of burn care is that 'the quality of the outcome must be worth the pain of survival'. More research is needed to understand how best to deliver care for patients with burns to achieve this aim. Loss of independence, function as well as loss of income for patients with burns and carers cause a significant burden at both individual and societal levels. Much is being done to advance knowledge in the clinical care field; however, there has been a paucity of research exploring psychosocial outcomes. This paper describes the study background and methods, as implemented in an Australian cohort study of psychosocial outcomes after major burn injuries. In this inception cohort study, a target sample of 230 participants, aged 18 years or over, admitted to a single statewide burns centre with a burn injury are identified by hospital staff for inclusion. Baseline survey data are collected either in person or by telephone within 28 days of the injury and participants then followed up with telephone interviews at 3, 6 and 12 months postburn. Injury and burns treatment information is collected from medical records. Social support is measured as a predictor variable using the Multidimensional Scale of Perceived Social Support. Outcome data are collected via standardised measures in the domains of Quality of Life (SF-12, EQ-5D, BSHS-B), depression (PHQ-9), post-traumatic stress disorder (PCL-C, PAS), community integration (CIQ-R) and Quality-Adjusted Life Years (EQ-5D). Additional survey questions measure life satisfaction, return to work and public services utilisation at 12 months postinjury. Data analysis methods will include analysis of variance, Pearson correlation and hierarchical multiple regression analyses. Hospital-based and University of Queensland Human Research Ethics Committees have approved the protocol. Results from the study will be disseminated at national and international conferences, in peer-reviewed journals and in a doctoral thesis. Australia New

[Burns in adolescents].

Science.gov (United States)

Ortiz Rodríguez, R; Domínguez Amillo, E; Soto Beauregard, C; Díaz González, M; López Gutiérrez, J C; Ros Mar, Z; Tovar Larrucea, J A

2012-04-01

The aim of this study was to know the epidemiology of burns in teenagers. Burn patients over 11 years old admitted in our Institution in the last 10 years were included. Etiology, burn size, hospital stay, quirurgical interventions and long term sequelae were registered. One thousand and eight patients were admitted, 89 were over 11 years (8.8%), 70.7% were boys and 29.3% girls. Fire was the principal agent in 58 cases (65.1%), due to fireworks in 13 (22.4%), alcohol in 7 (12%), explosion of flammable containers (spray) in 4 (6.8%) and gasoline in 3 (5.2%). Fireworks injuries and spray explosions affected face and hand in 88% cases. The median hospital stay was 8 days after admission (1 to 90). 83.1% required surgical treatment with mean of 1.8 +/- 1.4 interventions and 21.3% had long-term sequelaes that required at least one surgical intervention. Fire is the main cause of burns in adolescents. Fireworks injuries represented a quarter of that lesions, and highlights paint spray explosions as new causative agents. Considering the high morbidity in this age group, with permanent functional and aesthetic sequelae, prevention campaigns are needed to reduce such accidents.

Paediatric treadmill friction injuries.

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Jeremijenko, Luke; Mott, Jonathan; Wallis, Belinda; Kimble, Roy

2009-05-01

The aim of this study was to report on the severity and incidence of children injured by treadmills and to promote the implementation of safety standards. This retrospective review of children with treadmill friction injuries was conducted in a single tertiary-level burns centre in Australia between January 1997 and June 2007. The study revealed 37 children who sustained paediatric treadmill friction injuries. This was a presentation of 1% of all burns. Thirty-three (90%) of the injuries occurred in the last 3.5 years (January 2004 to June 2007). The modal age was 3.2 years. Thirty-three (90%) injuries were either full thickness or deep partial friction burns. Eleven (30%) required split thickness skin grafts. Of those who became entrapped, 100% required skin grafting. This study found that paediatric treadmill friction injuries are severe and increasing in incidence. Australian standards should be developed, implemented and mandated to reduce this preventable and severe injury.

Rational Selection and Use of Antimicrobials in Patients with Burn Injuries.

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Hill, David M; Sinclair, Scott E; Hickerson, William L

2017-07-01

Caring for patients with burn injuries is challenging secondary to the acute disease process, chronic comorbidities, and underrepresentation in evidence-based literature. Much current practice relies on extrapolation of guidance from different patient populations and wide variations in universal practices. Identifying infections or sepsis in this hypermetabolic population is imperfect and often leads to overprescribing of antimicrobials, suboptimal dosing, and multidrug resistance. An understanding of pharmacokinetics and pharmacodynamics may aid optimization of dosing regimens to better attain treatment targets. This article provides an overview of the current status of burn infection and attempts recommendations for consideration to improve universally accepted care. Copyright © 2017 Elsevier Inc. All rights reserved.

Routine systemic antibiotic prophylaxis for burn injuries in developing countries: A best evidence topic (BET)

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Stewart, Barclay T; Gyedu, Adam; Agbenorku, Pius; Amankwa, Richcane; Kushner, Adam L; Gibran, Nicole

2015-01-01

Background Burns are common in low- and middle-income countries (LMICs) and complicated by unhygienic conditions, malnutrition, use of high-risk homemade dressings and delayed presentation. Resultantly, use of routine systemic antibiotic prophylaxis (SAP) to prevent wound infection is common practice despite this intervention being abandoned in high-income countries due to increased antimicrobial resistance and non-bacterial suprainfection, Methods A best evidence topic (BET) was constructed using a structured protocol. The question addressed was: In LMICs, does routine use of SAP reduce burn wound infection, morbidity or mortality? Results From 704 retrieved records, 48 reports met criteria to be examined. Of those, 3 studies represented the best available evidence. Together, two randomized clinical trials (RCTs) and a retrospective cohort study reported no difference in the proportion of wound infection, any infection or length of hospital stay between SAP groups and controls. One RCT described a greater proportion of wounds infected with P. aeruginosa among SAP arms compared to controls. The studies had few participants and significant methodological weaknesses. Conclusion On the basis of limited, currently available evidence, the use of SAP cannot be recommended for patients in LMICs that present soon after burn injury. PMID:26260622

Fabrication and hemocompatibility assessment of novel polyurethane-based bio-nanofibrous dressing loaded with honey and Carica papaya extract for the management of burn injuries.

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Balaji, Arunpandian; Jaganathan, Saravana Kumar; Ismail, Ahmad Fauzi; Rajasekar, Rathanasamy

Management of burn injury is an onerous clinical task since it requires continuous monitoring and extensive usage of specialized facilities. Despite rapid improvizations and investments in burn management, >30% of victims hospitalized each year face severe morbidity and mortality. Excessive loss of body fluids, accumulation of exudate, and the development of septic shock are reported to be the main reasons for morbidity in burn victims. To assist burn wound management, a novel polyurethane (PU)-based bio-nanofibrous dressing loaded with honey (HN) and Carica papaya (PA) fruit extract was fabricated using a one-step electrospinning technique. The developed dressing material had a mean fiber diameter of 190±19.93 nm with pore sizes of 4-50 µm to support effective infiltration of nutrients and gas exchange. The successful blending of HN- and PA-based active biomolecules in PU was inferred through changes in surface chemistry. The blend subsequently increased the wettability (14%) and surface energy (24%) of the novel dressing. Ultimately, the presence of hydrophilic biomolecules and high porosity enhanced the water absorption ability of the PU-HN-PA nanofiber samples to 761.67% from 285.13% in PU. Furthermore, the ability of the bio-nanofibrous dressing to support specific protein adsorption (45%), delay thrombus formation, and reduce hemolysis demonstrated its nontoxic and compatible nature with the host tissues. In summary, the excellent physicochemical and hemocompatible properties of the developed PU-HN-PA dressing exhibit its potential in reducing the clinical complications associated with the treatment of burn injuries.

Single hind limb burn injury to mice alters nuclear factor-κB expression and [¹⁸F] 2-fluoro-2-deoxy-D-glucose uptake.

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Carter, Edward A; Hamrahi, Victoria; Paul, Kasie; Bonab, Ali A; Jung, Walter; Tompkins, Ronald G; Fischman, Alan J

2014-01-01

Burn trauma to the extremities can produce marked systemic effects in mice. Burn injury to the dorsal surface of mice is also associated with changes in glucose metabolism ([18F] 2-fluoro-2-deoxy-D-glucose [18FDG] uptake) by brown adipose tissue (BAT) and nuclear factor (NF)-κB activity in several tissues including skeletal muscle. This study examined the effect of a single hind limb burn in mice on 18FDG uptake by NF-κB activity in vivo, and blood flow was determined by laser Doppler techniques. Male NF-κB luciferase reporter mice (28-30 g) were anesthetized, both legs were shaven, and the right leg was subjected to scald injury by immersion in 90°C water for 5 seconds. Sham-treated animals were used as controls. Each burned and sham mouse was resuscitated with saline (2 mL, i.p.). The individual animals were placed in wire bottom cages with no food and free access to water. After 24 hours, the animals were imaged with laser Doppler for measuring blood flow in the hind limb. The animals were then unanesthetized with 50 μCi of FDG or luciferin (1.0 mg, i.v.) via tail vein. Five minutes after luciferin injection, NF-κB mice were studied by bioluminescence imaging with a charge-coupled device camera. One hour after 18FDG injection, the animals were killed with carbon dioxide overdose, and 18FDG biodistribution was measured. Tissues were also analyzed for NF-κB luciferase activity. The scalding procedure used here produced a full-thickness burn injury to the leg with sharp margins. 18FDG uptake by the burned leg was lower than that in the contralateral limb. Similarly, luciferase activity and blood flow in the burned leg were lower than those in the contralateral leg. 18FDG uptake by BAT and heart increased, whereas that by brain decreased. In conclusion, the present study suggests that burn injury to a single leg decreased FDG uptake by skeletal muscle but increased 18FDG uptake by BAT. The injury to the leg reduced NF-κB expression compared with the

Acute kidney injury in critically burned patients resuscitated with a protocol that includes low doses of Hydroxyethyl Starch

OpenAIRE

Sánchez-Sánchez, M.; Garcia-de-Lorenzo, A.; Cachafeiro, L.; Herrero, E.; Asensio, MJ.; Agrifoglio, A.; Flores, E.; Estebanez, B.; Extremera, P.; Iglesias, C.; Martinez, J.R..

2016-01-01

Acute kidney injury (AKI) is an important complication in burn patients. Recently, it has been recommended that hydroxyethyl starch (HES) be avoided in burn patients because it increases the incidence of AKI. Our purpose was to study incidence of AKI in critically ill burn patients resuscitated with Ringer’s solution and supplements of HES. We conducted an observational study of 165 patients admitted to the critical care burn unit (with 30 ± 15% TBSA burned). The main outcome measures were in...

Burns

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A burn is damage to your body's tissues caused by heat, chemicals, electricity, sunlight, or radiation. Scalds from hot ... and gases are the most common causes of burns. Another kind is an inhalation injury, caused by ...

Secondary hyperalgesia to heat stimuli after burn injury in man

DEFF Research Database (Denmark)

Pedersen, J L; Kehlet, H

1998-01-01

The aim of the study was to examine the presence of hyperalgesia to heat stimuli within the zone of secondary hyperalgesia to punctate mechanical stimuli. A burn was produced on the medial part of the non-dominant crus in 15 healthy volunteers with a 50 x 25 mm thermode (47 degrees C, 7 min......), and assessments were made 70 min and 40 min before, and 0, 1, and 2 h after the burn injury. Hyperalgesia to mechanical and heat stimuli were examined by von Frey hairs and contact thermodes (3.75 and 12.5 cm2), and pain responses were rated with a visual analog scale (0-100). The area of secondary hyperalgesia...... to punctate stimuli was assessed with a rigid von Frey hair (462 mN). The heat pain responses to 45 degrees C in 5 s (3.75 cm2) were tested in the area just outside the burn, where the subjects developed secondary hyperalgesia, and on the lateral crus where no subject developed secondary hyperalgesia (control...

Burns in sub-Saharan Africa: A review.

Science.gov (United States)

Nthumba, Peter M

2016-03-01

Burns are important preventable causes of morbidity and mortality, with a disproportionate incidence in sub-Saharan Africa. The management of these injuries in sub-Saharan Africa is a challenge because of multiple other competing problems such as infectious diseases (HIV/AIDS, tuberculosis and malaria), terrorist acts and political instability. There is little investment in preventive measures, pre-hospital, in-hospital and post-discharge care of burns, resulting in high numbers of burns, high morbidity and mortality. Lack of data that can be used in legislation and policy formulation is a major hindrance in highlighting the problem of burns in this sub-region. An online search of publications on burns from sub-Saharan countries was performed. A total of 54 publications with 32,862 patients from 14 countries qualified for inclusion in the study. The average age was 15.3 years. Children aged 10 years and below represented over 80% of the burn patient population. Males constituted 55% of those who suffered burns. Scalds were the commonest cause of thermal injuries, accounting for 59% of all burns, while flame burns accounted for 33%. The burn mortality averaged 17%, or the death of one of every five burn victims. These statistics indicate the need for an urgent review of burn policies and related legislation across the sub-Saharan region to help reduce burns, and provide a safe environment for children. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Saturday-morning television: do sponsors promote high-risk behavior for burn injury?

Science.gov (United States)

Palmieri, Tina L; Aoki, Traci; Combs, Elena; Curri, Terese; Garma, Sylvia; Kaulkin, Cammie; Lawless, Mary Beth; Nelson, Kate; Sanders, Johanna; Warden, Nancy; Greenhalgh, David G

2004-01-01

Television has become an important tool for learning and socialization in children. Although television violence has been associated with adverse effects, data on depiction of fire and burn injury are lacking. We sought to determine whether Saturday-morning television programming, viewed primarily by children, depicts fire and burn injury as safe or without consequence, thus potentially increasing the incidence of burn injury in children. This was a prospective observational study. Saturday-morning children's television programs were videotaped from 7 AM to 11 AM for eight different television networks during a 6-month period. Tapes were scored for scenes depicting fire or smoke by independent observers. Recorded items included show category, scene type, gender target, context of fire, and outcome after exposure to flame. Fire events were documented during programs and their associated commercials. A total of 108 hours of children's programs, 16 hours per network, were recorded. Scenes depicting fire or smoke were identified 1960 times, with 39% of events occurring during the program itself and 61% in commercials. Fire was depicted as either safe or without consequence in 64% of incidents. Action adventure stories accounted for 56% of flame depictions. Overall, one incident involving flame and fire was portrayed for each 3 minutes of television programming. Saturday-morning television programming frequently depicts fire as safe, empowering, or exciting. The incidence of flame use in programming varies between stations but is most prevalent in action/adventure stories. Television commercials, although brief, provide the majority of the misinformation regarding fire. Medical professional societies should alert the public to this potential hazard and recommend responsible portrayal of fire in children's television programming.

Epidemiology of Burns in Rural Bangladesh: An Update

Science.gov (United States)

He, Siran; Alonge, Olakunle; Agrawal, Priyanka; Sharmin, Shumona; Islam, Irteja; Mashreky, Saidur Rahman; Arifeen, Shams El

2017-01-01

Each year, approximately 265,000 deaths occur due to burns on a global scale. In Bangladesh, around 173,000 children under 18 sustain a burn injury. Since most epidemiological studies on burn injuries in low and middle-income countries are based on small-scale surveys or hospital records, this study aims to derive burn mortality and morbidity measures and risk factors at a population level in Bangladesh. A household survey was conducted in seven rural sub-districts of Bangladesh in 2013 to assess injury outcomes. Burn injuries were one of the external causes of injury. Epidemiological characteristics and risk factors were described using descriptive as well as univariate and multivariate logistic regression analyses. The overall mortality and morbidity rates were 2 deaths and 528 injuries per 100,000 populations. Females had a higher burn rate. More than 50% of injuries were seen in adults 25 to 64 years of age. Most injuries occurred in the kitchen while preparing food. 88% of all burns occurred due to flame. Children 1 to 4 years of age were four times more likely to sustain burn injuries as compared to infants. Age-targeted interventions, awareness of first aid protocols, and improvement of acute care management would be potential leads to curb death and disability due to burn injuries. PMID:28379160

Determination of the Pre-Hospital Practices Performed for Children with Burn Injuries

Directory of Open Access Journals (Sweden)

Mehtap Kavurmaci

2016-04-01

Full Text Available Aim: The objective of this study was to determine the first aid practices performed and, effecting factors in burn injuries in before hospital admission. Material and Method: The study was conducted in burn centers of two hospitals in the Erzurum, between December 2013 and August 2014. The population was consisted of inpatient children aged 0-12 years who were treated in burn centers of related hospitals and their mothers at the date of the study. The study was carried out with a total of 121 children and their mothers who met the research inclusion criteria. Questionnaire data was used to collect data. In data analysis, percentage distributions, means and chi-square test were used. Results: It was found that, children%u2019 mothers applicate the cold water first when the burns ocur (57.9%, secondly only applying cold water (27.3%, then the mothers took off their children to hospital not to any application (75.2%, burn wound on the olive oil riding (10.7%, burn wound yogurt riding (8.3%. Discussion: As a result, it was determined that children%u2019 mothers don%u2019t have an adequate level of first-aid knowledge, and younger mothers with low levels of education living in rural areas perform incorrect first aid practices.

Contributions of Severe Burn and Disuse to Bone Structure and Strength in Rats

Science.gov (United States)

Baer, L.A.; Wu, X.; Tou, J. C.; Johnson, E.; Wolf, S.E.; Wade, C.E.

2012-01-01

Burn and disuse results in metabolic and bone changes associated with substantial and sustained bone loss. Such loss can lead to an increased fracture incidence and osteopenia. We studied the independent effects of burn and disuse on bone morphology, composition and strength, and microstructure of the bone alterations 14 days after injury. Sprague-Dawley rats were randomized into four groups: Sham/Ambulatory (SA), Burn/Ambulatory (BA), Sham/Hindlimb Unloaded (SH) and Burn/Hindlimb Unloaded (BH). Burn groups received a 40% total body surface area full-thickness scald burn. Disuse by hindlimb unloading was initiated immediately following injury. Bone turnover was determined in plasma and urine. Femur biomechanical parameters were measured by three-point bending tests and bone microarchitecture was determined by microcomputed tomography (uCT). On day 14, a significant reduction in body mass was observed as a result of burn, disuse and a combination of both. In terms of bone health, disuse alone and in combination affected femur weight, length and bone mineral content. Bending failure energy, an index of femur strength, was significantly reduced in all groups and maximum bending stress was lower when burn and disuse were combined. Osteocalcin was reduced in BA compared to the other groups, indicating influence of burn. The reductions observed in femur weight, BMC, biomechanical parameters and indices of bone formation are primarily responses to the combination of burn and disuse. These results offer insight into bone degradation following severe injury and disuse. PMID:23142361

Methods to reduce intraocular pressure on secondary glaucoma after severe eye burns

Directory of Open Access Journals (Sweden)

A. V. Solovieva

2014-07-01

Full Text Available Purpose: Show the results of treatment of secondary glaucoma after severe eye burns.Methods: We observed 70 patients (108 eyes with severe burns the eyes and their consequences, secondary glaucoma was observed in 40 patients (58 eyes. All patients with secondary glaucoma received traditional antihypertensive therapy, with its failure to resort to antiglaucomatous surgery. Cataract extraction performed in 24 cases, 16 of them in combination with other surgery: the reconstruction of the anterior chamber, penetrating keratoplasty, sinustrabeculectomy, diode laser cyclocoagulation. Diode laser cy- clocoagulation performed 42 times in 8 of them in combination with other antiglaucomatous surgery: cataract surgery, reconstruction of the anterior chamber. Sinustrabeculectomy in patients with secondary glaucoma was performed in 7 cases, 4 of them with collagen implant drainage. Ahmed glaucoma drainage implant performed in 5 cases.Results: In 23 out of 58 (39.6% of long-term compensation glaucoma IOP was achieved antihypertensive therapy without sur- gery. After cataract extraction resistant compensated IOP was achieved in 10 cases, a temporary (1 to 42 months — in 11 cases, IOP is not reduced in 2 cases. After completing diode laser cyclocoagulation stable normalization of IOP occurred in 16 cases, the temporary (from 1 month to 2 years — in 20 cases, 4 cases of IOP reduction was not achieved. As a result sinustrabeculectomy in 4 cases IOP decreased, in one case the hypotensive effect is not there. After implantation Ahmed glaucoma valve in 2 cases was achieved stable normalization of IOP, in the 2 cases — the temporary; in 1 case developed endophthalmitis, and the device was removed.Conclusion: the immediate effect of antiglaucomatous treatment was 96.6%, but the high incidence of IOP decompensation (73.7% suggesting the need for continuous follow-up patients after severe eye burn injury, and a readiness to use other methods to reduce IOP.

Methods to reduce intraocular pressure on secondary glaucoma after severe eye burns

Directory of Open Access Journals (Sweden)

A. V. Solovieva

2012-01-01

Full Text Available Purpose: Show the results of treatment of secondary glaucoma after severe eye burns.Methods: We observed 70 patients (108 eyes with severe burns the eyes and their consequences, secondary glaucoma was observed in 40 patients (58 eyes. All patients with secondary glaucoma received traditional antihypertensive therapy, with its failure to resort to antiglaucomatous surgery. Cataract extraction performed in 24 cases, 16 of them in combination with other surgery: the reconstruction of the anterior chamber, penetrating keratoplasty, sinustrabeculectomy, diode laser cyclocoagulation. Diode laser cy- clocoagulation performed 42 times in 8 of them in combination with other antiglaucomatous surgery: cataract surgery, reconstruction of the anterior chamber. Sinustrabeculectomy in patients with secondary glaucoma was performed in 7 cases, 4 of them with collagen implant drainage. Ahmed glaucoma drainage implant performed in 5 cases.Results: In 23 out of 58 (39.6% of long-term compensation glaucoma IOP was achieved antihypertensive therapy without sur- gery. After cataract extraction resistant compensated IOP was achieved in 10 cases, a temporary (1 to 42 months — in 11 cases, IOP is not reduced in 2 cases. After completing diode laser cyclocoagulation stable normalization of IOP occurred in 16 cases, the temporary (from 1 month to 2 years — in 20 cases, 4 cases of IOP reduction was not achieved. As a result sinustrabeculectomy in 4 cases IOP decreased, in one case the hypotensive effect is not there. After implantation Ahmed glaucoma valve in 2 cases was achieved stable normalization of IOP, in the 2 cases — the temporary; in 1 case developed endophthalmitis, and the device was removed.Conclusion: the immediate effect of antiglaucomatous treatment was 96.6%, but the high incidence of IOP decompensation (73.7% suggesting the need for continuous follow-up patients after severe eye burn injury, and a readiness to use other methods to reduce IOP.

Making of a burn unit: SOA burn center

Directory of Open Access Journals (Sweden)

Jayant Kumar Dash

2016-01-01

Full Text Available Each year in India, burn injuries account for more than 6 million hospital emergency department visits; of which many require hospitalization and are referred to specialized burn centers. There are few burn surgeons and very few burn centers in India. In our state, Odisha, there are only two burn centers to cater to more than 5000 burn victims per year. This article is an attempt to share the knowledge that I acquired while setting up a new burn unit in a private medical college of Odisha.

The effect of family characteristics on the recovery of burn injuries in children.

Science.gov (United States)

Sheridan, Robert L; Lee, Austin F; Kazis, Lewis E; Liang, Matthew H; Li, Nien-Chen; Hinson, Michelle I; Bauk, Helena; Meyer, Walter J; Stubbs, Teresa K; Palmieri, Tina L; Tompkins, Ronald G

2012-09-01

Interactions between family members and characteristics of family life and function may affect a child's recovery from burn injury. We prospectively examined the relationship between family characteristics and physical and psychosocial recovery from burns. The families of 399 burned children aged 5 years to 18 years admitted to one of four Shriners Hospitals for Children for management of acute burns completed the Family Environment Scale within 7 days of admission and then the American Burn Association/Shriners Hospitals for Children Burn Outcome Questionnaire (BOQ) at baseline, 3, 6, 12, 18, 24, 36, and 48 months. Generalized estimating equations with random effects for the time since burn were used to track recovery of the BOQ patient-centered domains associated with baseline family characteristics during the course of the study. The children had a mean age of 11 years and burn size of 32% total body surface area burned. Higher Family Environment Scale scores in cohesion, independence, organization, and active recreational orientation were associated with significantly better rates of recovery in multiple BOQ domains of health-related quality of life. Higher scores in conflict and achievement orientation predicted statistically significant impaired recovery. Higher expressiveness predicted greater difficulty with school reentry. Family characteristics affect the recovery of children after serious burns. Some of these may be amenable to focused anticipatory family interventions to help optimize outcomes. In particular, those characteristics that impair school reentry should be targeted.

SAP buran injury management of mangoes (mangifera indica L.) in sri lanka

International Nuclear Information System (INIS)

Krishnapillai, N.

2016-01-01

Sap burn injury is one of the major postharvest disorders that causes postharvest losses of mangoes. Popular dessert mango fruits from northern Sri Lanka were selected for this study. Mature mango fruits - Willard, Karuthakolumban, Chembaddan and Ambalavi - were harvested carefully with 5cm stalk for different treatments to minimize sap burn injury. Stalks were removed and fruits were dipped in GRAS compounds of 1 and 5% sodium chloride (Table salt) and 0.5 and 1% calcium hydroxide separately for 5 minutes. De-stemming and dipping fruits in 5% sodium chloride and 1% calcium hydroxide were effective in reducing sap burn injury in Karuthakolumban. However, 1% table salt and 0.5% calcium hydroxide successfully reduced sap burn injury in Willard, Chembaddan and Ambalavi mangoes. Fruit quality was measured in terms of pH, Total Soluble Solids (TSS) and marketability. Quality parameters of treated fruits were not significantly different (P=0.05) from non chemical treated good quality mango fruits. Sap management dynamics was very useful in controlling sap burn in Chembaddan and Ambalavi mangoes. No latex exudation was observed in these mangoes when stalk was broken by next day after harvesting. These results suggest that low cost environmentally friendly methods could be used to reduce sap burn injury in mangoes. (author)

Animal Models in Burn Research

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Abdullahi, A.; Amini-Nik, S.; Jeschke, M.G

2014-01-01

Burn injury is a severe form of trauma affecting more than two million people in North America each year. Burn trauma is not a single pathophysiological event but a devastating injury that causes structural and functional deficits in numerous organ systems. Due to its complexity and the involvement of multiple organs, in vitro experiments cannot capture this complexity nor address the pathophysiology. In the past two decades, a number of burn animal models have been developed to replicate the various aspects of burn injury; to elucidate the pathophysiology and explore potential treatment interventions. Understanding the advantages and limitations of these animal models is essential for the design and development of treatments that are clinically relevant to humans. This review paper aims to highlight the common animal models of burn injury in order to provide investigators with a better understanding of the benefits and limitations of these models for translational applications. While many animal models of burn exist, we limit our discussion to the skin healing of mouse, rat, and pig. Additionally, we briefly explain hypermetabolic characteristics of burn injury and the animal model utilized to study this phenomena. Finally, we discuss the economic costs associated with each of these models in order to guide decisions of choosing the appropriate animal model for burn research. PMID:24714880

Comparing the reported burn conditions for different severity burns in porcine models: a systematic review.

Science.gov (United States)

Andrews, Christine J; Cuttle, Leila

2017-12-01

There are many porcine burn models that create burns using different materials (e.g. metal, water) and different burn conditions (e.g. temperature and duration of exposure). This review aims to determine whether a pooled analysis of these studies can provide insight into the burn materials and conditions required to create burns of a specific severity. A systematic review of 42 porcine burn studies describing the depth of burn injury with histological evaluation is presented. Inclusion criteria included thermal burns, burns created with a novel method or material, histological evaluation within 7 days post-burn and method for depth of injury assessment specified. Conditions causing deep dermal scald burns compared to contact burns of equivalent severity were disparate, with lower temperatures and shorter durations reported for scald burns (83°C for 14 seconds) compared to contact burns (111°C for 23 seconds). A valuable archive of the different mechanisms and materials used for porcine burn models is presented to aid design and optimisation of future models. Significantly, this review demonstrates the effect of the mechanism of injury on burn severity and that caution is recommended when burn conditions established by porcine contact burn models are used by regulators to guide scald burn prevention strategies. © 2017 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Burn mouse models

DEFF Research Database (Denmark)

Calum, Henrik; Høiby, Niels; Moser, Claus

2014-01-01

Severe thermal injury induces immunosuppression, involving all parts of the immune system, especially when large fractions of the total body surface area are affected. An animal model was established to characterize the burn-induced immunosuppression. In our novel mouse model a 6 % third-degree b......Severe thermal injury induces immunosuppression, involving all parts of the immune system, especially when large fractions of the total body surface area are affected. An animal model was established to characterize the burn-induced immunosuppression. In our novel mouse model a 6 % third...... with infected burn wound compared with the burn wound only group. The burn mouse model resembles the clinical situation and provides an opportunity to examine or develop new strategies like new antibiotics and immune therapy, in handling burn wound victims much....

Outpatient presentations to burn centers: data from the Burns Registry of Australia and New Zealand outpatient pilot project.

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Gabbe, Belinda J; Watterson, Dina M; Singer, Yvonne; Darton, Anne

2015-05-01

Most studies about burn injury focus on admitted cases. To compare outpatient and inpatient presentations at burn centers in Australia to inform the establishment of a repository for outpatient burn injury. Data for sequential outpatient presentations were collected at seven burn centers in Australia between December 2010 and May 2011 and compared with inpatient admissions from these centers recorded by the Burns Registry of Australia and New Zealand for the corresponding period. There were 788 outpatient and 360 inpatient presentations. Pediatric outpatients included more children burns (39% vs 24%). Adult outpatients included fewer males (58% vs 73%) and intentional injuries (3.3% vs 10%), and more scald (46% vs 30%) and contact burns (24% vs 13%). All pediatric, and 98% of adult, outpatient presentations involved a %TBSAburns presenting to burn centers differed to inpatient admission data, particularly with respect to etiology and burn severity, highlighting the importance of the need for outpatient data to enhance burn injury surveillance and inform prevention. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Prevention of burn injuries to children involving nightwear.

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Laing, R M; Bryant, V

1991-08-28

The effectiveness of legislative intervention in the New Zealand market for children's nightclothes as an injury prevention strategy has been reassessed by examining those hospital admissions for the period 1980-8 (with emphasis on the 1985-8 period) in which clothing and/or nightclothes were involved. The profiles of the production of children's nightclothes (1977-86) and domestic heating (1984-8) were also examined. Ninety-five cases of burn injury discharges were identified (1985-8), and of those cases involving clothing 42% involved nightwear (49% 1981-4). Some of the 27% unspecified cases may have also involved nightwear (23%, 1981-4). A very strong linear downward trend for nightwear incidents was noted (chi 2 slope = 31.06, p less than 0.001). Forty-eight percent of cases involved children aged 1-6 years, and 68% involved pajamas. Stoves were the main specified ignition agent for nightclothes (36%). Open fires as a form of household heating decreased from 49% to 34% of households (1984-8). Estimated production of nightdresses in New Zealand also decreased (460,000 to 80,000 units, 1973-86). The pronounced decrease in injuries attributable to ignition of children's nightclothes is likely to be the result of mandatory controls on children's nightclothes, increased use of pyjamas, and a steady decrease in use of open fires and portable electric heaters. The typical injury event portrayed to the public of a girl in front of a heater or open fire needs to be corrected.

Fancy a cup of scald? - The role of hot beverage burns in paediatric burns admissions in Ireland.

Science.gov (United States)

McGuire, F; Hegarty, M; Jennings, P; Marsden, P; Smith, L

2017-06-09

Burns and scalds are preventable injuries in children that typically occur in the home. This study aimed to examine the role of hot beverage scalds in paediatric burn admissions in order to identify key target audiences for future safety strategies. Using the Hospital Inpatient Enquiry System (HIPE) a retrospective study of paediatric burn admissions in 2014 examined demographics, cause and severity of injury and location of occurrence. There were 233 paediatric discharges (age 0-18 yrs.) with a principal diagnosis of burn injury; 57% of these occurred in children under three years and 95% of these occurred in the home. Scalds caused 74% of burn injuries; hot beverages accounted for least 33% of these of which 77% were partial thickness and 73% were upper body burns. Effective hot beverage scald prevention strategies, targeted towards caregivers in the home, are required.

Treatment of secondary burn wound progression in contact burns-a systematic review of experimental approaches.

Science.gov (United States)

Schmauss, Daniel; Rezaeian, Farid; Finck, Tom; Machens, Hans-Guenther; Wettstein, Reto; Harder, Yves

2015-01-01

After a burn injury, superficial partial-thickness burn wounds may progress to deep partial-thickness or full-thickness burn wounds, if kept untreated. This phenomenon is called secondary burn wound progression or conversion. Burn wound depth is an important determinant of patient morbidity and mortality. Therefore, reduction or even the prevention of secondary burn wound progression is one goal of the acute care of burned patients. The objective of this study was to review preclinical approaches evaluating therapies to reduce burn wound progression. A systematic review of experimental approaches in animals that aim at reducing or preventing secondary burn wound progression was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) guidelines. The selected references consist of all the peer-reviewed studies performed in vivo in animals and review articles published in English, German, Italian, Spanish, or French language relevant to the topic of secondary burn wound progression. We searched MEDLINE, Cochrane Library, and Google Scholar including all the articles published from the beginning of notations to the present. The search was conducted between May 3, 2012 and December 26, 2013. We included 29 experimental studies in this review, investigating agents that maintain or increase local perfusion conditions, as well as agents that exhibit an anti-coagulatory, an anti-inflammatory, or an anti-apoptotic property. Warm water, simvastatin, EPO, or cerium nitrate may represent particularly promising approaches for the translation into clinical use in the near future. This review demonstrates promising experimental approaches that might reduce secondary burn wound progression. Nevertheless, a translation into clinical application needs to confirm the results compiled in experimental animal studies.

Investigation of Bone Health Subsequent to Vitamin D Supplementation in Children Following Burn Injury.

Science.gov (United States)

Mayes, Theresa; Gottschlich, Michele M; Khoury, Jane; Kagan, Richard J

2015-12-01

The effect of supplemental vitamin D on fracture occurrence following burn injuries is unclear. The objective of this study was to evaluate postintervention incidence of fractures in children during the rehabilitative phase postburn (PB) following participation in a randomized clinical trial of vitamin D supplementation. Follow-up for fracture evaluation was obtained in 39 of 50 patients randomized to daily enteral vitamin D2, D3, or placebo throughout the acute burn course. Serum 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, D2, D3, calcitonin, and bone alkaline phosphatase (BAP) measurements were obtained PB day 7, midpoint, discharge, and 1-year PB. Urinary calcium was obtained PB day 7 and midpoint. Dual-energy x-ray absorptiometry (DXA) was performed at discharge and 1-year PB. Fractures were reported in 6 of 39 respondents. Four fractures occurred in the placebo group, 2 in the D2 group, and none in the D3 group. Serum vitamin D, calcitonin, BAP, and urinary calcium were similar between fracture groups. The group with fracture morbidity had larger burn size (83.8% ± 4.9% vs 53.0% ± 2.9%, P vitamin D3 in reducing postdischarge fracture risk. Results reaffirm the importance of monitoring bone health in pediatric patients postburn. © 2015 American Society for Parenteral and Enteral Nutrition.

The patient–body relationship and the "lived experience" of a facial burn injury: a phenomenological inquiry of early psychosocial adjustment

Directory of Open Access Journals (Sweden)

McLean LM

2015-08-01

Full Text Available Loyola M McLean,1–3 Vanessa Rogers,3–4 Rachel Kornhaber,5–7 Marie-Therese Proctor,8 Julia Kwiet,3–4 Jeffrey Streimer,3–4 John Vanderord6 1Brain and Mind Centre and Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, NSW, Australia; 2Westmead Psychotherapy Program, Discipline of Psychiatry, Sydney Medical School, University of Sydney and Western Sydney Local Health District, Parramatta, NSW, Australia; 3Consultation-Liaison Psychiatry, Royal North Shore Hospital, Sydney, NSW, Australia; 4Discipline of Psychiatry, Sydney Medical School, University of Sydney, Sydney, NSW, Australia; 5School of Health Sciences, Faculty of Health, University of Tasmania, Alexandria, NSW, Australia; 6Severe Burns Injury Unit, Royal North Shore Hospital, St Leonards, Sydney, NSW, Australia; 7School of Nursing, University of Adelaide, SA, Australia; 8Graduate School of Counselling, Excelsia College, Sydney, NSW, Australia Background: Throughout development and into adulthood, a person's face is the central focus for interpersonal communication, providing an important insight into one's identity, age, sociocultural background, and emotional state. The face facilitates important social, including nonverbal, communication. Therefore, sustaining a severe burn, and in particular a facial burn, is a devastating and traumatizing injury. Burn survivors may encounter unique psychosocial problems and experience higher rates of psychosocial maladjustment, although there may be a number of potentially mediating factors. Objectives: The purpose of this phenomenological study was to examine the early recovery experience of patients with a facial burn. In particular, this study focused on how the injury impacted on the participants’ relationship with their own body and the challenges of early psychosocial adjustment within the first 4 months of sustaining the injury. Methods: In 2011, six adult participants encompassing two females and four males

One Stage Reconstruction of Skull Exposed by Burn Injury Using a Tissue Expansion Technique

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Jae Young Cho

2012-03-01

Full Text Available BackgroundAn area of the skull exposed by burn injury has been covered by various methods including local flap, skin graft, or free flap surgery. Each method has disadvantages, such as postoperative alopecia or donor site morbidities. Due to the risk of osteomyelitis in the injured skull during the expansion period, tissue expansion was excluded from primary reconstruction. However, successful primary reconstruction was possible in burned skull by tissue expansion.MethodsFrom January 2000 to 2011, tissue expansion surgery was performed on 10 patients who had sustained electrical burn injuries. In the 3 initial cases, removal of the injured part of the skull and a bone graft was performed. In the latter 7 cases, the injured skull tissue was preserved and covered with a scalp flap directly to obtain natural bone healing and bone remodeling.ResultsThe mean age of patients was 49.9±12.2 years, with 8 male and 2 female. The size of the burn wound was an average of 119.6±36.7 cm2. The mean expansion duration was 65.5±5.6 days, and the inflation volume was an average of 615±197.6 mL. Mean defect size was 122.2±34.9 cm2. The complications including infection, hematoma, and the exposure of the expander were observed in 4 cases. Nonetheless, only 1 case required revision.ConclusionsSuccessful coverage was performed by tissue expansion surgery in burned skull primarily and no secondary reconstruction was needed. Although the risks of osteomyelitis during the expansion period were present, constant coverage of the injured skull and active wound treatment helped successful primary reconstruction of burned skull by tissue expansion.

Evaluating the superiority of honey over silver sulphadiazine dressing in shortening healing duration of burn injury: an evidence-based case report

Directory of Open Access Journals (Sweden)

Sandy S. Sopandi

2013-12-01

Full Text Available Background: Burn injury is a global health problem associated with major morbidity and mortality. Honey has long been used in wound management due to its ability to accelerate healing rates and prevent infection. This study is conducted to evaluate the efficacy of honey dressing in shortening healing duration of burn injury compared to silver sulphadiazine (SSD.Methods: A PubMed and Proquest database search was conducted to identify relevant studies. The studies were then appraised and ranked based on their validity, importance, and level of evidence.Results: The two studies appraised in this paper supported the supremacy of honey against SSD in shortening healing duration. However, the individual quality of studies involved was low.Conclusion: Honey is an alternative treatment in shortening burn wound healing duration. Further studies are needed to support clinical application of this conclusion. (Med J Indones. 2013;22:243-7. doi: 10.13181/mji.v22i4.608 Keywords: Burn injury, healing duration, honey, silver sulfadiazine

The Effect of Massage on Anticipatory Anxiety and Procedural Pain in Patients with Burn Injury.

Science.gov (United States)

Najafi Ghezeljeh, Tahereh; Mohades Ardebili, Fatimah; Rafii, Forough; Manafi, Farzad

2017-01-01

Pain related to burn injuries is one of the most troublesome pain intensity. This study aimed to investigate the effect of massage on anticipatory anxiety, procedural pain intensity, vital signs and relaxation level of patients with burn injury. In this quasi-experimental study, through convenience sampling, 60 hospitalized adult burn patients were selected from a specialized burn and reconstructive hospital. Subjects were assigned to massage and control groups through simple randomization. Massage was offered by using non aromatic oil about 10-15 minutes before wound care on intact part of the body once a day for 20 minutes on patients' bedside for 3 consecutive days. In the 3 days, the control group did not received any massage and were asked to stay at bed. Demographic and clinical characteristics and vital signs, Visual Analogue Scale and the Persian version of Burn Specific Pain Anxiety Scale were used to determine baseline and procedural pain, anxiety and relaxation levels and anticipatory anxiety. No significant difference was noted between mean score of pain intensity, anxiety and relaxation level, and vital signs in massage and control groups after intervention following wound care. In massage and control groups, there was no significant differences between mean scores of anticipatory anxiety before and after intervention. There was no significant difference between the mean scores of anticipatory anxiety in massage and control groups after intervention prior wound care. Massage was shown not to have any effect on anticipatory anxiety and procedural pain.

A Soft Casting Technique for Managing Pediatric Hand and Foot Burns.

Science.gov (United States)

Choi, Young Mee; Nederveld, Cindy; Campbell, Kristen; Moulton, Steven

2018-04-04

Hand and foot burns in children are difficult to dress. The authors have developed a soft casting technique to manage burns to these areas. The aim of this study is to report the outcomes using weekly dressing changes with a soft casting technique to manage pediatric hand and foot burns in the outpatient setting. A retrospective chart review was performed on children with burns to the hands or feet, who underwent dressing changes with a soft casting technique at the Children's Hospital Colorado Burn Center. Soft casting was performed by placing antibiotic ointment-impregnated nonadherent gauze over the burn wound(s), wrapping the extremity using rolled gauze, applying soft cast pad, plaster, soft cast tape, and an elastic bandage. This was changed weekly. Two hundred ninety-eight children with hand burns had a mean age of 16.8 ± 2 months. Two hundred forty-eight children had partial thickness burn injuries (83%), 50 had full thickness burn injuries (17%), and the mean total body surface area (TBSA) was 1 ± 2.4%. The mean time to heal was 10.1 ± 1.7 days for all subjects. Sixty-six children with foot burns were identified with a mean age of 24 ± 2.6 months. Forty-six children had partial thickness injuries (70%), 20 had full thickness burn injuries (30%), and the mean TBSA was 2.3 ± 2.9%. The mean time to heal was 14.1 ± 2.2 days for all subjects. Weekly dressing changes using a soft casting technique are effective for the outpatient management of pediatric hand and foot burns. This method avoids costly inpatient hospital care, reduces the number of painful dressing changes, and allows children to heal in their own environment.

Acute kidney injury in critically burned patients resuscitated with a protocol that includes low doses of Hydroxyethyl Starch.

Science.gov (United States)

Sánchez-Sánchez, M; Garcia-de-Lorenzo, A; Cachafeiro, L; Herrero, E; Asensio, M J; Agrifoglio, A; Flores, E; Estebanez, B; Extremera, P; Iglesias, C; Martinez, J R

2016-09-30

Acute kidney injury (AKI) is an important complication in burn patients. Recently, it has been recommended that hydroxyethyl starch (HES) be avoided in burn patients because it increases the incidence of AKI. Our purpose was to study incidence of AKI in critically ill burn patients resuscitated with Ringer's solution and supplements of HES. We conducted an observational study of 165 patients admitted to the critical care burn unit (with 30 ± 15% TBSA burned). The main outcome measures were incidence of AKI, contributions of colloids and crystalloids, various severity scores, comorbidities, complications and mortality. According to the RIFLE criteria, 10 (6.1%) patients presented with Risk, 11 (6.7%) presented with Injury and 11 (6.7%) presented with Failure. According to the AKIN criteria, 9.7% presented stage I, 3% stage II and 10.3% stage III. Replacement therapy (RRT) was performed in 15 patients (9.1%), but in 6 of them RRT was employed in the final stages of multi-organ failure. The incidence of AKI in severe burn patients is high according to the RIFLE or AKIN criteria and these patients experience more complications and higher mortality. Our study suggests that the use of HES in low doses in the burn resuscitation phase does not cause more AKI than resuscitation without HES, but further evaluation is required. Further studies should be conducted.

Novel burn device for rapid, reproducible burn wound generation.

Science.gov (United States)

Kim, J Y; Dunham, D M; Supp, D M; Sen, C K; Powell, H M

2016-03-01

Scarring following full thickness burns leads to significant reductions in range of motion and quality of life for burn patients. To effectively study scar development and the efficacy of anti-scarring treatments in a large animal model (female red Duroc pigs), reproducible, uniform, full-thickness, burn wounds are needed to reduce variability in observed results that occur with burn depth. Prior studies have proposed that initial temperature of the burner, contact time with skin, thermal capacity of burner material, and the amount of pressure applied to the skin need to be strictly controlled to ensure reproducibility. The purpose of this study was to develop a new burner that enables temperature and pressure to be digitally controlled and monitored in real-time throughout burn wound creation and compare it to a standard burn device. A custom burn device was manufactured with an electrically heated burn stylus and a temperature control feedback loop via an electronic microstat. Pressure monitoring was controlled by incorporation of a digital scale into the device, which measured downward force. The standard device was comprised of a heat resistant handle with a long rod connected to the burn stylus, which was heated using a hot plate. To quantify skin surface temperature and internal stylus temperature as a function of contact time, the burners were heated to the target temperature (200±5°C) and pressed into the skin for 40s to create the thermal injuries. Time to reach target temperature and elapsed time between burns were recorded. In addition, each unit was evaluated for reproducibility within and across three independent users by generating burn wounds at contact times spanning from 5 to 40s at a constant pressure and at pressures of 1 or 3lbs with a constant contact time of 40s. Biopsies were collected for histological analysis and burn depth quantification using digital image analysis (ImageJ). The custom burn device maintained both its internal

From Cholera to Burns: A Role for Oral Rehydration Therapy

Science.gov (United States)

Green, W.B.; Asuku, M.E.; Feldman, M.; Makam, R.; Noppenberger, D.; Price, L.A.; Prosciak, M.; van Loon, I.N.

2011-01-01

According to the practice guidelines of the American Burn Association on burn shock resuscitation, intravenous (IV) fluid therapy is the standard of care for the replacement of fluid and electrolyte losses in burn injury of ≥20% of the total body surface area. However, in mass burn casualties, IV fluid resuscitation may be delayed or unavailable. Oral rehydration therapy (ORT), which has been shown to be highly effective in the treatment of dehydration in epidemics of cholera, could be an alternate way to replace fluid losses in burns. A prospective case series of three patients was carried out as an initial step to establish whether oral Ceralyte®90 could replace fluid losses requiring IV fluid therapy in thermal injury. The requirement of the continuing IV fluid therapy was reduced by an average of 58% in the first 24 hours after the injury (range 37-78%). ORT may be a feasible alternative to IV fluid therapy in the resuscitation of burns. It could also potentially save many lives in mass casualty situations or in resource-poor settings where IV fluid therapy is not immediately available. Further studies are needed to assess the efficacy of this treatment and to determine whether the present formulations of ORT for cholera need modification. PMID:22283039

Increased chromium uptake in polymorphonuclear leukocytes from burned patients

International Nuclear Information System (INIS)

Davis, J.M.; Illner, H.; Dineen, P.

1984-01-01

Following thermal injury neutrophil function is severely impaired and thought to be hypometabolic; however, the host is considered to be hypermetabolic. To further investigate the metabolism and the function of neutrophils following thermal injury, neutrophil migration and chromium uptake were studied using radio-labelled neutrophils. Random and directed migration were found to be significantly reduced compared to control values. Neutrophil lysozyme content was also reduced in these burn cells while serum lysozyme from the same patients was significantly elevated over control values. These data suggest lysozyme is released by the neutrophil into the circulatory system. The influx of chromium in cells from burned patients was much greater than the influx in normal cells used in studies for chemotaxis. Influx of chromium over time and over varying concentrations of chromium was linear in cells from burned patients and normals. Cells from burned patients, however, took up more chromium than normals. Influx velocity of chromium was also determined and found to be greater in burn cells than normal cells. Since it has been shown that chromium influx is an energy-dependent reaction it is suggested that cellular energy stores are being depleted by the influx of chromium. Whether this is a response to an intracellular deficit or uncoupling of metabolic pathways is not known at this time

Air-Freshener Burns: A New Paradigm in Burns Etiology?

OpenAIRE

Sarwar, Umran; Nicolaou, M.; Khan, M. S.; Tiernan, E.

2011-01-01

Objectives: We report a rare case of burns following the use of automated air-fresheners. Methods: We present a case report with a brief overview of the literature relating to burns associated with air-fresheners. The mechanism and treatment of these types of injuries are also described. Results: A 44 year-old female was admitted under the care of the burns team following burns secondary to an exploding air-freshener canister. The patient sustained burns to the face, thorax and arms re...

An experimental prescribed burn to reduce fuel hazard in chaparral

Science.gov (United States)

Lisle R. Green

1970-01-01

The feasibility of reducing fuel hazard in chaparral during safe weather conditions was studied in an experimental prescribed burn in southern California. Burning was done under fuel and weather conditions when untreated brush would not bum readily. Preparatory treatment included smashing of brush on strips with a bulldozer, and reduction of moisture content of leaves...

Burn-center quality improvement: are burn outcomes dependent on admitting facilities and is there a volume-outcome "sweet-spot"?

Science.gov (United States)

Hranjec, Tjasa; Turrentine, Florence E; Stukenborg, George; Young, Jeffrey S; Sawyer, Robert G; Calland, James F

2012-05-01

Risk factors of mortality in burn patients such as inhalation injury, patient age, and percent of total body surface area (%TBSA) burned have been identified in previous publications. However, little is known about the variability of mortality outcomes between burn centers and whether the admitting facilities or facility volumes can be recognized as predictors of mortality. De-identified data from 87,665 acute burn observations obtained from the National Burn Repository between 2003 and 2007 were used to estimate a multivariable logistic regression model that could predict patient mortality with reference to the admitting burn facility/facility volume, adjusted for differences in age, inhalation injury, %TBSA burned, and an additional factor, percent full thickness burn (%FTB). As previously reported, all three covariates (%TBSA burned, inhalation injury, and age) were found to be highly statistically significant risk factors of mortality in burn patients (P value improve the multivariable model. The treatment/admitting facility was found to be an independent mortality predictor, with certain hospitals having increased odds of death and others showing a protective effect (decreased odds ratio). Hospitals with high burn volumes had the highest risk of mortality. Mortality outcomes of patients with similar risk factors (%TBSA burned, inhalation injury, age, and %FTB) are significantly affected by the treating facility and their admission volumes.

The protective effects of sildenafil in acute lung injury in a rat model of severe scald burn: A biochemical and histopathological study.

Science.gov (United States)

Gokakin, Ali Kagan; Deveci, Koksal; Kurt, Atilla; Karakus, Boran Cihat; Duger, Cevdet; Tuzcu, Mehmet; Topcu, Omer

2013-09-01

Severe burn induces biochemical mediators such as reactive oxygen species that leads to lipid peroxidation which may have a key role in formation of acute lung injury (ALI). Sildenafil is a selective and potent inhibitor of cyclic guanosine monophosphate specific phosphodiesterase-5. Sildenafil preserves alveolar growth, angiogenesis, reduces inflammation and airway reactivity. The purpose of the present study was to evaluate the effects of different dosages of sildenafil in ALI due to severe scald burn in rats. Twenty-four rats were subjected to 30% total body surface area severe scald injury and were randomly divided into three equal groups as follow: control, 10 and 20mg/kg sildenafil groups. Levels of malondialdehyde (MDA), activities of glutathione peroxidase (Gpx), catalase (Cat), total oxidative stress (TOS), and total antioxidative capacity (TAC) were measured in both tissues and serums. Oxidative stress index (OSI) was calculated. A semi-quantitative scoring system was used for the evaluation of histopatological findings. Sildenafil increased Gpx, Cat, TAC and decreased MDA, TOS and OSI. Sildenafil decreased inflammation scores in lungs. Our results reveal that sildenafil is protective against scald burn related ALI by decreasing oxidative stress and inflammation and the dosage of 10mg/kg could be apparently better than 20mg/kg. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

Use of cyanide antidotes in burn patients with suspected inhalation injuries in North America: a cross-sectional survey.

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Dumestre, Danielle; Nickerson, Duncan

2014-01-01

This study aimed to assess the use of cyanide antidotes and the determine the opinion on empiric administration of hydroxocobalamin in North American burn patients with suspected smoke inhalation injuries. An online cross-sectional survey was sent to directors of 90 major burn centers in North America, which were listed on the American Burn Association Web site. A multiple-choice format was used to determine the percentage of patients tested for cyanide poisoning on admission, the current administration of a cyanide antidote based solely on clinical suspicion of poisoning, and the antidote used. To ascertain views on immediate administration of hydroxocobalamin before confirmation of cyanide poisoning an option was included to expand the response in written format. Twenty-nine of 90 burn directors (32%) completed the survey. For the population of interest, the majority of burn centers (59%) do not test for cyanide poisoning on admission and do not administer an antidote based solely on clinical suspicion of cyanide poisoning (58%). The most commonly available antidote is hydroxocobalamin (50%), followed by the cyanide antidote kit (29%). The opinion regarding instant administration of hydroxocobalamin when inhalation injury is suspected is mixed: 31% support its empiric use, 17% do not, and the remaining 52% have varying degrees of confidence in its utility. In North America, most patients burnt in closed-space fires with inhalation injuries are neither tested for cyanide poisoning in a timely manner nor empirically treated with a cyanide antidote. Although studies have shown the safety and efficacy of empiric and immediate administration of hydroxocobalamin, most centers are not willing to do so.

Survival after burn in a sub-Saharan burn unit: Challenges and opportunities

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Tyson, Anna F.; Boschini, Laura P.; Kiser, Michelle M.; Samuel, Jonathan C.; Mjuweni, Steven N.; Cairns, Bruce A.; Charles, Anthony G.

2013-01-01

Background Burns are among the most devastating of all injuries and a major global public health crisis, particularly in sub-Saharan Africa. In developed countries, aggressive management of burns continues to lower overall mortality and increase lethal total body surface area (TBSA) at which 50% of patients die (LA50). However, lack of resources and inadequate infrastructure significantly impede such improvements in developing countries. Methods This study is a retrospective analysis of patients admitted to the burn center at Kamuzu Central Hospital in Lilongwe, Malawi between June 2011 and December 2012. We collected information including patient age, gender, date of admission, mechanism of injury, time to presentation to hospital, total body surface area (TBSA) burn, comorbidities, date and type of operative procedures, date of discharge, length of hospital stay, and survival. We then performed bivariate analysis and logistic regression to identify characteristics associated with increased mortality. Results A total of 454 patients were admitted during the study period with a median age of 4 years (range 0.5 months to 79 years). Of these patients, 53% were male. The overall mean TBSA was 18.5%, and average TBSA increased with age—17% for 0–18 year olds, 24% for 19–60 year olds, and 41% for patients over 60 years old. Scald and flame burns were the commonest mechanisms, 52% and 41% respectively, and flame burns were associated with higher mortality. Overall survival in this population was 82%; however survival reduced with increasing age categories (84% in patients 0–18 years old, 79% in patients 19–60 years old, and 36% in patients older than 60 years). TBSA remained the strongest predictor of mortality after adjusting for age and mechanism of burn. The LA50 for this population was 39% TBSA. Discussion Our data reiterate that burn in Malawi is largely a pediatric disease and that the high burn mortality and relatively low LA50 have modestly improved

History of burns: The past, present and the future

Directory of Open Access Journals (Sweden)

Kwang Chear Lee

2014-10-01

Full Text Available Burn injuries are one of the most common and devastating afflictions on the human body. In this article we look back at how the treatment of burns has evolved over the centuries from a primarily topical therapy consisting of weird and wonderful topical concoctions in ancient times to one that spans multiple scientific fields of topical therapy, antibiotics, fluid resuscitation, skin excision and grafting, respiratory and metabolic care and nutrition. Most major advances in burn care occurred in the last 50 years, spurred on by wars and great fires. The use of systemic antibiotics and topical silver therapy greatly reduced sepsis related mortality. This along with the advent of antiseptic surgical techniques, burn depth classification and skin grafting allowed the excision and coverage of full-thickness burns which resulted in greatly improved survival rates. Advancements in the methods of assessing the surface area of burns paved way for more accurate fluid resuscitation, minimising the effects of shock and avoiding fluid over-loading. The introduction of metabolic care, nutritional support and care of inhalational injuries further improved the outcome of burn patients. We also briefly discuss some future directions in burn care such as the use of cell and pharmalogical therapies.

Ceruloplasmin and Hypoferremia: Studies in Burn and Non-Burn Trauma Patients

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2015-03-06

ceruloplasmin; ferroxidase; iron status; oxidant stress; burn; trauma 1. Introduction Iron is an essential element for life that facilitates...899–906. 45. Shakespeare , P.G. Studies on the serum levels of iron, copper and zinc and the urinary excretion of zinc after burn injury. Burns Incl

Risk factors for frequent work-related burn and cut injuries and low back pain among commercial kitchen workers in Japan.

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Tomita, Shigeru; Muto, Takashi; Matsuzuki, Hiroe; Haruyama, Yasuo; Ito, Akiyoshi; Muto, Shigeki; Haratani, Takashi; Seo, Akihiko; Ayabe, Makoto; Katamoto, Shizuo

2013-01-01

This study investigated risk factors for frequent work-related burn and cut injuries and low back pain (LBP) among kitchen workers including personal, work-related and environmental factors. Subjects were 991 kitchen workers in 103 schools, 17 hospitals and nursing homes, and 6 restaurants in central Japan. A cross-sectional survey was carried out using a structured self-administered questionnaire. Logistic regression models were used to examine associations between frequent injuries/LBP and risk factors. The effective response rate was 75.1% (n=744), the mean age was 40.7 (SD 11.7) and 77.2% were female. Burn injury was associated with a smaller kitchen (OR 1.94; 95%CI, 1.13-3.33), and gas kitchens rather than electric kitchens (OR 2.30; 95%CI, 1.17-4.52). LBP was associated with female gender (OR 2.46; 95%CI, 1.37-4.43), high body height (>160 cm) (OR 2.03; 95%CI, 1.22-3.36), and large number of meals produced per person (≥ 150 meals) (OR 1.83; 95%CI, 1.12-3.00). The results of this study suggest that securing adequate work space and introducing electric kitchen systems may reduce the risk to kitchen workers, as well as the importance of adequate height of cooking equipment and selecting an appropriate volume of meals to produce per person to prevent LBP in kitchen workers.

The Adaptive QSE-reduced Nuclear Reaction Network for Silicon Burning

International Nuclear Information System (INIS)

Parete-Koon, Suzanne; Hix, William Raphael; Thielemann, Friedrich-Karl W.

2008-01-01

The nuclei of the 'iron peak' are formed in massive stars shortly before core collapse and during their supernova outbursts as well as during thermonuclear supernovae. Complete and incomplete silicon burning during these events are responsible for the production of a wide range of nuclei with atomic mass numbers from 28 to 64. Because of the large number of nuclei involved, accurate modeling of silicon burning is computationally expensive. However, examination of the physics of silicon burning has revealed that the nuclear evolution is dominated by large groups of nuclei in mutual equilibrium. We present an improvement on our hybrid equilibrium-network scheme which takes advantage of this quasi-equilibrium in order to reduce the number of independent variables calculated. Because the size and membership of these groups vary as the temperature, density and electron faction change, achieving maximal efficiency requires dynamic adjustment of group number and membership. Toward this end, we are implementing a scheme beginning with 2 QSE groups at appropriately high temperature, then progressing through, 3 and 3* group stages (with successively more independent variables) as temperature declines. This combination allows accurate prediction of the nuclear abundance evolution, deleptonization and energy generation at a further reduced computational cost when compared to a conventional nuclear reaction network or our previous 3 fixed group QSE-reduced network. During silicon burning, the resultant QSE-reduced network is up to 20 times faster than the full network it replaces without significant loss of accuracy. These reductions in computational cost and the number of species evolved make QSE-reduced networks well suited for inclusion within hydrodynamic simulations, particularly in multi-dimensional applications

A review of campfire burns in children: The QLD experience.

Science.gov (United States)

Okon, O; Zhu, L; Kimble, R M; Stockton, K A

2018-03-27

Campfire burns in children are a significant health issue. It is imperative that the extent of the problem is examined and strategies discussed to inform future prevention campaigns. A retrospective review of data from the Queensland Paediatric Burns Registry for all children presenting with campfire burns between January 2013 and December 2014 (inclusive). Information collected included patient demographics, detail regarding mechanism of injury, first aid, Total Body Surface Area (TBSA), burn depth, and treatment. Seventy-five children with campfire burns were seen in our paediatric burns centre during this 2-year period. The median age of patients was 3 years (range 10 days-14 years). The hands and feet were the areas most commonly affected. Eleven percent of patients suffered flame burns, whilst 89% suffered contact burns from the hot coals or ashes. Of the latter group, approximately half experienced burns from campfires that had been extinguished for at least one night. Thirteen percent of patients underwent split thickness skin grafting. The incidence of burns was increased during school holiday months. We have previously demonstrated the effectiveness of targeted campaigns in reducing the incidence of campfire burns. A significant portion of patients sustained burns from incorrectly extinguished campfires. These injuries are likely to be preventable with ongoing public awareness campaigns. Copyright © 2018 Elsevier Ltd and ISBI. All rights reserved.

[Forensic medical evaluation of a burn injury from combustion of flammable fluids on the human body based on morphological changes in internal organs].

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Khushkadamov, Z K

2009-01-01

The author describes morphological features of splanchnic organs in the patients that suffered an injury from combustion of flammable fluids at the body surface. The burn injury is a specific form of trauma originating from a combination of several injurious factors including thermoinhalation and intoxication with combustion products in the absence of oxygen in the centre of the hot spot. A rather specific combination of morphological changes in internal organs along with results of laboratory studies provides the most reliable criterion for forensic medical diagnosis of burn injuries from combustion of flammable fluids on the human body.

[Burns care following a nuclear incident].

Science.gov (United States)

Bargues, L; Donat, N; Jault, P; Leclerc, T

2010-09-30

Radiation injuries are usually caused by radioactive isotopes in industry. Detonations of nuclear reactors, the use of military nuclear weapons, and terrorist attacks represent a risk of mass burn casualties. Ionizing radiation creates thermal burns, acute radiation syndrome with pancytopenia, and a delayed cutaneous syndrome. After a latency period, skin symptoms appear and the depth of tissue damages increase with dose exposure. The usual burn resuscitation protocols have to be applied. Care of these victims also requires assessment of the level of radiation, plus decontamination by an experienced team. In nuclear disasters, the priority is to optimize the available resources and reserve treatment to patients with the highest probability of survival. After localized nuclear injury, assessment of burn depth and surgical techniques of skin coverage are the main difficulties in a burn centre. Training in medical facilities and burn centres is necessary in the preparation for management of the different types of burn injuries.

Benchmarks for multidimensional recovery after burn injury in young adults: the development, validation, and testing of the American Burn Association/Shriners Hospitals for Children young adult burn outcome questionnaire.

Science.gov (United States)

Ryan, Colleen M; Schneider, Jeffrey C; Kazis, Lewis E; Lee, Austin; Li, Nien-Chen; Hinson, Michelle; Bauk, Helena; Peck, Michael; Meyer, Walter J; Palmieri, Tina; Pidcock, Frank S; Reilly, Debra; Tompkins, Ronald G

2013-01-01

Although data exist on burn survival, there are little data on long-term burn recovery. Patient-centered health outcomes are useful in monitoring and predicting recovery and evaluating treatments. An outcome questionnaire for young adult burn survivors was developed and tested. This 5-year (2003-2008) prospective, controlled, multicenter study included burned and nonburned adults ages 19 to 30 years. The Young Adult Burn Outcome Questionnaires were completed at initial contact, 10 days, and 6 and 12 months. Factor analysis established construct validity. Reliability assessments used Cronbach α and test-retest. Recovery patterns were investigated using generalized linear models, with generalized estimating equations using mixed models and random effects. Burned (n = 153) and nonburned subjects (n = 112) completed 620 questionnaires (47 items). Time from injury to first questionnaire administration was 157 ± 36 days (mean ± SEM). Factor analysis included 15 factors: Physical Function, Fine Motor Function, Pain, Itch, Social Function Limited by Physical Function, Perceived Appearance, Social Function Limited by Appearance, Sexual Function, Emotion, Family Function, Family Concern, Satisfaction With Symptom Relief, Satisfaction With Role, Work Reintegration, and Religion. Cronbach α ranged from 0.72 to 0.92, with 11 scales >0.8. Test-retest reliability ranged from 0.29 to 0.94, suggesting changes in underlying health status after burns. Recovery curves in five domains, Itch, Perceived Appearance, Social Function Limited by Appearance, Family Concern, and Satisfaction with Symptom Relief, remained below the reference group at 24 months. The Young Adult Burn Outcome Questionnaire is a reliable and valid instrument for multidimensional functional outcomes assessment. Recovery in some domains was incomplete.

Burn injury in kitchen workers: a cause for prevention.

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Riina, L H; Simpson, R L; Gudjonsson, O; Glickman, L T; Harris, S U; Johnson, D; Ginocchio, M

2000-01-01

Preventable thermal injuries in professional kitchen workers have been identified, and we have introduced a protective garment. Because of the nature of their occupation, kitchen workers are prone to thermal injuries. It has been our experience that the majority of these injuries are scald injuries on the ankles and dorsum of the feet. We propose that a protective garment, such as a waterproof shoe and garter, could reduce the incidence of these injuries.

Ethnicity and etiology in burn trauma.

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Papp, Anthony; Haythornthwaite, Jordan

2014-01-01

The purpose of this study was to retrieve data from the British Columbia Professional Firefighters Burn Unit registry, with a focus on ethnicity and how it is involved in burn trauma. It is hypothesized that mechanism, severity, and other patient characteristics are significantly different among different ethnic groups. Furthermore, it is believed that these data can be used to augment burn prevention strategies. Data for burn patients admitted from 1979 to 2009 were reviewed from the burn registry. The main focus was with differences seen among the four main ethnicities throughout the analysis, Caucasian, Aboriginal, Asian, and Indoasian, reflecting the population distribution of the region. Age and sex were also considered when looking at burn mechanism, severity, contributing and copresenting factors. Caucasians were the largest group (79.1%) and included the largest male:female ratio (3.3:1), with high numbers of flame injury (53.9%). Caucasians presented with the highest mortality (6.6% compared with 4.1% for all other ethnicities; P workplace (28.9%) injuries with a larger proportion of scald injury (38.9%). Indoasian patients included larger numbers of women (36.4%) and household scald injuries (33.9%) whereas Aboriginals suffered the most flame injuries (60.1%) in rural areas with more frequent contributing factors such as alcohol. The study found multiple significant differences in the burn injury population when segmented by ethnicity. Though the exact reasons for these differences are difficult to say with certainty, it allows a unique opportunity to focus communication and prevention efforts to specific communities.

The hospital costs associated with acute paediatric burn injuries

African Journals Online (AJOL)

Priorities include effective resuscitation, early excision and ... Determining the true costs of a specialist service is important, .... TBSA if undertaken in the operating room. ..... of community-based ambulatory burn care systems to reduce the.

Burns in South Korea: An analysis of nationwide data from the Health Insurance Review and Assessment Service.

Science.gov (United States)

Oh, Hyunjin; Boo, Sunjoo

2016-05-01

The purpose of the study was to identify and describe the incidence of burn injuries in patients seen and treated in South Korea. Characteristics of inpatients and outpatients with burns were analyzed according to gender, age, burn site, and burn severity. This retrospective study examined the characteristics of a stratified sample of burn patients seen and treated in South Korea during the calendar year 2011. The sample was drawn from the national patient database Health Insurance Review and Assessment (HIRA). Approximately 1.71% of the total patients in the Patient Sample of HIRA for 2011 were burn-injured patients. The numbers of patients treated for burns were 913/10(5) males (n=8009) and 1454/10(5) females (n=11,881). Nearly all of these patients (94.1%) were covered by national health insurance and the majority of these patients (80.6%) were treated as outpatients. Nearly half of the burn injuries were of the upper extremities (43.5%), and most of these injuries (71.5%) were rated as second-degree burns. A review of the national data on patients seen and treated for burns in 2011 revealed that people in South Korea may experience higher numbers and more severe cases of burns and burn-related injuries than found in other countries. General burn prevention programs as well as gender- and age-specific prevention strategies are needed to reduce the risk of burns in this population. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

The Role of the Nurse in the Rehabilitation of Patients with Radical Changes in Body Image Due to Burn Injuries

OpenAIRE

Aacovou, I.

2005-01-01

Burn injuries are among the most serious causes of radical changes in body image. The subject of body image and self-image is essential in rehabilitation, and the nurse must be aware of the issues related to these concepts and take them seriously into account in drafting out the nursing programme. This paper defines certain key words related to body image and discusses the social context of body image. Burn injuries are considered in relation to the way each of these affects the patient's bod...

Lethal Area 50 in Patients with Burn Injuries in North West, Iran

Directory of Open Access Journals (Sweden)

Ahmad Mirza Aghazadeh

2018-03-01

Full Text Available Introduction: In view of their considerably high rates of mortality and morbidity, burns are still viewed as one of the most important health-threatening environmental hazards imposing a significant burden on the health care system in low and middle-income countries. This study seeks to determine the lethal area fifty percent (LA50 in all burn patients admitted over a period of five years and the factors influencing mortality in burn injuries. Methods: This study was a cross-sectional carried out from 2010 to 2014 in Sina Hospital of Tabriz, 1226 participant including 319 women, 346 men, 272 girls, and 289 boys were selected through stratified sampling. The demographic and clinical data of patients ( their age, gender, burn type, TBSA, the season and consequences of burning were all extracted and then analyzed, using descriptive statistics (measures of central tendency and variability and inferential statistics(chi-square and linear regressionat a significance level of 0.05. The LA50 was calculated through determining the relationship between the total body surface area and mortality rate (The extent of the body burns measured and recorded based on Lando Chart in hospitals. Results: The highest (47.6% and the lowest (3.8% rates of burns were observed among those aged below 16 and above 65, respectively. The majority of the participants were residents of cities (55.4%, married (34.6%, illiterate (56.6%, and housewives (14.8%. Most burns were caused by accidents (98.4% at home (90.6%. Most patients had suffered first- and second-degree burns (68.4%, with no inhalation damages (99.5%. Hot liquids were the main culprit in most of the burns (58.7% and the upper extremities were the most frequently affected areas (34.8%. There was .99 rise in mortality for every percent increase in TBSA, and there seemed to be a significant relationship between the age level and the eventual outcome- the higher the age, the more likely for the incident to end in death

The effects of sildenafil in liver and kidney injury in a rat model of severe scald burn: a biochemical and histopathological study.

Science.gov (United States)

Gökakın, Ali Kağan; Atabey, Mustafa; Deveci, Koksal; Sancakdar, Enver; Tuzcu, Mehmet; Duger, Cevdet; Topcu, Omer

2014-09-01

Severe burn induces systemic inflammation and reactive oxygen species leading to lipid peroxidation which may play role in remote organs injury. Sildenafil is a selective and potent inhibitor of cyclic guanosine monophosphate specific phosphodiesterase-5. Sildenafil reduces oxidative stress and inflammation in distant organs. The aim of the present study was to evaluate the effects of different dosages of sildenafil in remote organs injury. A total of thirty-two rats were randomly divided into four equal groups. The groups were designated as follows: Sham, Control, 10, and T20 mg/kg sildenafil treatment groups. Levels of malondialdehyde (MDA), vascular endothelial growth factor (VEGF), VEGF receptor (Flt-1), activities of glutathione peroxidase (Gpx), levels of total antioxidative capacity (TAC), and total oxidant status (TOS) were measured in both tissues and serum, and a semi-quantitative scoring system was used for the evaluation of histopathological findings. Sildenafil increased levels of Gpx, and Flt-1, and decreased MDA and VEGF levels in tissues. Sildenafil also increased serum levels of TAC and Flt-1 and decreased TOS, OSI, and VEGF. Sildenafil decreased inflammation scores in remote organs in histopathological evaluation. It has protective effects in severe burn-related remote organ injuries by decreasing oxidative stress and inflammation.

Rationalization of thermal injury quantification methods: application to skin burns.

Science.gov (United States)

Viglianti, Benjamin L; Dewhirst, Mark W; Abraham, John P; Gorman, John M; Sparrow, Eph M

2014-08-01

Classification of thermal injury is typically accomplished either through the use of an equivalent dosimetry method (equivalent minutes at 43 °C, CEM43 °C) or through a thermal-injury-damage metric (the Arrhenius method). For lower-temperature levels, the equivalent dosimetry approach is typically employed while higher-temperature applications are most often categorized by injury-damage calculations. The two methods derive from common thermodynamic/physical chemistry origins. To facilitate the development of the interrelationships between the two metrics, application is made to the case of skin burns. This thermal insult has been quantified by numerical simulation, and the extracted time-temperature results served for the evaluation of the respective characterizations. The simulations were performed for skin-surface exposure temperatures ranging from 60 to 90 °C, where each surface temperature was held constant for durations extending from 10 to 110 s. It was demonstrated that values of CEM43 at the basal layer of the skin were highly correlated with the depth of injury calculated from a thermal injury integral. Local values of CEM43 were connected to the local cell survival rate, and a correlating equation was developed relating CEM43 with the decrease in cell survival from 90% to 10%. Finally, it was shown that the cell survival/CEM43 relationship for the cases investigated here most closely aligns with isothermal exposure of tissue to temperatures of ~50 °C. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

Psychiatric aspects of burn

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Dalal P

2010-10-01

Full Text Available Burn injuries and their subsequent treatment cause one of the most excruciating forms of pain imaginable. The psychological aspects of burn injury have been researched in different parts of the world, producing different outcomes. Studies have shown that greater levels of acute pain are associated with negative long-term psychological effects such as acute stress disorder, depression, suicidal ideation, and post-traumatic stress disorder for as long as 2 years after the initial burn injury. The concept of allostatic load is presented as a potential explanation for the relationship between acute pain and subsequent psychological outcomes. A biopsychosocial model is also presented as a means of obtaining better inpatient pain management and helping to mediate this relationship.

Inhalation injury in a burn unit: a retrospective review of prognostic factors.

Science.gov (United States)

Monteiro, D; Silva, I; Egipto, P; Magalhães, A; Filipe, R; Silva, A; Rodrigues, A; Costa, J

2017-06-30

Inhalation injury (InI) is known to seriously affect the prognosis of burn patients, as it is strongly associated with high morbidity and mortality. Despite major advances in the treatment of burn patients in the past years, advances in the treatment of smoke InI have been somewhat limited; mortality reduction mostly results from improvements in critical care. It is difficult to separate the contribution of InI from other mechanisms that also affect respiratory tract and lungs. The aim of this study was to compare patients with and without InI and to identify prognostic factors among patients with smoke InI. Patients with InI displayed higher total body surface area (TBSA) burned, higher incidence of pneumonia and acute respiratory distress syndrome (ARDS), a higher rate of positive blood cultures and a significantly higher death rate. We could conclude that older age, higher TBSA, ARDS and pneumonia were independent predictive factors for mortality in our global study population. Older age and higher TBSA were the only independent factors found to be predictive of mortality in patients with InI.

Practice of first aid in burn related injuries in a developing country.

Science.gov (United States)

Fadeyibi, Idowu Olusegun; Ibrahim, Nasiru Akanmu; Mustafa, Ibrahim Akinwunmi; Ugburo, Andrew Omotayo; Adejumo, Adedeji Olusola; Buari, Adedayo

2015-09-01

First aid with cool running water reduces the severity of burn. Low level of knowledge of first aid in burns was shown in previous studies with few patients receiving first aid by water lavage. A study investigating the use of water lavage as first aid in patients presenting to hospital with burn in Lagos, Nigeria was carried out. Patients admitted to a University Teaching Hospital for treatment of burns were recruited for this prospective study. Data detailing demographics, scene and aetiology of burns, material used for first aid, who administered first aid, level of education and relationship of first-aider with patients, length of hospital stay, complications and outcome of treatment were collected and statistical analysis performed. 168 patients; 73 (43.4%) children and 95 (56.6%) adults were seen. Burns were sustained at home in 95 (74.2%) cases and outside in 33 (25.8%). Water lavage was used in 49 (29.2%) cases, raw eggs in 21 (12.5%), pap in 16 (9.5%) and other materials in 48.8%. 40 (23.8%) patients had not received any form of first aid at presentation. Patients that received no water first aid had higher complication rate (35.3% versus 18.4%) compared with those that had water first aid. The use of water first aid in burns was shown to reduce complication rate in this study. People should be educated on the efficacy of water first aid in pre-hospital care of burns. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Impact of a Newly Implemented Burn Protocol on Surgically Managed Partial Thickness Burns at a Specialized Burns Center in Singapore.

Science.gov (United States)

Tay, Khwee-Soon Vincent; Chong, Si-Jack; Tan, Bien-Keem

2016-03-01

This study evaluated the impact of a newly implemented protocol for superficial to mid-dermal partial thickness burns which involves early surgery and rapid coverage with biosynthetic dressing in a specialized national burns center in Singapore. Consecutive patients with 5% or greater total body surface area (TBSA) superficial to mid-dermal partial thickness burns injury admitted to the Burns Centre at the Singapore General Hospital between August and December 2014 for surgery within 48 hours of injury were prospectively recruited into the study to form the protocol group. Comparable historical cases from the year 2013 retrieved from the burns center audit database were used to form the historical control group. Demographics (age, sex), type and depth of burns, %TBSA burnt, number of operative sessions, and length of stay were recorded for each patient of both cohorts. Thirty-nine burns patients managed under the new protocol were compared with historical control (n = 39) comparable in age and extensiveness of burns. A significantly shorter length of stay (P burns was observed in the new protocol group (0.74 day/%TBSA) versus historical control (1.55 day/%TBSA). Fewer operative sessions were needed under the new protocol for burns 10% or greater TBSA burns (P protocol for surgically managed burns patients which involves early surgery and appropriate use of biosynthetic dressing on superficial to mid-dermal partial thickness burns. Clinically, shorter lengths of stay, fewer operative sessions, and decreased need for skin grafting of burns patient were observed.

Pathological changes after bone marrow and skin allograft transplantation in rats inflicted with severe combined radiation-burn injury

International Nuclear Information System (INIS)

Zheng Huaien; Cheng Tianmin; Yan Yongtang

1994-01-01

Bone marrow and skin allografts from the same donor were transplanted to rats inflicted with 8 Gy γ-radiation combined with third degree burns of 15% body surface area within 6 hr post injury. Pathological changes of hematopoietic tissues and skin allografts were studied. All injured controls died within 7 days post injury without bone marrow regeneration; 50% of treated rats survived with living skin allografts on 50th day post injury. On days 100 and 480 post operation, grafted skin still survived well on recipients with normal ultrastructure. Epidermic cells of skin allografts proliferated on day 5, developed and repaired on day 10. Histological structure of the skin returned to normal on day 30 post operation. The regeneration of bone marrow appeared on 5th day, increased markedly on day 10, and almost completed on day 15 after bone marrow transplantation. However, the regeneration of lymphocytes in cortex of spleen and lymph nodes did not appear until day 15 of BMT. The results show that bone marrow and skin allograft transplantation at early time post injury in most severe combined radiation-burn injury have tremendous beneficial effects, and the skin allograft can survive for a long time

Childhood burns in Sulaimaniyah province, Iraqi Kurdistan: a prospective study of admissions and outpatients.

Science.gov (United States)

Othman, Nasih; Kendrick, Denise; Al-Windi, Ahmad

2015-03-01

While it is globally observed that young children are at a higher risk of burn injuries, little is known about childhood burns in Iraqi Kurdistan. This study was undertaken to describe the epidemiology of burns amongst pre-school children in this region. A prospective study was undertaken from November 2007 to November 2008 involving all children aged 0-5 years attending the burns centre in Sulaimaniyah province for a new burn injury whether treated as an outpatient or admitted to hospital. 1,122 children attended the burns centre of whom 944 (84%) were interviewed (male 53%, female 47%). Mean age was 1.9 years with children aged 1 year comprising 32% and those aged 2 years comprising 21% of the sample. The incidence of burns was 1044/100,000 person-years (1030 in females and 1057 in males). Mechanisms of injury included scalds (80%), contact burns (12%) flames (6%) and other mechanisms (2%). Almost 97% of burns occurred at home including 43% in the kitchen. Winter was the commonest season (36%) followed by autumn (24%). There were 3 peak times of injury during the day corresponding to meal times. The majority of burns were caused by hot water (44%) and tea (20%) and the most common equipment/products responsible were tea utensils (41%). There were 237 admissions with an admission rate of 95 per 100,000 person-years. Scald injuries accounted for most admissions (84%). Median total body surface area affected by the burn or scald (TBSA) was 11% and median hospital stay was 7 days. In-hospital mortality was 8%. Mortality rate was 4% when TBSA was ≤25%, and 100% when TBSA was over 50%. Burn incidence is high in young children especially those aged 1-2 years. Preventive interventions targeted at families with young children & focusing on home safety measures could be effective in reducing childhood burns. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Development of the life impact burn recovery evaluation (LIBRE) profile: assessing burn survivors' social participation.

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Kazis, Lewis E; Marino, Molly; Ni, Pengsheng; Soley Bori, Marina; Amaya, Flor; Dore, Emily; Ryan, Colleen M; Schneider, Jeff C; Shie, Vivian; Acton, Amy; Jette, Alan M

2017-10-01

Measuring the impact burn injuries have on social participation is integral to understanding and improving survivors' quality of life, yet there are no existing instruments that comprehensively measure the social participation of burn survivors. This project aimed to develop the Life Impact Burn Recovery Evaluation Profile (LIBRE), a patient-reported multidimensional assessment for understanding the social participation after burn injuries. 192 questions representing multiple social participation areas were administered to a convenience sample of 601 burn survivors. Exploratory factor analysis and confirmatory factor analysis (CFA) were used to identify the underlying structure of the data. Using item response theory methods, a Graded Response Model was applied for each identified sub-domain. The resultant multidimensional LIBRE Profile can be administered via Computerized Adaptive Testing (CAT) or fixed short forms. The study sample included 54.7% women with a mean age of 44.6 (SD 15.9) years. The average time since burn injury was 15.4 years (0-74 years) and the average total body surface area burned was 40% (1-97%). The CFA indicated acceptable fit statistics (CFI range 0.913-0.977, TLI range 0.904-0.974, RMSEA range 0.06-0.096). The six unidimensional scales were named: relationships with family and friends, social interactions, social activities, work and employment, romantic relationships, and sexual relationships. The marginal reliability of the full item bank and CATs ranged from 0.84 to 0.93, with ceiling effects less than 15% for all scales. The LIBRE Profile is a promising new measure of social participation following a burn injury that enables burn survivors and their care providers to measure social participation.

Understanding burn injuries in Aboriginal and Torres Strait Islander children: protocol for a prospective cohort study

Science.gov (United States)

Ivers, Rebecca Q; Hunter, Kate; Clapham, Kathleen; Coombes, Julieann; Fraser, Sarah; Lo, Serigne; Gabbe, Belinda; Hendrie, Delia; Read, David; Kimble, Roy; Sparnon, Anthony; Stockton, Kellie; Simpson, Renee; Quinn, Linda; Towers, Kurt; Potokar, Tom; Mackean, Tamara; Grant, Julian; Lyons, Ronan A; Jones, Lindsey; Eades, Sandra; Daniels, John; Holland, Andrew J A

2015-01-01

Introduction Although Aboriginal and Torres Strait Islander children in Australia have higher risk of burns compared with non-Aboriginal children, their access to burn care, particularly postdischarge care, is poorly understood, including the impact of care on functional outcomes. The objective of this study is to describe the burden of burns, access to care and functional outcomes in Aboriginal and Torres Strait Islander children in Australia, and develop appropriate models of care. Methods and analysis All Aboriginal and Torres Strait Islander children aged under 16 years of age (and their families) presenting with a burn to a tertiary paediatric burn unit in 4 Australian States (New South Wales (NSW), Queensland, Northern Territory (NT), South Australia (SA)) will be invited to participate. Participants and carers will complete a baseline questionnaire; follow-ups will be completed at 3, 6, 12 and 24 months. Data collected will include sociodemographic information; out of pocket costs; functional outcome; and measures of pain, itch and scarring. Health-related quality of life will be measured using the PedsQL, and impact of injury using the family impact scale. Clinical data and treatment will also be recorded. Around 225 participants will be recruited allowing complete data on around 130 children. Qualitative data collected by in-depth interviews with families, healthcare providers and policymakers will explore the impact of burn injury and outcomes on family life, needs of patients and barriers to healthcare; interviews with families will be conducted by experienced Aboriginal research staff using Indigenous methodologies. Health systems mapping will describe the provision of care. Ethics and dissemination The study has been approved by ethics committees in NSW, SA, NT and Queensland. Study results will be distributed to community members by study newsletters, meetings and via the website; to policymakers and clinicians via policy fora, presentations and

[Effects of hydrogen on the lung damage of mice at early stage of severe burn].

Science.gov (United States)

Qin, C; Bian, Y X; Feng, T T; Zhang, J H; Yu, Y H

2017-11-20

( P hydrogen group during post injury days 7 were 100%. Compared with those in sham injury group, survival rates of mice in pure burn group from post injury days 3 to 7 were significantly decreased (with P values below 0.05). Compared with those in pure burn group, survival rates of mice in burn+ hydrogen group from post injury days 5 to 7 were significantly increased (with P values below 0.05). Conclusions: Hydrogen can significantly alleviate the infiltration of inflammatory cells and improve the pathological lesions of lung tissue of mice with severe burn. It has the effects of reducing inflammatory reaction and inhibiting oxidative stress, further showing the protective effect on the lung of burn mice.

[Factor XIII-guided treatment algorithm reduces blood transfusion in burn surgery].

Science.gov (United States)

Carneiro, João Miguel Gonçalves Valadares de Morais; Alves, Joana; Conde, Patrícia; Xambre, Fátima; Almeida, Emanuel; Marques, Céline; Luís, Mariana; Godinho, Ana Maria Mano Garção; Fernandez-Llimos, Fernando

Major burn surgery causes large hemorrhage and coagulation dysfunction. Treatment algorithms guided by ROTEM ® and factor VIIa reduce the need for blood products, but there is no evidence regarding factor XIII. Factor XIII deficiency changes clot stability and decreases wound healing. This study evaluates the efficacy and safety of factor XIII correction and its repercussion on transfusion requirements in burn surgery. Randomized retrospective study with 40 patients undergoing surgery at the Burn Unit, allocated into Group A those with factor XIII assessment (n = 20), and Group B, those without assessment (n = 20). Erythrocyte transfusion was guided by a hemoglobin trigger of 10g.dL -1 and the other blood products by routine coagulation and ROTEM ® tests. Analysis of blood product consumption included units of erythrocytes, fresh frozen plasma, platelets, and fibrinogen. The coagulation biomarker analysis compared the pre- and post-operative values. Group A (with factor XIII study) and Group B had identical total body surface area burned. All patients in Group A had a preoperative factor XIII deficiency, whose correction significantly reduced units of erythrocyte concentrate transfusion (1.95 vs. 4.05, p = 0.001). Pre- and post-operative coagulation biomarkers were similar between groups, revealing that routine coagulation tests did not identify factor XIII deficiency. There were no recorded thromboembolic events. Correction of factor XIII deficiency in burn surgery proved to be safe and effective for reducing perioperative transfusion of erythrocyte units. Copyright © 2017 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

[Surgical treatment of burns : Special aspects of pediatric burns].

Science.gov (United States)

Bührer, G; Beier, J P; Horch, R E; Arkudas, A

2017-05-01

Treatment of pediatric burn patients is very important because of the sheer frequency of burn wounds and the possible long-term ramifications. Extensive burns need special care and are treated in specialized burn centers. The goal of this work is to present current standards in burn therapy and important innovations in the treatment of burns in children so that the common and small area burn wounds and scalds in pediatric patients in day-to-day dermatological practice can be adequately treated. Analysis of current literature, discussion of reviews, incorporation of current guidelines. Burns in pediatric patients are common. Improvement of survival can be achieved by treatment in burn centers. The assessment of burn depth and area is an important factor for proper treatment. We give an overview for outpatient treatment of partial thickness burns. New methods may result in better long-term outcome. Adequate treatment of burn injuries considering current literature and guidelines improves patient outcome. Rational implementation of new methods is recommended.

Epidemiological Study Of Burn Cases And Their Mortality Experiences Amongst Adults From A Tertiary Level Care Centre

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Kumar P

1997-01-01

Full Text Available Research question: How to use hospital statistics in establishing epidemiology of burns amongst adults? Objectives: To identify epidemiological determinants for Ii Various burn injuries and ii their mortality experiences. Study design: Hospital based study carried out for a period of one year (1st January 1991 to 31st December 1991. Settings: Wards of department of Burn & Plastic Surgery, BJ Medical College, Ahmedabad. Participants: 386 adults (20 years and above admitted at the centre for burn injuries during 1991. Study variables: Epidemiological determinants (age, sex, temporal, place, etc. for various burn injuries and the determinants of mortality (type of burn, extent of burn, referral time lag etc. Outcome profile: Common profile of burn victims with relation to the epidemiological factors and other factors responsible for high mortality in burn cases. Statistical analysis: Chi- square and Z tests. Results:Burns occured more in females specially in the age group of 20-24 years. Eighty five percent were flame burns. Flame burns were more in females, while electric burns were more in males. Burns were less during monsoon (27.7% than winter (32.6% and summer (39.6%, but electric burns were twice more common during monsoon. Maximum burns (81.9% were domestic, occurring mainly either in kitchen or living room. They were seen more in late evening. Sixty two percent cases were severe as total burn surface area (TBSA was >40%. Case fatality correlated positively with TBSA and death was almost universal with TBSA >60%. Early referral reduced fatality significantly in less severe burns (TBSA<40% but failed to influence it in severe burns. Appraisal of alleged suicide cases (2.6% and of stove bursting (4.4% revealed that young females carry additional risk of burn injuries.

Poverty, population density, and the epidemiology of burns in young children from Mexico treated at a U.S. pediatric burn facility.

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Patel, Dipen D; Rosenberg, Marta; Rosenberg, Laura; Foncerrada, Guillermo; Andersen, Clark R; Capek, Karel D; Leal, Jesus; Lee, Jong O; Jimenez, Carlos; Branski, Ludwik; Meyer, Walter J; Herndon, David N

2018-03-07

Children 5 and younger are at risk for sustaining serious burn injuries. The causes of burns vary depending on demographic, cultural and socioeconomic variables. At this pediatric burn center we provided medical care to children from Mexico with severe injuries. The purpose of this study was to understand the impact of demographic distribution and modifiable risk factors of burns in young children to help guide prevention. A retrospective chart review was performed with children 5 and younger from Mexico who were injured from 2000-2013. The medical records of 447 acute patients were reviewed. Frequency counts and percentages were used to identify geographic distribution and calculate incidence of burns. Microsoft Powermap software was used to create a geographical map of Mexico based on types of burns. A binomial logistic regression was used to model the incidence of flame burns as opposed to scald burns in each state with relation to population density and poverty percentage. In all statistical tests, alpha=0.05 for a 95% level of confidence. Burns were primarily caused by flame and scald injuries. Admissions from flame injuries were mainly from explosions of propane tanks and gas lines and house fires. Flame injuries were predominantly from the states of Jalisco, Chihuahua, and Distrito Federal. Scalds were attributed to falling in large containers of hot water or food on the ground, and spills of hot liquids. Scald injuries were largely from the states of Oaxaca, Distrito Federal, and Hidalgo. The odds of a patient having flame burns were significantly associated with poverty percentage (ppoverty led to decrease in odds of a flame burn, but an increase in the odds of scald burns. Similarly, we found that increasing population density led to a decrease in the odds of a flame burn, but an increase in the odds of a scald burn. Burns in young children from Mexico who received medical care at this pediatric burn center were attributed to flame and scalds. Potential

Effects of burn location and investigator on burn depth in a porcine model.

Science.gov (United States)

Singer, Adam J; Toussaint, Jimmy; Chung, Won Taek; Thode, Henry C; McClain, Steve; Raut, Vivek

2016-02-01

In order to be useful, animal models should be reproducible and consistent regardless of sampling bias, investigator creating burn, and burn location. We determined the variability in burn depth based on biopsy location, burn location and investigator in a porcine model of partial thickness burns. 24 partial thickness burns (2.5 cm by 2.5 cm each) were created on the backs of 2 anesthetized pigs by 2 investigators (one experienced, one inexperienced) using a previously validated model. In one of the pigs, the necrotic epidermis covering each burn was removed. Five full thickness 4mm punch biopsies were obtained 1h after injury from the four corners and center of the burns and stained with Hematoxylin and Eosin and Masson's trichrome for determination of burn depth by a board certified dermatopathologist blinded to burn location and investigator. Comparisons of burn depth by biopsy location, burn location and investigator were performed with t-tests and ANOVA as appropriate. The mean (SD) depth of injury to blood vessels (the main determinant of burn progression) in debrided and non-debrided pigs pooled together was 1.8 (0.3)mm, which included 75% of the dermal depth. Non-debrided burns were 0.24 mm deeper than debrided burns (Plocations, in debrided burns. Additionally, there were also no statistical differences in burn depths from midline to lateral in either of these burn types. Burn depth was similar for both investigators and among biopsy locations. Burn depth was greater for caudal locations in non-debrided burns and overall non-debrided burns were deeper than debrided burns. However, burn depth did not differ based on investigator, biopsy site, and medial-lateral location. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Preliminary evidence of early bone resorption in a sheep model of acute burn injury: an observational study.

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Klein, Gordon L; Xie, Yixia; Qin, Yi-Xian; Lin, Liangjun; Hu, Minyi; Enkhbaatar, Perenlei; Bonewald, Lynda F

2014-03-01

Treatment with bisphosphonates within the first 10 days of severe burn injury completely prevents bone loss. We therefore postulated that bone resorption occurs early post burn and is the primary explanation for acute bone loss in these patients. Our objective was to assess bone for histological and biomechanical evidence of early resorption post burn. We designed a randomized controlled study utilizing a sheep model of burn injury. Three sheep received a 40 % total body surface area burn under isoflurane anesthesia, and three other sheep received cotton-smoke inhalation and served as control. Burned sheep were killed 5 days post procedure and controls were killed 2 days post procedure. Backscatter scanning electron microscopy was performed on iliac crests obtained immediately postmortem along with quantitative histomorphometry and compression testing to determine bone strength (Young's modulus). Blood ionized Ca was also determined in the first 24 h post procedure as was urinary CTx. Three of three sheep killed at 5 days had evidence of scalloping of the bone surface, an effect of bone resorption, whereas none of the three sheep killed at 2 days post procedure had scalloping. One of the three burned sheep killed at 5 days showed quantitative doubling of the eroded surface and halving of the bone volume compared to sham controls. Mean values of Young's modulus were approximately one third lower in the burned sheep killed at 5 days compared to controls, p = 0.08 by unpaired t test, suggesting weaker bone. These data suggest early post-burn bone resorption. Urine CTx normalized to creatinine did not differ between groups at 24 h post procedure because the large amounts of fluids received by the burned sheep may have diluted urine creatinine and CTx and because the urine volume produced by the burned sheep was threefold that of the controls. We calculated 24 h urinary CTx excretion, and with this calculation CTx excretion/24 h in the burned sheep was

Prescribed burning in ponderosa pine: fuel reductions and redistributing fuels near boles to prevent injury

Science.gov (United States)

Prescribed burning can be an effective tool for thinning forests and reducing fuels to lessen wildfire risks. However, prescribed burning sometimes fails to substantially reduce fuels and sometimes damages/kills valuable, large trees. This study compared fuel reductions between fall and spring pre...

Burns and military clothing.

Science.gov (United States)

McLean, A D

2001-02-01

Burn injury is a ubiquitous threat in the military environment. The risks during combat are well recognised, but the handling of fuel, oil, munitions and other hot or flammable materials during peacetime deployment and training also imposes an inherent risk of accidental burn injury. Over the last hundred years, the burn threat in combat has ranged from nuclear weapons to small shoulder-launched missiles. Materials such as napalm and white phosphorus plainly present a risk of burn, but the threat extends to encompass personnel in vehicles attacked by anti-armour weapons, large missiles, fuel-air explosives and detonations/conflagrations on weapons platforms such as ships. Large numbers of burn casualties were caused at Pearl Harbor, in Hiroshima and Nagasaki, Vietnam, during the Arab/Israeli Wars and in the Falkland Islands conflict. The threat from burns is unlikely to diminish, indeed new developments in weapons seek to exploit the vulnerability of the serviceman and servicewoman to burns. Clothing can be a barrier to some types of burn--both inherently in the properties of the material, but also by trapping air between clothing layers. Conversely, ignition of the clothing may exacerbate a burn. There is hearsay that burnt clothing products within a wound may complicate the clinical management, or that materials that melt (thermoplastic materials) should not be worn if there is a burn threat. This paper explores the incidence of burn injury, the mechanisms of heat transfer to bare skin and skin covered by materials, and the published evidence for the complication of wound management by materials. Even light-weight combat clothing can offer significant protection to skin from short duration flash burns; the most vulnerable areas are the parts of the body not covered--face and hands. Multilayered combat clothing can offer significant protection for short periods from engulfment by flames; lightweight tropical wear with few layers offers little protection. Under

Terminal Maturation of Orthochromatic Erythroblasts Is Impaired in Burn Patients.

Science.gov (United States)

Hasan, Shirin; Mosier, Michael J; Conrad, Peggie; Szilagyi, Andrea; Gamelli, Richard L; Muthumalaiappan, Kuzhali

2018-02-20

Mechanisms of erythropoietin (Epo)-resistant anemia in burn patients are poorly understood. We have recently found that administering a nonselective beta 1,2-adrenergic blocker propranolol (PR) was effective in reversing myelo-erythroid commitment through MafB regulation and increase megakaryocyte erythrocyte progenitors in burn patients' peripheral blood mononuclear cell (PBMC)-derived ex vivo culture system. Having known that Epo-dependent proliferation of early erythroblasts is intact after burn injury, here we inquired whether or not Epo-independent maturation stage of erythropoiesis is affected by burn injury and the relative role of PR on late-stage erythropoiesis. While majority of erythropoiesis occurs in the bone marrow, maturation into reticulocytes is crucial for their release into sinusoids to occupy the peripheral circulation for which enucleation is vital. peripheral blood mononuclear cells (PBMCs) from burn patients were extended beyond commitment and proliferation stages to late maturation stage in ex vivo culture to understand the role of PR in burn patients. Burn impedes late maturation of orthochromatic erythroblasts into reticulocytes by restricting the enucleation step. Late-stage erythropoiesis is impaired in burn patients irrespective of PR treatment. Further, substituting the microenvironment with control plasma (homologous) in place of autologous plasma rescues the conversion of orthochromatic erythroblasts to reticulocytes. Results show promise in formulating interventions to regulate late-stage erythropoiesis, which can be used in combination with PR to reduce the number of transfusions.

Burn related mortality in Greater Manchester: 11-year review of Regional Coronial Department Data.

Science.gov (United States)

Hussain, Amer; Dunn, Ken

2015-03-01

The Coroners Department (CD) records hold important demographic, injury and death details for victims of burn injuries derived from various sources yet this rich source of data has been infrequently utilised previously in describing the epidemiology of burn related mortality. The aim of this study was to use CD data to comprehensively investigate burn related mortality in the Greater Manchester region of United Kingdom. A retrospective study design was used to collect data for deceased demographics, injury details, site of death and cause of death from four CD offices in GM over an 11-year period (2000-2010 inclusive). Office of National Statistics (ONS) population metrics were used to calculate age- and gender-specific population denominators and mortality rates. Index of Multiple Deprivation (IMD) was used to correlate mortality with deprivation. Linear regression and Pearson's/Spearman's rank correlation were used to calculate trends and correlations. Poisson regression was used to calculate relative risk (IRR) between age- and gender groups. There were 314 recorded deaths in the region over the study period and thermal injury was 3-times less likely to result in death in 2010 compared to 2000. The largest proportion of these deaths (24.8%) was comprised of individuals ≥75 years in age. The relative risk of mortality in males was nearly 1.5-times higher and a significant majority of victims (77%) sustained their burn injury at their own home/residence. Inhalation injury without cutaneous burns was the most frequent type of injury (33%) and accidental house fires caused nearly half (49%) the injuries resulting in death. Sixty-five percent of deaths during this period were recorded to have occurred outside of regional burn service (RBS) hospitals and the commonest cause of immediate death on the death certificates was "inhalation of products of combustion" (32.1%). Within the >75 years age group the risk of death significantly increased with every quintile

Epidermal-dermal crosstalk during burn wound scar maturation

NARCIS (Netherlands)

T.E. Hakvoort (Eveline)

1999-01-01

textabstractBurn injuries arc among the worst traumas which can happen to man. The larger a burn injury, the more severe the consequences and the highcr the chance of an adverse outcome or even death. In The Netherlands each year 40,000 people visit a general practitioner for treatment of a burn

Major Full Skin Thickness Burn Injuries in an Infant due to an Incubator: A Case Report

Directory of Open Access Journals (Sweden)

Ilhan Ciftci

2011-06-01

We conclude that in neonates and infants, relatively low temperatures may cause deep burn injuries. We therefore recommend the delivery of preterm childbirths at well equipped facilities with staff who are qualified to nurse premature neonates. [J Contemp Med 2011; 1(2.000: 85-88

Evaluating the superiority of honey over silver sulphadiazine dressing in shortening healing duration of burn injury: an evidence-based case report

OpenAIRE

Sandy S. Sopandi

2013-01-01

Background: Burn injury is a global health problem associated with major morbidity and mortality. Honey has long been used in wound management due to its ability to accelerate healing rates and prevent infection. This study is conducted to evaluate the efficacy of honey dressing in shortening healing duration of burn injury compared to silver sulphadiazine (SSD).Methods: A PubMed and Proquest database search was conducted to identify relevant studies. The studies were then appraised and ranke...

Pediatric burn rehabilitation: Philosophy and strategies

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Shohei Ohgi

2013-09-01

Full Text Available Burn injuries are a huge public health issue for children throughout the world, with the majority occurring in developing countries. Burn injuries can leave a pediatric patient with severely debilitating and deforming contractures, which can lead to significant disability when left untreated. Rehabilitation is an essential and integral part of pediatric burn treatment. The aim of this article was to review the literature on pediatric burn rehabilitation from the Medline, CINAHL, and Web of Science databases. An attempt has been made to present the basic aspects of burn rehabilitation, provide practical information, and discuss the goals and conceptualization of rehabilitation as well as the development of rehabilitation philosophy and strategies.

Reasons for Distress Among Burn Survivors at 6, 12, and 24 Months Postdischarge: A Burn Injury Model System Investigation.

Science.gov (United States)

Wiechman, Shelley A; McMullen, Kara; Carrougher, Gretchen J; Fauerbach, Jame A; Ryan, Colleen M; Herndon, David N; Holavanahalli, Radha; Gibran, Nicole S; Roaten, Kimberly

2017-12-16

To identify important sources of distress among burn survivors at discharge and 6, 12, and 24 months postinjury, and to examine if the distress related to these sources changed over time. Exploratory. Outpatient burn clinics in 4 sites across the country. Participants who met preestablished criteria for having a major burn injury (N=1009) were enrolled in this multisite study. Participants were given a previously developed list of 12 sources of distress among burn survivors and asked to rate on a 10-point Likert-type scale (0=no distress to 10=high distress) how much distress each of the 12 issues was causing them at the time of each follow-up. The Medical Outcomes Study 12-Item Short-Form Health Survey was administered at each time point as a measure of health-related quality of life. The Satisfaction With Appearance Scale was used to understand the relation between sources of distress and body image. Finally, whether a person returned to work was used to determine the effect of sources of distress on returning to employment. It was encouraging that no symptoms were worsening at 2 years. However, financial concerns and long recovery time are 2 of the highest means at all time points. Pain and sleep disturbance had the biggest effect on ability to return to work. These findings can be used to inform burn-specific interventions and to give survivors an understanding of the temporal trajectory for various causes of distress. In particular, it appears that interventions targeted at sleep disturbance and high pain levels can potentially effect distress over financial concerns by allowing a person to return to work more quickly. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Sedation and Analgesia in Burn

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Özkan Akıncı

2011-07-01

Full Text Available Burn injury is one of the most serious injuries that mankind may face. In addition to serious inflammation, excessive fluid loss, presence of hemodynamic instability due to intercurrent factors such as debridements, infections and organ failure, very different levels and intensities of pain, psychological problems such as traumatic stress disorder, depression, delirium at different levels that occur in patient with severe burn are the factors which make it difficult to provide the patient comfort. In addition to a mild to moderate level of baseline permanent pain in burn patients, which is due to tissue damage, there is procedural pain as well, which occurs by treatments such as grafting and dressings, that are severe, short-term burst style 'breakthrough' pain. Movement and tactile stimuli are also seen in burn injury as an effect to sensitize the peripheral and central nervous system. Even though many burn centers have established protocols to struggle with the pain, studies show that pain relief still inadequate in burn patients. Therefore, the treatment of burn pain and the prevention of possible emergence of future psychiatric problems suc as post-traumatic stress disorder, the sedative and anxiolytic agents should be used as a recommendation according to the needs and hemodynamic status of individual patient. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 26-30

Air-freshener burns: a new paradigm in burns etiology?

Science.gov (United States)

Sarwar, Umran; Nicolaou, M; Khan, M S; Tiernan, E

2011-10-01

We report a rare case of burns following the use of automated air-fresheners. We present a case report with a brief overview of the literature relating to burns associated with air-fresheners. The mechanism and treatment of these types of injuries are also described. A 44 year-old female was admitted under the care of the burns team following burns secondary to an exploding air-freshener canister. The patient sustained burns to the face, thorax and arms resulting in a seven-day hospital admission. The burns were treated conservatively. To our knowledge this is one of the few documented cases of burns as a result of air-fresheners. As they become more ubiquitous, we anticipate the incidence of such cases to increase. As such, they pose a potential public health concern on a massive scale.

Simvastatin Treatment Improves Survival in a Murine Model of Burn Sepsis

Science.gov (United States)

Beffa, David C; Fischman, Alan J.; Fagan, Shawn P.; Hamrahi, Victoria F.; Kaneki, Masao; Yu, Yong-Ming; Tompkins, Ronald G.; Carter, Edward A.

2014-01-01

Infection is the most common and most serious complication of a major burn injury related to burn size. Despite improvements in antimicrobial therapies sepsis still accounts for 50–60% of deaths in burn patients. Given the acute onset and unpredictable nature of sepsis, primary prevention was rarely attempted in its management. However, recent studies have demonstrated that statin treatment can decrease mortality is a murine model of sepsis by preservation of cardiac function and reversal of inflammatory alterations. In addition, it has been shown that treatment with statins is associated with reduced incidence of sepsis in human patients. In the current study groups of CD1 male mice (n=12) were anesthetized and subjected to a dorsal 30% TBSA scald burn injury. Starting 2 hours post burn, the animals were divided into a treatment group receiving 0.2 µ/g simvastatin or a sham group receiving placebo. Simvastatin and placebo were administered by intraperitoneal injection with two dosing regimens; once daily and every 12 hours. On Post burn day 7 cecal ligation and puncture with a 21-gauge needle was performed under ketamine/xylazine anesthesia and the two different dosing schedules were continued. A simvastatin dose dependant improvement in survival was observed in the burn sepsis model. PMID:21145172

Understanding burn injuries in Aboriginal and Torres Strait Islander children: protocol for a prospective cohort study.

Science.gov (United States)

Ivers, Rebecca Q; Hunter, Kate; Clapham, Kathleen; Coombes, Julieann; Fraser, Sarah; Lo, Serigne; Gabbe, Belinda; Hendrie, Delia; Read, David; Kimble, Roy; Sparnon, Anthony; Stockton, Kellie; Simpson, Renee; Quinn, Linda; Towers, Kurt; Potokar, Tom; Mackean, Tamara; Grant, Julian; Lyons, Ronan A; Jones, Lindsey; Eades, Sandra; Daniels, John; Holland, Andrew J A

2015-10-13

Although Aboriginal and Torres Strait Islander children in Australia have higher risk of burns compared with non-Aboriginal children, their access to burn care, particularly postdischarge care, is poorly understood, including the impact of care on functional outcomes. The objective of this study is to describe the burden of burns, access to care and functional outcomes in Aboriginal and Torres Strait Islander children in Australia, and develop appropriate models of care. All Aboriginal and Torres Strait Islander children aged under 16 years of age (and their families) presenting with a burn to a tertiary paediatric burn unit in 4 Australian States (New South Wales (NSW), Queensland, Northern Territory (NT), South Australia (SA)) will be invited to participate. Participants and carers will complete a baseline questionnaire; follow-ups will be completed at 3, 6, 12 and 24 months. Data collected will include sociodemographic information; out of pocket costs; functional outcome; and measures of pain, itch and scarring. Health-related quality of life will be measured using the PedsQL, and impact of injury using the family impact scale. Clinical data and treatment will also be recorded. Around 225 participants will be recruited allowing complete data on around 130 children. Qualitative data collected by in-depth interviews with families, healthcare providers and policymakers will explore the impact of burn injury and outcomes on family life, needs of patients and barriers to healthcare; interviews with families will be conducted by experienced Aboriginal research staff using Indigenous methodologies. Health systems mapping will describe the provision of care. The study has been approved by ethics committees in NSW, SA, NT and Queensland. Study results will be distributed to community members by study newsletters, meetings and via the website; to policymakers and clinicians via policy fora, presentations and publication in peer-reviewed journals. Published by the BMJ

Suicide by burning: epidemiological and clinical profiles.

Science.gov (United States)

Theodorou, Panagiotis; Phan, Vu T Q; Weinand, Christian; Maegele, Marc; Maurer, Christoph A; Perbix, Walter; Leitsch, Sebastian; Lefering, Rolf; Spilker, Gerald

2011-04-01

Self-immolation constitutes a rare form of suicide in developed countries, though it accounts for unique injury characteristics in the burn intensive care unit. The aim of this study was to present the epidemiological and clinical features of patients burned during a suicidal attempt seen in a North Rhine-Westphalia burn intensive care unit (BICU). To address this aim, we undertook a 21-year retrospective study involving patients with thermal injuries admitted to the largest burn unit in Germany. A total of 125 suicide-related burn victims were identified in the study period (9.4%). Comparing the self-immolation group with the rest burn patient cohort, suicide victims were more likely to be single and to act under the influence of alcohol. The suicidal group had a larger extent of burns, higher incidence of inhalation injury, required more surgical procedures, catecholamines, blood transfusions, and a longer BICU stay. Their clinical course was complicated by prolonged intubation period, higher rate of multiple drug-resistant bacteria acquisition and sepsis, leading to a higher mortality rate. Although the proportion of self-immolation victims among all burned patients is not high, the markedly higher severity of their burns and their poorer quality of outcomes makes them an important clinical subgroup for further study.

Plasma NGAL predicts early acute kidney injury no earlier than s-creatinine or cystatin C in severely burned patients.

Science.gov (United States)

Rakkolainen, Ilmari; Vuola, Jyrki

2016-03-01

Neutrophil gelatinase-associated lipocalin (NGAL) is a novel biomarker used in acute kidney injury (AKI) diagnostics. Studies on burn patients have highlighted it as a promising biomarker for early detection of AKI. This study was designed to discover whether plasma NGAL is as a biomarker superior to serum creatinine and cystatin C in detecting AKI in severely burned patients. Nineteen subjects were enrolled from March 2013 to September 2014 in the Helsinki Burn Centre. Serum creatinine, cystatin C, and plasma NGAL were collected from the patients at admission and every 12h during the first 48h and thereafter daily until seven days following admission. AKI was defined by acute kidney injury network criteria. Nine (47%) developed AKI during their intensive care unit stay and two (11%) underwent renal replacement therapy. All biomarkers were significantly higher in the AKI group but serum creatinine- and cystatin C values reacted more rapidly to changes in kidney function than did plasma NGAL. Plasma NGAL tended to rise on average 72h±29h (95% CI) later in patients with early AKI than did serum creatinine. Area-under-the-curve values calculated for each biomarker were 0.92 for serum creatinine, 0.87 for cystatin C, and 0.62 for plasma NGAL predicting AKI by the receiver-operating-characteristic method. This study demonstrated serum creatinine and cystatin C as faster and more reliable biomarkers than plasma NGAL in detecting early AKI within one week of injury in patients with severe burns. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Pediatric Thermal Burns and Treatment: A Review of Progress and Future Prospects

Directory of Open Access Journals (Sweden)

Elton Mathias

2017-12-01

Full Text Available Burn injuries are a devastating critical care problem. In children, burns continue to be a major epidemiologic problem around the globe resulting in significant morbidity and death. Apparently, treating these burn injuries in children and adults remains similar, but there are significant physiological and psychological differences. The dermal layer of the skin is generally thinner in neonates, infants, and children than in adults. Enhanced evaporative loss and need for isotonic fluids increases the risk of hypothermia in the pediatric population. The pain management of the children with major burns challenges the skills of the personnel of every unit. Managing these wounds requires intensive therapeutic treatment for multi-organ dysfunction, and surgical treatment to prevent sepsis and other complications that further delay wound closure. Alternatives to the practice of donor site harvest and autografting for the treatment of severe burns and other complex skin defects are urgently needed for both adult and pediatric populations. This review article focuses on thermal burn pathophysiology and pain management and provides an overview of currently approved products used for the treatment of pediatric burn wounds. A new promising approach has been presented as a first-line therapy in the treatment of burns to reduce surgical autografting in pediatric patients.

Patterns of burns and scalds in Mongolian children: a hospital-based prospective study.

Science.gov (United States)

Gerelmaa, Gunsmaa; Tumen-Ulzii, Badarch; Nakahara, Shinji; Ichikawa, Masao

2018-03-01

To describe the circumstances of burn injury occurrence among Mongolian children and the products involved. Study participants were children aged 15 years and younger who were admitted to the Burn Unit of the National Trauma Orthopedic Research Center from August 2015 to July 2016. We collected data on participant demographics and the aetiology and clinical features of their burn injuries, and we analysed the data based on the NOMESCO Classification model. Of 906 children, 83% were aged 0-3 years, 66% were injured around the cooking area in the traditional tent-like dwelling called a ger or a detached house where no specified kitchen exists, and 28% were injured in a kitchen. Burn injuries resulted mostly from exposure to overflowing hot liquids (93%). Electric pots and electric kettles were the products most frequently involved in causing burn injuries (41% and 14%, respectively). Of 601 major burn injuries, 52% were due to electric pots. Moreover, burn injuries inflicted by electric pots were most likely to be major burn injuries (83%). Children typically fell into electric pots, while electric kettles were often pulled down by children. Burn injuries among Mongolian children mainly occurred in cooking area of a ger involving electric pots. The current practice of cooking on the floor should be reconsidered for child burn prevention. © 2018 John Wiley & Sons Ltd.

Pediatric superficial scald burns--reassessment of our follow-up protocol.

Science.gov (United States)

Egro, Francesco M; O'Neill, Jennifer K; Briard, Robert; Cubison, Tania C S; Kay, Alan R; Estela, Catalina M; Burge, Timothy S

2010-01-01

The most common pediatric burn injury is a superficial scald. The current follow-up protocol for such burns includes review of the patient at 2 weeks postinjury and then 2 months later. The authors decided to review the protocol to assess the need for this second follow-up. A retrospective study reviewed the case notes of patients younger than 16 years at the time of their injury presenting with a scald over 5% TBSA. The progress of healing and scar development up to 5 years follow-up was assessed. This study showed that scalds healing within 2 weeks following injury rarely became hypertrophic. A prospective study was performed over a 10-month period. All children who suffered a superficial partial-thickness scald injury were included. At the 2-week appointment, the need for further follow-up was predicted. The accuracy of this prediction was assessed 2 months later. This study showed that an experienced member of the burns team could reliably predict at 2-week appointment those children who could be safely discharged with no subsequent need for scar management. This study suggests that it will be safe to modify the follow-up protocol, reducing the number of clinic attendances.

Mouse Model of Burn Wound and Infection

DEFF Research Database (Denmark)

Calum, Henrik; Høiby, Niels; Moser, Claus

2017-01-01

The immunosuppression induced by thermal injury renders the burned victim susceptible to infection. A mouse model was developed to examine the immunosuppression, which was possible to induce even at a minor thermal insult of 6% total body surface area. After induction of the burn (48 hr) a depres......The immunosuppression induced by thermal injury renders the burned victim susceptible to infection. A mouse model was developed to examine the immunosuppression, which was possible to induce even at a minor thermal insult of 6% total body surface area. After induction of the burn (48 hr...

Dynamics of proteolytic activity of blood enzymes in combined burn and radiation injury and in its treatment with local cryoeffect and with wound closing preparation RZP-3

International Nuclear Information System (INIS)

Gertman, V.Z.

1982-01-01

The proteolytic activity of trypsine-like proteases of blood at acute injury period doesn't increase as in animals with mere burn and in animals with nure irradiation as well. It can be explained by the absence of adequate stress reaction of the organism due to the sharp decrease of organism reactivity in case of combined burn and radiation injury. Application of low temperatures and combination of cryogenic effect and RZP-3 preparation promotes proteolytic activity increase in animals with combined burn and radiation injury in the climax of radiation sickness. The normalization of the factor was observed at late periods of the investigation. It can be regarded as recovery of the organism reactivity

Telemedicine and burns: an overview.

Science.gov (United States)

Atiyeh, B; Dibo, S A; Janom, H H

2014-06-30

Access to specialized burn care is becoming more difficult and is being restricted by the decreasing number of specialized burn centers. It is also limited by distance and resources for many patients, particularly those living in poverty or in rural medically underserved communities. Telemedicine is a rapidly evolving technology related to the practice of medicine at a distance through rapid access to remote medical expertise by telecommunication and information technologies. Feasibility of telemedicine in burn care has been demonstrated by various centers. Its use facilitates the delivery of care to patients with burn injuries of all sizes. It allows delivery of acute care and can be appropriately used for a substantial portion of the long-term management of patients after a burn by guiding less-experienced surgeons to treat and follow-up patients more appropriately. Most importantly, it allows better effective triage which reduces unnecessary time and resource demanding referrals that might overwhelm system capacities. However, there are still numerous barriers to the implementation of telemedicine, including technical difficulties, legal uncertainties, limited financial support, reimbursement issues, and an inadequate evidence base of its value and efficiency.

Healthcare costs of burn patients from homes without fire sprinklers.

Science.gov (United States)

Banfield, Joanne; Rehou, Sarah; Gomez, Manuel; Redelmeier, Donald A; Jeschke, Marc G

2015-01-01

The treatment of burn injuries requires high-cost services for healthcare and society. Automatic fire sprinklers are a preventive measure that can decrease fire injuries, deaths, property damage, and environmental toxins. This study's aim was to conduct a cost analysis of patients with burn or inhalation injuries caused by residential fires and to compare this with the cost of implementing residential automatic fire sprinklers. We conducted a cohort analysis of adult burn patients admitted to our provincial burn center (1995-2012). Patient demographics and injury characteristics were collected from medical records and clinical and coroner databases. Resource costs included average cost per day at our intensive care and rehabilitation program, transportation, and property loss. During the study period, there were 1557 residential fire-related deaths province-wide and 1139 patients were admitted to our provincial burn center as a result of a flame injury occurring at home. At our burn center, the average cost was CAN$84,678 per patient with a total cost of CAN$96,448,194. All resources totaled CAN$3,605,775,200. This study shows the considerable healthcare costs of burn patients from homes without fire sprinklers.

Emergency department management of patients with thermal burns [digest].

Science.gov (United States)

Tolles, Juliana; Gupta, Nachi; Nusbaum, Jeffrey

2018-02-01

Thermal burn injuries are a significant cause of morbidity and mortality worldwide. In addition to treatment of the burns, emergency clinicians must assess for inhalation injury, exposure to toxic gases, and related traumatic injuries. Priorities for emergency resuscitation include stabilization of airway and breathing, intravenous fluid administration, pain control, and local wound care. Special populations, including children and pregnant women, require additional treatment considerations. Referral to specialized burn care for select patients is necessary to improve long-term outcomes. This article reviews thermal burn classification and evidence-based treatment strategies. [Points & Pearls is a digest of Emergency Medicine Practice.].

Burn Injury: A Challenge for Tissue Engineers

Directory of Open Access Journals (Sweden)

Yerneni LK

2009-01-01

Full Text Available Ever since man invented fire he has been more frequently burning himself by this creation than by the naturally occurring bushfires. It is estimated that over 1.152 million people in India suffer from burn injuries requiring treatment every year and majority of them are women aged between 16-40 years and most of them occur in the kitchen. The treatment for burns basically involves autologous skin grafting, which originated in India more than two thousand years ago (Sushruta Samhita, is still the gold standard for the wound resurfacing, although, autografting is difficult where graftable donor sites are limited. Although, Cadaver skin, porcine or bovine xenografts are used alternatively over the past thirty years, modern approaches like the Bioengineering of skin substitutes emerged during the past 20 years as advanced wound management technologies with no social impediment. They can be broadly categorized as Acellular and Cellular biotechnological products. The acellular products like Alloderm (LifeCell Corporation, Integra (Integra Life Sciences act like template and depend on natural regeneration, while the cellular ones are either ‘Off-the-Shelf’ products like Apligraf (Organogenesis Inc and Orcel (Ortec International have allogenic elements and ‘home grown’ autologous cell products like Cultured Epithelial Autograft (CEA and epidermal-dermal composite skin use synthetic or natural non-human matrices. The CEA is based on the ex-vivo epidermal stem cell-expansion and our laboratory has been engaged in CEA technique development with innovative cost-effective approach and yielded promising preliminary clinical success. The basic methodological approach in CEA technique which is still clinically adopted by several developed countries involves the use of growth arrested mouse dermal fibroblasts as growth supportive matrix and is thus considered a drawback as a whole. Additionally, there is no superior enough method available to augment the

The Burns Registry of Australia and New Zealand: progressing the evidence base for burn care.

Science.gov (United States)

Cleland, Heather; Greenwood, John E; Wood, Fiona M; Read, David J; Wong She, Richard; Maitz, Peter; Castley, Andrew; Vandervord, John G; Simcock, Jeremy; Adams, Christopher D; Gabbe, Belinda J

2016-03-21

Analysis of data from the Burns Registry of Australia and New Zealand (BRANZ) to determine the extent of variation between participating units in treatment and in specific outcomes during the first 4 years of its operation. BRANZ, an initiative of the Australian and New Zealand Burn Association, is a clinical quality registry developed in accordance with the Australian Commission on Safety and Quality in Healthcare national operating principles. Patients with burn injury who fulfil pre-defined criteria are transferred to and managed in designated burn units. There are 17 adult and paediatric units in Australia and New Zealand that manage almost all patients with significant burn injury. Twelve of these units treat adult patients. Data on 7184 adult cases were contributed by ten acute adult burn units to the registry between July 2010 and June 2014.Major outcomes: In-hospital mortality, hospital length of stay, skin grafting rates, and rates of admission to intensive care units. Considerable variations in unit profiles (including numbers of patients treated), in treatment and in outcomes were identified. Despite the highly centralised delivery of care to patients with severe or complex burn injury, and the relatively small number of specialist burn units, we found significant variation between units in clinical management and in outcomes. BRANZ data from its first 4 years of operation support its feasibility and the value of further development of the registry. Based on these results, the focus of ongoing research is to improve understanding of the reasons for variations in practice and of their effect on outcomes for patients, and to develop evidence-informed clinical guidelines for burn management in Australia and New Zealand.

Fabrication and hemocompatibility assessment of novel polyurethane-based bio-nanofibrous dressing loaded with honey and Carica papaya extract for the management of burn injuries

Directory of Open Access Journals (Sweden)

Balaji A

2016-09-01

-HN-PA nanofiber samples to 761.67% from 285.13% in PU. Furthermore, the ability of the bio-nanofibrous dressing to support specific protein adsorption (45%, delay thrombus formation, and reduce hemolysis demonstrated its nontoxic and compatible nature with the host tissues. In summary, the excellent physicochemical and hemocompatible properties of the developed PU-HN-PA dressing exhibit its potential in reducing the clinical complications associated with the treatment of burn injuries. Keywords: electrospinning, porous morphology, surface energy, protein adsorption

Patterns of scald injuries in children--has anything changed?

LENUS (Irish Health Repository)

Yates, J

2011-10-01

The objective was to study presentation patterns of scald injuries in children and suggest potential countermeasures to reduce these injuries. We retrospectively studied scald injuries in children attending an urban paediatric emergency department between January 1st and December 31st 2008. Data was extracted from our emergency department database using search terms \\'burn\\

Car radiator burns: a prevention issue.

Science.gov (United States)

Rabbitts, Angela; Alden, Nicole E; Conlin, Tara; Yurt, Roger W

2004-01-01

Scald burns continue to be the major cause of injury to patients admitted to the burn center. Scald burns occurring from car radiator fluid comprise a significant subgroup. Although manufacturer warning labels have been placed on car radiators, these burns continue to occur. This retrospective review looks at all patients admitted to our burn center who suffered scald burns from car radiator fluid to assess the extent of this problem. During the study period, 86 patients were identified as having suffered scald burns as a result of contact with car radiator fluid. Seventy-one percent of the burn injuries occurred in the summer months. The areas most commonly burned were the head and upper extremities. Burn prevention efforts have improved greatly over the years; however, this study demonstrates that scald burns from car radiator fluid continue to cause physical, emotional, and financial devastation. The current radiator warning labels alone are not effective. The National Highway Traffic Safety Administration has proposed a new federal motor vehicle safety standard to aid in decreasing the number of scald burns from car radiators. The results of this study were submitted to the United States Department of Transportation for inclusion in a docket for federal legislation supporting these safety measures.

Outcomes of burns in the elderly: revised estimates from the Birmingham Burn Centre.

Science.gov (United States)

Wearn, Christopher; Hardwicke, Joseph; Kitsios, Andreas; Siddons, Victoria; Nightingale, Peter; Moiemen, Naiem

2015-09-01

Outcomes after burn have continued to improve over the last 70 years in all age groups including the elderly. However, concerns have been raised that survival gains have not been to the same magnitude in elderly patients compared to younger age groups. The aims of this study were to analyze the recent outcomes of elderly burn injured patients admitted to the Birmingham Burn Centre, compare data with a historical cohort and published data from other burn centres worldwide. A retrospective review was conducted of all patients ≥65 years of age, admitted to our centre with cutaneous burns, between 2004 and 2012. Data was compared to a previously published historical cohort (1999-2003). 228 patients were included. The observed mortality for the study group was 14.9%. The median age of the study group was 79 years, the male to female ratio was 1:1 and median Total Body Surface Area (TBSA) burned was 5%. The incidence of inhalation injury was 13%. Median length of stay per TBSA burned for survivors was 2.4 days/% TBSA. Mortality has improved in all burn size groups, but differences were highly statistically significant in the medium burn size group (10-20% TBSA, p≤0.001). Burn outcomes in the elderly have improved over the last decade. This reduction has been impacted by a reduction in overall injury severity but is also likely due to general improvements in burn care, improved infrastructure, implementation of clinical guidelines and increased multi-disciplinary support, including Geriatric physicians. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Factors Associated With Length of Stay and Hospital Charges among Pediatric Burn Injury in Kermanshah, West of Iran

Directory of Open Access Journals (Sweden)

Satar Rezaei

2015-01-01

This study highlights that the independent predictors affecting hospital costs and LOS associated with pediatric burn injury in Kermanshah. Also, our study indicates the BBS was the main factors affecting hospital costs and LOS for the study population. 

Five-year experience with burns from glass fireplace doors in the pediatric population.

Science.gov (United States)

Baryza, Mary Jo; Hinson, Michelle; Conway, Jennifer; Ryan, Colleen M

2013-01-01

Burns from contact with glass doors of gas fireplaces have been previously reported. The purpose of this study is to examine the incidence and severity of this injury in our population. Patients were identified for inclusion in the retrospective chart review study using the National Trauma Registry of the American College of Surgeons (NTRACS) and our local outpatient database. Criteria for inclusion were burn injuries sustained from contact with fireplace glass doors treated at our pediatric burn center from 2007 through 2011. Fifty children met these criteria, including two children whose burns were caused by electric fireplace glass doors. BSA burned was 1.5 ± 1.5% (mean ± SD), range 0.5 to 10%. Age was 27.2 ± 27.3 months, range 8 months to 13 years. Forty-five children (90%) had hand burns; of these, 18 children had bilateral hand involvement. Facial burns were found in three children (6%), and eight children (16%) had other areas burned. One patient developed cellulitis. Two patients required surgery. Six children (12%) required hospitalization; mean length of stay was 5.8 ± 5 days, range 1 to 5 days. Although the number of inpatient admissions was relatively few, 329 outpatient visits and 309 rehabilitation visits were required for treatment of these children. Nineteen patients (38%) required splints and six patients (12%) required scar treatment with pressure garments. Burns from contact with fireplace glass doors are a recurring problem. Toddlers are most at risk. Directed preventive strategies including parent education, safety warnings, and design modifications such as temperature sensors and barrier screens could be potentially helpful in reducing the incidence of this injury.

Clothing Flammability and Burn Injuries: Public Opinion Concerning an Overlooked, Preventable Public Health Problem.

Science.gov (United States)

Frattaroli, Shannon; Spivak, Steven M; Pollack, Keshia M; Gielen, Andrea C; Salomon, Michele; Damant, Gordon H

2016-01-01

The objective of this study was to describe knowledge of clothing flammability risk, public support for clothing flammability warning labels, and stronger regulation to reduce the risk. As part of a national survey of homeowners about residential sprinkler systems, the authors included questions about clothing flammability. The authors used an online web panel to sample homeowners and descriptive methods to analyze the resulting data. The sample included 2333 homeowners. Knowledge of clothing flammability and government oversight of clothing flammability risk was low. Homeowners were evenly split about the effectiveness of current standards; however, when presented with clothing-related burn injury and death data, a majority (53%) supported stricter standards. Most homeowners (64%) supported warning labels and indicated that such labels would either have no effect on their purchasing decisions (64%) or be an incentive (24%) to purchase an item. Owners of sprinkler-equipped homes were more likely to support these interventions than owners of homes without sprinkler systems. Public knowledge about clothing flammability risks is low. Most homeowners supported clothing labels to inform consumers of this risk and increased government intervention to reduce the risk.

Pediatric burns: Kids' Inpatient Database vs the National Burn Repository.

Science.gov (United States)

Soleimani, Tahereh; Evans, Tyler A; Sood, Rajiv; Hartman, Brett C; Hadad, Ivan; Tholpady, Sunil S

2016-04-01

Burn injuries are one of the leading causes of morbidity and mortality in young children. The Kids' Inpatient Database (KID) and National Burn Repository (NBR) are two large national databases that can be used to evaluate outcomes and help quality improvement in burn care. Differences in the design of the KID and NBR could lead to differing results affecting resultant conclusions and quality improvement programs. This study was designed to validate the use of KID for burn epidemiologic studies, as an adjunct to the NBR. Using the KID (2003, 2006, and 2009), a total of 17,300 nonelective burn patients younger than 20 y old were identified. Data from 13,828 similar patients were collected from the NBR. Outcome variables were compared between the two databases. Comparisons revealed similar patient distribution by gender, race, and burn size. Inhalation injury was more common among the NBR patients and was associated with increased mortality. The rates of respiratory failure, wound infection, cellulitis, sepsis, and urinary tract infection were higher in the KID. Multiple regression analysis adjusting for potential confounders demonstrated similar mortality rate but significantly longer length of stay for patients in the NBR. Despite differences in the design and sampling of the KID and NBR, the overall demographic and mortality results are similar. The differences in complication rate and length of stay should be explored by further studies to clarify underlying causes. Investigations into these differences should also better inform strategies to improve burn prevention and treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

Epidemiology of operative burns at Kijabe Hospital from 2006 to 2010: pilot study of a web-based tool for creation of the Kenya Burn Repository.

Science.gov (United States)

Dale, Elizabeth L; Mueller, Melissa A; Wang, Li; Fogerty, Mary D; Guy, Jeffrey S; Nthumba, Peter M

2013-06-01

In order to implement effective burn prevention strategies, the WHO has called for improved data collection to better characterize burn injuries in low and middle income countries (LMIC). This study was designed to gather information on burn injury in Kenya and to test a model for such data collection. The study was designed as a retrospective case series study utilizing an electronic data collection tool to assess the scope of burn injuries requiring operation at Kijabe Hospital from January 2006 to May 2010. Data were entered into a web-based tool to test its utility as the potential Kenya Burn Repository (KBR). 174 patients were included. The median age was 10 years. There was a male predominance (59% vs. 41%). Findings included that timing of presentation was associated with burn etiology (p=0.009). Length of stay (LOS) was associated with burn etiology (pBurn injuries in Kenya show similarities with other LMIC in etiology and pediatric predominance. Late presentation for care and prolonged LOS are areas for further investigation. The web-based database is an effective tool for data collection and international collaboration. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

Burn Injury Caused by Laptop Computers

African Journals Online (AJOL)

generated in central processing unit (CPU), graphics processing unit, hard drive, internal ... change its position. Discussion ... Suzuki, et al. reported that the critical temperature for superficial burn was 37.8°C, for deep dermal burns 41.9°C and ... The laptop should be placed on a hard surface and not on soft surfaces like.

Modulation of inflammatory and catabolic responses in severely burned children by early burn wound excision in the first 24 hours

NARCIS (Netherlands)

Barret, JP; Herndon, DN

Hypothesis: Early burn wound excision modulates the hypermetabolic response in severe pediatric burn injuries. Design: Before-after trial. Setting: A 30-bed burn referral center in a private, university-affiliated hospital. Methods: We studied 35 severely burned children who were divided into 2

Pediatric Burns from Glass-Fronted Fireplaces in Canada: A Growing Issue Over the Past 20 Years.

Science.gov (United States)

Toor, Jay; Crain, Jennifer; Kelly, Charis; Verchere, Cindy; Fish, Joel

2016-01-01

There is an alarming lack of public awareness surrounding the safety of glass-fronted fireplaces. This has resulted in an active campaign from the American Burn Association Prevention Committee. One issue encountered while advocating for prevention among manufacturers is the lack of corroborating and accurate data. The purpose of this study was to examine the annual trends and epidemiology of glass-fronted fireplace-related burn injuries to children less than 15 years old, who presented to Canadian emergency departments between 1990 and 2010. Records of pediatric burn injuries related to glass-fronted fireplaces were extracted from the Canadian Hospitals Injury Reporting and Prevention Program database for the study period (1990-2010). Cases were analyzed in terms of anatomic area affected, demographics, seasonality, safety device use, and injury severity. A total of 616 cases of burns from glass-fronted fireplaces were identified. The incidence increased at an average of 2.7 cases per year. This is a greater than 20-fold increase over 20 years. Seventy-five percentage of the cases occurred in children less than 2 years, and 95% occurred in children less than 5 years. The study demonstrated a growing risk from glass-fronted fireplace burns, likely due to the increasing popularity of household gas fireplace units. These units are a particular risk to children less than 2 years, attributable to their developing mobility and reduced reaction time. This is a preventable injury that should be addressed through changes to legislation and manufacturing.

Perineal burn contractures: An experience in tertiary hospital of a Himalayan state

Directory of Open Access Journals (Sweden)

Thakur Jagdeep

2008-01-01

Full Text Available Perineal burn contracture is a rare burn sequel. We conducted a retrospective analysis of cases with perineal burn contractures managed in a tertiary care centre of a Himalayan state. We found that all cases sustained burn injury from burning firewood and the time of presentation was two to six years after the burn injury. We analyzed our treatment method and have classified these contractures into two types.

Satisfaction with life after burn: A Burn Model System National Database Study.

Science.gov (United States)

Goverman, J; Mathews, K; Nadler, D; Henderson, E; McMullen, K; Herndon, D; Meyer, W; Fauerbach, J A; Wiechman, S; Carrougher, G; Ryan, C M; Schneider, J C

2016-08-01

While mortality rates after burn are low, physical and psychosocial impairments are common. Clinical research is focusing on reducing morbidity and optimizing quality of life. This study examines self-reported Satisfaction With Life Scale scores in a longitudinal, multicenter cohort of survivors of major burns. Risk factors associated with Satisfaction With Life Scale scores are identified. Data from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) Burn Model System (BMS) database for burn survivors greater than 9 years of age, from 1994 to 2014, were analyzed. Demographic and medical data were collected on each subject. The primary outcome measures were the individual items and total Satisfaction With Life Scale (SWLS) scores at time of hospital discharge (pre-burn recall period) and 6, 12, and 24 months after burn. The SWLS is a validated 5-item instrument with items rated on a 1-7 Likert scale. The differences in scores over time were determined and scores for burn survivors were also compared to a non-burn, healthy population. Step-wise regression analysis was performed to determine predictors of SWLS scores at different time intervals. The SWLS was completed at time of discharge (1129 patients), 6 months after burn (1231 patients), 12 months after burn (1123 patients), and 24 months after burn (959 patients). There were no statistically significant differences between these groups in terms of medical or injury demographics. The majority of the population was Caucasian (62.9%) and male (72.6%), with a mean TBSA burned of 22.3%. Mean total SWLS scores for burn survivors were unchanged and significantly below that of a non-burn population at all examined time points after burn. Although the mean SWLS score was unchanged over time, a large number of subjects demonstrated improvement or decrement of at least one SWLS category. Gender, TBSA burned, LOS, and school status were associated with SWLS scores at 6 months

Predictors of muscle protein synthesis after severe pediatric burns.

Science.gov (United States)

Diaz, Eva C; Herndon, David N; Lee, Jinhyung; Porter, Craig; Cotter, Matthew; Suman, Oscar E; Sidossis, Labros S; Børsheim, Elisabet

2015-04-01

Following a major burn, skeletal muscle protein synthesis rate increases but is often insufficient to compensate for massively elevated muscle protein breakdown rates. Given the long-term nature of the pathophysiologic response to burn injury, we hypothesized that muscle protein synthesis rate would be chronically elevated in severely burned children. The objectives of this study were to characterize muscle protein synthesis rate of burned children over a period of 24 months after injury and to identify predictors that influence this response. A total of 87 children with 40% or greater total body surface area (TBSA) burned were included. Patients participated in stable isotope infusion studies at 1, 2, and approximately 4 weeks after burn and at 6, 12, and 24 months after injury to determine skeletal muscle protein fractional synthesis rate. Generalized estimating equations with log link normal distribution were applied to account for clustering of patients and control for patient characteristics. Patients (8 ± 6 years) had large (62, 51-72% TBSA) and deep (47% ± 21% TBSA third degree) burns. Muscle protein fractional synthesis rate was elevated throughout the first 12 months after burn compared with established values from healthy young adults. Muscle protein fractional synthesis rate was lower in boys, in children older than 3 years, and when burns were greater than 80% TBSA. Muscle protein synthesis is elevated for at least 1 year after injury, suggesting that greater muscle protein turnover is a component of the long-term pathophysiologic response to burn trauma. Muscle protein synthesis is highly affected by sex, age, and burn size in severely burned children. These findings may explain the divergence in net protein balance and lean body mass in different populations of burn patients. Prognostic study, level III.

Sustained high incidence of injuries from burns in a densely populated urban slum in Kenya: an emerging public health priority.

Science.gov (United States)

Wong, Joshua M; Nyachieo, Dhillon O; Benzekri, Noelle A; Cosmas, Leonard; Ondari, Daniel; Yekta, Shahla; Montgomery, Joel M; Williamson, John M; Breiman, Robert F

2014-09-01

Ninety-five percent of burn deaths occur in low- and middle-income countries (LMICs); however, longitudinal household-level studies have not been done in urban slum settings, where overcrowding and unsafe cook stoves may increase likelihood of injury. Using a prospective, population-based disease surveillance system in the urban slum of Kibera in Kenya, we examined the incidence of household-level burns of all severities from 2006-2011. Of approximately 28,500 enrolled individuals (6000 households), we identified 3072 burns. The overall incidence was 27.9/1000 person-years-of-observation. Children slums rapidly increases in many African countries, characterizing and addressing the rising burden of burns is likely to become a public health priority. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Electrical burns in sports fishing: a case report.

Science.gov (United States)

Valença-Filipe, R; Egipto, P; Horta, R; Braga, J M; Costa, J; Silva, A

2014-11-01

Electrical burns are among the most devastating types of burns, with wide-ranging injuries. They can sometimes occur in the context of fishing, usually involving high voltages. The authors present the case of a 59-year-old-man who suffered a sports accident during a fishing competition, with the formation of an electrical arc due to proximity of the fishing rod and high voltage cables. He presented burns affecting 3% of TBSA, third degree deep burns on trunk and left hand; no signs of cardiac injury. He was admitted to our Burn Unit for monitoring, care dressing and surgical treatment; complete wound healing was achieved after 24 days. Due to its relatively small share among burns, published data on electrical injuries and fishing remain scarce, and differ in patient collectives due to infrastructural or environmental differences. The authors are not aware of published specific reports on electrical burns in sports fishing practice, like the case here presented. The authors want to alert for potential medical, social and economic consequences of this type of sports accidents that could be entirely avoidable with some preventive measures. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Management of acid burns: experience from Bangladesh.

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Das, Kishore Kumar; Olga, Loren; Peck, Michael; Morselli, Paolo G; Salek, A J M

2015-05-01

Acid burn injuries in Bangladesh primarily occur as a result of intentional attacks although there are incidences of accidental acid burns in industry, on the street, and at home. A total of 126 patients with acid burns, 95 from attacks and 31 from accidents, were studied from July 2004 to December 2012. A diagnosis of acid burn was made from history, physical examination and in some cases from chemical analysis of the patients' clothing. Alkali burns were excluded from the study. In the burn unit of Dhaka Medical College Hospital, we applied a slightly different protocol for management of acid burns, beginning with plain water irrigation of the wound, which effectively reduced burn depth and the requirement of surgical treatment. Application of hydrocolloid dressing for 48-72 h helped with the assessment of depth and the course of treatment. Early excision and grafting gives good results but resultant acid trickling creates a marble cake-like appearance of the wound separated by the vital skin. Excision with a scalpel and direct stitching of the wounds are often a good option. Observation of patients on follow-up revealed that wounds showed a tendency for hypertrophy. Application of pressure garments and other scar treatments were given in all cases unless the burn was highly superficial. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Impact of anesthesia, analgesia, and euthanasia technique on the inflammatory cytokine profile in a rodent model of severe burn injury.

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Al-Mousawi, Ahmed M; Kulp, Gabriela A; Branski, Ludwik K; Kraft, Robert; Mecott, Gabriel A; Williams, Felicia N; Herndon, David N; Jeschke, Marc G

2010-09-01

Anesthetics used in burn and trauma animal models may be influencing results by modulating inflammatory and acute-phase responses. Accordingly, we determined the effects of various anesthetics, analgesia, and euthanasia techniques in a rodent burn model. Isoflurane (ISO), ketamine-xylazine (KX), or pentobarbital (PEN) with or without buprenorphine were administered before scald-burn in 72 rats that were euthanized without anesthesia by decapitation after 24 h and compared with unburned shams. In a second experiment, 120 rats underwent the same scald-burn injury using KX, and 24 h later were euthanized under anesthesia or carbon dioxide (CO2). In addition, we compared euthanasia by exsanguination with that of decapitation. Serum cytokine levels were determined by an enzyme-linked immunosorbent assay. In the first experiment, ISO was associated with elevation of cytokine-induced neutrophil chemoattractant 2 (CINC-2) and monocyte chemotactic protein 1 (MCP-1), and KX and PEN was associated with elevation of CINC-1,CINC-2, IL-6, and MCP-1. Pentobarbital also decreased IL-1". IL-6 increased significantly when ISO or PEN were combined with buprenorphine. In the second experiment, euthanasia performed by exsanguination under ISO was associated with reduced levels of IL-1", CINC-1, CINC-2, and MCP-1, whereas KX reduced CINC-2 and increased IL-6 levels. Meanwhile, PEN reduced levels of IL-1" and MCP-1, and CO2 reduced CINC-2 and MCP-1. In addition,decapitation after KX, PEN, or CO2 decreased IL-1" and MCP-1, although we found no significant difference between ISO and controls. Euthanasia by exsanguination compared with decapitation using the same agent also led to modulation of several cytokines. Differential expression of inflammatory markers with the use of anesthetics and analgesics should be considered when designing animal studies and interpreting results because these seem to have a significant modulating impact. Our findings indicate that brief anesthesia with ISO

Managing burn wounds with SMARTPORE Technology polyurethane foam: two case reports.

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Imran, Farrah-Hani; Karim, Rahamah; Maat, Noor Hidayah

2016-05-12

Successful wound healing depends on various factors, including exudate control, prevention of microbial contaminants, and moisture balance. We report two cases of managing burn wounds with SMARTPORE Technology polyurethane foam dressing. In Case 1, a 2-year-old Asian girl presented with a delayed (11 days) wound on her right leg. She sustained a thermal injury from a hot iron that was left idle on the floor. Clinical inspection revealed an infected wound with overlying eschar that traversed her knee joint. As her parents refused surgical debridement under general anesthesia, hydrotherapy and wound dressing using SMARTPORE Technology Polyurethane foam were used. Despite the delay in presentation of this linear thermal pediatric burn injury that crossed the knee joint, the patient's response to treatment and its outcome were highly encouraging. She was cooperative and tolerated each dressing change without the need of supplemental analgesia. Her wound was healed by 24 days post-admission. In Case 2, a 25-year-old Asian man presented with a mixed thickness thermal flame burn on his left leg. On examination, the injury was a mix of deep and superficial partial thickness burn, comprising approximately 3% of his total body surface area. SMARTPORE Technology polyurethane foam was used on his wound; his response to the treatment was very encouraging as the dressing facilitated physiotherapy and mobility. The patient rated the pain during dressing change as 2 on a scale of 10 and his pain score remained the same in every subsequent change. His wound showed evidence of epithelialization by day 7 post-burn. There were no adverse events reported. Managing burn wounds with SMARTPORE Technology polyurethane foam resulted in reduced pain during dressing changes and the successful healing of partial and mixed thickness wounds. The use of SMARTPORE Technology polyurethane foam dressings showed encouraging results and requires further research as a desirable management option in

Tourniquet associated chemical burn

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Jae-Hyuk Yang

2012-01-01

Full Text Available Chemical burn under pneumatic tourniquet is an iatrogenic preventable injury and is rarely reported in the literature. The two important mechanisms are maceration (friction and wetness underneath the tourniquent. In this report, our experience with two illustrative patients who presented with iatrogenic tourniquet associated burn is described.

Care of the burn wound: As I do it

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Arvind Madhusudan Vartak

2016-01-01

Full Text Available Skin covers the entire body. It is the most important protective organ. Since the burn injury is most painful of all injuries, dressings play an important part of the management. Dressing of the burn wound is very essential to provide pain relief, to promote early healing, to prevent contractures, and to help early mobilization. Many workers from time immemorial have used different types of dressings so as to provide desired results. I use sterile polyethylene drape as a dressing material after covering it with the first layer of gauze soaked in silver sulfadiazine cream. The results are encouraging as there is near total absence of pain experienced by patients and removal is totally pain-free without any bleeding. There is no need for escharotomies, and there is early removal of the slough with no contracture. The polyethylene drapes are easily available in the market, easy to store, available sterile, and totally cost-effective. They help reduce the hospital stay of the patient. The need of anesthesia for surgeries such as escharotomies and debridement is significantly reduced.

Measuring the impact of a burns school reintegration programme on the time taken to return to school: A multi-disciplinary team intervention for children returning to school after a significant burn injury.

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Arshad, Sira N; Gaskell, Sarah L; Baker, Charlotte; Ellis, Nicola; Potts, Jennie; Coucill, Theresa; Ryan, Lynn; Smith, Jan; Nixon, Anna; Greaves, Kate; Monk, Rebecca; Shelmerdine, Teresa; Leach, Alison; Shah, Mamta

2015-06-01

Returning to school can be a major step for burn-injured children, their family, and staff and pupils at the receiving school. Previous literature has recognised the difficulties children may face after a significant injury and factors that may influence a successful reintegration. A regional paediatric burns service recognised that some patients were experiencing difficulties in returning to school. A baseline audit confirmed this and suggested factors that hindered or facilitated this process, initiating the development of a school reintegration programme (SRP). Since the programme's development in 2009, it has been audited annually. The aim of this paper was to evaluate the impact of the SRP by presenting data from the 2009 to 2011 audits. For the baseline audit, the burn care team gathered information from clinical records (age, gender, total body surface area burned (TBSA), skin grafting and length of stay) and telephone interviews with parents and teachers of the school returners. For the re-audits, the same information was gathered from clinical records and feedback questionnaires. Since its introduction, the mean length of time from discharge to return to school has dropped annually for those that opted into the programme, when compared to the baseline by 62.3% (53 days to 20 days). Thematic analysis highlights positive responses to the programme from all involved. Increased awareness and feeling supported were amongst the main themes to emerge. Returning to school after a significant burn injury can be challenging for all involved, but we hypothesise that outreach interventions in schools by burns services can have a positive impact on the time it takes children to successfully reintegrate. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Peripheral Neuropathy and Nerve Compression Syndromes in Burns.

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Strong, Amy L; Agarwal, Shailesh; Cederna, Paul S; Levi, Benjamin

2017-10-01

Peripheral neuropathy and nerve compression syndromes lead to substantial morbidity following burn injury. Patients present with pain, paresthesias, or weakness along a specific nerve distribution or experience generalized peripheral neuropathy. The symptoms manifest at various times from within one week of hospitalization to many months after wound closure. Peripheral neuropathy may be caused by vascular occlusion of vasa nervorum, inflammation, neurotoxin production leading to apoptosis, and direct destruction of nerves from the burn injury. This article discusses the natural history, diagnosis, current treatments, and future directions for potential interventions for peripheral neuropathy and nerve compression syndromes related to burn injury. Copyright © 2017 Elsevier Inc. All rights reserved.

Importance of proper initial treatment of moderate and major burns

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Vulović Dejan

2008-01-01

Full Text Available Background/Aim. Burns are common injuries with frequency depending on human factors, development of protection, industry and traffic, eventual wars. Organized treatment of major burn injuries has tremendous medical, social and economic importance. The aim of this study was to analyze initial treatment of major and moderate burns, to compare it with the current recommendations and to signify the importance of organized management of burns. Methods. In a prospective study 547 adult patients with major burns were analyzed, covering a period of eight years, with the emphasis on the initial hospital admission and emergency care for burns greater than 10% of total body surface area (TBSA. Results. In the different groups of major burns, the percentage of hospital admission was: 81.5 in burns greater than 10% TBSA, 37.7 in burns of the functional areas, 54.5 in the III degree burns, 81.6 in electrical burns, 55.9 in chemical burns, 61.9 in inhalation injury, 41.0 in burns in patients with the greater risk and 100 in burns with a concomitant trauma. In the group of 145 patients with burns greater than 10% TBSA, intravenous fluids were given in 87 patients, analgesics in 45, corticosteroids in 29, antibiotics in 23 and oxygen administration in 14. In the same group, wound irrigation was done in 14.4%, removing of the clothing and shoes in 29.6%, elevation of the legs in 8.9% and prevention of hypothermia in 7.6% of the victims. There were no initial estimations of burn extent (percentage of a burn, notes about the patient and injury and tetanus immunizations. Conclusion. Based on these findings, it is concluded that there should be much more initial hospital admissions of major burns, and also, necessary steps in the emergency care of burns greater than 10% TBSA should be taken more frequently. On the other side, unnecessary or wrong steps should be avoided in the initial burn treatment.

Electronic nicotine delivery system (ENDS) battery-related burns presenting to US emergency departments, 2016.

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Corey, Catherine G; Chang, Joanne T; Rostron, Brian L

2018-03-05

Currently, an estimated 7.9 million US adults use electronic nicotine delivery systems (ENDS). Although published reports have identified fires and explosions related to use of ENDS since 2009, these reports do not provide national estimates of burn injuries associated with ENDS batteries in the US. We analyzed nationally representative data provided in the National Electronic Injury Surveillance System (NEISS) to estimate the number of US emergency department (ED) visits for burn injuries associated with ENDS batteries. We reviewed the case narrative field to gain additional insights into the circumstances of the burn injury. In 2016, 26 ENDS battery-related burn cases were captured by NEISS, which translates to a national estimate of 1007 (95%CI: 357-1657) injuries presenting in US EDs. Most of the burns were thermal burns (80.4%) and occurred to the upper leg/lower trunk (77.3%). Examination of the case narrative field indicated that at least 20 of the burn injuries occurred while ENDS batteries were in the user's pocket. Our study provides valuable information for understanding the current burden of ENDS battery-related burn injuries treated in US EDs. The nature and circumstances of the injuries suggest these incidents were unintentional and would potentially be prevented through battery design requirements, battery testing standards and public education related to ENDS battery safety.

Expression of DNA repair genes in burned skin exposed to low-level red laser.

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Trajano, Eduardo Tavares Lima; Mencalha, Andre Luiz; Monte-Alto-Costa, Andréa; Pôrto, Luís Cristóvão; de Souza da Fonseca, Adenilson

2014-11-01

Although red laser lights lie in the region of non-ionizing radiations in the electromagnetic spectrum, there are doubts whether absorption of these radiations causes lesions in the DNA molecule. Our aim was to investigate the expression of the genes involved with base excision and nucleotide excision repair pathways in skin tissue submitted to burn injury and exposed to low-level red laser. Wistar rats were divided as follows: control group-rats burned and not irradiated, laser group-rats burned and irradiated 1 day after injury for five consecutive days, and later laser group-rats injured and treated 4 days after injury for five consecutive days. Irradiation was performed according to a clinical protocol (20 J/cm(2), 100 mW, continuous wave emission mode). The animals were sacrificed on day 10, and scarred tissue samples were withdrawn for total RNA extraction, complementary DNA (cDNA) synthesis, and evaluation of gene expression by quantitative polymerase chain reaction. Low-level red laser exposure (1) reduces the expression of APE1 messenger (mRNA), (2) increases the expression of OGG1 mRNA, (3) reduces the expression of XPC mRNA, and (4) increases the expression of XPA mRNA both in laser and later laser groups. Red laser exposure at therapeutic fluences alters the expression of genes related to base excision and nucleotide excision pathways of DNA repair during wound healing of burned skin.

Burns injury in children: Is antibiotic prophylaxis recommended?

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Jamila Chahed

2014-01-01

Full Text Available Background: Wound infection is the most frequent complication in burn patients. There is a lack of guidelines on the use of systemic antibiotics in children to prevent this complication. Patients and Methods: A prospective study is carried out on 80 patients to evaluate the role of antibiotic prophylaxis in the control of infections. Results: The mean age was 34 months (9 months to 8 years. There was a male predominance with sex ratio of 1.66. The mean burn surface size burn was 26.5% with total burn surface area ranging from 5% to 33%, respectively. According to American Burn Association 37% (30/80 were severe burns with second and third degree burns >10% of the total surface body area in children aged <10 years old. Scalds represented 76.2% (61/80 of the burns. Burns by hot oil were 11 cases (13.7%, while 8 cases (10% were flame burns. The random distribution of the groups was as follow: Group A (amoxicilline + clavulanic acid = 25 cases, Group B (oxacilline = 20 cases and Group C (no antibiotics = 35 cases. Total infection rate was 20% (16/80, distributed as follow: 8 cases (50% in Group C, 5 cases (31.2% in Group A and 3 cases in Group B (18.7%. Infection rate in each individual group was: 22.9% (8 cases/35 in Group C, 20% (5 cases/25 in Group A and 15% (3 cases/20 in Group B (P = 0.7. They were distributed as follow: Septicaemia 12 cases/16 (75%, wound infection 4 cases/16 (25%. Bacteria isolated were with a decreasing order: Staphylococcus aureus (36.3%, Pseudomonas (27.2%, Escherichia coli (18.1%, Klebsiella (9% and Enterobacteria (9%. There is a tendency to a delayed cicatrisation (P = 0.07 in case of hot oil burns (65.18 ± 120 days than by flame (54.33 ± 19.8 days than by hot water (29.55 ± 26.2 days. Otherwise no toxic shock syndrome was recorded in this study. Conclusion: It is concluded that adequate and careful nursing of burn wounds seems to be sufficient to prevent complications and to obtain cicatrisation. Antibiotics are

Burns From Hot Wheat Bags: A Public Safety Issue

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Collins, Anna; Amprayil, Mathew; Solanki, Nicholas S.; Greenwood, John Edward

2011-01-01

Introduction: Wheat bags are therapeutic devices that are heated in microwaves and commonly used to provide relief from muscle and joint pain. The Royal Adelaide Hospital Burns Unit has observed a number of patients with significant burn injuries resulting from their use. Despite their dangers, the products come with limited safety information. Methods: Data were collected from the Burns Unit database for all patients admitted with burns due to hot wheat bags from 2004 to 2009. This was analyzed to determine the severity of the burn injury and identify any predisposing factors. An experimental study was performed to measure the temperature of wheat bags when heated to determine their potential for causing thermal injury. Results: 11 patients were admitted with burns due to hot wheat bags. The median age was 52 years and the mean total body surface area was 1.1%. All burns were either deep dermal (45.5%) or full thickness (54.5%). Ten patients required operative management. Predisposing factors (eg, neuropathy) to thermal injury were identified in 7 patients. The experimental study showed that hot wheat bags reached temperatures of 57.3°C (135.1°F) when heated according to instructions, 63.3°C (145.9°F) in a 1000 W microwave and 69.6°C (157.3°F) on reheating. Conclusions: Hot wheat bags cause serious burn injury. When heated improperly, they can reach temperatures high enough to cause epidermal necrosis in a short period of time. Patients with impaired temperature sensation are particularly at risk. There should be greater public awareness of the dangers of wheat bag use and more specific safety warnings on the products. PMID:21915357

Protocol for a systematic review of quantitative burn wound microbiology in the management of burns patients.

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Kwei, Johnny; Halstead, Fenella D; Dretzke, Janine; Oppenheim, Beryl A; Moiemen, Naiem S

2015-11-06

Sepsis from burn injuries can result from colonisation of burn wounds, especially in large surface area burns. Reducing bacterial infection will reduce morbidity and mortality, and mortality for severe burns can be as high as 15 %. There are various quantitative and semi-quantitative techniques to monitor bacterial load on wounds. In the UK, burn wounds are typically monitored for the presence or absence of bacteria through the collection and culture of swabs, but no absolute count is obtained. Quantitative burn wound culture provides a measure of bacterial count and is gaining increased popularity in some countries. It is however more resource intensive, and evidence for its utility appears to be inconsistent. This systematic review therefore aims to assess the evidence on the utility and reliability of different quantitative microbiology techniques in terms of diagnosing or predicting clinical outcomes. Standard systematic review methods aimed at minimising bias will be employed for study identification, selection and data extraction. Bibliographic databases and ongoing trial registers will be searched and conference abstracts screened. Studies will be eligible if they are prospective studies or systematic reviews of burn patients (any age) for whom quantitative microbiology has been performed, whether it is compared to another method. Quality assessment will be based on quality assessment tools for diagnostic and prognostic studies and tailored to the review as necessary. Synthesis is likely to be primarily narrative, but meta-analysis may be considered where clinical and methodological homogeneity exists. Given the increasing use of quantitative methods, this is a timely systematic review, which will attempt to clarify the evidence base. As far as the authors are aware, it will be the first to address this topic. PROSPERO, CRD42015023903.

Influence of early childhood burns on school performance: an Australian population study.

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Azzam, Nadin; Oei, Ju-Lee; Adams, Susan; Bajuk, Barbara; Hilder, Lisa; Mohamed, Abdel-Latif; Wright, Ian M R; Holland, Andrew J A

2018-05-01

To determine the influence of burn injuries on childhood performance in national standardised curriculum-based school tests. Birth and health records of 977 children who were hospitalised with a burn injury between 2000 and 2006 in the state of New South Wales, Australia, were linked to performance scores in the National Assessment Program: Literacy and Numeracy test, a compulsory nationwide curriculum-based test (CBT) and compared with children who were not hospitalised for burns and who were matched for birth year, gender, gestation and socioeconomic status. Test scores in years 3 (ages 8-9), 5 (ages 10-11) and 7 (ages 13-14) in numeracy, writing, reading, spelling, grammar and punctuation. Mean age at first burn injury was 28 months (median: 20, range: 0-140). Children with burns were significantly more likely to have younger mothers (28.5 vs 29.6 years) (Pchildhood burn injuries occur before the start of formal schooling. Children who are hospitalised for burns perform more poorly in CBT even after accounting for family and socioeconomic disadvantage. Rehabilitation of children with burn injuries must address school performance to decrease any long-term negative societal impact of burns. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A multicenter study of preventable contact burns from glass fronted gas fireplaces.

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Wibbenmeyer, Lucy; Gittelman, Michael A; Kluesner, Karen; Liao, Junlin; Xing, Yunfan; Faraklas, Iris; Anyan, Walter; Gamero, Chelsea; Moulton, Steven; Nederveld, Cindy; Banks, Ashley; Ryan, Colleen M; Conway, Jennifer A; Reilly, Debra A; Fish, Joel; Kelly, Charis; Peltier, George; Schwantke, Emily; Conrad, Peggie F; Caruso, Daniel M; Richey, Karen J; McCrory, Kristine; Elfar, Mohamed S A; Pittinger, Timothy; Sadie, Christine; Greenhalgh, David; Palmieri, Tina; Grossman, Peter H; Richards, Kurt M; Joyce, Teresa; Pozez, Andrea L; Savetamal, Alisa; Harrington, David T; Duncan, Kimberley; Pomerantz, Wendy J; Dillard, B Daniel

2015-01-01

Glass fronted gas fireplaces (GFGFs) have exterior surfaces that can reach extremely high temperatures. Burn injuries from contact with the glass front can be severe with long-term sequelae. The Consumer Product Safety Commission reported that these injuries are uncommon, whereas single-center studies indicate a much higher frequency. The purpose of this multi-institutional study was to determine the magnitude and severity of GFGF injuries in North America. Seventeen burn centers elected to participate in this retrospective chart review. Chart review identified 402 children ≤10 years of age who sustained contact burns from contact with GFGF, who were seen or admitted to the study hospitals from January 2006 to December 2010. Demographic, burn, treatment, and financial data were collected. The mean age of the study group was 16.8 ± 13.3 months. The majority suffered burns to their hands (396, 98.5%), with burns to the face being the second, much less common site (14, 3.5%). Two hundred and sixty-nine required rehabilitation therapy (66.9%). The number of GFGF injuries reported was 20 times greater than the approximately 30 injuries estimated by the Consumer Product Safety Commission's 10-year review. For the affected children, these injuries are painful, often costly and occasionally can lead to long-term sequelae. Given that less than a quarter of burn centers contributed data, the injury numbers reported herein support a need for broader safety guidelines for gas fireplaces in order to have a significant impact on future injuries.

Burn Incidence and Treatment in the U.S.

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... News and Activities Media Contact Us Disaster Response Burn Incidence Fact Sheet Home / Who We Are / Media / ... hospitals with specialized services provided by “burn centers.” Burn Injuries Receiving Medical Treatment: 486,000 This general ...

Identifying and Understanding the Health Information Experiences and Preferences of Individuals With TBI, SCI, and Burn Injuries

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Nathan T Coffey MPH

2016-09-01

Full Text Available Introduction: Traumatic brain injury, spinal cord injury, and burn injury can cause lifelong disability and changes in quality of life. In order to meet the challenges of postinjury life, various types of health information are needed. We sought to identify preferred sources of health information and services for persons with these injuries and discover how accessibility could be improved. Methods: Thirty-three persons with injury participated in semistructured interviews. Responses to interview questions were coded using NVivo. Results: Participants’ difficulties accessing health information varied by injury type and individually. The majority of respondents found information via the Internet and advocated its use when asked to describe their ideal health information system. Nearly all participants supported the development of a comprehensive care website. When searching for health information, participants sought doctor and support group networks, long-term health outcomes, and treatments specific to their injury. Conclusion: To optimize the quality of health information resources, Internet-based health-care platforms should add or highlight access points to connect patients to medical professionals and support networks while aggregating specialized, injury-specific research and treatment information.

Factors associated with chemical burns in Zhejiang province, China: An epidemiological study

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Jiang Rui M

2011-09-01

Full Text Available Abstract Background Work-related burns are common among occupational injuries. Zhejiang Province is an industrial area with a high incidence of chemical burns. We aimed to survey epidemiological features of chemical burns in Zhejiang province to determine associated factors and acquire data for developing a strategy to prevent and treat chemical burns. Methods Questionnaires were developed, reviewed and validated by experts, and sent to 25 hospitals in Zhejiang province to prospectively collect data of 492 chemical burn patients admitted during one year from Sept. 1, 2008 to Aug. 31, 2009. Questions included victims' characteristics and general condition, injury location, causes of accident, causative chemicals, total body surface area burn, concomitant injuries, employee safety training, and awareness level of protective measures. Surveys were completed for each of burn patients by burn department personnel who interviewed the hospitalized patients. Results In this study, 417 victims (87.61% got chemical burn at work, of which 355 victims (74.58% worked in private or individual enterprises. Most frequent chemicals involved were hydrofluoric acid and sulfuric acid. Main causes of chemical injury accidents were inappropriate operation of equipment or handling of chemicals and absence of or failure to use effective individual protection. Conclusions Most chemical burns are preventable occupational injuries that can be attributed to inappropriate operation of equipment or handling of chemicals, lack of employee awareness about appropriate action and lack of effective protective equipment and training. Emphasis on safety education and protection for workers may help protect workers and prevent chemical burns.

Serum creatine phosphokinase as prognostic indicator in the management of electrical burn

International Nuclear Information System (INIS)

Memon, A.R.; Memon, F.M.; Shaikh, B.F.

2008-01-01

To determine the mean difference of serum creatine phosphokinase according to the extent of tissue damage and prognosis of the patients suffering from electrical burn injuries. During the study period, 38 patients with electrical burn injuries were enrolled. Victims of electrical burns with evidence of myocardial injury were excluded. Following admission, serum creatine phosphokinase was measured serially on 10 consecutive occasions. The data was later analyzed statistically using SPSS-10.0. Of the 38 patients, the mean age of the victims was 28 years, with males dominating the study population (82%). A statistically significant association was found between the level of serum creatine phosphokinase and likelihood of death (p=0.000). It was also found that serial monitoring of this enzyme can be used as prognostic indicator in the management of electrical burns injury. The level of creatine phosphokinase increased with the degree of tissue injuries in patients with electrical burns. This prognostic value is of great importance in the local setup, where sophisticated investigations to detect extent of injuries are not available. (author)

Methamphetamine-related burns in the cornbelt.

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Burke, Bridget A; Lewis, Robert W; Latenser, Barbara A; Chung, Joseph Y; Willoughby, Clark; Kealey, G Patrick; Wibbenmeyer, Lucy A

2008-01-01

Methamphetamine (MA) is a highly addictive drug that is easily manufactured from everyday household products and chemicals found at local farm stores. The proliferation of small MA labs has led to a dramatic increase in patients sustaining thermal injury while making and/or using MA. We hypothesized that these patients have larger injuries with longer hospital stays, and larger, nonreimbursed hospital bills compared with burn patients not manufacturing or using MA. In a retrospective case-control study, all burn patients >or=16 years of age admitted to our burn center from January 2002 to December 2005 were stratified into two groups based on urine MA status. Of the 660 burn patients >or=16 years of age admitted during this 4 year period, urine drug screens were obtained at admission on 410 patients (62%); 10% of urine drug screens were MA (+). MA (+) patients have larger burns compared with MA (-) patients (9.3 vs 8.6% body surface area burns), have higher rates of inhalation injuries (20.4 vs 9.3%, P = .015), and more nonthermal trauma (13.0 vs 3.1%, P = .001). When compared with MA (-) patients, MA (+) patients require longer hospital stays (median 9.5 vs 7.0 days, P = .036), accrue greater hospital bills per day (dollars 4292 vs dollars 2797, P = .01), and lack medical insurance (66.7 vs 17.7%, P manufacture mandates that burn centers monitor patients for MA use and develop and institute protocols to ensure proper care of this increasingly costly population.

Medical response to the radioinduced burns

International Nuclear Information System (INIS)

Portas, Mercedes

2001-01-01

For over two years the Hospital for Burns in Buenos Aires has been studying the burns caused by radiation, in accordance to an agreement with the Nuclear Regulatory Authority (ARN) of Argentina. The analysis of each case showed the importance of the differential diagnosis from conventional injuries, of this early diagnosis depends the possibility of treatment from the 0 (zero) hour (time at which the accident took place) and achieve the wound healing with the best possible treatment, weather it is medical or surgical in nature. The Hospital's medical staff has developed the necessary skills to recognize this type of burns from an early stage. Most patients arrive to the consultation on their own accord due to the general practitioners inability to correctly diagnose the wounds appeared after radiotherapy has been applied. In this article, we present the general guidelines that the doctors of the Hospital for Burns follow in the presence of radio inducted injuries, objectifying the ethiopathogenic differences of the various burns. (author)

The Effects of Punica granatum Flower Extract on Skin Injuries Induced by Burn in Rats

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Ebrahim Nasiri

2017-01-01

Full Text Available Background. We compared the efficacy of P. granatum (P flower extract with that of silver sulfadiazine (SSD for treating thermal burn injuries in rats. Methods. Ten Wistar rats in each group were topically given base cream, normal saline, cream containing 1% SSD, or creams containing 5% or 10% Punica granatum flower extract. The treatments were administered once daily until complete wound healing was observed. The wound area and healing time were assessed. In addition, percentage wound contraction and histopathological characteristics such as neovascularization and collagen formation were determined. The tannin content in P. granatum extract was determined. Results. The decrease in the average size of wounds on day 15 of the treatment was higher in rats treated with creams containing P. granatum extract than in rats treated with cream containing SSD (2.8±0.9 cm2 versus 8.4±3.2 cm2. The wounds completely healed on day 25 of the treatment in rats treated with creams containing P. granatum flower extract compared with those in rats treated with the other agents. Conclusion. These results indicated that P. granatum flower extract promoted wound healing in rats and could be used for managing burn injuries.

The Effects of Punica granatum Flower Extract on Skin Injuries Induced by Burn in Rats.

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Nasiri, Ebrahim; Hosseinimehr, Seyed Jalal; Akbari, Jafar; Azadbakht, Mohammad; Azizi, Soheil

2017-01-01

Background . We compared the efficacy of P. granatum (P) flower extract with that of silver sulfadiazine (SSD) for treating thermal burn injuries in rats. Methods . Ten Wistar rats in each group were topically given base cream, normal saline, cream containing 1% SSD, or creams containing 5% or 10% Punica granatum flower extract. The treatments were administered once daily until complete wound healing was observed. The wound area and healing time were assessed. In addition, percentage wound contraction and histopathological characteristics such as neovascularization and collagen formation were determined. The tannin content in P. granatum extract was determined. Results . The decrease in the average size of wounds on day 15 of the treatment was higher in rats treated with creams containing P. granatum extract than in rats treated with cream containing SSD (2.8 ± 0.9 cm 2 versus 8.4 ± 3.2 cm 2 ). The wounds completely healed on day 25 of the treatment in rats treated with creams containing P. granatum flower extract compared with those in rats treated with the other agents. Conclusion . These results indicated that P. granatum flower extract promoted wound healing in rats and could be used for managing burn injuries.

Reduced need for grafting and low incidence of hypertrophic scarring in burns after enzymatic debridement

OpenAIRE

Corrales-Benítez, Carlos; Martínez-Méndez, José Ramón; González-Miranda, Álvaro; Serrano-Alonso, Maite; Casado-Pérez, César

2016-01-01

Background and Objective. Early burn scar removal is the standard of care for burn patients; excisional debridement, however, often leads to excision of dermal remnants, making autografting unavoidable. Enzymatic debridement with proteolytic enzymes enriched in Bromelain (Nexobrid®) leaves these dermal remnants to allow spontaneous healing of partial thickness burns. This study evaluates if Nexobrid® (MediWound Ltd., Israel) reduces the need for surgery and autografting in intermediate and de...

Predictors of Discharge Disposition in Older Adults With Burns: A Study of the Burn Model Systems.

Science.gov (United States)

Pham, Tam N; Carrougher, Gretchen J; Martinez, Erin; Lezotte, Dennis; Rietschel, Carly; Holavanahalli, Radha; Kowalske, Karen; Esselman, Peter C

2015-01-01

Older patients with burn injury have a greater likelihood for discharge to nursing facilities. Recent research indicates that older patients discharged to nursing facilities are two to three times as likely to die within a 3-year period relative to those discharged to home. In light of these poor long-term outcomes, we conducted this study to identify predictors for discharge to independent vs nonindependent living status in older patients hospitalized for burns. We retrospectively reviewed all older adults (age ≥ 55 years) who were prospectively enrolled in a longitudinal multicenter study of outcomes from 1993 to 2011. Patient, injury, and treatment outcomes data were analyzed. Recognizing that transfer to inpatient rehabilitation may have impacted final hospital discharge disposition: we assessed the likelihood of inpatient rehabilitation stay, based on identified predictors of inpatient rehabilitation. We subsequently performed a logistic regression analysis on the clustered, propensity-matched cohort to assess associations of burn and injury characteristics on the primary outcome of final discharge status. A total of 591 patients aged ≥55 years were treated and discharged alive from three participating U.S. burn centers during the study period. Mean burn size was 14.8% (SD 11.2%) and mean age was 66.7 years (SD 9.3 years). Ninety-three patients had an inpatient rehabilitation stay before discharge (15.7%). Significant factors predictive of inpatient rehabilitation included a burn >20% TBSA, mechanical ventilation, older age, range of motion deficits at acute care discharge, and study site. These factors were included in the propensity model. Four hundred seventy-one patients (80%) were discharged to independent living status. By matched propensity analysis, older age was significantly associated with a higher likelihood of discharge to nonindependent living (P burn centers need to be elucidated to better understand discharge disposition status in older

An Examination of a Yoga Intervention With Pediatric Burn Survivors.

Science.gov (United States)

Conn, Amy S; Hall, Morgan S; Quinn, Kristen; Wiggins, Bradley; Memmott, Carolyn; Brusseau, Timothy A

Burn injuries have a major influence on the survivors' physical and psychological functioning. In pediatric burns, the consequences persist long after the injury. The objective of this study is to evaluate an existing yoga kids program to gain better understanding of the physical and psychosocial effects of a yoga practice among children with burn injuries. Thirty campers participated in a series of four (1 hour) yoga sessions during the summer of 2014. Nationally trained Instructors had taught children's yoga in the Southwestern United States for at least 10 years. A Yoga Evaluation Questionnaire, designed for children, was used to evaluate perceptions of somatic and cognitive anxiety before and after each Yoga session. Camper's age ranged from 6 to 12 years old with burn severities ranging from 5 to 75%. A dependent samples t-test was used to test for differences between composite pre- and postintervention scores for both somatic and cognitive anxiety. Significant effects emerged for somatic anxiety t(29) = -4.24, P Yoga program may lower perceptions of cognitive and somatic anxiety in pediatric burn survivors. Further, Yoga is one technique that may compliment the short- and long-term treatment of burn injuries.

EPIDEMOLOGY OF BURNS IN ENUGU, NIGERIA

African Journals Online (AJOL)

JIBURUM

community is encouraged to study the epidemiology of burns since this important ... CONCLUSION The incidence and mortality of burn injury has remained high in this .... they are a group at risk. ... epidemiology and the compliance factors in.

A Novel Classification System for Injuries After Electronic Cigarette Explosions.

Science.gov (United States)

Patterson, Scott B; Beckett, Allison R; Lintner, Alicia; Leahey, Carly; Greer, Ashley; Brevard, Sidney B; Simmons, Jon D; Kahn, Steven A

Electronic cigarettes (e-cigarettes) contain lithium batteries that have been known to explode and/or cause fires that have resulted in burn injury. The purpose of this article is to present a case study, review injuries caused by e-cigarettes, and present a novel classification system from the newly emerging patterns of burns. A case study was presented and online media reports for e-cigarette burns were queried with search terms "e-cigarette burns" and "electronic cigarette burns." The reports and injury patterns were tabulated. Analysis was then performed to create a novel classification system based on the distinct injury patterns seen in the study. Two patients were seen at our regional burn center after e-cigarette burns. One had an injury to his thigh and penis that required operative intervention after ignition of this device in his pocket. The second had a facial burn and corneal abrasions when the device exploded while he was inhaling vapor. The Internet search and case studies resulted in 26 cases for evaluation. The burn patterns were divided in direct injury from the device igniting and indirect injury when the device caused a house or car fire. A numerical classification was created: direct injury: type 1 (hand injury) 7 cases, type 2 (face injury) 8 cases, type 3 (waist/groin injury) 11 cases, and type 5a (inhalation injury from using device) 2 cases; indirect injury: type 4 (house fire injury) 7 cases and type 5b (inhalation injury from fire started by the device) 4 cases. Multiple e-cigarette injuries are occurring in the United States and distinct patterns of burns are emerging. The classification system developed in this article will aid in further study and future regulation of these dangerous devices.

Projector-based virtual reality dome environment for procedural pain and anxiety in young children with burn injuries: a pilot study.

Science.gov (United States)

Khadra, Christelle; Ballard, Ariane; Déry, Johanne; Paquin, David; Fortin, Jean-Simon; Perreault, Isabelle; Labbe, David R; Hoffman, Hunter G; Bouchard, Stéphane; LeMay, Sylvie

2018-01-01

Virtual reality (VR) is a non-pharmacological method to distract from pain during painful procedures. However, it was never tested in young children with burn injuries undergoing wound care. We aimed to assess the feasibility and acceptability of the study process and the use of VR for procedural pain management. From June 2016 to January 2017, we recruited children from 2 months to 10 years of age with burn injuries requiring a hydrotherapy session in a pediatric university teaching hospital in Montreal. Each child received the projector-based VR intervention in addition to the standard pharmacological treatment. Data on intervention and study feasibility and acceptability in addition to measures on pain (Face, Legs, Activity, Cry, Consolability scale), baseline (Modified Smith Scale) and procedural (Procedure Behavior Check List) anxiety, comfort (OCCEB-BECCO [behavioral observational scale of comfort level for child burn victims]), and sedation (Ramsay Sedation Scale) were collected before, during, and after the procedure. Data analyses included descriptive and non-parametric inferential statistics. We recruited 15 children with a mean age of 2.2±2.1 years and a mean total body surface area of 5% (±4). Mean pain score during the procedure was low (2.9/10, ±3), as was the discomfort level (2.9/10, ±2.8). Most children were cooperative, oriented, and calm. Assessing anxiety was not feasible with our sample of participants. The prototype did not interfere with the procedure and was considered useful for procedural pain management by most health care professionals. The projector-based VR is a feasible and acceptable intervention for procedural pain management in young children with burn injuries. A larger trial with a control group is required to assess its efficacy.

Feet sunk in molten aluminium: The burn and its prevention.

Science.gov (United States)

Alonso-Peña, David; Arnáiz-García, María Elena; Valero-Gasalla, Javier Luis; Arnáiz-García, Ana María; Campillo-Campaña, Ramón; Alonso-Peña, Javier; González-Santos, Jose María; Fernández-Díaz, Alaska Leonor; Arnáiz, Javier

2015-08-01

Nowadays, despite improvements in safety rules and inspections in the metal industry, foundry workers are not free from burn accidents. Injuries caused by molten metals include burns secondary to molten iron, aluminium, zinc, copper, brass, bronze, manganese, lead and steel. Molten aluminium is one of the most common causative agents of burns (60%); however, only a few publications exist concerning injuries from molten aluminium. The main mechanisms of lesion from molten aluminium include direct contact of the molten metal with the skin or through safety apparel, or when the metal splash burns through the pants and rolls downward along the leg. Herein, we report three cases of deep dermal burns after 'soaking' the foot in liquid aluminium and its evolutive features. This paper aims to show our experience in the management of burns due to molten aluminium. We describe the current management principles and the key features of injury prevention. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Pediatric Burns: A Single Institution Retrospective Review of Incidence, Etiology, and Outcomes in 2273 Burn Patients (1995-2013).

Science.gov (United States)

Lee, Christina J; Mahendraraj, Krishnaraj; Houng, Abraham; Marano, Michael; Petrone, Sylvia; Lee, Robin; Chamberlain, Ronald S

Unintentional burn injury is the third most common cause of death in the U.S. for children age 5 to 9, and accounts for major morbidity in the pediatric population. Pediatric burn admission data from U.S. institutions has not been reported recently. This study assesses all pediatric burn admissions to a State wide Certified Burn Treatment Center to evaluate trends in demographics, burn incidence, and cause across different age groups. Demographic and clinical data were collected on 2273 pediatric burn patients during an 18-year period (1995-2013). Pediatric patients were stratified by age into "age 0 to 6," "age 7 to 12," and "age 13 to 18." Data were obtained from National Trauma Registry of the American College of Surgeons and analyzed using standard statistical methodology. A total of 2273 burn patients under age 18 were treated between 1995 and 2013. A total of 1663 (73.2%) patients were ages 0 to 6, 294 (12.9%) were 7 to 12, and 316 (13.9%) were age 13 to 18. A total of 1400 (61.6%) were male and 873 (38.4%) were female (male:female ratio of 1.6:1). Caucasians had the highest burn incidence across all age groups (40.9%), followed by African-Americans (33.6%), P burns occurred at home, P burned was 8.9%, with lower extremity being the most common site (38.5%). Scald burns constituted the majority of cases (71.1%, n = 1617), with 53% attributable to hot liquids related to cooking, including coffee or tea, P burns were the dominant cause (53.8%). Overall mean length of stay was 10.5 ± 10.8 days for all patients, and15.5 ± 12 for those admitted to the intensive care unit, P burn injuries are scald burns that occur at home and primarily affect the lower extremities in Caucasian and African-American males. Among Caucasian teenagers flame burns predominate. Mean length of stay was 10 days, 23% of patients required skin grafting surgery, and mortality was 0.9%. The results of this study highlight the need for primary prevention programs focusing on avoiding

Burns induced by cupping therapy in a burn center in northeast china.

Science.gov (United States)

Jing-Chun, Zhao; Jia-Ao, Yu; Chun-Jing, Xian; Kai, Shi; Lai-Jin, Lu

2014-07-01

Cupping therapy as a curative skill has been developed and applied throughout history. Despite reports of adverse effects, this therapy is considered to be relatively safe with no systemic reviews documenting negative side effects. The aim of this study was to explore methods that avoid the adverse effects sometimes associated with this therapy. Clinical records of 14 outpatients and inpatients that visited the First Hospital of Jilin University (Changchun, China) for management of burn injuries caused by cupping therapy were retrospectively reviewed. Characteristics, history of injury, and treatment of each patient was collected and analyzed. Burn injury induced by cupping therapy was not uncommon. Most of the injuries were mild to moderate and cured by conservative methods without severe complications. The use of wet cupping was more prevalent among injured patients than dry cupping. Cupping therapy as an ancient alternative treatment is still popular with a large number of devoted practitioners. Although there is the potential for injury during the application of this therapy, this is mostly preventable. Standardized training for health care professionals and increased the awareness among the public about the proper methods to administer this therapy to avoid adverse effects is important.

Treatment of burn injuries with keratinocyte cultures

International Nuclear Information System (INIS)

Syring, C.; Maenig, H.J.; Von Versen, R.; Bruck, J.

1999-01-01

The German Institute for Cell and Tissue Replacement (DIZG) provides burned patients with skin and amnion for a temporary wound closure. Severely burned patients (>60% BSA for adults, >40% BSA for children) were supplied with autologous and allogenic grafts from cultured keratinocytes. The keratinocyte culture is done under GMP-conditions using the method of Rheinwald and Green. The 3T3 fibroblasts were irradiated with 60 Gy and used as feeder cells to produce keratinocyte sheets within 3 weeks. In this time up to 6.000 cm are available. The sheets were harvested by detachment with dispase (1,2 U/ml), fixed to gauze and transported to the hospital. The DIZG has a 3 years experience in the treatment of burns with keratinocyte sheets. The sheets were transplanted to patients in different hospitals, the total transplanted area is about 30.000 cm. This paper describes the experiences with ten severely burned patients treated with keratinocyte sheet

Feasibility and potential effect of a low-cost virtual reality system on reducing pain and anxiety in adult burn injury patients during physiotherapy in a developing country.

Science.gov (United States)

Morris, Linzette Deidré; Louw, Quinette Abegail; Crous, Lynette Christine

2010-08-01

The purpose of this study was to ascertain the feasibility and potential effect of a low-cost VR system (eMagin Z800 3DVisor), used in conjunction with pharmacological analgesia, on reducing pain and anxiety in adult burn patients undergoing physiotherapy treatment, compared to pharmacologic analgesia alone at a South African hospital. Single-blind, within-subject study design. Pain and anxiety outcome measures were measured by a blinded assessor using the Numeric Pain Rating Scale and Burn Specific Pain and Anxiety Scale. Box-and-whisker plot method, Chi-square tests as well as the Student's paired t-test were used to analyze data. Eleven eligible adult burn patients consented to participate in this study (3 female, 8 male; median age 33 years: range 23-54 years). A marginal (p=0.06) to insignificant (p=0.13) difference between the two sessions (analgesia with VR and analgesia without VR) in reducing pain was found. No significant difference (p=0.58) was found between the two sessions (analgesia with VR and analgesia without VR) for anxiety. There seems to be a trend that the low-cost VR system, when added to routine pharmacological analgesics, is a safe technique and could be of considerable benefit if implemented into the pain management regime of burn units at a South African hospital.

Long-Term Social Reintegration Outcomes for Burn Survivors With and Without Peer Support Attendance: A Life Impact Burn Recovery Evaluation (LIBRE) Study.

Science.gov (United States)

Grieve, Brian; Shapiro, Gabriel D; Wibbenmeyer, Lucy; Acton, Amy; Lee, Austin; Marino, Molly; Jette, Alan; Schneider, Jeffrey C; Kazis, Lewis E; Ryan, Colleen M

2017-10-31

To examine differences in long-term social reintegration outcomes for burn survivors with and without peer support attendance. Cross-sectional survey. Community-dwelling burn survivors. Burn survivors (N=601) aged ≥18 years with injuries to ≥5% total body surface area (TBSA) or burns to critical areas (hands, feet, face, or genitals). Not applicable. The Life Impact Burn Recovery Evaluation Profile was used to examine the following previously validated 6 scale scores of social participation: Family and Friends, Social Interactions, Social Activities, Work and Employment, Romantic Relationships, and Sexual Relationships. Burn support group attendance was reported by 330 (55%) of 596 respondents who responded to this item. Attendees had larger burn size (43.4%±23.6% vs 36.8%±23.4% TBSA burned, P10 years from injury (50% vs 42.5%, Preintegration in burn survivors. This cross-sectional study prompts further exploration into the potential benefits of peer support groups on burn recovery with future intervention studies. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Application effects of dexmedetomidine combined with sevoflurane for anesthesia in short operations in children with burn injury

Directory of Open Access Journals (Sweden)

Jin-xin WANG

2016-04-01

Full Text Available Objective 　To evaluate the effectiveness and safety of dexmedetomidine combined with sevoflurane for anesthesia in short operations in pediatric burn patients. Methods 　Forty hospitalized children undergoing short operation for burn injury were allocated to sevoflurane group (S group or sevoflurane combined dexmedetomidine group (group D(20 patients each. Children in group D inhaled 8% sevoflurane in the beginning until loss of eyelash reflex, and then the density of sevoflurane was reduced to 3% for maintenance, 5μg/(kg.h of dexmedetomidine was pumped for 10 mins, then the density was reduced to 0.5μg/(kg.h. Then operation was started herewith till to the end. Children in group S received sevoflurane anethesia alone, and dexmedetomidine was replaced by the same volume of physiological saline. Additional 3mg/kg propofol was injected when anesthesia was inadequate. During the procedure, HR, MAP, SpO2 and Ramsay scale were recorded at baseline (T1, loss of eyelash reflex (T2, 5min after the start of operation (T4, 10min (T5 and the end of operation (T6. The operation time, anethesia time, propofol consumption, case of respiratory depression and pediatric anesthesia emergence delirium scale (PAED in pediatric anesthesia care unit (PACU were recorded. Results 　There was no significant difference in operation time between the two groups. Intraoperative SpO2 was higher in group D than in group S (P<0.05, respiratory inhibition occurred in 4 cases of group D and 10 cases of group S (P<0.05. Propofol consumption was less and the operation time was longer in group D than in group S (P<0.05. At T3-T6, the MAP and HR were lower, but the Ramsay scale was higher in group D than in group S (P<0.05. In PACU, PAED scale was lower in group D than in group S (P<0.05. Conclusions 　Dexmedetomidine combined with sevoflurane for anesthesia for short burn surgery in children not only stabilize hemodynamic parameters but also reduce the impact to respiration

Aircraft Engine Technology for Green Aviation to Reduce Fuel Burn

Science.gov (United States)

Hughes, Christopher E.; VanZante, Dale E.; Heidmann, James D.

2013-01-01

The NASA Fundamental Aeronautics Program Subsonic Fixed Wing Project and Integrated Systems Research Program Environmentally Responsible Aviation Project in the Aeronautics Research Mission Directorate are conducting research on advanced aircraft technology to address the environmental goals of reducing fuel burn, noise and NOx emissions for aircraft in 2020 and beyond. Both Projects, in collaborative partnerships with U.S. Industry, Academia, and other Government Agencies, have made significant progress toward reaching the N+2 (2020) and N+3 (beyond 2025) installed fuel burn goals by fundamental aircraft engine technology development, subscale component experimental investigations, full scale integrated systems validation testing, and development validation of state of the art computation design and analysis codes. Specific areas of propulsion technology research are discussed and progress to date.

Comparison of mortality prediction models and validation of SAPS II in critically ill burns patients.

Science.gov (United States)

Pantet, O; Faouzi, M; Brusselaers, N; Vernay, A; Berger, M M

2016-06-30

Specific burn outcome prediction scores such as the Abbreviated Burn Severity Index (ABSI), Ryan, Belgian Outcome of Burn Injury (BOBI) and revised Baux scores have been extensively studied. Validation studies of the critical care score SAPS II (Simplified Acute Physiology Score) have included burns patients but not addressed them as a cohort. The study aimed at comparing their performance in a Swiss burns intensive care unit (ICU) and to observe whether they were affected by a standardized definition of inhalation injury. We conducted a retrospective cohort study, including all consecutive ICU burn admissions (n=492) between 1996 and 2013: 5 epochs were defined by protocol changes. As required for SAPS II calculation, stays burned (TBSA) and inhalation injury (systematic standardized diagnosis since 2006). Study epochs were compared (χ2 test, ANOVA). Score performance was assessed by receiver operating characteristic curve analysis. SAPS II performed well (AUC 0.89), particularly in burns burns <40% TBSA. Ryan and BOBI scores were least accurate, as they heavily weight inhalation injury.

Radiator scald burns: a preventable hazard.

Science.gov (United States)

Benmeir, P; Rosenberg, L; Sagi, A; Ben-Yakar, Y

1990-04-01

During the last 13 years 80 patients have been admitted to our department suffering from burns caused by a vehicle's radiator. Ten of them were deeply burned and had to be treated surgically. The preventive aspect of this injury is emphasized.

Gap analysis of pharmacokinetics and pharmacodynamics in burn patients: a review.

Science.gov (United States)

Steele, Amanda N; Grimsrud, Kristin N; Sen, Soman; Palmieri, Tina L; Greenhalgh, David G; Tran, Nam K

2015-01-01

Severe burn injury results in a multifaceted physiological response that significantly alters drug pharmacokinetics and pharmacodynamics (PK/PD). This response includes hypovolemia, increased vascular permeability, increased interstitial hydrostatic pressure, vasodilation, and hypermetabolism. These physiologic alterations impact drug distribution and excretion-thus varying the drug therapeutic effect on the body or microorganism. To this end, in order to optimize critical care for the burn population it is essential to understand how burn injury alters PK/PD parameters. The purpose of this article is to describe the relationship between burn injury and drug PK/PD. We conducted a literature review via PubMed and Google to identify burn-related PK/PD studies. Search parameters included "pharmacokinetics," "pharmacodynamics," and "burns." Based on our search parameters, we located 38 articles that studied PK/PD parameters specifically in burns. Twenty-seven articles investigated PK/PD of antibiotics, 10 assessed analgesics and sedatives, and one article researched an antacid. Out of the 37 articles, there were 19 different software programs used and eight different control groups. The mechanisms behind alterations in PK/PD in burns remain poorly understood. Dosing techniques must be adapted based on burn injury-related changes in PK/PD parameters in order to ensure drug efficacy. Although several PK/PD studies have been undertaken in the burn population, there is wide variation in the analytical techniques, software, and study sample sizes used. In order to refine dosing techniques in burns and consequently improve patient outcomes, there must be harmonization among PK/PD analyses.

Assessing inhalation injury in the emergency room

Directory of Open Access Journals (Sweden)

Tanizaki S

2015-07-01

Full Text Available Shinsuke Tanizaki Department of Emergency Medicine, Fukui Prefectural Hospital, Fukui, Japan Abstract: Respiratory tract injuries caused by inhalation of smoke or chemical products are related to significant morbidity and mortality. While many strategies have been built up to manage cutaneous burn injuries, few logical diagnostic strategies for patients with inhalation injuries exist and almost all treatment is supportive. The goals of initial management are to ensure that the airway allows adequate oxygenation and ventilation and to avoid ventilator-induced lung injury and substances that may complicate subsequent care. Intubation should be considered if any of the following signs exist: respiratory distress, stridor, hypoventilation, use of accessory respiratory muscles, blistering or edema of the oropharynx, or deep burns to the face or neck. Any patients suspected to have inhalation injuries should receive a high concentration of supplemental oxygen to quickly reverse hypoxia and to displace carbon monoxide from protein binding sites. Management of carbon monoxide and cyanide exposure in smoke inhalation patients remains controversial. Absolute indications for hyperbaric oxygen therapy do not exist because there is a low correlation between carboxyhemoglobin levels and the severity of the clinical state. A cyanide antidote should be administered when cyanide poisoning is clinically suspected. Although an ideal approach for respiratory support of patients with inhalation injuries do not exist, it is important that they are supported using techniques that do not further exacerbate respiratory failure. A well-organized strategy for patients with inhalation injury is critical to reduce morbidity and mortality. Keywords: inhalation injury, burn, carbon monoxide poisoning, cyanide poisoning

Burns first aid treatment in remote Northern Australia.

Science.gov (United States)

Read, David J; Tan, Swee Chin; Ward, Linda; McDermott, Kathleen

2018-03-01

It is well demonstrated that adequate burns first aid treatment (BFAT) improves clinical outcomes for the injured but adequacy remains low in many studies. This study presents a twelve month assessment of the adequacy of burns first aid treatment for patients managed by the Burns Service, Royal Darwin Hospital (RDH). Prospective study design of all patients managed by the Burns Service, Royal Darwin Hospital. Data were collated from two sources; RDH Burns Registry, and the Burns Registry of Australia and New Zealand (BRANZ). Inclusion criterion was all patients managed by the Burns Service, Royal Darwin Hospital for the period 1 January 2014-31 December 2014. Variables collected and analysed include: demographics, burn mechanism, burn wound depth and adequacy of and circumstances around first aid. Overall 310 cases were analysed. Most injuries involved adults (68%), 19% Indigenous persons and 70% of all patients had their burn injury occur in the urban region. Adequate BFAT occurred in 41% of cases. Adults, contact burns and those where the burn injury occurred in the remote regions were less likely to receive adequate BFAT. Indigenous persons were less likely to attempt any BFAT at all and when they did receive BFAT it was more likely applied by an emergency responder or health professional. Overall adequacy of BFAT is low in the Top End of the Northern Territory. Remote dwellers and Indigenous persons are at increased risk of not applying or receiving adequate BFAT. The poor level of adequate BFAT demonstrated in this study suggests that the Top End community particularly remote and Indigenous persons would benefit from targeted BFAT education programs that are delivered in a culturally and linguistically appropriate fashion. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Surgical management and hypermetabolic modulation of pediatric burns

NARCIS (Netherlands)

Barret Nerín, Juan Pedro

2002-01-01

The purpose of the present thesis is to test the hypothesis that immediate burn wound excision of massive pediatric burns is safe and efficacious, presenting with negligible postoperative complications and with salutary effects on the inflammatory and catabolic response after burn injury.

Nutritional management of the burn patient | Prins | South African ...

African Journals Online (AJOL)

Burn injury, the most severe type of injury from a metabolic point of view, is characterised by the most profound alterations in basal metabolic rate and urinary nitrogen excretion. In addition, requirements for and/or metabolism of macro- and micronutrients are altered or increased. The major improvement in burn survival can ...

[Ischemic cholangiopathy induced by extended burns].

Science.gov (United States)

Cohen, Laurence; Angot, Emilie; Goria, Odile; Koning, Edith; François, Arnaud; Sabourin, Jean-Christophe

2013-04-01

Ischemic cholangiopathy is a recently described entity occurring mainly after hepatic grafts. Very few cases after intensive care unit (ICU) for extended burn injury were reported. We report the case of a 73-year-old woman consulting in an hepatology unit, for a jaundice appearing during a hospitalisation in an intensive care unit and increasing from her leaving from ICU, where she was treated for an extended burn injury. She had no pre-existing biological features of biliary disease. Biological tests were normal. Magnetic resonance imaging acquisitions of biliary tracts pointed out severe stenosing lesions of diffuse cholangiopathy concerning intrahepatic biliary tract, mainly peri-hilar. Biopsie from the liver confirmed the diagnosis, showing a biliary cirrhosis with bile infarcts. This case is the fourth case of ischemic cholangiopathy after extended burn injury, concerning a patient without a prior history of hepatic or biliary illness and appearing after hospitalisation in intensive care unit. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Mortality risk prediction in burn injury: Comparison of logistic regression with machine learning approaches.

Science.gov (United States)

Stylianou, Neophytos; Akbarov, Artur; Kontopantelis, Evangelos; Buchan, Iain; Dunn, Ken W

2015-08-01

Predicting mortality from burn injury has traditionally employed logistic regression models. Alternative machine learning methods have been introduced in some areas of clinical prediction as the necessary software and computational facilities have become accessible. Here we compare logistic regression and machine learning predictions of mortality from burn. An established logistic mortality model was compared to machine learning methods (artificial neural network, support vector machine, random forests and naïve Bayes) using a population-based (England & Wales) case-cohort registry. Predictive evaluation used: area under the receiver operating characteristic curve; sensitivity; specificity; positive predictive value and Youden's index. All methods had comparable discriminatory abilities, similar sensitivities, specificities and positive predictive values. Although some machine learning methods performed marginally better than logistic regression the differences were seldom statistically significant and clinically insubstantial. Random forests were marginally better for high positive predictive value and reasonable sensitivity. Neural networks yielded slightly better prediction overall. Logistic regression gives an optimal mix of performance and interpretability. The established logistic regression model of burn mortality performs well against more complex alternatives. Clinical prediction with a small set of strong, stable, independent predictors is unlikely to gain much from machine learning outside specialist research contexts. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Development of a Consistent and Reproducible Porcine Scald Burn Model

Science.gov (United States)

Kempf, Margit; Kimble, Roy; Cuttle, Leila

2016-01-01

There are very few porcine burn models that replicate scald injuries similar to those encountered by children. We have developed a robust porcine burn model capable of creating reproducible scald burns for a wide range of burn conditions. The study was conducted with juvenile Large White pigs, creating replicates of burn combinations; 50°C for 1, 2, 5 and 10 minutes and 60°C, 70°C, 80°C and 90°C for 5 seconds. Visual wound examination, biopsies and Laser Doppler Imaging were performed at 1, 24 hours and at 3 and 7 days post-burn. A consistent water temperature was maintained within the scald device for long durations (49.8 ± 0.1°C when set at 50°C). The macroscopic and histologic appearance was consistent between replicates of burn conditions. For 50°C water, 10 minute duration burns showed significantly deeper tissue injury than all shorter durations at 24 hours post-burn (p ≤ 0.0001), with damage seen to increase until day 3 post-burn. For 5 second duration burns, by day 7 post-burn the 80°C and 90°C scalds had damage detected significantly deeper in the tissue than the 70°C scalds (p ≤ 0.001). A reliable and safe model of porcine scald burn injury has been successfully developed. The novel apparatus with continually refreshed water improves consistency of scald creation for long exposure times. This model allows the pathophysiology of scald burn wound creation and progression to be examined. PMID:27612153

Child Supervision and Burn Outcome among Admitted Patients at Major Trauma Hospitals in the Gambia

Directory of Open Access Journals (Sweden)

Edrisa Sanyang

2017-07-01

Full Text Available Burn-related injuries are a significant burden in children, particularly in low- and middle-income countries (LMICs, where more than 90% of burn-related pediatric deaths occur. Lack of adult supervision of children is a major risk for pediatric burn injuries. The goal of this paper was to examine the general characteristics of burns and identify burn injury outcomes among adult-supervised children compared to those who were not supervised. The study examined burn injury and clinical characteristics among all burn patients admitted to two trauma hospitals in The Gambia, West Africa. At intake in the emergency room, the treating physician or nurse determined the need for admission based on body surface area burned (BSAB, depth of burn, and other clinical considerations such as co-occurring injuries and co-morbidities. During the study period of 1 April 2014 through 31 October 2016, 105 burn patients were admitted and data were collected by the treating physician for all of them. Information about supervision was only asked for children aged five years or less. More than half (51% of the burn patients were children under 18 years, and 22% were under 5 years. Among children under five, most (86.4% were supervised by an adult at the time of burn event. Of the 19 supervised children, 16 (84.2% had body area surface burned (BSAB of less than 20%. Two of the three children without adult supervision at the time of burn event had BSAB ≥ 20%. Overall, 59% of the patients had 20% + BSAB. Females (aOR = 1.25; 95% CI = 0.43–3.62, those burned in rural towns and villages (aOR = 2.29; 95% CI = 0.69–7.57, or burned by fire or flames (aOR = 1.47; 95% CI = 0.51–4.23 had increased odds of having a BSAB ≥ 20%, although these differences were not statistically significant. Children 0–5 years or 5–18 years (aOR = 0.04, 95% CI = 0.01–0.17; aOR = 0.07, 95% CI = 0.02–0.23, respectively were less likely to have BSAB ≥ 20% than adults. Those burned in a

Protect the Ones You Love: Burns Safety

Science.gov (United States)

... Submit Search The CDC Protect the Ones You Love: Child Injuries are Preventable Note: Javascript is disabled ... ways you can help protect the children you love from burns. Key Prevention Tips To prevent burns ...

Domestic bioethanol-fireplaces--a new source of severe burn accidents.

Science.gov (United States)

Neubrech, Florian; Kiefer, Jurij; Schmidt, Volker J; Bigdeli, Amir K; Hernekamp, J Frederick; Kremer, Thomas; Kneser, Ulrich; Radu, Christian Andreas

2016-02-01

Bioethanol-fueled fireplaces are popular interior home decoration accessories. Although their safety is promoted frequently, actual presentations of severe burn injuries in our burn intensive care unit (ICU) have focused the authors on safety problems with these devices. In this article we want to explore the mechanisms for these accidents and state our experiences with this increasingly relevant risk for severe burn injuries. The computerized medical records of all burn intensive care patients in our burn unit between 2000 and 2014 were studied. Since 2010, 12 patients with bioethanol associated burn injuries were identified. Their data was compared to the values of all patients, except the ones injured by bioethanol fireplaces that presented themselves to our burn ICU between the years 2010 and 2014. At time of admission the bioethanol patients had a mean ABSI-score of 4.8 (+/- 2.2 standard deviation (SD)). A mean of 17 percent (+/- 9.1 SD) body surface area was burned. Involvement of face and hands was very common. An operative treatment was needed in 8 cases. A median of 20 days of hospitalization (range 3-121) and a median of 4.5 days on the ICU (range 1-64) were necessary. No patient died. In most cases the injuries happened while refilling or while starting the fire, even though safety instructions were followed. In the control group, consisting of 748 patients, the mean ABSI-score was 5.6 (+/- 2.7 SD). A mean of 16.5 percent (+/- 10.1 SD) body surface area was burned. Treatment required a median of 3 days on the burn ICU (range 1-120). Regarding these parameters, the burden of disease was comparable in both groups. Bioethanol-fueled fireplaces for interior home decoration are a potential source for severe burn accidents even by intended use. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

Infections in critically ill burn patients.

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Hidalgo, F; Mas, D; Rubio, M; Garcia-Hierro, P

2016-04-01

Severe burn patients are one subset of critically patients in which the burn injury increases the risk of infection, systemic inflammatory response and sepsis. The infections are usually related to devices and to the burn wound. Most infections, as in other critically ill patients, are preceded by colonization of the digestive tract and the preventative measures include selective digestive decontamination and hygienic measures. Early excision of deep burn wound and appropriate use of topical antimicrobials and dressings are considered of paramount importance in the treatment of burns. Severe burn patients usually have some level of systemic inflammation. The difficulty to differentiate inflammation from sepsis is relevant since therapy differs between patients with and those without sepsis. The delay in prescribing antimicrobials increases morbidity and mortality. Moreover, the widespread use of antibiotics for all such patients is likely to increase antibiotic resistance, and costs. Unfortunately the clinical usefulness of biomarkers for differential diagnosis between inflammation and sepsis has not been yet properly evaluated. Severe burn injury induces physiological response that significantly alters drug pharmacokinetics and pharmacodynamics. These alterations impact antimicrobials distribution and excretion. Nevertheless the current available literature shows that there is a paucity of information to support routine dose recommendations. Copyright © 2016. Publicado por Elsevier España, S.L.U.

Five-year epidemiology of liquefied petroleum gas-related burns.

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Jin, Ronghua; Wu, Pan; Ho, Jon Kee; Wang, Xingang; Han, Chunmao

2018-02-01

The incidence of liquefied petroleum gas (LPG)-related burns has increased over recent years, and it has become a serious public health issue in developing countries such as India and Turkey. This paper aims to investigate the epidemiological characteristics of LPG-related burns to provide assistance and suggestions for planning prevention strategies. A 5-year retrospective study was conducted in patients with LPG-related burns admitted to the Department of Burns & Wound Care Center, Second Affiliated Hospital of Zhejiang University, College of Medicine, between 1st January 2011 and 31st December 2015. Information obtained for each patient included age, gender, education status, occupation, medical insurance, average hospital cost, length of hospital stay, monthly distribution of incidence, place of burns, mechanism of burns, extent of burns, site of burns, accompanying injuries, and treatment outcomes. For the first 4 years (2011-2014), the yearly incidence of LPG-related burns was at approximately 10% of all burns; however, in the fifth year (2015) alone, there was a surge to 26.94%. A total of 1337 burn patients were admitted during this period. Of these, 195 patients were admitted because of 169 LPG-related accidents; there were 11 accidents involving more than one victim. LPG-related burns occurred most frequently in patients aged 21-60 years (73.85%). The majority of injuries occurred from May to August (56.41%), and the most common place was home (83.08%, 162 patients). Gas leak (81.03%) was the main cause of LPG-related burns, followed by inappropriate operation (7.69%) and cooking negligence (2.05%). The mean burn area was 31.32±25.40% of TBSA. The most common sites of burns were the upper extremities (37.47%), followed by the head/face and neck (24.80%) and lower extremities (19.95%). The most common accompanying injuries included inhalation injury (23.59%), shock (8.71%), and external injury (7.18%). The average hospital stay was 22.90±19.47days (range

Socioeconomic impact of children's burns-a pilot study.

Science.gov (United States)

Kilburn, Nadia; Dheansa, Baljit

2014-12-01

This pilot study aimed to gain empirical data on the social and economic impacts of child burns on children and parents, in the context of the outpatient setting. A questionnaire was completed by 52 parents of paediatric patients attending the burns outpatient department at Queen Victoria Hospital (QVH), East Grinstead, for at least the third time. Children's medical notes were used to extract demographic and medical data. Quantitative data was analyzed statistically and qualitative data was analyzed manually using content analysis. The financial burden related to the injury posed the greatest impact on parents, and was mainly associated with making the journey to the hospital, with lower income households being most affected. Self-employed parents and those who had to attend more than 6 hospital appointments also ran into difficulties. On the whole, there was not a considerable social impact on the burn-injured child, which may reflect the minor nature of burns in this study (mean depth partial thickness, median TBSA 1.0%). Parents were shown to perceive a greater impact from their child's burn injury than their child. Certain groups of parents were identified as requiring additional support following the burn injury. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

Firework related injury and legislation: the epidemiology of firework injuries and the effect of legislation in Northern Ireland.

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Fogarty, B J; Gordon, D J

1999-02-01

The efficacy of legislation in reducing firework associated injuries is uncertain as is the nature of the problem within the United Kingdom (UK). In September 1996 the legislation governing firework sale in Northern Ireland was relaxed thus equalling that of the rest of the UK. For the 2 years following the change in legislation we prospectively assessed those patients who were admitted with a firework injury over the Halloween period. We then compared these results with retrospective data for the 3 years prior to the change in firework law. In the pre-legislation series the mean number of patients admitted annually was 0.38 per 100,000 while in the post-legislation series the mean was 0.43 per 100,000. Blast injury to the hand was the commonest injury accounting for 53% of cases in both series. Burn injuries were the second commonest form of injury comprising 30% of all admissions. Of those admitted with a hand injury 47% had at least one finger terminalised and nearly half of those patients admitted with burns (44%) required skin grafting. We conclude that early evidence suggests that liberalisation of the law on firework sale has not resulted in a significant increase in firework related injuries requiring hospital admission.

The treatment of extensively burned patents and β irradiational injury skin burn patients with irradiated pigskin

International Nuclear Information System (INIS)

Tang Zhongyi; Lu Xingan; Jing Ling; Qi Qiang

1994-01-01

Obvious therapeutic effects achieved by the covering of irradiation sterilized pigskin on burn wounds, escarectomized 3rd degree burn wounds β injured burns are discussed. The article also describes the manufacture processes of irradiated pigskins and the selection of surgical treatments of various burns. 5 refs., 1 tab., 4 figs

Epidemiology of burns in teaching hospital of Northern India

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Mumtazudin Wani

2016-01-01

Full Text Available Background: There is no information on the pattern of outcomes among burn patients in relation to clinical aspects in India. Hence, the present study was undertaken in a burn unit to determine selected epidemiological variables, assess the clinical aspects (etiology, extent and anatomical location and finally to analyze the outcomes in cases of burn injury. Materials and Methods: This prospective study was undertaken to analyze the patients admitted to the Burn Unit of Government Medical college Srinagar. The study was carried over a period 2 years from January 2013 to December 2014. Various variables including age and sex distribution, nature of burn injuries, Anatomical location, percentage of total body surface area burnt, depth of burns, Survival of expired patients and mortality were recorded and analyzed. Results: Highest incidence of burns was in the age group between 21 and 40 years; 61% patients were females and 39% were males; majority of our patients had burns in the range of 20 to 40% TBSA (total body surface area; mortality rate in our study was 36.82%; most common site of the burn injury was upper limb(30.19%;among patients who died those with TBSA burn of >60%, 41 to 60% and 31 to 40% succumbed within three, six and nine days respectively. Age ranged from 6 months to 93 years. Mean age of the patients was 31 years. Eighty percent patients belonged to rural areas and 20% belonged to Urban locality. Conclusion: People with low educational qualification should be taught about the proper and safe usage of modern appliances based on electricity, LPG or kerosene. People with psychiatric problems or low intelligence quotient (I.Q should be helped by their care takers in avoiding the burn injuries and also devices with alarms should be used in their households. Fuel or electric devices should be checked by a trained person regularly (e.g once in month to avoid usage of faulty devices.

Outcomes of patients who commit suicide by burning.

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Castana, O; Kourakos, P; Moutafidis, M; Stampolidis, N; Triantafyllou, V; Pallantzas, Ath; Filippa, E; Alexandropoulos, C

2013-03-31

Cases in which people use fire when attempting or committing suicide are not common but nevertheless constitute a cause of admission to burns units worldwide. Usually these people are suffering from stress and have been diagnosed as mentally ill. Schizophrenia, depression, and personality disorders are the most frequently diagnosed conditions. The psychological problems appear to have been overlooked by the family or not to have been presented to them. The aim of this study is to present the clinical features, characteristics, and outcomes of patients burned during a suicide attempt. The role of the psychiatrist is important, starting in the emergency room. The incidence of patients committing self-injury by burning appears to be higher in women burn patients. Deceased patients usually have a larger extent of burns and a higher incidence of other injuries and require more surgical procedures and longer hospitalization times. The problems for burn unit staff and qualified psychiatric care are discussed.

Outcomes of patients who commit suicide by burning

Science.gov (United States)

Castana, O.; Kourakos, P.; Moutafidis, M.; Stampolidis, N.; Triantafyllou, V.; Pallantzas, Ath.; Filippa, E.; Alexandropoulos, C.

2013-01-01

Summary Cases in which people use fire when attempting or committing suicide are not common but nevertheless constitute a cause of admission to burns units worldwide. Usually these people are suffering from stress and have been diagnosed as mentally ill. Schizophrenia, depression, and personality disorders are the most frequently diagnosed conditions. The psychological problems appear to have been overlooked by the family or not to have been presented to them. The aim of this study is to present the clinical features, characteristics, and outcomes of patients burned during a suicide attempt. The role of the psychiatrist is important, starting in the emergency room. The incidence of patients committing self-injury by burning appears to be higher in women burn patients. Deceased patients usually have a larger extent of burns and a higher incidence of other injuries and require more surgical procedures and longer hospitalization times. The problems for burn unit staff and qualified psychiatric care are discussed. PMID:23966897

Treatment of radiation burns, 1987 [videorecording][Radiation injuries following an accident at a nuclear power plant, 1986. Medical aspects of Chernobyl, 1986

Energy Technology Data Exchange (ETDEWEB)

NONE

1987-07-01

After the accident at Chernobyl, patients with various degrees of radiation burns were given treatment at Moscow hospital No. 6. The video shows the radiation injuries as well as therapy and treatment in detail.

Necrostatin-1 Reduces Neurovascular Injury after Intracerebral Hemorrhage

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Melanie D. King

2014-01-01

Full Text Available Intracerebral hemorrhage (ICH is the most common form of hemorrhagic stroke, accounting for 15% of all strokes. ICH has the highest acute mortality and the worst long-term prognosis of all stroke subtypes. Unfortunately, the dearth of clinically effective treatment options makes ICH the least treatable form of stroke, emphasizing the need for novel therapeutic targets. Recent work by our laboratory identified a novel role for the necroptosis inhibitor, necrostatin-1, in limiting neurovascular injury in tissue culture models of hemorrhagic injury. In the present study, we tested the hypothesis that necrostatin-1 reduces neurovascular injury after collagenase-induced ICH in mice. Necrostatin-1 significantly reduced hematoma volume by 54% at 72 h after-ICH, as compared to either sham-injured mice or mice administered an inactive, structural analogue of necrostatin-1. Necrostatin-1 also limited cell death by 48%, reduced blood-brain barrier opening by 51%, attenuated edema development to sham levels, and improved neurobehavioral outcomes after ICH. These data suggest a potential clinical utility for necrostatin-1 and/or novel necroptosis inhibitors as an adjunct therapy to reduce neurological injury and improve patient outcomes after ICH.

The value of WhatsApp communication in paediatric burn care.

Science.gov (United States)

Martinez, R; Rogers, A D; Numanoglu, A; Rode, H

2018-06-01

compared to the five years prior to the intervention, outpatient visits reduced significantly during the study period. It was estimated that over 150 unnecessary admissions were also avoided as a result of the triage made possible by WhatsApp, which translated into considerable cost saving for the institution. Incorporating WhatsApp technology into the daily processes of burn care has significantly improved the quality of paediatric burn care referrals to specialist burn services. Specifically, WhatsApp has contributed to reductions in unnecessary referrals and outpatient visits, facilitated opportunities for continuing medical education, improved the care of major burn injuries through more effective prehospital communication, and enabled greater allocation of scarce specialist resources at the burn centre. This study motivates for the wider application of WhatsApp for burn care referrals, especially in developing countries. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Coagulopathy and its management in patients with severe burns

NARCIS (Netherlands)

Glas, G. J.; Levi, M. [=Marcel M.; Schultz, M. J.

2016-01-01

Severe burn injury is associated with systemic coagulopathy. The changes in coagulation described in patients with severe burns resemble those found patients with sepsis or major trauma. Coagulopathy in patients with severe burns is characterized by procoagulant changes, and impaired fibrinolytic

OPTIMIZATION OF RESULTS AND TREATMENT TIMING OF DEEP DERMAL BURNS IN CHILDREN

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Konstantin Aleksandrovich Afonichev

2014-06-01

Full Text Available Untreated deep dermal burns in children are the cause of long-term treatment and severe cicatricial deformities, resulting in poor cosmetic results and greatly impairing functional outcome. The problem of optimizing the results and timing of treatment of deep burns in children in recent years has become particularly urgent. We observed 1853 children with III-A degree burns. Some of the children's burns healed spontaneously, which led to the development of scar deformities during the first six months after injury. Risk factors for their development, depending on the patient's age and location of the lesion, are pointed out. Other children underwent early tangential excision of eschar. The analysis of the treatment results showed that the use of early surgery in children with deep dermal burns can reduce treatment time, as well as significantly to improve the cosmetic and functional outcomes of trauma.

Vitamin E Supplementation in Burn Patients

Science.gov (United States)

2015-10-01

AWARD NUMBER: W81XWH-12-1-0429 TITLE: Vitamin E Supplementation in Burn Patients PRINCIPAL INVESTIGATOR: Perenlei Enkhbaatar, MD., PhD...NOTES 14. ABSTRACT Our recent findings demonstrate that burn injury significantly depleted stores of vitamin E in adipose tissue of children by nearly...oxidative stress. The objectives of our proposal were to a) attenuate alpha-tocopherol depletion in burn patients by vitamin E supplementation, b) to

Effectiveness of medical hypnosis for pain reduction and faster wound healing in pediatric acute burn injury: study protocol for a randomized controlled trial.

Science.gov (United States)

Chester, Stephen J; Stockton, Kellie; De Young, Alexandra; Kipping, Belinda; Tyack, Zephanie; Griffin, Bronwyn; Chester, Ralph L; Kimble, Roy M

2016-04-29

Burns and the associated wound care procedures can be extremely painful and anxiety-provoking for children. Burn injured children and adolescents are therefore at greater risk of experiencing a range of psychological reactions, in particular posttraumatic stress disorder, which can persist for months to years after the injury. Non-pharmacological intervention is critical for comprehensive pain and anxiety management and is used alongside pharmacological analgesia and anxiolysis. However, effective non-pharmacological pain and anxiety management during pediatric burn procedures is an area still needing improvement. Medical hypnosis has received support as a technique for effectively decreasing pain and anxiety levels in adults undergoing burn wound care and in children during a variety of painful medical procedures (e.g., bone marrow aspirations, lumbar punctures, voiding cystourethrograms, and post-surgical pain). Pain reduction during burn wound care procedures is linked with improved wound healing rates. To date, no randomized controlled trials have investigated the use of medical hypnosis in pediatric burn populations. Therefore this study aims to determine if medical hypnosis decreases pain, anxiety, and biological stress markers during wound care procedures; improves wound healing times; and decreases rates of traumatic stress reactions in pediatric burn patients. This is a single-center, superiority, parallel-group, prospective randomized controlled trial. Children (4 to 16 years, inclusive) with acute burn injuries presenting for their first dressing application or change are randomly assigned to either the (1) intervention group (medical hypnosis) or (2) control group (standard care). A minimum of 33 participants are recruited for each treatment group. Repeated measures of pain, anxiety, stress, and wound healing are taken at every dressing change until ≥95 % wound re-epithelialization. Further data collection assesses impact on posttraumatic stress

Burn-induced increase in atrogin-1 and MuRF-1 in skeletal muscle is glucocorticoid independent but downregulated by IGF-I.

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Lang, Charles H; Huber, Danuta; Frost, Robert A

2007-01-01

The present study determined whether thermal injury increases the expression of the ubiquitin (Ub) E3 ligases referred to as muscle ring finger (MuRF)-1 and muscle atrophy F-box (MAFbx; aka atrogin-1), which are muscle specific and responsible for the increased protein breakdown observed in other catabolic conditions. After 48 h of burn injury (40% total body surface area full-thickness scald burn) gastrocnemius weight was reduced, and this change was associated with an increased mRNA abundance for atrogin-1 and MuRF-1 (3.1- to 8-fold, respectively). Similarly, burn increased polyUb mRNA content in the gastrocnemius twofold. In contrast, there was no burn-induced atrophy of the soleus and no significant change in atrogin-1, MuRF-1, or polyUb mRNA. Burns also did not alter E3 ligase expression in heart. Four hours after administration of the anabolic agent insulin-like growth factor (IGF)-I to burned rats, the mRNA content of atrogin-1 and polyUb in gastrocnemius had returned to control values and the elevation in MuRF-1 was reduced 50%. In contrast, leucine did not alter E3 ligase expression. In a separate study, in vivo administration of the proteasome inhibitor Velcade prevented burn-induced loss of muscle mass determined at 48 h. Finally, administration of the glucocorticoid receptor antagonist RU-486 did not prevent burn-induced atrophy of the gastrocnemius or the associated elevation in atrogin-1, MuRF-1, or polyUb. In summary, the acute muscle wasting accompanying thermal injury is associated with a glucocorticoid-independent increase in the expression of several Ub E3 ligases that can be downregulated by IGF-I.

The trend of acute burns pre-hospital management

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Abubakar Hamdiya

2015-08-01

Conclusions: Burn injuries are common in our settings, a more reason for all to know the immediate intervention to give to victims of such accidents. The kind of first aid administered to burns victims possibly affects the burns management outcome. Thus, the earlier the right intervention implemented, the lesser the complications.

Do OSHA Inspections Reduce Injuries? A Panel Analysis

OpenAIRE

Wayne B. Gray; John T. Scholz

1991-01-01

Using data on injuries and OSHA inspections for 6,842 large manufacturing plants between 1979 and 1985, we find evidence that OSHA inspections significantly reduce injuries. This effect comes exclusively from inspections that impose penalties, inspections which do not impose penalties appear to have no effect on injuries. Plants which are inspected (and penalized) in a given year experience a 22 percent decline in their injuries during the following few years. In our sample, total OSHA enforc...

Prevention of Infections Associated with Combat-Related Burn Injuries

Science.gov (United States)

2011-08-01

microbial flora and wound colonization in burned patients. Burns. 2004;30:357–361. 20. Barret JP, Herndron DN. Effects of burn wound excision on bacterial...Biobrane versus 1% silver sulfadiazine. Ann Emerg Med. 1990;19:121–124. 57. Barret JP, Dziewulski P, Ramzy PI, Wolf SE, Desai MH, Herndon DN

Acute pain management in burn patients

DEFF Research Database (Denmark)

Gamst-Jensen, Hejdi; Vedel, Pernille Nygaard; Lindberg-Larsen, Viktoria Oline

2014-01-01

OBJECTIVE: Burn patients suffer excruciating pain due to their injuries and procedures related to surgery, wound care, and mobilization. Acute Stress Disorder, Post-Traumatic Stress Disorder, chronic pain and depression are highly prevalent among survivors of severe burns. Evidence-based pain...... patients. The most highly recommended guidelines provided clear and accurate recommendations for the nursing and medical staff on pain management in burn patients. We recommend the use of a validated appraisal tool such as the AGREE instrument to provide more consistent and evidence-based care to burn...

Long term mortality in critically ill burn survivors.

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Nitzschke, Stephanie; Offodile, Anaeze C; Cauley, Ryan P; Frankel, Jason E; Beam, Andrew; Elias, Kevin M; Gibbons, Fiona K; Salim, Ali; Christopher, Kenneth B

2017-09-01

Little is known about long term survival risk factors in critically ill burn patients who survive hospitalization. We hypothesized that patients with major burns who survive hospitalization would have favorable long term outcomes. We performed a two center observational cohort study in 365 critically ill adult burn patients who survived to hospital discharge. The exposure of interest was major burn defined a priori as >20% total body surface area burned [TBSA]. The modified Baux score was determined by age + %TBSA+ 17(inhalational injury). The primary outcome was all-cause 5year mortality based on the US Social Security Administration Death Master File. Adjusted associations were estimated through fitting of multivariable logistic regression models. Our final model included adjustment for inhalational injury, presence of 3rd degree burn, gender and the acute organ failure score, a validated ICU risk-prediction score derived from age, ethnicity, surgery vs. medical patient type, comorbidity, sepsis and acute organ failure covariates. Time-to-event analysis was performed using Cox proportional hazard regression. Of the cohort patients studied, 76% were male, 29% were non white, 14% were over 65, 32% had TBSA >20%, and 45% had inhalational injury. The mean age was 45, 92% had 2nd degree burns, 60% had 3rd degree burns, 21% received vasopressors, and 26% had sepsis. The mean TBSA was 20.1%. The mean modified Baux score was 72.8. Post hospital discharge 5year mortality rate was 9.0%. The 30day hospital readmission rate was 4%. Patients with major burns were significantly younger (41 vs. 47 years) had a significantly higher modified Baux score (89 vs. 62), and had significantly higher comorbidity, acute organ failure, inhalational injury and sepsis (all Pburns. In the multivariable logistic regression model, major burn was associated with a 3 fold decreased odds of 5year post-discharge mortality compared to patients with TBSAburn, gender and the acute organ failure score

Application of Haddon’s matrix in qualitative research methodology: an experience in burns epidemiology

Directory of Open Access Journals (Sweden)

Deljavan R

2012-07-01

Full Text Available Reza Deljavan,1 Homayoun Sadeghi-Bazarganim,2,3 Nasrin Fouladim,4 Shahnam Arshi,5 Reza Mohammadi61Injury Epidemiology and Prevention Research Center, 2Neuroscience Research Center, Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran; 3Public Health Department, Karolinska Institute, Stockholm, Sweden; 4Ardabil University of Medical Sciences, Ardabil, Iran; 5Shahid Beheshti University of Medical Sciences, Tehran, Iran; 6Public Health Department, Karolinska Institute, Stockholm, SwedenBackground: Little has been done to investigate the application of injury specific qualitative research methods in the field of burn injuries. The aim of this study was to use an analytical tool (Haddon’s matrix through qualitative research methods to better understand people’s perceptions about burn injuries.Methods: This study applied Haddon’s matrix as a framework and an analytical tool for a qualitative research methodology in burn research. Both child and adult burn injury victims were enrolled into a qualitative study conducted using focus group discussion. Haddon’s matrix was used to develop an interview guide and also through the analysis phase.Results: The main analysis clusters were pre-event level/human (including risky behaviors, belief and cultural factors, and knowledge and education, pre-event level/object, pre-event phase/environment and event and post-event phase (including fire control, emergency scald and burn wound management, traditional remedies, medical consultation, and severity indicators. This research gave rise to results that are possibly useful both for future injury research and for designing burn injury prevention plans.Conclusion: Haddon’s matrix is applicable in a qualitative research methodology both at data collection and data analysis phases. The study using Haddon’s matrix through a qualitative research methodology yielded substantially rich information regarding burn injuries

Ethanol exacerbates T cell dysfunction after thermal injury.

Science.gov (United States)

Choudhry, M A; Messingham, K A; Namak, S; Colantoni, A; Fontanilla, C V; Duffner, L A; Sayeed, M M; Kovacs, E J

2000-07-01

To understand the mechanism of suppressed immunity following alcohol consumption and thermal injury, we analyzed T cell functions in a mouse model of acute alcohol exposure and burn injury. Mice with blood alcohol levels at approximately 100 mg/dl were given a 15% scald or sham injury. Mice were sacrificed 48 h after injury. Our data demonstrated a 20-25% decrease in Con A-mediated splenic T cell proliferation (p<0.01) and 45-50% decrease in interleukin-2 (IL-2) production (p<0.01) following burn injury compared to the T cells from sham animals. A further decrease in the proliferation (25-30%) and IL-2 production (40-45%) was detected in T cells derived from burned animals receiving alcohol as compared to burn alone. No significant change in the proliferation and IL-2 production was observed in splenic T cells derived from sham-injured mice regardless of alcohol exposure. Additionally, there was no demonstrable difference in splenocyte apoptosis in any treatment group. These results suggest that alcohol consumption prior to burn injury causes a greater decrease in T cell proliferation and IL-2 production compared to either burn or alcohol injury alone that may further attenuate the cell-mediated immunity and thus enhance susceptibility to infection.

Epidemiology of pediatric burns and future prevention strategies-a study of 475 patients from a high-volume burn center in North India.

Science.gov (United States)

Dhopte, Amol; Tiwari, V K; Patel, Pankaj; Bamal, Rahul

2017-01-01

Pediatric burns have a long-term social impact. This is more apparent in a developing country such as India, where their incidence and morbidity are high. The aim of this study was to provide recent prospective epidemiological data on pediatric burns in India and to suggest future preventive strategies. Children up to 18 years old admitted to the Department of Burns, Plastic & Maxillofacial Surgery, VMMC & Safdarjung Hospital, New Delhi, between January and December 2014 were included in the study. Data regarding age, sex, etiology, total body surface area (TBSA), circumstances of injury, and clinical assessment were collected. The Mann-Whitney test or Kruskal-Wallis test or ANOVA was used to compare involved TBSA among various cohort groups accordingly. Univariate and multivariate linear regression analyses were used to determine the predictors of TBSA. There were a total of 475 patients involved in the study, including seven suicidal burns, all of whom were females with a mean age greater than the cohort average. Age, type of burns, mode of injury, presence or absence of inhalation injury, gender, and time of year (quarter) for admission were found to independently affect the TBSA involved. Electrical burns also formed an important number of presenting burn patients, mainly involving teenagers. Several societal issues have come forth, e.g., child marriage, child labor, and likely psychological problems among female children as suggested by a high incidence of suicidal burns. This study also highlights several issues such as overcrowding, lack of awareness, dangerous cooking practices, and improper use of kerosene oil. There is an emergent need to recognize the problems, formulate strategies, spread awareness, and ban or replace hazardous substances responsible for most burn accidents.

Imipenem in burn patients: pharmacokinetic profile and PK/PD target attainment.

Science.gov (United States)

Gomez, David S; Sanches-Giraud, Cristina; Silva, Carlindo V; Oliveira, Amanda M Ribas Rosa; da Silva, Joao Manoel; Gemperli, Rolf; Santos, Silvia R C J

2015-03-01

Unpredictable pharmacokinetics (PK) in burn patients may result in plasma concentrations below concentrations that are effective against common pathogens. The present study evaluated the imipenem PK profile and pharmacokinetic/pharmacodynamics (PK/PD) correlation in burn patients. Fifty-one burn patients, 38.7 years of age (mean), 68.0 kg, 36.3% total burn surface area (TBSA), of whom 84% (43/51) exhibited thermal injury, 63% inhalation injury and 16% electrical injury (8/51), all of whom were receiving imipenem treatment were investigated. Drug plasma monitoring, PK study (120 sets of plasma levels) and PK/PD correlation were performed in a series of blood samples. Only 250 μl of plasma samples were required for drug plasma measurements using the ultra filtration technique for the purification of biological matrix and quantification using liquid chromatography. Probability of target attainment (PTA) was calculated using a PD target of 40% free drug concentrations above the minimum inhibitory concentration (40%fT>MIC). Significant differences in PK parameters (medians), such as biological half-life (2.2 vs 5.5 h), plasma clearance (16.2 vs 1.4 l h(-1)) and volume of distribution (0.86 vs 0.19 l kg(-1)), were registered in burn patients via comparisons of set periods with normal renal function against periods of renal failure. Correlations between creatinine clearance and total body plasma clearance were also obtained. In addition, the PK profile did not change according to TBSA during sets when renal function was preserved. PTA was >89% for MIC values up to 4 mg l(-1). In conclusion, imipenem efficacy for the control of hospital infection on the basis of PK/PD correlation was guaranteed for burn in patients at the recommended dose regimens for normal renal function (31.1±9.7 mg kg(-1) daily), but the daily dose must be reduced to 17.2±9.7 mg kg(-1) during renal failure to avoid neurotoxicity.

Profile of children abused by burning.

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