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Sample records for burns injuries

  1. Systemic Responses to Burn Injury

    OpenAIRE

    ÇAKIR, Barış; YEĞEN, Berrak Ç.

    2004-01-01

    The major causes of death in burn patients include multiple organ failure and infection. It is important for the clinician to understand the pathophysiology of burn injury and the effects it will have on the pharmacokinetics of a drug. The local and systemic inflammatory response to thermal injury is extremely complex, resulting in both local burn tissue damage and deleterious systemic effects on all other organ systems distant from the burn area itself. Thermal injury initiates systemic infl...

  2. Burn Injuries: Burn Depth, Physiopathology and Type of Burns

    OpenAIRE

    Kemalettin Koltka

    2011-01-01

    A significant burn injury is a serious and mortal event. The most important threat to life is hypovolemic shock with complex pathophysiologic mechanisms. Burn depth is classified as first, second, or third degree. Local inflammatory response results a vasodilatation and an increase in vascular permeability. A burn injury is a three dimensional ischemic wound. Zone of coagulation is the zone with maximum damage. Zone of stasis consists of damaged but viable tissues, the tissue is salvageable. ...

  3. Burn Injuries: Burn Depth, Physiopathology and Type of Burns

    Directory of Open Access Journals (Sweden)

    Kemalettin Koltka

    2011-07-01

    Full Text Available A significant burn injury is a serious and mortal event. The most important threat to life is hypovolemic shock with complex pathophysiologic mechanisms. Burn depth is classified as first, second, or third degree. Local inflammatory response results a vasodilatation and an increase in vascular permeability. A burn injury is a three dimensional ischemic wound. Zone of coagulation is the zone with maximum damage. Zone of stasis consists of damaged but viable tissues, the tissue is salvageable. In zone of hyperemia tissue perfusion is increased. At the beginning, cardiac output falls and systemic vascular resistance increases; cardiac performance improves as hypovolemia is corrected with fluid resuscitation. While cardiac output increases systemic vascular resistance falls below normal values and a hypermetabolic state develops. Pulmonary vascular resistance increases immediately after thermal injury and this is more prolonged. To avoid secondary pulmonary complications, the smallest resuscitation volume of fluids that maintains adequate tissue perfusion should be given. Changes parallel to the cardiovascular response develop in other organ systems. The reasons of burn injury can be thermal, electrical, chemical or radiation. It is important to know the exact mechanism of burn injury because of different therapies for a specific cause. In this review information about burn depth, local and systemic responses to burn injury and major causes of burn injury are presented. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl:1-6

  4. [Burn injuries and mental health].

    Science.gov (United States)

    Palmu, Raimo; Vuola, Jyrki

    2016-01-01

    Currently a large proportion of patients with severe burn injuries survive. This gives increasing challenges also for psychological recovery after the trauma. More than half of burn patients have mental disorders already before the burn injury but also patients who previously had no mental disorders may suffer from them. Some of the hospitalize burn patients have injuries due to suicidal attempts. Only a small proportion of burn patients receive appropriate psychiatric care although psychosocial interventions specifically planned for burn victims exist. More frequent screening of symtoms of mental disorders and psychiatric consultation, also after acute care in hospital, could lead to better management of post-burn psychiatric care as well as better management of the burn treatment and rehabilitation itself. PMID:27089616

  5. Alcohol use and burn injury.

    Science.gov (United States)

    Jones, J D; Barber, B; Engrav, L; Heimbach, D

    1991-01-01

    Charts of 108 consecutive adult patients with flame burns of 20% to 70% total body surface area were reviewed to determine the incidence of acute alcohol intoxication and the likelihood that intoxicated patients were chronic alcohol abusers, to assess morbidity and mortality in the alcoholic patient with burns, and to characterize the intervention used in postdischarge treatment of the alcoholic patient with burns who survives. Twenty-seven percent of patients were acutely intoxicated at the time of injury. Evidence for chronic alcohol abuse was apparent in 90% of intoxicated patients, compared to only 11% of nonintoxicated patients (p = 0.0001). Alcoholic patients with burns not only had an overall mortality rate three times that of nonalcoholics (p = 0.001) but also died of smaller burns (p less than 0.05). Surviving alcoholic patients with burns required significantly more intravenous antibiotics and a longer hospitalization. Social service evaluation of use of alcohol was made in 84% of the cases of surviving intoxicated burn victims. Further intervention was undertaken in two thirds of these cases, usually involving an outpatient treatment program. PMID:2050723

  6. Early Enteral Nutrition for Burn Injury

    OpenAIRE

    Mandell, Samuel P.; Gibran, Nicole S.

    2014-01-01

    Significance: Nutrition has been recognized as a critical component of acute burn care and ultimate wound healing. Debate remains over the appropriate timing of enteral nutrition and the benefit of supplemental trace elements, antioxidants, and immunonutrition for critically ill burn patients. Pharmacotherapy to blunt the metabolic response to burn injury plays a critical role in effective nutritional support.

  7. Epidemiology and Statistical Modeling in Burn Injuries

    OpenAIRE

    Sadeghi Bazargani, Homayoun

    2010-01-01

    An important issue in assessing the epidemiology of injuries, including burns, is the investigation of appropriate methodologies and statistical modeling techniques to study injuries in an efficient and trustworthy manner. The overall aim of this thesis is to analyze epidemiological patterns and assess the appropriateness of supervised statistical models to investigate burn risks and patterns. This thesis contains four papers: the first two concern descriptive epidemiology of burns in Arda...

  8. National programme for prevention of burn injuries

    Directory of Open Access Journals (Sweden)

    Gupta J

    2010-10-01

    Full Text Available The estimated annual burn incidence in India is approximately 6-7 million per year. The high incidence is attributed to illiteracy, poverty and low level safety consciousness in the population. The situation becomes further grim due to the absence of organized burn care at primary and secondary health care level. But the silver lining is that 90% of burn injuries are preventable. An initiative at national level is need of the hour to reduce incidence so as to galvanize the available resources for more effective and standardized treatment delivery. The National Programme for Prevention of Burn Injuries is the endeavor in this line. The goal of National programme for prevention of burn injuries (NPPBI would be to ensure prevention and capacity building of infrastructure and manpower at all levels of health care delivery system in order to reduce incidence, provide timely and adequate treatment to burn patients to reduce mortality, complications and provide effective rehabilitation to the survivors. Another objective of the programme will be to establish a central burn registry. The programme will be launched in the current Five Year Plan in Medical colleges and their adjoining district hospitals in few states. Subsequently, in the next five year plan it will be rolled out in all the medical colleges and districts hospitals of the country so that burn care is provided as close to the site of accident as possible and patients need not to travel to big cities for burn care. The programme would essentially have three components i.e. Preventive programme, Burn injury management programme and Burn injury rehabilitation programme.

  9. Burn Injury Arise From Flying Balloon Toys

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    Yalcin Kulahci

    2007-08-01

    Full Text Available Many of peoples are faced minor or major burn injuries in their life. Even the most widespread burn cause is flame injuries, too different burn cause pointed out in literature like Acetylen burns. The cases which imply in literature, mostly causes from explosion of high pressure acetylene tube, metal oxygene patch flame or carbide lamp using from cave explorers. An interesting acetylene burn cause in Turkey was publised by the authors. This cases was to come into being from flying toy balloons flame. 80 person was injured from flying toy ballons flame in a meeting in 2002. Although this potential risks of acetylene, helium have not any of some risk. But helium was provided from other countries and have more price. The injuries which caused from acetylene burns like 1st -2nd degree burns. Consequently that was known helium is more avaliable for using in toy sector, and never cause burn injuries like this. [TAF Prev Med Bull. 2007; 6(4: 291-296

  10. Sexual Function Following Burn Injuries: Literature Review.

    Science.gov (United States)

    Pandya, Atisha A; Corkill, Helen A; Goutos, Ioannis

    2015-01-01

    Sexual function is a profound facet of the human personality. Burns due their sudden and devastating nature can have longstanding effects on intimate function by virtue of physical sequelae as well as alterations in body image and perceived desirability. A considerable number of patients encounter problems with intimate function in burns rehabilitation; nevertheless, the topic appears to be poorly addressed in specialist centers worldwide. Review of the literature suggests that a number of parameters can affect the quality of sexual life following burn injuries including age at the time of injury, location, and severity of the burn as well as coping mechanisms employed by the individual survivor. Addressing issues of intimacy relies on awareness, education, and a holistic approach on behalf of the multidisciplinary team members and, to this effect, recommendations are made on managing sexual function concerns in burns rehabilitation. PMID:25423439

  11. Calcium and ER Stress Mediate Hepatic Apoptosis after Burn Injury

    OpenAIRE

    Jeschke, Marc G.; Gauglitz, Gerd G.; Song, Juquan; Kulp, Gabriela A; Finnerty, Celeste C.; Cox, Robert A.; Barral, José M.; Herndon, David N; Boehning, Darren

    2009-01-01

    A hallmark of the disease state following severe burn injury is decreased liver function, which results in gross metabolic derangements that compromise patient survival. The underlying mechanisms leading to hepatocyte dysfunction post-burn are essentially unknown. The aim of the present study was to determine the underlying mechanisms leading to hepatocyte dysfunction and apoptosis post-burn. Rats were randomized to either control (no burn) or burn (60% total body surface area burn) and sacri...

  12. Epidemiology of severe burn injuries in a Tertiary Burn Centre in Tehran, Iran

    OpenAIRE

    Mohammadi-Barzelighi, H.; Alaghehbandan, R.; Motevallian, A.; Alinejad, F.; Soleimanzadeh-Moghadam, S.; Sattari, M.; A R Lari

    2011-01-01

    The aim of the study was to examine the epidemiological characteristics of hospitalized burn patients in a tertiary burn centre in Tehran, Iran. A hospital-based cross-sectional study of all hospitalized patients with burn injuries was conducted in Motahari Burn and Reconstruction Center in Tehran from August to December 2010. Medical records of all hospitalized burn patients were reviewed and pertinent information was captured. A total of 135 patients with severe burns requiring hospitalizat...

  13. Analgesic effects of dexamethasone in burn injury

    DEFF Research Database (Denmark)

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

    2002-01-01

    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 m...... administration of dexamethasone 2 hours before a burn injury does not reduce the inflammatory-mediated changes in quantitative sensory thresholds, pain perception, or skin erythema in humans....... differences between treatments in regard to skin erythema (P >.8), thermal or mechanical thresholds (P >.2), thermal or mechanical pain response (P >.2), or mechanical secondary hyperalgesia (P >.2). Dexamethasone had no analgesic effects in normal skin. CONCLUSIONS: The study indicates that systemic...... 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...

  14. Physical Fitness in People After Burn Injury : A Systematic Review

    NARCIS (Netherlands)

    Disseldorp, Laurien M.; Nieuwenhuis, Marianne K.; Van Baar, Margriet E.; Mouton, Leonora J.

    2011-01-01

    Disseldorp LM, Nieuwenhuis MK, Van Baar ME, Mouton U. Physical fitness in people after burn injury: a systematic review. Arch Phys Med Rehabil 2011;92:1501-10. Objective: To gain insight into the physical fitness of people after burn injury compared with healthy subjects, and to present an overview

  15. Characterization of burn injuries using terahertz time-domain spectroscopy

    Science.gov (United States)

    Arbab, M. Hassan; Dickey, Trevor C.; Winebrenner, Dale P.; Chen, Antao; Mourad, Pierre D.

    2011-03-01

    The accuracy rates of the clinical assessment techniques used in grading burn injuries remain significantly low for partial thickness burns. In this paper, we present experimental results from terahertz characterization of 2nd and 3rd degree burn wounds induced on a rat model. Reflection measurements were obtained from the surface of both burned and normal skin using pulsed terahertz spectroscopy. Signal processing techniques are described for interpretation of the acquired terahertz waveform and differentiation of burn wounds. Furthermore, the progression of burn injuries is shown by comparison between acute characterization and 72-hours survival studies. While the water content of healthy and desiccated skin has been considered as a source of terahertz signal contrast, it is demonstrated that other biological effects such as formation of post-burn interstitial edema as well as the density of the discrete scattering structures in the skin (such as hair follicles, sweat glands, etc.) play a significant role in the terahertz response of the burn wounds.

  16. 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.

  17. THE PATHOPHYSIOLOGIC RESPONSE TO SEVERE BURN INJURY

    Science.gov (United States)

    Jeschke, Marc G; Chinkes, David L; Finnerty, Celeste C; Kulp, Gabriela; Suman, Oscar E; Norbury, William B; Branski, Ludwik K; Gauglitz, Gerd G; Mlcak, Ronald P; Herndon, David N

    2014-01-01

    Objective To improve clinical outcome and to determine new treatment options, we studied the pathophysiologic response postburn in a large prospective, single center, clinical trial. Summary Background Data A severe burn injury leads to marked hypermetabolism and catabolism, which are associated with morbidity and mortality. The underlying pathophysiology and the correlations between humoral changes and organ function have not been well delineated. Methods Two hundred forty-two severely burned pediatric patients [>30% total body surface area (TBSA)], who received no anabolic drugs, were enrolled in this study. Demographics, clinical data, serum hormones, serum cytokine expression profile, organ function, hypermetabolism, muscle protein synthesis, incidence of wound infection sepsis, and body composition were obtained throughout acute hospital course. Results Average age was 8 ± 0.2 years, and average burn size was 56 ± 1% TBSA with 43 ± 1% third-degree TBSA. All patients were markedly hypermetabolic throughout acute hospital stay and had significant muscle protein loss as demonstrated by a negative muscle protein net balance (−0.05% ± 0.007 nmol/100 mL leg/min) and loss of lean body mass (LBM) (−4.1% ± 1.9%); P < 0.05. Patients lost 3% ± 1% of their bone mineral content (BMC) and 2 ± 1% of their bone mineral density (BMD). Serum proteome analysis demonstrated profound alterations immediately postburn, which remained abnormal throughout acute hospital stay; P < 0.05. Cardiac function was compromised immediately after burn and remained abnormal up to discharge; P < 0.05. Insulin resistance appeared during the first week postburn and persisted until discharge. Patients were hyperinflammatory with marked changes in IL-8, MCP-1, and IL-6, which were associated with 2.5 ± 0.2 infections and 17% sepsis. Conclusions In this large prospective clinical trial, we delineated the complexity of the postburn pathophysiologic response and conclude that the postburn

  18. Calcium and ER stress mediate hepatic apoptosis after burn injury

    Science.gov (United States)

    Gauglitz, Gerd G.; Song, Juquan; Kulp, Gabriela A.; Finnerty, Celeste C.; Cox, Robert A.; Barral, José M.; Herndon, David N.; Boehning, Darren

    2009-01-01

    Abstract A hallmark of the disease state following severe burn injury is decreased liver function, which results in gross metabolic derangements that compromise patient survival. The underlying mechanisms leading to hepatocyte dysfunction after burn are essentially unknown. The aim of the present study was to determine the underlying mechanisms leading to hepatocyte dysfunction and apoptosis after burn. Rats were randomized to either control (no burn) or burn (60% total body surface area burn) and sacrificed at various time‐points. Liver was either perfused to isolate primary rat hepatocytes, which were used for in vitro calcium imaging, or liver was harvested and processed for immunohistology, transmission electron microscopy, mitochondrial isolation, mass spectroscopy or Western blotting to determine the hepatic response to burn injury in vivo. We found that thermal injury leads to severely depleted endoplasmic reticulum (ER) calcium stores and consequent elevated cytosolic calcium concentrations in primary hepatocytes in vitro. Burn‐induced ER calcium depletion caused depressed hepatocyte responsiveness to signalling molecules that regulate hepatic homeostasis, such as vasopressin and the purinergic agonist ATP. In vivo, thermal injury resulted in activation of the ER stress response and major alterations in mitochondrial structure and function – effects which may be mediated by increased calcium release by inositol 1,4,5‐trisphosphate receptors. Our results reveal that thermal injury leads to dramatic hepatic disturbances in calcium homeostasis and resultant ER stress leading to mitochondrial abnormalities contributing to hepatic dysfunction and apoptosis after burn injury. PMID:20141609

  19. Children with burns referred for child abuse evaluation: Burn characteristics and co-existent injuries.

    Science.gov (United States)

    Pawlik, Marie-Christin; Kemp, Alison; Maguire, Sabine; Nuttall, Diane; Feldman, Kenneth W; Lindberg, Daniel M

    2016-05-01

    Intentional burns represent a serious form of physical abuse that must be identified to protect children from further harm. This study is a retrospectively planned secondary analysis of the Examining Siblings To Recognize Abuse (ExSTRA) network data. Our objective was to describe the characteristics of burns injuries in children referred to Child Abuse Pediatricians (CAPs) in relation to the perceived likelihood of abuse. We furthermore compare the extent of diagnostic investigations undertaken in children referred to CAPs for burn injuries with those referred for other reasons. Within this dataset, 7% (215/2890) of children had burns. Children with burns were older than children with other injuries (median age 20 months vs. 10 months). Physical abuse was perceived as likely in 40.9% (88) and unlikely in 59.1% (127). Scalds accounted for 52.6% (113) and contact burns for 27.6% (60). Several characteristics of the history and burn injury were associated with a significantly higher perceived likelihood of abuse, including children with reported inflicted injury, absent or inadequate explanation, hot water as agent, immersion scald, a bilateral/symmetric burn pattern, total body surface area ≥10%, full thickness burns, and co-existent injuries. The rates of diagnostic testing were significantly lower in children with burns than other injuries, yet the yield of skeletal survey and hepatic transaminases testing were comparable between the two groups. This would imply that children referred to CAPs for burns warrant the same level of comprehensive investigations as those referred for other reasons. PMID:27088728

  20. Predictors of insulin resistance in pediatric burn injury survivors 24 to 36 months post-burn

    Science.gov (United States)

    Chondronikola, Maria; Meyer, Walter J.; Sidossis, Labros S.; Ojeda, Sylvia; Huddleston, Joanna; Stevens, Pamela; Børsheim, Elisabet; Suman, Oscar E.; Finnerty, Celeste C.; Herndon, David N.

    2014-01-01

    Background Burn injury is a dramatic event with acute and chronic consequences including insulin resistance. However, factors associated with insulin resistance have not been previously investigated. Purpose To identify factors associated with long-term insulin resistance in pediatric burn injury survivors. Methods The study sample consisted of 61 pediatric burn injury survivors 24 to 36 months after the burn injury, who underwent an oral glucose tolerance test. To assess insulin resistance, we calculated the area under the curve for glucose and insulin. The diagnostic criteria of the American Diabetes Association were used to define individuals with impaired glucose metabolism. Additional data collected include body composition, anthropometric measurements, burn characteristics and demographic information. The data were analyzed using multivariate linear regression analysis. Results Approximately 12% of the patients met the criteria for impaired glucose metabolism. After adjusting for possible confounders, burn size, age and percent body fat were associated with the area under the curve for glucose (p<0.05 for all). Time post-burn and lean mass were inversely associated with the area under the curve for glucose (p<0.05 for both). Similarly, older age predicted higher insulin area under the curve. Conclusion A significant proportion of pediatric injury survivors suffer from glucose abnormalities 24–36 months post-burn. Burn size, time post-burn, age, lean mass and adiposity are significant predictors of insulin resistance in pediatric burn injury survivors. Clinical evaluation and screening for abnormal glucose metabolism should be emphasized in patients with large burns, older age and survivors with high body fat. PMID:24918945

  1. Study on acute burn injury survivors and the associated issues

    Institute of Scientific and Technical Information of China (English)

    Jonathan Bayuo; Pius Agbenorku; Richcane Amankwa

    2016-01-01

    Objective: To explore the phenomenon of surviving burn injury and its associated issues and concerns. Methods: A cross sectional survey approach was utilized to obtain data from one hundred burn survivors who were purposely selected. Descriptive statistics and content analysis were used to analyze data. Results: Findings from the study indicate that burns from flames stood out as a major cause of burns. Physical discomfort/pain, anxiety, needing assistance in meeting self-care needs, financial and social limitations were identified as the major impact of the injury. Furthermore, participants perceived the existence of societal stigma. In addition, hope in God or a spiritual being as well as family support were the two key resources participants relied on to cope effectively. Conclusions: Surviving burn injury is associated with varied physical, social and psy-chological factors and survivors may need professional assistance to fully adjust after discharge.

  2. Burn Injury: A Challenge for Tissue Engineers

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    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

  3. Burns and injuries resulting from the use of gel candles.

    Science.gov (United States)

    Pickus, E J; Lionelli, G T; Parmele, J B; Lawrence, W T; Korentager, R A

    2001-01-01

    Scented gel candles are common decorative household items composed of gelled mineral oil, fragrances, and dye. Like traditional wax candles, they have an open flame. Because of defective design, there have been several burns and injuries caused by these products. Here we report our experience with a scald burn from a gel candle and describe 34 additional injuries attributed to gel candles previously unreported in the medical literature. PMID:11403248

  4. Acute Kidney Injury Predicts Mortality after Charcoal Burning Suicide.

    Science.gov (United States)

    Chen, Yu-Chin; Tseng, Yi-Chia; Huang, Wen-Hung; Hsu, Ching-Wei; Weng, Cheng-Hao; Liu, Shou-Hsuan; Yang, Huang-Yu; Chen, Kuan-Hsin; Chen, Hui-Ling; Fu, Jen-Fen; Lin, Wey-Ran; Wang, I-Kuan; Yen, Tzung-Hai

    2016-01-01

    A paucity of literature exists on risk factors for mortality in charcoal burning suicide. In this observational study, we analyzed the data of 126 patients with charcoal burning suicide that seen between 2002 and 2013. Patients were grouped according to status of renal damage as acute kidney injury (N = 49) or non-acute kidney injury (N = 77). It was found that patients with acute kidney injury suffered severer complications such as respiratory failure (P = 0.002), myocardial injury (P = 0.049), hepatic injury (P acute kidney injury. Moreover, patients with acute kidney injury suffered longer hospitalization duration (16.9 ± 18.3 versus 10.7 ± 10.9, P = 0.002) and had higher mortality rate (8.2% versus 0%, P = 0.011) than patients without injury. In a multivariate Cox regression model, it was demonstrated that serum creatinine level (P = 0.019) and heart rate (P = 0.022) were significant risk factors for mortality. Finally, Kaplan-Meier analysis revealed that patients with acute kidney injury suffered lower cumulative survival than without injury (P = 0.016). In summary, the overall mortality rate of charcoal burning suicide population was 3.2%, and acute kidney injury was a powerful predictor of mortality. Further studies are warranted. PMID:27430168

  5. Burn injuries in eastern Zambia: impact of multidisciplinary teaching teams.

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    Edwards, Dianna; Heard, Jason; Latenser, Barbara A; Quinn, Keely Y; van Bruggen, Jaap; Jovic, Goran

    2011-01-01

    The American Burn Association/Children's Burn Foundation (ABA/CBF) sponsors teams who offer burn education to healthcare providers in Zambia, a sub-Saharan country. The goals of this study are 1) to acquire burn-patient demographics for the Eastern Province, Zambia and 2) to assess the early impact of the ABA/CBF-sponsored burn teams. This is a retrospective chart review of burn patients admitted in one mission hospital in Katete, Zambia, July 2002 to June 2009. July 2002 to December 2006 = data before ABA/CBF burn teams and January 2007 to June 2009 = burn care data during/after burn outreach. There were 510 burn patients hospitalized, male:female ratio 1.2:1. Average age = 15.6 years, with 44% younger than 5 years. Average TBSA burned = 11% and mean fatal TBSA = 25%. Average hospital length of stay = 16.9 days survivors and 11.6 days nonsurvivors. Most common mechanisms of burn injuries: flame (52%) and scald (41%). Ninety-two patients (18%) died and 23 (4.5%) left against medical advice. There were 191 (37.4%) patients who underwent 410 surgical procedures (range 1-13/patient). There were 138 (33.7%) sloughectomies, 118 (28.7%) skin grafts, 39 (9.5%) amputations, and 115 (28.1%) other procedures. Changes noted in the 2007 to 2009 time period: more patients had burn diagrams (48.6 vs 27.6%, P set for a sub-Saharan region in Africa. There has been a statistically significant improvement in documentation of burn size as well as administration of analgesics, validating the efficacy of the ABA/CBF-sponsored burn teams. Continued contact with burn teams may lead to increased use of resuscitation fluids, topical antimicrobials, and more patients undergoing operative intervention, translating into improved burn patient outcomes. PMID:21131848

  6. Changes in Fat Distribution in Children Following Severe Burn Injury

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    Patel, Pavankumar; Sallam, Hanaa S.; Ali, Arham; Chandalia, Manisha; Suman, Oscar; Finnerty, Celeste C.; Herndon, David N.

    2014-01-01

    Abstract Background: Children with severe cutaneous burn injury show persistent metabolic abnormalities, including inflammation and insulin resistance. Such abnormalities could potentially increase their future risk for developing type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). This could be related to changes in body composition and fat distribution. Methods: We studied body composition, fat distribution, and inflammatory cytokines changes in children with severe burn injury up to 6 months from discharge. Sixty-two boys and 35 girls (burn ≥30% of total body surface area) were included. Results: We found a decrease in total body fat and subcutaneous peripheral fat at 6 months (6% and 2%, respectively; P<0.05 each). An inverse correlation between the decrease in peripheral fat content at 6 months and the extent of burn injury (r=−041, P=0.02) was also observed. In addition, there was a 12% increase in serum tumor necrosis factor-α (TNF-α) (P=0.01 vs. discharge) and 9% decrease in serum interleukin-10 (IL-10) (P<0.0001 vs. discharge) over 6 months after burn. Conclusion: Severe burn injury in children is associated with changes in body fat content and distribution up to 6 months from hospital discharge. These changes, accompanied by persisting systemic inflammation, could possibly mediate the observed persistence of insulin resistance, predisposing burn patients to the development of T2DM and CVD. PMID:25211297

  7. Children with burn injuries-assessment of trauma, neglect, violence and abuse

    OpenAIRE

    Antoinette Runge; Walter Meyer; John Francis Fraser; Arceneaux, Lisa L.; Dirk Manfred Maybauer; Michael Howard Toon; Marc Oliver Maybauer

    2011-01-01

    Abstract: Burns are an important cause of injury to young children, being the third most frequent cause of injury resulting in death behind motor vehicle accidents and drowning. Burn injuries account for the greatest length of stay of all hospital admissions for injuries and costs associated with care are substantial. The majority of burn injuries in children are scald injuries resulting from hot liquids, occurring most commonly in children aged 0-4 years. Other types of burns include electri...

  8. Etiology of Burn Injuries Among 0-6 Aged Children in One University Hospital Burn Unit, Bursa, Turkey

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    Neriman Akansel

    2013-01-01

    Full Text Available Background; Children whose verbal communications are not fully developed are the ones at risk for burn injuries. Causes of burn injuries vary among different age groups and scald injuries are the common cause of burn injuries among children. The majority of burns result from contact with thermal agents such as flame, hot surfaces, or hot liquids.Aim: The aim of this study was to determine etiologic factors of the burn injured children Methods: Data were collected for burn injured children treated in Uludag University Medical Hospital Burn Unit between January 2001 – December 2008. Patients’ demographic variables, etiology of burn injury, TBSA(total body surface area, degree of the burn injury, duration of hospitalization was detected from medical records of the hospitalized patients.Results: The mean age of the children was 2.5±1.5 (median=2. Although 4.6 % of burned patients were under one year of age, most of the children (67.8% were between 1-3 years. All of the patients were burned as a result of accident and house environment was the place where the burn incident occurred. Burn injuries occurredmostly during summer (29.9% and spring (28.7%. Scald injuries (75.3% were mostly seen burn injury types all among other burn injuries.Conclusions: Lack of supervision and observation are usually the most common causes of burn injuries in children. Statistical differences were found among age groups according to their burn etiology (p<0.05. An effect of TBSA on patient survival was statistically significant (p<0.000 and also statistically significant results were seen among age groups according to their TBSA’s (p<0.005.

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

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    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. PMID:20644489

  10. Burn injury reduces neutrophil directional migration speed in microfluidic devices.

    Directory of Open Access Journals (Sweden)

    Kathryn L Butler

    Full Text Available Thermal injury triggers a fulminant inflammatory cascade that heralds shock, end-organ failure, and ultimately sepsis and death. Emerging evidence points to a critical role for the innate immune system, and several studies had documented concurrent impairment in neutrophil chemotaxis with these post-burn inflammatory changes. While a few studies suggest that a link between neutrophil motility and patient mortality might exist, so far, cumbersome assays have prohibited exploration of the prognostic and diagnostic significance of chemotaxis after burn injury. To address this need, we developed a microfluidic device that is simple to operate and allows for precise and robust measurements of chemotaxis speed and persistence characteristics at single-cell resolution. Using this assay, we established a reference set of migration speed values for neutrophils from healthy subjects. Comparisons with samples from burn patients revealed impaired directional migration speed starting as early as 24 hours after burn injury, reaching a minimum at 72-120 hours, correlated to the size of the burn injury and potentially serving as an early indicator for concurrent infections. Further characterization of neutrophil chemotaxis using this new assay may have important diagnostic implications not only for burn patients but also for patients afflicted by other diseases that compromise neutrophil functions.

  11. Treatment of burn injuries with keratinocyte cultures

    International Nuclear Information System (INIS)

    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

  12. High voltage electrical burn injuries in teenage children: case studies with similarities (an indian perspective)

    OpenAIRE

    Mathangi Ramakrishnan, K.; Babu, M.; Mathivanan,; B. Ramachandran; Balasubramanian, S.; Raghuram, K

    2013-01-01

    From 1992 to 2012, a total of 911 paediatric burns were admitted and treated at Kanchi Kamakoti Childs Trust Hospital Intensive Burn Care Unit, of these 28 children had suffered electrical injuries and burns. 7 teenagers suffered high voltage electrical burn injuries: 2 were involved in train accidents which caused fatal electrical injuries, and 5 had electrical burn injuries caused by similar types of accidents, requiring Paediatric Intensive Care Unit (PICU) care, repeated surgeries and ext...

  13. Comparative study on effects of burn-blast combined injury and burn-firearm combined injury complicated with seawater immersion on vascular endothelial cells

    Institute of Scientific and Technical Information of China (English)

    YAN Hong; LAI Xi-nan; GE Heng-jiang

    2005-01-01

    Objective: To comparatively study the effects and mechanisms of burn-blast combined injury and burn-firearm combined injury complicated with seawater immersion on vascular endothelial cells. Methods: A total of 40 healthy adult hybrid dogs of both sexes, weighing 12-15 kg, were used in this study. Randomly-selected 20 dogs were established as models of burn-blast combined injury (the burn-blast injury group) and the other 20 dogs as models of burn-firearm combined injury (the burn-firearm injury group). Then the wounds of all the dogs were immediately immersed in seawater for 4 hours, and then they were taken out from the seawater. Blood samples were withdrawn from the central vein of the dogs before injury, and at 4, 7, 10, 20, and 28 hours after injury to measure the circulating endothelial cells and the von Willebrand factor. Results: Circulating endothelial cells increased significantly at 4 hours after injury in all the dogs. But they reached peak at 7 hours after injury in the burn-blast injury group and at 28 hours after injury in the burn-firearm injury group. The changes of circulating endothelial cells in the burn-blast injury group were significantly different from those in the burn-firearm injury group at 4, 7, 20, and 28 hours after injury (P<0.01). The von Willebrand factor reached peak at 4 hours after injury in the burn-blast injury group and at 28 hours in the burn-firearm injury group. The changes of von Willebrand factor in the burn-blast injury group were significantly different from those in the burn-firearm injury group at 4, 20, and 28 hours after injury (P<0.01).Conclusions: In burn-blast injury combined with seawater immersion, the vascular endothelial cells changed most significantly at 4 hours or 7 hours after injury, while burn-firearm injury combined with seawater immersion have the same at 20 hours or 28 hours after injury.

  14. 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.

  15. Functioning, Disability, and Social Adaptation Six Months After Burn Injury.

    Science.gov (United States)

    Palmu, Raimo; Partonen, Timo; Suominen, Kirsi; Vuola, Jyrki; Isometsä, Erkki

    2016-01-01

    Major injuries commonly cause long-standing functional impairment. The authors investigated the levels of and predictors for functioning, disability, and social adaptation 6 months after a burn injury. The overall level of functioning at 6 months postburn was assessed among 87 (81%) of the 107 consecutive acute adult burn patients (mean TBSA 9.7%) admitted to the Helsinki Burn Centre during an 18-month period. Social and Occupational Functioning Assessment Scale (SOFAS) was used to evaluate functioning overall, and Sheehan Disability Scale (SDS) to assess the domains of working capacity, social life, and family life. Social Adaptation Self-Evaluation Scale (SASS) was used to measure social adaptation. Structured clinical interview was used to assess mental disorders at baseline and 6 months after injury. The mean SOFAS score was 69.7 (SD = 20.8), indicating some impairment in social and occupational functioning. The strongest independent predictors of SOFAS were mental disorders during follow-up (P personality disorders (P = .007). Six months after a burn injury, some difficulties in social and occupational functioning remained. Level of functioning was predicted strongly and consistently by mental disorders, particularly depression. Length of stay and hand burns also predicted functioning, more in a clinician's evaluation (SOFAS) than in self-reported measures (SDS and SASS). PMID:26056759

  16. Investigating the phenomenology of imagery following traumatic burn injuries.

    Science.gov (United States)

    Cockerham, Elaine Sara; Çili, Soljana; Stopa, Lusia

    2016-06-01

    Intrusive images related to adverse experiences are an important feature of a number of psychological disorders and a hallmark symptom of posttraumatic stress disorder (PTSD). Depression, anxiety, and PTSD are all common reactions following a burn injury. However, the nature of burn-related trauma memories and associated intrusions and their contribution to psychological disorders is not well understood. The aim of the study was to take a broad look at the nature of imagery experienced by people who have sustained a burn injury. Nineteen participants completed self-report questionnaires assessing depression, anxiety, and PTSD symptoms and were administered a semi-structured interview which explored the characteristics (vividness, sensory modalities, intrusions, emotion intensity) of imagery formed in relation to their burn injuries. Ongoing intrusive imagery was reported by over half the participants and there were significant correlations between frequency of intrusive images and posttraumatic symptoms, and between intensity of emotions associated with intrusive images and depression and posttraumatic symptoms. A thematic analysis of the memory narratives revealed four main themes: threat to self, view of the world, view of others, and positive psychological change. These results are discussed in relation to existing trauma theory and burn injury literature. Implications for clinical practice and recommendations for further research are proposed. PMID:27005586

  17. [Current status in rehabilitation of burn injury in China].

    Science.gov (United States)

    Chiyu, Jia; Xiaofang, Zou

    2015-06-01

    Along with the advance in national economy, modern concept of burn rehabilitation from major burn injury implies that measures should be taken to help the patients return to society with dignity. This article briefly reviews the development and achievement of burn rehabilitation in our country, as well as the current difficulties in carrying out rehabilitation measures such as outmoded ideology, lack of trained personnel, low rat of popularization, outdated techniques and methodology, and relatively low level in scientific research, etc. The future development of burn rehabilitation in our country needs more social support, popular attention, and multidisciplinary joint efforts to help burn patients return to society with dignity. In order to fulfill this goal, we still have a long way to go. PMID:26564559

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

    OpenAIRE

    Ana Lúcia Ferreira; Juliana Montez Ferreira; da Silva, Paula Marques C.; Dilene Francisco Constancio

    2014-01-01

    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 consiste...

  19. The leading causes of death after burn injury in a single pediatric burn center

    OpenAIRE

    Williams, Felicia N.; Herndon, David N; Hawkins, Hal K.; Lee, Jong O; Cox, Robert A.; Kulp, Gabriela A; Finnerty, Celeste C.; Chinkes, David L.; Jeschke, Marc G.

    2009-01-01

    Introduction Severe thermal injury is characterized by profound morbidity and mortality. Advances in burn and critical care, including early excision and grafting, aggressive resuscitation and advances in antimicrobial therapy have made substantial contributions to decrease morbidity and mortality. Despite these advances, death still occurs. Our aim was to determine the predominant causes of death in burned pediatric patients in order to develop new treatment avenues and future trajectories a...

  20. Frequencies of micronucleated polychromatic erythrocytes in mouse bone marrow induced by combined radiation-burn injury

    International Nuclear Information System (INIS)

    Objective: In order to detect if any analysis of frequency of micronucleated polychromatic erythrocytes (fMPCE) in mouse bone marrow was possible to diagnose combined radiation-burn injuries. Methods: By using the index of fMPCE, the investigation was carried out in the conditions of burn injury alone, radiation injury alone and combined radiation-burn injury. Results: The fMPCE induced by 10% and 20% body surface area (BSA) burns were not significantly increased at 24h compared with untreated groups. The fMPCE induced by combined radiation-burn injury significantly lower than those by radiation alone, and the fMPCE in the 20% BSA combined radiation-burn injury groups were lower than those in 10% BSA groups. Conclusion: These results indicate that radiation combined burns have an effect to reduce the fMPCE induced by radiation injury. The reason may be due to the frequency of increase of PCE after burn injury

  1. Changes in Fat Distribution in Children Following Severe Burn Injury

    OpenAIRE

    Patel, Pavankumar; Hanaa S. Sallam; Ali, Arham; Chandalia, Manisha; Suman, Oscar; Finnerty, Celeste C.; Herndon, David N; Abate, Nicola

    2014-01-01

    Background: Children with severe cutaneous burn injury show persistent metabolic abnormalities, including inflammation and insulin resistance. Such abnormalities could potentially increase their future risk for developing type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). This could be related to changes in body composition and fat distribution.

  2. Inhalation injury in severely burned children does not augment the systemic inflammatory response

    OpenAIRE

    Finnerty, Celeste C.; Herndon, David N; Jeschke, Marc G.

    2007-01-01

    Introduction Inhalation injury in combination with a severe thermal injury increases mortality. Alterations in inflammatory mediators, such as cytokines, contribute to the incidence of multi-organ failure and mortality. The aim of the present study was to determine the effect of inhalation injury on cytokine expression in severely burned children. Methods Thirty severely burned pediatric patients with inhalation injury and 42 severely burned children without inhalation injury were enrolled in...

  3. Military and civilian burn injuries during armed conflicts.

    Science.gov (United States)

    Atiyeh, B S; Gunn, S W A; Hayek, S N

    2007-12-31

    Burn injury is a ubiquitous threat in the military environment, and war burns have been described for more than 5,000 years of written history. Fire was probably utilized as a weapon long before that. With the ever-increasing destructive power and efficiency of modern weapons, casualties, both fatal and non-fatal, are reaching new highs, particularly among civilians who are becoming the major wartime targets in recent wars, accounting for most of the killed and wounded. Even though medical personnel usually believe that a knowledge of weaponry has little relevance to their ability to effectively treat injuries and that it may in some way be in conflict with their status, accorded under the Geneva and Hague treaties, it is imperative that they know how weapons are used and understand their effects on the human body. The present review explores various categories of weapons of modern warfare that are unfamiliar to most medical and paramedical personnel responsible for burn treatment. The mechanisms and patterns of injury produced by each class of weapons are examined so that a better understanding of burn management in a warfare situation may be achieved. PMID:21991098

  4. Military and Civilian Burn Injuries During Armed Conflicts

    OpenAIRE

    Atiyeh, B.S.; Gunn, S.W.A.; Hayek, S.N.

    2007-01-01

    Burn injury is a ubiquitous threat in the military environment, and war burns have been described for more than 5,000 years of written history. Fire was probably utilized as a weapon long before that. With the ever-increasing destructive power and efficiency of modern weapons, casualties, both fatal and non-fatal, are reaching new highs, particularly among civilians who are becoming the major wartime targets in recent wars, accounting for most of the killed and wounded. Even though medical pe...

  5. Acute kidney injury in burns: a story of volume and inflammation

    OpenAIRE

    COLPAERT, KIRSTEN; Hoste, Eric A

    2008-01-01

    Acute kidney injury occurs in approximately one-quarter to one-third of patients with major burn injury. Apart from the usual suspects – such as older age, severity of burn injury, sepsis and multiple organ dysfunction – volume overload probably has an important role in the pathogenesis of acute kidney injury.

  6. The effect of burn injury on adolescents autobiographical memory.

    Science.gov (United States)

    Stokes, D J; Dritschel, B H; Bekerian, D A

    2004-11-01

    Autobiographical memory recall was investigated in two female adolescent groups; one group who had experienced a burn injury and a matched control group. The Burn group was not currently depressed or anxious, but scored significantly higher on the intrusion subscale of the impact of event scale compared to controls. Two autobiographical memory tasks, the autobiographical memory cueing task and the Children's Autobiographical Memory Inventory (CAMI), were used. For the cueing task, the Burn group was significantly slower to recall specific memories. This group also recalled significantly fewer specific memories and significantly more extended overgeneral memories. For the CAMI, the burns group produced significantly lower semantic and episodic recall. The Burn group also produced significant correlations between sub-scales of the impact of event scale and selected measures on the autobiographical memory tasks. Higher intrusion scores were associated with less detailed episodic recall. Higher avoidance scores were associated with longer latencies to recall memories to negative cue words and fewer specific memories to all cue words. These results are discussed from the perspective that the Burn group experienced intrusive thoughts which interfered with normal autobiographical functioning. PMID:15381443

  7. Frailty score on admission predicts outcomes in elderly burn injury.

    Science.gov (United States)

    Romanowski, Kathleen S; Barsun, Alura; Pamlieri, Tina L; Greenhalgh, David G; Sen, Soman

    2015-01-01

    With longer life expectancy, the number of burn injuries in the elderly continues to increase. Prediction of outcomes for the elderly is complicated by preinjury physical fitness and comorbid illness. The authors hypothesize that admission frailty assessment would be predictive of outcomes in the elderly burn population. Our primary aim was to determine if higher frailty scores were associated with higher risk of mortality for elderly burn patients. The secondary aims were to assess if higher frailty scores were associated with increased length of stay, increased needs for mechanical ventilation and poor discharge disposition. A 2-year retrospective chart review was performed of all admitted acute burn patients 65 years or older. Data collected included: age, gender, %TBSA of burn injury, presence of inhalation injury, in hospital mortality, hospital length of stay, ventilator days, ICU length of stay, surgical procedures, insurance status, and discharge disposition. Frailty scores were assessed from admission data and calculated using the Canadian Study of Health and Aging clinical frailty scale. A total of 89 patients met entry criteria. Mean age was 75.3 ± 8.1 years and consisted of 62 men and 27 women. Mean %TBSA was 9.6 ± 9.1% and mean frailty score (FS) was 4.5 ± 1.2. Eighty patients survived to discharge and nine died. Nonsurvivors had significantly higher FS compared to survivors (5.2 ± 1.2 vs 4.4 ± 1.2). FS were also significantly higher in patients discharged to skilled nursing facilities (SNF) (5.34 ± 0.9) compared to those who were discharged home (4.1 ± 1.2) or to physical rehabilitation facilities (4 ± 1.5). Multivariate linear regression analysis revealed that age (B = 0.04) and discharge to SNF (B = 1.2) are independently associated with higher FS. However, survivors were independently associated with a significantly lower FS (B = -1.3). Multivariate logistic regression analysis revealed high admission FS independently increased the risk of

  8. Terahertz spectroscopy for the assessment of burn injuries in vivo.

    Science.gov (United States)

    Arbab, M Hassan; Winebrenner, Dale P; Dickey, Trevor C; Chen, Antao; Klein, Matthew B; Mourad, Pierre D

    2013-07-01

    A diagnosis criterion is proposed for noninvasive grading of burn injuries using terahertz radiation. Experimental results are presented from in vivo terahertz time-domain spectroscopy of second- and third-degree wounds, which are obtained in a 72-hour animal study. During this period, the change in the spectroscopic response of the burned tissue is studied. It is shown that terahertz waves are sensitive not only to the postburn formation of interstitial edema, but also to the density of skin structures derived from image processing analysis of histological sections. Based on these preliminary results, it is suggested that the combination of these two effects, as probed by terahertz spectroscopy of the tissue, may ultimately be used to differentiate partial-thickness burns that will naturally heal from those that will require surgical intervention. PMID:23860943

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

    Directory of Open Access Journals (Sweden)

    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

  10. Ustioni da fuoco / Burn injuries / Les brûlures

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Sibling experiences after a major childhood burn injury.

    Science.gov (United States)

    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. PMID:21067076

  13. HIV seroprevalence and its effect on outcome of moderate to severe burn injuries: A Ugandan experience

    OpenAIRE

    Ssentongo Robert; Chalya Phillipo L; Kakande Ignatius

    2011-01-01

    Abstract Background HIV infection in a patient with burn injuries complicates the care of both the patient and the treating burn team. This study was conducted to establish the prevalence of HIV among burn patients in our setting and to compare the outcome of these patients who are HIV positive with those who are HIV negative. Methods This was a prospective cohort study involving burn injury patients admitted to Mulago Hospital between November 2005 and February 2006. Patients were stratified...

  14. OUTCOME OF PHYSICAL THERAPY AND SPLINTING IN HAND BURNS INJURY. OUR LAST FOUR YEARS’ EXPERIENCE

    OpenAIRE

    Rrecaj, Shkurta; Hysenaj, Hajrie; Martinaj, Merita; Murtezani, Ardiana; Ibrahimi-Kacuri, Dafina; Haxhiu, Bekim; Buja, Zene

    2015-01-01

    Objective: Burn injuries in hands are much more complex and the appearance of contractures is a common complication. Hand burn injuries often result in limited functionality, flexion and extension of fingers and present a major hindrance in rehabilitation. The aim of physical therapy and splinting after hand burn injury is to maintain mobility, prevent the development of the contracture and to promote the functionality of hand and good cosmetic results. The purpose of this study is to present...

  15. Hot asphalt burns: a review of injuries and management options.

    Science.gov (United States)

    Bosse, George M; Wadia, Shernaz A; Padmanabhan, Pradeep

    2014-07-01

    Hot asphalt burns to human tissue can increase the likelihood of infection and potential conversion of partial thickness to full-thickness injuries. Successful intervention for hot asphalt burns requires immediate and effective cooling of the asphalt on the tissue followed by subsequent gradual removal of the cooled asphalt. A review of the literature reveals that multiple substances have been used to remove asphalt, including topical antibiotics, petroleum jelly, a commercial product known as De-Solv-It (ORANGE-SOL, Chandler, AZ), sunflower oil, baby oil, liquid paraffin, butter, mayonnaise, and moist-exposed burn ointment (MEBO). Although many of these products may be effective in the removal of asphalt, they may not be readily available in an emergency department setting. Topical antibiotics are readily available, are more commonly described in the medical literature, and would be expected to be effective in the removal of asphalt. We developed guidelines for on scene (first-aid) management and the initial care of such patients upon presentation to a health care facility. These guidelines emphasize the principles of early cooling, gradual removal of adherent asphalt using topical antibiotics, and avoidance of the use of topical agents, which are likely to result in tissue toxicity. PMID:24630605

  16. 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...

  17. Baux’s and Abbreviated Burn Severity Score for the Prediction of Mortality in Patients with Acute Burn Injury

    Directory of Open Access Journals (Sweden)

    Peeyush Dahal

    2016-01-01

    Full Text Available jdjdBackground & Objectives: Prediction of outcome for patients with major thermal injury is important to inform clinical decision making, alleviate individual suffering and improve hospital resource allocation. Early prediction of outcome (i.e., survival or mortality may help triage effectively, and to implement medical and surgical interventions efficiently as soon as possible. Burn mortality has decreased markedly with the improvement in burn management in the past 100 years, and multiple burn mortality prediction models have been developed over these times in response to that decline. But these services are still not enough to reduce the burn related injuries in low income country like Nepal. So we did a study to observe the effectiveness of two different but very popular models (Baux and ABSI in our context.Materials & Methods: This was a prospective observational study where 92 cases of severe burn injury was selected and the results were compared with Baux and ABSI scoring system.Results: Total admission was 140 and mortality was 33. Out of these admission 92 cases of severe burn injury was selected for the study. Most (85.8 % of were among the young group 16-40 years. It comprises 41.3 % in total. In total 63.7 % were female. Mortality with severe burn injury was 29.3%. No death had occurred below the Baux’s score 30 and there was more than 51% mortality above the score of 60. There was no mortality with ABSI scoring < 3 and mortality was high in ABSI scoring > 6.Conclusion: Baux and ABSI score systems are simple to calculate and ABSI is more accurate for prediction of acute burn injury.Journal of College of Medical Sciences-Nepal, Vol.11(4 2015: 24-27

  18. High voltage electrical burn injuries in teenage children: case studies with similarities (an indian perspective)

    Science.gov (United States)

    Mathangi Ramakrishnan, K.; Babu, M.; Mathivanan; Ramachandran, B.; Balasubramanian, S.; Raghuram, K.

    2013-01-01

    Summary From 1992 to 2012, a total of 911 paediatric burns were admitted and treated at Kanchi Kamakoti Childs Trust Hospital Intensive Burn Care Unit, of these 28 children had suffered electrical injuries and burns. 7 teenagers suffered high voltage electrical burn injuries: 2 were involved in train accidents which caused fatal electrical injuries, and 5 had electrical burn injuries caused by similar types of accidents, requiring Paediatric Intensive Care Unit (PICU) care, repeated surgeries and extensive rehabilitation. A common factor among these latter 5 patients was that they were injured by overhead high electrical voltage cables. Their management was labour intensive and highly costly. In this report, the type of accident, the electrical voltage that produced burns and the treatment details are elaborated. Findings included similarities in age and type of accident, and failure to implement safety procedures and apply standard norms of high voltage transmission feeder lines. PMID:24563637

  19. Thermal injury induces impaired function in polymorphonuclear neutrophil granulocytes and reduced control of burn wound infection

    DEFF Research Database (Denmark)

    Calum, H.; Moser, C.; Jensen, P. O.;

    2009-01-01

    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 burn...... infected burn wound. Furthermore, the oxidative burst and the phagocytic capacity of the PMNs were reduced in the group of mice with burn wound. Using this novel mouse model of thermal injury a decline of peripheral leucocytes was observed, whereas the increased local inflammatory response at the site of...... injury was induced in mice with a hot-air blower. The third-degree burn was confirmed histologically. The mice were allocated into five groups: control, shave, burn, infection and burn infection group. At 48 h, a decline in the concentration of peripheral blood leucocytes was observed in the group of...

  20. Inhalation injury in severely burned children does not augment the systemic inflammatory response

    Science.gov (United States)

    Finnerty, Celeste C; Herndon, David N; Jeschke, Marc G

    2007-01-01

    Introduction Inhalation injury in combination with a severe thermal injury increases mortality. Alterations in inflammatory mediators, such as cytokines, contribute to the incidence of multi-organ failure and mortality. The aim of the present study was to determine the effect of inhalation injury on cytokine expression in severely burned children. Methods Thirty severely burned pediatric patients with inhalation injury and 42 severely burned children without inhalation injury were enrolled in the study. Inhalation injury was diagnosed by bronchoscopy during the first operation. Blood was collected within 24 hours of admission and again at five to seven days following admission. Cytokine expression was profiled using multi-plex antibody-coated beads. Significance was accepted at a p value of less than 0.05. Results The mean percentages of total body surface area burned were 67% ± 4% (56% ± 6%, third-degree burns) in the inhalation injury group and 60% ± 3% (45% ± 3%, third-degree burns) in the non-inhalation injury group (p value not significant [NS]). Mean age was 9 ± 1 years in the inhalation injury group and 8 ± 1 years in the non-inhalation injury group (p value NS). Time from burn to admission in the inhalation injury group was 2 ± 1 days compared to 3 ± 1 days in the non-inhalation injury group (p value NS). Mortalities were 40% in the inhalation injury group and 12% in the non-inhalation injury group (p < 0.05). At the time of admission, serum interleukin (IL)-7 was significantly increased in the non-inhalation injury group, whereas IL-12p70 was significantly increased in the inhalation injury group compared to the non-inhalation injury group (p < 0.05). There were no other significant differences between groups. Five to seven days following admission, all cytokines decreased with no differences between the inhalation injury and non-inhalation injury cohorts. Conclusion In the present study, we show that an inhalation injury causes alterations in IL-7

  1. An assessment of acute kidney injury with modified RIFLE criteria in pediatric patients with severe burns

    OpenAIRE

    Palmieri, Tina; Lavrentieva, Athina; Greenhalgh, David

    2009-01-01

    Objective To apply the modified pediatric RIFLE criteria for severity of acute kidney injury (AKI) to pediatric burn ICU patients and to evaluate the overall incidence of AKI, risk factors for AKI and influence of AKI on outcome. Design Retrospective, descriptive cohort study. Setting 10-bed burn PICU facility. Patients All consecutive patients with a burn injury of 10% or more of total body surface area percentage (TBSA, %) admitted during a 2 year period. Measurements and results Data of 12...

  2. An assessment of acute kidney injury with modified RIFLE criteria in pediatric patients with severe burns

    OpenAIRE

    Palmieri, Tina; Lavrentieva, Athina; Greenhalgh, David

    2009-01-01

    To apply the modified pediatric RIFLE criteria for severity of acute kidney injury (AKI) to pediatric burn ICU patients and to evaluate the overall incidence of AKI, risk factors for AKI and influence of AKI on outcome. Retrospective, descriptive cohort study. 10-bed burn PICU facility. All consecutive patients with a burn injury of 10% or more of total body surface area percentage (TBSA, %) admitted during a 2 year period. Data of 123 patients were studied. The incidence of AKI w...

  3. Predictive Value of IL-8 for Sepsis and Severe Infections after Burn Injury - A Clinical Study

    OpenAIRE

    Kraft, Robert; Herndon, David N; Finnerty, Celeste C.; Cox, Robert A.; Song, Juquan; Jeschke, Marc G.

    2015-01-01

    The inflammatory response induced by burn injury contributes to increased incidence of infections, sepsis, organ failure, and mortality. Thus, monitoring post-burn inflammation is of paramount importance but so far there are no reliable biomarkers available to monitor and/or predict infectious complications after burn. As IL-8 is a major mediator for inflammatory responses, the aim of our study was to determine whether IL-8 expression can be used to predict post-burn sepsis, infections, and m...

  4. Cardiovascular Dysfunction Following Burn Injury: What We Have Learned from Rat and Mouse Models

    OpenAIRE

    Guillory, Ashley N.; Clayton, Robert P.; Herndon, David N; Finnerty, Celeste C.

    2016-01-01

    Severe burn profoundly affects organs both proximal and distal to the actual burn site. Cardiovascular dysfunction is a well-documented phenomenon that increases morbidity and mortality following a massive thermal trauma. Beginning immediately post-burn, during the ebb phase, cardiac function is severely depressed. By 48 h post-injury, cardiac function rebounds and the post-burn myocardium becomes tachycardic and hyperinflammatory. While current clinical trials are investigating a variety of ...

  5. Coping with burns : the role of coping self-efficacy in the recovery from traumatic stress following burn injuries

    OpenAIRE

    Bosmans, Mark W. G.; Hofland, Helma W.; De Jong, Alette E.; van Loey, Nancy E.

    2015-01-01

    We conducted a three-wave prospective study among patients with burns (N = 178) to examine the prospective influence of coping self-efficacy (CSE) perceptions on trajectories of posttraumatic stress symptoms in the first 12 months after burn injuries. Using linear growth curve modeling, we corrected for demographics, the number of surgeries during initial admittance, trait coping styles, and changing levels of health-related quality of life. CSE during initial admission was by far the stronge...

  6. The biochemistry of blister fluid from pediatric burn injuries: proteomics and metabolomics aspects.

    Science.gov (United States)

    Zang, Tuo; Broszczak, Daniel A; Broadbent, James A; Cuttle, Leila; Lu, Haitao; Parker, Tony J

    2016-01-01

    Burn injury is a prevalent and traumatic event for pediatric patients. At present, the diagnosis of burn injury severity is subjective and lacks a clinically relevant quantitative measure. This is due in part to a lack of knowledge surrounding the biochemistry of burn injuries and that of blister fluid. A more complete understanding of the blister fluid biochemistry may open new avenues for diagnostic and prognostic development. Burn insult induces a highly complex network of signaling processes and numerous changes within various biochemical systems, which can ultimately be examined using proteome and metabolome measurements. This review reports on the current understanding of burn wound biochemistry and outlines a technical approach for 'omics' profiling of blister fluid from burn wounds of differing severity. PMID:26581649

  7. Epidemiology of burn injuries in the East Mediterranean Region: a systematic review

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    Kendrick Denise

    2010-02-01

    Full Text Available Abstract Background Burn injuries remain one of the leading causes of injury morbidity and mortality in the World Health Organization's East Mediterranean Region. To provide an overview on the epidemiology of burn injuries in this region, a systematic review was undertaken. Methods Medline, Embase and CINAHL were searched for publications on burns in this region published between 01/01/1997 and 16/4/2007. Data were extracted to a standard spreadsheet and synthesised using a narrative synthesis. No attempt has been made to quantitatively synthesise the data due to the large degree of clinical heterogeneity between study populations. Results Seventy one studies were included in the review, from 12 countries. Burn injuries were found to be one of the leading causes of injury morbidity and mortality. The reported incidence of burns ranged from 112 to 518 per 100,000 per year. Burn victims were more frequently young and approximately one third of the victims were children aged 0-5 years. Hospital mortality ranged from 5 to 37%, but was commonly above 20%. Intentional self-harm burns particularly involving women were common in some countries of the region and were associated with a very high mortality of up to 79%. Conclusion Burn injuries remain an important public health issue in the East Mediterranean Region therefore further research is required to investigate the problem and assess the effectiveness of intervention programmes.

  8. Children with burn injuries-assessment of trauma, neglect, violence and abuse

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    Antoinette Runge

    2011-07-01

    Full Text Available Burns are an important cause of injury to young children, being the third most frequent cause of injury resulting in death behind motor vehicle accidents and drowning. Burn injuries account for the greatest length of stay of all hospital admissions for injuries and costs associated with care are substantial. The majority of burn injuries in children are scald injuries resulting from hot liquids, occurring most commonly in children aged 0-4 years. Other types of burns include electrical, chemical and intentional injury. Mechanisms of injury are often unique to children and involve exploratory behavior without the requisite comprehension of the dangers in their environment. Assessment of the burnt child includes airway, breathing and circulation stabilization, followed by assessment of the extent of the burn and head to toe examination. The standard rule of 9s for estimating total body surface area (TBSA of the burn is inaccurate for the pediatric population and modifications include utilizing the Lund and Browder chart, or the child’s palm to represent 1% TBSA. Further monitoring may include cardiac assessment, indwelling catheter insertion and evaluation of inhalation injury with or without intubation depending on the context of the injury. Risk factors and features of intentional injury should be known and sought and vital clues can be found in the history, physical examination and common patterns of presentation. Contemporary burn management is underscored by several decades of advancing medical and surgical care however, common to all injuries, it is in the area of prevention that the greatest potential to reduce the burden of these devastating occurrences exists.

  9. MILD OBESITY IS PROTECTIVE AFTER SEVERE BURN INJURY

    Science.gov (United States)

    Jeschke, Marc G.; Finnerty, Celeste C.; Emdad, Fatemeh; Rivero, Haidy G.; Kraft, Robert; Williams, Felicia N; Gamelli, Richard L.; Gibran, Nicole S.; Klein, Matthew B.; Arnoldo, Brett D.; Tompkins, Ronald G.; Herndon, David N.

    2014-01-01

    Objective To assess the impact of obesity on morbidity and mortality in severely burned patients. Background Despite the increasing number of people with obesity, little is known about the impact of obesity on postburn outcomes. Methods A total of 405 patients were prospectively enrolled as part of the multicenter trial Inflammation and the Host Response to Injury Glue Grant with the following inclusion criteria: 0 to 89 years of age, admitted within 96 hours after injury, and more than 20% total body surface area burn requiring at least 1 surgical intervention. Body mass index was used in adult patients to stratify according to World Health Organization definitions: less than 18.5 (underweight), 18.5 to 29.9 (normal weight), 30 to 34.9 (obese I), 35 to 39.9 (obese II), and body mass index more than 40 (obese III). Pediatric patients (2 to ≤18 years of age) were stratified by using the Centers for Disease Control and Prevention and World Health Organization body mass index-for-age growth charts to obtain a percentile ranking and then grouped as underweight (<5th percentile), normal weight (5th percentile to <95th percentile), and obese (≥95th percentile). The primary outcome was mortality and secondary outcomes were clinical markers of patient recovery, for example, multiorgan function, infections, sepsis, and length of stay. Results A total of 273 patients had normal weight, 116 were obese, and 16 were underweight; underweight patients were excluded from the analyses because of insufficient patient numbers. There were no differences in primary and secondary outcomes when normal weight patients were compared with obese patients. Further stratification in pediatric and adult patients showed similar results. However, when adult patients were stratified in obesity categories, log-rank analysis showed improved survival in the obese I group and higher mortality in the obese III group compared with obese I group (P < 0.05). Conclusions Overall, obesity was not

  10. Effect of fasting on the metabolic response of liver to experimental burn injury.

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    Mehmet A Orman

    Full Text Available Liver metabolism is altered after systemic injuries such as burns and trauma. These changes have been elucidated in rat models of experimental burn injury where the liver was isolated and perfused ex vivo. Because these studies were performed in fasted animals to deplete glycogen stores, thus simplifying quantification of gluconeogenesis, these observations reflect the combined impact of fasting and injury on liver metabolism. Herein we asked whether the metabolic response to experimental burn injury is different in fed vs. fasted animals. Rats were subjected to a cutaneous burn covering 20% of the total body surface area, or to similar procedures without administering the burn, hence a sham-burn. Half of the animals in the burn and sham-burn groups were fasted starting on postburn day 3, and the others allowed to continue ad libitum. On postburn day 4, livers were isolated and perfused for 1 hour in physiological medium supplemented with 10% hematocrit red blood cells. The uptake/release rates of major carbon and nitrogen sources, oxygen, and carbon dioxide were measured during the perfusion and the data fed into a mass balance model to estimate intracellular fluxes. The data show that in fed animals, injury increased glucose output mainly from glycogen breakdown and minimally impacted amino acid metabolism. In fasted animals, injury did not increase glucose output but increased urea production and the uptake of several amino acids, namely glutamine, arginine, glycine, and methionine. Furthermore, sham-burn animals responded to fasting by triggering gluconeogenesis from lactate; however, in burned animals the preferred gluconeogenic substrate was amino acids. Taken together, these results suggest that the fed state prevents the burn-induced increase in hepatic amino acid utilization for gluconeogenesis. The role of glycogen stores and means to increase and/or maintain internal sources of glucose to prevent increased hepatic amino acid

  11. Gendered pattern of burn injuries in India: a neglected health issue.

    Science.gov (United States)

    Bhate-Deosthali, Padma; Lingam, Lakshmi

    2016-05-01

    There are an estimated 7 million burn injuries in India annually, of which 700,000 require hospital admission and 140,000 are fatal. According to the National Burns Programme, 91,000 of these deaths are women; a figure higher than that for maternal mortality. Women of child bearing age are on average three times more likely than men to die of burn injuries. This paper reviews the existing literature on burn injuries in India and raises pertinent issues about prevalence, causes and gaps in recognising the gendered factors leading to a high number of women dying due to burns. The work of various women's groups and health researchers with burns victims raises several questions about the categorisation of burn deaths as accident, suicide and homicide and the failure of the health system to recognise underlying violence. Despite compelling evidence, the health system has not recognised this as a priority. Considering the substantial cost of burns care, prevention is the key which requires health systems to recognise the linkages between burn injuries and domestic violence. Health systems need to integrate awareness programmes about domestic violence and train health professionals to identify signs and symptoms of violence. This would contribute to early identification of abuse so that survivors are able to access support services at an early stage. PMID:27578343

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

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    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.

  13. Are serum cytokines early predictors for the outcome of burn patients with inhalation injuries who do not survive?

    OpenAIRE

    Gauglitz, Gerd G.; Finnerty, Celeste C.; Herndon, David N; Mlcak, Ronald P.; Jeschke, Marc G.

    2008-01-01

    Introduction Severely burned patients suffering from inhalation injury have a significantly increased risk for mortality compared with burned patients without inhalation injury. Severe burn is associated with a distinct serum cytokine profile and alterations in cytokines that contribute to morbidity and mortality. The aim of the present study was therefore to determine whether severely burned pediatric patients with concomitant inhalation injury who had a fatal outcome exhibited a different s...

  14. Long-Term Persistance of the Pathophysiologic Response to Severe Burn Injury

    OpenAIRE

    Jeschke, Marc G.; Gauglitz, Gerd G.; Kulp, Gabriela A; Finnerty, Celeste C.; Williams, Felicia N.; Kraft, Robert; Oscar E Suman; Mlcak, Ronald P.; Herndon, David N

    2011-01-01

    Background Main contributors to adverse outcomes in severely burned pediatric patients are profound and complex metabolic changes in response to the initial injury. It is currently unknown how long these conditions persist beyond the acute phase post-injury. The aim of the present study was to examine the persistence of abnormalities of various clinical parameters commonly utilized to assess the degree hypermetabolic and inflammatory alterations in severely burned children for up to three yea...

  15. Long-term persistance of the pathophysiologic response to severe burn injury.

    OpenAIRE

    Jeschke, Marc G.; Gauglitz, Gerd G.; Kulp, Gabriela A; Finnerty, Celeste C.; Williams, Felicia N.; Kraft, Robert; Oscar E Suman; Mlcak, Ronald P.; Herndon, David N

    2011-01-01

    Main contributors to adverse outcomes in severely burned pediatric patients are profound and complex metabolic changes in response to the initial injury. It is currently unknown how long these conditions persist beyond the acute phase post-injury. The aim of the present study was to examine the persistence of abnormalities of various clinical parameters commonly utilized to assess the degree hypermetabolic and inflammatory alterations in severely burned children for up to three years post-bur...

  16. Applications of visible near-infrared spectroscopy and imaging in burn injury assessment

    Science.gov (United States)

    Leonardi, Lorenzo; Sowa, Michael G.; Payette, Jeri R.; Hewko, Mark D.; Schattka, Bernhard J.; Matas, Anna; Mantsch, Henry H.

    2000-05-01

    The major objective of the project is to develop a noninvasive method to assess thermal burns. Currently, the diagnosis relies primarily upon visual assessment of the injury by a burn specialist and/or plastic surgeon. The diagnosis is based on the surface appearance of the wound to determine the type or depth of the burn. Near IR spectroscopic measurements of injured tissue provide an objective means of distinguishing between surface and subsurface changes related to the tissue injury. An acute porcine model is employed to investigate the potential of near IR spectroscopy to accurately distinguish between burns of varying severity in the early postburn period. Parallel factor analysis is used to investigate the spectral changes related to burns of varying severity. Burn injuries drastically alter the physical and optical properties of the tissue. Thermal destruction of cutaneous vasculature disrupts perfusion and oxygen delivery to the affected tissue. Tissue blood oxygenation decreases with increased severity of the burn. The result demonstrate that near IR spectroscopy may provide a new tool for objective clinical assessment of burn injuries.

  17. Micronucleus frequency in peripheral lymphocytes for the differential diagnosis of radiation injuries combined with thermal burns

    International Nuclear Information System (INIS)

    An investigation was conducted to determine if any analysis of micronucleus frequency in human peripheral lymphocytes was useful to diagnostically differentiate radiation injuries in the presence of thermal burns. In the first part of the study, 27 patients with burns of various degrees were tested to determine if the peripheral lymphocytes stimulated in vitro for mitotic division would contain micronuclei--a type of chromosomal aberration inducible by many genotoxic substances. Data showed that the frequency of micronuclei did not increase with burn injury but did correlate with age. Therefore, it is suggested that in cases of radiation injuries combined with burns, the pathologic process related to the latter type of injury does not influence the differential diagnostic value of the micronucleus test. In the second part of the study, the validity of this hypothesis was tested in guinea pigs exposed to various doses of gamma-radiation (between 0.5 and 4.0 Gy) and then inflicted with thermal burns. The results confirmed that when radiation injuries and thermal burns coexist, the micronucleus test is a reliable biologic indicator of radiation injury

  18. Long-term persistance of the pathophysiologic response to severe burn injury.

    Directory of Open Access Journals (Sweden)

    Marc G Jeschke

    Full Text Available BACKGROUND: Main contributors to adverse outcomes in severely burned pediatric patients are profound and complex metabolic changes in response to the initial injury. It is currently unknown how long these conditions persist beyond the acute phase post-injury. The aim of the present study was to examine the persistence of abnormalities of various clinical parameters commonly utilized to assess the degree hypermetabolic and inflammatory alterations in severely burned children for up to three years post-burn to identify patient specific therapeutic needs and interventions. METHODOLOGY/PRINCIPAL FINDINGS: PATIENTS: Nine-hundred seventy-seven severely burned pediatric patients with burns over 30% of the total body surface admitted to our institution between 1998 and 2008 were enrolled in this study and compared to a cohort non-burned, non-injured children. Demographics and clinical outcomes, hypermetabolism, body composition, organ function, inflammatory and acute phase responses were determined at admission and subsequent regular intervals for up to 36 months post-burn. Statistical analysis was performed using One-way ANOVA, Student's t-test with Bonferroni correction where appropriate with significance accepted at p<0.05. Resting energy expenditure, body composition, metabolic markers, cardiac and organ function clearly demonstrated that burn caused profound alterations for up to three years post-burn demonstrating marked and prolonged hypermetabolism, p<0.05. Along with increased hypermetabolism, significant elevation of cortisol, catecholamines, cytokines, and acute phase proteins indicate that burn patients are in a hyperinflammatory state for up to three years post-burn p<0.05. CONCLUSIONS: Severe burn injury leads to a much more profound and prolonged hypermetabolic and hyperinflammatory response than previously shown. Given the tremendous adverse events associated with the hypermetabolic and hyperinflamamtory responses, we now identified

  19. Long-Term Persistance of the Pathophysiologic Response to Severe Burn Injury

    Science.gov (United States)

    Finnerty, Celeste C.; Williams, Felicia N.; Kraft, Robert; Suman, Oscar E.; Mlcak, Ronald P.; Herndon, David N.

    2011-01-01

    Background Main contributors to adverse outcomes in severely burned pediatric patients are profound and complex metabolic changes in response to the initial injury. It is currently unknown how long these conditions persist beyond the acute phase post-injury. The aim of the present study was to examine the persistence of abnormalities of various clinical parameters commonly utilized to assess the degree hypermetabolic and inflammatory alterations in severely burned children for up to three years post-burn to identify patient specific therapeutic needs and interventions. Methodology/Principal Findings Patients: Nine-hundred seventy-seven severely burned pediatric patients with burns over 30% of the total body surface admitted to our institution between 1998 and 2008 were enrolled in this study and compared to a cohort non-burned, non-injured children. Demographics and clinical outcomes, hypermetabolism, body composition, organ function, inflammatory and acute phase responses were determined at admission and subsequent regular intervals for up to 36 months post-burn. Statistical analysis was performed using One-way ANOVA, Student's t-test with Bonferroni correction where appropriate with significance accepted at p<0.05. Resting energy expenditure, body composition, metabolic markers, cardiac and organ function clearly demonstrated that burn caused profound alterations for up to three years post-burn demonstrating marked and prolonged hypermetabolism, p<0.05. Along with increased hypermetabolism, significant elevation of cortisol, catecholamines, cytokines, and acute phase proteins indicate that burn patients are in a hyperinflammatory state for up to three years post-burn p<0.05. Conclusions Severe burn injury leads to a much more profound and prolonged hypermetabolic and hyperinflammatory response than previously shown. Given the tremendous adverse events associated with the hypermetabolic and hyperinflamamtory responses, we now identified treatment needs for

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

    Directory of Open Access Journals (Sweden)

    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

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

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    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.

  2. Cardiovascular Dysfunction Following Burn Injury: What We Have Learned from Rat and Mouse Models

    Directory of Open Access Journals (Sweden)

    Ashley N. Guillory

    2016-01-01

    Full Text Available Severe burn profoundly affects organs both proximal and distal to the actual burn site. Cardiovascular dysfunction is a well-documented phenomenon that increases morbidity and mortality following a massive thermal trauma. Beginning immediately post-burn, during the ebb phase, cardiac function is severely depressed. By 48 h post-injury, cardiac function rebounds and the post-burn myocardium becomes tachycardic and hyperinflammatory. While current clinical trials are investigating a variety of drugs targeted at reducing aspects of the post-burn hypermetabolic response such as heart rate and cardiac work, there is still a paucity of knowledge regarding the underlying mechanisms that induce cardiac dysfunction in the severely burned. There are many animal models of burn injury, from rodents, to sheep or swine, but the majority of burn related cardiovascular investigations have occurred in rat and mouse models. This literature review consolidates the data supporting the prevalent role that β-adrenergic receptors play in mediating post-burn cardiac dysfunction and the idea that pharmacological modulation of this receptor family is a viable therapeutic target for resolving burn-induced cardiac deficits.

  3. Cardiovascular Dysfunction Following Burn Injury: What We Have Learned from Rat and Mouse Models

    Science.gov (United States)

    Guillory, Ashley N.; Clayton, Robert P.; Herndon, David N.; Finnerty, Celeste C.

    2016-01-01

    Severe burn profoundly affects organs both proximal and distal to the actual burn site. Cardiovascular dysfunction is a well-documented phenomenon that increases morbidity and mortality following a massive thermal trauma. Beginning immediately post-burn, during the ebb phase, cardiac function is severely depressed. By 48 h post-injury, cardiac function rebounds and the post-burn myocardium becomes tachycardic and hyperinflammatory. While current clinical trials are investigating a variety of drugs targeted at reducing aspects of the post-burn hypermetabolic response such as heart rate and cardiac work, there is still a paucity of knowledge regarding the underlying mechanisms that induce cardiac dysfunction in the severely burned. There are many animal models of burn injury, from rodents, to sheep or swine, but the majority of burn related cardiovascular investigations have occurred in rat and mouse models. This literature review consolidates the data supporting the prevalent role that β-adrenergic receptors play in mediating post-burn cardiac dysfunction and the idea that pharmacological modulation of this receptor family is a viable therapeutic target for resolving burn-induced cardiac deficits. PMID:26729111

  4. Free radicals and lipid peroxidation mediated injury in burn trauma: the role of antioxidant therapy

    International Nuclear Information System (INIS)

    Burn trauma produces significant fluid shifts that, in turn, reduce cardiac output and tissue perfusion. Treatment approaches to major burn injury include administration of crystalloid solutions to correct hypovolemia and to restore peripheral perfusion. While this aggressive postburn volume replacement increases oxygen delivery to previously ischemic tissue, this restoration of oxygen delivery is thought to initiate a series of deleterious events that exacerbate ischemia-related tissue injury. While persistent hypoperfusion after burn trauma would produce cell death, volume resuscitation may exacerbate the tissue injury that occurred during low flow state. It is clear that after burn trauma, tissue adenosine triphosphate (ATP) levels gradually fall, and increased adenosine monophosphate (AMP) is converted to hypoxanthine, providing substrate for xanthine oxidase. These complicated reactions produce hydrogen peroxide and superoxide, clearly recognized deleterious free radicals. In addition to xanthine oxidase related free radical generation in burn trauma, adherent-activated neutrophils produce additional free radicals. Enhanced free radical production is paralleled by impaired antioxidant mechanisms; as indicated by burn-related decreases in superoxide dismutase, catalase, glutathione, alpha tocopherol, and ascorbic acid levels. Burn related upregulation of inducible nitric oxide synthase (iNOS) may produce peripheral vasodilatation, upregulate the transcription factor nuclear factor kappa B (NF-κB), and promote transcription and translation of numerous inflammatory cytokines. NO may also interact with the superoxide radical to yield peroxynitrite, a highly reactive mediator of tissue injury. Free radical mediated cell injury has been supported by postburn increases in systemic and tissue levels of lipid peroxidation products such as conjugated dienes, thiobarbituric acid reaction products, or malondialdehyde (MDA) levels. Antioxidant therapy in burn therapy

  5. Minor burn injuries in children: inpatient versus outpatient treatment?

    Science.gov (United States)

    La Ferla, G. A.; Fyfe, A. H.; Drainer, I. K.

    1983-01-01

    Seventy-two children with minor superficial burns presented at our casualty department over a 5-month period. Half were treated as inpatients and the other half as outpatients. The colonisation rates were similar in the two groups. Colonised and sterile burns treated as inpatients showed no significant difference in healing rates. The healing time, however, was prolonged in colonised outpatient treated burns. Cosmetic results were satisfactory overall. In the absence of a definite benefit from inpatient treatment, outpatient care of a child with a minor burn should therefore be used if circumstances allow. PMID:6357035

  6. Epidemiology of Pediatric Burn Injuries in Isfahan, Iran

    OpenAIRE

    Rafii, Mohammad Hadi; Saberi, Hamid Reza; Hosseinpour, Mehrdad; Fakharian, Esmaeil; Mohammadzadeh, Mahdi

    2012-01-01

    Background Burns are major cause of death and disability worldwide, particularly in the developing countries. Objectives The aim of this study was to determine the incidence and causes of burns in children under the age of 15 years in Isfahan province, Iran. Patients and Methods All children admitted to the burn center of Isfahan, the largest city in central Iran, between 2007 and 2009 were enrolled in this study. We analyzed the data on age, sex, location, cause and spread of the burn, durat...

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

    International Nuclear Information System (INIS)

    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 TH 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

  8. Burn injury differentially alters whole-blood and organ glutathione synthesis rates: An experimental model

    Directory of Open Access Journals (Sweden)

    Zhe-Wei Fei

    2013-09-01

    Full Text Available Previous studies from our laboratories revealed a reduced rate of whole-blood (WB glutathione (GSH synthesis in severely burned patients. To determine whether WB GSH metabolism is an indicator of the status of GSH metabolism in one or more of the major organs, we used a burn rabbit model to determine GSH concentrations and rates of synthesis in WB, liver, lungs, kidney, and skeletal muscle. L-[1- 13 C]-cysteine was infused intravenously for 6 h in rabbits at 3 days post-burn and in sham burn controls. WB and organ 13 C-enrichment of cysteine and GSH was determined by gas chromatography/mass spectrometry. Plasma cysteine metabolic flux was increased significantly (P < 0.01 following burn injury. WB, liver, and lung GSH concentrations (P = 0.054, P < 0.05, and P < 0.05, respectively and fractional rates of GSH synthesis (P < 0.05, P< 0.01, and P< 0.05, respectively were reduced at 3 days post-burn. Kidney was unaffected. There also appears to be an increased rate of GSH transport out of the liver after burn injury. Hence, there is a differential impact of burn injury on tissue and organ GSH status, with WB qualitatively reflecting the changes in lung and liver. It will be important to determine whether these changes are due to alterations in the intrinsic capacity for GSH synthesis and/or availability of amino acid precursors of GSH.

  9. Impaired respiratory function and heightened pulmonary inflammation in episodic binge ethanol intoxication and burn injury.

    Science.gov (United States)

    Shults, Jill A; Curtis, Brenda J; Chen, Michael M; O'Halloran, Eileen B; Ramirez, Luis; Kovacs, Elizabeth J

    2015-11-01

    Clinical data indicate that cutaneous burn injuries covering greater than 10% of the total body surface area are associated with significant morbidity and mortality, in which pulmonary complications, including acute respiratory distress syndrome (ARDS), contribute to nearly half of all patient deaths. Approximately 50% of burn patients are intoxicated at the time of hospital admission, which increases days on ventilators by 3-fold, and doubles the length of hospitalization, compared to non-intoxicated burn patients. The most common drinking pattern in the United States is binge drinking, where an individual rapidly consumes alcoholic beverages (4 for women, 5 for men) in 2 h. An estimated 38 million Americans binge drink, often several times per month. Experimental data demonstrate that a single binge-ethanol exposure, prior to scald injury, impairs innate and adaptive immune responses, thereby enhancing infection susceptibility and amplifying pulmonary inflammation, neutrophil infiltration, and edema, and is associated with increased mortality. Since these characteristics are similar to those observed in ARDS burn patients, our study objective was to determine whether ethanol intoxication and burn injury and the subsequent pulmonary congestion affect physiological parameters of lung function, using non-invasive and unrestrained plethysmography in a murine model system. Furthermore, to mirror young adult binge-drinking patterns, and to determine the effect of multiple ethanol exposures on pulmonary inflammation, we utilized an episodic binge-ethanol exposure regimen, where mice were exposed to ethanol for a total of 6 days (3 days ethanol, 4 days rest, 3 days ethanol) prior to burn injury. Our analyses demonstrate mice exposed to episodic binge ethanol and burn injury have higher mortality, increased pulmonary congestion and neutrophil infiltration, elevated neutrophil chemoattractants, and respiratory dysfunction, compared to burn or ethanol intoxication alone

  10. Estrogen treatment following severe burn injury reduces brain inflammation and apoptotic signaling

    Directory of Open Access Journals (Sweden)

    Idris Ahamed H

    2009-10-01

    Full Text Available Abstract Background Patients with severe burn injury experience a rapid elevation in multiple circulating pro-inflammatory cytokines, with the levels correlating with both injury severity and outcome. Accumulations of these cytokines in animal models have been observed in remote organs, however data are lacking regarding early brain cytokine levels following burn injury, and the effects of estradiol on these levels. Using an experimental animal model, we studied the acute effects of a full-thickness third degree burn on brain levels of TNF-α, IL-1β, and IL-6 and the protective effects of acute estrogen treatment on these levels. Additionally, the acute administration of estrogen on regulation of inflammatory and apoptotic events in the brain following severe burn injury were studied through measuring the levels of phospho-ERK, phospho-Akt, active caspase-3, and PARP cleavage in the placebo and estrogen treated groups. Methods In this study, 149 adult Sprague-Dawley male rats received 3rd degree 40% total body surface area (TBSA burns. Fifteen minutes following burn injury, the animals received a subcutaneous injection of either placebo (n = 72 or 17 beta-estradiol (n = 72. Brains were harvested at 0.5, 1, 2, 4, 6, 8, 12, 18, and 24 hours after injury from the control (n = 5, placebo (n = 8/time point, and estrogen treated animals (n = 8/time point. The brain cytokine levels were measured using the ELISA method. In addition, we assessed the levels of phosphorylated-ERK, phosphorylated-Akt, active caspase-3, and the levels of cleaved PARP at the 24 hour time-point using Western blot analysis. Results In burned rats, 17 beta-estradiol significantly decreased the levels of brain tissue TNF-α (~25%, IL-1β (~60%, and IL-6 (~90% when compared to the placebo group. In addition, we determined that in the estrogen-treated rats there was an increase in the levels of phospho-ERK (p p p p Conclusion Following severe burn injury, estrogens decrease both

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

    OpenAIRE

    Sadeghi-Bazargani H; Maghsoudi H; Soudmand-Niri M; Ranjbar F; Mashadi-Abdollahi H

    2011-01-01

    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 con...

  12. Application of Silver Sulfadiazine Cream With Early Surgical Intervention in Patients Suffering From Combined Burn-Blast Injury Facial Tattoos

    OpenAIRE

    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...

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

    OpenAIRE

    Disseldorp Laurien M; Mouton Leonora J; Takken Tim; van Brussel Marco; Beerthuizen Gerard IJM; Van der Woude Lucas HV; Nieuwenhuis Marianne K

    2012-01-01

    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 an...

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

    OpenAIRE

    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 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 adoles...

  15. Burns

    Science.gov (United States)

    ... Chemical burns Burns can be the result of: House and industrial fires Car accidents Playing with matches ... hairs Burned lips and mouth Coughing Difficulty breathing Dark, black-stained mucus Voice changes Wheezing

  16. Experimental study of extremely severe combined radiation-burn injury in dogs

    International Nuclear Information System (INIS)

    Thirty adult healthy dogs were equally divided into three groups: 1) Radiation injury group (RIG): whole body irradiated with 4 Gy of gamma rays; 2) Burn group (BG): inflicted with flash burn (8% TBSA III deg, 12% TBSA II deg burn); 3) Combined radiation-burn injury group (CRIG): exposed to both radiation and burn. All animals in RIG and CRIG died; the mean survival times were 11 and 8 days, respectively. Three dogs of BG died with survival time of 10 days.The main clinical manifestation and course of dogs in CRIG were similar to those in RIG. Since it was a combined injury, an addition effect was observed. The characteristics of combined effect was as follows: 1) The relationship between the radiation doses and combined effects of mortality and infection showed an S curve; 2) The incidence of sepsis in burn wound was high and it was the main portal of bacterial invasion; and 3) Negative nitrogen balance, gastrointestinal pathological changes, digestive and absorptive disturbances, and anorexia were observed after injury. Besides, the mechanism of lower rate of lymphocyte transformation is discussed

  17. Burns injury in children: Is antibiotic prophylaxis recommended?

    Directory of Open Access Journals (Sweden)

    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

  18. Umbilical cord mesenchymal stem cell transplantation ameliorates burn-induced acute kidney injury in rats.

    Science.gov (United States)

    Lu, Gang; Huang, Sha; Chen, Yongbin; Ma, Kui

    2013-09-01

    Excessive systemic inflammation following burns could lead to acute kidney injury (AKI). Mesenchymal stromal cells (MSCs) suppress immune cell responses and have beneficial effects in various inflammatory-related immune disorders. However, autologous MSCs are not vital enough for the treatment because of the severely burned patients' deleterious condition. Umbilical cord-derived mesenchymal stem cells (UC-MSCs) could be a suitable substitute cell candidate but no data are available on the therapeutic effectiveness of UC-MSCs transplantation for burn injury and its consequences. In this study, UC-MSCs or ulinastatin was administered intravenously in the rats with burn trauma, and the therapeutic effects of UC-MSCs on the survival of severe burn-induced AKI rats and functional protection of kidney were analyzed. Results showed that UC-MSCs promoted the survival and prevented commitment to apoptosis of resident kidney cells and reduced organ microscopic damage in kidneys after thermal trauma. Thus, our study demonstrates that intravenously delivered UC-MSCs protected the host from death caused by kidney injury subsequent to severe burn, identifying UC-MSCs transplantation may be an attractive candidate for cell-based treatments for burns and induced organ damage. PMID:24043673

  19. Variation in Inpatient Rehabilitation Utilization After Hospitalization for Burn Injury in the United States.

    Science.gov (United States)

    Greene, Nathaniel H; Pham, Tam N; Esselman, Peter C; Rivara, Frederick P

    2015-01-01

    Approximately 45,000 individuals are hospitalized annually for burn treatment. Rehabilitation after hospitalization can offer a significant improvement in functional outcomes. Very little is known nationally about rehabilitation for burns, and practices may vary substantially depending on the region based on observed Medicare post-hospitalization spending amounts. This study was designed to measure variation in rehabilitation utilization by state of hospitalization for patients hospitalized with burn injury. This retrospective cohort study used nationally collected data over a 10-year period (2001 to 2010), from the Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases (SIDs). Patients hospitalized for burn injury (n = 57,968) were identified by ICD-9-CM codes and were examined to see specifically if they were discharged immediately to inpatient rehabilitation after hospitalization (primary endpoint). Both unadjusted and adjusted likelihoods were calculated for each state taking into account the effects of age, insurance status, hospitalization at a burn center, and extent of burn injury by TBSA. The relative risk of discharge to inpatient rehabilitation varied by as much as 6-fold among different states. Higher TBSA, having health insurance, higher age, and burn center hospitalization all increased the likelihood of discharge to inpatient rehabilitation following acute care hospitalization. There was significant variation between states in inpatient rehabilitation utilization after adjusting for variables known to affect each outcome. Future efforts should be focused on identifying the cause of this state-to-state variation, its relationship to patient outcome, and standardizing treatment across the United States. PMID:25423440

  20. How to Help a Person with a Serious Burn Injury

    Science.gov (United States)

    ... Study Ways to Give Give Monthly Membership Gifts Corporate Support Current Partners Workplace Giving Create a Legacy ... the patient and unable to fulfill their normal responsibilities. There are many ... and social aspects of burn recovery. All Rights Reserved. The ...

  1. Local cooling does not prevent hyperalgesia following burn injury in humans

    DEFF Research Database (Denmark)

    Werner, Mads U; Lassen, Birgit Vibeke; Pedersen, Juri L;

    2002-01-01

    -inflammatory or anti-hyperalgesic potential of early cooling after thermal injury. Twenty-four healthy volunteers participated in this randomized, single-blinded study. Following baseline measurements, which included inflammatory variables (skin temperature, erythema index) and sensory variables (thermal and...... the burns. One of the thermodes cooled the burn (8 degrees C for 30 min) whereas the other thermode was a non-active dummy on the control burn. Inflammatory and sensory variables were followed for 160 min after end of the cooling procedure. The burn injury induced significant increases in skin...... temperature (P<0.0005), erythema index (P<0.0001), thermal pain responses (P<0.0005), mechanical pain responses (P<0.005) and secondary hyperalgesia, and significant decreases in heat pain threshold (P<0.0005) and mechanical pain threshold (P<0.0005). There were no post-cooling effects on skin temperature (P...

  2. Cardiac contraction and calcium transport function aftersevere burn injury in rats

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To examine the function change of myocardial calcium transports and determined what role the change plays in cardiac dysfunction after severe burn injury in rats. Methods: The contraction and relaxation properties of the left ventricle (LV) were studied in the isolated hearts preparations of Wistar rats at 3, 8, and 24 h after a 30%TBSA (total body surface area) full-thickness burn. The calcium transport function of the sarcoplasmic reticulum (SR) was measured by the millipore filtration technique. Results: The maximal rate of LV pressure (± dp/dtmax) of the burn group was significantly lower than that of the control group (P < 0.01). In addition, the calciumdependent ATPase activity and the coupling ratio of SR were also markedly depressed. Conclusions: It indicates that the decrease in the SR calcium transport function is one of the important mechanisms for the cardiac contractile dysfunction after severe burn injury.

  3. The Development of a New Way of a Combined Burning Injury Modeling

    Directory of Open Access Journals (Sweden)

    Peretyagin S.P.

    2011-06-01

    Full Text Available The objective of the study is to develop a new way of a combined burning injury modeling enabling to consider all pathogenic mechanisms of injury occurrence. Materials and Methods. There has been designed an original inhalation chamber: a disiccator with a ground stopper and a tray. Two groups of white Wistar rats (n=50 have taken part in the experiment. Results. There has been suggested a new way of a combined burning injury modeling consisting of applying a contact burn to an animal (damage area is 20% of body surface with an additional thermoinhalation exposure of hot air and combustion products within 20—30 sec in the conditions of an inhalation chamber.

  4. Propranolol Improves Impaired Hepatic Phosphatidylinositol 3-Kinase/Akt Signaling after Burn Injury

    OpenAIRE

    Brooks, Natasha C; Song, Juquan; Boehning, Darren; Kraft, Robert; Finnerty, Celeste C.; Herndon, David N; Jeschke, Marc G.

    2012-01-01

    Severe burn injury is associated with induction of the hepatic endoplasmic reticulum (ER) stress response. ER stress leads to activation of c-Jun N-terminal kinase (JNK), suppression of insulin receptor signaling via phosphorylation of insulin receptor substrate 1 and subsequent insulin resistance. Marked and sustained increases in catecholamines are prominent after a burn. Here, we show that administration of propranolol, a nonselective β1/2 adrenergic receptor antagonist, attenuates ER stre...

  5. Burn Injury Reveals Altered Phenotype in Mannan-Binding Lectin-Deficient Mice

    OpenAIRE

    Møller-Kristensen, Mette; Hamblin, Michael R.; Thiel, Steffen; Jensenius, Jens Chr.; Takahashi, Kazue

    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 f...

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

    OpenAIRE

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

    2016-01-01

    Background 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 exp...

  7. Intentional burn injury: an evidence-based, clinical and forensic review.

    Science.gov (United States)

    Greenbaum, Adam R; Donne, Jeremy; Wilson, Diana; Dunn, Kenneth W

    2004-11-01

    Burn injury can be inflicted intentionally either by one person to another whenever one has the ability to physically control the other, or it can be self-inflicted. There is scant evidential basis for much that is written about and practiced in the evaluation and care of patients that have sustained intentional burn injuries. Yet this is an area in which medical personnel must necessarily be trained in both the therapeutic and forensic aspects of a complex problem. Failure to appreciate the complexity of medical and forensic interactions may have far reaching effects. A missed diagnosis can result in inappropriate medical care, on-going abuse and future fatality. Inept management can result on the one hand, in blame levelled inappropriately placing incomparable strain on family units and innocent parties, and on the other, allow abusers to continue unchecked. This is the first review on the subject in which lawyers and doctors collaborate to produce a holistic approach to this subject. In it we describe the legal considerations that medical staff must appreciate when approaching patients who may have suffered intentional burns. We analyse the various scenarios in which intentional burning can be found and challenge the clinical dogma with much of the management of paediatric inflicted burns has become imbued. We suggest a rational and balanced approach to all intentional burn injuries-especially when children are involved. In the light of current case law in which dogmatic medical evidence has been implicated in wrongful convictions for child abuse in the UK, it is imperative that medical professionals gather evidence carefully and completely and apply it with logic and impartiality. This paper will aid clinicians who may not be experienced in dealing with burn injuries, but find themselves in the position of seeing a burn acutely, to avoid common mistakes. PMID:15475134

  8. Pattern of childhood burn injuries and their management outcome at Bugando Medical Centre in Northwestern Tanzania

    Directory of Open Access Journals (Sweden)

    Chalya Phillipo L

    2011-11-01

    Full Text Available Abstract Background Burn injuries constitute a major public health problem and are the leading cause of childhood morbidity and mortality worldwide. There is paucity of published data on childhood burn injuries in Tanzania, particularly the study area. This study was conducted to describe the pattern of childhood burn injuries in our local setting and to evaluate their management outcome. Methods A cross sectional study was conducted at Bugando Medical Centre (in Northwestern Tanzania over a 3-year period from January 2008 to December 2010. Data was collected using a pre-tested coded questionnaire and statistical analyses performed using SPSS software version 15.0. Results A total of 342 burned children were studied. Males were mainly affected. Children aged = 2 were the majority accounting for 45.9% of cases. Intentional burn injuries due to child abuse were reported in 2.9% of cases. Scald was the most common type of burns (56.1%. The trunk was the most commonly involved body region (57.3%. Majority of patients (48.0% sustained superficial burns. Eight (2.3% patients were HIV positive. Most patients (89.8% presented to the hospital later than 24 h. The rate of burn wound infection on admission and on 10th day were 32.4% and 39.8% respectively.Staphylococcus aureus were more common on admission wound swabs, with Pseudomonas aeruginosa becoming more evident after 10th day. MRSA was detected in 19.2% of Staphylococcus aureus. Conservative treatment was performed in 87.1% of cases. Surgical treatment mainly skin grafting (65.9% was performed in 44 (12.9% of patients. The overall average of the length of hospital stay (LOS was 22.12 ± 16.62 days. Mortality rate was 11.7%. Using multivariate logistic regression analysis; age of the patient, type of burn, delayed presentation, clothing ignition, %TBSA and severity of burn were found to be significantly associated with LOS (P P Conclusion Childhood burn injuries still remain a menace in our

  9. Changes of interleukin-3 expression after combined radiation-burn injury in mice

    International Nuclear Information System (INIS)

    Objective: To study the changes of IL-3 expression after 5 Gy irradiation, 30% total body surface area burn and combined radiation-burn injury in mice. Methods: Northern dot blotting, production of mRNA, cell culture, assay of IL-3 biological activity, etc. Results: The IL-3 mRNA was markedly decreased by 77% and 21% on the 3rd day and the 14th day after irradiation, respectively. The IL-3 protein was decreased by 83% and 36% on 3rd and 14th day, respectively. There was a significant inhibition of IL-3 expression on the 3rd day after simple burn and slight increase of IL-3 expression on the 14th day. In groups with combined injury, IL-3 was more than that in the irradiated groups but less than that in the groups with burn injury. The changes of IL-3 expression were parallel with the changes of bone marrow cells. Conclusion: Inhibition of IL-3 expression is one of the reasons of hematopoietic failure caused by radiation and combined radiation-burn injury in mice

  10. Analysis of the microcirculation after soft tissue reconstruction of the outer ear with burns in patients with severe burn injuries.

    Science.gov (United States)

    Medved, Fabian; Medesan, Raluca; Rothenberger, Jens Martin; Schaller, Hans-Eberhard; Schoeller, Thomas; Manoli, Theodora; Weitgasser, Lennart; Naumann, Aline; Weitgasser, Laurenz

    2016-07-01

    Reconstruction of soft tissue defects of the ear with burns remains one of the most difficult tasks for the reconstructive surgeon. Although numerous reconstructive options are available, the results are often unpredictable and worse than expected. Besides full and split skin grafting, local random pattern flaps and pedicled flaps are frequently utilized to cover soft tissue defects of the outer auricle. Because of the difficulty and unpredictable nature of outer ear reconstruction after burn injury, a case-control study was conducted to determine the best reconstructive approach. The microcirculatory properties of different types of soft tissue reconstruction of the outer ear with burns in six severely burned Caucasian patients (three men and three women; mean age, 46 years (range, 22-70)) were compared to those in the healthy tissue of the outer ear using the O2C device (Oxygen to See; LEA Medizintechnik, Gießen, Germany). The results of this study revealed that the investigated microcirculation parameters such as the median values of blood flow (control group: 126 AU), relative amount of hemoglobin (control group: 59.5 AU), and tissue oxygen saturation (control group: 73%) are most similar to those of normal ear tissue when pedicled flaps based on the superficial temporal artery were used. These findings suggest that this type of reconstruction is superior for soft tissue reconstruction of the outer ear with burns in contrast to random pattern flaps and full skin grafts regarding the microcirculatory aspects. These findings may improve the knowledge on soft tissue viability and facilitate the exceptional and delicate process of planning the reconstruction of the auricle with burns. PMID:26997326

  11. Sleep Onset Insomnia Symptoms during Hospitalization for Major Burn Injury Predict Chronic Pain

    OpenAIRE

    Smith, Michael T; Klick, Brendan; Kozachik, Sharon; Edwards, Robert E.; Holavanahalli, Radha; Wiechman, Shelley; Blakeney, Patricia; Lezotte, Dennis; Fauerbach, James A.

    2008-01-01

    Both cross-sectional studies of chronic pain and sleep deprivation experiments suggest a bi-directional relationship between sleep and pain. Few longitudinal studies, however, have assessed whether acute-insomnia following traumatic injury predicts the development of persistent pain. We sought to evaluate: 1) whether in-hospital insomnia independently predicts long-term pain after burn injury and 2) whether in-hospital pain predicts future insomnia symptoms. We analyzed data on 333 subjects h...

  12. Does naloxone reinstate secondary hyperalgesia in humans after resolution of a burn injury?

    DEFF Research Database (Denmark)

    Pereira, Manuel P; Werner, Mads U; Ringsted, Thomas K; Rowbotham, Michael C; Taylor, Bradley K; Dahl, Joergen B

    2013-01-01

    Development of secondary hyperalgesia following a cutaneous injury is a centrally mediated, robust phenomenon. The pathophysiological role of endogenous opioid signalling to the development of hyperalgesia is unclear. Recent animal studies, carried out after the resolution of inflammatory pain, h......, have demonstrated reinstatement of tactile hypersensitivity following administration of μ-opioid-receptor-antagonists. In the present study in humans, we analyzed the effect of naloxone when given after the resolution of secondary hyperalgesia following a first-degree burn injury....

  13. Organ-specific inflammation following acute ethanol and burn injury

    OpenAIRE

    Bird, Melanie D.; Kovacs, Elizabeth J

    2008-01-01

    Clinical and experimental evidence demonstrates that ethanol exposure prior to injury alters local and systemic inflammatory responses, increasing morbidity and mortality. Moreover, the aberrant inflammatory responses can directly and indirectly lead to the poor prognosis after injury by altering leukocyte infiltration into the wound site and remote organs and by suppressing immunity leading to increased susceptibility to opportunistic infections. Recent studies from our laboratory have focus...

  14. Development of a long-term ovine model of cutaneous burn and smoke inhalation injury and the effects of early excision and skin autografting

    OpenAIRE

    Yamamoto, Yusuke; Enkhbaatar, Perenlei; Sakurai, Hiroyuki; Rehberg, Sebastian; Asmussen, Sven; Ito, Hiroshi; Sousse, Linda E.; Cox, Robert A.; Deyo, Donald J.; Traber, Lillian D.; TRABER, MARET G.; Herndon, David N.; Traber, Daniel L.

    2012-01-01

    Smoke inhalation injury frequently increases the risk of pneumonia and mortality in burn patients. The pathophysiology of acute lung injury secondary to burn and smoke inhalation is well studied, but long-term pulmonary function, especially the process of lung tissue healing following burn and smoke inhalation, has not been fully investigated. By contrast, early burn excision has become the standard of care in the management of major burn injury. While many clinical studies and small-animal e...

  15. α-Tocopherol adipose tissue stores are depleted after burn injury in pediatric patients123

    OpenAIRE

    Traber, Maret G.; Leonard, Scott W.; Traber, Daniel L; Traber, Lillian D; Gallagher, James; Bobe, Gerd; Jeschke, Marc G.; Finnerty, Celeste C.; Herndon, David

    2010-01-01

    Background: We previously showed that thermal injury depletes plasma vitamin E in pediatric burn patients; however, plasma changes may reflect immediate alterations in vitamin E nutriture. Adipose tissue α-tocopherol concentrations are generally accepted to reflect long-term vitamin E status.

  16. EXPERIENCE IN TREATING SECONDARY SYSTEMIC MYCOTIC INFECTION AFTER SEVERE BURNS ASSOCIATED WITH ELECTRIC INJURY

    Institute of Scientific and Technical Information of China (English)

    谢卫兴; 李秀芝

    1995-01-01

    One patient with wound surface sepsis caused by secondary pyocyanic infection after extensive burns associated with visceral injuries (peptic ulcer hemorrhage, renal insufficiency and hepatic dysfunction) and generalized candidiasis albicans was cured after anti-infection treatment with proper antibiotics, removal of the infected focus, and effective anti-fungal drugs.

  17. OUTCOME OF PHYSICAL THERAPY AND SPLINTING IN HAND BURNS INJURY. OUR LAST FOUR YEARS’ EXPERIENCE

    Science.gov (United States)

    Rrecaj, Shkurta; Hysenaj, Hajrie; Martinaj, Merita; Murtezani, Ardiana; Ibrahimi-Kacuri, Dafina; Haxhiu, Bekim; Buja, Zene

    2015-01-01

    Objective: Burn injuries in hands are much more complex and the appearance of contractures is a common complication. Hand burn injuries often result in limited functionality, flexion and extension of fingers and present a major hindrance in rehabilitation. The aim of physical therapy and splinting after hand burn injury is to maintain mobility, prevent the development of the contracture and to promote the functionality of hand and good cosmetic results. The purpose of this study is to presents our experience of 38 children with hand burn injuries, admitted and treated at the Department of Plastic Surgery, UCCK-Pristina, Kosovo, during the years 2012-2015. Methods: Physical therapy is focused on active/passive range of motion in affected joints, management of cicatrix, strengthening exercise, coordination and use of splints for correction contractures. Patients were evaluated in three, six months and the definitive evaluation is done after 9 months of physical therapy and splinting. Results: We have improvement in range of motion (ROM), functionality, coordination, muscle force, decrease of keloids scars. Conclusion: This study shows the importance of physical therapy and splinting, achieving good results in preventing contracture, improving range of motion, muscle force and good cosmetic results. PMID:26889095

  18. Nosocomial Infections in Iranian Pediatric Patients With Burn Injuries: A Review

    Directory of Open Access Journals (Sweden)

    Mohammad Sadegh Rezai

    2015-07-01

    Full Text Available Context: Nosocomial infections (NIs are the most common life-threatening complications and leading cause of morbidity and mortality in pediatric patients with burn injuries. It is estimated that annually two million infections, 90000 deaths, and 4.5 billion USD in excess healthcare costs are imposed by NIs. Herein, we reviewed the articles related to NIs in Iranian pediatric patients with burn injuries. Evidence Acquisition: A review of epidemiologic studies on NI in pediatric patients with burn injuries in Iran was performed by searching studies indexed in PubMed, Google scholar, Iranmedex, Magiran, SID databases, published in English language in 2014. Keywords for searching included “Nosocomial Infections”, “Hospital- acquired infection”, “Healthcare- associated infections”, “burn”, “children”, “pediatric”, and “Iran”. All articles related to NIs in pediatric patients with burn injuries or about general population with burn injuries, which included pediatric population up to the age 18 years in Iran, were included. Articles out of the definition for age group or lack of significant data, outpatients, and patients selected for reconstructive surgeries were excluded. Results: Of 43 reviewed articles, nine eligible articles were selected. The male to female ratio was 1.6:1. The age ranged from birth to 18 years with the mean of 3.4 years. Overall incidence of NIs was 20.94%. Pseudomonas aeruginosa (30.39%, Klebsiella pneumonia (17.54%, Acinetobacter (17.47%, and Staphylococcus aureus (14.98% were the most common prominent isolates with high antibiotic resistance isolated from the cultures of different sites of infections including burn wound. Vancomycin was highly specific antibiotic against Gram-positive bacteria isolates. All spices of Acinetobacter were multidrug resistant. The mean of mortality rate was 8.75%. Conclusions: In spite of higher incidence of NIs in children with burn injuries, there are no well

  19. Involvement of NADPH oxidases in alkali burn-induced corneal injury.

    Science.gov (United States)

    Gu, Xue-Jun; Liu, Xian; Chen, Ying-Ying; Zhao, Yao; Xu, Man; Han, Xiao-Jian; Liu, Qiu-Ping; Yi, Jing-Lin; Li, Jing-Ming

    2016-07-01

    Chemical burns are a major cause of corneal injury. Oxidative stress, inflammatory responses and neovascularization after the chemical burn aggravate corneal damage, and lead to loss of vision. Although NADPH oxidases (Noxs) play a crucial role in the production of reactive oxygen species (ROS), the role of Noxs in chemical burn-induced corneal injury remains to be elucidated. In the present study, the transcription and expression of Noxs in corneas were examined by RT-qPCR, western blot analysis and immunofluorescence staining. It was found that alkali burns markedly upregulated the transcription and expression of Nox2 and Nox4 in human or mouse corneas. The inhibition of Noxs by diphenyleneiodonium (DPI) or apocynin (Apo) effectively attenuated alkali burn-induced ROS production and decreased 3-nitrotyrosine (3-NT) protein levels in the corneas. In addition, Noxs/CD11b double‑immunofluorescence staining indicated that Nox2 and Nox4 were partially co-localized with CD11b. DPI or Apo prevented the infiltration of CD11b-positive inflammatory cells, and inhibited the transcription of inflammatory cytokines following alkali burn-induced corneal injury. In our mouse model of alkali burn-induced corneal injury, corneal neovascularization (CNV) occurred on day 3, and it affected 50% of the whole area of the cornea on day 7, and on day 14, CNV coverage of the cornea reached maximum levels. DPI or Apo effectively attenuated alkali burn‑induced CNV and decreased the mRNA levels of angiogenic factors, including vascular endothelial growth factor (VEGF), VEGF receptors and matrix metalloproteinases (MMPs). Taken together, our data indicate that Noxs play a role in alkali burn-induced corneal injury by regulating oxidative stress, inflammatory responses and CNV, and we thus suggest that Noxs are a potential therapeutic target in the future treatment of chemical-induced corneal injury. PMID:27221536

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

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    L.D. Morris

    2010-02-01

    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.

  1. Propranolol Improves Impaired Hepatic Phosphatidylinositol 3-Kinase/Akt Signaling after Burn Injury

    Science.gov (United States)

    Brooks, Natasha C; Song, Juquan; Boehning, Darren; Kraft, Robert; Finnerty, Celeste C; Herndon, David N; Jeschke, Marc G

    2012-01-01

    Severe burn injury is associated with induction of the hepatic endoplasmic reticulum (ER) stress response. ER stress leads to activation of c-Jun N-terminal kinase (JNK), suppression of insulin receptor signaling via phosphorylation of insulin receptor substrate 1 and subsequent insulin resistance. Marked and sustained increases in catecholamines are prominent after a burn. Here, we show that administration of propranolol, a nonselective β1/2 adrenergic receptor antagonist, attenuates ER stress and JNK activation. Attenuation of ER stress by propranolol results in increased insulin sensitivity, as determined by activation of hepatic phosphatidylinositol 3-kinase and Akt. We conclude that catecholamine release is responsible for the ER stress response and impaired insulin receptor signaling after burn injury. PMID:22396018

  2. IL-15 Superagonist Expands mCD8+ T, NK and NKT Cells after Burn Injury but Fails to Improve Outcome during Burn Wound Infection.

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    Naeem K Patil

    Full Text Available Severely burned patients are highly susceptible to opportunistic infections and sepsis, owing to the loss of the protective skin barrier and immunological dysfunction. Interleukin-15 (IL-15 belongs to the IL-2 family of common gamma chain cytokines and stimulates the proliferation and activation of T (specifically memory CD8, NK and NKT cells. It has been shown to preserve T cell function and improve survival during cecal ligation and puncture (CLP-induced sepsis in mice. However, the therapeutic efficacy of IL-15 or IL-15 superagonist (SA during infection after burn injury has not been evaluated. Moreover, very few, if any, studies have examined, in detail, the effect of burn injury and infection on the adaptive immune system. Thus, we examined the effect of burn and sepsis on adaptive immune cell populations and the effect of IL-15 SA treatment on the host response to infection.Mice were subjected to a 35% total body surface area burn, followed by wound infection with Pseudomonas aeruginosa. In some experiments, IL-15 SA was administered after burn injury, but before infection. Leukocytes in spleen, liver and peritoneal cavity were characterized using flow cytometry. Bacterial clearance, organ injury and survival were also assessed.Burn wound infection led to a significant decline in total white blood cell and lymphocyte counts and induced organ injury and sepsis. Burn injury caused decline in CD4+ and CD8+ T cells in the spleen, which was worsened by infection. IL-15 treatment inhibited this decline and significantly increased cell numbers and activation, as determined by CD69 expression, of CD4+, CD8+, B, NK and NKT cells in the spleen and liver after burn injury. However, IL-15 SA treatment failed to prevent burn wound sepsis-induced loss of CD4+, CD8+, B, NK and NKT cells and failed to improve bacterial clearance and survival.Cutaneous burn injury and infection cause significant adaptive immune dysfunction. IL-15 SA does not augment host

  3. 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.

  4. 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...... 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...

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

    Science.gov (United States)

    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. PMID:26154205

  6. Predictive Value of IL-8 for Sepsis and Severe Infections after Burn Injury - A Clinical Study

    Science.gov (United States)

    Kraft, Robert; Herndon, David N; Finnerty, Celeste C; Cox, Robert A; Song, Juquan; Jeschke, Marc G

    2014-01-01

    The inflammatory response induced by burn injury contributes to increased incidence of infections, sepsis, organ failure, and mortality. Thus, monitoring post-burn inflammation is of paramount importance but so far there are no reliable biomarkers available to monitor and/or predict infectious complications after burn. As IL-8 is a major mediator for inflammatory responses, the aim of our study was to determine whether IL-8 expression can be used to predict post-burn sepsis, infections, and mortality other outcomes post-burn. Plasma cytokines, acute phase proteins, constitutive proteins, and hormones were analyzed during the first 60 days post injury from 468 pediatric burn patients. Demographics and clinical outcome variables (length of stay, infection, sepsis, multiorgan failure (MOF), and mortality were recorded. A cut-off level for IL-8 was determined using receiver operating characteristic (ROC) analysis. Statistical significance is set at (p<0.05). ROC analysis identified a cut-off level of 234 pg/ml for IL-8 for survival. Patients were grouped according to their average IL-8 levels relative to this cut off and stratified into high (H) (n=133) and low (L) (n=335) groups. In the L group, regression analysis revealed a significant predictive value of IL-8 to percent of total body surface area (TBSA) burned and incidence of MOF (p<0.001). In the H group IL-8 levels were able to predict sepsis (p<0.002). In the H group, elevated IL-8 was associated with increased inflammatory and acute phase responses compared to the L group (p<0.05). High levels of IL-8 correlated with increased MOF, sepsis, and mortality. These data suggest that serum levels of IL-8 may be a valid biomarker for monitoring sepsis, infections, and mortality in burn patients. PMID:25514427

  7. Lateral lower face and neck contouring following burn injury.

    Directory of Open Access Journals (Sweden)

    Sadrollah Motamed

    2015-04-01

    Full Text Available The neck is normally a concave and highly mobile structure. Facial and cervical skin is prone to burn scar contracture because of its thin nature. The goal of treatment is to reconstruct this region to achieve a good aesthetic outcome and also normal neck and chin mobilization. This study was conducted to compare the effect of one row of suture and three rows of suture in critical points of the neck to recreate cervicomandibular angle for better contouring of the neck. A cross-sectional study was performed from July 2006 until August 2010. A total of 65 patients underwent lower lateral face and neck burn scar contracture reconstruction. The mean age of participants was 25.5 years old. After designing a local flap, in 31 patients we applied one row of suture. In 34 patients, we used three rows of suture on each side of the neck incorporation with  the recipient bed and the flap dermis or capsule to recreate a natural lower lateral face and neck contour (P<0.001. The standard deviation in hospitalization was 7 ± 2 days for group A and 6 ± 1 days for group B. In a two years follow-up, no blunting of cervicomandibular angle occurred and three rows of suture were superior according to present findings.

  8. 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

  9. Analysis of factorial time-course microarrays with application to a clinical study of burn injury

    Science.gov (United States)

    Zhou, Baiyu; Xu, Weihong; Herndon, David; Tompkins, Ronald; Davis, Ronald; Xiao, Wenzhong; Wong, Wing Hung; Toner, Mehmet; Warren, H. Shaw; Schoenfeld, David A.; Rahme, Laurence; McDonald-Smith, Grace P.; Hayden, Douglas; Mason, Philip; Fagan, Shawn; Yu, Yong-Ming; Cobb, J. Perren; Remick, Daniel G.; Mannick, John A.; Lederer, James A.; Gamelli, Richard L.; Silver, Geoffrey M.; West, Michael A.; Shapiro, Michael B.; Smith, Richard; Camp, David G.; Qian, Weijun; Storey, John; Mindrinos, Michael; Tibshirani, Rob; Lowry, Stephen; Calvano, Steven; Chaudry, Irshad; West, Michael A.; Cohen, Mitchell; Moore, Ernest E.; Johnson, Jeffrey; Moldawer, Lyle L.; Baker, Henry V.; Efron, Philip A.; Balis, Ulysses G.J.; Billiar, Timothy R.; Ochoa, Juan B.; Sperry, Jason L.; Miller-Graziano, Carol L.; De, Asit K.; Bankey, Paul E.; Finnerty, Celeste C.; Jeschke, Marc G.; Minei, Joseph P.; Arnoldo, Brett D.; Hunt, John L.; Horton, Jureta; Cobb, J. Perren; Brownstein, Bernard; Freeman, Bradley; Maier, Ronald V.; Nathens, Avery B.; Cuschieri, Joseph; Gibran, Nicole; Klein, Matthew; O’Keefe, Grant

    2010-01-01

    Time-course microarray experiments are capable of capturing dynamic gene expression profiles. It is important to study how these dynamic profiles depend on the multiple factors that characterize the experimental condition under which the time course is observed. Analytic methods are needed to simultaneously handle the time course and factorial structure in the data. We developed a method to evaluate factor effects by pooling information across the time course while accounting for multiple testing and nonnormality of the microarray data. The method effectively extracts gene-specific response features and models their dependency on the experimental factors. Both longitudinal and cross-sectional time-course data can be handled by our approach. The method was used to analyze the impact of age on the temporal gene response to burn injury in a large-scale clinical study. Our analysis reveals that 21% of the genes responsive to burn are age-specific, among which expressions of mitochondria and immunoglobulin genes are differentially perturbed in pediatric and adult patients by burn injury. These new findings in the body’s response to burn injury between children and adults support further investigations of therapeutic options targeting specific age groups. The methodology proposed here has been implemented in R package “TANOVA” and submitted to the Comprehensive R Archive Network at http://www.r-project.org/. It is also available for download at http://gluegrant1.stanford.edu/TANOVA/. PMID:20479259

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

    International Nuclear Information System (INIS)

    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)

  11. α-Tocopherol adipose tissue stores are depleted after burn injury in pediatric patients123

    Science.gov (United States)

    Leonard, Scott W; Traber, Daniel L; Traber, Lillian D; Gallagher, James; Bobe, Gerd; Jeschke, Marc G; Finnerty, Celeste C; Herndon, David

    2010-01-01

    Background: We previously showed that thermal injury depletes plasma vitamin E in pediatric burn patients; however, plasma changes may reflect immediate alterations in vitamin E nutriture. Adipose tissue α-tocopherol concentrations are generally accepted to reflect long-term vitamin E status. Objective: To test the hypothesis that thermal injury depletes body stores of vitamin E, α-tocopherol concentrations were measured in adipose tissue samples. Design: Pediatric patients (n = 8) were followed up to 1 y after burn injury. Surgically obtained samples were collected at various intervals and stored at −80°C in a biorepository. α- and γ-Tocopherols, cholesterol, and triglycerides were measured in the same tissue aliquot. Results: During the first week after injury, adipose tissue α-tocopherol concentrations were within the expected normal range of 199 ± 40 nmol/g adipose tissue but were substantially lower at weeks 2 and 3 (133 ± 13 and 109 ± 8 nmol/g adipose tissue, respectively). Individual rates of decrease, estimated by linear regression, showed that adipose tissue α-tocopherol decreased by an average of 6.1 ± 0.6 nmol/g daily. During the first month after injury, adipose tissue triglyceride concentrations also decreased, whereas no changes in cholesterol concentrations occurred. Conclusions: These data emphasize that the burn injury experienced by these pediatric patients altered their metabolism such that vitamin E status diminished during the month after injury. Further studies are needed to evaluate the mechanism and consequences of the observed vitamin E depletion. This trial was registered at clinicaltrials.gov as NCT00675714. PMID:20881067

  12. HIV seroprevalence and its effect on outcome of moderate to severe burn injuries: A Ugandan experience

    Directory of Open Access Journals (Sweden)

    Ssentongo Robert

    2011-06-01

    Full Text Available Abstract Background HIV infection in a patient with burn injuries complicates the care of both the patient and the treating burn team. This study was conducted to establish the prevalence of HIV among burn patients in our setting and to compare the outcome of these patients who are HIV positive with those who are HIV negative. Methods This was a prospective cohort study involving burn injury patients admitted to Mulago Hospital between November 2005 and February 2006. Patients were stratified into HIV positive (exposed group and HIV-negative (unexposed group. Data was collected using a pre-tested coded questionnaire and analyzed using SPSS statistical computer software version 11.5. Results Of the 130 patients included in the study, 17 (13.1% patients tested HIV positive and this formed the study (exposed group. The remaining 113 patients (86.9% formed the control (unexposed group. In the HIV positive group, females outnumbered males by a ratio of 1.4:1 and the mean age was 28.4 ± 21.5 years (range 3 months-34 years. 64.7% of HIV positive patients reported to have risk factors for HIV infection. Of these, multiple sexual partners [Odds Ratio 8.44, 95% C.I. (3.87-143.23, P = 0.011] and alcoholism [Odds Ratio 8.34, 95% C.I. (5.76-17.82, P = 0.002] were found to be independently and significantly associated with increased risk to HIV infection. The mean CD4 count for HIV positive and HIV negative patients were 394 ± 328 cells/μL and 912 ± 234 cells/μL respectively which is statistically significant (P = 0.001. There was no difference in the bacteria cultured from the wounds of HIV positive and negative patients (P = 0.322. Patients with clinical signs of sepsis had lower CD4+ counts compared to patients without sepsis (P Conclusion HIV infection is prevalent among burn injury patients in our setting and thus presents an occupational hazard to health care workers who care for these patients. All burn health care workers in this region need to

  13. Effects of early escharectomy on rats with combined radiation-burn injury

    International Nuclear Information System (INIS)

    Objective: To provide evidence for beneficial effect of clinical therapy with early escharectomy on survival and wound healing in rats combined radiation-burn injury. Methods: Rats were exposed to 5 Gy whole-body γ-ray irradiation from a 60Co source and to thermal-radiation burn (10% TBSA, full thickness burn) successively by a 5 kW bromo-tungsten lamp. Then the animals were given anti-shock and anti-infection remedies. Early escharectomy and stitch (EES) at 24 h after injury, eschar-protecting treatment, or other treatment modalities were carried out. The 60-day survival rate, the duration of wound healing and the changes of the body weight of animals were observed. Results: The 60-day survival rate of EES group reached 78%, being higher than that of the no-escharectomy group (40%, P < 0.05) and even higher than that of the escharectomy with non-stitch group (15%, P < 0.01) and that of the control group (10%, P < 0.01). Besides, in the EES group, the wound showed no sign of infection and healed well, and the body weights recovered faster. Conclusions: EES is effective and available on this model of combined injuries. It is appropriate for operation at 24-48 h after injury

  14. Unusual presentation of firework injury causing intraoral burns

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    Patel Chintan

    2005-01-01

    Full Text Available Fireworks are commonly used in celebrate festive occasions. We present a case of an unusual presentation of intraoral firework injury, which is a very rare case. A fifteen year old boy kept four explosive papercaps wrapped in a small polythene bags in between his left molars and crushed them. This resulted in a contused lacerated wound over the left buccal mucosa. Patient was treated conservatively with maintenance of intraoral hygiene, antibiotics, proteolytic enzymes and analgesics. It took 18 days for complete healing of the wound.

  15. The effect of levamisole on mortality rate among patients with severe burn injuries

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    Mohammad Javad Fatemi

    2013-01-01

    Full Text Available Background: Burn injuries are one of the main causes of mortality and morbidity throughout the world and burn patients have higher chances for infection due to their decreased immune resistance. Levamisole, as an immunomodulation agent, stimulates the immune response against infection. Materials and Methods: This randomized clinical trial was conducted in Motahari Burn Center, Tehran, Iran. Patients who had second- or third-degree burn with involvement of more than 50% of total body surface area (TBSA were studied. The levamisole group received levamisole tablet, 100 mg per day. Meantime, both the levamisole and control groups received the standard therapy of the Burn Center, based on a standard protocol. Then, the outcome of the patients was evaluated. Results: 237 patients entered the study. After excluding 42 patients with inhalation injury, electrical and chemical burns, and the patients who died in the first 72 h, 195 patients remained in the study, including 110 patients in the control group and 85 in the treatment group. The mean age of all patients (between 13 to 64 years was 33.29 ± 11.39 years (Mean ± SD, and it was 33.86 ± 11.45 years in the control group and 32.57 ± 11.32 years in the treatment group. The mean percentage of TBSA burn was 64.50 ± 14.34 and 68.58 ± 14.55 for the levamisole and control groups, respectively, with the range of 50-100% and 50-95% TBSA. The mortality rate was 68 (61.8% patients in the control group and 50 (58.8% patients in the treatment group (P = 0.8. Conclusion: According to this study, there was no significant relationship between improvement of mortality and levamisole consumption.

  16. Outcomes in Adult Survivors of Childhood Burn Injuries as Compared with Matched Controls.

    Science.gov (United States)

    Stone, James; Gawaziuk, Justin P; Khan, Sazzadul; Chateau, Dan; Bolton, James M; Sareen, Jitender; Enns, Jessica; Doupe, Malcolm; Brownell, Marni; Logsetty, Sarvesh

    2016-01-01

    Limited research exists examining long-term mental and physical health outcomes in adult survivors of pediatric burns. The authors examine the postinjury lifetime prevalence of common mental and physical disorders in a large pediatric burn cohort and compare the results with matched controls. Seven hundred and forty five survivors of childhood burns identified in the Burn Registry (1% between April 1, 1988 and March 31, 2010) were matched 1:5 to the general population based on age at time of injury (index date), sex, and geographic residence. Postinjury rate ratio (RR) was used to compare burn cases and control cohorts for common mental and physical illnesses through physician billings, and hospital claims. RR was adjusted for sex, rural residence, and income. Compared with matched controls, postburn cases had significantly higher RR of all mental disorders, which remained significant (P abuse RR = 2.3 [CL: 1.7-3.2], suicide attempt RR = 4.3 [CL: 1.6-12.1], or any mental disorder RR = 1.5 [CL: 1.3-1.8]). The relative rate of some physical illnesses was also significantly increased in burn survivors: arthritis RR = 1.2 (CL: 1.1-1.4), fractures RR = 1.4 (CL: 1.2-1.6), total respiratory morbidity RR = 1.1 (CL: 1.02-1.3), and any physical illness RR = 1.2 (CL: 1.1-1.3). Adult survivors of childhood burn injury have significantly increased rates of postburn mental and physical illnesses. Screening and appropriate management of these illnesses is essential when caring for this population. PMID:26594866

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

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    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.

  18. Development of an Animal Model for Burn-Blast Combined Injury and Cardiopulmonary System Changes in the Early Shock Stage.

    Science.gov (United States)

    Hu, Quan; Chai, Jiake; Hu, Sen; Fan, Jun; Wang, Hong-Wei; Ma, Li; Duan, Hong-Jie; Liu, Lingying; Yang, Hongming; Li, Bai-Ling; Wang, Yi-He

    2015-12-01

    The purposes of this study were to establish an animal model for burn-blast combined injury research and elaborate cardiopulmonary system changes in the early shock stage. In this study, royal demolition explosive or RDX (hexagon, ring trimethylene nitramine) was used as an explosive source, and the injury conditions of the canine test subjects at various distances to the explosion (30, 50, and 70 cm) were observed by gross anatomy and pathology to determine a larger animal model of moderate blast injury. The canines were then subjected to a 35 % total body surface area (TBSA) full-thickness flame injury using napalm, which completed the development of a burn-blast combined injury model. Based on this model, the hemodynamic changes and arterial blood gas analysis after the burn-blast combined injury were measured to identify the cardiopulmonary system characteristics. In this research, RDX explosion and flame injury were used to develop a severe burn-blast injury animal model that was stable, close to reality, and easily controllable. The hemodynamic and arterial blood gas changes in the canine subjects after burn-blast injury changed distinctly from the burn and blast injuries. Blood pressure and cardiac output fluctuated, and the preload was significantly reduced, whereas the afterload significantly increased. Meanwhile, the oxygen saturation (SO2) decreased markedly with carbon dioxide partial pressure (PCO2), and lactic acid (Lac) rose, and oxygen partial pressure (PO2) reduced. These changes suggested that immediate clinical treatment is important during burn-blast injury both to stabilize cardiac function and supply blood volume and to reduce the vascular permeability, thereby preventing acute pneumonedema or other complications. PMID:27011494

  19. Comparison of Healing Effect of Aloe Vera Extract and Silver Sulfadiazine in Burn Injuries in Experimental Rat Model

    OpenAIRE

    Akhoondinasab, Mohammad Reza; Akhoondinasab, Motahhare; Saberi, Mohsen

    2014-01-01

    BACKGROUND Wound healing is widely discussed in the medical literature. This study compared the healing effect of aloe vera extract and silver sulfadiazine in burn injuries in experimental rat model. METHODS Sixteen rats were randomly assigned to one of two groups, each group 8 rats. A deep second-degree burn on the lower back and 3rd degree burn on upper back of each rat were created with a standard burning procedure. Burns were dressed daily with aloe vera extract in group 2 and silver sulf...

  20. Early markers of renal injury in predicting outcome in thermal burn patients

    International Nuclear Information System (INIS)

    Acute renal failure (ARF) is a well known complication of severe burn and is an important factor that can increase mortality. To determine the predictors of acute renal failure that occur in major burns, we studied 40 patients with moderate to severe thermal burn injury - second to third degree with > 20% of total body surface area. All patients were subjected to routine investigations including: Serum creatinine, blood urea nitrogen, fractional excretion of sodium, uri-nary malondialdehyde and microalbuminuria on day 0, 3, 7, 14 and 21 of hospitalization. Nine patients (22.5 %) developed acute renal failure; 4 patients required supportive dialysis. The group that developed ARF showed an increase of markers of glomerular damage with appearance of microalbuminuria on day 0 that reached 3 - 4 folds above its normal level on day 14 and remained constant with elevated serum creatinine and burn size in the 3 rd week of ARF, and progressed to overt proteinuria in 3 cases. Urinary malondialdehyde increased 3 folds above normal values before developing acute renal failure, and gradually increased on day 14, which coincided with the increased of microalbuminuria. Two cases (22.2%) in the ARF group who developed septicemia and required dialysis died on the 32nd and 36th days post-burn. Burn size and occurrence of septicemia were the only predictors of acute renal failure using multiple regression analysis (P value < 0.001 and < 0.0371, respectively). We conclude that acute renal failure complicates burn patients and is related to the size and depth of burn and occurrence of septicemia. Microalbuminuria and urinary malondialdehyde are useful markers for prediction of renal outcome in such group of patients. (author)

  1. Bone Marrow Mesenchymal Stromal Cells Attenuate Organ Injury Induced by LPS and Burn

    OpenAIRE

    Yagi, Hiroshi; Soto-Gutierrez, Alejandro; Kitagawa, Yuko; Tilles, Arno W.; Tompkins, Ronald G.; Yarmush, Martin L

    2010-01-01

    Bone marrow mesenchymal stromal cells (MSCs) suppress immune cell responses and have beneficial effects in various inflammatory-related immune disorders. A therapeutic modality for systemic inflammation and its consequences is not available yet. Thus, this work investigates the therapeutic effects of MSCs in injury-models induced by Lipopolysaccharide (LPS) or burn. Gene expression was analyzed in MSCs when exposed to inflammatory serum from injured animals and it showed remarkable alteration...

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

    Directory of Open Access Journals (Sweden)

    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

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

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    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. 

  4. Burns

    Science.gov (United States)

    ... touching the stove This list is not all-inclusive. You can also burn your airways if you ... extinguishers in key locations at home, work, and school. Remove electrical cords from floors and keep them ...

  5. Measuring coping behavior in patients with major burn injuries: a psychometric evaluation of the BCOPE.

    Science.gov (United States)

    Amoyal, Nicole R; Mason, Shawn T; Gould, Neda F; Corry, Nida; Mahfouz, Soad; Barkey, Adam; Fauerbach, James A

    2011-01-01

    Burn injuries involve significant physiological, psychological, and social challenges with which individuals must cope. Although the brief COPE (BCOPE) is frequently used, knowledge of its factor structure and construct validity is limited, thus limiting confidence with interpreting results. This study assessed psychometric properties of the BCOPE in hospitalized patients with burn injury. Participants had a major burn injury (n = 362). Measures assessed coping behavior and physical, psychological, and social functioning. Exploratory factorial analysis was conducted to evaluate patterns of coping strategies. To assess construct validity, the BCOPE scale scores were correlated with the distress measures across time points. Exploratory factorial analysis revealed seven factors accounting for 51% of total variance. The pattern matrix indicated four items loaded onto factor 1 (active coping = 0.47-0.80) and four onto factor 2 (avoidant coping = 0.59-0.73). The remaining factors were consistent with original scale assignments reported by Carver (Int J Behav Med 1997;4:92-100). Construct validity of BCOPE scales (active and avoidant) was demonstrated by their association with the Davidson trauma scale, short form-12, and satisfaction with appearance scale. The results indicate that the BCOPE is valid, reliable, and can be meaningfully interpreted. Research using these factors may improve knowledge about interrelationships among stress, coping, and outcome, thus building the evidence base for managing distress in this population. PMID:21562462

  6. Burn injury, gender and cancer risk: population-based cohort study using data from Scotland and Western Australia

    OpenAIRE

    Duke, Janine M; Bauer, Jacqui; Fear, Mark W.; Rea, Suzanne; Wood, Fiona M; Boyd, James

    2014-01-01

    Objective To investigate the risk of cancer and potential gender effects in persons hospitalised with burn injury. Design Population-based retrospective cohort study using record-linkage systems in Scotland and Western Australia. Participants Records of 37 890 and 23 450 persons admitted with a burn injury in Scotland and Western Australia, respectively, from 1983 to 2008. Deidentified extraction of all linked hospital morbidity records, mortality and cancer records were provided by the Infor...

  7. Impact of Oxandrolone Treatment on Acute Outcomes After Severe Burn Injury

    Science.gov (United States)

    Pham, Tam N.; Klein, Matthew B.; Gibran, Nicole S.; Arnoldo, Brett D.; Gamelli, Richard L.; Silver, Geoffrey M.; Jeschke, Marc G.; Finnerty, Celeste C.; Tompkins, Ronald G.; Herndon, David N.

    2013-01-01

    Pharmacologic modulation of hypermetabolism clearly benefits children with major burns, however, its role in adult burns remains to be defined. Oxandrolone appears to be a promising anabolic agent although few outcome data are as yet available. We examined whether early oxandrolone treatment in severely burned adults was associated with improved outcomes during acute hospitalization. We evaluated for potential associations between oxandrolone treatment and outcomes in a large cohort of severely burned adults in the context of a multicenter observational study. Patients were dichotomized with respect to oxandrolone treatment, defined as administration within 7 days after admission, with duration of at least 7 days. Acute hospitalization outcomes were compared with univariate and multivariate analyses. One hundred seventeen patients were included in this analysis. Mean patient age was 42.6 years (range, 18–86); 77% were male, with an average TBSA of 44.1%. Baseline and injury characteristics were similar among treatment and nontreatment cohorts. Oxandrolone treatment (N =59) did not impact length of stay but was associated with a lower mortality rate (P = .01) by univariate analysis. Oxandrolone treatment was independently associated with higher survival by adjusted analyses (P = .02). Examination of early oxandrolone treatment in this cohort of severely burned adults suggests that this therapy is safe and may be associated with improved survival. Further studies are necessary to define the exact mechanisms by which oxandrolone is beneficial during inpatient treatment. PMID:18849836

  8. 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.

  9. Managing severe burn injuries: challenges and solutions in complex and chronic wound care

    Directory of Open Access Journals (Sweden)

    Rogers AD

    2016-06-01

    Full Text Available Alan D Rogers, Marc G Jeschke Ross Tilley Burn Centre, Division of Plastic and Reconstructive Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada Abstract: Encountered regularly by health care providers across both medical and surgical fields and an increasing socioeconomic burden globally, wound care is severely neglected. Practice is heavily influenced by anecdote rather than evidence-based protocols and industry-biased literature rather than robust randomized controlled trials. Burn units are well placed to address this considerable need, as a result of their infrastructure, their multispecialty staffing, and their need to evolve in light of the declining incidence of major burn injury in developed countries. The aim of this review is to evaluate some of the ideological and practical challenges facing wound practitioners and burn surgeons while managing chronic and complex wounds. It also includes an approach to wound assessment and how to conceptualize and implement dressing strategies and new and existing multimodal therapies. Keywords: negative pressure wound therapy, instillation, antiseptic solutions, dressings, multidisciplinary wound care, stem cells, surgery, autograft, allograft, reconstructive ladder

  10. Post-traumatic stress disorder in patients with acute burn injury

    International Nuclear Information System (INIS)

    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)

  11. Assessment of electrical burn injury using structured illumination in an in-vivo electrical injury model

    Science.gov (United States)

    Nguyen, Thu T. A.; Basiri, Ali; Shupp, J. W.; Moffatt, L. T.; Jordan, M. H.; Jeng, J. C.; Leto, E.; Ramella-Roman, J. C.

    2011-03-01

    Electrical injury is a devastating and hard to treat clinical lesion. Fully understanding the pathophysiology of electrical trauma is still a challenge for clinicians and scientists. Further elucidating the natural history of this form of tissue injury could be helpful in improving limb salvage and offering stage-appropriate therapy. Multi-spectral imaging technique is a non-invasive technology that can be used to determine optical properties of tissues in and adjacent to injury. Images at different wavelengths can provide essential information related to the pathophysiological condition of the tissue. To promote the applicability of this technique in medical diagnosis, we built a complete experimental model of electrical injury. In this model, electrical injuries were created by a reliable high-tension shock system at preset voltage or current. A thermal camera recorded the change of skin temperature during the electrical shock. Then, a high-resolution spectral imaging system based on structured illumination was used to capture images for post analysis to extrapolate optical properties of the tissue. To test accuracy, this imaging system was calibrated by using a set of epoxy phantoms with known optical properties. In this paper, the results of experiments conducted on rats and discussions on the systemic changes in tissue optical properties before and after electrical shock are presented.

  12. A clinico-epidemiologic study of 892 patients with burn injuries at a tertiary care hospital in Punjab, India

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    Gupta Ashok

    2011-01-01

    Full Text Available Aim : To analyze the causes, demographic and socio-cultural aspects, and the magnitude of burn injuries prospectively and to evaluate the outcome of treatment of patients admitted to burns ICU of tertiary care hospital. Materials and Methods : A total of 892 burn patients admitted over a period of 6 years from January 2002 to December 2007 at tertiary care hospital in Punjab, India, were analyzed. Results : 54% patients were males. A majority of the patients, 704(79%, were in the age group of 15-45 years. Six hundred and thirty-four patients (72% sustained flame burns, while 17% and 7% sustained electrical and scald burns, respectively. A total of 470(53% patients sustained major two to three degree flame burns involving more than 45% of total body surface area (TBSA. The mortality rate was 40%, i.e. 357 patients died of burns and its related problems, in our study. Six hundred and thirty-nine patients (72% sustained burns in closed space of which 331 patients (52% sustained burns in kitchen. Seven hundred and seventy-nine patients sustained accidental burns. Burn victims were mainly Hindus and Sikhs. The mean hospital stay varied depending upon the percentage of burns. On an average, a patient with >45% TBSA burns received 15 whole blood transfusions. Split skin grafting was done in 416 patients. Most common complication encountered during their hospital stay was wound infection which was seen in 671 patients, followed by ARDS in 221 patients. The most common organisms causing wound infection were Pseudomonas and Acinetobacter. Conclusion : Developing country like India need an aggressive public education program so that people become more literate about various etiological factors causing burns and means of preventing them. Also needed are burn care hospitals which are easily accessible and affordable.

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

    Directory of Open Access Journals (Sweden)

    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

  14. Plasma Proteome Response to Severe Burn Injury Revealed by 18O-Labeled “Universal” Reference-based Quantitative Proteomics

    OpenAIRE

    Qian, Wei-Jun; Petritis, Brianne O.; Kaushal, Amit; Finnerty, Celeste C.; Jeschke, Marc G.; Monroe, Matthew E.; Moore, Ronald J.; Schepmoes, Athena A.; Xiao, Wenzhong; Moldawer, Lyle L; Davis, Ronald W; Tompkins, Ronald G.; Herndon, David N; Camp, David G.; Smith, Richard D.

    2010-01-01

    A burn injury represents one of the most severe forms of human trauma and is responsible for significant mortality worldwide. Here, we present the first quantitative proteomics investigation of the blood plasma proteome response to severe burn injury by comparing the plasma protein concentrations of 10 healthy control subjects with those of 15 severe burn patients at two time-points following the injury. The overall analytical strategy for this work integrated immunoaffinity depletion of the ...

  15. An alteration of the gut-liver axis drives pulmonary inflammation after intoxication and burn injury in mice.

    Science.gov (United States)

    Chen, Michael M; Zahs, Anita; Brown, Mary M; Ramirez, Luis; Turner, Jerrold R; Choudhry, Mashkoor A; Kovacs, Elizabeth J

    2014-10-01

    Approximately half of all adult burn patients are intoxicated at the time of their injury and have worse clinical outcomes than those without prior alcohol exposure. This study tested the hypothesis that intoxication alters the gut-liver axis, leading to increased pulmonary inflammation mediated by burn-induced IL-6 in the liver. C57BL/6 mice were given 1.2 g/kg ethanol 30 min prior to a 15% total body surface area burn. To restore gut barrier function, the specific myosin light chain kinase inhibitor membrane-permeant inhibitor of kinase (PIK), which we have demonstrated to reduce bacterial translocation from the gut, was administered 30 min after injury. Limiting bacterial translocation with PIK attenuated hepatic damage as measured by a 47% reduction in serum alanine aminotransferase (P intoxicated and burn-injured mice without PIK. This mitigation of hepatic damage was associated with a 49% decline in pulmonary neutrophil infiltration (P antibiotics before intoxication and burn injury. Overall, these data suggest that the gut-liver axis is deranged when intoxication precedes burn injury and that limiting bacterial translocation in this setting attenuates hepatic damage and pulmonary inflammation. PMID:25104501

  16. Are serum cytokines early predictors for the outcome of burn patients with inhalation injuries who do not survive?

    Science.gov (United States)

    Gauglitz, Gerd G; Finnerty, Celeste C; Herndon, David N; Mlcak, Ronald P; Jeschke, Marc G

    2008-01-01

    Introduction Severely burned patients suffering from inhalation injury have a significantly increased risk for mortality compared with burned patients without inhalation injury. Severe burn is associated with a distinct serum cytokine profile and alterations in cytokines that contribute to morbidity and mortality. The aim of the present study was therefore to determine whether severely burned pediatric patients with concomitant inhalation injury who had a fatal outcome exhibited a different serum cytokine profile compared with burn patients with inhalation injury who survived. Early identification followed by appropriate management of these high-risk patients may lead to improved clinical outcome. Methods Thirteen severely burned children with inhalation injury who did not survive and 15 severely burned pediatric patients with inhalation injury who survived were enrolled in the study. Blood was collected within 24 hours of admission and 5 to 7 days later. Cytokine levels were profiled using multiplex antibody coated beads. Inhalation injury was diagnosed by bronchoscopy during the initial surgery. The number of days on the ventilator, peak inspiratory pressure rates, arterial oxygen tension (PaO2)/fraction of inspired oxygen (FiO2) ratio and incidence of acute respiratory distress syndrome were recorded for those patients. Results Significantly altered levels of IL-4, IL-6, IL-7, IL-10, and IL-13 were detected within the first 7 days after admission in serum from burn pediatric patients with concomitant inhalation injury who did not survive when compared with similar patients who did (P < 0.05). Alterations in these cytokines were associated with increased incidence of acute respiratory distress syndrome, number of days under ventilation, increased peak inspiratory pressure, and lower PaO2/FiO2 ratio in this patient population. Multiple logistic regression analysis revealed that patients with increased IL-6 and IL-10 as well as decreased IL-7 serum levels had a

  17. Self-perceptions of young adults who survived severe childhood burn injury.

    Science.gov (United States)

    Russell, William; Robert, Rhonda S; Thomas, Christopher R; Holzer, Charles E; Blakeney, Patricia; Meyer, Walter J

    2013-01-01

    significantly lower self-concept scores on the TSCS2 physical scale are consistent with the physical disfigurement and handicaps common with major burn injuries, and a strong indication of this group's perception of the first impression made when interacting with others. The survivors seem to feel worthwhile within the contexts of family and friends. Although the major limitation of this study using the TSCS2 is the lack of a matched reference population to compare the burn survivors, the TSCS2 does help in gaining insight into the self-esteem issues of the burn survivor population. PMID:23202876

  18. Nonpharmacological interventions for acute wound care distress in pediatric patients with burn injury: a systematic review.

    Science.gov (United States)

    Hanson, Mark D; Gauld, Mary; Wathen, C Nadine; Macmillan, Harriet L

    2008-01-01

    Acute wound care distress among burn-injured pediatric patients is of major clinical concern. This systematic review evaluates the benefits of nonpharmacological interventions to reduce this distress. MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, and the Cochrane Library databases were searched using appropriate search terms for articles reporting overall psychological effects of pediatric burn injury. Key references were hand-searched. Searches yielded approximately 900 unique citations. Two authors reviewed each abstract, and 198 articles were retrieved, of which 34 were selected for full review. Of these 34 articles, 12 focused on acute wound care distress and nonpharmacological interventions. Critical appraisal of individual studies was conducted using the methods of the US Preventive Services Task Force, with a particular focus on assessing nonrandomized controlled trial designs. Twelve articles were reviewed and categorized according to intervention types child mediated (CM), parent mediated (PM), and health care provider mediated (HCPM). Using the US Preventive Services Task Force criteria, 7 of the 12 articles were rated "fair" or "good" and five were rated as having "poor" internal validity. The HCPM and CM intervention categories reported patient benefit. The two PM studies were both rated "poor." Studies of nonpharmacological interventions to reduce pediatric burn distress were few, with a significant proportion (5/12) having concerns about internal validity. Patient benefit was reported for HCPM and CM interventions. Research designs incorporating control groups in studies that are adequately powered are needed. Additional research is required in the area of PM interventions in particular. PMID:18695617

  19. Antithrombin attenuates myocardial dysfunction and reverses systemic fluid accumulation following burn and smoke inhalation injury: a randomized, controlled, experimental study

    OpenAIRE

    Rehberg, S; Yamamoto, Y; Bartha, E; Sousse, L.E. (Linda); Jonkam, C. (Collette); Zhu, Y; Traber, L.D. (Lillian); Cox, R. A.; Traber, D.L. (Daniel); Enkhbaatar, P

    2013-01-01

    Introduction: We hypothesized that maintaining physiological plasma levels of antithrombin attenuates myocardial dysfunction and inflammation as well as vascular leakage associated with burn and smoke inhalation injury. Therefore, the present prospective, randomized experiment was conducted using an established ovine model. Methods: Following 40% of total body surface area, third degree flame burn and 4 × 12 breaths of cold cotton smoke, chronically instrumented sheep were randomly assigned t...

  20. Bacterial Respiratory Tract Infections are Promoted by Systemic Hyperglycemia after Severe Burn Injury in Pediatric Patients

    Science.gov (United States)

    Kraft, Robert; Herndon, David N; Mlcak, Ronald P; Finnerty, Celeste C; Cox, Robert A; Williams, Felicia N; Jeschke, Marc G

    2014-01-01

    Background Burn injuries are associated with hyperglycemia leading to increased incidence of infections with pneumonia being one of the most prominent and adverse complication. Recently, various studies in critically ill patients indicated that increased pulmonary glucose levels with airway/blood glucose threshold over 150 mg/dl lead to an overwhelming growth of bacteria in the broncho-pulmonary system, subsequently resulting in an increased risk of pulmonary infections. The aim of the present study was to determine whether a similar cutoff value exists for severely burned pediatric patients. Methods One-hundred six severely burned pediatric patients were enrolled in the study. Patients were divided in two groups: high (H) defined as daily average glucose levels >75% of LOS >150 mg/dl), and low (L) with daily average glucose levels >75% of the LOS <150 mg/dl). Incidences of pneumonia, atelectasis, and acute respiratory distress syndrome (ARDS) were assessed. Incidence of infections, sepsis, and respiratory parameters were recorded. Blood was analyzed for glucose and insulin levels. Statistical analysis was performed using Student’s t-test and chi-square test. Significance was set at p<0.05. Results Patient groups were similar in demographics and injury characteristics. Pneumonia in patients on the mechanical ventilation (L: 21% H: 32%) and off mechanical ventilation (L: 5% H: 15%), as well as ARDS were significantly higher in the high group (L: 3% H: 19%), p<0.05, while atelectasis was not different. Patients in the high group required significantly longer ventilation compared to low patients (p<0.05). Furthermore, incidence of infection and sepsis were significantly higher in the high group, p<0.05. Conclusion Our results indicate that systemic glucose levels over 150 mg/dl are associated with a higher incidence of pneumonia confirming the previous studies in critically ill patients. PMID:24074819

  1. Injuria inhalatoria en pacientes quemados: Revisión Inhalation injury in burned patient: A review

    Directory of Open Access Journals (Sweden)

    CESAR PEDREROS P

    2007-06-01

    Full Text Available Cada año casi tres mil personas sufren quemaduras en Chile. En la población adulta se estima que este número se incrementará en los próximos años. En este grupo, cerca del 40% de las quemaduras graves se asocian a injuria inhalatoria. la injuria inhalatoria aumenta significativamente la mortalidad en los pacientes quemados. la prevalencia, fisiopatologia, cuadro clínico, manejo y pronóstico de esta patología no han sido incorporados en los estudios de pregrado de las escuelas de medicina y son temas desconocidos para la mayoría de los médicos. En el contexto de la próxima incorporación de este tipo de dolencias en el plan de garantías explícitas en la salud chilena hemos realizado una actualización del temaEvery year almost three thousand people get burned in Chile. In this group, about 40% of the critical burned patients also suffer inhalation injury. This number is expected to grow bigger among the adult population in the next few years. Inhalation injury significantly increases mortality in burned patients. The prevalence, pathophysiology, clinical characteristics, treatment, and prognosis of this pathology have not been incorporated in the undergraduate curses of Chilean medical schools. Therefore, this subject is pooly known by most of our physicians. Because this disease will be included in the explicit warranties health plan of the public health care system in Chile, we decide to write this review about this pathological condition

  2. 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...

  3. Beneficial Effects of Concomitant Neuronal and Inducible Nitric Oxide Synthase Inhibition in Ovine Burn and Inhalation Injury

    OpenAIRE

    Lange, Matthias; Hamahata, Atsumori; Enkhbaatar, Perenlei; Cox, Robert A.; Nakano, Yoshimitsu; Westphal, Martin; Traber, Lillian D.; Herndon, David N.; Traber, Daniel L.

    2011-01-01

    Different isoforms of nitric oxide synthase are critically involved in the development of pulmonary failure secondary to acute lung injury. Here we tested the hypothesis that simultaneous blockade of inducible and neuronal nitric oxide synthase effectively prevents the pulmonary lesions in an ovine model of acute respiratory distress syndrome (ARDS) induced by combined burn and smoke inhalation injury. Chronically instrumented sheep were allocated to a sham-injured group (n = 6), an injured a...

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

    Directory of Open Access Journals (Sweden)

    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.

  5. T cell IFN-γ suppression following alcohol and burn injury is independent of miRNA155.

    Directory of Open Access Journals (Sweden)

    Xiaoling Li

    Full Text Available miRNA155 has been implicated in normal T cell function and their differentiations into the Th1 subtype. We have shown that acute alcohol (ethanol intoxication combined with burn injury suppresses T cell IFN-γ release. Herein, we examined whether the decrease in IFN-γ is resulted from altered expression of miRNA155 and transcription factors--NFAT, Tbx21, Jun and Fos--in T cells following ethanol and burn injury. Mice received ethanol (∼3 g/Kg 4 hours prior to ∼12.5% total body surface area sham or burn injury and were sacrificed one day after injury. Splenic T cells were harvested and cultured with anti-CD3 (2 µg/ml in the presence or absence of rIL-12 (10 ng/ml or PMA (10 ng/ml plus ionomycin (50 ng/ml for 48 hours. We observed a significant decrease in miRNA155, NFAT, Tbx21, Jun and Fos expression as well as IFN-γ release in T cells cultured with anti-CD3 following ethanol and burn injury compared with shams. The co-treatment of T cells with rIL-12 prevented the decrease in IFN-γ and NFAT, Tbx21, Jun and Fos, but not miRNA155. In contrast, the co-treatment with PMA plus ionomycin normalized the expression of NFAT. It did not prevent the decrease in IFN-γ, Tbx21, Jun, Fos and miRNA155. Finally, results obtained in miRNA155-/- mice did not show any change in T cell release of IFN-γ or expression of nuclear factors compared to wildtype mice. Together, these findings suggest that while ethanol and burn injury decreases the expression of miRNA155, it may not be involved in decreased IFN-γ under those conditions.

  6. Acute kidney injury is common, parallels organ dysfunction or failure, and carries appreciable mortality in patients with major burns: a prospective exploratory cohort study

    OpenAIRE

    Steinvall, Ingrid; Bak, Zoltan; Sjöberg, Folke

    2008-01-01

    Introduction: The purpose of this study was to determine the incidence, time course, and outcome of acute kidney injury after major burns and to evaluate the impact of possible predisposing factors ( age, gender, and depth and extent of injury) and the relation to other dysfunctioning organs and sepsis. Method: We performed an explorative cohort study on patients with a TBSA% (percentage burned of total body surface area) of 20% or more who were admitted to a national burn centre. Acute kidne...

  7. Astaxanthin Attenuates Early Acute Kidney Injury Following Severe Burns in Rats by Ameliorating Oxidative Stress and Mitochondrial-Related Apoptosis

    Directory of Open Access Journals (Sweden)

    Song-Xue Guo

    2015-04-01

    Full Text Available Early acute kidney injury (AKI is a devastating complication in critical burn patients, and it is associated with severe morbidity and mortality. The mechanism of AKI is multifactorial. Astaxanthin (ATX is a natural compound that is widely distributed in marine organisms; it is a strong antioxidant and exhibits other biological effects that have been well studied in various traumatic injuries and diseases. Hence, we attempted to explore the potential protection of ATX against early post burn AKI and its possible mechanisms of action. The classic severe burn rat model was utilized for the histological and biochemical assessments of the therapeutic value and mechanisms of action of ATX. Upon ATX treatment, renal tubular injury and the levels of serum creatinine and neutrophil gelatinase-associated lipocalin were improved. Furthermore, relief of oxidative stress and tubular apoptosis in rat kidneys post burn was also observed. Additionally, ATX administration increased Akt and Bad phosphorylation and further down-regulated the expression of other downstream pro-apoptotic proteins (cytochrome c and caspase-3/9; these effects were reversed by the PI3K inhibitor LY294002. Moreover, the protective effect of ATX presents a dose-dependent enhancement. The data above suggested that ATX protects against early AKI following severe burns in rats, which was attributed to its ability to ameliorate oxidative stress and inhibit apoptosis by modulating the mitochondrial-apoptotic pathway, regarded as the Akt/Bad/Caspases signalling cascade.

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

    International Nuclear Information System (INIS)

    Rats were exposed to 6 Gy whole body γ-ray irradiation from a 60Co 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

  9. The risk of burn injury during long-term oxygen therapy: a 17-year longitudinal national study in Sweden

    Directory of Open Access Journals (Sweden)

    Tanash HA

    2015-11-01

    Full Text Available Hanan A Tanash,1 Fredrik Huss,2,3 Magnus Ekström41Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Lund, 2Department of Surgical Sciences, Plastic Surgery, Uppsala University, 3Burn Center, Department of Plastic and Maxillofacial Surgery, University Hospital of Uppsala, Uppsala, 4Department of Clinical Sciences, Division of Respiratory Medicine & Allergology, Lund University, Lund, SwedenBackground: Long-term oxygen therapy (LTOT improves the survival time in hypoxemic chronic obstructive pulmonary disease. Despite warnings about potential dangers, a considerable number of patients continue to smoke while on LTOT. The incidence of burn injuries related to LTOT is unknown. The aim of this study was to estimate the rate of burn injury requiring health care contact during LTOT.Methods: Prospective, population-based, consecutive cohort study of people starting LTOT from any cause between January 1, 1992 and December 31, 2009 in the Swedish National Register of Respiratory Failure (Swedevox.Results: In total, 12,497 patients (53% women were included. The mean (standard deviation age was 72±9 years. The main reasons for starting LTOT were chronic obstructive pulmonary disease (75% and pulmonary fibrosis (15%. Only 269 (2% were active smokers when LTOT was initiated. The median follow-up time to event was 1.5 years (interquartile range, 0.55–3.1. In total, 17 patients had a diagnosed burn injury during 27,890 person-years of LTOT. The rate of burn injury was 61 (95% confidence interval, 36–98 per 100,000 person-years. There was no statistically significant difference in the rate of burn injury between ever-smokers and never-smokers, or between men and women.Conclusion: The rate of burn injuries in patients on LTOT seems to be low in Sweden. The strict requirements in Sweden for smoking cessation before LTOT initiation may contribute to this finding.Keywords: respiratory failure, oxygen, fire

  10. Erythrocyte Aggregation due to Surface Nanobubble Interactions During the Onset of Thermal Burn Injury

    Science.gov (United States)

    Seidner, Harrison S.

    Red Blood Cell (RBC) aggregation is an important hemorheological phenomenon especially in microcirculation. In healthy individuals, RBCs are known to aggregate and gravitate toward the faster flow in the center of vessels to increase their throughput for more efficient oxygen delivery. Their aggregation is known to occur during a variety of environmental, pathological, and physiological conditions and is reversible when aggregates are subject to the relatively high shear forces in the circulation. The likelihood that aggregates will monodisperse in flow is dependent on the conditions during which they form. In situations where such aggregates are not sheared to monodispersion their presence can impact the perfusion of microvascular networks. More specifically, aggregates subject to the low shear rates in the zone of stasis near regions of thermal burn injury are capable of occluding vessels in the microcirculation and inhibiting the delivery of oxygen and nutrients to tissue downstream. The basic mechanism leading to erythrocyte aggregation at the onset of thermal injury is unknown. This dissertation investigates parameters involved in erythrocyte aggregation, methods of measuring and testing erythrocyte aggregation, and incorporates modeling based on first principles ultimately to propose a mechanism of this phenomenon.

  11. Third-Degree Hindpaw Burn Injury Induced Apoptosis of Lumbar Spinal Cord Ventral Horn Motor Neurons and Sciatic Nerve and Muscle Atrophy in Rats

    Directory of Open Access Journals (Sweden)

    Sheng-Hua Wu

    2015-01-01

    Full Text Available Background. Severe burns result in hypercatabolic state and concomitant muscle atrophy that persists for several months, thereby limiting patient recovery. However, the effects of burns on the corresponding spinal dermatome remain unknown. This study aimed to investigate whether burns induce apoptosis of spinal cord ventral horn motor neurons (VHMNs and consequently cause skeletal muscle wasting. Methods. Third-degree hindpaw burn injury with 1% total body surface area (TBSA rats were euthanized 4 and 8 weeks after burn injury. The apoptosis profiles in the ventral horns of the lumbar spinal cords, sciatic nerves, and gastrocnemius muscles were examined. The Schwann cells in the sciatic nerve were marked with S100. The gastrocnemius muscles were harvested to measure the denervation atrophy. Result. The VHMNs apoptosis in the spinal cord was observed after inducing third-degree burns in the hindpaw. The S100 and TUNEL double-positive cells in the sciatic nerve increased significantly after the burn injury. Gastrocnemius muscle apoptosis and denervation atrophy area increased significantly after the burn injury. Conclusion. Local hindpaw burn induces apoptosis in VHMNs and Schwann cells in sciatic nerve, which causes corresponding gastrocnemius muscle denervation atrophy. Our results provided an animal model to evaluate burn-induced muscle wasting, and elucidate the underlying mechanisms.

  12. Prediction of Mortality in Pediatric Burn Injuries: R-Baux Score to Be Applied in Children (Pediatrics-Baux Score

    Directory of Open Access Journals (Sweden)

    Hamid Karimi

    2013-04-01

    Full Text Available Objective: R-Baux score has obtained an acceptable validity and accuracy in predicting burn-related mortality. However, its usage and efficacy among pediatric burn patients has not been well documented. The aim of this study was to employ Pediatrics-Baux (P-Buax score as modified version of R-Baux score in these patients to determine how it could be applicable in this population.Methods: Through a prospective study, 870 pediatric burn patients were enrolled. P-Baux and R-Baux scores were calculated for each patient and they were categorized to different groups according to these scores. Mortality and further death probability were measured for each subject and then analyzed by logistic regression model to reveal how they change in relation with age in pediatric burn patients.Findings: R-Baux score for 95% probability of death revealed a mean of 73 among patients of this study. Also P-Baux score was measured in these patients with inhalation injury which showed to be 55 for 95% probability of death. Results showed that age had a positive prognostic value in contrast to the negative prognostic value of Total Body Surface Area (TBSA and inhalation injury.Conclusion: Our analysis showed that in children under the age of 15 years, age has a positive prognostic value while TBSA and inhalation injuries had negative prognostic values in relation to mortality. Hence, in contrast to the adult population, burn injury related mortality may be predicted by modified R-Baux score as (TBSA - age + [18×R] which could be named as P-Baux score.

  13. Burn Rehabilitation

    OpenAIRE

    Koray Aydemir; Mehmet Ali Taşkaynatan

    2011-01-01

    Burn injuries are important in terms of causing serious disability and threatening life. With the establishment of modern burn treatment units and advances in acute care management contributed to a reduced mortality rate over the last decades. As a result of improved outcome, more attention has to be given to a comprehensive burn rehabilitation program. Burn rehabilitation is a process that starts from day of admission and continues for months or sometimes years after the initial event. The t...

  14. Guideline for diagnosis, prophylaxis and treatment of invasive fungal infection post burn injury in China 2013

    Directory of Open Access Journals (Sweden)

    Gaoxing Luo

    2014-04-01

    Full Text Available Invasive fungal infection is one of the major complication of severe burns which can induce local or systemic inflammatory response and cause serious substantial damage to the patient. The incidence of fungal infection for burn victims is increasing dramatically during recent years. This guideline, organized by Chinese Society of Burn Surgeons, aims to standardize the diagnosis, prevention and treatment of burn invasive fungal infection. It can be used as one of the tools for treatment of major burn patients.

  15. Time-Dependent and Organ-Specific Changes in Mitochondrial Function, Mitochondrial DNA Integrity, Oxidative Stress and Mononuclear Cell Infiltration in a Mouse Model of Burn Injury.

    Directory of Open Access Journals (Sweden)

    Bartosz Szczesny

    Full Text Available Severe thermal injury induces a pathophysiological response that affects most of the organs within the body; liver, heart, lung, skeletal muscle among others, with inflammation and hyper-metabolism as a hallmark of the post-burn damage. Oxidative stress has been implicated as a key component in development of inflammatory and metabolic responses induced by burn. The goal of the current study was to evaluate several critical mitochondrial functions in a mouse model of severe burn injury. Mitochondrial bioenergetics, measured by Extracellular Flux Analyzer, showed a time dependent, post-burn decrease in basal respiration and ATP-turnover but enhanced maximal respiratory capacity in mitochondria isolated from the liver and lung of animals subjected to burn injury. Moreover, we detected a tissue-specific degree of DNA damage, particularly of the mitochondrial DNA, with the most profound effect detected in lungs and hearts of mice subjected to burn injury. Increased mitochondrial biogenesis in lung tissue in response to burn injury was also observed. Burn injury also induced time dependent increases in oxidative stress (measured by amount of malondialdehyde and neutrophil infiltration (measured by myeloperoxidase activity, particularly in lung and heart. Tissue mononuclear cell infiltration was also confirmed by immunohistochemistry. The amount of poly(ADP-ribose polymers decreased in the liver, but increased in the heart in later time points after burn. All of these biochemical changes were also associated with histological alterations in all three organs studied. Finally, we detected a significant increase in mitochondrial DNA fragments circulating in the blood immediately post-burn. There was no evidence of systemic bacteremia, or the presence of bacterial DNA fragments at any time after burn injury. The majority of the measured parameters demonstrated a sustained elevation even at 20-40 days post injury suggesting a long-lasting effect of thermal

  16. Fabrication and evaluation of auto-stripped tri-layer wound dressing for extensive burn injury

    International Nuclear Information System (INIS)

    In the study, we are going to develop a tri-layer membrane as the artificial skin for extensive burn injury. The first layer is a three-dimensional tri-copolymer sponge of gelatin/hyaluronan/chodroitin-6-sulfate with 70% in porosity and 20-100 μm in pore size. The layer is constructed as a dermis analogous layer to stimulate capillaries penetration, to promote dermal fibroblast migration and to induce the secretion of extra-cellular matrix, which provides a better physiological environment for burn patient recovery. The second layer is as so called auto-stripped layer composed by poly-N-isopropyacrylamide (PNIPAAm). The layer will be automatically peeled off from the tri-copolymer layer once the wound site closed and recovered. The third layer is composed by polypropylene (PP) non-woven fabric, which provides an open structure for exudates drainage out that will reduce the risk of second infection. The tri-layer wound dressing has been successfully prepared by subsequently high-energy plasma treatment, γ-ray irradiation, UV light exposure, and lyophilized process. From the results of MTT, IL-8, IL-1α, IL-6, and TNF-α measurement, the developed material will not induce tissue inflammatory or immune response. The dermal fibroblasts showed initial contact with the material surface through the radial extension of filopodia followed by cytoplasmic webbing that could be examined by SEM. Dermal fibroblasts subsequently flattened for further proliferation and extra-cellular matrix secretion. Dermal analog layer provides a three-dimensional architecture for normal dermis regeneration. The layer can be completely biodegraded within 4 weeks post-operation. After served as a scaffold for the ingrowth of self-fibroblasts, a normal dermis like layer will be regenerated. The dressing will fall off automatically without any damage once the wound site healed completely

  17. Fabrication and evaluation of auto-stripped tri-layer wound dressing for extensive burn injury

    Energy Technology Data Exchange (ETDEWEB)

    Lin, F.-H. [Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan (China); Department of Biomedical Engineering, National Taiwan University Hospital, Taipei, Taiwan (China); Tsai, J.-C. [Department of Materials Engineering, Ta Tung University, Taipei, Taiwan (China); Chen, T.-M. [Department of Plastic Surgery, Tri-service Hospital, Taipei, Taiwan (China); Chen, K.-S. [Department of Materials Engineering, Ta Tung University, Taipei, Taiwan (China); Yang, J.-M. [Department of Chemical Engineering, Chang Gung University, Tao-Yuan, Taiwan (China); Kang, P.-L. [Cardiovascular Division, Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan (China)]. E-mail: plkang@vghks.gov.tw; Wu, T-H. [Institute of Nuclear Energy Research, ROCEA, Tao-Yuan, Taiwan (China)

    2007-04-15

    In the study, we are going to develop a tri-layer membrane as the artificial skin for extensive burn injury. The first layer is a three-dimensional tri-copolymer sponge of gelatin/hyaluronan/chodroitin-6-sulfate with 70% in porosity and 20-100 {mu}m in pore size. The layer is constructed as a dermis analogous layer to stimulate capillaries penetration, to promote dermal fibroblast migration and to induce the secretion of extra-cellular matrix, which provides a better physiological environment for burn patient recovery. The second layer is as so called auto-stripped layer composed by poly-N-isopropyacrylamide (PNIPAAm). The layer will be automatically peeled off from the tri-copolymer layer once the wound site closed and recovered. The third layer is composed by polypropylene (PP) non-woven fabric, which provides an open structure for exudates drainage out that will reduce the risk of second infection. The tri-layer wound dressing has been successfully prepared by subsequently high-energy plasma treatment, {gamma}-ray irradiation, UV light exposure, and lyophilized process. From the results of MTT, IL-8, IL-1{alpha}, IL-6, and TNF-{alpha} measurement, the developed material will not induce tissue inflammatory or immune response. The dermal fibroblasts showed initial contact with the material surface through the radial extension of filopodia followed by cytoplasmic webbing that could be examined by SEM. Dermal fibroblasts subsequently flattened for further proliferation and extra-cellular matrix secretion. Dermal analog layer provides a three-dimensional architecture for normal dermis regeneration. The layer can be completely biodegraded within 4 weeks post-operation. After served as a scaffold for the ingrowth of self-fibroblasts, a normal dermis like layer will be regenerated. The dressing will fall off automatically without any damage once the wound site healed completely.

  18. The design and evaluation of a system for improved surveillance and prevention programmes in resource-limited settings using a hospital-based burn injury questionnaire

    Science.gov (United States)

    Peck, Michael; Falk, Henry; Meddings, David; Sugerman, David; Mehta, Sumi; Sage, Michael

    2016-01-01

    Background Limited and fragmented data collection systems exist for burn injury. A global registry may lead to better injury estimates and identify risk factors. A collaborative effort involving the WHO, the Global Alliance for Clean Cookstoves, the CDC and the International Society for Burn Injuries was undertaken to simplify and standardise inpatient burn data collection. An expert panel of epidemiologists and burn care practitioners advised on the development of a new Global Burn Registry (GBR) form and online data entry system that can be expected to be used in resource-abundant or resource-limited settings. Methods International burn organisations, the CDC and the WHO solicited burn centre participation to pilot test the GBR system. The WHO and the CDC led a webinar tutorial for system implementation. Results During an 8-month period, 52 hospitals in 30 countries enrolled in the pilot and were provided the GBR instrument, guidance and a data visualisation tool. Evaluations were received from 29 hospitals (56%). Key findings Median time to upload completed forms was <10 min; physicians most commonly entered data (64%), followed by nurses (25%); layout, clarity, accuracy and relevance were all rated high; and a vast majority (85%) considered the GBR ‘highly valuable’ for prioritising, developing and monitoring burn prevention programmes. Conclusions The GBR was shown to be simple, flexible and acceptable to users. Enhanced regional and global understanding of burn epidemiology may help prioritise the selection, development and testing of primary prevention interventions for burns in resource-limited settings. PMID:27044496

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

    International Nuclear Information System (INIS)

    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

  20. Inhibition of long myosin light-chain kinase activation alleviates intestinal damage after binge ethanol exposure and burn injury

    OpenAIRE

    Zahs, Anita; Bird, Melanie D.; Ramirez, Luis; Turner, Jerrold R; Choudhry, Mashkoor A.; Kovacs, Elizabeth J

    2012-01-01

    Laboratory evidence suggests that intestinal permeability is elevated following either binge ethanol exposure or burn injury alone, and this barrier dysfunction is further perturbed when these insults are combined. We and others have previously reported a rise in both systemic and local proinflammatory cytokine production in mice after the combined insult. Knowing that long myosin light-chain kinase (MLCK) is important for epithelial barrier maintenance and can be activated by proinflammatory...

  1. Management of severe burn injuries with topical heparin: the first evidence-based study in Ghana

    OpenAIRE

    Agbenorku, Pius; Fugar, Setri; Akpaloo, Joseph; Hoyte-Williams, Paa E; Alhassan, Zainab; Agyei, Fareeda

    2013-01-01

    Conventional therapy for burns has always produced a nightmarish illness for patients. The lack of the ability to prevent contractures often produces dysfunctional limbs and the ugly scars resulting from severe burns are an ongoing reminder of this lengthy painful illness. This study is to determine the effectiveness of topical heparin in burns management among some patients at the Burns Intensive Care Unit (BICU) of the Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana. Patients for this ...

  2. Response to: Practice of first aid in burn related injuries in a developing country.

    Science.gov (United States)

    Baker, Benjamin; Amin, Kavit; Khor, Wee Sim; Khwaja, Nadeem

    2015-12-01

    Traditional remedies for burns first aid are rarely compliant with current best practice. Greater Manchester is one of the most ethnically diverse regions in the UK. Our burns centre has noted the prevalent use of traditional remedies over recognised first aid prior to presentation. We review traditional burns remedies and highlight the importance of burns first aid education that is accessible to migrant communities. PMID:26428366

  3. The Immune Response to Skin Trauma Is Dependent on the Etiology of Injury in a Mouse Model of Burn and Excision.

    Science.gov (United States)

    Valvis, Samantha M; Waithman, Jason; Wood, Fiona M; Fear, Mark W; Fear, Vanessa S

    2015-08-01

    Skin trauma has many different causes including incision, blunt force, and burn. All of these traumas trigger an immune response. However, it is currently unclear whether the immune response is specific to the etiology of the injury. This study was established to determine whether the immune response to excision and burn injury of equivalent extent was the same. Using a mouse model of a full-thickness 19 mm diameter excision or 19 mm diameter full-thickness burn injury, we examined the innate immune response at the level of serum cytokine induction, whole-blood lymphocyte populations, dendritic cell function/phenotype, and the ensuing adaptive immune responses of CD4 and CD8 T-cell populations. Strikingly, both the innate and adaptive immune system responses differed between the burn and excision injuries. Acute cytokine induction was faster and different in profile to that of excision injury, leading to changes in systemic monocyte and neutrophil levels. Differences in the immune profile between burn and excision were also noted up to day 84 post injury, suggesting that the etiology of injury leads to sustained changes in the response. This may in part underlie clinical observations of differences in patient morbidity and mortality in response to different skin injury types. PMID:25826422

  4. In vivo imaging of human burn injuries with polarization-sensitive optical coherence tomography

    Science.gov (United States)

    Kim, Ki Hean; Pierce, Mark C.; Maguluri, Gopi; Park, B. Hyle; Yoon, Sang June; Lydon, Martha; Sheridan, Robert; de Boer, Johannes F.

    2012-06-01

    The accurate determination of burn depth is critical in the clinical management of burn wounds. Polarization-sensitive optical coherence tomography (PS-OCT) has been proposed as a potentially non-invasive method for determining burn depth by measuring thermally induced changes in the structure and birefringence of skin, and has been investigated in pre-clinical burn studies with animal models and ex vivo human skin. In this study, we applied PS-OCT to the in-vivo imaging of two pediatric burn patients. Deep and superficial burned skins along with contralateral controls were imaged in 3D. The imaging size was 8 mm×6 mm×2 mm in width, length, and depth in the air respectively, and the imaging time was approximately 6 s per volume. Superficially burned skins exhibited the same layered structure as the contralateral controls, but more visible vasculature and reduced birefringence compared to the contralateral controls. In contrast, a deeply burned skin showed loss of the layered structure, almost absent vasculature, and smaller birefringence compared to superficial burns. This study suggested the vasculature and birefringence as parameters for characterizing burn wounds.

  5. Impact of Oxandrolone Treatment on Acute Outcomes After Severe Burn Injury

    OpenAIRE

    Pham, Tam N.; Klein, Matthew B.; Gibran, Nicole S.; Arnoldo, Brett D.; Gamelli, Richard L.; Silver, Geoffrey M.; Jeschke, Marc G.; Finnerty, Celeste C.; Tompkins, Ronald G.; Herndon, David N

    2008-01-01

    Pharmacologic modulation of hypermetabolism clearly benefits children with major burns, however, its role in adult burns remains to be defined. Oxandrolone appears to be a promising anabolic agent although few outcome data are as yet available. We examined whether early oxandrolone treatment in severely burned adults was associated with improved outcomes during acute hospitalization. We evaluated for potential associations between oxandrolone treatment and outcomes in a large cohort of severe...

  6. A Retrospective Analysis of the Burn Injury Patients Records in the Emergency Department, an Epidemiologic Study

    OpenAIRE

    Nilgün Aksoy; Senay Arli; Ozlem Yigit

    2014-01-01

    Introduction: Burns can be very destructive, and severely endanger the health and lives of humans. It maybe cause disability and even psychological trauma in individuals. . Such an event can also lead to economic burden on victim’s families and society. The aim of our study is to evaluate epidemiology and outcome of burn patients referring to emergency department. Methods: This is a cross-sectional study was conducted by evaluation of patients’ files and forensic reports of burned patients’ r...

  7. Central activation of TRPV1 and TRPA1 by novel endogenous agonists contributes to mechanical and thermal allodynia after burn injury

    Science.gov (United States)

    Green, Dustin P; Ruparel, Shivani; Gao, Xiaoli; Ruparel, Nikita; Patil, Mayur; Akopian, Armen

    2016-01-01

    The primary complaint of burn victims is an intense, often devastating spontaneous pain, with persistence of mechanical and thermal allodynia. The transient receptor potential channels, TRPV1 and TRPA1, are expressed by a subset of nociceptive sensory neurons and contribute to inflammatory hypersensitivity. Although their function in the periphery is well known, a role for these TRP channels in central pain mechanisms is less well defined. Lipid agonists of TRPV1 are released from peripheral tissues via enzymatic oxidation after burn injury; however, it is not known if burn injury triggers the release of oxidized lipids in the spinal cord. Accordingly, we evaluated whether burn injury evoked the central release of oxidized lipids. Analysis of lipid extracts of spinal cord tissue with HPLC-MS revealed a significant increase in levels of the epoxide and diol metabolites of linoleic acid: 9,10-DiHOME, 12,13-DiHOME, 9(10)-EpOME, and 12(13)-EpOME, that was reduced after intrathecal (i.t.) injection of the oxidative enzyme inhibitor ketoconazole. Moreover, we found that these four lipid metabolites were capable of specifically activating both TRPV1 and TRPA1. Intrathecal injection of specific antagonists to TRPV1 (AMG-517) or TRPA1 (HC-030031) significantly reduced post-burn mechanical and thermal allodynia. Finally, i.t. injection of ketoconazole significantly reversed post-burn mechanical and thermal allodynia. Our data indicate that spinal cord TRPV1 and TRPA1 contributes to pain after burn and identifies a novel class of oxidized lipids elevated in the spinal cord after burn injury. Since the management of burn pain is problematic, these findings point to a novel approach for treating post-burn pain. PMID:27411353

  8. Burn Rehabilitation

    Directory of Open Access Journals (Sweden)

    Koray Aydemir

    2011-07-01

    Full Text Available Burn injuries are important in terms of causing serious disability and threatening life. With the establishment of modern burn treatment units and advances in acute care management contributed to a reduced mortality rate over the last decades. As a result of improved outcome, more attention has to be given to a comprehensive burn rehabilitation program. Burn rehabilitation is a process that starts from day of admission and continues for months or sometimes years after the initial event. The term ‘burn rehabilitation’ incorporates the physical, physiological and social aspects of care. Burns can leave a patient with severely debilitating and deforming contractures, which can lead to significant disability when left untreated. Burn rehabilitation aims to prevent the possible complications, minimalize joint contractures and deformities, increase range of motion, control hypertrophic scarring, achieve the best possible functional capacity and to regain the patients vocational and recreational activities. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 70-7

  9. Plasma Proteome Response to Severe Burn Injury Revealed by 18O-Labeled “Universal” Reference-based Quantitative Proteomics

    Science.gov (United States)

    Qian, Wei-Jun; Petritis, Brianne O.; Kaushal, Amit; Finnerty, Celeste C; Jeschke, Marc G; Monroe, Matthew E.; Moore, Ronald J.; Schepmoes, Athena A.; Xiao, Wenzhong; Moldawer, Lyle L.; Davis, Ronald W.; Tompkins, Ronald G.; Herndon, David N.; Camp, David G.; Smith, Richard D.

    2010-01-01

    A burn injury represents one of the most severe forms of human trauma and is responsible for significant mortality worldwide. Here, we present the first quantitative proteomics investigation of the blood plasma proteome response to severe burn injury by comparing the plasma protein concentrations of 10 healthy control subjects with those of 15 severe burn patients at two time-points following the injury. The overall analytical strategy for this work integrated immunoaffinity depletion of the 12 most abundant plasma proteins with cysteinyl-peptide enrichment-based fractionation prior to LC-MS analyses of individual patient samples. Incorporation of an 18O-labeled “universal” reference among the sample sets enabled precise relative quantification across samples. In total, 313 plasma proteins confidently identified with two or more unique peptides were quantified. Following statistical analysis, 110 proteins exhibited significant abundance changes in response to the burn injury. The observed changes in protein concentrations suggest significant inflammatory and hypermetabolic response to the injury, which is supported by the fact that many of the identified proteins are associated with acute phase response signaling, the complement system, and coagulation system pathways. The regulation of ~35 proteins observed in this study is in agreement with previous results reported for inflammatory or burn response, but approximately 50 potentially novel proteins previously not known to be associated with burn response or inflammation are also found. Elucidating proteins involved in the response to severe burn injury may reveal novel targets for therapeutic interventions, as well as potential predictive biomarkers for patient outcomes such as multiple organ failure. PMID:20698492

  10. Increased poly(ADP-ribosyl)ation in skeletal muscle tissue of pediatric patients with severe burn injury: prevention by propranolol treatment

    Science.gov (United States)

    Oláh, Gábor; Finnerty, Celeste; Sbrana, Elena; Elijah, Itoro; Gerö, Domokos; Herndon, David; Szabó, Csaba

    2011-01-01

    Summary Activation of the nuclear enzyme poly (ADP-ribose) polymerase (PARP) has been shown to promote cellular energetic collapse and cellular necrosis in various forms of critical illness. Most of the evidence implicating the PARP pathway in disease processes is derived from preclinical studies. With respect to PARP and burns, studies in rodent and large animal models of burn injury have demonstrated the activation of PARP in various tissues and the beneficial effect of its pharmacological inhibition. The aim of the current study was to measure the activation of PARP in human skeletal muscle biopsies at various stages of severe pediatric burn injury and to identify the cell types where this activation may occur. Another aim of the study was to test the effect of propranolol (an effective treatment of patients with burns), on the activation of PARP in skeletal muscle biopsies. PARP activation was measured by Western blotting for its product, poly(ADP-ribose) (PAR). The localization of PARP activation was determined by PAR immunohistochemistry. The results showed that PARP becomes activated in the skeletal muscle tissue after burns, with the peak of the activation occurring in the middle stage of the disease (13–18 days after burns). Even at the late stage of the disease (69–369 days post-burn) an elevated degree of PARP activation persisted in some of the patients. Immunohistochemical studies localized the staining of PAR primarily to vascular endothelial cells, and occasionally to resident mononuclear cells. There was a marked suppression of PARP activation in the skeletal muscle biopsies of patients who received propranolol treatment. We conclude that human burn injury is associated with the activation of PARP. We hypothesize that this response may contribute to the inflammatory responses and cell dysfunction in burns. Some of the clinical benefit of propranolol in burns may be related to its inhibitory effect on PARP activation. PMID:21368715

  11. Acute changes in oxygen consumption and body temperature after burn injury.

    OpenAIRE

    Childs, C.; Little, R. A.

    1994-01-01

    This study describes the pattern of oxygen consumption (VO2), rectal temperature (Tr), and acral skin temperature (Tac) in sleeping and resting (awake) burned children nursed in a thermoneutral environment. Measurements of respiratory gas exchange (VO2 and carbon dioxide production (VCO2)) were made using an open circuit, flow through system of indirect calorimetry. Tr and Tac were monitored continuously. Sixteen patients were studied during the first 18 hours after being burned. Three phases...

  12. Trimetazidine effect on burn-induced intestinal mucosal injury and kidney damage in rats

    OpenAIRE

    Yalcin, Arzu Didem; Bisgin, Atil; Erbay, Riza Hakan; Oguz, Oguzhan; Demir, Suleyman; Yilmaz, Mustafa; Gumuslu, Saadet

    2012-01-01

    Background: Trimetazidine (TMZ) has been used in cardiology practice for protection from ischemiareperfusion injury. But its effects on intestinal mucosa are not well known. Our aim was to investigate the protective effect of TMZ on intestinal mucosa and on damaged kidney due to thermal injury in rats. Material and methods: Total of 30 male Sprague-Dawley rats were used in the study of intestinal mucosa damage and 24 female Sprague-Dawley rats in renal injury model. Back regions were shaved a...

  13. Increased poly(ADP-ribosyl)ation in skeletal muscle tissue of pediatric patients with severe burn injury: prevention by propranolol treatment

    OpenAIRE

    Oláh, Gábor; Finnerty, Celeste; Sbrana, Elena; Elijah, Itoro; Gerö, Domokos; Herndon, David; Szabó, Csaba

    2011-01-01

    Activation of the nuclear enzyme poly (ADP-ribose) polymerase (PARP) has been shown to promote cellular energetic collapse and cellular necrosis in various forms of critical illness. Most of the evidence implicating the PARP pathway in disease processes is derived from preclinical studies. With respect to PARP and burns, studies in rodent and large animal models of burn injury have demonstrated the activation of PARP in various tissues and the beneficial effect of its pharmacological inhibiti...

  14. Adult patients are more catabolic than children during acute phase after burn injury: a retrospective analysis on muscle protein kinetics

    Science.gov (United States)

    Tuvdendorj, Demidmaa; Chinkes, David L.; Zhang, Xiao-Jun; Ferrando, Arny A.; Elijah, Itoro E.; Mlcak, Ronald P.; Finnerty, Celeste C.; Wolfe, Robert R.; Herndon, David N.

    2011-01-01

    Purpose This study was performed to determine if there is an age-related specificity in the response of muscle protein metabolism to severe burn injury during acute hospitalization. This is a retrospective analysis of previously published data. Methods: Nineteen adult and 58 pediatric burn-injured patients (age 43.3 ± 14.3 vs. 7.2 ± 5.3 years, adult vs. children) participated in stable isotope [ring-2H5]phenylalanine (Phe) infusion studies. Femoral arterial and venous blood samples and muscle biopsy samples were collected throughout the study. Data are presented as means ± standard deviation (SD). A p value less than 0.05 was considered statistically significant. Results Muscle net protein balance (NB) was higher in children (adult vs. children, -43 ± 61 vs. 8 ± 68 nmol Phe/min/100 ml leg volume, p < 0.05). Muscle protein fractional synthesis rate (FSR) was higher in children (adult vs. children, 0.11 ± 0.05 vs. 0.16 ± 0.10 %/h, p < 0.05). Leg muscle protein breakdown was not different between the groups (adult vs. children, 179 ± 115 vs. 184 ± 124 nmol Phe/ min/100 ml leg volume, p < 0.05; synthesis rate was 134 ± 96 and 192 ± 128 nmol Phe/min/100 ml leg volume in adults and children, respectively (p = 0.07). Age significantly correlated with muscle protein NB (p = 0.01) and FSR (p = 0.02); but not with breakdown (p = 0.67) and synthesis (p = 0.07) rates measured by using a three-pool model. Conclusion In burn injury, the muscle protein breakdown may be affected to the same extent in adults and children, whereas synthesis may have age-related specificities, resulting in a better but still low NB in children. PMID:21647721

  15. A Retrospective Analysis of the Burn Injury Patients Records in the Emergency Department, an Epidemiologic Study

    Directory of Open Access Journals (Sweden)

    Nilgün Aksoy

    2014-08-01

    Full Text Available Introduction: Burns can be very destructive, and severely endanger the health and lives of humans. It maybe cause disability and even psychological trauma in individuals. . Such an event can also lead to economic burden on victim’s families and society. The aim of our study is to evaluate epidemiology and outcome of burn patients referring to emergency department. Methods: This is a cross-sectional study was conducted by evaluation of patients’ files and forensic reports of burned patients’ referred to the emergency department (ED of Akdeniz hospital, Turkey, 2008. Demographic data, the season, place, reason, anatomical sites, total body surface area, degrees, proceeding treatment, and admission time were recorded. Multinomial logistic regression was used to compare frequencies’ differences among single categorized variables. Stepwise logistic regression was applied to develop a predictive model for hospitalization. P<0.05 was defined as a significant level. Results: Two hundred thirty patients were enrolled (53.9% female. The mean of patients' ages was 25.3 ± 22.3 years. The most prevalence of burn were in the 0-6 age group and most of which was hot liquid scalding (71.3%. The most affected parts of the body were the left and right upper extremities. With increasing the severity of triage level (OR=2.2; 95% CI: 1.02-4.66; p=0.046, intentional burn (OR=4.7; 95% CI: 1.03-21.8; p=0.047, referring from other hospitals or clinics (OR=3.4; 95% CI: 1.7-6.6; p=0.001, and percentage of burn (OR=18.1; 95% CI: 5.42-62.6; p<0.001 were independent predictive factor for hospitalization. In addition, odds of hospitalization was lower in patients older than 15 years (OR=0.7; 95% CI: 0.5-0.91; p=0.035. Conclusion: This study revealed the most frequent burns are encountered in the age group of 0-6 years, percentage of <10%, second degree, upper extremities, indoor, and scalding from hot liquids. Increasing ESI severity, intentional burn, referring from

  16. About the tactics of treatment and visual rehabilitation in case of an acute severe alkaline burn injury of the eye. A case report

    OpenAIRE

    V.F. Chernysh; E.V. Boyko

    2013-01-01

    ABSTRACT Purpose. To acquaint ophthalmologists with tactics of treatment of a victim with an acute severe chemical burn injury of the eye i n one of follow-up cases fr om practice. Material and methods. The female patient of 31 years old had a severe alkaline burn injury with total limbal stem cell deficiency in the right eye. до (до After an emergency aid an ischemia of a limbus zone, a total corneal erosion and its moderate edema, a deepithelization of conjunctiva...

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

    DEFF Research Database (Denmark)

    Møller-Kristensen, Mette; Hamblin, MR; Thiel, Steffen; Jensenius, Jens Christian; Takahashi, K

    2007-01-01

    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...

  18. 放烧复合伤的治疗研究%Studies on the treatment of combined radiation-burn injury

    Institute of Scientific and Technical Information of China (English)

    程天民; 冉新泽

    2008-01-01

    Combined radiation-bum injuries mainly occur under the circumstances of nuclear explosion, nuclear accident, nuclear terrorism, depleted uranium attack, as well as secondary injuries following attack on nuclear installation. Combination of burn and radiation injuries bring along more serious whole body damage, more complicated pathological mechanism and much more difficult management. Research progress on the pathological mechanism and medical management of several key links of combined injury were discussed in this paper.①En-hancement of early first aid and prevention of early death of wounded. ②Damage and restoration of hemopoetic function.③Disturbance of immune function and prevention and treatment of infection (mainly on the intestinla mucosa immunity and enter-ological infection).④Management of burn wound.⑤The uole of several important measures in the comprehensive treatment.

  19. Epidemiology of ventilator-associated tracheobronchitis and vantilator-associated pneumonia in patients with inhalation injury at the Burn Centre in Brno (Czech Republic)

    OpenAIRE

    Lipovy, B; Rihová, H.; Gregorova, N; Hanslianova, M.; Zaloudikova, Z.; Kaloudova, Y.; Brychta, P.

    2011-01-01

    Aim. The aim of this work is to determine the incidence of ventilator-associated tracheobronchitis (VAT) and ventilator-associated pneumonia (VAP) and to define the define the most important respiratory pathogens in patients with inhalation injury. Introduction. Infectious complications in severely burned patients present serious problems. Patients with inhalation injuries are exposed to greater risk owing to the possible development of infectious complications in the lower respiratory tract....

  20. The Value and Prognostic Role of the CT Scan versus Chest Radiography in the Follow-up of Intubated Burn Patients with Possible Inhalation Injury

    OpenAIRE

    Spyropoulou, G.A.; Iconomou, T.; Tsagarakis, M.; Tsoutsos, D.

    2005-01-01

    The admission and follow-up chest radiographs as well as the follow-up CT scans of 13 burn patients admitted to our clinic requiring ventilatory support were analysed for signs of inhalation injury and pulmonary complications. The findings were compared with the results of the clinical examination, the blood gas tests, and bronchoscopy. Eleven out of the 13 patients underwent bronchoscopy revealing inhalation injury. The CT scan detected pleural effusion in two patients with a normal chest ra...

  1. Management of acute burns and burn shock resuscitation.

    Science.gov (United States)

    Faldmo, L; Kravitz, M

    1993-05-01

    Initial management of minor and moderate, uncomplicated burn injury focuses on wound management and patient comfort. Initial management of patients with major burn injury requires airway support, fluid resuscitation for burn shock, treatment for associated trauma and preexisting medical conditions, management of adynamic ileus, and initial wound treatment. Fluid resuscitation, based on assessment of the extent and depth of burn injury, requires administration of intravenous fluids using resuscitation formula guidelines for the initial 24 hours after injury. Inhalation injury complicates flame burns and increases morbidity and mortality. Electrical injury places patients at risk for cardiac arrest, metabolic acidosis, and myoglobinuria. Circumferential full-thickness burns to extremities compromise circulation and require escharotomy or fasciotomy. Circumferential torso burns compromise air exchange and cardiac return. Loss of skin function places patients at risk for hypothermia, fluid and electrolyte imbalances, and systemic sepsis. The first 24 hours after burn injury require aggressive medical management to assure survival and minimize complications. PMID:8489882

  2. Role of the PPAR-α agonist fenofibrate in severe pediatric burn injury

    OpenAIRE

    Elijah, Itoro E.; Børsheim, Elisabet; Maybauer, Dirk M.; Finnerty, Celeste C.; Herndon, David N; Maybauer, Marc O.

    2012-01-01

    Fenofibrate is a peroxisome proliferator activated receptor alpha agonist that contains both pro and anti-inflammatory properties, and has been used in the treatment of dyslipidemia and diabetes for decades. Its receptors are expressed in the liver, skeletal muscle, cardiac, enteric, and renal cells, which allow it to provide systemic regulation of lipoprotein metabolism, fatty acid oxidation, and fatty acid transport. Hyperglycemia is a common complication found in the burn population becaus...

  3. Managing severe burn injuries: challenges and solutions in complex and chronic wound care

    OpenAIRE

    Jeschke, Marc

    2016-01-01

    Alan D Rogers, Marc G Jeschke Ross Tilley Burn Centre, Division of Plastic and Reconstructive Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada Abstract: Encountered regularly by health care providers across both medical and surgical fields and an increasing socioeconomic burden globally, wound care is severely neglected. Practice is heavily influenced by anecdote rather than evidence-based protocols and industry-biased lite...

  4. Managing severe burn injuries: challenges and solutions in complex and chronic wound care

    OpenAIRE

    AD Rogers; MG, Jeschke

    2016-01-01

    Alan D Rogers, Marc G Jeschke Ross Tilley Burn Centre, Division of Plastic and Reconstructive Surgery, Department of Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada Abstract: Encountered regularly by health care providers across both medical and surgical fields and an increasing socioeconomic burden globally, wound care is severely neglected. Practice is heavily influenced by anecdote rather than evidence-based protocols and industry-biased literatu...

  5. Role of the PPAR-α agonist fenofibrate in severe pediatric burn injury

    Science.gov (United States)

    Elijah, Itoro E.; Børsheim, Elisabet; Maybauer, Dirk M.; Finnerty, Celeste C.; Herndon, David N.; Maybauer, Marc O.

    2013-01-01

    Fenofibrate is a peroxisome proliferator activated receptor alpha agonist that contains both pro and anti-inflammatory properties, and has been used in the treatment of dyslipidemia and diabetes for decades. Its receptors are expressed in the liver, skeletal muscle, cardiac, enteric, and renal cells, which allow it to provide systemic regulation of lipoprotein metabolism, fatty acid oxidation, and fatty acid transport. Hyperglycemia is a common complication found in the burn population because hepatic glucose production and catecholamine-mediated hepatic glycogenolysis are augmented. Insulin resistance occurs often in these patients and is associated with poor outcomes. In the pediatric burn population, fenofibrate has been found to ameliorate or decrease the number of hypoglycemic episodes when compared to management with insulin alone. Its mechanism of action is thought to involve an improvement in insulin signaling in skeletal muscle, as well as improvements in mitochondrial function, glucose oxidation, and insulin sensitivity. The long term use of fenofibrate in severely burned patients may improve hyperglycemia and insulin resistance, as well as improve wound healing, and reduce apoptosis, and oxidative stress. PMID:22226866

  6. Repair effect of transplantation of bone marrow mesenchymal stem cells on liver injury in severe burned rats and its mechanism

    International Nuclear Information System (INIS)

    Objective: To investigate the repair effect of transplantation of bone marrow mesenchymal stem cells (BMSCs) on liver injury in severe burned rats, and to clarify its mechanism. Methods: The BMSCs of rats were isolated, cultured, amplified, identified, and labeled in vitro. 30 Wistar rats were randomly divided into normal control group (n=10), model group (n=10) and cell therapy group (n=10). The burned rat model was established. The BMSCs labeled by chlormethyl-benzamidodialkylcarbocyanine (CM-Dil) were transplanted into the rats in cell therapy group by retro-orbital intravenous injection and the saline was injected into the rats in model group. The general status of all rats were observed. The liver tissues of rats were obtained 2 weeks after transplantation, and the pathohistological changes were observed and the pathohistological scores were detected; the apoptotic rate of liver cells was detected by TUNEL method; the engraftment of BMSCs in liver tissues of the rats was observed under laser scanning confocal microscope. Results: 2 weeks after transplantation, the rats in model group were obviously malaise dispirited and the rats in cell therapy group showed obviously better, and the body weight of the rats in cell therapy group was higher than that in model group (P<0.05). The pathohistological results showed the normal liver lobules of the rats in model group disappeared, and the liver cords disordered, and some liver sinusoids dilated and congested, lymphocytes infiltrated with occasional focal aggregating, and cell edema was found, cytoplasm loose and steatosis were seen in liver tissue. However, the pathohistological changes of liver tissue of the rats in cell therapy group were significantly better than those in model group. The pathohistological score of the rats in cell therapy group was significantly lower than that in model group (P<0.05). The TUNEL staining results showed that there were lots of apoptotic liver cells in liver tissue of the rats in

  7. Does mixing acute medical admissions with burn patients increase infective complications from paediatric thermal injuries?

    OpenAIRE

    Shaban, Fadlo; Stewart, Ken; Kalima, Pota

    2010-01-01

    In the winter of 2005–2006, the management at our children's hospital elected to admit ‘overspill’ acute medical admissions to the ward used for plastic surgery and burns for logistical reasons. This study was conducted to assess the effects of that change on the incidence of infective complications in thermally-injured patients. Seventy-three patients were studied, 23 in the sample winter and 50 in the two preceding control winters. The data gathered included days on IV fluids and antibiotic...

  8. 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

  9. 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

  10. Laboratory-based evaluation of MDR strains of Pseudomonas in patients with acute burn injuries

    Science.gov (United States)

    Zhang, Hong-Tu; Liu, Hui

    2015-01-01

    Localization of burn was variable: head and face in 76 patients (29%), trunk in 58 (49%), upper limb in 37 (52%), lower limbs in 44 (41%), hands in 16 (15%), perinea area in 26 (5.5%) and whole body except perinea area in 10 (9%) patients. Inhalation syndrome was present in 56 (44%) patients. Ninety patients (82%) had indwelling venous catheters, 83 (75.5%) patients’ arterial catheter and 86 (78%) patients’ urinary catheters. By multivariate analysis: age ≤4 years, Garcés 4, colistin use in documented multiresistant infections, and mechanical ventilation were independent variables related with mortality and graft requirement was a protective factor for mortality. Despite advances in care, gram negative bacterial infections and infection with Pseudomonas aeruginosa remain the most common cause of bacteria related mortality early in the hospital course. Viral infections are also associated with mortality and numbers have remained stable when compared to data from prior years. PMID:26629178

  11. The Effect of Different Topical Agents (Silver Sulfadiazine, Povidone-Iodine, and Sodium Chloride 0.9%) on Burn Injuries in Rats

    OpenAIRE

    Emir Burak Yüksel; Alpagan Mustafa Yıldırım; Ali Bal; Tuncay Kuloglu

    2014-01-01

    It was aimed to comparatively evaluate the effects of dressing methods with silver sulfadiazine, povidone-iodine, and saline which have a common use in routine practices for burn injuries. Twenty-eight Sprague Dawley adult female rats were used in this study. All the rats were divided into 4 groups: the control group, the povidone-iodine group, the saline group, and the silver sulfadiazine group. On each rat, a second degree burn which covered less than 10% of the body surface area was create...

  12. The media glorifying burns: a hindrance to burn prevention.

    Science.gov (United States)

    Greenhalgh, David G; Palmieri, Tina L

    2003-01-01

    The media have a profound influence on the actions of children and adults. Burns and burn prevention tend to be ignored or even mocked. The purpose of this presentation is to reveal the callousness of the media in its dealings with burns and burn prevention. Printed materials with a relationship to burns, risk of burning, or disrespect for the consequences of burns were collected. The materials were tabulated into four categories: comics, advertisements (ads), articles that made light of burns, and television shows that portrayed behavior that would risk burn injury. Most burn-related materials were found in comics or advertisements. Several comics made light of high-risk behavior with flames, scald injury, contact injury, or burns. In addition, several advertisements showed people on fire or actions that could easily lead to burns. Several articles and televisions shows portrayed high-risk behavior that, in some instances, led to copycat injuries. Flames are frequently used to sell items that target adolescent boys or young men. The high incidence injuries that frequent this population parallel the high-risk behaviors portrayed by the media. The media portrays flames and high-risk behavior for burn injury as being cool, funny, and without consequence. The use of flames on clothing and recreational equipment (skateboards, hot rods) particularly targets the high-risk adolescent male. The burn community should make the media aware of the harm it causes with its callous depiction and glorification of burns. PMID:12792237

  13. 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

  14. About the tactics of treatment and visual rehabilitation in case of an acute severe alkaline burn injury of the eye. A case report

    Directory of Open Access Journals (Sweden)

    V.F. Chernysh

    2013-04-01

    Full Text Available ABSTRACT Purpose. To acquaint ophthalmologists with tactics of treatment of a victim with an acute severe chemical burn injury of the eye i n one of follow-up cases fr om practice. Material and methods. The female patient of 31 years old had a severe alkaline burn injury with total limbal stem cell deficiency in the right eye. до (до After an emergency aid an ischemia of a limbus zone, a total corneal erosion and its moderate edema, a deepithelization of conjunctiva up to the fornices were observed. Visual acuity was 0.3 (before the burn it was 1.0. At 8 days after the burn the covering of ocular surface structures without epithelium was performed using a fresh amnion transplant which edges were sutured closely to the edges of intact bulbar conjunctiva. The total epithelization of the ocular surface (including the cornea was noted at 39 days after the operation. Visual acuity was 0.2. One year later the visual acuity was 0.07 and the total fibrovascular pannus with the effects of corneal epitheliopathy was detected. The сonjunctival limbal autograft was carried out. Six months later the visual acuity w as 0.9. Conclusion. During the early periods of ocular burn disease with the total limbal stem cell deficiency, the covering of the ocular surface using amnion in a variant of conjunctival plasty reduced the healing time, stabilized the condition of the corneal stroma after the burn, prevented the corneal opacity and an inevitable vascular in-growth creating favorable conditions for the limbal stem cell transplantation.

  15. A qualitative study of the background and in-hospital medicolegal response to female burn injuries in India

    OpenAIRE

    Daruwalla, N.; Belur, J.; Kumar, M.; Tiwari, V; Sarabahi, S.; Tilley, N.; Osrin, D

    2014-01-01

    Background Most burns happen in low- and middle-income countries. In India, deaths related to burns are more common in women than in men and occur against a complex background in which the cause – accidental or non-accidental, suicidal or homicidal – is often unclear. Our study aimed to understand the antecedents to burns and the problem of ascribing cause, the sequence of medicolegal events after a woman was admitted to hospital, and potential opportunities for improvement. Methods We conduc...

  16. Friction Burns: Epidemiology and Prevention

    OpenAIRE

    Agrawal, A; Raibagkar, S.C.; Vora, H.J.

    2008-01-01

    This epidemiological study deals with 60 patients with friction burns between January 2004 and January 2006. The age group most affected was that between 21 and 30 years, with male predominance. Road traffic accidents were the commonest cause of friction burns (56 patients), and the lower limb was the most frequently affected part of the body. Patient management was performed according to the degree of the burn injury. It is suggested that most friction burn injuries are neglected on admissio...

  17. 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. PMID:23313241

  18. Sustainable antimicrobial effect of silver sulfadiazine-loaded nanosheets on infection in a mouse model of partial-thickness burn injury.

    Science.gov (United States)

    Ito, Keisuke; Saito, Akihiro; Fujie, Toshinori; Nishiwaki, Keisuke; Miyazaki, Hiromi; Kinoshita, Manabu; Saitoh, Daizoh; Ohtsubo, Shinya; Takeoka, Shinji

    2015-09-01

    Partial-thickness burn injury has the potential for reepithelialization and heals within 3weeks. If the wound is infected by bacteria before reepithelization, however, the depth of disruption increases and the lesion easily progresses to the full-thickness dermal layers. In the treatment of partial-thickness burn injury, it is important to prevent the wound area from bacterial infection with an antimicrobial dressing. Here, we have tested the antimicrobial properties of polymeric ultra-thin films composed of poly(lactic acid) (termed "PLA nanosheets"), which have high flexibility, adhesive strength and transparency, and silver sulfadiazine (AgSD), which exhibits antimicrobial efficacy. The AgSD-loaded nanosheet released Ag(+) for more than 3days, and exerted antimicrobial efficacy against methicillin-resistant Staphylococcus aureus (MRSA) in an in vitro Kirby-Bauer test. By contrast, a cell viability assay indicated that the dose of AgSD used in the PLA nanosheets did not show significant cytotoxicity toward fibroblasts. In vivo evaluation using a mouse model of infection in a partial-thickness burn wound demonstrated that the nanosheet significantly reduced the number of MRSA bacteria on the lesion (more than 10(5)-fold) and suppressed the inflammatory reaction, thereby preventing a protracted wound healing process. PMID:26079191

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

    Science.gov (United States)

    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. PMID:23385436

  20. Current situation and prospect of measures of rehabilitation after burn injury%烧伤康复治疗技术现状与展望

    Institute of Scientific and Technical Information of China (English)

    胡大海; 易南

    2014-01-01

    In the wound healing process after a deep burn injury,improper treatment in the early stage and lack of functional rehabilitation measures in the late stage usually lead tohyperplastic scar,joint contracture,synarthrophysis,and other deformities.All of them may result in cosmetic and functional impairments,loss of work ability,poor life quality,and even psychopathy of the patients.Thus,the improvement in rehabilitation methods and the maximal recovery of appearance and functions have drawn intense attention.This article mainly discusses the prevention,systematic treatment principles and methods for the hyperplastic scar and scar contracture,as well as the problems need to be solved in burn rehabilitation,based on the introduction of the new advancement in the rehabilitation techniques.

  1. The efficacy of playing a virtual reality game in modulating pain for children with acute burn injuries: A randomized controlled trial [ISRCTN87413556

    Directory of Open Access Journals (Sweden)

    McRae Sarah E

    2005-03-01

    Full Text Available Abstract Background The management of burn injuries is reported as painful, distressing and a cause of anxiety in children and their parents. Child's and parents' pain and anxiety, often contributes to extended time required for burns management procedures, in particular the process of changing dressings. The traditional method of pharmacologic analgesia is often insufficient to cover the burnt child's pain, and it can have deleterious side effects 12. Intervention with Virtual Reality (VR games is based on distraction or interruption in the way current thoughts, including pain, are processed by the brain. Research on adults supports the hypothesis that virtual reality has a positive influence on burns pain modulation. Methods This study investigates whether playing a virtual reality game, decreases procedural pain in children aged 5–18 years with acute burn injuries. The paper reports on the findings of a pilot study, a randomised trial, in which seven children acted as their own controls though a series of 11 trials. Outcomes were pain measured using the self-report Faces Scale and findings of interviews with parent/carer and nurses. Results The average pain scores (from the Faces Scale for pharmacological analgesia only was, 4.1 (SD 2.9, while VR coupled with pharmacological analgesia, the average pain score was 1.3 (SD 1.8 Conclusion The study provides strong evidence supporting VR based games in providing analgesia with minimal side effects and little impact on the physical hospital environment, as well as its reusability and versatility, suggesting another option in the management of children's acute pain.

  2. 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....

  3. Fms-like tyrosine kinase-3 ligand alters antigen-specific responses to infections after severe burn injury

    OpenAIRE

    Bohannon, Julia; Fang, Geping; Cui, Weihua; Sherwood, Edward; Toliver-Kinsky, Tracy

    2009-01-01

    Burn patients are susceptible to opportunistic infections due partly to decreased immune functions, especially Th1-driven antigen-specific responses, which are regulated by dendritic cells. The dendritic cell growth factor, fms-like tyrosine kinase-3 ligand (FL), has been shown to increase resistance to P. aeruginosa, in a dendritic cell-dependent manner, in a mouse model of burn wound infection. The specific mechanisms of protection are not known. This study tested the hypothesis that FL can...

  4. Inhalation Injuries

    Science.gov (United States)

    ... increase mortality 30% to 40% when patients with cutaneous burns and inhalation injury are compared with patients ... nasal hairs • Facial burnsBurns around the mouth • Mineral spirits – 104º F – paint thinner, brush cleaner. • Redness, ...

  5. Epoetin Alpha and Epoetin Zeta: A Comparative Study on Stimulation of Angiogenesis and Wound Repair in an Experimental Model of Burn Injury

    Directory of Open Access Journals (Sweden)

    Natasha Irrera

    2015-01-01

    Full Text Available Deep second-degree burns are characterized by delayed formation of granulation tissue and impaired angiogenesis. Erythropoietin (EPO is able to stimulate angiogenesis and mitosis, activating vascularization and cell cycle. The aim of our study was to investigate whether two biosimilar recombinant human erythropoietins, EPO-α and EPO-Z, may promote these processes in an experimental model of burn injury. A total of 84 mice were used and a scald burn was produced on the back after shaving, in 80°C water for 10 seconds. Mice were then randomized to receive EPO-α (400 units/kg/day/sc or EPO-Z (400 units/kg/day/sc or their vehicle (100 μL/day/sc 0.9% NaCl solution. After 12 days, both EPO-α and EPO-Z increased VEGF protein expression. EPO-α caused an increased cyclin D1/CDK6 and cyclin E/CDK2 expression compared with vehicle and EPO-Z (p<0.001. Our study showed that EPO-α and EPO-Z accelerated wound closure and angiogenesis; however EPO-α resulted more effectively in achieving complete skin regeneration. Our data suggest that EPO-α and EPO-Z are not biosimilars for the wound healing effects. The higher efficacy of EPO-α might be likely due to its different conformational structure leading to a more efficient cell proliferation and skin remodelling.

  6. Clinical profile of burn injured patients

    OpenAIRE

    Efstathiou, Flora; Svardagalou, Paraskevi

    2016-01-01

    Abstract Introduction: Burn injury is a severe systemic disease with social implications. Aim: The recording of patient’s clinical profile with burn injury worldwide and in Greece, the outcome and impact of the injury on the patient’s mental health and social, professional and family life. Methods: There were collected surveys and reports concerned burn victims, men and women, teenagers and adults of all types and severities of burns in the world and in Greece. The inf...

  7. 烧伤后早期心肌损害与防治%Myocardial injury after burn at early stage and its treatment

    Institute of Scientific and Technical Information of China (English)

    黄跃生

    2008-01-01

    Isehemia/hypoxia is one of the key clinical issues following severe burns, and isehemic/hypoxic damage of tissues and organs is still hard to be prevented or minimized by various fluid resuscitation regimens . To those who suffered severe bums, even though fluid replacement therapy is delivered promptly, isehemic/hypoxie damage of organs is still inevitable. Previously, blood flow in vital organs such as heart was eonsidered not to be reduced because of blood redistribution under the circumstance of stress. The postbum cardiac dysfunction has been mainly attributed to the reduced blood flow returned to the heart due to decreased blood volume caused by increased capillary permeability. Therefore, postbum cardiac dysfunction has been considered to be the result of burn shock. During the past two decades, we have performed serial studies on severe burns, and found that isehemie/hypoxie myocardial damage and functional impairment of myocardium due to activation of reninangio tensin system existing in the heart itself occur immediately after severe bums even before significant reduction in blood volume secondary to an increase of capillary permeability . Such prompt myocardial damage leads to cardiac deficiency, and it is also a precipitating factor for bum shock and isehemic/hypoxie injury of systemic tissues and organs. Therefore, we called it " shock heart" in our reports. The cellular and molecular mechanisms leading to myocardial damage were systematically investigated. Strategies for prevention of early postburn myocardial damage and dysfunction, and a new effective burn shock resuscitation regimen "volume replacement" plus "dynamic support" (cardiac support and myocardial protection) have been proposed based on our previous studies.

  8. Animal Models in Burn Research

    OpenAIRE

    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...

  9. Ghrelin Therapy Improves Survival after Whole-Body Ionizing Irradiation or Combined with Burn or Wound: Amelioration of Leukocytopenia, Thrombocytopenia, Splenomegaly, and Bone Marrow Injury

    Science.gov (United States)

    Kiang, Juliann G.; Zhai, Min; Liao, Pei-Jyun; Elliott, Thomas B.; Gorbunov, Nikolai V.

    2014-01-01

    Exposure to ionizing radiation alone (RI) or combined with traumatic tissue injury (CI) is a crucial life-threatening factor in nuclear and radiological events. In our laboratory, mice exposed to 60Co-γ-photon radiation (9.5 Gy, 0.4 Gy/min, bilateral) followed by 15% total-body-surface-area skin wounds (R-W CI) or burns (R-B CI) experienced an increment of ≥18% higher mortality over a 30-day observation period compared to RI alone. CI was accompanied by severe leukocytopenia, thrombocytopenia, erythropenia, and anemia. At the 30th day after injury, numbers of WBC and platelets still remained very low in surviving RI and CI mice. In contrast, their RBC, hemoglobin, and hematocrit were recovered towards preirradiation levels. Only RI induced splenomegaly. RI and CI resulted in bone-marrow cell depletion. In R-W CI mice, ghrelin (a hunger-stimulating peptide) therapy increased survival, mitigated body-weight loss, accelerated wound healing, and increased hematocrit. In R-B CI mice, ghrelin therapy increased survival and numbers of neutrophils, lymphocytes, and platelets and ameliorated bone-marrow cell depletion. In RI mice, this treatment increased survival, hemoglobin, and hematocrit and inhibited splenomegaly. Our novel results are the first to suggest that ghrelin therapy effectively improved survival by mitigating CI-induced leukocytopenia, thrombocytopenia, and bone-marrow injury or the RI-induced decreased hemoglobin and hematocrit. PMID:25374650

  10. Burns: Treatment and Outcomes

    OpenAIRE

    Burd, Andrew

    2010-01-01

    Burns can cause extensive and devastating injuries of the head and neck. Prevention of the initial injury must always be a priority, but once an injury has occurred, then prevention of progression of the damage together with survival of the patient must be the immediate goals. The acute care will have a major influence on the subsequent scarring, reconstructive need, and long-term outcome. In the majority of cases, the reconstruction will involve restoration of form and function to the soft t...

  11. The risk of burn injury during long-term oxygen therapy: a 17-year longitudinal national study in Sweden

    OpenAIRE

    Tanash, Hanan

    2015-01-01

    Hanan A Tanash,1 Fredrik Huss,2,3 Magnus Ekström41Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Lund, 2Department of Surgical Sciences, Plastic Surgery, Uppsala University, 3Burn Center, Department of Plastic and Maxillofacial Surgery, University Hospital of Uppsala, Uppsala, 4Department of Clinical Sciences, Division of Respiratory Medicine & Allergology, Lund University, Lund, SwedenBackg...

  12. The risk of burn injury during long-term oxygen therapy: a 17-year longitudinal national study in Sweden

    OpenAIRE

    Tanash HA; Huss F; Ekström M

    2015-01-01

    Hanan A Tanash,1 Fredrik Huss,2,3 Magnus Ekström41Department of Respiratory Medicine and Allergology, Skåne University Hospital, Lund University, Lund, 2Department of Surgical Sciences, Plastic Surgery, Uppsala University, 3Burn Center, Department of Plastic and Maxillofacial Surgery, University Hospital of Uppsala, Uppsala, 4Department of Clinical Sciences, Division of Respiratory Medicine & Allergology, Lund University, Lund, SwedenBackground: Long-term oxygen ...

  13. 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

  14. Vitamin C in Burn Resuscitation.

    Science.gov (United States)

    Rizzo, Julie A; Rowan, Matthew P; Driscoll, Ian R; Chung, Kevin K; Friedman, Bruce C

    2016-10-01

    The inflammatory state after burn injury is characterized by an increase in capillary permeability that results in protein and fluid leakage into the interstitial space, increasing resuscitative requirements. Although the mechanisms underlying increased capillary permeability are complex, damage from reactive oxygen species plays a major role and has been successfully attenuated with antioxidant therapy in several disease processes. However, the utility of antioxidants in burn treatment remains unclear. Vitamin C is a promising antioxidant candidate that has been examined in burn resuscitation studies and shows efficacy in reducing the fluid requirements in the acute phase after burn injury. PMID:27600125

  15. Psychiatric aspects of burn

    Directory of Open Access Journals (Sweden)

    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.

  16. Pediatric burn rehabilitation: Philosophy and strategies

    OpenAIRE

    Shohei Ohgi; Shouzhi Gu

    2013-01-01

    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 Sc...

  17. Bilateral Lower Limb Amputations in a Nigerian Child Following High-Voltage Electrical Burns Injury: A Case Report

    OpenAIRE

    Dim, EM; Amanari, OC; Nottidge, TE; Inyang, UC; Nwashindi, A

    2013-01-01

    Abstract The human body conducts electricity very well. Direct contact with electric current can be lethal. The passage of electric current through the body is capable of producing a wide spectrum of injuries, including serious damage to the heart, brain, skin and muscles. Naked high-voltage electric cables negligently abandoned in residential, commercial and industrial areas are a recipe for disaster. This is a case report of a 5-year girl child who had bilateral lower limb gangrene followin...

  18. How Disabling Are Pediatric Burns? Functional Independence in Dutch Pediatric Patients with Burns

    Science.gov (United States)

    Disseldorp, Laurien M.; Niemeijer, Anuschka S.; Van Baar, Margriet E.; Reinders-Messelink, Heleen A.; Mouton, Leonora J.; Nieuwenhuis, Marianne K.

    2013-01-01

    Although the attention for functional outcomes after burn injury has grown over the past decades, little is known about functional independence in performing activities of daily living in children after burn injury. Therefore, in this prospective cohort study functional independence was measured by burn care professionals with the WeeFIM[R]…

  19. Inhalation Injury

    OpenAIRE

    Coşkun Araz; Arash Pirat

    2011-01-01

    Despite significant advances in wound care of patients with burn injuries, inhalation injury remains as an important contributor to morbidity and mortality in these patients. Unfortunately, there are limited studies that have focused on the diagnosis, grading, pathophysiology, and therapy of inhalation injury, therefore a widely accepted consensus is lacking on these topics. Inhalation injury is generally defined as the inhalation of thermal or chemical irritants and can be divided into three...

  20. Review of Burn Research for Year 2014.

    Science.gov (United States)

    Sen, Soman; Palmieri, Tina; Greenhalgh, David

    2015-01-01

    Management of burn injuries requires treatments and interventions from many disciplines. Worldwide, burn patients suffer from physical and psychological challenges that impact their lives socially and economically. In this review, we will highlight a handful of the numerous articles published in multiple areas of burn care. The areas of burn care addressed in the article are: epidemiology; burn resuscitation, critical care, and infection; nutrition and metabolism; pain and rehabilitation; prevention and firefighter safety; psychology; and reconstruction and wounds. PMID:26204384

  1. [Major Burn Trauma Management and Nursing Care].

    Science.gov (United States)

    Lo, Shu-Fen

    2015-08-01

    Major burn injury is one of the most serious and often life-threatening forms of trauma. Burn patients not only suffer from the physical, psychological, social and spiritual impacts of their injury but also experience considerable changes in health-related quality of life. This paper presents a review of the literature on the implications of previous research and clinical care guidelines related to major burn injuries in order to help clinical practice nurses use evidence-based care guidelines to respond to initial injury assessments, better manage the complex systemic response to these injuries, and provide specialist wound care, emotional support, and rehabilitation services. PMID:26242439

  2. Epidemiological data, outcome, and costs of burn patients in Kermanshah

    OpenAIRE

    Karami Matin, B.; Karami Matin, R.; Ahmadi Joybari, T.; Ghahvehei, N.; M Haghi; M. Ahmadi; S. Rezaei

    2012-01-01

    Burn injuries in both developed and developing countries cause long-term disability, mortality, and socio-economic costs that are imposed on patients, families, and societies. This study was carried out to investigate the epidemiology, outcome, and cost of hospitalization of 388 burn patients admitted to the Imam Khomeini Hospital Burn Center in Kermanshah, Iran, between 21 March 2011 and 20 March 2012. The data about demographics, cause of burns, degree of burns, outcome of burns, burned bod...

  3. Inhalation Injury

    Directory of Open Access Journals (Sweden)

    Coşkun Araz

    2011-07-01

    Full Text Available Despite significant advances in wound care of patients with burn injuries, inhalation injury remains as an important contributor to morbidity and mortality in these patients. Unfortunately, there are limited studies that have focused on the diagnosis, grading, pathophysiology, and therapy of inhalation injury, therefore a widely accepted consensus is lacking on these topics. Inhalation injury is generally defined as the inhalation of thermal or chemical irritants and can be divided into three types of injury: thermal injury, which is mostly restricted to the upper airway; chemical injury, which affects tracheobronchial tree; and systemic toxicity owing to toxic gases such as carbon monoxide. Inhalation injury increases the burn injury associated morbidity and mortality by causing airway problems and respiratory failure during the early phase and by contributing to the development of pneumonia and atelectasis during the late phase. Additionally, systemic effects of toxic gases such as carbon monoxide may also adversely affect the early and long-term outcome in burn victims. The early diagnosis and therapy of these problems plays a key role in improving the outcome of burn patients. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 37-45

  4. Prognosis and treatment of burns.

    OpenAIRE

    Mann, R; Heimbach, D

    1996-01-01

    Survival rates for burn patients in general have improved markedly over the past several decades. The development of topical antibiotic therapy for burn wounds, the institution of the practice of early excision and grafting, and major advances in intensive care management have all contributed to this success. In this review we address these 3 important advances in the modern treatment of burn injuries and provide a brief historical overview of these accomplishments and others, emphasizing spe...

  5. BACTERIOLOGICAL STUDY OF BURNS INFECTION

    OpenAIRE

    Shareen; Basavarajappa; Hanumanthappa

    2015-01-01

    A burn is a wound in which there is coagulative necrosis of the tissue, majority of which are caused by heat. Burn injury is a major public health problem in many areas of the world. Burns predispose to infection by damaging the protective barrier function of the skin, thus facilitating the entry of pa thogenic microorganisms and by inducing systemic immunosuppression . (1) OBJECTIVE : The present study was therefore undertaken to isolate and identify the a...

  6. Accumulative eschar after burn.

    Science.gov (United States)

    Ma, Fushun

    2016-02-01

    Eschar formation is a potential sequela of burn injuries. Definitive management may include escharectomy and eschar debridement. After eschar removal, the wound can be covered with a skin graft or reepithelialization. For prolonged refractory eschar on the fingertips, topical use of rb-bFGF after debridement can achieve an optimal outcome. PMID:26862412

  7. Accumulative eschar after burn

    OpenAIRE

    Ma, Fushun

    2015-01-01

    Key Clinical Message Eschar formation is a potential sequela of burn injuries. Definitive management may include escharectomy and eschar debridement. After eschar removal, the wound can be covered with a skin graft or reepithelialization. For prolonged refractory eschar on the fingertips, topical use of rb‐bFGF after debridement can achieve an optimal outcome.

  8. Epidemiology of outpatient burns in Iran: an update

    OpenAIRE

    Karimi, H.; Motevalian, S.A.; M. Momeni

    2014-01-01

    Burn injury remains a serious and devastating issue faced by developing countries. It is also true, however, that the developed world still tackles many of the challenges caused by burns. In order to reduce this problem through preventive programs, the characteristics of this type of injury must be studied and well documented in each setting. Our study aims to show the epidemiology, demographic distribution and clinical outcomes of burns patients referred to Motahari Burn Hospital, the burn c...

  9. Bubble bath burns: an unusual case.

    Science.gov (United States)

    Nizamoglu, Metin; Tan, Alethea; El-Muttardi, Naguib

    2016-01-01

    We present an unusual case of flash burn injury in an adolescent following accidental combination of foaming bath bubbles and tea light candle flame. There has not been any reported similar case described before. This serves as a learning point for public prevention and clinicians managing burn injuries. PMID:27583271

  10. Skin Dendritic Cells in Burn Patients

    OpenAIRE

    D’Arpa, N.; D’Amelio, L.; Accardo-Palumbo, A.; Pileri, D.; Mogavero, R.; Amato, G.; Napoli, B.; Alessandro, G.; Lombardo, C.; F. Conte

    2009-01-01

    The body's immunological response to burn injury has been a subject of great inquiry in recent years. Burn injury disturbs the immune system, resulting in a progressive suppression of the immune response that is thought to contribute to the development of sepsis. Dendritic cells (DCs) are potent antigen-presenting cells that possess the ability to stimulate naïve T cells.

  11. Pediatric burn rehabilitation: Philosophy and strategies

    Directory of Open Access Journals (Sweden)

    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.

  12. Epidemiology of paediatric burns in Iran

    OpenAIRE

    Karimi, H.; Montevalian, A.; Motabar, A.R.; Safari, R.; Parvas, M.S.; Vasigh, M.

    2012-01-01

    We surveyed the epidemiology of the patients in a tertiary burn care centre (the Motahari Burn Hospital) in Tehran in the 4-yr period 2005-2009. Scalding was the major cause of burn injury for patients under the age of 6, while there were many more flame and electrical burns in late childhood. Males were mainly affected (male to female ratio, 1.7:1). Most burns occurred in the summer, probably due to older children’s increased outdoor activities during school vacations. Most of the injuries t...

  13. [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. PMID:21991218

  14. Burn healing plants in Iranian Traditional Medicine

    OpenAIRE

    Sh. Fahimi; H. Hajimehdipoor; Abdollahi, M.; S.A. Mortazavi

    2015-01-01

    Burns are known as one of the most common forms of injury with devastating consequences. Despite the discovery of several antiseptics, burn wound healing has still remained a challenge to modern medicine. Herbal products seem to possess moderate efficacy with no or less toxicity and are less expensive compared to synthetic drugs. Burn is a well-known disorder in Iranian Traditional Medicine (ITM). Iranian physicians have divided burns into various types based on the cause and recommended trea...

  15. Burn wound: How it differs from other wounds?

    OpenAIRE

    Tiwari, V K

    2012-01-01

    Management of burn injury has always been the domain of burn specialists. Since ancient time, local and systemic remedies have been advised for burn wound dressing and burn scar prevention. Management of burn wound inflicted by the different physical and chemical agents require different regimes which are poles apart from the regimes used for any of the other traumatic wounds. In extensive burn, because of increased capillary permeability, there is extensive loss of plasma leading to shock wh...

  16. Effects of glutamine combined with panthenol on intestinal injury in burned canis familiaris%谷氨酰胺联合泛醇对烧伤家犬肠道损伤的影响及机制研究

    Institute of Scientific and Technical Information of China (English)

    王裴; 赵云; 戚华兵; 彭曦; 尤忠义; 汪仕良

    2012-01-01

    目的 观察应用谷氨酰胺、泛醇及其复方制剂对减轻烧伤家犬肠道损伤的疗效并探讨其机制.方法 采用30%体表面积Ⅲ度烧伤家犬模型,动物随机分为正常对照、烧伤对照、泛醇、谷氨酰胺、泛醇+谷氨酰胺5个组,每组6只家犬,观察伤后7 d各组动物肠道损伤和修复指标.结果 烧伤家犬乙酰胆碱、肠黏膜蛋白含量明显降低,血浆二胺氯化酶(DAO)含量和损伤指数则明显增高(P<0.05),给予谷氨酰胺、泛醇以及复方药物均可明减轻烧伤后肠道损伤,降低血浆DAO活性和黏膜损伤指数(P<0.05);给予泛醇则能明显增加乙酰胆碱合成.与单方组相比,复方制剂组上述各项指标均明显优于单方组.结论 烧伤后肠道损伤明显,给予谷氨酰胺能明显减轻肠道损伤,给予泛醇能明显促进乙酰胆碱合成,促进胃肠运动,复方制剂疗效明显优于单方.%Objective To observe the effects of glutamine , panthenol and its compound preparation on lessening intestinal injury in burned canis familiaris . Methods Thirty canis familiaris were randomly divided into five groups , i. e. normal control ( C) group, burn control (B) group, glutamine group , panthenol group and its compound preparation group. Burned canis familiaris were inflicted with 30% TBSA full thickness burn injury. Observe the intestinal injury and repair post burn 7 d. Results After burn injury , the activity of plasma diamine oxidase (DAO) , intestine mucosal damage index were significantly higher , and the contents of intestine mucosal protein and plasma acetylcholine were remarkable decrease than those of C group (P < 0. 05 ). Compare with B group , the activity of plasma DAO, intestine mucosal damage index were markedly decreased in glutamine group , and the plasma acetylcholine contents was significantly increased in panthenol group . Compare with simple recipe group , there were more conspicuous therapeutic effect on compound preparation

  17. Epidemiological investigation of hospitalized children with burn injuries in a hospital of Fuzhou%福州某医院烧伤住院患儿流行病学调查

    Institute of Scientific and Technical Information of China (English)

    李琳; 林仁琴; 许乐; 潘琼; 戴嘉喜; 江美云; 陈昭宏

    2016-01-01

    伤后2h内入院者为主,占79.7%(1 121/1 407).烧伤后在现场以看护者脱去患儿衣物者或未行任何处理居多.本组患儿主要在入院后2周内出院(80.0%,1 126/1 407),热液烫伤、火焰烧伤、电烧伤、高温固体烫伤、化学烧伤引起的烧伤患儿住院天数比较,差异明显(X 2=17.33,P=0.002).本组患儿主要采取非手术治疗方式,最终大部分患儿好转或痊愈出院. 结论 笔者单位烧伤住院患儿主要为幼儿期男童室内热液烫伤,多集中于夏季用餐及洗澡时间,因此需大力普及烧伤预防知识.%Objective To analyze the epidemiological characteristics of hospitalized children with burn injuries in Fujian Medical University Union Hospital,so as to provide evidence to complete an adequate,timely,and effective prevention and treatment system of children with burn injuries.Methods Medical records of children with burn injuries,aged 14 and under,hospitalized in the Department of Burns from July 2012 to June 2015 were collected.Data of gender and age,location and cause of injury,time of injury,state of injury,admission time after injury,first aid,length of hospital stay,and treatment and so on were recorded.They were divided into 4 age brackets:less than or equal to 1 year old,more than 1 year old and less than or equal to 3 years old,more than 3 years old and less than or equal to 7 years old,more than 7 years old and less than or equal to 14 years old,then gender and cause of injury of children in the 4 age brackets were analyzed.Admission months of the children were divided into spring (March to May),summer (June to August),autumn (September to November) and winter (December to February of the following year),and then the cause of injury of children in each season was analyzed.Severities of male and female children,length of hospital stay of children with different causes of injury were analyzed.Data were processed with chi-square test,Wilcoxon rank-sum test.Results Out of 2 608

  18. Sedation and Analgesia in Burn

    Directory of Open Access Journals (Sweden)

    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

  19. Cognitive emotion regulation strategies and neuroticism in relation to depressive symptoms following burn injury: a longitudinal study with a 2-year follow-up

    NARCIS (Netherlands)

    Van Loey, N.E.E.; Oggel, A.; Goemanne, A.S.; Braem, L.; Vanbrabant, L.; Geenen, R.

    2014-01-01

    Sustaining burns is considered a stressful life event that has the power to elicit depressive symptoms. This study aimed to identify predictors of depressive symptoms by investigating the role of demographic variables, the number of operations (burn severity), neuroticism, and cognitive emotion regu

  20. Epidemiology of major burns at the Lebanese Burn Center in Geitawi, Lebanon

    OpenAIRE

    Ghanimé, G.; Rizkallah, N.; Said, J.M.

    2013-01-01

    Burn care is one of the few areas in medicine considered both medically and surgically challenging, with burn injuries affecting people of all ages and both sexes. Between May 1992 and March 2012, 1,524 patients were admitted to the Lebanese Burn Center in Geitawi, with an average length of stay (LOS) of 36.5 days. The most frequently encountered injuries were thermal burns, generally resulting from domestic accidents. Of our patients, 47% were from rural areas and burned body surface (BBS) w...

  1. 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

    2003-01-01

    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 grou

  2. Burns and beauty nails

    Science.gov (United States)

    Bélanger, Richard E; Marcotte, Marie-Eve; Bégin, François

    2013-01-01

    A case involving a five-month-old girl brought to the emergency department with burns over her abdomen is described. The child was reported to have spilled two small bottles of beauty nail adhesive on her clothes while her mother was preparing dinner. After undressing the infant, the mother discovered several lesions on the child’s abdomen and quickly sought medical attention. Given the unusual circumstances of the presentation, the child was hospitalized for both treatment and supervision. The beauty nail adhesive contained cyanoacrylate. In addition to its well-appreciated adhesive capacity, cyanoacrylate, in the presence of cotton or other tissues, is known to produce an exothermic reaction that may cause burns. Cyanoacrylate-based products, due to their possible adverse effects, should be kept away from children as advised. Odd injuries should always raise concerns about the possibility of inflicted injury. PMID:24421671

  3. BARC solution for burn injuries

    CERN Multimedia

    2003-01-01

    The Bhabha Atomic Research Centre (BARC), has developed Hydrogel which is expected to be mass marketed soon in India. Dr Anil Kakodkar, Chairman of Atomic Energy Commission, said the product not only heals the wound, but also eliminates scars (1/2 page).

  4. Epidemiology of U.K. military burns.

    Science.gov (United States)

    Foster, Mark Anthony; Moledina, Jamil; Jeffery, Steve L A

    2011-01-01

    The authors review the etiology of U.K. military burns in light of increasing hybrid warfare. Analysis of the nature of these injured personnel will provide commanders with the evidence to plan for on-going and future operations. Case notes of all U.K. Armed Forces burn injured patients who were evacuated to the Royal Centre for Defence Medicine were reviewed. Demographics, burn severity, pattern, and mortality details were included. There were 134 U.K. military personnel with burns requiring return to the United Kingdom during 2001-2007. The median age was 27 (20-62) years. Overall, 60% of burns seen were "accidental." Burning waste, misuse or disrespect of fuel, and scalds were the most prevalent noncombat burns. Areas commonly burned were the face, legs, and hands. During 2006-2007 in the two major conflicts, more than 59% (n = 36) of the burned patients evacuated to the United Kingdom were injured during combat. Burns sustained in combat represent 5.8% of all combat casualties and were commonly associated with other injuries. Improvised explosive device, minestrike, and rocket-propelled grenade were common causes. The mean TBSA affected for both groups was 5% (1-70). The majority of combat burn injuries have been small in size. Greater provision of flame retardant equipment and clothing may reduce the extent and number of combat burns in the future. The numbers of noncombat burns are being reduced by good military discipline. PMID:21422938

  5. Psychological Aspects of Paediatric Burns (A Clinical Review)

    OpenAIRE

    A Sousa

    2010-01-01

    Burn injuries in childhood can be traumatic with lasting effects until adulthood. This article reviews the various psychological issues one confronts when treating paediatric patients with burn injuries. A wide range of factors influence recovery and rehabilitation from paediatric burns. The role of family members, family dynamics, parental reactions, parental psychiatric illness, and pre-morbid psychiatric illness in the child are important factors. The entire family and the burned child hav...

  6. Epidemiologic Characteristics of Occupational Burns in Yazd, Iran

    OpenAIRE

    Seyyed Jalil Mirmohammadi; Amir Houshang Mehrparvar; Kazem Kazemeini; Mehrdad Mostaghaci

    2013-01-01

    Objective: Occupational burns are among the important causes of work-related fatalities and absenteeism. Epidemiologic assessment of these injuries is important to define high-risk jobs. We designed this study to evaluate the epidemiology of occupational burns in Yazd, an industrial province in Iran. Methods: This is a prospective study on work-related burns in a 1-year period (2008-2009). A questionnaire was completed for them about the characteristics of the burn injury. Results: Th...

  7. Soluble urokinase-type plasminogen activator receptor levels in patients with burn injuries and inhalation trauma requiring mechanical ventilation: an observational cohort study

    OpenAIRE

    Backes, Yara; van der Sluijs, Koenraad F; Tuip de Boer, Anita M; Hofstra, Jorrit Jan; Vlaar, Alexander PJ; Determann, Rogier M; Knape, Paul; David P Mackie; Schultz, Marcus J.

    2011-01-01

    Introduction Soluble urokinase-type plasminogen activator receptor (suPAR) has been proposed as a biologic marker of fibrinolysis and inflammation. The aim of this study was to investigate the diagnostic and prognostic value of systemic and pulmonary levels of suPAR in burn patients with inhalation trauma who need mechanical ventilation. Methods suPAR was measured in plasma and nondirected lung-lavage fluid of mechanically ventilated burn patients with inhalation trauma. The samples were obta...

  8. Burns: an update on current pharmacotherapy

    Science.gov (United States)

    Rojas, Yesinia; Finnerty, Celeste C.; Radhakrishnan, Ravi S.; Herndon, David N.

    2013-01-01

    Introduction The world-wide occurrence of burn injuries remains high despite efforts to reduce injury incidence through public awareness campaigns and improvements in living conditions. In 2004, almost 11 million people experienced burns severe enough to warrant medical treatment. Advances over the past several decades in aggressive resuscitation, nutrition, excision, and grafting have reduced morbidity and mortality. Incorporation of pharmacotherapeutics into treatment regimens may further reduce complications of severe burn injuries. Areas covered Severe burn injuries, as well as other forms of stress and trauma, trigger a hypermetabolic response that, if left untreated, impedes recovery. In the past two decades, use of anabolic agents, beta adrenergic receptor antagonists, and anti-hyperglycemic agents has successfully counteracted post-burn morbidities including catabolism, the catecholamine-mediated response, and insulin resistance. Here we review the most up-to-date information on currently used pharmacotherapies in the treatment of these sequelae of severe burns and the insights that have expanded our understanding of the pathophysiology of severe burns. Expert opinion Existing drugs offer promising advances in the care of burn injuries. Continued gains in our understanding of the molecular mechanisms driving the hypermetabolic response will enable the application of additional existing drugs to be broadened to further attenuate the hypermetabolic response. PMID:23121414

  9. Rehabilitation of the burn patient

    Directory of Open Access Journals (Sweden)

    Procter Fiona

    2010-10-01

    Full Text Available Rehabilitation is an essential and integral part of burn treatment. It is not something which takes place following healing of skin grafts or discharge from hospital; instead it is a process that starts from day one of admission and continues for months and sometimes years after the initial event. Burns rehabilitation is not something which is completed by one or two individuals but should be a team approach, incorporating the patient and when appropriate, their family. The term ′Burns Rehabilitation′ incorporates the physical, psychological and social aspects of care and it is common for burn patients to experience difficulties in one or all of these areas following a burn injury. Burns can leave a patient with severely debilitating and deforming contractures, which can lead to significant disability when left untreated. The aims of burn rehabilitation are to minimise the adverse effects caused by the injury in terms of maintaining range of movement, minimising contracture development and impact of scarring, maximising functional ability, maximising psychological wellbeing, maximising social integration

  10. Methods and Procedures in the rescue of burn injury patients in the bus rapid transit (BRT) bomb blasts case in Xiamen%厦门公交车纵火案烧伤伤员救治的护理管理

    Institute of Scientific and Technical Information of China (English)

    黄榕; 殷婷婷; 卓龙彩; 夏哲远; 孔悦

    2013-01-01

    目的:探讨批量烧伤伤员救治的方法与程序。方法:迅速启动批量伤员救治应急预案,准备各种抢救物资,合理分配人员,高效实施救治,积极应对突发公共卫生事件。结果:18名患者平稳度过休克期,救治工作取得阶段性成果。结论:有效的救护管理体系可以在突发公共卫生事件中发挥重要作用。%Objective:To explore the methods and procedures in the rescue of mass patients with burn injuries. Methods:The emergency preparedness which included the preparation of medical supplies, rational division of nursing staff, and effective treatment were carried out to respond positively to the public health emergencies. Results:Eighteen burn injury patients passed the shock stage smoothly and signiifcant results were achieved. Conclusion:The effective ifrst aid system plays a major role in public health emergencies.

  11. 烧伤临床营养新理念:从营养支持到营养治疗%A new concept of nutrition in treatment of burn injury:from nutrition support to nutrition therapy

    Institute of Scientific and Technical Information of China (English)

    彭曦; 汪仕良

    2011-01-01

    For many years,the major concerns in the treatment of a major burn injury have always been shock resuscitation,infection control,and wound treatment,while nutrition has been considered as a subordinate concern.The concept of nutrition in the treatment of a major burn has been recognized as “nutrition support”,only with the purpose of restraining negative nitrogen balance through administration of energy and protein,in order to prevent malnutrition in patients with severe burn.In recent 10 years,however,increasing evidences have showed that optimal nutritional management could improve the outcome of severe burn patients.Now it is recognized that nutrition is not only to provide exogenous nutrients to improve nutritional status of the patients,but also to regulate celI metabolism,enhance cell activity,maintain and uphold the structure and function of the gastrointestinal mucosa,thus to improve patient's outcome.Therefore,the term of “nutrition support”seems to be far from comprehensiveness to reflect the purpose and the aim of this important treatment strategy.Medical literatures especially those in nutritional guidelines have begun to use the term of “nutrition therapy” instead of “ nutrition support”,which typifies the changes in nutritional concept,aim,means,and clinical evaluation.The aim of nutrition has changed from simply “providing nutritional substrate and improving nutritional status of patients” to “ regulating cell metabolism,maintaining organ structure and function,and ultimately improving outcome of patient”.Meanwhile,nutritional means has been more consummate,including special nutrients,hormones,and growth factors,in addition to use of conventional nutrients,in order to enhance therapeutic effect of nutrition in treatment of massive burn injury.Burn nutrition is no longer confined to maintenance of positive nitrogen balance,it should also consider the regulation of cell activity,metabolic status,immune and organ function

  12. Burning Issue: Handling Household Burns

    Science.gov (United States)

    ... take steps to avoid household burns. Never leave cooking food unattended on the stove. Set your water heater’s thermostat to 120 °F or lower to prevent scalding burns. And install smoke alarms on every floor of your home. Keep yourself and your family safe from unexpected ...

  13. Treatment of radiation burns, 1987 [videorecording

    International Nuclear Information System (INIS)

    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

  14. Protect the Ones You Love: Burns Safety

    Science.gov (United States)

    ... Recreational Safety Child Abuse and Neglect Prevention Youth Violence Prevention ... keep our children safe and secure and help them live to their full potential. Knowing how to prevent leading causes of child injury, like burns, is a step ...

  15. Nutrition and Metabolic Support in Burn

    Directory of Open Access Journals (Sweden)

    Perihan Ergin Özcan

    2011-07-01

    Full Text Available Burn injury results in a dramatic increase of the basal metabolic rate. Severe burn injury nearly doubles resting energy expenditure and hypermetabolism associated with burn results in a loss of body fat stores and a loss of visceral and structural protein mass. The clinical effects of these changes include immunosuppression, delayed wound healing, and generalized muscle weakness. Post burn, the metabolic and catabolic responses are prolonged in severity and time course, lasting weeks to months in contrast to the days and weeks observed in other injuries. Nutrition support provides the substrates and nutrients to prevent the complications of deficiencies as well as supporting wound healing, and recovery from hormonal and metabolic abnormalities after thermal injury. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 21-5

  16. Incidence of cardiac events in burned patients.

    Science.gov (United States)

    Meyers, David G; Hoestje, Sara M; Korentager, Richard A

    2003-06-01

    Given the increased level of adrenergic stimulation in burn patients, it would be expected that they would experience an increased incidence of cardiac arrhythmias and other cardiac events. We performed a retrospective chart review of 56 acute burn patients matched by age, length of hospital stay, and sex to 56 trauma patients, all of whom had been continuously monitored electrocardiographically. Burn and trauma patients were similar in injury severity, admission laboratory values, and prior history of cardiopulmonary diseases. Arrhythmias were noted in 34% of burn patients and 28% of trauma patients. One myocardial infarction and six deaths occurred in burn patients. No myocardial infarctions or deaths were observed in trauma patients. A past history of cardiopulmonary disease increased the risk of myocardial infarction or death by 6.6 times. Cardiac arrhythmias and other events are relatively infrequent and benign in burn patients and are similar to those experienced by other patients with acute injuries. PMID:12781616

  17. Cheiloplasty in Post-burn Deformed Lips

    OpenAIRE

    Saadeldeen, W.M.

    2009-01-01

    The lip is a part of the face that is frequently affected by burn injury. Post-burn scar sequelae in this area often result in cosmetic disfigurement and psychological upsets in patients, especially young adult females. A burn destroys the aesthetic features and lines of the lip. Plastic and reconstructive surgery of the face has a long history. Many local and regional flaps have been used for reconstruction of surgical or traumatic defects. Procedures to enhance the cosmetic features of the ...

  18. Neuroendocrine Stress Response after Burn Trauma

    OpenAIRE

    Lindahl, Andreas

    2013-01-01

    Some aspects of the stress response during acute intensive care for severe burns are described and quantified by measuring hormonal and neuroendocrine patterns and relating these to organ function in the short term. This includes an assessment of whether there are markers for the severity of stress that are better than conventional descriptors of the severity of a burn in predicting failing organ function. P-CgA after a major burn injury is an independent and better predictor of organ dysfunc...

  19. Intensive Care Management in Pediatric Burn Patients

    Directory of Open Access Journals (Sweden)

    Ayşe Ebru Sakallıoğlu Abalı

    2011-07-01

    Full Text Available Burn injury is still a leading cause of morbidity and mortality in children. This article aimed to review the current principles of management from initial assessment to early management and intensive care for pediatric burn patients. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 62-9

  20. A ring burn--electric or contact?

    Science.gov (United States)

    Attalla, M F; el-Ekiabi, S; Al-Baker, A

    1990-02-01

    A circumferential band of deep burn affecting the ring finger sustained by a car electrician is presented. Although it was caused by short circuiting the car battery by a metal spanner and the ring he was wearing, the injury was purely a contact burn. PMID:2322399

  1. 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...

  2. Burning Mouth Syndrome

    Science.gov (United States)

    ... OralHealth > Topics > Burning Mouth Syndrome > Burning Mouth Syndrome Burning Mouth Syndrome Main Content Key Points Symptoms Diagnosis Primary and Secondary BMS Treatment Helpful Tips Key Points Burning mouth syndrome is burning pain in the mouth that may ...

  3. 广州市中小学生烧烫伤影响因素病例对照分析%A matched case-control study on the risk factors of burn injury among primary and secondary school students in Guangzhou

    Institute of Scientific and Technical Information of China (English)

    刘伟佳; 刘伟; 林汉生; 张维蔚; 林蓉; 麦锦城; 何秀芳; 杜琳

    2010-01-01

    Objective To investigate the relative factors of burn injury among primary and secondary school students in Guangzhou and to provide scientific evidence for intervention.Methods 1:1 case-control study was conducted in 428 cases and 428 controls based on different sex and classes. The relationship between relative factors and burn injury was analyzed by univariate and multivariate conditional logistic regression. Results Following facts were discovered: burn injury mainly occurred in the upper limbs (57.9%), home was the place that most of burn injury (58.2%)took place, 51.0% of the burn injuries was caused by hot liquid, 43.9% burn injury needed medical treatment and 7.7% burn injury left with sequelae as dysfunction or disability. Data from the multivariate conditional logistic regression showed that boarding students (OR=2.47), older age of the mothers (OR=1.03), non-nuclear family (OR=1.25-1.84) were risk factors of burn injury.Being the only child (OR=0.60), having sufficient time for sleep (OR=0.84), good performance record (OR=0.85), higher maternal education background were protective factors on burn injury.Conclusion Among primary and secondary school students in Guangzhou, burn injury mainly occurred in the upper limbs, and home was the place that most of burn injury took place.%目的 探讨广州市中小学生烧烫伤发生的影响因素.方法 采用整群随机抽样方法,在广州市区县中小学按性别、班级1∶1配对原则,选择428对烧烫伤病例和对照组,采用单因素和多因素条件logistic回归分析.结果 广州市中小学生烧烫伤发生主要部位是上肢(57.9%),主要发生地点是家中(58.2%).51.0%烧烫伤是热水导致的;43.9%的烧烫伤需要医疗单位处理;7.7%伤后留下后遗症(活动不如往常、功能受限、致残).多因素分析结果显示,住宿生(OR=2.47)、母亲年龄大(OR=1.03)、非核心家庭(OR=1.25~1.84)等是烧烫伤发生的影响因素.独生子女(OR=0.60)

  4. Oral rehydration solutions for burn management in the field and underdeveloped regions: a review

    OpenAIRE

    Vyas, Krishna S; Wong, Lesley K

    2013-01-01

    Burn injuries are the fourth most common type of trauma worldwide, and the appropriate care of burn injuries in resource-limited settings such as the battlefield, underdeveloped nations, or in mass casualtiesremains a significant challenge. Rehydration constitutes the primary treatment of the systemic effects of burns and is a major factor in patient recovery. The standard of care for the replenishment of fluid and electrolyte losses in burn injury remains intravenous fluid therapy, but oral ...

  5. Burns in Tanzania: Morbidity and Mortality, Causes and Risk Factors: A Review.

    OpenAIRE

    Outwater, Anne H; Ismail, Hawa; Mgalilwa, Lwidiko; Justin Temu, Mary; Mbembati, Naboth A

    2013-01-01

    Burn injuries in low and middle income countries still remain a significant health problem, even though numbers of burn injuries in high income countries have decreased showing that such events are not “accidents” but are usually preventable. WHO states that the vast majority (over 95%) of fire-related burns occur in low and middle income countries. Burn injuries are a major cause of prolonged hospital stays, disfigurement, disability, and death in Africa Region. Evidence shows that preventio...

  6. Assessment of Substances Abuse in Burn Patients by Using Drug Abuse Screening Test

    OpenAIRE

    Kobra Gaseminegad; Bita Kamranfar; Parviz Nemazi; Faride Ahrari; Jaber Musavi; Kamran As'adi; Seyed Hamid Salehi; Somaie Faramarzi; Saeed Shoar

    2012-01-01

    There has been an increase in the frequency of substance abuse among hospitalized burn injury patients. However, few studies have investigated substance abuse among burn patients. This study was aimed to identify the incidence of substance abuse in burn injury patients using the "Drug Abuse Screening Test" (DAST-20). We determined the validity of DAST-20 in spring 2010. Subsequently, this descriptive study was performed on 203 burn injury patients who fit the study's inclusion criteria. We ch...

  7. An Epidemiologic Survey on Burns in Yazd from 2008 till 2009

    OpenAIRE

    Negar Delbari; Kazem Kazemeini; Mohammad Jalilmanesh; Amir Houshang Mehrparvar; Seyed Jalil Mirmohammadi; Mehrdad Mostaghaci

    2012-01-01

    Burns are injuries which may require long hospitalization and may result in important impairment and disability. Burn injuries are still common especially in developing countries. Assessment of the epidemiology of burns is very important for introduction of preventive methods. This study was conducted in Yazd to assess and describe the epidemiology of burns including its main causes, and its demographics. In a prospective study during a 1 year period, we assessed the epidemiology of burns in ...

  8. Complicated Burn Resuscitation.

    Science.gov (United States)

    Harrington, David T

    2016-10-01

    More than 4 decades after the creation of the Brooke and Parkland formulas, burn practitioners still argue about which formula is the best. So it is no surprise that there is no consensus about how to resuscitate a thermally injured patient with a significant comorbidity such as heart failure or cirrhosis or how to resuscitate a patient after an electrical or inhalation injury or a patient whose resuscitation is complicated by renal failure. All of these scenarios share a common theme in that the standard rule book does not apply. All will require highly individualized resuscitations. PMID:27600129

  9. Epidemiological Analysis of 483 cases of Work Injury Patients Caused by Burn%483例烧伤所致工伤患者的流行病学分析

    Institute of Scientific and Technical Information of China (English)

    纪雪亮; 李建新; 易先锋; 蓝蔚; 陈胜; 涂荣梅; 刘衍智

    2014-01-01

    Objective To provide epidemiologic information of burns for clinical studies and industrial prevention. Methods Collected 483 burn patients admitted in our department from January 2010 to December 2012. They were work injury patients. The clinical data of them were analyzed retrospectively mainly on the distribution of sex, age, the nature of employer, occupation, the intensity of labor, protection, injuries, treatment and prognosis. Results The male to female ratio was 5.71:1 in burn patients who were industrial injury patients. The young is the highest proportion. The injury patients from the private enterprise were the most. Most of the patients come from the front work. The main cause is the lfame, hot object, electrical and thermal lfuid. There were a lot of deifciencies in prevention and emergency measures. The date of hospitalization was long, and the cost of treatment was high. But the prognosis was poor. Conclusion There was a lack of protection for burn occurred in the work. But the consequences were serious. So we must strengthen the safety propaganda, improve the protection measures. And the relevant departments must strengthen supervision.%目的:为临床研究和工伤预防提供有效的烧伤流行病资料。方法回顾性分析2010年1月至2012年12月期间我院收治工伤职工中的483例烧伤患者,分析其性别和年龄分布、单位性质、工伤职工职业分布、劳动强度差异、防护情况、受伤情况、诊治经过和转归情况。结果工伤职工中烧伤患者男女比例为5.71∶1,中青年占据的比例最高。私营企业的工伤职工最多。大部分患者来自于一线工作岗位,病因多为火焰、热物体、电及热液;其预防、急救措施存在着不足。患者住院日期长、治疗费用高、转归情况较差。结论发生在工作中的烧伤防护不足、后果严重,需要加强安全宣传、完善保护措施及有关部门的监管力度。

  10. Protect the Ones You Love From Burns

    Centers for Disease Control (CDC) Podcasts

    2008-12-10

    This podcast, developed as part of the Protect the Ones You Love initiative, discusses steps parents can take to help protect their children from burns, one of the leading causes of child injury.  Created: 12/10/2008 by National Center for Injury Prevention and Control (NCIPC).   Date Released: 12/10/2008.

  11. Micafungin Concentrations in the Plasma and Burn Eschar of Severely Burned Patients

    OpenAIRE

    Sasaki, Junichi; Yamanouchi, Satoshi; Kudo, Daisuke; Endo, Tomoyuki; Nomura, Ryosuke; Takuma, Kiyotsugu; Kushimoto, Shigeki; Shinozawa, Yotaro; Kishino, Satoshi; Hori, Shingo; Aikawa, Naoki

    2012-01-01

    Micafungin concentrations in plasma and burn eschar after daily intravenous infusion (1 h) of micafungin (200 to 300 mg) were investigated for six patients with severe burns. Micafungin treatment was initiated more than 72 h after the burn injuries. The peak and trough levels in the plasma after the initial administration and repeated administrations for more than 4 days were comparable with or slightly lower than the reported values for healthy volunteers. Micafungin concentrations in the pl...

  12. ISBI Practice Guidelines for Burn Care.

    Science.gov (United States)

    Isbi Practice Guidelines Committee

    2016-08-01

    Practice guidelines (PGs) are recommendations for diagnosis and treatment of diseases and injuries, and are designed to define optimal evaluation and management. The first PGs for burn care addressed the issues encountered in developed countries, lacking consideration for circumstances in resource-limited settings (RLS). Thus, the mission of the 2014-2016 committee established by the International Society for Burn Injury (ISBI) was to create PGs for burn care to improve the care of burn patients in both RLS and resource-abundant settings. An important component of this effort is to communicate a consensus opinion on recommendations for burn care for different aspects of burn management. An additional goal is to reduce costs by outlining effective and efficient recommendations for management of medical problems specific to burn care. These recommendations are supported by the best research evidence, as well as by expert opinion. Although our vision was the creation of clinical guidelines that could be applicable in RLS, the ISBI PGs for Burn Care have been written to address the needs of burn specialists everywhere in the world. PMID:27542292

  13. From Cholera to Burns: A Role for Oral Rehydration Therapy

    OpenAIRE

    Milner, S. M.; Green, W.B.; Asuku, M.E.; M. Feldman; 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 alt...

  14. CASE REPORT Playing Football Burns More Than Just Calories

    OpenAIRE

    Wain, Richard A. J.; Shah, Syed H. A.

    2010-01-01

    Objective: To highlight the case of a sports-related alkali burn due to a common household chemical and emphasize the importance of a detailed medical history in chemical burns patients. Methods: A single-patient case study is presented along with references from existing literature. Results: Alkaline burn injuries associated with sports have previously been described in the literature; however, this case demonstrates an unusual presentation of a chemical burn with a readily available househo...

  15. Bacteremia in burned patients admitted to Sina Hospital, Tabriz, Iran

    OpenAIRE

    Parviz Saleh; Hamid Noshad

    2014-01-01

    Introduction: One of the most important causes of mortality and morbidity in burn wards is infection, and it is the major reason of death in burn injuries. There are several reasons that make burn victims predisposed to infection. The current study aimed to investigate the role of different factors that have an effect on bacteremia occurrence in burn patients and factors which are relevant to mortality in these patients. Methods: This descriptive-analytic study conducted in a 1...

  16. Posttraumatic Stress and Cognitive Processes in Patients with Burns

    OpenAIRE

    Sveen, Josefin

    2011-01-01

    A severe burn is one of the most traumatic injuries a person can experience. Posttraumatic stress disorder (PTSD) is relatively common after burns, and can be devastating for the individual’s possibilities for recovery. The principal aims were to gain knowledge regarding posttraumatic stress symptoms and cognitive processes after burn and to evaluate methods for assessing symptoms of PTSD up to one year after burn. The psychometric properties of a Swedish version of the Impact of Event Scale-...

  17. Unusual explosive growth of a squamous cell carcinoma of the scalp after electrical burn injury and subsequent coverage by sequential free flap vascular connection – a case report

    International Nuclear Information System (INIS)

    Squamous cell carcinomos may arise from chronic ulcerating wounds in scars, most commonly postburn scars. Tumour growth usually takes place over months to years. Localization on the scalp is a relatively rare condition. This report presents the case of a 63-year-old man with chronic ulceration of a postburn scar of the scalp due to an electrical burn 58 years ago. Sudden tumour growth started within weeks and on presentation already had extended through the skull into frontal cortex. After radical tumour resection, defect was covered with a free radial forearm flap. Local recurrence occurred 6 weeks later. Subsequent wide excision including discard of the flap and preservation of the radial vessels was followed by transfer of a free latissimus dorsi muscle flap, using the radial vessels of the first flap as recipient vessels. The patient received radiotherapy post-operatively. There were no problems with flap survivals or wound healing. Due to rapidly growing recurrence the patient died 2 months later. Explosive SCC tumour growth might occur in post-burn scars after more than 50 years. As a treatment option the use of sequential free flap connections might serve in repeated extensive tumour resections, especially in the scalp region, where suitable donor vessels are often located in distance to the defect

  18. Exercise behaviors and barriers to exercise in adult burn survivors: A questionnaire survey

    OpenAIRE

    Jennifer Baldwin; Frank Li

    2013-01-01

    Exercise is a key component of burn rehabilitation across all phases of care. Supervised outpatient exercise programs have been shown to improve outcomes following burn injury. However, little is known about the exercise behaviors of burn survivors who do not undertake such programs. This study aimed to investigate self-reported exercise behaviors and barriers to exercise in adult burn survivors. A short questionnaire survey was conducted on adult burn survivors attending the ambulatory burns...

  19. Burn wounds infected with Pseudomonas aeruginosa triggers weight loss in rats

    OpenAIRE

    Su Grace; Lehnhardt Marcus; Jacobsen Frank; Fan Ming H; Burkhard Olaf; Steinstraesser Lars; Daigeler Adrien; Steinau Hans U; Remick Daniel; Wang Stewart C

    2005-01-01

    Abstract Background Despite dramatic improvements in the management of burns, infection still remains a serious risk for the burn patient. The aim of this study was to shed light on the impact of acute burn injury with or without infection on cytokine profiles. Methods Sprague-Dawley rats (n = 21) were randomized into three groups: 1) burn only 2) burn and infection or 3) sham burn. Weight was monitored and blood was collected for cytokine ELISA, LPS quantification, and peripheral blood analy...

  20. Comparative Study Between Sodium Carboxymethyl-Cellulose Silver, Moist Exposed Burn Ointment, and Saline-Soaked Dressing for Treatment of Facial Burns

    OpenAIRE

    Hindy, A.

    2009-01-01

    Facial burns vary from relatively minor insults to severe debilitating injuries. Sustaining a burn injury is often a psychological trauma for the victim and is especially menacing when the face and neck are involved. This study was carried out on 60 patients with superficial dermal burns to the face admitted to the Burn Unit of Tanta University Hospital, Egypt, from September 2007 to July 2008. The patients were allocated randomly to one of three groups, each of which was treated with one of ...

  1. MORBIDITY AND SURVIVAL PROBABILITY IN BURN PATIENTS IN MODERN BURN CARE

    Science.gov (United States)

    Jeschke, Marc G.; Pinto, Ruxandra; Kraft, Robert; Nathens, Avery B.; Finnerty, Celeste C.; Gamelli, Richard L.; Gibran, Nicole S.; Klein, Matthew B.; Arnoldo, Brett D.; Tompkins, Ronald G.; Herndon, David N.

    2014-01-01

    Objective Characterizing burn sizes that are associated with an increased risk of mortality and morbidity is critical because it would allow identifying patients who might derive the greatest benefit from individualized, experimental, or innovative therapies. Although scores have been established to predict mortality, few data addressing other outcomes exist. The objective of this study was to determine burn sizes that are associated with increased mortality and morbidity after burn. Design and Patients Burn patients were prospectively enrolled as part of the multicenter prospective cohort study, Inflammation and the Host Response to Injury Glue Grant, with the following inclusion criteria: 0–99 years of age, admission within 96 hours after injury, and >20% total body surface area burns requiring at least one surgical intervention. Setting Six major burn centers in North America. Measurements and Main Results Burn size cutoff values were determined for mortality, burn wound infection (at least two infections), sepsis (as defined by ABA sepsis criteria), pneumonia, acute respiratory distress syndrome, and multiple organ failure (DENVER2 score >3) for both children (<16 years) and adults (16–65 years). Five-hundred seventy-three patients were enrolled, of which 226 patients were children. Twenty-three patients were older than 65 years and were excluded from the cutoff analysis. In children, the cutoff burn size for mortality, sepsis, infection, and multiple organ failure was approximately 60% total body surface area burned. In adults, the cutoff for these outcomes was lower, at approximately 40% total body surface area burned. Conclusions In the modern burn care setting, adults with over 40% total body surface area burned and children with over 60% total body surface area burned are at high risk for morbidity and mortality, even in highly specialized centers. PMID:25559438

  2. 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. PMID:25687835

  3. A clarion to recommit and reaffirm burn rehabilitation.

    Science.gov (United States)

    Richard, Reginald L; Hedman, Travis L; Quick, Charles D; Barillo, David J; Cancio, Leopoldo C; Renz, Evan M; Chapman, Ted T; Dewey, William S; Dougherty, Mary E; Esselman, Peter C; Forbes-Duchart, Lisa; Franzen, Beth J; Hunter, Hope; Kowalske, Karen; Moore, Merilyn L; Nakamura, Dana Y; Nedelec, Bernedette; Niszczak, Jon; Parry, Ingrid; Serghiou, Michael; Ward, R Scott; Holcomb, John B; Wolf, Steven E

    2008-01-01

    Burn rehabilitation has been a part of burn care and treatment for many years. Yet, despite of its longevity, the rehabilitation outcome of patients with severe burns is less than optimal and appears to have leveled off. Patient survival from burn injury is at an all-time high. Burn rehabilitation must progress to the point where physical outcomes parallel survival statistics in terms of improved patient well-being. This position article is a treatise on burn rehabilitation and the state of burn rehabilitation patient outcomes. It describes burn rehabilitation interventions in brief and why a need is felt to bring this issue to the forefront. The article discusses areas for change and the challenges facing burn rehabilitation. Finally, the relegation and acceptance of this responsibility are addressed. PMID:18388581

  4. 烧伤后期特大未愈创面伴脓毒症患者的救治%Treatment of a patient with massive unhealed wound accompanied by wound sepsis in late stage after burn injury

    Institute of Scientific and Technical Information of China (English)

    李志清; 王甲汉; 吴起; 杨磊

    2012-01-01

    This article analyzed the medical records of a patient with 90% TBSA unhealed wound accompanied with wound sepsis 50 days post burn (PBD) and to discuss the ideal strategies of treatment for such patients in such condition.This was a 24-year-old male patient suffering from flame burn with 95% TBSA wound and severe inhalation injury.Meek skin grafting with autologous scalp was performed once to the thoracic and abdominal regions; intermingled skin grafting of autologous scalp microskin and large sheet of allograft was performed twice to the limbs within PBD 31.The patient was transferred to our hospital on PBD 50 with 90% TBSA wound unhealed,leaving a vast amount of necrotic tissue and allografts.Furthermore,he was complicated by sepsis,pulmonary infection,and gastric ulcer.Debridement and allogenic skin grafting were performed on the first day after hospitalization.When the condition of wounds was improved,transplantation of a large sheet of allogenic skin with inlaid small pieces of autologous skin,intermingled skin grafting of autologous and allogenic skin,and small pieces of autologous skin grafting were performed.Because of the shortage of donor area,the exposed wounds were temporarily covered with allogeneic skin.Epidermal growth factor was used to promote the healing of autologous skin donor site and deep partial-thickness bum wound.Autologous skin grafting was performed whenever source of healthy skin was available.Systemic use of effective antibiotics,nutritional support and therapy,and other comprehensive measures also contributed to the success of treatment of this patient suffering from wound sepsis.The patient was cured and discharged on PBD 145.

  5. Gram-Negative Bacterial Infection in Thigh Abscess Can Migrate to Distant Burn Depending on Burn Depth

    Directory of Open Access Journals (Sweden)

    Victoria Hamrahi

    2012-01-01

    Full Text Available Sepsis remains the major cause of death in patients with major burn injuries. In the present investigation we evaluated the interaction between burn injuries of varying severity and preexisting distant infection. We used Gram-negative bacteria (Pseudomonas aeruginosa and Proteus mirabilis that were genetically engineered to be bioluminescent, which allowed for noninvasive, sequential optical imaging of the extent and severity of the infection. The bioluminescent bacteria migrated from subcutaneous abscesses in the leg to distant burn wounds on the back depending on the severity of the burn injury, and this migration led to increased mortality of the mice. Treatment with ciprofloxacin, injected either in the leg with the bacterial infection or into the burn eschar, prevented this colonization of the wound and decreased mortality. The present data suggest that burn wounds can readily become colonized by infections distant from the wound itself.

  6. Burn-Center Quality Improvement: Are Burn Outcomes Dependent On Admitting Facilities and Is There a Volume-Outcome “Sweet-Spot”?

    OpenAIRE

    Hranjec, Tjasa; TURRENTINE, FLORENCE E.; STUKENBORG, GEORGE; Young, Jeffrey S; Sawyer, Robert G.; Calland, James F

    2012-01-01

    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 ...

  7. Burning plasmas

    Energy Technology Data Exchange (ETDEWEB)

    Furth, H.P.; Goldston, R.J.; Zweben, S.J. (Princeton Univ., NJ (USA). Plasma Physics Lab.); Sigmar, D.J. (Massachusetts Inst. of Tech., Cambridge, MA (USA))

    1990-10-01

    The fraction of fusion-reaction energy that is released in energetic charged ions, such as the alpha particles of the D-T reaction, can be thermalized within the reacting plasma and used to maintain its temperature. This mechanism facilitates the achievement of very high energy-multiplication factors Q, but also raises a number of new issues of confinement physics. To ensure satisfactory reaction operation, three areas of energetic-ion interaction need to be addressed: single-ion transport in imperfectly symmetric magnetic fields or turbulent background plasmas; energetic-ion-driven (or stabilized) collective phenomena; and fusion-heat-driven collective phenomena. The first of these topics is already being explored in a number of tokamak experiments, and the second will begin to be addressed in the D-T-burning phase of TFTR and JET. Exploration of the third topic calls for high-Q operation, which is a goal of proposed next-generation plasma-burning projects. Planning for future experiments must take into consideration the full range of plasma-physics and engineering R D areas that need to be addressed on the way to a fusion power demonstration.

  8. Care of burns in Scotland: 3-year data from the managed clinical network national registry

    OpenAIRE

    Gilhooly, Charlotte; Kinsella, John

    2014-01-01

    Introduction The Managed Clinical Network for Care of Burns in Scotland (COBIS) was launched in April 2007. Primary aims included establishing and maintaining a registry of complex burn injury in Scotland and setting mechanisms to regularly audit outcome of burn treatment against nationally agreed standards of care. On behalf of COBIS, we present 3-year incidence and mortality data of Scottish patients admitted with a complex burn injury in this abstract. Methods From January 2010 o...

  9. Epidemiology and screening of intentional burns in children in a Dutch burn centre.

    Science.gov (United States)

    Bousema, Sara; Stas, Helene G; van de Merwe, Marjolijn H; Oen, Irma M M H; Baartmans, Martin G A; van Baar, Margriet E

    2016-09-01

    International estimates of the incidence of non-accidental burns (NAB) in children admitted to burn centres vary from 1% to 25%. Hardly any data about Dutch figures exist. The aim of this study was to evaluate the incidence, treatment and outcome of burns due to suspected child abuse in paediatric burns. We described the process of care and outcome, including the accuracy of the SPUTOVAMO screening tool and examined child, burn and treatment characteristics related to suspicions of child abuse or neglect. A retrospective study was conducted in children aged 0-17 years with a primary admission after burn injuries to the burn centre Rotterdam in the period 2009-2013. Data on patient, injury and treatment characteristics were collected, using the Dutch Burn Repository R3. In addition, medical records were reviewed. In 498 paediatric admissions, suspected child abuse or neglect was present in 43 children (9%). 442 screening questionnaires (89%) were completed. In 52 out of 442 questionnaires (12%) the completed SPUTOVAMO had one or more positive signs. Significant independent predictors for suspected child abuse were burns in the genital area or buttocks (OR=3.29; CI: 143-7.55) and a low socio-economic status (OR=2.52; 95%CI: 1.30-4.90). The incidence of suspected child abuse indicating generation of additional support in our population is comparable to studies with a similar design in other countries. PMID:27211360

  10. New treatment strategies to reduce burn wound progression

    Directory of Open Access Journals (Sweden)

    Schmauss, Daniel

    2014-01-01

    Full Text Available [english] Background: After a burn injury certain superficial partial-thickness burn wounds spontaneously progress into deep partial-thickness or full-thickness burn wounds. This poorly understood phenomenon is called burn wound progression. The aim of this study was to investigate whether treatment strategies using warm water (preservation of microcirculation on the one side and erythropoietin (EPO (molecule with anti-inflammatory, anti-apoptotic, vasodilatory and neoangiogenic properties can prevent, delay and/or reduce secondary burn wound progression in a rat model.Methods: We used a burn comb model in 63 rats, creating eight rectangular contact burns (2x1 cm each intercalated by unburned zones (2x0.5 cm prone to burn wound progression. In a first experimental set we treated burn wounds with locally applied warm (37°C or cold (17°C water for 20 minutes.In a second experimental set, animals were treated systemically with EPO at two different dosages of 500 and 2,500 IU/kg bodyweight (bw and initiated at 2 different time-points (45 minutes vs. 6 hours after burn injury. Evaluation of microcirculatory perfusion, interspace necrosis and burn depth was performed using respectively laser Doppler flowmetry, planimetry and histology. For statistical analysis the two-way ANOVA-test followed by an adequate post-hoc test (Bonferroni were used. Results: In untreated control animals a conversion from superficial to full-thickness burns was observed within 24 hours. Warm and cold water treatment significantly delayed burn depth progression, nevertheless after 4 days, burn depth was similar in all three groups. Warm water significantly reduced interspace necrosis compared to untreated controls and cold water with a significantly improved perfusion in the warm water group. Surface extension and particularly burn depth progression were significantly decreased by EPO only if administered at a dosage of bw and initiated 45 minutes after burn injury. EPO

  11. HEPATIC APOPTOSIS POST-BURN IS MEDIATED BY C-JUN N-TERMINAL KINASE-2

    OpenAIRE

    Marshall, Alexandra H; Brooks, Natasha C; Hiyama, Yaeko; Qa’aty, Nour; Al-mousawi, Ahmed; Finnerty, Celeste C.; Jeschke, Marc G.

    2013-01-01

    The trauma of a severe burn injury induces a hypermetabolic response that increases morbidity and mortality. Previously, our group showed that insulin resistance post-burn injury is associated with endoplasmic reticulum (ER) stress. Evidence suggests that c-jun N-terminal kinase (JNK) -2 may be involved in ER stress-induced apoptosis. Here, we hypothesized that JNK2 contributes to the apoptotic response after burn injury downstream of ER stress. To test this, we compared JNK2 knockout mice (−...

  12. Hyperglycemia Exacerbates Burn-Induced Liver Inflammation via Noncanonical Nuclear Factor-κB Pathway Activation

    OpenAIRE

    Gabriela A. Kulp; Tilton, Ronald G.; Herndon, David N.; Jeschke, Marc G.

    2012-01-01

    Hyperglycemia and inflammation are hallmarks of burn injury. In this study, we used a rat model of hyperglycemia and burn injury to investigate the effects of hyperglycemia on inflammatory responses in the liver. Hyperglycemia was induced in male Sprague-Dawley rats with streptozotocin (STZ) (35–40 mg/kg), followed by a 60% third-degree scald burn injury. Cytokine levels (by multiplex, in cytosolic liver extracts), hormones (by enzyme-linked immunosorbent assay [ELISA], in serum), nuclear fac...

  13. Childhood burns in south eastern Nigeria

    Directory of Open Access Journals (Sweden)

    Okoro Philemon

    2009-01-01

    Full Text Available Background: Burns injuries are recognized as a major health problem worldwide. In children and, particularly, in our environment where poverty, ignorance and disease are still high, they constitute significant morbidity and mortality. Previous studies on this topic in parts of Nigeria either lumped adults and children together or were retrospective. We, therefore, prospectively studied the current trends in burns in children. Patients and Methods: This prospective study of burns spanned over a period of 18 months (June 2006-December 2007 at the Paediatric Surgery Units of the Imo State University Teaching Hospital, Orlu, and the Federal Medical Centre, Owerri, Imo State. Data were collected and analysed for age, sex, cause/type of burn, place of burn, presence or absence of adult/s, initial prehospital intervention, interval between injury and presentation, surface area and depth of burn and treatment and outcome. Results: Fifty-three patients were studied, 31 (58.4% were male and 22 (41.6% were female (M:F = 1.4:1. Patients mostly affected were aged 2 years and below. The most common cause of burns was hot water in 31 (58.5% patients. The vast majority of these injuries happened in a domestic environment (92.5% and in the presence of competent adult/s (88.7%. Outcome of treatment was good: there were two (3.8% deaths and 46 (86% patients had complete recovery. Conclusion: Burns is still a major health problem among children in south eastern Nigeria. Fortunately, outcome of appropriate treatment is good. However, we think that poor safety consciousness among parents is a major predisposing factor. Public enlightenment on measures to ensure safe home environment may be necessary to avoid or limit childhood burns.

  14. [Integration of burn treatment and rehabilitation for a child with extremely severe burn].

    Science.gov (United States)

    Li, Hongming; Zhang, Jiaping; Chen, Jian; Song, Huapei; Liu, Qiushi; Fan, Xin; Peng, Yizhi; Wu, Jun

    2015-04-01

    This article reports the successful experience of integration of burn treatment and rehabilitation for a child suffering from 91% TBSA flame burn injury (with 60% TBSA full-thickness injury, 30% TBSA deep partial-thickness injury, and 1% TBSA superficial partial-thickness injury), severe inhalation injury, severe burn shock, stress ulcer, gastrointestinal bleeding and atelectasis of the right upper lung. The patient was given effective fluid infusion against shock, treatment for gastrointestinal bleeding, and other effective supportive treatment for functions of various organs after being admitted to our burn ward. When vital signs became stable at 30 hours post injury, bedside rehabilitation was begun. On post injury day (PID) 4, escharectomy was performed for both lower limbs, followed by microskin grafting and allogeneic skin covering. On PID 10, invasive infection of multi-drug resistant bacteria was found with accompanied high fever, and at the same time allograft began to disintegrate, with dissolution of large area of eschar, leading to a raw surface reaching 86% TBSA. Following debridement, dressing, application of compound polymyxin B ointment, temporary covering of wounds with porcine acellular dermal matrix, adjustment of antibiotics, patient's condition was finally stabilized. From PID 28 on, split-thickness skin grafting was conducted 7 times, and the raw surface of 75% TBSA involving the upper and lower limbs and trunk was successfully covered. At the same time, our rehabilitation team launched comprehensive rehabilitation measures comprising active exercise, occupational therapy, prevention of scar formation, organ function training and psychological intervention. Finally, the patient was able to walk unaided and fed herself when the wounds were almost entirely healed in 3 months after injury. Oriented forwards functional rehabilitation, strong cooperation between team members, and synchronous effective implementation of burn treatment and

  15. Special considerations in paediatric burn patients

    Directory of Open Access Journals (Sweden)

    Sharma Ramesh

    2010-10-01

    Full Text Available Burn injuries are a major cause of morbidity and mortality in children. In India, the figure constitutes about one-fourth of the total burn accidents. The management of paediatric burns can be a major challenge for the treating unit. One has to keep in mind that "children are not merely small adults"; there are certain features in this age group that warrant special attention. The peculiarities in the physiology of fluid and electrolyte handling, the uniqueness of the energy requirement and the differences in the various body proportions in children dictate that the paediatric burn management should be taken with a different perspective than for adults. This review article would deal with the special situations that need to be addressed while treating this special class of thermal injuries. We must ensure that not only the children survive the initial injury, but also the morbidity and complications are minimized. If special care is taken during the initial management of paediatric burn injuries, these children can be effectively integrated into the society as very useful and productive members.

  16. Burn healing plants in Iranian Traditional Medicine

    Directory of Open Access Journals (Sweden)

    Sh. Fahimi

    2015-11-01

    Full Text Available Burns are known as one of the most common forms of injury with devastating consequences. Despite the discovery of several antiseptics, burn wound healing has still remained a challenge to modern medicine. Herbal products seem to possess moderate efficacy with no or less toxicity and are less expensive compared to synthetic drugs. Burn is a well-known disorder in Iranian Traditional Medicine (ITM. Iranian physicians have divided burns into various types based on the cause and recommended treatment for each type. According to ITM references, herbal therapy was the major treatment prescribed by Iranian physicians for burns. In the present study, seven ancient Iranian medical texts were screened for the herbs with burn healing effects along with their applied dosage forms. The medicinal herbs were listed and scored based on the frequency of their repetition. Moreover, the best scientific name that was suitable for each plant as well as surveying modern studies about their biological effects has been carried out. In our investigation eighteen plants with seven topical application categories have been obtained as the most frequent herbs for burn healing in ITM. Modern studies have revealed that these plants have shown some biological activities such as anti-inflammatory, antimicrobial and antioxidant effects which might establish the relationship between the mentioned activities and burn wound healing property. This list can provide a suitable resource for future researches in the field of burn treatment.

  17. Crusted Scabies in the Burned Patient

    DEFF Research Database (Denmark)

    Berg, Jais Oliver; Alsbjørn, Bjarne

    2011-01-01

    The objectives of this study were 1) to describe a case of crusted scabies (CS) in a burned patient, which was primarily undiagnosed and led to a nosocomial outbreak in the burn unit; 2) to analyze and discuss the difficulties in diagnosing and treating this subset of patients with burn injury; and...... 3) to design a treatment strategy for future patients. Case analysis and literature review were performed. The index patient had undiagnosed crusted scabies (sive Scabies norvegica) with the ensuing mite hyperinfestation when admitted to the department with minor acute dermal burns. Conservative...... healing and autograft healing were impaired because of the condition. Successful treatment of the burns was only accomplished secondarily to scabicide treatment. An outbreak of scabies among staff members indirectly led to diagnosis. CS is ubiquitous, and diagnosis may be difficult. This is the first...

  18. 严重烧伤后早期大鼠肾脏细胞粘附分子1和白介素6的表达与肾功能损害的相关性研究%Expression of intercellular adhesion molecule 1 and interleukin 6 in the rat's kidney after severe burn and its relation with renal injury

    Institute of Scientific and Technical Information of China (English)

    刘开军; 魏敏; 刘杰; 鲁华玉; 王德文; 张燕

    2002-01-01

    Objective To clarify the mechanism and provide the basis for prevention and treatment of the early injuries of kidney after severe burn in rats.We observed the expression of intercellular adhesion molecule 1 and interleukin 6 and the early pathological changes in different time.Method Early pathological changes in the kidney were observed by LM and EM.The expression of ICAM 1 were observed by immunohistochemistry,in situ hybridization.The expression of IL 6 was also observed.Result From 5 min to 72 h after burn,the early changes in the kidney included edema,hemorrhage, and congestion,injury of capillary epithelium cells.2ICAM 1 and IL 6 were higher in the kidney 30 min after burn,and from 2 h to 24 h,they were strongest positive,but on 72 h,they were negative.Conclusion ICAM-1 and IL 6 may play important roles in mechanisms of kidney injury,and the major target cells may be the endothelium cells.

  19. Burn wound: How it differs from other wounds?

    Directory of Open Access Journals (Sweden)

    V K Tiwari

    2012-01-01

    Full Text Available Management of burn injury has always been the domain of burn specialists. Since ancient time, local and systemic remedies have been advised for burn wound dressing and burn scar prevention. Management of burn wound inflicted by the different physical and chemical agents require different regimes which are poles apart from the regimes used for any of the other traumatic wounds. In extensive burn, because of increased capillary permeability, there is extensive loss of plasma leading to shock while whole blood loss is the cause of shock in other acute wounds. Even though the burn wounds are sterile in the beginning in comparison to most of other wounds, yet, the death in extensive burns is mainly because of wound infection and septicemia, because of the immunocompromised status of the burn patients. Eschar and blister are specific for burn wounds requiring a specific treatment protocol. Antimicrobial creams and other dressing agents used for traumatic wounds are ineffective in deep burns with eschar. The subeschar plane harbours the micro-organisms and many of these agents are not able to penetrate the eschar. Even after complete epithelisation of burn wound, remodelling phase is prolonged. It may take years for scar maturation in burns. This article emphasizes on how the pathophysiology, healing and management of a burn wound is different from that of other wounds.

  20. Burns in diabetic patients

    OpenAIRE

    Maghsoudi, Hemmat; Aghamohammadzadeh, Naser; Khalili, Nasim

    2008-01-01

    CONTEXT AND AIMS: Diabetic burn patients comprise a significant population in burn centers. The purpose of this study was to determine the demographic characteristics of diabetic burn patients. MATERIALS AND METHODS: Prospective data were collected on 94 diabetic burn patients between March 20, 2000 and March 20, 2006. Of 3062 burns patients, 94 (3.1%) had diabetes; these patients were compared with 2968 nondiabetic patients with burns. Statistical analysis was performed using the statistical...

  1. Burning Mouth Syndrome and "Burning Mouth Syndrome".

    Science.gov (United States)

    Rifkind, Jacob Bernard

    2016-03-01

    Burning mouth syndrome is distressing to both the patient and practitioner unable to determine the cause of the patient's symptoms. Burning mouth syndrome is a diagnosis of exclusion, which is used only after nutritional deficiencies, mucosal disease, fungal infections, hormonal disturbances and contact stomatitis have been ruled out. This article will explore the many causes and treatment of patients who present with a chief complaint of "my mouth burns," including symptomatic treatment for those with burning mouth syndrome. PMID:27209717

  2. Proteomics Improves the Prediction of Burns Mortality: Results from Regression Spline Modeling

    OpenAIRE

    Finnerty, Celeste C.; Ju, Hyunsu; Spratt, Heidi; Victor, Sundar; Jeschke, Marc G.; Hegde, Sachin; Bhavnani, Suresh K.; Luxon, Bruce A.; Allan R Brasier; Herndon, David N

    2012-01-01

    Prediction of mortality in severely burned patients remains unreliable. Although clinical covariates and plasma protein abundance have been used with varying degrees of success, the triad of burn size, inhalation injury, and age remains the most reliable predictor. We investigated the effect of combining proteomics variables with these three clinical covariates on prediction of mortality in burned children. Serum samples were collected from 330 burned children (burns covering >25% of the tota...

  3. [I Am an Occupational Therapist. I Will Accompany You Through the Process of Burn Rehabilitation].

    Science.gov (United States)

    Chen, Sheng-Sung

    2016-02-01

    Burn injuries nearly always occur by accident. Burn injuries that cover large areas of the body typically cause hypertrophic scarring and joint contractures that affect the ability of the burn patient to handle normal activities of daily living. Occupational therapists begin the related interventions as early as possible, and patients require rehabilitation continuously until scar maturation. The present article provides an overview of the approach that occupational therapists should take in treating burn patients. Key elements of this approach include creating a burn rehabilitation program and helping patients achieve independence in their activities of daily living by applying individual assistive devices. The goal of this program is to allow burn patients to return to the workplace and to a normal life. We hope that this article makes more specialists aware of the proper approach to occupational therapy for burn patients and reduces the incidence of post-burn-injury sequelae. PMID:26813062

  4. 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.

    2012-01-01

    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 < 0.0001). The additional variable, %FTB, was also found to be a statistically significant determinant, although it did not greatly 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. PMID:22546129

  5. BOMB BLAST: PATTERN AND NATURE OF INJURIES

    Directory of Open Access Journals (Sweden)

    Brahmaji Master

    2015-01-01

    Full Text Available Bomb blast cause injury on large groups of people by multiple mechanisms. Bomb blast injuries differ from the conventional description of trauma complexity. Primary injuries are caused by blast wave and over pressure. Secondary injuries are caused by flyin g debris and cause shrapnel wounds. Tertiary injuries are caused by blast wind due to forceful impact and quaternary injuries are caused by other vectors like heat, radiation etc. Combined injuries, especially blast and burn injury or blast and crush injur y, are common during an explosive event. Knowledge about nature of injuries is essential for medicolegal and postmortem reports.

  6. BACTERIOLOGICAL STUDY OF BURNS INFECTION

    Directory of Open Access Journals (Sweden)

    Shareen

    2015-10-01

    Full Text Available A burn is a wound in which there is coagulative necrosis of the tissue, majority of which are caused by heat. Burn injury is a major public health problem in many areas of the world. Burns predispose to infection by damaging the protective barrier function of the skin, thus facilitating the entry of pa thogenic microorganisms and by inducing systemic immunosuppression . (1 OBJECTIVE : The present study was therefore undertaken to isolate and identify the aerobic bacterial flora in burn patients and its antibiotic susceptibility pattern. MATERIAL & METHODS : A total of 100 patients admitted with different degree of burns were studied. Wound swabs were taken with aseptic precautions by dry sterile cotton swab sticks. These swabs were transported to the microbiology laboratory and the isolates were identified based on standard microbiological methods. Antibiotic susceptibility testing was done by Kirby Bauer’s disc diffusion method. RESULT : A total of 127 bacterial pathogens were isolated from 100 patients. Of these, 69% were monomicrobial in nature and 28% wer e polymicrobial. The most frequent cause of infection was found to be Staphylococcus aureus (39.4%, followed by Pseudomonas aeruginosa (14.2%, Klebsiella pneumonia (13.4%, E.coli (8.7% and Acinetobacter species (7.9%.Out of the total Staphylococcus au reus isolates, 19 were Methicillin sensitive and 31 were Methicillin resistant (MRSA. All the MRSA strains were 100% sensitive to Vancomycin and Linezolid. The Pseudomonas aeruginosa isolates were most sensitive to Amikacin (9 4.4%, Fluroquinolones (61.1% . CONCLUSION : Staphylococcus aureus and Pseudomonas aeruginosa were major causes of infection in burn wounds. Therefore it is necessary to implement urgent measures for restriction of nosocomial infections, sensible limitation on the use of antimicrobial agents, strict disinfection and hygiene.

  7. Gold standards for primary care of burn management

    OpenAIRE

    Fatih Zor; Nail Ersöz; Yalçın Külahçı; Emin Kapı; Mehmet Bozkurt

    2009-01-01

    Every year, about 2.5 million people are affected from burns in the world. In our country there is no reliable database related to this subject. There are ongoing studies about the epidemiology of burns in Turkey. After burn injury had represent many various complications, such as myocardial infarction, cardiac deficiency, acute hypertension, endocarditis, thromboembolism, pulmonary edema, pneumonia, respiratuar failure, renal failure, gastric ulcus, ileus, sepsis, coagulopathy and anemia. Su...

  8. Enhancement of burn wounds healing by platelet dressing

    OpenAIRE

    Maghsoudi, Hemmat; Nezami, Nariman; Mirzajanzadeh, Mehdi

    2013-01-01

    Background and aims: The goal of this study was to evaluate the efficacy of platelet dressing in the treatment of burn wounds and compare its results with silver sulfadiazine dressing. Material and methods: Between 21 march 2011 to 21 September, 50 patients with burn injuries were selected by a randomized double-blind controlled trial. In order to eliminate the biological and personal variables among the various treated burn wounds, in the same patient, distal or proximal, lateral or medial p...

  9. An Epidemiologic Survey on Burns in Yazd from 2008 till 2009

    Directory of Open Access Journals (Sweden)

    Negar Delbari

    2012-01-01

    Full Text Available Burns are injuries which may require long hospitalization and may result in important impairment and disability. Burn injuries are still common especially in developing countries. Assessment of the epidemiology of burns is very important for introduction of preventive methods. This study was conducted in Yazd to assess and describe the epidemiology of burns including its main causes, and its demographics. In a prospective study during a 1 year period, we assessed the epidemiology of burns in Shahid Sadoughi Burns hospital in Yazd. During this period, 1947 injured patients referred to this hospital. Data were gathered using a questionnaire about demographics and the properties of the burn injury. Burns were more frequent among men than women. A significant number of patients were children. 8.8% of patients needed hospitalization. Thermal burns were much more common than other types. Scalds were the most common cause of burn, and hands were the body region most commonly affected. Mean total body surface area burned (TBSA was 6.16% (±9.93. This study showed a high incidence of burn injuries at home and in the workplace. The burns were mostly preventive and many of them can be prevented by education.

  10. The effect of application of multiple psychological interventions in the treatment process of patients with facial burn injury%综合心理干预在颜面部烧伤患者治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    周琴; 官浩; 何飞; 折涛; 石雪琴; 邹小梅; 焦晓春

    2012-01-01

    目的:通过对颜面部烧伤患者的综合心理干预,探讨颜面部烧伤患者心理健康状况及对生活能力的影响,评估综合心理干预在颜面部烧伤患者临床疗效中的重要作用.方法:将95例患者随机分为实验组和对照组.实验组在实施常规医学护理的同时给予各类综合心理干预措施.干预前后均采用抑郁自评量表、焦虑自评量表、症状自评量表和Barthe1指数记分法对患者心理状况及生活能力进行评定.结果:综合心理干预后,实验组SDS评分、SAS评分均明显低于对照组,实验组抑郁、焦虑、恐怖、精神病性因子评分等也明显低于对照组.结论:在颜面部烧伤患者的临床治疗中,综合心理干预能够更好的改善患者的焦虑、抑郁、心理健康状况、生活自理能力.对颜面烧伤患者实施综合心理干预,在其整个治疗中非常必要且具有重要意义.%Objective Multiple psychological intervention were applied in the process of facial bum injury treatment. Jo explore the effect of multiple psychological interventions on patients' mental health and living ability. Methods Ninety five patients were divided into experiment group and control group. In the experiment group, patients not only received routine nursing care but also got multiple psychological interventions. Self-rating depression scale (SDS), self-rating anxiety scale (SAS), symptom checklist 90 (SCL-90) and Barthel index of ADL (ADL) were employed to evaluate the mental health and living ability of facial burn patients before and after multiple psychological intervention. Results The scores of SDS and SAS in experiment group were significantly lower than that of in control group. After the intervention, patients in experiment group had lower scores in depression, phobic-anxiety and psychoticism score. Conclusions In facial burn patients treatment process applied multiple psychological interventions can improve depression, phobic

  11. Antibiotics and the burn patient.

    Science.gov (United States)

    Ravat, François; Le-Floch, Ronan; Vinsonneau, Christophe; Ainaud, Pierre; Bertin-Maghit, Marc; Carsin, Hervé; Perro, Gérard

    2011-02-01

    Infection is a major problem in burn care and especially when it is due to bacteria with hospital-acquired multi-resistance to antibiotics. Moreover, when these bacteria are Gram-negative organisms, the most effective molecules are 20 years old and there is little hope of any new product available even in the distant future. Therefore, it is obvious that currently available antibiotics should not be misused. With this aim in mind, the following review was conducted by a group of experts from the French Society for Burn Injuries (SFETB). It examined key points addressing the management of antibiotics for burn patients: when to use or not, time of onset, bactericidia, combination, adaptation, de-escalation, treatment duration and regimen based on pharmacokinetic and pharmacodynamic characteristics of these compounds. The authors also considered antibioprophylaxis and some other key points such as: infection diagnosis criteria, bacterial inoculae and local treatment. French guidelines for the use of antibiotics in burn patients have been designed up from this work. PMID:20510518

  12. Suicidal burn in Hong Kong.

    Science.gov (United States)

    Chan, R C; Burd, A

    2012-09-01

    The aim of our study is to review our experience in the management of patients who sustained burns associated with suicidal attempts over a 10-year period. In particular, we look into the outcome and incidence of self-harm/suicide after discharge among the survivors. Thirty-one patients with median age 36 years, ranging from 10 to 74, were included. Twenty-three (74%) were males and eight (26%) were females. Nearly three quarters (74%) of our patients had a known history of psychiatric illness: 11 had known history of substance abuse; 3 of them had drug-induced psychosis; 6 had schizophrenia; 5 had depression; 4 had personality disorders; 1 had pathological gambling and another one had adjustment disorder. Relationship problems and work/financial difficulties were the commonest reason for the suicidal attempts. Self-inflicted flame burn was the most frequent (39%; 12 patients) method of burning. Six patients (19%) died. The remaining 25 patients healed and were discharged. Seventeen patients required ICU care. The median length of stay in ICU was 7 days. The overall median length of stay was 35 days. The median follow up time for those survived is 63 months. Only 4 of these patients had further suicidal/parasuicidal attempts. Despite the high mortality, once these patients survived the initial injury, they are unlikely to commit suicide again. Thus, we believe that aggressive resuscitation should therefore be advocated for all suicidal burn patients. PMID:22360959

  13. Medical management of radiation burns - some experiences

    International Nuclear Information System (INIS)

    Localized exposure resulting in radiation burns are serious injuries, seen not only in this country but all over the world. All of these injuries have resulted from accidents in Industrial Radiography (non-destructive testing). In our country all these injuries have occurred in the private sectors who handle these radiography sources. These sources can be of Iridium-192 or Cobalt-60. Some of these accidents have occurred involving trained radiographers but sometimes casual workers have been exposed. Skin is highly vulnerable to the external radiation exposure. Damage of varying extent can be seen following radiotherapy and accidents involving X- and gamma-ray sources. The reaction is related to the absorbed dose, which in turn is dependent upon the energy of radiation and weather it is particulate or electromagnetic radiation. Beta particles give up their energy within a short range and hence are more hazardous. Radiation burns develop slowly and blister formation occurs usually after 4 weeks. After exposure the skin response occurs in the form of transient erythema, fixed erythema, transepidermal burns, full thickness radiation burns and epilation. In radiation accidents, particularly those involving X-ray machines, the patients may not be aware of the time of accident and the dose may not be known in those circumstances. The medical management and treatment of such patients, therefore, has its own challenges. This talk will share some experiences on treatment of radiation injuries. (author)

  14. Antithrombin in the treatment of burn trauma.

    Science.gov (United States)

    Kowal-Vern, Areta; Orkin, Bruce A

    2016-02-01

    Antithrombin (AT) is a natural anticoagulant with anti-inflammatory properties that has demonstrated value in sepsis, disseminated intravascular coagulation and in burn and inhalation injury. With high doses, AT may decrease blood loss during eschar excision, reducing blood transfusion requirements. There are no human randomized, placebo-controlled studies, which have tested the true benefit of this agent in these conditions. Two main forms of AT are either plasma-derived AT (phAT) and recombinant AT (rhAT). Major ovine studies in burn and smoke inhalation injury have utilized rhAT. There have been no studies which have either translated the basic rhAT research in burn trauma, or determined the tolerance and pharmacokinetics of rhAT concentrate infusions in burn patients. Advantages of rhAT infusions are no risk of blood borne diseases and lower cost. However, the majority of human burn patient studies have been conducted utilizing phAT. Recent Japanese clinical trials have started using phAT in abdominal sepsis successfully. This review examines the properties of both phAT and rhAT, and analyzes studies in which they have been utilized. We believe that it is time to embark on a randomized placebo-controlled multi-center trial to establish the role of AT in both civilian and military patients with burn trauma. PMID:26855890

  15. Burns related to sunbed use.

    Science.gov (United States)

    Hemington-Gorse, S J; Slattery, M A; Drew, P J

    2010-09-01

    The quest for a year round tan has led to an increase in the use of artificial tanning devices, namely sunbeds. There has been much debate in the press recently regarding the dangers of sunbed use and calls for tighter regulation of the industry, particularly the licensing of unmanned tanning salons. The dangers of sunbed use have long been recognised and the body of evidence linking sunbed use to skin malignancy is growing, in fact this month the Lancet published a review from the International Agency for Research on Cancer classifying UV emitting tanning devices as carcinogenic to humans. At the Welsh Centre for Burns and Plastic Surgery we noticed a rise in the number of patients presenting with burns related to sunbed use and present our data surrounding this injury over the last 6 years. PMID:20171016

  16. Characteristics of 985 pediatric burn patients in the south of Liaoning province of China

    Directory of Open Access Journals (Sweden)

    Hongjun Zhai

    2014-07-01

    Full Text Available Accidental injury due to burns is a serious and common, but preventable, occurrence in children. To analyze the characteristics of pediatric burns in the south of Liaoning province of China, a retrospective review was conducted of information, including general characteristics, demographics, etiology of burns, anatomical areas burned, and severity of injuries, obtained from medical records of pediatric burn patients admitted to the Burn Center of Anshan Hospital of the First Hospital of China Medical University from 2002 to 2011. Differences between age-groups and cause and severity of injuries were examined using Cochran-Mantel-Haenzsel ­(C-M-H statistic or chi-square (χ2 analyses where appropriate. A total of 985 pediatric burn cases were included, with only one death. The maximal burn area recorded was 80% and the maximal third-degree burn area was 45%. The majority of burns (637/985, 64.67% were moderate second-degree wounds, encompassing 5-14% of the total body surface area. The infant age-group (<3 years old had the largest representation (622/985, 63.15%, with more males than females affected. Most of the injuries occurred at home in children living in the local region. Scalding accounted for 89.85% (885/985 of all injuries, with a decreasing incidence with age, whereas injuries due to flames and from electrical sources markedly increased with age. Only a minority of guardians (244/985, 24.77% had burn prevention knowledge, and none of them knew how to provide first-aid treatment for burn injuries. These results indicate that the majority of pediatric burns occur in children less than 3 years of age from scalds received while at home. As a large proportion of these cases occurred in rural areas, programs emphasizing burn prevention and treatment knowledge should therefore be made more available to these families.

  17. Early diagnostics and treatment with acute burn sepsis

    Institute of Scientific and Technical Information of China (English)

    Ahmedov A.A.; Shakirov B.M.; Karabaev H.K

    2015-01-01

    Objective: To determine the value of the procalcitonin test used for early diagnosis of sepsis and to study the course and treatment of burn sepsis in patients with severe burns. Methods: Eighty patients in the Burn Department of Republican Scientific Centre of Emergency Medical Care, aged 17-75 years with burn injuries covering 30%-85% of the body surface, were enrolled in the study. Procalcitonin is marker of sepsis, procalcitonin > 2 ng/mL, sensitivity -89%, specific feature -94%. Results: The result showed that among septic patients with severe burns, rational use of intensive therapy for burn sepsis and septic shock in combination with parentrial ozonotherapy resulted in decreases of syndrome of poly organ insufficiency and lethal outcomes from 70%accordingly. The result allows the conclusion that the treatment examined leads to a significant increase in survival coefficient. Conclusions: This in turn confirms the efficacy of early necrectomy and auto dermoplasty of deep burn wounds in victims with sepsis.

  18. Lawnmower injuries in children.

    LENUS (Irish Health Repository)

    Nugent, Nora

    2012-02-03

    OBJECTIVE: Power lawnmowers can pose significant danger of injury to both the operator and the bystander, from direct contact with the rotary blades or missile injury. Our objective was to review our experience with paediatric lawnmower-associated trauma, and the safety recommendations available to operators of power lawnmowers. METHODS: The patient cohort comprised paediatric (<16 years of age) patients treated for lawnmower-associated trauma, by the plastic surgery service, between 1996 and 2003. These patients were identified retrospectively. Age at the time of injury, location and extent of bony and soft tissue injuries sustained, treatment instituted and clinical outcome were recorded. Brochures and instruction manuals of six lawnmower manufacturers were reviewed, and safety recommendations noted. RESULTS: Fifteen patients were identified. The majority of injuries occurred from direct contact with the rotary blades (93%); the remaining child sustained a burn injury. Fourteen children (93%) required operative intervention. Seven patients (46%) sustained injuries resulting in amputation, two of whom had major limb amputations. All children, except the burns patient, underwent wound debridement and received antibiotic therapy. Reconstructive methods ranged from primary closure to free tissue transfer. Many patients required multiple procedures. In all instruction manuals, instructions to keep children and pets indoors or out of the yard when mowing were found. CONCLUSIONS: Lawnmower injuries can be devastating, particularly in children. Many victims have lasting deformities as a result of their injuries. Awareness of and stringent adherence to safety precautions during use of power lawnmowers can prevent many of these accidents.

  19. THE DEVELOPMENT OF BURN SURGERY IN CHINA-A RETROSPECTIVE OVERVIEW

    Institute of Scientific and Technical Information of China (English)

    盛志勇

    2002-01-01

    @@ Compared with other surgical disciplines,burn surgery is a young one ,as 4 decades ago,the treatment of thermal injuries belonged to the realm of general surgery.Nevertheless,with the advancement of medical sciences in our country,we have reached global standards both in clinic and pertinent research in burn injuries.

  20. The isolated burned palm in children : Epidemiology and long-term sequelae

    NARCIS (Netherlands)

    Barret, JP; Desai, MH; Herndon, DN

    2000-01-01

    The isolated burn of the palm is a typical injury in young children. Positioning and splinting in small hands is difficult, and long-term sequelae of these injuries are not uncommon. The objective of the present study was to assess the outcome of palm burns and to identify the risk factors for long-

  1. Transdermal fluid loss in severely burned patients

    Directory of Open Access Journals (Sweden)

    Lange, Thomas

    2010-01-01

    Full Text Available Introduction: The skin protects against fluid and electrolyte loss. Burn injury does affect skin integrity and protection against fluid loss is lost. Thus, a systemic dehydration can be provoked by underestimation of fluid loss through burn wounds. Purpose: We wanted to quantify transdermal fluid loss in burn wounds. Method: Retrospective study. 40 patients admitted to a specialized burn unit were analyzed and separated in two groups without (Group A or with (Group B hypernatremia. Means of daily infusion-diuresis-ratio (IDR and the relationship to totally burned surface area (TBSA were analyzed. Results: In Group A 25 patients with a mean age of 47±18 years, a mean TBSA of 23±11%, and a mean abbreviated burned severity index (ABSI score of 6.9±2.1 were summarized. In Group B 15 patients with a mean age of 47±22 years, a mean TBSA of 30±13%, and a mean ABSI score of 8.1±1.7 were included. Statistical analysis of the period from day 3 to day 6 showed a significant higher daily IDR-amount in Group A (Group A vs. Group B: 786±1029 ml vs. –181±1021 ml; p<0.001 and for daily IDR-TBSA-ratio (Group A vs. Group B: 40±41 ml/% vs. –4±36 ml/%; p<0.001. Conclusions: There is a systemic relevant transdermal fluid loss in burn wounds after severe burn injury. Serum sodium concentration can be used to calculate need of fluid resuscitation for fluid maintenance. There is a need of an established fluid removal strategy to avoid water and electrolyte imbalances.

  2. Full thickness burn caused by exposure to giant hogweed: delayed presentation, histological features and surgical management.

    LENUS (Irish Health Repository)

    Chan, Jeffrey C Y

    2012-02-01

    We report the case of a 10-year-old boy with a full thickness chemical burn on his right pretibial area due to phytophotodermatitis (PPD) following contact with giant hogweed (Heracleum mantegazzianum). Although cutaneous burns due to plants are a well-established cause of chemical burn, previous reports described partial thickness burns that healed with conservative measures. This patient presented to our unit two weeks after the initial injury with an established full thickness burn. Debridement and split thickness skin grafting was required. We presented the histological features of the debrided skin specimen and discussed potential factors leading to this unexpected full thickness injury.

  3. Lightning and thermal injuries.

    Science.gov (United States)

    Sanford, Arthur; Gamelli, Richard L

    2014-01-01

    Electrical burns are classified as either high voltage (1000 volts and higher) or low voltage (release of myoglobin, the presence of heme pigments in the urine must be evaluated promptly. Presence of these products of breakdown of myoglobin and hemoglobin puts the injured at risk for acute renal failure and must be treated. The exact mechanism of nerve injury has not been explained, but both direct injury by electrical current overload or a vascular cause receive the most attention. Because electrical injuries carry both externally visible cutaneous injuries and possible hidden musculoskeletal damage, conventional burn resuscitation formulas based on body surface area injured may not provide enough fluid to maintain urine output. Damaged muscle resulting in swelling within the investing fascia of an extremity may result in compartment syndromes, requiring further attention. If myoglobin has been detected in the urine, treatment is aggressive volume resuscitation and possibly alkalinization of the urine or mannitol is given IV push to minimize pigment precipitation in the renal tubules. Approximately 15% of electrical burn victims also sustain traumatic injuries. This is because of falls from height or being thrown against an object. The tetanic contractions that result from exposure to electrical injury cause imbalance in flexor versus extensor muscles, with the flexor groups being stronger. Not only is the victim unable to release from the electrical contact, but they are at risk for fracture of bones from this prolonged muscular contracture. Neurologic and psychological symptoms were the most common sequelae of electrical and lightning injuries. Many of these symptoms are nonspecific, and they often do not appear until several months after the injury. A full neurologic examination must be performed on admission, documenting initial presentation and at any change in symptoms. Electrical injuries can have devastating consequences. Prevention of electrical injuries

  4. An overview of war-related thermal injuries.

    Science.gov (United States)

    Roeder, Rosiane Alfinito; Schulman, Carl I

    2010-07-01

    Thermal injuries have always been a source of morbidity and mortality in times of war. Historically, they constitute 5% to 20% of all injuries and approximately 4% mortality. Although burn patients constitute a small number of casualties, they consume a disproportionate amount of resources and require specialized care. The current conflicts in the Middle East report similar numbers for thermal injuries despite improvement in predeployment education to reduce noncombat-related burns, flame retardant military clothing, and decline of war patterns usually associated with increased thermal injuries. However, the increased use of improvised explosive devices and vehicle-borne improvised explosive devices presents a new source of potential thermal injury. Indeed, the burden of explosion-related burns has increased as has its associated Injury Severity Score. As has been the case in previous conflicts, most burns are hand and head burns. Although usually not life threatening, burns to hands and face lead to significant physical and psychologic morbidities. In this paper, we will review the currently available literature on war-related thermal injuries in Operation Iraqi and Operation Enduring Freedom. We will describe the epidemiology of burn injuries, prewar preparation to prevent and treat thermal injuries, and the assessment, triage, and final treatment of burn patients. In addition, we will discuss the associated physical and psychologic morbidities and, finally, the role of plastic surgeon in burn rehabilitation and reconstruction. PMID:20613571

  5. [Inherit enterprising spirit of burn discipline and meet the new challenge].

    Science.gov (United States)

    Sun, Y H

    2016-01-01

    Burn is a common trauma in peace time and war. Burn care was not designated as a specific discipline but a subspecialty of general surgery in China until the 1950s. In 1958, along with the development of metallurgical industry in China, the number of burn patients was increased remarkably, followed by establishment of modern burn departments. A steel worker sustaining a burn injury with size of 89% total burn surface area (TBSA) and full-thickness wound size of 23% TBSA was successfully cured by burn experts of Shanghai Guangci Hospital (renamed Ruijin Hospital Affiliated to the School of Medicine of Shanghai Jiao Tong University). This was considered as a miracle in the history of burn treatment in the world. Thenceforth a number of burn patients with size over 80% TBSA were saved in Beijing, Shanghai, Chongqing, Xi'an, and other cities. However, with rapid advances in burn treatment, it was soon recognized that one should fully grasp the science of the underlying pathophysiological mechanism. To fulfill these demands, specialists devoted themselves to the study of basic problems, and they made significant and valuable contributions to the knowledge concerning basic problems in burn injury, followed by significant improvements in burn care. In the meantime, Chinese Burn Association and Chinese Journal of Burns were inaugurated. An overall strategy for treatment of severe burn patients with Chinese characteristics was established. However, it is also important to inherit traditional ideologies, namely"morality, diligence, excellence, and creativity". PMID:27426063

  6. E P I DEMIOLOGY OF PAEDIATRIC BURNS: A RETROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Jangpreet Singh

    2015-04-01

    Full Text Available BACKGROUND: Burn injuries are a major cause of morbidity and mortality in children. These are the third most common injury causing death in children, following motor vehicle accidents and drowning accidents. AIM: To study the Epidemiological parameters for assessment of morbidity & mortality rate in pediatric burns and to form effective preventive strategy. MATERIAL AND METHODS: The study was done at the Department of Surgery, PIMS, Jalandhar. Total 50 patients (n=50 up to age of 12 years, were included in the study retrospectively. Data regarding age, sex, demographic distribution, seasonal variation, Total body surface area (TBSA involved, type and place of burn injury, parent’s occupation, family size and mortality rate were noted and analysed. RESULT S: Total 50 patients (n =50 of which 32 were males and 18 females were included in the study. Mean age of burn injuries was 3.6 years. Scalds burns were the most common cause of burns followed by thermal burns. It involved mostly upper limbs (67%, anterio r trunk (56%, lower limbs (53%, face (4%, and posterior trunk including buttocks (16% . The time lapse from injury to presentation to hospital ranged from 1 hour to 3 weeks. Total body surface area burnt was ranged from 2 – 60%. Mean hospital duration was 12 . 4 days. Complications ranged from wound sepsis in 11 patients (22%, contractures of fingers in 3 patients ( 6 % and hypertrophic scarring in 8 patients (16% . After healing of wounds, patients were advised pressure garments and oil massage and night splint age regularly for six months. CONCLUSION: Children constitute a vulnerable group of burns. Most injuries occur in the home setting where effective control measures can be adopted. Advances have also made in resuscitation, intensive care, antimicrobi als, vascular access, nutritional support, and skin banking. Splintage, physiotherapy, massage and pressure garments also help in reducing the morbidity and overall long term burden over

  7. Treating and Preventing Burns

    Science.gov (United States)

    ... Issues Listen Español Text Size Email Print Share Treating and Preventing Burns Page Content Article Body Burns ... home, out of children’s reach, and away from heat or ignition sources. Lower the temperature of your ...

  8. Burns and Fire Safety

    Science.gov (United States)

    ... Tap water burns most often occur in the bathroom and tend to be more severe and cover a larger portion of the body than other scald burns. 9 10 11 A survey found that only 8 percent of adults felt ...

  9. Medical response to the radioinduced burns

    International Nuclear Information System (INIS)

    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)

  10. Benchmarking Outcomes in the Critically Injured Burn Patient

    Science.gov (United States)

    Klein, Matthew B.; Goverman, Jeremy; Hayden, Douglas L.; Fagan, Shawn P.; McDonald-Smith, Grace P.; Alexander, Andrew K.; Gamelli, Richard L.; Gibran, Nicole S.; Finnerty, Celeste C.; Jeschke, Marc G.; Arnoldo, Brett; Wispelwey, Bram; Mindrinos, Michael N.; Xiao, Wenzhong; Honari, Shari E.; Mason, Philip H.; Schoenfeld, David A.; Herndon, David N.; Tompkins, Ronald G.

    2014-01-01

    Objective To determine and compare outcomes with accepted benchmarks in burn care at six academic burn centers. Background Since the 1960s, U.S. morbidity and mortality rates have declined tremendously for burn patients, likely related to improvements in surgical and critical care treatment. We describe the baseline patient characteristics and well-defined outcomes for major burn injuries. Methods We followed 300 adults and 241 children from 2003–2009 through hospitalization using standard operating procedures developed at study onset. We created an extensive database on patient and injury characteristics, anatomic and physiological derangement, clinical treatment, and outcomes. These data were compared with existing benchmarks in burn care. Results Study patients were critically injured as demonstrated by mean %TBSA (41.2±18.3 for adults and 57.8±18.2 for children) and presence of inhalation injury in 38% of the adults and 54.8% of the children. Mortality in adults was 14.1% for those less than 55 years old and 38.5% for those age ≥55 years. Mortality in patients less than 17 years old was 7.9%. Overall, the multiple organ failure rate was 27%. When controlling for age and %TBSA, presence of inhalation injury was not significant. Conclusions This study provides the current benchmark for major burn patients. Mortality rates, notwithstanding significant % TBSA and presence of inhalation injury, have significantly declined compared to previous benchmarks. Modern day surgical and medically intensive management has markedly improved to the point where we can expect patients less than 55 years old with severe burn injuries and inhalation injury to survive these devastating conditions. PMID:24722222

  11. Optimization of burn referrals

    DEFF Research Database (Denmark)

    Reiband, Hanna K; Lundin, Kira; Alsbjørn, Bjarne;

    2014-01-01

    INTRODUCTION: Correct estimation of the severity of burns is important to obtain the right treatment of the patient and to avoid over- and undertriage. In this study we aimed to assess how often the guidelines for referral of burn injured patients are met at the national burn centre (NBC), Denmar...

  12. First Aid: Burns

    Science.gov (United States)

    ... Story" 5 Things to Know About Zika & Pregnancy First Aid: Burns KidsHealth > For Parents > First Aid: Burns Print A A A Text Size Scald ... THIS TOPIC Kitchen: Household Safety Checklist Fireworks Safety First Aid: Sunburn Firesetting Fire Safety Burns Household Safety: Preventing ...

  13. Cytokine expression profile over time in burned mice

    Science.gov (United States)

    Finnerty, Celeste C; Przkora, Rene; Herndon, David N; Jeschke, Marc G

    2009-01-01

    The persistent inflammatory response induced by a severe burn increases patient susceptibility to infections and sepsis, potentially leading to multi-organ failure and death. In order to use murine models to develop interventions that modulate the post-burn inflammatory response, the response in mice and the similarities to the human response must first be determined. Here we present the temporal serum cytokine expression profiles in burned in comparison to sham mice and human burn patients. Male C57BL/6 mice were randomized to control (n=47) or subjected to a 35% TBSA scald burn (n=89). Mice were sacrificed 3, 6, 9, 12, 24, 48 hours and 7, 10, and 14 days post-burn; cytokines were measured by multi-plex array. Following the burn injury, IL-6, IL-1β, KC, G-CSF, TNF, IL-17, MIP-1α, RANTES, and GM-CSF were increased, p<0.05. IL-2, IL-3, and IL-5 were decreased, p<0.05. IL-10, IFN-γ, and IL-12p70 were expressed in a biphasic manner, p<0.05. This temporal cytokine expression pattern elucidates the pathogenesis of the inflammatory response in burned mice. Expression of 11 cytokines were similar in mice and children, returning to lowest levels by post-burn day 14, confirming the utility of the burned mouse model for development of therapeutic interventions to attenuate the post-burn inflammatory response. PMID:19019696

  14. Inflammatory pain in experimental burns in man

    DEFF Research Database (Denmark)

    Pedersen, J L

    2000-01-01

    Human experimental pain models are important tools in pain research. The primary aims of pain research in normal man is 1) to provide insight in pain mechanisms, 2) to provide a rational basis for clinical trials of pain relieving interventions, and 3) to confirm the anti-nociceptive effects...... inflammatory responses to superficial thermal burns in skin have been studied in healthy volunteers. Burns have the potential for releasing most of the inflammatory and chemical mediators that produce sensitisation and excitation of nociceptors, and the intense nociceptive input during injury produces...

  15. The Effect of Ketoconazole on Post-Burn Inflammation, Hypermetabolism and Clinical Outcomes

    OpenAIRE

    Jeschke, Marc G.; Williams, Felicia N.; Finnerty, Celeste C.; Rodriguez, Noe A.; Kulp, Gabriela A; Arny Ferrando; Norbury, William B.; Oscar E Suman; Robert Kraft; Branski, Ludwik K.; Al-Mousawi, Ahmed M.; Herndon, David N

    2012-01-01

    BACKGROUND: Hypercortisolemia has been suggested as a primary hormonal mediator of whole-body catabolism following severe burn injury. Ketoconazole, an anti-fungal agent, inhibits cortisol synthesis. We, therefore, studied the effect of ketoconazole on post-burn cortisol levels and the hyper-catabolic response in a prospective randomized trial (block randomization 2:1). METHODOLOGY/PRINCIPAL FINDINGS: Fifty-five severely burned pediatric patients with >30% total body surface area (TBSA) burns...

  16. Role of stanniocalcin 1 in brain injury of coal-burning-borne fluorosis rats%斯钙素蛋白1在大鼠燃煤型氟中毒脑损伤中的作用

    Institute of Scientific and Technical Information of China (English)

    陈旭义; 梁冰; 汤锋武; 张永春; 孙发; 谷江; 张赛

    2013-01-01

    目的 观察燃煤型氟中毒大鼠脑组织中斯钙素蛋白(STC)1及钙离子的变化,探讨STC1在燃煤型氟中毒脑损伤机制中的作用.方法 24只雄性SD大鼠按体质量随机分为4组:对照组、低、中、高氟组;对照组采用常规大鼠饲料(含氟1.3 mg/kg),低、中、高氟组分别饲以含氟为20.0、40.0、60.0 mg/kg的饲料,所有大鼠均饮用蒸馏水,自由饮食、饮水;180 d后,采用免疫组化和RT-PCR方法,检测大鼠脑组织中STC1蛋白及基因的表达,并检测脑组织内钙离子含量.结果 与对照组[(24.70±3.53)%]相比,低、中、高氟组大鼠STC1细胞阳性率[(48.10±2.11)%、(54.90±1.73)%、(79.30±3.71)%]均显著增高(P<0.05),其中高氟组明显高于低、中氟组(P均< 0.05).低、中、高组大鼠脑组织中STC1的mRNA表达(0.58±0.09、0.85±0.17、1.75±0.04)均高于对照组(0.37±0.12,P<0.05),高氟组STCl mRNA表达高于低、中氟组(P均<0.05).低、中、高氟组大鼠脑皮质钙离子浓度[(138.62±4.19)、(167.43±6.57)、(189.45±3.72)nmol/L]显著高于对照组[(101.47±9.46)nmol/L,P均<0.05],其中高氟组高于低、中氟组(P均<0.05),中氟组高于低氟组(P<0.05).结论 STC1可能依靠调节钙离子平衡的功能参与了燃煤型氟中毒脑损伤机制.%Objective To observe the change of stanniocalcin 1 (STC1) and calcium content in brain of coal-burning-borne fluorosis rats,and to explore the role of STC1 in brain injury of coal-burning-borne fluorosis.Methods Twenty four male SD rats were randomly divided into control,low,medium,and high fluoride groups according to body mass.Control group was fed conventional rat chow(fluorinated 1.3 mg/kg),and low,medium and high fluoride groups fed with fluorinated feed(20.0,40.0,60.0 mg/kg).All rats were given distilled water and feed ad libitum.One hundred and eighty days after modeling,STC1 protein and gene expression in the brain tissue of rats were detected using

  17. Candidemia in major burns patients.

    Science.gov (United States)

    Renau Escrig, Ana I; Salavert, Miguel; Vivó, Carmen; Cantón, Emilia; Pérez Del Caz, M Dolores; Pemán, Javier

    2016-06-01

    Major burn patients have characteristics that make them especially susceptible to candidemia, but few studies focused on this have been published. The objectives were to evaluate the epidemiological, microbiological and clinical aspects of candidemia in major burn patients, determining factors associated with a poorer prognosis and mortality. We conducted a retrospective observational study of candidemia between 1996 and 2012 in major burn patients admitted to the La Fe University Hospital, Valencia, Spain. The study included 36 episodes of candidemia in the same number of patients, 55.6% men, mean age 37.33 years and low associated comorbidity. The incidence of candidemia varied between 0.26 and 6.09 episodes/1000 days stay in the different years studied. Candida albicans was the most common species (61.1%) followed by Candida parapsilosis (27.8%). Candidemia by C. krusei, C. glabrata or C. tropicalis were all identified after 2004. Central vascular catheter (CVC) was established as a potential source of candidemia in 36.1%, followed by skin and soft tissues of thermal injury (22.2%) and urinary tract (8.3%). Fluconazole was used in 19 patients (52.7%) and its in vitro resistance rate was 13.9%. The overall mortality was 47.2%, and mortality related to candidemia was 30.6%. Factors associated with increased mortality were those related to severe infection and shock. CVC was the most usual focus of candidemia. Fluconazole was the most common antifungal drug administered. The management of candidemia in major burn patients is still a challenge. PMID:26931414

  18. Burn wound coverage and burn wound closure

    Czech Academy of Sciences Publication Activity Database

    Konigová, R.; Matoušková, Eva; Brož, L.

    2000. s. 9. [International Symposium and Course on Burns and Fire Desaster Management. Jerusalem Meeting /3./. 13.02.2000-16.02.2000, Jerusalem] R&D Projects: GA MZd IZ4368 Subject RIV: EB - Genetics ; Molecular Biology

  19. Ultrasonic pulse-echo determination of burn depth in partial-thickness burns

    International Nuclear Information System (INIS)

    A number of possible techniques for measuring burn depth were considered, and it was concluded that high-frequency ultrasound offers the best possibility for investigation of burn injury. A conventional ultrasonic pulse-echo system was assembled and modified so that small distances in tissue (less than or equal to 1 mm) can be resolved. Typical transducers used during the course of measurements on human and porcine skin are described. Ultimate success of the ultrasonic technique is dependent on the validity of the assumption that the acoustic impedance of necrotic burn tissue is sufficiently different from that of viable tissue to allow for ultrasonic reflections at the interface between burned and viable tissue. In general, this assumption seems to have been valid in animal and human experiments carried out to date

  20. Discussion on effective vibratory sputum ejection machine for patients with extremely severe burn and inhalation injury%振动排痰机用于特重度烧伤伴吸入性损伤患者有效排痰的探讨

    Institute of Scientific and Technical Information of China (English)

    张迪

    2015-01-01

    Objective:to study the vibratory sputum ejection machine's prevention effect of the pulmonary infection for patients with extremely severe burn and inhalation injury: a clinical observation of human nature.Methods:70 patients with extremely severe burn and inhalation injury were randomly divided into 35 in the experimental group and 35 in a control group. G5 vibratory sputum ejection machine is used in the experimental group for sputum excretion while handcuff is used in the control group.The effects are drawn and compared via chest auscultation, SpO2 and arterial partial pressure of oxygen (PaO2), the amount of excreted sputum and the sucted sputum.Results: the sputum expectoration effect of the experimental group is much better than that of the control group because the indexes of the chest auscultation, oxygen saturation and blood gas analysis indices are signiifcantly higher than those in the control group (P < 0.05).Conclusion: vibratory sputum ejection machine has ramarkable effect for patients with extremely severe burn and inhalation injury patients in sputum expectoration. What's more, it also helps to prevent the pulmonary infection for patients with extremely severe burn.%目的 探讨振动排痰机用于特重度烧伤伴吸人性损伤患者预防肺部感染的疗效观察.方法 70例特重度烧伤伴有吸入性损伤患者随机分成实验组35和对照组35例.实验组应用G5振动排痰机排痰,对照组采用手扣法对患者进行排痰治疗,在胸部听诊、SpO2、动脉血氧分压(PaO2)、咳痰或吸痰量的多少等方面进行比较.结果 实验组排痰效果明显优于对照组,胸部听诊、氧饱和度和血气分析指标也明显高于对照组(P<0.05).结论 振动排痰机对特重度烧伤伴有吸入性损伤患者协助排痰效果显著,有利特重度烧伤患者肺部感染的控制.

  1. Burns and epilepsy.

    Science.gov (United States)

    Berrocal, M

    1997-01-01

    This is a report of the first descriptive analytic study of a group of 183 burn patients, treated in the Burn Unit at the University Hospital of Cartagena, Colombia during the period since January 1985 until December 1990. There is presented experience with the selected group of 24 patients in whom the diagnosis of burn was associated with epilepsy. There is also analysed and described the gravity of the scars sequels, neurological disorders, the complication of the burn and an impact of this problem on the patient, his (her) family and the community. It is very important to report that there was found Neurocisticercosis in 66.6% of the group of burn patients with epilepsy, and it is probably the first risk factor of burn in this group. PMID:9212488

  2. Pyoderma gangrenosum in burned patient: Case report

    OpenAIRE

    Obradović-Tomašev Milana; Jovanović Mladen; Popović Aleksandra

    2015-01-01

    Introduction. Pyoderma gangrenosum is a rare, chronic, destructive, ulcerating skin disease of uncertain etiology. It develops most frequently in patients between 25-45 years of age and affects both sexes equally. Case report. We present a case of pyoderma gangrenosum in a young female patient who sustained a burn injury of 40% total body surface area. She underwent four operations. She developed a wound infection and urinary infection during her hospital s...

  3. 蛋白激酶Cδ对燃煤污染型砷中毒肝损伤的调控机制%The regulation mechanism of protein kinase Cδ on arsenic liver injury caused by coal-burning

    Institute of Scientific and Technical Information of China (English)

    胡勇; 张爱华; 姚茂琳; 唐旭东; 黄晓欣

    2013-01-01

    白表达水平分别为0.38±0.06、0.31±0.05、0.35±0.05、0.36±0.05,均高于对照组(0.24±0.05)(P值均<0.05).结论 砷可能通过调控pPKCδ蛋白表达,诱导其膜转位活化,导致燃煤型砷中毒肝损伤的发生发展.%Objective To investigate the effects of mRNA transcriptional and protein expressions of protein kinase Cδ (PKCδ) on the development of arsenic liver injury caused by coal-burning.Methods Population study:133 arsenic exposures were selected as arsenic exposure groups including the ward nonpatient group(25 cases),no obvious hepatopathy group(38 cases),mild (43 cases)and moderate to severe hepatopathy group(27 cases)from the area with endemic arsenism in Guizhou province.Another 34 healthy residents were selected as the control group in non-arsenic pollution village.The urine and peripheral blood were collected from the subjects.The arsenic contents in urine and mRNA expressions of PKCδ in peripheral blood were detected.Animal experiment study:thirty wistar rats were randomly by random number tabledivided into control group,drinking water arsenic poisoning group and coal-burning arsenic poisoning group (i.e.,low,medium and high arsenic contaminated grain group) by random number table method,including 6 rats in each group.The control group was fed normally for 3 months,drinking water arsenic poisoning group and coal-burning arsenic poisoning groups were fed respectively with 10 mg/kg As2O3 solution and different concentrations (25,50 and 100 mg/kg) of arsenic-containing feed which was persisted 3 months.The arsenic contents in urine,mRNA expression levels of PKCδ in peripheral blood and liver tissue and the protein expression levels of phosphorylated protein kinase C8(pPKCδ) in liver tissue were detected.Results The median (quartile) of arsenic contents in urine were 25.58 (18.62-40.73),56.66 (38.93-76.77),64.90 (39.55-98.37) and 75.47(41.30-109.70) μg/g Cr respectively for the non-patient group,no obvious hepatopathy group,mild and moderate to

  4. Perineal Burns in Children

    OpenAIRE

    Ameh AEmmanuel

    2004-01-01

    Perineal burns are not common in childhood but when they occur, they can produce severe complications. Conservative management by open wound care and topical agents is effective in most cases. However, in deep burns and when control of infection proves problematic, diverting colostomy may be necessary to control infection and achieve wound healing and graft take. Burns wound excision and skin grafting may be required in such cases. Contractures of various forms may develop and require plastic...

  5. 中国烧伤医学50年进展%Achievements in burn surgery over the past 50 years in China

    Institute of Scientific and Technical Information of China (English)

    汪仕良; 肖光夏; 杨宗城; 盛志勇

    2008-01-01

    This paper reflects briefly the main advancements of clinical and scientific research in the field of burn surgery over the past 50 years in China. It ineludes emergency care of massive burns, resuscitation, anti-infection, prevention and treatment of internal organ injury, metabolic and nutritional support, repair of wound and rehabilitation, and special types of burns. The article also covers the researches in pathology, microbiology, immunology, cell biology, molecular biology, and tissue engineering pertaining to burn injury.

  6. Psychiatric History and Adaptation in Burn Injured Patients

    OpenAIRE

    Dyster-Aas, Johan

    2006-01-01

    The intertwined relationship between physical and psychological problems is a topic of much interest in the rehabilitation of severely injured patients, e.g. after a burn. The present study aims at gaining further knowledge concerning the impact of psychological factors and psychiatric morbidity on short and long-term adaptation after burn injury. Outcome was assessed for three main areas: pruritus, return to work and psychiatric health. Three separate samples of previous or current adult pat...

  7. Comparison of Two Types of Gels in Improving Burn Wound

    OpenAIRE

    Rahimzadeh Golnar; Seyedi Dolatabad Shahnaz; Fallah Rostami Fatemeh

    2014-01-01

    Objective: Kefir are natural probiotic compounds with anti-inflammatory properties, which were tested in experimental burn injury. Kefir gels were prepared from an extract of continuously cultured kefir in Man, Rogosa and Sharpe Broth medium for 48 and 96 h. Their extracts were used for evaluation of antibacterial effect against Pseudomonas aeruginosa in standard sample (ATCC 27853) and samples taken from patients with burns. The antibacterial effect of dif...

  8. Intensive chromic acid burns and acute chromium poisoning with acute renal failure

    Institute of Scientific and Technical Information of China (English)

    XIANG Jun; SUN Zhen; HUAN Jing-ning

    2011-01-01

    In this case report, we describe our experience of managing a patient with chemical burns caused by hot chromic acid that covered over 60% of the patient's body. The patient developed anuria 48 hours after injury. Early excision of burn eschars and hemodialysis were carried out. The patient survived after a series of comprehensive treatments, including allografting and autografting. In patients burned by hot chromic acid, excision of affected skin down to the muscle fascia should be carried out as soon as possible after injury. Dialysis to remove circulating chromium in the first 24 hours after injury is also recommended.

  9. Ventilator associated pneumonia in major paediatric burns.

    Science.gov (United States)

    Rogers, Alan David; Deal, Cailin; Argent, Andrew Charles; Hudson, Donald Anthony; Rode, Heinz

    2014-09-01

    More than three-quarters of deaths related to major burns are a consequence of infection, which is frequently ventilator associated pneumonia (VAP). A retrospective study was performed, over a five-year period, of ventilated children with major burns. 92 patients were included in the study; their mean age was 3.5 years and their mean total body surface area burn was 30%. 62% of the patients sustained flame burns, and 31% scalds. The mean ICU stay was 10.6 days (range 2-61 days) and the mean ventilation time was 8.4 days (range 2-45 days). There were 59 documented episodes of pneumonia in 52 patients with a rate of 30 infections per 1000 ventilator days. Length of ventilation and the presence of inhalational injury correlate with the incidence of VAP. 17.4% of the patients died (n=16); half of these deaths may be attributed directly to pneumonia. Streptococcus pneumonia, Pseudomonas aeruginosa, Acinetobacter baumanii and Staphylococcus aureus were the most prominent aetiological organisms. Broncho-alveolar lavage was found to be more specific and sensitive at identifying the organism than other methods. This study highlights the importance of implementing strictly enforced strategies for the prevention, detection and management of pneumonia in the presence of major burns. PMID:24468505

  10. Epidemiology of pneumonia in a burn care unit: the influence of inhalation trauma on pneumonia and of pneumonia on burn mortality

    OpenAIRE

    Liodaki, E.; Kalousis, K; Mauss, K. L.; Kisch, T; Mailaender, P; F. Stang

    2015-01-01

    The aim of this study is to determine the epidemiological characteristics of burn patients developing pneumonia, as well as the predisposing factors and the mortality of these patients. Infectious complications present serious problems in severely burned patients. Pneumonia, in particular, is a major cause of morbidity and mortality in burn patients. Patients with inhalation injuries are exposed to a greater risk due to the possible development of infectious complications in the lower respira...

  11. Gold standards for primary care of burn management

    Directory of Open Access Journals (Sweden)

    Fatih Zor

    2009-01-01

    Full Text Available Every year, about 2.5 million people are affected from burns in the world. In our country there is no reliable database related to this subject. There are ongoing studies about the epidemiology of burns in Turkey. After burn injury had represent many various complications, such as myocardial infarction, cardiac deficiency, acute hypertension, endocarditis, thromboembolism, pulmonary edema, pneumonia, respiratuar failure, renal failure, gastric ulcus, ileus, sepsis, coagulopathy and anemia. Such complications can preventable or treatable. In this respect, preventive management in the first step burn treatment had very importantly in burn cases. Skin is a barrier which protects evaporative heat loss. In cases of acute burn, hypothermia occurs related to skin loss. For these cases, care must be taken to keep the patient warm. In addition fluid resuscitation is very important in these cases. Furthermore, the damaged tissues are highly susceptible to infection in burned patients. Burn care and rehabilitation includes challenging and complex procedures. Briefly, treatments of burn cases require a multidisciplinary and meticulous approach.

  12. Treatment strategies for mass burn casualties

    Institute of Scientific and Technical Information of China (English)

    CHAI Jia-ke; SHENG Zhi-yong; YANG Hong-ming; HAO Dai-feng; SHEN Chuan-an; JIA Xiao-ming; LI Feng; JING Sa; LI Li-gen; SONG Hui-feng; JIA Chi-yu; TUO Xiao-ye; SUN Tian-jun; HU Quan

    2009-01-01

    Background Mass burn casualties are always a great challenge to a medical team because a large number of seriously injured patients were sent in within a short time. Usually a high mortality is impending. Experiences gained from successful treatment of the victims may be useful in guiding the care of mass casualties in an armed conflict.Methods Thirty-five burn victims in a single batch, being transferred nonstop by air and highway from a distant province,were admitted 48 hours post-injury. All patients were male with a mean age of (22.4±8.7) years. The burn extent ranged from 4% to 75% ((13.6±12.9)%) total body surface area. Among them, thirty-two patients were complicated by moderate and severe inhalation injury, and tracheostomy had been performed in 15 patients. Decompression incisions of burn eschar on extremities were done in 17 cases before transportation. All the thirty-five patients arrived at the destination smoothly via 4-hour airlift and road transportation. Among them, twenty-five patients were in critical condition.Results These thirty-five patients were evacuated 6 hours from the scene of the injury, and they were transferred to a local hospital for primary emergency care. The patients were in very poor condition when admitted to our hospital because of the severe injury with delayed and inadequate treatment. Examination of these patients at admission showed that one patient was suffering from sepsis and multiple organ dysfunction syndrome. Dysfunction of the heart, lung, liver,kidney, and coagulation were all found in the patients. Forty-eight operations were performed in the 23 patients during one month together with comprehensive treatment, and the function of various organs was ameliorated after appropriate treatment. All the 35 patients survived.Conclusions A well-organized team consisting of several cooperative groups with specified duties is very important. As a whole, the treatment protocol should be individualized, basing on the extent of

  13. Negative Pressure Wound Therapy Decreases Mortality in a Murine Model of Burn-Wound Sepsis Involving Pseudomonas aeruginosa Infection

    OpenAIRE

    Yang Liu; Qin Zhou; Yunchuan Wang; Zhengcai Liu; Maolong Dong; Yaojun Wang; Xiao Li; Dahai Hu

    2014-01-01

    BACKGROUND: The colonization of burn wounds by Pseudomonas aeruginosa can lead to septic shock, organ injuries, and high mortality rates. We hypothesized that negative pressure wound therapy (NPWT) would decrease invasion and proliferation of P. aeruginosa within the burn wound and reduce mortality. METHODS: Thermal injuries were induced in anesthetized mice, and P. aeruginosa was applied to the wound surface for 24 h. After removing the burn eschar and debridement, the animals were subjected...

  14. Crude oil burning mechanisms

    DEFF Research Database (Denmark)

    van Gelderen, Laurens; Malmquist, Linus Mattias Valdemar; Jomaas, Grunde

    2015-01-01

    In order to improve predictions for the burning efficiency and the residue composition of in-situ burning of crude oil, the burning mechanism of crude oil was studied in relation to the composition of its hydrocarbon mixture, before, during and after the burning. The surface temperature, flame...... height, mass loss rate and residues of three hydrocarbon liquids (n-octane, dodecane and hexadecane), two crude oils (DUC and REBCO) and one hydrocarbon liquid mixture of the aforementioned hydrocarbon liquids were studied using the Crude Oil Flammability Apparatus. The experimental results were compared...... to the predictions of four conceptual models that describe the burning mechanism of multicomponent fuels. Based on the comparisons, hydrocarbon liquids were found to be best described by the Equilibrium Flash Vaporization model, showing a constant gas composition and gasification rate. The...

  15. Burning mouth syndrome

    Directory of Open Access Journals (Sweden)

    K A Kamala

    2016-01-01

    Full Text Available Burning mouth syndrome (BMS is multifactorial in origin which is typically characterized by burning and painful sensation in an oral cavity demonstrating clinically normal mucosa. Although the cause of BMS is not known, a complex association of biological and psychological factors has been identified, suggesting the existence of a multifactorial etiology. As the symptom of oral burning is seen in various pathological conditions, it is essential for a clinician to be aware of how to differentiate between symptom of oral burning and BMS. An interdisciplinary and systematic approach is required for better patient management. The purpose of this study was to provide the practitioner with an understanding of the local, systemic, and psychosocial factors which may be responsible for oral burning associated with BMS, and review of treatment modalities, therefore providing a foundation for diagnosis and treatment of BMS.

  16. Hydrocolloid dressing in pediatric burns may decrease operative intervention rates.

    LENUS (Irish Health Repository)

    Martin, Fiachra T

    2010-03-01

    Partial-thickness scalds are the most common pediatric burn injury, and primary management consists of wound dressings to optimize the environment for reepithelialization. Operative intervention is reserved for burns that fail to heal using conservative methods. Worldwide, paraffin-based gauze (Jelonet) is the most common burn dressing; but literature suggests that it adheres to wounds and requires more frequent dressing change that may traumatize newly epithelialized surfaces. Hydrocolloid dressings (DuoDERM) provide an occlusive moist environment to optimize healing and are associated with less frequent dressing changes.

  17. Indications and strategies for Mechanical Ventilation in the Burned Patients

    Directory of Open Access Journals (Sweden)

    Murat Yılmaz

    2011-07-01

    Full Text Available Respiratory tract is one of the most seriously injured system in burned patients. Besides the direct inhalation injury, respiratory organs may be effected by the inflammatory mediators released due to systemic inflammatory response syndrome. As a result, many severely burned patients are needed to be intubated and mechanically ventilated after admitted to ICU. For this purpose, the medical staff working in the ICU’s which admit severely burned patients should be experienced in mechanical ventilation modes, complications related to mechanical ventilation and weaning strategies. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 31-6

  18. The trend of acute burns pre-hospital management

    Institute of Scientific and Technical Information of China (English)

    Abubakar Hamdiya; Agbenorku Pius; Aboah Ken; Paa Ekow Hoyte-Williams

    2015-01-01

    Objective: To study the trend and knowledge of first aid administration of any kind among the burns patients and also to create awareness to the general public who mostly act as first aid givers who seem ignorant about the appropriate immediate care to render to the burns victim. Methods: Pre-tested questionnaires were administered to the burns victims who had received or not some form of first aid at the scene of the burn injury. Results: The study showed varied first aid knowledge and administration outcomes as a result of different substances such as water or sand, muddy water, starch, corn dough, cow dung, egg white, calamine lotion, gentian violet, ointments, creams, lotions, tooth paste etc. applied as first aid. 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.

  19. BURN SIZE AND SURVIVAL PROBABILITY IN PEDIATRIC PATIENTS IN MODERN BURN CARE

    Science.gov (United States)

    Kraft, Robert; Herndon, David N; Al-Mousawi, Ahmed M; Williams, Felicia N; Finnerty, Celeste C; Jeschke, Marc G

    2012-01-01

    Background Patient survival following severe burn injury is largely determined by burn size. Modern developments in burn care have tremendously improved survival and outcomes. However, no large analysis on outcomes in pediatric burn patients with current treatment regimen exists. This study was designed to identify the burn size presently associated with significant increases in morbidity and mortality in pediatric burn patients. Methods Single center prospective observational cohort study utilizing the clinical data of severely burned pediatric patients admitted between 1998 and 2009. This study included 952 severely burned pediatric patients with burns over at least 30% of their total body surface area (TBSA). Patients were stratified by burn size in 10% increments, ranging from 30 to 100%, with a secondary assignment made according to the outcome of a receiver operating characteristic (ROC) analysis. Statistical analysis was performed using Student’s t-test, χ2 test, logistic regression and ROC analysis, as appropriate, with significance set at p<0.05. Findings All groups were comparable in age (age in years: 30–39: 6.1±5.1, 40–49: 7.1±5.2, 50–59: 7.6±5.1, 60–69: 7.2±5.1, 70–79: 8.3±5.9, 80–89: 8.4±5.6, 90–100: 9.6±5.4), and gender distribution (male: 30–39: 68%, 40–49: 64%, 50–59: 65%, 60–69: 59%, 70–79: 71%, 80–89: 62%, 90–100: 82%). Mortality (30–39: 3%, 40–49: 3%, 50–59: 7%, 60–69: 16%, 70–79: 22%, 80–89: 35%, 90–100: 55%), multi-organ failure (30–39: 6%, 40–49: 6%, 50–59: 12%, 60–69: 27%, 70–79: 29%, 80–89: 44%, 90–100: 45%), and sepsis (30–39: 2%, 40–49: 5%, 50–59: 6%, 60–69: 15%, 70–79: 13%, 80–89: 22%, 90–100: 26%), increased significantly (p<0.001) among the groups and at a threshold of 62% TBSA. Comparison of patients with burns larger than 62% with those smaller showed significant differences in inflammatory (Cytokines), acute phase (CRP) and hypermetabolic responses (REE

  20. 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

  1. The Birmingham Burn Centre archive: A photographic history of post-war burn care in the United Kingdom.

    Science.gov (United States)

    Hardwicke, Joseph; Kohlhardt, Angus; Moiemen, Naiem

    2015-06-01

    The Medical Research Council Burns and Industrial Injuries Unit at the Birmingham Accident Hospital pioneered civilian burn care and research in the United Kingdom during the post-war years. A photographic archive has been discovered that documents this period from 1945 to 1975. The aim of this project was to sort, digitize and archive the images in a secure format for future reference. The photographs detail the management of burns patients, from injury causation and surgical intervention, to nursing care, rehabilitation and long-term follow-up. A total of 2650 images files were collected from over 600 patients. Many novel surgical, nursing, dressing and rehabilitation strategies are documented and discussed. We have chosen to report part of the archive under the sections of (1) aseptic and antimicrobial burn care; (2) burn excision and wound closure; (3) rehabilitation, reconstruction and long-term outcomes; (4) accident prevention; and (5) response to a major burns incident. The Birmingham collection gives us a valuable insight into the approach to civilian burn care in the post-war years, and we present a case from the archive to the modern day, the longest clinical photographic follow-up to date. PMID:25749201

  2. Burn prevention mechanisms and outcomes: pitfalls, failures and successes.

    Science.gov (United States)

    Atiyeh, Bishara S; Costagliola, Michel; Hayek, Shady N

    2009-03-01

    Burns are responsible for significant mortality and morbidity worldwide and are among the most devastating of all injuries, with outcomes spanning the spectrum from physical impairments and disabilities to emotional and mental consequences. Management of burns and their sequelae even in well-equipped, modern burn units of advanced affluent societies remains demanding and extremely costly. Undoubtedly, in most low and middle income countries (LMICs) with limited resources and inaccessibility to sophisticated skills and technologies, the same standard of care is obviously not possible. Unfortunately, over 90% of fatal fire-related burns occur in developing or LMICs with South-East Asia alone accounting for over half of these fire-related deaths. If burn prevention is an essential part of any integrated burn management protocol anywhere, focusing on burn prevention in LMICs rather than treatment cannot be over-emphasized where it remains the major and probably the only available way of reducing the current state of morbidity and mortality. Like other injury mechanisms, the prevention of burns requires adequate knowledge of the epidemiological characteristics and associated risk factors, it is hence important to define clearly, the social, cultural and economic factors, which contribute to burn causation. While much has been accomplished in the areas of primary and secondary prevention of fires and burns in many developed or high-income countries (HICs) such as the United States due to sustained research on the epidemiology and risk factors, the same cannot be said for many LMICs. Many health authorities, agencies, corporations and even medical personnel in LMICs consider injury prevention to have a much lower priority than disease prevention for understandable reasons. Consequently, burns prevention programmes fail to receive the government funding that they deserve. Prevention programmes need to be executed with patience, persistence, and precision, targeting high

  3. Improvement of survival in patients with extensive burns involving the perineum with use of a faecal management system

    OpenAIRE

    Farroha, A.; Frew, Q.; Philp, B.; Dziewulski, P.

    2014-01-01

    The purpose of this study is to assess the effectiveness of faecal management systems in improving survival of patients with extensive burns involving the perineum. All adults with burns of more than 30% total body surface area (TBSA) who were actively treated in our regional burn service between December 2008 and July 2012 were reviewed and compared to an historical cohort of 18 adult patients with similar injury involving the perineum, treated in our regional burn service between 1999 and 2...

  4. EFFECTS OF BURN ON THE MOBILITY OF UPPER LIMB/S, FUNCTIONS OF HAND /S & ACTIVITIES OF DAILY LIVING

    OpenAIRE

    Perera M M N; Nanayakkarawasam P P; Katulanda P

    2015-01-01

    Background: Burn is an injury cause destruction of skin and underling tissue. Post burns complications are severe. Objective of this study is to identify the effects on the Active Range of Motion (AROM) of upper limb/s, hand functions and Activities of Daily Living (ADL) who attend the physical therapy department of burns unit. Methodology: It was a descriptive cross sectional study carried out at out-patient physical therapy department of burns unit of National Hospital of SriLanka (NHS...

  5. 9例大面积烧伤合并吸入性气道损伤患者下呼吸道感染的预防与控制%The prevention and control of lower respiratory tract infection in 9 cases of patients with large area burn combined inhalation injury

    Institute of Scientific and Technical Information of China (English)

    沈小玥; 穆晓苏; 徐晓莉; 黄慧敏; 方红梅; 尹湘毅; 李亚楠; 尹诺

    2016-01-01

    目的:探讨9例大面积烧伤合并吸入性气道损伤患者下呼吸道感染的预防与控制措施。方法调查9例大面积烧伤合并吸入性损伤患者的下呼吸道分泌物培养的病原菌细菌谱及耐药情况。结果共检出下呼吸道病原菌2种,共38株,其中鲍曼不动杆菌37株,占97.36%(37/38);嗜麦芽假单胞菌1株,占2.64%(1/38)。鲍曼不动杆菌耐药率达到75.59%,对替加环素、米诺环素敏感性90%以上。经过严格实施感染预防与控制,合理使用抗菌药物等综合措施后取得了良好的疗效,鲍曼不动杆菌检出率明显下降。结论本文患者的下呼吸道病原菌以鲍曼不动杆菌最常见,虽然鲍曼不动杆菌感染率及耐药率高,但可以通过有效的消毒隔离、严格的下呼吸道医院感染预防措施及合理应用抗菌药物等方法,使鲍曼不动杆菌的检出率明显下降。%Objective To prevent and reduce lower respiratory tract infection in the batch of patients with large area burn combined inhalation injury. Methods 9 cases of large area burn with inhalation injury patients were investigated of bacterial spectrum and drug resistance of lower respiratory tract secretion. Results In the survey, we detected a total of 38 strains of 2 kinds of the lower respiratory tract pathogen, including 37 strains of acinetobacter baumannii accounting for 97. 36% and 1 strain of eosinophilic malt pseudomonas accounting for 2.64%. Acinetobacter baumannii antibiotic resistant rate rised up to 75.59%. The sensitive rate of tigecy⁃cline and minocycline rised significantly (>90%) . After strict infection control, reasonable use of antibiotics and other comprehensive measures, we have obtained a good curative effect. The detection rate of acinetobacter baumannii declined obviously. Conclusion In large area burn with inhalation injury patients, acinetobacter baumannii is the most common in lower respiratory tract

  6. Injury prevention and public health

    Directory of Open Access Journals (Sweden)

    David A. Sleet

    2010-06-01

    Full Text Available Injuries are one of the most under-recognized public health problems facing the world today. With more than 5 million deaths every year, violence and injuries account for 9% of global mortality, as many deaths as from HIV, Malaria and Tuberculosis combined. Eight of the 15 leading causes of death for people ages 15 to 29 years are injury-related: road traffic injuries, suicides, homicides, drowning, burns, war injuries, poisonings and falls. For every death due to war, there are three deaths due to homicide and five deaths due to suicide. However, most violence happens to people behind closed doors and results not in death, but often in years of physical and emotional suffering [1]. Injuries can be classified by intent: unintentional or intentional. Traffic injuries, fire-related injuries, falls, drowning, and poisonings are most often classified as unintentional injuries; injuries due to assault, selfinflicted violence such as suicide, and war are classified as intentional injuries, or violence. Worldwide, governments and public and private partners are increasingly aware of the strains that unintentional injuries and violence place on societies. In response they are strengthening data collection systems, improving services for victims and survivors, and increasing prevention efforts [1].

  7. Building resilience in burns nurses: a descriptive phenomenological inquiry.

    Science.gov (United States)

    Kornhaber, Rachel Anne; Wilson, Anne

    2011-01-01

    The purpose of this qualitative study was to explore the concept of building resilience as a strategy for responding to adversity experienced by burns nurses. Nurses who care for patients with severe burn injury are often exposed to patients' pain and disfigurement, encountering emotional exhaustion, distress, reduced self-esteem, and desensitization to pain. Resilience has been identified as an essential characteristic for nurses in their work environment. Resilience assists nurses to bounce back and to cope in the face of adversity, sustaining them through difficult and challenging working environments. Nonetheless, there remains limited information that addresses the concept of building resilience in burns nurses. In 2009, seven burns nurses were recruited from a severe burn injury unit in New South Wales, Australia. A qualitative phenomenological methodology was used to construct themes depicting nurses' experiences. Participants were selected through purposeful sampling, and data were collected through in-depth individual semistructured interviews using open-ended questions. Data were analyzed with Colaizzi's phenomenological method of data analysis. The concept of building resilience as a strategy for coping with adversity was identified and organized into six categories: toughening up, natural selection, emotional toughness, coping with the challenges, regrouping and recharging, and emotional detachment. The findings clearly demonstrate that it is vital for burns nurses to build resilience to endure the emotional trauma of nursing patients with severe burn injury. Knowledge about building resilience could be incorporated into nursing education for both undergraduate and experienced nurses. Building resilience within the domain of burns nursing has the potential to retain nurses within the profession, having implications for staff development, orientation, and retention. PMID:21747335

  8. 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 patient factors. Furthermore, clinical practice variations among the three study sites also

  9. Study on the changes of serum complement C 3 and IL-10 after burn injury and infection%烧伤感染后血清补体 C3 IL-10的变化

    Institute of Scientific and Technical Information of China (English)

    高敏; 刘鲲; 刘宁; 戴军; 王文军

    2015-01-01

    目的:探究机体烧伤感染后免疫因子的水平变化。方法选取2013年4月至2014年2月我院收治的200例烧伤患者,分别于烧伤后第3、7、14天检测观察外周血补体C3、IL‐10水平并进行比较。结果随着时间的推移,患者创面感染率升高;烧伤后患者补体C3和IL‐10的水平均呈现先上升后下降的变化;感染患者体内的补体C3水平均高于未感染患者;烧伤后脓毒血症患者机体补体C3和IL‐10水平均高于单独创面感染患者。结论烧伤后感染可影响患者血清补体C3和 IL‐10水平的改变,可通过对相应免疫因子水平的调节进行治疗以维持患者体内免疫反应平衡,防止感染加重。%Objective To explore the changes of serum complement C3 and IL‐10 after the burn infection .Meth‐ods Burn patients were selected from April 2013 to February 2014 in our hospital ,and the levels of serum comple‐ment C3 and IL‐10 in the peripheral blood were detected on days 3 ,7 ,14 after burns .Results Wound infection rate of patients elevated in a time‐dependent manner .Complement factor C3 and IL‐10 levels of all patients increased then declined after burn .Complement C3 levels of infected patients were higher than those of uninfected patients in different periods .Complement C3 and IL‐10 levels of sepsis patients were higher than those of patients with a single wound infection at different periods .The results have statistically significant ( P<0.05) .Conclusion Burn infec‐tion can affect the serum levels of immune factors .We can regulate levels of immune factors in order to maintain immune balance and prevent the aggravation of infection .

  10. Prescribed burning plan : Stillwater NWR : de Braga Burn Unit 67

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This 1991 Annual Prescribed Burning Plan for Stillwater NWR calls for all 67 acres of the de Braga burn unit to be burned. The objective of this burn is to remove...

  11. Crude oil burning mechanisms

    DEFF Research Database (Denmark)

    van Gelderen, Laurens; Malmquist, L.M.V.; Jomaas, Grunde

    2015-01-01

    In order to improve predictions for the burning efficiency and the residue composition of in-situ burning of crude oil, the burning mechanism of crude oil was studied in relation to the composition of its hydrocarbon mixture, before, during and after the burning. The surface temperature, flame...... height, mass loss rate and residues of three hydrocarbon liquids (n-octane, dodecane and hexadecane), two crude oils (DUC and REBCO) and one hydrocarbon liquid mixture of the aforementioned hydrocarbon liquids were studied using the Crude Oil Flammability Apparatus. The experimental results were compared...... on the highest achievable oil slick temperature. Based on this mechanism, predictions can then be made depending on the hydrocarbon composition of the fuel and the measured surface temperature....

  12. A Burning Question

    Institute of Scientific and Technical Information of China (English)

    LAN XINZHEN

    2010-01-01

    @@ As heaping piles of garbage grow in cities and communities across China,a divide has formed over two possible solutions to this smelly problem: Should excessive mounds of trash be burned,or should it be buried?

  13. Risk factors for mortality in burn children

    Directory of Open Access Journals (Sweden)

    Maria Teresa Rosanova

    2014-04-01

    Full Text Available Studies about risk factors for mortality in burn children are scarce. We conducted this study to evaluate the risk factors for mortality in pediatric burn patients. We included 110 patients. Mean age was 31.5 months (range: 1 to 204. The burn surface was between 1% and 95%(median 27% Type of burn was: A or superfitial in 39 patients (36%, AB or intermediate in 19 (17%, and B or full thickness in 52 (47%. Inhalatory injury was present in 52 patients (47%. Invasive procedures were: venous catheter, 90 patients (82%, arterial catheter, 83patients (75.5%, urinary catheter, 86 patients (78%, and mechanical ventilation, 75 patients (68%. In 84 patients, 128 infections were diagnosed. in 53 cases (48%. Multiresistant Pseudomonas aeruginosa and Acynetobacter baumannii were the most common organisms isolated. The median length of hospital stay was 33 days (r: 8-139 days. Seventeen patients (15% died and 14 of them of infection-related causes. Age 40% burn surface, presence of inhalatory syndrome, use of venous catheter, arterial catheter, urinary catheter and mechanical ventilation, positive blood cultures, colistin use in documented multiresistant infections, antifungal use and graft requirement, were identified as risks factors for mortality in the univariate analysis. By multivariate analysis: age <4 years, Garcés 4, colistin use in multiresistant infections, mechanical ventilation and graft requirement were independent variables related with mortality. CONCLUSIONS: In this series of burn children age < 4 years, Garces index score 4, colistin use in documented multiresistant infections, mechanical ventilation and graft requirement were identified as independent variables related with mortality.

  14. Advances in burn treatment

    OpenAIRE

    Lahoda, LU; Vogt, PM

    2006-01-01

    The German-speaking burn specialist, organized in the DAV (Deutsche Arbeitsgemeinschaft für Verbrennungsmedizin) held their yearly meeting in 2004 in Rottach-Egern, Bavaria. Participants from Switzerland, Germany and Austria found a high standing, very well organized and thorough program summoned by the host, Dr. Guido Graf Henckel von Donnersmarck, Munich. The topics consisted of reconstructive surgery, skin substitutes and replacement, advances in burn medicine over the last 10 years and bu...

  15. Burning mouth syndrome

    OpenAIRE

    Sudha Jimson; Rajesh, E.; R Jayasri Krupaa; M. Kasthuri

    2016-01-01

    Burning mouth syndrome is a debilitating medical condition affecting nearly 1.3 million of Americans. Its common features include a burning painful sensation in the mouth, often associated with dysgeusia and xerostomia, despite normal salivation. Classically, symptoms are better in the morning, worsen during the day and typically subside at night. Its etiology is largely multifactorial, and associated medical conditions may include gastrointestinal, urogenital, psychiatric, neurologic and met...

  16. Temporal Cytokine Profiles in Severely Burned Patients: A Comparison of Adults and Children

    OpenAIRE

    Finnerty, Celeste C.; Jeschke, Marc G.; Herndon, David N; Gamelli, Richard; Gibran, Nicole; Klein, Matthew; Silver, Geoff; Arnoldo, Brett; Remick, Daniel; Tompkins, Ronald G.

    2008-01-01

    A severe burn leads to hypermetabolism and catabolism resulting in compromised function and structural changes of essential organs. The release of cytokines has been implicated in this hypermetabolic response. The severity of the hypermetabolic response following burn injury increases with age, as does the mortality rate. Due to the relationship between the hypermetabolic and inflammatory responses, we sought to compare the plasma cytokine profiles following a severe burn in adults and in chi...

  17. Pulmonary Histopathologic Abnormalities and Predictor Variables in Autopsies of Burned Pediatric Patients

    Science.gov (United States)

    Sousse, Linda E.; Herndon, David N.; Andersen, Clark R.; Zovath, Andrew; Finnerty, Celeste C.; Mlcak, Ronald P.; Cox, Robert A.; Traber, Daniel L.; Hawkins, Hal K.

    2014-01-01

    Pulmonary abnormalities occur in 30–80% of fatalities after burn injury. The objective of our study is to investigate lung pathology in autopsy tissues of pediatric burn patients. METHODS Three scientists with pathology training in pediatric burn care reviewed masked autopsy slides of burned children who died after admission to a burn center from 2002–2012 (n=43). Autopsy lung tissue was assigned scores for histologic abnormalities in 9 categories, including alveolar and interstitial fibrosis, hyaline membranes, and type II epithelial cell proliferation. Scores were then tested for correlation with age, TBSA burn, number of days between burn and death, time between burn and admission, and the presence of inhalation injury using analyses with linear models. RESULTS Type II epithelial cell proliferation was significantly more common in cases with a longer time between burn and admission (p<0.02). Interstitial fibrosis was significantly more severe in cases with longer survival after burn (p<0.01). The scores for protein were significantly higher in cases with longer survival after burn (p<0.03). Enlarged air spaces were significantly more prominent in cases with longer survival after burn (p<0.01), and in cases with the presence of inhalation injury (p<0.01). CONCLUSIONS Histological findings associated with Diffuse Alveolar Damage (DAD), which is the pathological correlate of the Acute Respiratory Distress Syndrome (ARDS), were seen in approximately 42% of autopsies studied. Protein-rich alveolar edema, which is the abnormality that leads to ARDS, may occur from multiple causes, including inhalation injury. PMID:25445004

  18. The Use of Stem Cells in Burn Wound Healing: A Review

    OpenAIRE

    Fadi Ghieh; Rosalyn Jurjus; Amir Ibrahim; Alice Gerges Geagea; Hisham Daouk; Bassel El Baba; Sana Chams; Michel Matar; Wadih Zein; Abdo Jurjus

    2015-01-01

    Burn wound healing involves a series of complex processes which are subject to intensive investigations to improve the outcomes, in particular, the healing time and the quality of the scar. Burn injuries, especially severe ones, are proving to have devastating effects on the affected patients. Stem cells have been recently applied in the field to promote superior healing of the wounds. Not only have stem cells been shown to promote better and faster healing of the burn wounds, but also they h...

  19. Bench-to-bedside review: Burn-induced cerebral inflammation – a neglected entity?

    OpenAIRE

    Flierl, Michael A; Stahel, Philip F.; Touban, Basel M; Beauchamp, Kathryn M; Morgan, Steven J; Smith, Wade R; Ipaktchi, Kyros R

    2009-01-01

    Severe burn injury remains a major burden on patients and healthcare systems. Following severe burns, the injured tissues mount a local inflammatory response aiming to restore homeostasis. With excessive burn load, the immune response becomes disproportionate and patients may develop an overshooting systemic inflammatory response, compromising multiple physiological barriers in the lung, kidney, liver, and brain. If the blood–brain barrier is breached, systemic inflammatory molecules and phag...

  20. Licking as an out-of-hospital burns treatment-An isolated cultural phenomenon?

    LENUS (Irish Health Repository)

    Seoighe, Deirdre M

    2012-02-01

    Wound management in burns is a potentially complex issue. Salivary constituents have been shown experimentally to be of benefit in the treatment of thermal injuries. In our clinical experience we have encountered patients who have saliva directly applied to the burn wound prior to presenting to the national burns service. The practice is known as "Licking". We report two cases to illustrate the presentations we have encountered. We believe that these illustrate an isolated phenomenon unique to the Republic of Ireland.

  1. Open burn wound dressing: a practical option in resource constrained settings

    OpenAIRE

    Olawoye, O.A.; Osinupebi, O.O.; Ayoade, B.A.

    2013-01-01

    Various types of wound care products abound for the treatment of burn injuries. Most of these products are rather expensive and beyond the means of many patients in poorer countries. This poses a challenge to burn care workers in these environments and calls for the adoption of practical solutions with the use of less expensive and readily available alternatives. The aim of this study is to review the outcome of our burn patients managed with topical silver sulphadiazine dressing in terms of ...

  2. Effect of Antioxidants on the Incidence of Wound Infection in Burn Patients

    OpenAIRE

    Sahib, A.S.; Al-Jawad, F.H.; Alkaisy, A.A.

    2010-01-01

    Background. Thermal injury causes the destruction of the physical skin barrier that normally protects the body from invasion by micro-organisms and induces an immunocompromised state that predisposes burn patients to infection, sepsis, and multiple organ failure. Reactive oxygen species contribute to burn-mediated immune suppression, and as the use of antioxidants has a positive effect on immune function, this may reduce the incidence of wound infection and related complications in burn patie...

  3. Achievements in burn surgery over the past 50 years in China

    Institute of Scientific and Technical Information of China (English)

    Shiliang WANG

    2008-01-01

    This paper reflects on the advancements of clinical and scientific research in the field of burn sur-gery in China. It includes emergency care of massive burns, resuscitation, anti-infection, prevention and cure of internal organ injuries, metabolic and nutritional sup-port, wound repair and rehabilitation, and special types of burns; it also covers pathology, microbiology, immunology, cell biology, molecular biology, and tissue engineering.

  4. Applications of virtual reality for pain management in burn-injured patients

    OpenAIRE

    Sharar, Sam R.; Miller, William; Teeley, Aubriana; Soltani, Maryam; Hoffman, Hunter G.; Jensen, Mark P.; Patterson, David R.

    2008-01-01

    The pain associated with burn injuries is intense, unremitting and often exacerbated by anxiety, depression and other complicating patient factors. On top of this, modern burn care involves the repetitive performance – often on a daily basis for weeks to months – of painful and anxiety-provoking procedures that create additional treatment-related pain, such as wound care, dressing changes and rehabilitation activities. Pain management in burn patients is primarily achieved by potent pharmacol...

  5. Sports Injuries

    Science.gov (United States)

    ... most common sports injuries are Sprains and strains Knee injuries Swollen muscles Achilles tendon injuries Pain along the shin bone Rotator cuff injuries Fractures Dislocations If you get hurt, stop playing. Continuing ...

  6. Pain insensitivity syndrome misinterpreted as inflicted burns.

    Science.gov (United States)

    van den Bosch, Gerbrich E; Baartmans, Martin G A; Vos, Paul; Dokter, Jan; White, Tonya; Tibboel, Dick

    2014-05-01

    We present a case study of a 10-year-old child with severe burns that were misinterpreted as inflicted burns. Because of multiple injuries since early life, the family was under suspicion of child abuse and therefore under supervision of the Child Care Board for 2 years before the boy was burned. Because the boy incurred the burns without feeling pain, we conducted a thorough medical examination and laboratory testing, evaluated detection and pain thresholds, and used MRI to study brain morphology and brain activation patterns during pain between this patient and 3 healthy age- and gender-matched controls. We found elevated detection and pain thresholds and lower brain activation during pain in the patient compared with the healthy controls and reference values. The patient received the diagnosis of hereditary sensory and autonomic neuropathy type IV on the basis of clinical findings and the laboratory testing, complemented with the altered pain and detection thresholds and MRI findings. Hereditary sensory and autonomic neuropathy IV is a very rare congenital pain insensitivity syndrome characterized by the absence of pain and temperature sensation combined with oral mutilation due to unawareness, fractures, and anhidrosis caused by abnormalities in the peripheral nerves. Health care workers should be aware of the potential presence of this disease to prevent false accusations of child abuse. PMID:24733875

  7. Reclaiming body image: the hidden burn.

    Science.gov (United States)

    Willis-Helmich, J J

    1992-01-01

    At the age of 4, I incurred a major burn injury that left 45% of my body with permanent scars. Normal clothing covers most of the scars. I was able to reclaim a positive body image through a gradual process of verbal and "body" disclosure. As an adult, I joined a burn survivors' self-help group; as a result of talking with other burn survivors, my self expectations increased. Later, I joined a facilitated group in which nudity and personal growth were the norm. In this group, I was the only person who had experienced a major physical trauma. I replaced my strongly held beliefs that others could not accept my unclothed, burn-injured body with the belief that some persons can, and I came to a personal understanding of why others could not. Fun, exercise, and relaxation led to a reclamation of positive feelings about my unclothed body and allowed my femininity and the character of my body image to emerge and become integrated. PMID:1572860

  8. Accidental radioisotope burns - Management of late sequelae

    Directory of Open Access Journals (Sweden)

    Varghese Bipin

    2010-10-01

    Full Text Available Accidental radioisotope burns are rare. The major components of radiation injury are burns, interstitial pneumonitis, acute bone marrow suppression, acute renal failure and adult respiratory distress syndrome. Radiation burns, though localized in distribution, have systemic effects, and can be extremely difficult to heal, even after multiple surgeries. In a 25 year old male who sustained such trauma by accidental industrial exposure to Iridium192 the early presentation involved recurrent haematemesis, pancytopenia and bone marrow suppression. After three weeks he developed burns in contact areas in the left hand, left side of the chest, abdomen and right inguinal region. All except the inguinal wound healed spontaneously but the former became a non-healing ulcer. Pancytopenia and bone marrow depression followed. He was treated with morphine and NSAIDs, epidural buprinorphine and bupivicaine for pain relief, steroids, antibiotics followed by wound excision and reconstruction with tensor fascia lata(TFL flap. Patient had breakdown of abdominal scar later and it was excised with 0.5 cm margins up to the underlying muscle and the wound was covered by a latissimis dorsi flap. Further scar break down and recurrent ulcers occurred at different sites including left wrist, left thumb and right heel in the next two years which needed multiple surgical interventions.

  9. Infection control in burn patients: are fungal infections underestimated?

    OpenAIRE

    Struck Manuel F

    2009-01-01

    Abstract With great interest, I read the paper of David J. Dries about recent developments, infection control and outcomes research in the management of burn injuries 1. I have some comments about an important, however missing, topic in the paragraphs concerning infection control.

  10. In vivo terahertz imaging of rat skin burns

    Science.gov (United States)

    Tewari, Priyamvada; Kealey, Colin P.; Bennett, David B.; Bajwa, Neha; Barnett, Kelli S.; Singh, Rahul S.; Culjat, Martin O.; Stojadinovic, Alexander; Grundfest, Warren S.; Taylor, Zachary D.

    2012-04-01

    A reflective, pulsed terahertz (THz) imaging system was used to acquire high-resolution (d10-90/ λ~1.925) images of deep, partial thickness burns in a live rat. The rat's abdomen was burned with a brass brand heated to ~220°C and pressed against the skin with contact pressure for ~10 sec. The burn injury was imaged beneath a Mylar window every 15 to 30 min for up to 7 h. Initial images display an increase in local water concentration of the burned skin as evidenced by a marked increase in THz reflectivity, and this likely correlates to the post-injury inflammatory response. After ~1 h the area of increased reflectivity consolidated to the region of skin that had direct contact with the brand. Additionally, a low reflecting ring of tissue could be observed surrounding the highly reflective burned tissue. We hypothesize that these regions of increased and decreased reflectivity correlate to the zones of coagulation and stasis that are the classic foundation of burn wound histopathology. While further investigations are necessary to confirm this hypothesis, if true, it likely represents the first in vivo THz images of these pathologic zones and may represent a significant step forward in clinical application of THz technology.

  11. 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\\

  12. Clinical characteristics and treatment of burn wound sepsis in extensive burn patients: successful experience with eight cases

    Institute of Scientific and Technical Information of China (English)

    柴家科; 盛志勇; 杨红明

    2000-01-01

    Eight burn wound sepsis patients, in which 6 cases were diagnosed as MODS and two as septic shock, were treated consecutively in our hospital from September 1997 to October 1998. The plasma concentration of IL-6, IL-8, TNFα and LPS were assayed before and after surgical intervention, as well as when the patients' vital signs became stable. The results showed: ①The patients' conditions abruptly deteriorated when the burn wound sepsis emerged;②The major cause related to burn wound sepsis was extensive burn injuries, with large areas of deep burn remaining open; ③Although wound swabs taken on admission revealed the presence of colonization by many pathogenic bacteria, Pseudomonas aeruginosa was one of the most frequent bacteria isolated from the subeschar tissue; ④The plasma concentrations of IL-6, IL-8, TNF and LPS before surgical intervention were significantly higher than that after surgical intervention (P<0.05) ;⑤The lowest level of the inflammatory mediators was observed when the patients' conditions became stable, as compared with before surgical intervention (P<0. 001).These findings suggest that the clinical characteristics of burn wound sepsis are abrupt deterioration of the general condition and prominent septic symptoms, often complicated by MODS. The main cause of burn wound sepsis is the presence of a large area of open deep burn wounds, which should be excised and covered early. LPS and pro-inflammatory mediators play an important role in the pathogenesis of burn wound sepsis. Although success in treating these patients is the result of appropriate application of multiple treatments, early, aggressive and thorough surgical excision of invasive burn infectious tissue and closure of wound play a crucial role in the successful treatment of patients complicated by burn wound sepsis. Other treatments are adjuvant but also important.

  13. An idiosyncratic history of burn scars.

    Science.gov (United States)

    Petro, Jane A

    2015-03-01

    The history of burn scars can best be found in military medical history. The care of wounded soldiers documented in the Illiad reflected the trauma of the weapons of war, arrow, spear, sword, and ax. The introduction of gunpowder in the 14th century, increasingly sophisticated explosives, and in modern times, petroleum-driven vehicles, including airplanes, created a new subset of wounds requiring attention and post-survival scars challenging the quality of survival. This article selects from among a myriad of examples of modern military treatments as they relate to those survivors. Larrey, with Napolean's Grand Army, Sir Harold Gilles during and following World War I, and the Boston area preparation and response to the Cocoanut Grove Fire in 1942 are the principle topics examined. Recent modern interventions, related to the survival of horrific blast and burn injuries, with modern wound care and scar manipulation techniques provide context to the current ability to modify healing and scars. PMID:25922950

  14. Inhalation injury: epidemiology, pathology, treatment strategies

    OpenAIRE

    Dries, David J; Endorf, Frederick W

    2013-01-01

    Lung injury resulting from inhalation of smoke or chemical products of combustion continues to be associated with significant morbidity and mortality. Combined with cutaneous burns, inhalation injury increases fluid resuscitation requirements, incidence of pulmonary complications and overall mortality of thermal injury. While many products and techniques have been developed to manage cutaneous thermal trauma, relatively few diagnosis-specific therapeutic options have been identified for patie...

  15. Again, new, Afresh: Electric Injuries In Children

    OpenAIRE

    Almiş, Habip; Yakıncı, Cengiz; KAYHAN, Eda; Kaplan, Fatih; Karakurt, Cemşit

    2014-01-01

    OBJECTIVESIn this study, we planned to determine the factors affecting the mortality, and morbidity of electrical injuries.Electric injuries, is cause of high morbidity and mortality, major burns, leading to cardiac and orthopedic problems and trauma, in all age groups are at risk type.This study of children presenting with electric injuries to determine the demographic characteristics, can be taken to reduce mortality and morbidity measures were planned to be discussed.MATERIAL AND METHODSIn...

  16. A three decade analysis of factors affecting burn mortality in the elderly.

    Science.gov (United States)

    Lionelli, G T; Pickus, E J; Beckum, O K; Decoursey, R L; Korentager, R A

    2005-12-01

    This study's objective was to identify variables that affect the mortality of elderly burn patients and to assess their changes over time. A retrospective review was conducted on all patients 75 or older (n=201) admitted to a university-based burn center between 1972 and 2000. Variables examined were age, sex, TBSA, ABSI, inhalation injury, timing from burn to operative intervention, the number of surgical procedures, the number of pre-morbid conditions, and mortality. There were 95 fatalities. TBSA strongly correlated with mortality (p<0.0001). Adjusting for TBSA and inhalation injury, mortality significantly decreased (p=0.04, odds ratio=0.58). Mortality significantly increased with inhalation injury (p<0.01). Fatality risk increased by 400% with inhalation injury. Absence of inhalation injury was not significant with respect to mortality in the 1970s, however there was a significant decrease (p=0.02) in mortality without an inhalation injury in the 1980s and 1990s. ABSI was strongly predictive of mortality (p<0.0001). On average there was a 200% increase in mortality per unit increase of ABSI. The elderly are 58% less likely to die from burns now as compared to the 1970s. Although mortality rose with increasing TBSA equally in each decade, the absolute risk of mortality decreased over time. This data suggests major strides have been made in burn care, however similar success has not been achieved with inhalation injuries. PMID:16269217

  17. Effect of Human Burn Wound Exudate on Pseudomonas aeruginosa Virulence.

    Science.gov (United States)

    Gonzalez, Manuel R; Fleuchot, Betty; Lauciello, Leonardo; Jafari, Paris; Applegate, Lee Ann; Raffoul, Wassim; Que, Yok-Ai; Perron, Karl

    2016-01-01

    Burn wound sepsis is currently the main cause of morbidity and mortality after burn trauma. Infections by notorious pathogens such as Pseudomonas aeruginosa, Staphylococcus aureus, and Acinetobacter baumannii impair patient recovery and can even lead to fatality. In this study, we investigated the effect of burn wound exudates (BWEs) on the virulence of those pathogens. BWEs were collected within 7 days after burn trauma from 5 burn patients. We first monitored their effect on pathogen growth. In contrast to A. baumannii and S. aureus, P. aeruginosa was the only pathogen able to grow within these human fluids. Expression of typical virulence factors such as pyocyanin and pyoverdine was even enhanced compared the levels seen with standard laboratory medium. A detailed chemical composition analysis of BWE was performed, which enabled us to determine the major components of BWE and underline the metabolic modifications induced by burn trauma. These data are essential for the development of an artificial medium mimicking the burn wound environment and the establishment of an in vitro system to analyze the initial steps of burn wound infections. IMPORTANCE Microbial infection of severe burn wounds is currently a major medical challenge. Of the infections by bacteria able to colonize such injuries, those by Pseudomonas aeruginosa are among the most severe, causing major delays in burn patient recovery or leading to fatal issues. In this study, we investigated the growth properties of several burn wound pathogens in biological fluids secreted from human burn wounds. We found that P. aeruginosa strains were able to proliferate but not those of the other pathogens tested. In addition, burn wound exudates (BWEs) stimulate the expression of virulence factors in P. aeruginosa. The chemical composition analysis of BWEs enabled us to determine the major components of these fluids. These data are essential for the development of an artificial medium mimicking the burn wound

  18. Pattern and outcome of children admitted for burns in Benin City, mid-western Nigeria

    Directory of Open Access Journals (Sweden)

    Oludiran O

    2009-01-01

    Full Text Available Children are a vulnerable to burns, an injury, which is often preventable. A study of the profile of cases of children admitted for burns will provide background information to suggest locally doable preventive strategies as well as supply basic information for future reference. We studied the records of 62 children aged 0-16 years, admitted for burns, at the University of Benin Teaching Hospital, Benin City, between January 2002 and December 2006. There were 34 male and 28 female children. Children under three years constituted 56.5%. Whereas the leading cause of burns in all the children was flame burns from kerosene explosions (52%, scalds were responsible for 68.6% of cases in those under three. The extent of burn injury ranged from 6 to 50% and most of them presented late. 64.6% were discharged within three weeks. Wound sepsis and post burn contractures were the most frequently encountered complications (19.4% and 9.7% respectively. There were two deaths (3.2% related to sepsis. Particular attention to burn safety precautions in children (especially, in the> 3 years age group, safer storage and dispensing of combustible chemicals particularly petroleum products is advocated. Fire safety awareness, correct first aid measures and early presentation in the hospital will reduce morbidity and mortality. Early physiotherapy and splinting strategies will reduce contractures. There is the need locally for the establishment of specialized burn centres both to treat these children and to stimulate interest in burn management.

  19. The view of severely burned patients and healthcare professionals on the blind spots in the aftercare process: a qualitative study

    OpenAIRE

    Christiaens, Wendy; Van de Walle, Elke; Devresse, Sophie; Van Halewyck, Dries; Benahmed, Nadia; Paulus, Dominique; Van den Heede, Koen

    2015-01-01

    Background In most Western countries burn centres have been developed to provide acute and critical care for patients with severe burn injuries. Nowadays, those patients have a realistic chance of survival. However severe burn injuries do have a devastating effect on all aspects of a person’s life. Therefore a well-organized and specialized aftercare system is needed to enable burn patients to live with a major bodily change. The aim of this study is to identify the problems and unmet care ne...

  20. Bacteremia in burned patients admitted to Sina Hospital, Tabriz, Iran

    Directory of Open Access Journals (Sweden)

    Parviz Saleh

    2014-11-01

    Full Text Available Introduction: One of the most important causes of mortality and morbidity in burn wards is infection, and it is the major reason of death in burn injuries. There are several reasons that make burn victims predisposed to infection. The current study aimed to investigate the role of different factors that have an effect on bacteremia occurrence in burn patients and factors which are relevant to mortality in these patients. Methods: This descriptive-analytic study conducted in a 1 year period in Sina Hospital, Tabriz University of Medical Sciences, Iran, and 81 burn were included. We collected patients’ data about their age, body weight, cause of burn, lesion color, place and percentage of burn by getting history and studying of their files. Then we documented all interventions. Blood tests and cultures and colonies criteria were recorded. Results: In this study, 39 patients were male (48.1%, and 42 was female (51.9%. Mean age was 32.06 ± 17.46 years. In patients without bacteremia, 57 patients did not need catheterization (89.1%, however in patients with bacteremia 9 patients demanded catheter insertion (52.9%. In patients with bacteremia 12 patients survived (70.9%, however in the without bacteremia group 56 patients survived (92.2%. Then, the relationship between type of burn, wound infection and bacterial species investigated, (P = 0.650, P = 0.210 and P = 0.110 respectively. Conclusion: We concluded, invasive interventions increased bacteremia susceptibility in our studied burned patients. Mortality rate is directly related to bacteremia prevalence and increased by extent of burn area in these patients. The three most frequent microbial agents responsible for bacteremia were Pseudomona aeruginosa, Klebsiella and Staphylococcus aureus.

  1. Electrothermal Ring Burn

    OpenAIRE

    Yakup Çil; Hamza Yıldız; Özlem Karabudak Abuaf

    2012-01-01

    Low-voltage fountainheads such as car, tractor or motorcycle batteries are predisposed to produce large currents. Any metal object that comes into contact with these batteries may result in short-circuit. This may result in rapid and excessive heating of metal object and an electrothermal burn. Herein we presented a motorcycle driver who was 28-year-old man with electrothermal ring burn which was caused by metal chain that was used as a ring. (Turk J Dermatol 2012; 6: 106-7)

  2. Electrothermal Ring Burn

    Directory of Open Access Journals (Sweden)

    Yakup Çil

    2012-09-01

    Full Text Available Low-voltage fountainheads such as car, tractor or motorcycle batteries are predisposed to produce large currents. Any metal object that comes into contact with these batteries may result in short-circuit. This may result in rapid and excessive heating of metal object and an electrothermal burn. Herein we presented a motorcycle driver who was 28-year-old man with electrothermal ring burn which was caused by metal chain that was used as a ring. (Turk J Dermatol 2012; 6: 106-7

  3. Burning mouth syndrome

    Directory of Open Access Journals (Sweden)

    Sudha Jimson

    2015-01-01

    Full Text Available Burning mouth syndrome (BMS is a complex disorder that is characterized by warm or burning sensation in the oral mucosa without changes on physical examination. It occurs more commonly in middle-aged and elderly women and often affects the tip of the tongue, lateral borders, lips, hard and soft palate. This condition is probably of multi-factorial origin, often idiopathic, and its etiopathogensis is unknown. BMS can be classified into two clinical forms namely primary and secondary BMS. As a result, a multidisciplinary approach is required for better control of the symptoms. In addition, psychotherapy and behavioral feedback may also help eliminate the BMS symptoms.

  4. Operative utilization following severe combat-related burns.

    Science.gov (United States)

    Chan, Rodney K; Aden, James; Wu, Jesse; Hale, Robert G; Renz, Evan M; Wolf, Steven E

    2015-01-01

    The goal of burn surgical therapy is to minimize mortality and to return survivors to their preinjury state. Prompt removal of the burn eschar, early durable coverage, and late corrections of functional deformities are the basic surgical principles. The operative burden, while presumed to be substantial and significant, is neither well described nor quantified. The burn registry at the U.S. Institute of Surgical Research Burn Center was queried from March 2003 to August 2011 for all active duty burn admissions; active duty subjects were chosen to eliminate subject follow-up as a significant variable. Subject demographics including age, sex, branch of service, injury type, injury severity score, transfusion, allograft use, length of stay, mechanism of injury, and survival were tabulated as were their percentage TBSA, specific body region involvement, and nature and dates of operations performed. Univariate analysis and multiple logistic regressions were performed to determine independent factors which predict early and late operative burden. In the 8-year study period, 864 active duty patients were admitted to the burn center. Among them, 569 (66%) were operative in nature. The operations that were performed during acute hospitalization were 62%, while the remaining 38% were performed following discharge. A linear relationship exists between TBSA and the number of acute operations with an average of one acute operation required per 5% TBSA. No direct relationships however were found between TBSA and the number of reconstructive operations. Based on multiple logistic regression, battle vs nonbattle (odds ratio [OR], 0.559; 95% confidence interval [CI], 0.298-1.050; P = .0706), injury severity score (OR, 1.021; 95% CI, 1.003-1.039; P = .0222), intensive care unit length of stay (OR, 1.076; 95% CI, 1.053-1.099; P ≤ .0001), allograft use (OR, 2.610; 95% CI, 1.472-4.628; P = .0010), and TBSA of the trunk (OR, 0.982; 95% CI, 0.965-1.000; P = .0439) (but not overall TBSA

  5. Explanatory Model of Resilience in Pediatric Burn Survivors.

    Science.gov (United States)

    Quezada, Lucía; González, Mónica T; Mecott, Gabriel A

    2016-01-01

    Identifying factors of adjustment in pediatric burn patients may facilitate appropriate mental health interventions postinjury. The aim of this is study was to explore the roles of both the patient's and caregivers' resilience and posttraumatic stress in pediatric burn survivor adjustment. For the purposes of the study, "51 patient-parent/guardian" dyads participated. Patients answered the Resilience Questionnaire for Children and Adolescents, and caregivers answered the Mexican Resilience Scale and the Davidson Trauma Scale. The roles of patient age, time since the burn, and size of burn injury were also considered. Statistical analyses included Spearman's ρ for correlations and structural equation modeling. P less than .05 was considered significant. Patients and caregivers reported high levels of resilience, and the majority of caregivers reported low severity of posttraumatic stress disorder symptoms. Pediatric burn survivors' resilience was associated with being younger at the time of the burn and less severity of intrusive and avoidance symptoms in caregivers; it was also associated with a higher resilience in caregivers. It can be concluded that psychological responses of caregivers of pediatric burn survivors affect the well being and positive adjustment of patients; thus psychological services for caregivers would likely have a double benefit for both caregivers and patients. PMID:26056758

  6. Burn Safety Awareness on Playgrounds: Thermal Burns from Playground Equipment

    Science.gov (United States)

    ... Safety Awareness on Playgrounds Thermal Burns from Playground Equipment The U.S. Consumer Product Safety Commission CPSC wants ... of the risk of thermal burns from playground equipment. You may remember the metal slides of your ...

  7. Independent Predictive Factors of Hospitalization in a North-West Burn Center of Iran; an Epidemiologic Study

    Directory of Open Access Journals (Sweden)

    Samad Shams Vahdati

    2015-01-01

    Full Text Available Introduction: A high grade burn is one of the most devastating injuries with several medical, social, economic, and psychological effects. These injuries are the most common cause of accidental deaths after traffic injuries in both the developed and developing countries. Therefore this research was aimed to determine demographic characteristics of patients with burn injury admitted to the emergency department and identify predictive factors of hospitalization. Methods: This is a cross sectional descriptive study, which is done in 20 March up to 20 September 2011 in emergency department of Sina Hospital, Tabriz, Iran. Patients’ information including demographic characteristic, cause of burn, place of accident, anatomical areas burned, grading and percent of burning and disposition were gathered and analyzed using SPSS version 18.0 statistical software. Stepwise multivariate regression analysis was used for recognition of independent predictive factors of hospitalization in burned patients. Results: One hundred and sixty patients were enrolled (54.4% female. The average age of those was 20.47±13.5 years. The prevalence of burn was significantly higher in ages under 20 years (p<0.001. Lower limb (37.5%, head and neck (21.25% and upper limb (17.5% were three frequent site of burn. The most common cause of burns was boiling water scalding (34.4%. Home related burn was significantly higher than other place (p<0.001. The most frequent percent of burn was <5% (46.25%. Finally 50 (31.25% cases hospitalized. Univariate analysis demonstrated that age under 20 years old (p=0.02 female gender (p=0.02, burning site (p=0.002, cause (p=0.005, place (p<0.001, grade (p<0.001, and percent (p<0.001 was related to disposition of patients. Stepwise multiple logistic regression showed female gender (OR=3.52; 95% CI: 1.57-7.88; p=0.002, work related burning (OR=1.78; 95% CI: 1.26-2.52; p=0.001, and burning over 5 percent (OR=2.15; 95% CI: 1.35-3.41; p=0.001 as

  8. Psychophysiological Processing of Itch in Patients with Chronic Post-burn Itch: An Exploratory Study.

    Science.gov (United States)

    van Laarhoven, Antionette I M; Ulrich, Dietmar J O; Wilder-Smith, Oliver H; van Loey, Nancy E E; Nieuwenhuis, Marianne; van der Wee, Nic J A; Evers, Andrea W M

    2016-06-15

    A substantial proportion of patients with burn injury develop chronic itch, which can severely affect their quality of life. As found in research on chronic pain, different psychophysiological processes may also play a role in chronic itch, of which central sensitization, conditioned modulation, and attentional processes have been studied most frequently. This study aimed to explore psychophysiological processes of chronic post-burn itch by comparing 15 patients with long-term itch due to burn injury with 15 matched healthy controls. Exploratory results indicated tendencies for higher itch sensitivity in patients than in controls, for mechanical stimuli and histamine, but not for electrical stimulation. Results further suggest that the efficacy of itch modulation by an itch- or pain-conditioning stimulus or directing attention towards itch stimuli do not differ between these patients and controls. Further elucidation of the processes underlying post-burn itch may improve the early identification and treatment of burn patients developing chronic itch. PMID:26694745

  9. Fat burn X: burning more than fat.

    Science.gov (United States)

    Hannabass, Kyle; Olsen, Kevin Robert

    2016-01-01

    A 50-year-old man presented with a 2-day history of bilateral lower extremity cramping and dark urine. The patient was found to have a creatine phosphokinase (CPK) elevated of up to 2306 U/L, a serum uric acid of 9.7 mg/dL and 101 red blood cell's per high-powered field on urinalysis. On questioning, the patient endorsed daily exercise with free weights. There were no changes in his regular exercise and medication regimen, no muscle trauma, no recent drug use and no illness. The patient did mention using a new fat burner known as 'Fat Burn X', which he had begun taking 2 days prior to the onset of his muscle cramps. The patient was given normal saline intravenous fluid resuscitation for 48 h with resultant normalisation of his CPK and creatinine, and was discharged with primary care follow-up. PMID:26811412

  10. Burning clean and green

    International Nuclear Information System (INIS)

    A new style of oil burner has been developed for use on exploration platforms offshore. The design improves oil combustion through enhanced air induction, producing stable flames in the clean burn region which do not generate smoke and oil fallout. Successful tests have led to it now being ready for commercial exploitation. (UK)

  11. Nanoemulsion Therapy for Burn Wounds Is Effective as a Topical Antimicrobial Against Gram-Negative and Gram-Positive Bacteria.

    Science.gov (United States)

    Dolgachev, Vladislav A; Ciotti, Susan M; Eisma, Rone; Gracon, Stephen; Wilkinson, J Erby; Baker, James R; Hemmila, Mark R

    2016-01-01

    The aim of this study is to investigate the antimicrobial efficacy of two different nanoemulsion (NE) formulations against Gram-positive and Gram-negative bacteria in an in vivo rodent scald burn model. Male Sprague-Dawley rats were anesthetized and received a partial-thickness scald burn. Eight hours after burn injury, the wound was inoculated with 1 × 10(8) colony-forming units of Pseudomonas aeruginosa or Staphylococcus aureus. Treatment groups consisted of two different NE formulations (NB-201 and NB-402), NE vehicle, or saline. Topical application of the treatment was performed at 16 and 24 hours after burn injury. Animals were killed 32 hours after burn injury, and skin samples were obtained for quantitative wound culture and determination of dermal inflammation markers. In a separate set of experiments, burn wound progression was measured histologically after 72 hours of treatment. Both NE formulations (NB-201 and NB-402) significantly reduced burn wound infections with either P. aeruginosa or S. aureus and decreased median bacterial counts at least three logs when compared with animals with saline applications (p wound as measured by myeloperoxidase (MPO) assay and histopathology (p wound progression 72 hours after injury. Topically applied NB-201 and NB-402 are effective in decreasing Gram-positive and Gram-negative bacteria growth in burn wounds, reducing inflammation, and abrogating burn wound progression. PMID:26182074

  12. An assessment of burn care professionals' attitudes to major burn.

    LENUS (Irish Health Repository)

    Murphy, A D

    2008-06-01

    The resuscitation of severe burn remains a controversial area within the burn care profession. There is ongoing debate as to what percentage burn is associated with a sufficient quality of life to support initial resuscitation efforts. We conducted a survey of delegates at the 39th Annual Meeting of the British Burns Association (2005), regarding attitudes towards resuscitation following major burns. Respondents were asked the maximum percentage total body surface area (TBSA) burn beyond which they would not wish to be resuscitated. They were also asked what maximum TBSA they perceived to be commensurate with an acceptable quality of life (QOL). One hundred and forty three of 300 delegates responded to the questionnaire. Thirty three percent of respondents would not wish to be resuscitated with 50-75% TBSA burns or greater. A further 35% would not wish to have life-sustaining intervention with 75-95% TBSA burns or greater. The remaining 32% indicated that they would not want resuscitation with TBSA burns>95%. Regardless of TBSA affected, 16% would not wish resuscitation if they had full thickness facial burns, a further 10% did not want resuscitation if both their hands and faces were affected. Our survey demonstrates the diversity of personal preference amongst burn care professionals. This would suggest that a unifying philosophy regarding the resuscitation of extensive burns will remain elusive.

  13. Back Bay Wilderness burning support

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This document is a memorandum concerning prescribed burns between members of the Bureau of Sport Fisheries and Wildlife. It states that burning should be supported...

  14. Treatment of hydrofluoric acid burns

    Energy Technology Data Exchange (ETDEWEB)

    Thiele, B.; Winter, U.J.; Mahrle, G.; Steigleder, G.K.

    1986-01-31

    A chemical-plant worker sustained hydrofluoric acid burns during cleaning procedures. Intra-arterial perfusion and intralesional injections of calcium gluconate solution prevented progression of the burns into deeper tissue layers.

  15. [Treatment of hydrofluoric acid burns].

    Science.gov (United States)

    Thiele, B; Winter, U J; Mahrle, G; Steigleder, G K

    1986-01-31

    A chemical-plant worker sustained hydrofluoric acid burns during cleaning procedures. Intra-arterial perfusion and intralesional injections of calcium gluconate solution prevented progression of the burns into deeper tissue layers. PMID:3943470

  16. Comparison of Two Types of Gels in Improving Burn Wound

    Directory of Open Access Journals (Sweden)

    Rahimzadeh Golnar

    2014-01-01

    Full Text Available Objective: Kefir are natural probiotic compounds with anti-inflammatory properties, which were tested in experimental burn injury. Kefir gels were prepared from an extract of continuously cultured kefir in Man, Rogosa and Sharpe Broth medium for 48 and 96 h. Their extracts were used for evaluation of antibacterial effect against Pseudomonas aeruginosa in standard sample (ATCC 27853 and samples taken from patients with burns. The antibacterial effect of different kefir extract was assessment of minimum inhibitory concentration and minimum bactericidal concentration. The density of bacteria and percentage of organic acids (lactic and acetic acids were also determined. Materials and Methods: Similar burn injuries were made on dorsal skin surface of 40 rats. The rats were divided into 5 groups of 8 rats each. The base gel, silver sulfadiazine ointment, kefir 48 h gel, kefir 96 h gel were applied twice daily. Burn wound area was measured at baseline, 1 and 2 weeks. Results: Results indicated that by increasing the time of fermentation, concentration of lactic and acetic acid increased in orders of: Kefir 48 h < kefir 96 h, the end of the 2nd week the percentage of wound size were lowest in order of kefir 96 h gel < kefir grains 48 h gel < silver sulfadiazine 1% < untreated and based gel groups. Conclusion: In conclusion, the kefir gel therapy was an effective therapeutic approach to improve outcomes after severe burn when compared with conventional silver sulfadiazine treatment.

  17. Head Injuries

    Science.gov (United States)

    ... Aid: Falls First Aid: Head Injuries Preventing Children's Sports Injuries Getting Help: Know the Numbers Concussions Stay Safe: ... Tips: Inline Skating Safety Tips: Skateboarding Dealing With Sports Injuries Concussions: What to Do Contact Us Print Resources ...

  18. Sports Injuries

    Science.gov (United States)

    ... sometimes you can injure yourself when you play sports or exercise. Accidents, poor training practices, or improper ... can also lead to injuries. The most common sports injuries are Sprains and strains Knee injuries Swollen ...

  19. Injury Statistics

    Science.gov (United States)

    ... Data Consumer Opinion Surveys Home / Research & Statistics Injury Statistics This is the statistic reports page for scientific ... Home Appliances, Maintenance and Construction Injury Statistics Injury Statistics September 30, 2012 Submersions Related to Non-Pool ...

  20. Eye Injuries

    Science.gov (United States)

    The structure of your face helps protect your eyes from injury. Still, injuries can damage your eye, sometimes severely enough that you could lose your vision. Most eye injuries are preventable. If you play sports or ...

  1. Effect of topical silver sulfadiazine on plasma copper, zinc and silver concentrations in a burn rat model

    Energy Technology Data Exchange (ETDEWEB)

    Shippee, R.; Boosalis, M.; McClain, C.; Becker, W.; Watiwat, S. (Army Inst. of Surgery Research, Ft. Sam Houston, TX (United States))

    1991-03-15

    One percent silver sulfadiazine cream (AgSD) is routinely used as a topical agent to prevent wound infection in burned patients. This report describes the effect of such topical therapy on plasma copper, silver and zinc concentrations in burned rats. Twelve male Sprague-Dawley rats received full thickness burns of 30% of the total body surface and were maintained for seven days on Purina Rat Chow and deionized water ad libitum. Twelve sham burned animals were similarly maintained. The wounds in six burned and a similar area in six sham burned animals were treated daily with 3 gms of AgSD, beginning on the day of injury. Blood was drawn on the seventh postburn day and analyzed for plasma copper, silver and zinc, using graphite furnace atomic absorption spectrophotometry. Silver absorption was associated with decreased plasma copper concentration in both burned and sham burned animals. Zinc concentrations did not differ significantly.

  2. Burn wounds infected with Pseudomonas aeruginosa triggers weight loss in rats

    Directory of Open Access Journals (Sweden)

    Su Grace

    2005-09-01

    Full Text Available Abstract Background Despite dramatic improvements in the management of burns, infection still remains a serious risk for the burn patient. The aim of this study was to shed light on the impact of acute burn injury with or without infection on cytokine profiles. Methods Sprague-Dawley rats (n = 21 were randomized into three groups: 1 burn only 2 burn and infection or 3 sham burn. Weight was monitored and blood was collected for cytokine ELISA, LPS quantification, and peripheral blood analysis. Animals were sacrificed either after 6 or 12 days. Results Infected animals showed substantial weight loss until day 6 post-burn as compared to burn alone. Endotoxin and TNF-α levels were elevated early in the infected burn group within 48 hours post-burn. In contrast, significant up-regulation of the anti-inflammatory cytokine IL-10 occurred later in the clinical course and was associated with the recovery from weight loss. Conclusion Our results suggest that in the presence of infection, you get a SIRS response possibly due to transient endotoxemia that is only seen in the infection group. In contrast, both burn and infection get a late IL-10 (CARS response, which is then associated with a return to normal weight in the infection group.

  3. Opioid-induced hyperalgesia and burn pain.

    Science.gov (United States)

    Holtman, Joseph R; Jellish, W Scott

    2012-01-01

    The treatment of pain produced during the management of burn injury has been an ongoing problem for physicians caring for these patients. The main therapeutic option for analgesia has been the repeated and prolonged use of opioids. The adverse effects of opioids are well known but the long term use of opioids which produces tolerance with accompanying dose escalation and dependence is most problematic. Another potentially important consequence of opioid exposure that sometimes masks as tolerance is that of opioid induced hyperalgesia. This syndrome is manifest as enhanced pain, sensitivity and loss of analgesic efficacy in patients treated with opioids who actually become sensitized to painful stimuli. This article focuses on the treatment of burn pain and how current analgesic therapies with opioids may cause hyperalgesia and affect the adequacy of treatment for burn pain. This article also provides possible modalities to help therapeutically manage these patients and considers future analgesic strategies which may help to improve pain management in this complicated patient population. PMID:23143613

  4. Is proportion burned severely related to daily area burned?

    International Nuclear Information System (INIS)

    The ecological effects of forest fires burning with high severity are long-lived and have the greatest impact on vegetation successional trajectories, as compared to low-to-moderate severity fires. The primary drivers of high severity fire are unclear, but it has been hypothesized that wind-driven, large fire-growth days play a significant role, particularly on large fires in forested ecosystems. Here, we examined the relative proportion of classified burn severity for individual daily areas burned that occurred during 42 large forest fires in central Idaho and western Montana from 2005 to 2007 and 2011. Using infrared perimeter data for wildfires with five or more consecutive days of mapped perimeters, we delineated 2697 individual daily areas burned from which we calculated the proportions of each of three burn severity classes (high, moderate, and low) using the differenced normalized burn ratio as mapped for large fires by the Monitoring Trends in Burn Severity project. We found that the proportion of high burn severity was weakly correlated (Kendall τ = 0.299) with size of daily area burned (DAB). Burn severity was highly variable, even for the largest (95th percentile) in DAB, suggesting that other variables than fire extent influence the ecological effects of fires. We suggest that these results do not support the prioritization of large runs during fire rehabilitation efforts, since the underlying assumption in this prioritization is a positive relationship between severity and area burned in a day. (letters)

  5. Impact of Isolated Burns on Major Organs: A Large Animal Model Characterized.

    Science.gov (United States)

    Burmeister, David M; McIntyre, Matthew K; Baker, Bryan A; Rizzo, Julie A; Brown, Ammon; Natesan, Shanmugasundaram; Chung, Kevin K; Christy, Robert J

    2016-09-01

    Severe burn results in systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction (MOD). Currently, large-animal models of burn-induced SIRS/MOD mostly use secondary insults resulting in a paucity of knowledge on the effect of burn alone on different organ systems. The objective of the current study was to develop and characterize a large animal model of burn-induced SIRS over the course of 2 weeks. Yorkshire swine (n = 16) were randomized to sham controls (n = 4) or 40% total body surface area contact burns (n = 6 at 2 and 14 days post-burn). Blood chemistry and complete blood count analyses were performed at baseline and post-burn days 1, 2, 3, 7, 10, and 14. Upon euthanasia, tissue samples were taken for histopathology. Burns were found to be full thickness and did not re-epithelialize. SIRS was evidenced by increased body temperature, respiration rate, pulse, and white blood cell count for the duration of the experiment. Both acute liver injury and acute kidney injury were induced as determined biochemically and histologically. Histology also revealed atelectasis of the lungs which was associated with increased myeloperoxidase activity. Intestinal structure as well as enterocyte homeostasis was also disrupted. All of these organ abnormalities recovered to varying degrees by 14 days post-burn. We report a unique reproducible large animal model of burn-induced SIRS that can be tailored to specific organ systems for investigation into potential immunomodulatory interventions that prevent organ failure or promote organ recovery after burn injury. PMID:27380531

  6. Dangers to Children at Home: Corrosive esophageal burn

    Directory of Open Access Journals (Sweden)

    Ahmet Guven

    2008-12-01

    Full Text Available Inappropriate storage of cleaners which excessively used in daily is hazardous to children. Ingestion of potent corrosive agents, especially alkaline solutions may lead to acute esophageal burns, esophageal or stomach perforation, and even to death. Early of these injuries may be associated with esophageal strictures in later and the treatment of strictures might be and take long follow-up. This article reviews related issues on the diagnosis and management of esophageal burns, strictures and preventive medicine in children. [TAF Prev Med Bull 2008; 7(6.000: 535-540

  7. A STUDY ON ROLE OF VARIOUS TYPES OF TOPICAL OINTMENT AND ITS OUTCOME AMONG BURN PATIENTS : AN INTERESTING FOLLOW UP STUDY

    OpenAIRE

    Sunita; Kamlesh; Avinash; Singh,; Dhiraj

    2015-01-01

    Burn injury causes major bulk of the surgical emergencies. Burn infection makes the burn wound complicated causes considerable mortality and morbidity. Timely and effective use of antimicrobial and topical dressings revolutionizes burn care by decreasing invasive wound infection. The administration of broad - spectrum antibiotics on routine basis is likely to en courage. The emergence of resistant organism therefore, timely and judicial use of antibiotics is essenti...

  8. Incidence of early burn-induced effects on liver functionas reflected by the plasma disappearance rate of indocyanine green : a prospective descriptive cohort study

    OpenAIRE

    Steinvall, Ingrid; Fredrikson, Mats; Bak, Zoltan; Sjöberg, Folke

    2012-01-01

    Organ dysfunction and failure are important for burned patients as they increase morbidity and mortality. Recent evidence has suggested that organ injuries are occurring earlier after burns, and are more common, than previously thought. In this study we have assessed the extent to which liver function, assessed by the plasma disappearance rate of indocyanine green (PDRICG), is affected in patients with severe burns. This is a prospective, descriptive exploratory study at a national burn centr...

  9. OPTIMIZED FLUID MANAGEMENT IMPROVES OUTCOMES OF PEDIATRIC BURN PATIENTS

    Science.gov (United States)

    Kraft, Robert; Herndon, David N; Branski, Ludwik K; Finnerty, Celeste C; Leonard, Katrina R; Jeschke, Marc G

    2012-01-01

    Background One of the major determinants for survival of severely burned patients is appropriate fluid resuscitation. At present, fluid resuscitation is calculated based on bodyweight or body surface area, burn size, and urinary output. However, recent evidence suggests that fluid calculation is inadequate and that over- and under-resuscitation is associated with increased morbidity and mortality. We hypothesize that optimizing fluid administration during the critical initial phase using a transcardiopulmonary thermo-dilution monitoring device (PiCCO) would have beneficial effects on the outcome of burned patients. Methods A cohort of seventy-six severely burned pediatric patients with burns over 30% total body surface area (TBSA) who received adjusted fluid resuscitation using the PiCCO (P) system were compared to 76 conventionally monitored patients (C). Clinical hemodynamic measurements, organ function (DENVER2 score), and biomarkers were recorded prospectively for the first 20 days after burn injury. Results Both cohorts were similar in demographic and injury characteristics. Patients in the PiCCO group received significantly less fluids (p<0.05) with similar urinary output, resulting in a significantly lower positive fluid balance (p<0.05). The central venous pressure (CVP) in the P group was maintained in a more controlled range (p<0.05), associated with a significantly lower heart rate and significantly lower incidence of cardiac and renal failure, p<0.05. Conclusions Fluid resuscitation guided by transcardiopulmonary thermo-dilution during hospitalization represents an effective adjunct and is associated with beneficial effects on post-burn morbidity. PMID:22703982

  10. Burn Teams and Burn Centers: The Importance of a Comprehensive Team Approach to Burn Care

    OpenAIRE

    Al-Mousawi, Ahmed M.; Mecott-Rivera, Gabriel A.; Jeschke, Marc G.; Herndon, David N

    2009-01-01

    Advances in burn care have been colossal, but while extra work is needed, it is clear that the organized effort of burn teams can continue making improvements in survival rates and quality of life possible for patients. Burn patients are unique, representing the most severe model of trauma,33 and hence this necessitates treatment in the best facilities available for that endeavor. Burn centers have developed to meet these intricate needs but can only function productively and most efficiently...

  11. COLLAGEN DRESSING VERSUS HEPARIN DRESSING IN BURN WOUND MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Rakesh

    2013-11-01

    Full Text Available One of the greatest discoveries of mankind is the double edge sword “fi re”. This has been both a boon and a bane to mankind, on one side it helps in the survival and on the other it causes suffering to those who succumb to its injuries. Burn injuries are known for their complexity and their treatment requires a complete under standing of patho - physiology and interaction of the major organ systems. In India burn injuries account for most of the hospital admissions. Various treatment options are available for burn wound management. Heparin and collagen are the two dressings have been found to useful in burn wound management, hence we decided to study their comparison in burn wound management. AIMS: In view of the above said we considered to study the effectiveness of collagen dressing in treating burns with that of heparin dressin g. METHODS AND MATERIAL: A prospective study was done at between June 2010 to September 2012 in which 100 patients who presented with second degree burns were chosen by random sampling technique, and were grouped into 2 groups consisting of 50 patients eac h after excluding patients who did not meet the inclusion criteria and those who met the exclusion criteria . STATISTICAL ANALYSIS: Chi square test, Fishers exact test used to assess the statistically significant values. Values of p<0.05 or less were consid ered to be statistically significant. RESULTS: In our study it was observed that duration taken for wound healing is lesser in the collagen group than heparin group, 17.36 days in case of collagen dressing and 21.26 days in case of conventional dressings. It was also observed that duration of hospital stay was less that is 10.02 days in those treated with collagen dressing as compared to 15.32 days in heparin group. It was also observed that there was less pain and better patient compliance with collagen dr essing. CONCLUSION: Collagen sheet is very useful in second - degree burns when compared to heparin. It

  12. The Burning Saints

    DEFF Research Database (Denmark)

    Xygalatas, Dimitris

    The Anastenaria are Orthodox Christians in Northern Greece who observe a unique annual ritual cycle focused on two festivals, dedicated to Saint Constantine and Saint Helen. The festivals involve processions, music, dancing, animal sacrifices, and culminate in an electrifying fire-walking ritual....... Carrying the sacred icons of the saints, participants dance over hot coals as the saint moves them. The Burning Saints presents an analysis of these rituals and the psychology behind them. Based on long-term fieldwork, The Burning Saints traces the historical development and sociocultural context of the...... Greek fire-walking rituals. As a cognitive ethnography, the book aims to identify the social, psychological and neurobiological factors which may be involved and to explore the role of emotional and physiological arousal in the performance of such ritual. A study of participation, experience and meaning...

  13. [Chemical and electrical burns].

    Science.gov (United States)

    Sanchez, Raymond

    2002-12-15

    Chemical burns are less frequent in routine practice, but could be very serious owing to the complexity and severity of their actions. Influx of casualty after a civil disaster (industrial explosion) or military (war or terrorism) is possible. The action of these agents could be prolonged and deep. In addition to the skin, respiratory lesions and general intoxication could be observed. The urgent local treatment rely essentially on prolonged washing. Prevention and adequate emergency care could limit the serious consequences of these accidents. Accidents (thermal burns or electrisations) due to high or low voltage electricity are frequent. The severity is linked with the affected skin but especially with internal lesions, muscular, neurological or cardiac lesions. All cases of electrisation need hospital care. Locally, the lesions are often deep with difficult surgical repairs and often require amputation. Aesthetic and functional sequela are therefore frequent. Secondary complications could appear several months after the accident: cataract, dysesthesia and hypotonia. PMID:12621941

  14. Bowel injury from rollerball ablation of the endometrium.

    Science.gov (United States)

    Kivnick, S; Kanter, M H

    1992-05-01

    A woman underwent apparently uneventful rollerball endometrial ablation but presented with an acute abdomen 2 days later. At laparotomy, a large uterine serosal burn was found and a nearby loop of ileum contained two small injuries: a serosal burn and a perforation. The ileal injuries were oversewn and the patient recovered. Pathologic examination of the uterus showed full-thickness coagulative myometrial necrosis but no uterine perforation. More experience is needed to establish the incidence of this complication. PMID:1565382

  15. Burns and beauty nails

    OpenAIRE

    Richard E. Bélanger; Marcotte, Marie-Eve; Bégin, François

    2013-01-01

    A case involving a five-month-old girl brought to the emergency department with burns over her abdomen is described. The child was reported to have spilled two small bottles of beauty nail adhesive on her clothes while her mother was preparing dinner. After undressing the infant, the mother discovered several lesions on the child’s abdomen and quickly sought medical attention. Given the unusual circumstances of the presentation, the child was hospitalized for both treatment and supervision. T...

  16. A Quantitative Model of Thermal Injury-Induced Acute Inflammation

    OpenAIRE

    Yang, Qian; Berthiaume, Francois; Androulakis, Ioannis P.

    2010-01-01

    Severe burns are among the most common causes of death from unintentional injury. The induction and resolution of the burn-induced systemic inflammatory response are mediated by a network of factors and regulatory proteins. Numerous mechanisms operate simultaneously, thus requiring a systems level approach to characterize their overall impact. Towards this goal, we propose an in silico semi-mechanistic model of burn-induced systemic inflammation using liver specific gene expression from a rat...

  17. Epidemiology and Outcome of Chemical Burn Patients Admitted in Burn Unit of JNMC Hospital, Aligarh Muslim University, Aligarh, Uttar Pradesh, India: A 5-year Experience

    OpenAIRE

    Akhtar, Md Sohaib; Ahmad, Imran; Khurram, M. Fahud; Kanungo, Srikanta

    2015-01-01

    Aims and Objective: The objectives of this study were to evaluate the epidemiology, clinical variable of chemical burns, and their outcomes to prevent or reduce the frequency and morbidity of such injuries. Materials and Methods: A retrospective analysis was performed on all the patients with chemical burns admitted at author's center between November 2008 and December 2013. All the patients were evaluated in terms of age, sex, total body surface area, etiology, treatment given, morbidity, mo...

  18. Technology of straw burning

    International Nuclear Information System (INIS)

    The paper deals with the example of application of straw as fuel for a power plant with capacity of 1 MW, which is reconstructed from an old coal power plant. The article shows the advantages of straw as a source of energy, analyses the physical and chemical characteristics and temperature parameters, typical for straw. Moreover it indicates the specific circumstances of the straw burning processes. The paper focuses also on preparation and storing of straw for public use and in the energy sector. Comparing with fossil fuel, straw is a low-caloric natural source, whose energy value reached to 14-19 MJ/kg. This value depends partly on the kind of straw and its water or moisture content (MC). To the basic characteristics of energy aspects belong: - energy or heating value (HV) MJ/kg (in LPG it is MJ/ m3); - burning temperature; - melting point - temperature of ash; - weight kg/m3; - density; - Energy density MWh /m3; - Energy potential GJ/t; - Size-homogeneity of straw; - Water or Moisture Content (MC). The above mentioned characteristics have an influence on technical parameters of straw-burning boiler. These parameters define conditions process of straw preparation. (author)

  19. Intensive care unit-acquired weakness in the burn population.

    Science.gov (United States)

    Cubitt, Jonathan J; Davies, Menna; Lye, George; Evans, Janine; Combellack, Tom; Dickson, William; Nguyen, Dai Q

    2016-05-01

    Intensive care unit-acquired weakness is an evolving problem in the burn population. As patients are surviving injuries that previously would have been fatal, the focus of treatment is shifting from survival to long-term outcome. The rehabilitation of burn patients can be challenging; however, a certain subgroup of patients have worse outcomes than others. These patients may suffer from intensive care unit-acquired weakness, and their treatment, physiotherapy and expectations need to be adjusted accordingly. This study investigates the condition of intensive care unit-acquired weakness in our burn centre. We conducted a retrospective analysis of all the admissions to our burn centre between 2008 and 2012 and identified 22 patients who suffered from intensive care unit-acquired weakness. These patients were significantly younger with significantly larger burns than those without intensive care unit-acquired weakness. The known risk factors for intensive care unit-acquired weakness are commonplace in the burn population. The recovery of these patients is significantly affected by their weakness. PMID:26975787

  20. Self-Burns in Fars Province, Southern Iran

    Science.gov (United States)

    Mohammadi, Ali Akbar; Tohidinik, Hamid Reza; Zardosht, Mitra; Seyed Jafari, Seyed Morteza

    2016-01-01

    BACKGROUND The alarming incidence of self- burning provoked to set up a multidisciplinary preventive program to decrease the incidence and complications of this harmful issue. This study investigated the incidence and the preventive measures in self-burn in Fars Province, southern Iran. METHODS This study was a longitudinal prospective design on trend of self-inflicted burn injuries in Fars province after setting up a regional multidisciplinary preventive plan (2009-2012). RESULTS From 18862 admitted patients, 388 (2%) committed self-burning. While the incidence showed a constant decrease in proportion of suicidal cases among all admitted patients (2.5% to 1.6%). The mean age of self-burning victims ranged from 28.3±10.8 to 30.3±11.7 years. The female victims comprised 67.4% of all suicidal burn patients (Female to male ratio: 2.18). The leading causes of suicide commitment were familial conflicts (75.6%) and psychological problems (16.7%) CONCLUSION It is crucial to continue the regional preventive programs and pave the way to set up national, and even international collaborations to alleviate relevant financial, social, cultural and infrastructural difficulties in order to have lower incidence for this dramatic issue. PMID:27308238

  1. HYPOGLYCEMIA IS ASSOCIATED WITH INCREASED POST-BURN MORBIDITY AND MORTALITY IN PEDIATRIC PATIENTS

    Science.gov (United States)

    Jeschke, Marc G; Pinto, Ruxandra; Herndon, David N; Finnerty, Celeste C; Kraft, Robert

    2014-01-01

    Objective The objective of this study was to determine the incidence of hypoglycemia after burn injury and whether hypoglycemia is associated with increased post-burn morbidity and mortality. Design Cohort analysis. Setting Academic pediatric burn hospital. Patients This analysis included 760 pediatric burn patients, who were stratified according the number of hypoglycemic episodes (<60 mg/dl glucose) they experienced while in the intensive care unit. Clinical outcomes as well as metabolic and inflammatory biomarkers were analyzed during the first 60 days post admission. Patients with one or more hypoglycemic events were matched with patients not experiencing any event using propensity score matching, and outcomes and biomarker expression were compared between groups. Measurements and main results Eighty-four patients had one episode of hypoglycemia, 108 patients had two or more episodes of hypoglycemia, and 568 patients never experienced hypoglycemia. Patients with one or more hypoglycemic episodes had longer hospitalization as well as more frequent infections, sepsis, multiple organ failure (MOF), and death (p<0.05). The 166 propensity score-matched patients with one or more hypoglycemic events had greater inflammatory and metabolic responses, incidence of sepsis, MOF, and mortality than burn patients without hypoglycemic (p<0.05). Conclusions Hypoglycemic episodes correlate with injury severity and inhalation injury. When adjusted for injury severity, hypoglycemia is associated with significantly higher post-burn morbidity and mortality. PMID:24368343

  2. Nutrition in the severely burned child.

    Science.gov (United States)

    Solomon, J R

    1981-01-01

    Adequate nutrition in the severely burned child often determines the morbidity and mortality and its supervision demands a high priority in the management of the burn injury. A disciplined, detailed programme is required, but this is often neglected. The hypermetabolism experienced in the severe burn may require a calorie intake up to 2 1/2 times normal, and in the growing child, with extra requirements, a negative balance can easily eventuate if careful management is not instituted. A daily metabolic plan provides firstly, the basic calories and protein per kilogram depending on age as for a normal child and, secondly additional requirements depending on the surface area of the burn. With such a programme the weakness of treating all children, whatever their age, on the same formula related only to surface area burn, is overcome. Parenteral nutrition is commenced as soon as the shock phase has been controlled and is continued until enteral intake by gastric tube is sufficient to cover the requirements. Such tube feeding requires the selection of an isotonic liquid diet so as so limit the possibility of diarrhoea. Isocal (Mead Johnson) has been found generally acceptable. Gradually as the patient recovers, oral intake is introduced and the child returns home on a normal nutritional diet, expectantly without weight loss and even with some weight gain, which befits any normal child under treatment for some months. Preburn nutrition, disease and infection, hyperthermia, hypothermia, evaporative water loss, active exercise, psychological well being, social state, early skin cover and limitation of stress are important aspects affecting metabolism and require careful supervision and management. The limitation of metabolism is as important as increasing the caloric intake and this is exemplified at the time of operation, which should be as nonstressful as possible. Every two weeks an adjusted assessment is made of the burned area still to be grafted and the caloric

  3. Cycling injuries.

    OpenAIRE

    Cohen, G. C.

    1993-01-01

    Bicycle-related injuries have increased as cycling has become more popular. Most injuries to recreational riders are associated with overuse or improper fit of the bicycle. Injuries to racers often result from high speeds, which predispose riders to muscle strains, collisions, and falls. Cyclists contact bicycles at the pedals, seat, and handlebars. Each is associated with particular cycling injuries.

  4. Back Injuries

    Science.gov (United States)

    ... pelvis. Back injuries can result from sports injuries, work around the house or in the garden, or a sudden jolt such as a car accident. The lower back is the most common site of back injuries and back pain. Common back injuries include Sprains and strains Herniated ...

  5. Assessment of Substances Abuse in Burn Patients by Using Drug Abuse Screening Test

    Directory of Open Access Journals (Sweden)

    Kobra Gaseminegad

    2012-04-01

    Full Text Available There has been an increase in the frequency of substance abuse among hospitalized burn injury patients. However, few studies have investigated substance abuse among burn patients. This study was aimed to identify the incidence of substance abuse in burn injury patients using the "Drug Abuse Screening Test" (DAST-20. We determined the validity of DAST-20 in spring 2010. Subsequently, this descriptive study was performed on 203 burn injury patients who fit the study's inclusion criteria. We chose a score of 6 as the cutoff and thus achieved a sensitivity of 89% and a specificity of 85% for the DAST-20. During the study, we gathered demographic data, burn features and DAST-20 results for all patients. Patients with scores of 6 or more were considered to be substances abusers. A statistical analysis was conducted using SPSS v16 software. According to the DAST-20 results, 33% of the patients were in the user group. The mean score of DAST-20 was significantly higher among users than it was among nonusers (P<0.05. The level of substance abuse was severe in 77% of users. No significant differences were found among the substances, with the exception of alcohol. Substance abuse is an important risk factor for burn patients. In addition, this study showed that DAST-20 is a valid screening measure for studies on burn patients.

  6. Bony ankylosis following thermal and electrical injury

    Energy Technology Data Exchange (ETDEWEB)

    Balen, P.F.; Helms, C.A. [Dept. of Radiology, Duke University Medical Center, Durham, NC (United States)

    2001-07-01

    Objective. Bony ankylosis has been described following trauma, paralysis, psoriasis, Reiter's syndrome, ankylosing spondylitis, juvenile chronic arthritis and rheumatoid arthritis. Reports of bony ankylosis following thermal and electrical injury are limited.Design and patients. Thirteen cases of burn-related joint ankylosis in four patients are presented.Conclusion. Patients with burns from thermal or electrical injury may develop bony ankylosis among other radiographic manifestations. This bony ankylosis may result either from bridging extra-articular heterotopic ossification with preservation of the underlying joint or from intra-articular fusion due to joint destruction. (orig.)

  7. Bony ankylosis following thermal and electrical injury

    International Nuclear Information System (INIS)

    Objective. Bony ankylosis has been described following trauma, paralysis, psoriasis, Reiter's syndrome, ankylosing spondylitis, juvenile chronic arthritis and rheumatoid arthritis. Reports of bony ankylosis following thermal and electrical injury are limited.Design and patients. Thirteen cases of burn-related joint ankylosis in four patients are presented.Conclusion. Patients with burns from thermal or electrical injury may develop bony ankylosis among other radiographic manifestations. This bony ankylosis may result either from bridging extra-articular heterotopic ossification with preservation of the underlying joint or from intra-articular fusion due to joint destruction. (orig.)

  8. Syndesmosis injuries

    OpenAIRE

    Hunt, Kenneth J.

    2013-01-01

    Traumatic injuries to the distal tibiofibular syndesmosis commonly result from high-energy ankle injuries. They can occur as isolated ligamentous injuries and can be associated with ankle fractures. Syndesmotic injuries can create a diagnostic and therapeutic challenge for musculoskeletal physicians. Recent literature has added considerably to the body of knowledge pertaining to injury mechanics and treatment outcomes, but there remain a number of controversies regarding diagnostic tests, imp...

  9. The Bali burn disaster: implications and lessons learned.

    Science.gov (United States)

    Kennedy, Peter J; Haertsch, Peter A; Maitz, Peter K

    2005-01-01

    In October 2002, a terrorist attack on a nightclub in Bali resulted in an explosion and fire, causing the deaths of more than 200 people, including 88 Australian citizens. After first aid and primary care, the injured were repatriated to Darwin for triage and continued treatment and were then disseminated to various burn units throughout Australia. At the Repatriation General Hospital Concord Sydney, we received 12 patients with burns and a variety of blast injuries. Their treatment was complicated by infection with multiresistant organisms that were previously unseen in our unit and the presence of complex shrapnel wounds. There were no deaths and, with two exceptions, all patients were discharged within 6 weeks. This incident had profound effects on our unit, particularly related to the management of high-velocity shrapnel injuries, serious ongoing septic complications, and the psychological effects on both patients and staff, all of which are detailed and discussed. PMID:15756113

  10. Burn-induced stimulation of lysosomal enzyme synthesis in skeletal muscle

    International Nuclear Information System (INIS)

    A localized burn injury to a rat hindlimb results in atrophy of soleus muscle (in the absence of cellular damage) which is attributable to an increase in muscle protein breakdown. Previous work has shown that lysosomal enzyme activities (cathepsins B, H, L, and D) are elevated in muscle from the burned leg by 50% to 100%. There is no change in endogenous neutral protease activity (+/- Ca++). The increase in protease activity can not be attributed to changes in endogenous protease inhibitors. The latency [(Triton X100 treated - control)/triton treated] of lysosomal enzymes is approximately 50% and is not altered by burn injury. The rate of sucrose uptake is also not altered by burn. These experiments suggest that the rate of substrate supply to the lysosomal apparatus via endocytosis or autophagocytosis is not altered by burn. When muscles are preincubated with 3H-phenylalanine or 3H-mannose burn increased incorporation into protein of the fraction containing lysosomes by 100%. Preincubation in the presence of tunicamycin (an inhibitor of glycoprotein synthesis) inhibited incorporation of both labels into a microsomal fraction of the muscle from the burned leg, but has little effect on incorporation in the control muscle. These findings are consistent with the hypothesis that the burn-induced increase in protein breakdown is caused by an increase in lysosomal protease synthesis

  11. Efficacy of silver sulfadiazine phonophoresis on wound healing in acute burn patients

    DEFF Research Database (Denmark)

    Omar, Ghada Said Mohammed

    2003-01-01

    The purpose of the current study was to evaluate the efficacy of SSD phonophoresis approaches (continuous and pulsed modes on the rate of healing following acute burn injury . forty female patients with second degree burn in thrir anterior aspect of the dominant foream were divided randomly into ...... phonophoresis might be valuable for enhance acute burn healing and the pulsed SSD phonophoresis is more effective for accelerating the acute burn wound healing......The purpose of the current study was to evaluate the efficacy of SSD phonophoresis approaches (continuous and pulsed modes on the rate of healing following acute burn injury . forty female patients with second degree burn in thrir anterior aspect of the dominant foream were divided randomly into...... frequency of 1 MHz , and intensity of 1 W/cm2 . the parameters investigated inclding 1.burn surface area measured by tracing the burn wound parameters , and 2.determination of glycosaminoglycan in urine by using cetylpyridinuin chloride turbidity method . both parameters are measured 24 hours post...

  12. Acoustic emission strand burning technique for motor burning rate prediction

    Science.gov (United States)

    Christensen, W. N.

    1978-01-01

    An acoustic emission (AE) method is being used to measure the burning rate of solid propellant strands. This method has a precision of 0.5% and excellent burning rate correlation with both subscale and large rocket motors. The AE procedure burns the sample under water and measures the burning rate from the acoustic output. The acoustic signal provides a continuous readout during testing, which allows complete data analysis rather than the start-stop clockwires used by the conventional method. The AE method helps eliminate such problems as inhibiting the sample, pressure increase and temperature rise, during testing.

  13. Tokamak burn control

    International Nuclear Information System (INIS)

    Research of the fusion plasma thermal instability and its control is reviewed. General models of the thermonuclear plasma are developed. Techniques of stability analysis commonly employed in burn control research are discussed. Methods for controlling the plasma against the thermal instability are reviewed. Emphasis is placed on applications to tokamak confinement concepts. Additional research which extends the results of previous research is suggested. Issues specific to the development of control strategies for mid-term engineering test reactors are identified and addressed. 100 refs., 24 figs., 10 tabs

  14. Explosive hydrogen burning

    International Nuclear Information System (INIS)

    Although an impressive quantity of work has been devoted to understanding nucleosynthesis during explosive hydrogen burning, much work remain to be done. Reactions which occur in novae, x-ray bursts, and supernovae are discussed. Much attention is given to the reactions of hot CNO cycles and of reactions in the rp-process. The many reactions described in this review are not all of the reactions which may be of interest to nuclear physicists, although the rates of those reactions not discussed are essentially unknown. 123 refs., 9 figs

  15. Positive Effect of Propolis on Free Radicals in Burn Wounds

    OpenAIRE

    Pawel Olczyk; Pawel Ramos; Katarzyna Komosinska-Vassev; Jerzy Stojko; Barbara Pilawa

    2013-01-01

    Concentration and properties of free radicals in the burn wounds treated with propolis were examined by the use of electron paramagnetic resonance spectroscopy. Magnetic spin-spin interactions and complex free radicals structures in wound beds were studied. The results were compared to those obtained for silver sulphadiazine used as a standard pharmaceutical agent. The changes of free radicals in the matrix of injury with time of exposition on these substances were tested. The aim of this stu...

  16. Lisfranc injuries.

    Science.gov (United States)

    Welck, M J; Zinchenko, R; Rudge, B

    2015-04-01

    Lisfranc injuries are commonly asked about in FRCS Orthopaedic trauma vivas. The term "Lisfranc injury" strictly refers to an injury where one or more of the metatarsals are displaced from the tarsus. The term is more commonly used to describe an injury to the midfoot centred on the 2nd tarsometatarsal joint. The injury is named after Jacques Lisfranc de St. Martin (1790-1847), a French surgeon and gynaecologist who first described the injury in 1815. 'Lisfranc injury' encompasses a broad spectrum of injuries, which can be purely ligamentous or involve the osseous and articular structures. They are often difficult to diagnose and treat, but if not detected and appropriately managed they can cause long-term disability. This review outlines the anatomy, epidemiology, classification, investigation and current evidence on management of this injury. PMID:25543185

  17. Development of a Burn Escharotomy Assessment Tool: A Pilot Study.

    Science.gov (United States)

    Ur, Rebecca; Holmes, James H; Johnson, James E; Molnar, Joseph A; Carter, Jeffrey E

    2016-01-01

    Severe burn injuries can require escharotomies which are urgent, infrequent, and relatively high-risk procedures necessary to preserve limb perfusion and sometimes ventilation. The American Burn Association Advanced Burn Life Support© course educates surgeons and emergency providers about escharotomy incisions but lacks a biomimetic trainer to demonstrate, practice, or provide assessment. The goal was to build an affordable biomimetic trainer with discrete points of failure and pilot a validation study. Fellowship-trained burn and plastic surgeons worked with special effect artists and anatomists to develop a biomimetic trainer with three discrete points of failure: median or ulnar nerve injury, fasciotomy, and failure to check distal pulse. Participants were divided between experienced and inexperienced, survey pre- and post-procedure on a biomimetic model while being timed. The trainer total cost per participant was less than $35. Eighteen participants were involved in the study. The inexperienced (0-1 prior escharotomies performed) had significantly more violations at the discrete points of failure relative to more experienced participants (P = .036). Face validity was assessed with 100% of participants agreement that the model appeared similar to real life and was valuable in their training. Given the advancements in biomimetic models and the need to train surgeons in how to perform infrequent, emergent surgical procedures, an escharotomy trainer is needed today. The authors developed an affordable model with a successful pilot study demonstrating discrimination between experienced and inexperienced surgeons. Additional research is needed to increase the reliability and assessment metrics. PMID:26594860

  18. Topical agents in burn care

    OpenAIRE

    Momčilović Dragan

    2002-01-01

    Introduction Understanding of fluid shifts and recognition of the importance of early and appropriate fluid replacement therapy have significantly reduced mortality in the early post burn period. After the bum patient successfully passes the resuscitation period, the burn wound represents the greatest threat to survival. History Since the dawn of civilization, man has been trying to find an agent which would help burn wounds heal, and at the same time, not harm general condition of the injure...

  19. Rehabilitation of the burn patient

    OpenAIRE

    Procter Fiona

    2010-01-01

    Rehabilitation is an essential and integral part of burn treatment. It is not something which takes place following healing of skin grafts or discharge from hospital; instead it is a process that starts from day one of admission and continues for months and sometimes years after the initial event. Burns rehabilitation is not something which is completed by one or two individuals but should be a team approach, incorporating the patient and when appropriate, their family. The term ′Burns...

  20. Preventing unintentional injury in children and adolescents--the importance of local injury data collection.

    LENUS (Irish Health Repository)

    O'Carroll, C

    2012-02-01

    We sought to prospectively study all injuries in children and adolescents up to 16 years of age presenting to a regional Emergency Department (ED), to ascertain detailed injury patterns and to use this data to recommend injury prevention priorities. Electronic injury surveillance was prospectively collected over a 10 year period (1997-2007) in a hospital with a paediatric catchment population of 75,000 in a region with pockets of high social deprivation. All fatalities were obtained from data provided by the Central Statistics Office (CSO). Over a 10 year period, there were 31 fatalities, 5,408 admissions and 40,817 new attendances due to injury. Males outnumbered females in a 3:2 ratio. Of all injuries 24,317 (60%) occurred at home. Peak injury presentation time was in the evening between 18:00 and 20:00. Minor injuries (bruises, minor head injuries, lacerations and sprains) accounted for 32,456 (80%) of total. Fractures resulting from high falls (n=1,194) tended to result from bunk beds, staircases, horses, walls and playground equipment. Burns (n=630) involved hot liquids (tea, coffee), hot bath water, hot cooking oil and hot cooking plates. Pedestrian injuries (n=251) were predominantly \\'dart outs\\' in urban areas. Car passenger injuries (n=869) showed low rates of documented car restraint use. Poisonings (n= 1,153) were predominantly medicinal products. Cyclist injuries (n=477) indicated low documented use of appropriate helmet wear. Prevention priorities should focus on home injuries, hot liquid burn and scald injuries and high falls from walls, beds and playground equipment. To prevent road-related injuries and deaths, further legislation, urban planning and greater police enforcement is required.

  1. Nutrition Support in Burn Patients

    Directory of Open Access Journals (Sweden)

    Cem Aydoğan

    2012-08-01

    Full Text Available Severe burn trauma causes serious metabolic derangements. Increased metabolic rate which is apart of a pathophysiologic characteristic of burn trauma results in protein-energy malnutrition. This situation causes impaired wound healing, muscle and fat tissue’s breakdown, growth retardation in children and infections. Nutrition support is vital in the treatment strategies of burn victims to prevent high mortal and disabling complications in this devastating trauma. Our aim in this study is to review management of nutrition in burn victims. (Journal of the Turkish Society Intensive Care 2012; 10: 74-83

  2. Hepatic and intestinal blood flow following thermal injury

    International Nuclear Information System (INIS)

    Because cardiac output decreases after burn injuries, investigators have assumed, based upon dye clearance techniques, that hepatic and intestinal blood flow are also decreased following these injuries. Blood flow to the liver, stomach, small intestine, and kidney was determined by the uptake of 201thallium and 125I-labeled fatty acid (para-125I-phenyl-3-methyl pentanoic acid) in a 20% body surface area scald injury that also included plasma volume replacement resuscitation. Uptake of these radioisotopes was determined 15 minutes, 18 hours, and 72 hours after injury. The uptake of the 201thallium and 125I-labeled fatty acid by the gastrointestinal tissues was not statistically different at any of the time periods after comparison of the injured and control (sham-treated) animals. 201Thallium uptake by the kidney was significantly diminished 15 minutes after the burn injury (P less than 0.01). Based on these blood flow measurement techniques, the data suggest that the 20% body surface area scald injury did not alter blood flow to the liver or gastrointestinal tract within the initial 72 hours after the burn injury even though a decrease in renal blood flow was easily detected. These results suggest that the dysfunction of the gastrointestinal system or hepatic system observed after an acute burn injury is not simply the result of hypovolemic shock, which reduces both renal and mesenteric blood flow. These gastrointestinal and hepatic alterations may be related to a factor or factors other than intestinal ischemia

  3. An Exploration of Molecular Correlates Relevant to Radiation Combined Skin-Burn Trauma.

    Directory of Open Access Journals (Sweden)

    Aminul Islam

    Full Text Available Exposure to high dose radiation in combination with physical injuries such as burn or wound trauma can produce a more harmful set of medical complications requiring specialist interventions. Currently these interventions are unavailable as are the precise biomarkers needed to help both accurately assess and treat such conditions. In the present study, we tried to identify and explore the possible role of serum exosome microRNA (miRNA signatures as potential biomarkers for radiation combined burn injury (RCBI.Female B6D2F1/J mice were assigned to four experimental groups (n = 6: sham control (SHAM, burn injury (BURN, radiation injury (RI and combined radiation skin burn injury (CI. We performed serum multiplex cytokine analysis and serum exosome miRNA expression profiling to determine novel miRNA signatures and important biological pathways associated with radiation combined skin-burn trauma.Serum cytokines, IL-5 and MCP-1, were significantly induced only in CI mice (p<0.05. From 890 differentially expressed miRNAs identified, microarray analysis showed 47 distinct miRNA seed sequences significantly associated with CI mice compared to SHAM control mice (fold change ≥ 1.2, p<0.05. Furthermore, only two major miRNA seed sequences (miR-690 and miR-223 were validated to be differentially expressed for CI mice specifically (fold change ≥ 1.5, p<0.05.Serum exosome miRNA signature data of adult mice, following RCBI, provides new insights into the molecular and biochemical pathways associated with radiation combined skin-burn trauma in vivo.

  4. Propranolol attenuates hemorrhage and accelerates wound healing in severely burned adults

    OpenAIRE

    Ali, Arham; Herndon, David N; Mamachen, Ashish; Hasan, Samir; Andersen, Clark R.; Grogans, Ro-Jon; Brewer, Jordan L.; Lee, Jong O; Heffernan, Jamie; Oscar E Suman; Finnerty, Celeste C.

    2015-01-01

    Introduction Propranolol, a nonselective β-blocker, exerts an indirect effect on the vasculature by leaving α-adrenergic receptors unopposed, resulting in peripheral vasoconstriction. We have previously shown that propranolol diminishes peripheral blood following burn injury by increasing vascular resistance. The purpose of this study was to investigate whether wound healing and perioperative hemodynamics are affected by propranolol administration in severely burned adults. Methods Sixty-nine...

  5. Preserving self-concept in the burn survivors: A qualitative study

    Directory of Open Access Journals (Sweden)

    Vahid Zamanzadeh

    2015-01-01

    Full Text Available Background: Burn injury is a devastating experience affecting all aspects of a person′s essence, including his/her identity and perception. These patients require complex cognitive efforts to redefine their identity to deal with difficult condition after burn injury and preserve self-concept. The experience of life after burn injury is generally a solitary one, closely related to the patients′ cultural and religious context. Therefore, this study was conducted aiming at investigating burn patients′ experiences regarding how to preserve self-concept in life after burn injury in Iran. Materials and Methods: This qualitative study was carried out using qualitative content analysis and in-depth unstructured interviews with 17 surviving burn subjects. Results: During the qualitative content analysis process, the concept of "locating" as the essence of the participants′ experience was extracted as follows: (A self-exploration (exploring the changes in one′s life, (B others′ exploration (exploring the changes in the life of family members and the relationship between self and others, (C position evaluation (self-position analysis, and (D self-concept preservation. Conclusion: The present study has developed new understandings of mental experiences of burn patients′ self-concept by describing the concept of "self-locating." It helps us in classifying and understanding the concepts described in comprehensive theories developed in this area. They do this by focusing on what burn patients experience for choosing self-preservation strategies and having a meaningful life. The finding can be used as a conceptual framework for palliative care program in Iran.

  6. Post-burn facial contractures in pediatric patients: Challenging aspects of difficult airway management

    OpenAIRE

    Sukhminder Jit Singh Bajwa; Jasbir Kaur; Amarjit Singh; Gurpratap Singh

    2012-01-01

    Pediatric burn injuries are the most challenging to handle especially when they involve the face as the airway compromise invariably occurs due to edema and inflammation of the soft tissues of pharynx and larynx. The healing of the facial burns causes development of contractures and deformities after survival from the initial insults. Such patients when presented for surgery of the affected area or for that matter any surgery under general anesthesia, poses unique challenges to the attending ...

  7. [Use of enterosgel in middle-aged and aged patients with medium-severity burns].

    Science.gov (United States)

    Naĭda, I V

    1994-01-01

    The comparative dynamics of intoxication and natural humoral organism resistance indexes in elderly and senile patients with burn disease of middle degree severity while application of generally used therapy and incorporating in treatment complex the enterosgel preparation prescribed since 24 hours after injury occurrence was studied. Under the enterosgel influence the intoxication syndrome intensity has been markedly decreased, what promoted the skin loss restoration, favourable burn disease course, mortality reduction, and the shortening of patients hospital stay. PMID:7799576

  8. Efficacy of topical honey therapy against silver sulphadiazine treatment in burns: A biochemical study

    OpenAIRE

    Nagane, N. S.; Ganu, J. V.; Bhagwat, V. R.; Subramanium, M.

    2004-01-01

    Thermal injury is associated with biochemical changes. The present study was undertaken to investigate relation of oxidative free radical generation and related biochemical parameters in burn trauma. The specific aim was to compare the levels of serum lipid peroxide, Ceruloplasmin and Uric Acid in burn patients during treatment with Silver Sulfadiazine Cream and honey therapy. It is a single blind prospective controlled study involving comparison of biochemical changes after treatment with si...

  9. Oral Rehydration Therapy in Burn Patients

    Science.gov (United States)

    2014-04-24

    Burn Any Degree Involving 20-29 Percent of Body Surface; Burn Any Degree Involving 30-39 Percent of Body Surface; Burn Any Degree Involving 40-49 Percent of Body Surface; Burn Any Degree Involving 50-59 Percent of Body Surface; Burn Any Degree Involving 60-65 Percent of Body Surface

  10. Injury Prevention

    Science.gov (United States)

    ... Traumatic Brain Injury School sports Injuries can land students in the ER. Text Messaging: Emergency Physicians ... For You American College of Emergency Phycisians Copyright © American College of Emergency ...

  11. In-situ burning of Orimulsion : small scale burns

    International Nuclear Information System (INIS)

    This study examined the feasibility of burning Orimulsion. In-situ burning has always been a viable method for cleaning oil spills on water because it can effectively reduce the amount of spilled oil and eliminate the need to collect, store, transport and dispose of recovered oil. Orimulsion, however, behaves very differently from conventional oil when it is spilled because of its composition of 70 per cent bitumen in 30 per cent water. In-situ burning of this surfactant-stablized oil-in-water emulsion has never been seriously considered because of the perception that Orimulsion could not be ignited, and if it could, ignition would not be sustained. In this study, burn tests were conducted on 3 scales in a Cleveland Open Cup apparatus of 5 cm, 10 cm and 50 cm diameters. Larger scale burns were conducted in specially built pans. All tests were conducted on salt water which caused the bitumen to separate from the water. The objective was to determine if sufficient vapours could be generated to ignite the Orimulsion. The study also measured if a sustained flame would result in successful combustion. Both objectives were successfully accomplished. Diesel fuel was used to ignite the Orimulsion in the specially designed pan for large scale combustion. Quantitative removal of Orimulsion was achieved in all cases, but in some burns it was necessary to re-ignite the Orimulsion. It was noted that when Orimulsion burns, some trapped water droplets in the bitumen explode with enough force to extinguish a small flame. This did not occur on large-scale burns. It was concluded that the potential for successful in-situ burning increases with size. It was determined that approximately 1 mm in thickness of diesel fuel is needed to ignite a burn. 5 refs., 3 tabs., 4 figs

  12. Queimaduras em crianças e adolescentes: caracterização clínica e epidemiológica Quemaduras en niños y adolescentes: caracterización clínica y epidemiológica Burn injuries in children and adolescents: clinical and epidemiological characterization

    Directory of Open Access Journals (Sweden)

    Fernanda Maria Félix de Alencar Fernandes

    2012-12-01

    concluye la necesidad en intensificar programas educacionales en las escuelas, centros comunitarios y medios de comunicación ya que gran parte de los accidentes ocurrió en el ambiente doméstico pudiendo ser evitados.Burns are important causes of morbidity and mortality in children and adolescents whose effects are reflected in significant functional limitations. This is a descriptive, quantitative study aimed to characterize the clinical and epidemiological profile of children and adolescents victims of burns admitted to a referral Hospital of Joao Pessoa, Brazil, from January 2007 to December 2009. The majority of victims were infants (37%, preschoolers (33.2% and boys (54%. The incident mostly occurred at home (85.5% by accident (90% and scalding (69.6%. Second-degree burns were predominant in 62.6% of cases and about 24.2% of the sample developed complications and secondary infection was the most common (12.1%. Balneotherapy is one of the most common procedures. We conclude that education programs at schools, community centers and in the media need to be strengthen since most injuries occur in the home environment and could be prevented.

  13. Radiation injuries in atomic bomb survivors, chapter 2

    International Nuclear Information System (INIS)

    Atomic bombs, for the first time in human history, were dropped on Hiroshima in August 6, and on Nagasaki on August 9, 1945. Though the powers of these bombs were small as compared with those of present day nuclear weapons, the atomic bombs claimed many lives instantaneously, damaged human bodies, and destroyed all objects, annihilating the urban areas. Even today, the dreadful consequences of the bombings still remain in both body and mind of the victims. Meanwhile, the experiences of atomic bomb disasters are fading constantly. In order to maintain the vivid information, in Part 2 ''Bodily injuries'', the following matters are described: early bodily injuries such as burns, (blast) external wounds, radiation injuries, and pathology in bodily injuries; later bodily injuries such as keloids, injuries to blood and eyes, injuries in exposed women, injuries in growth, aging and life, injuries in mental/nervous system, malignant tumors, and changes in chromosomes; and genetic effects. (J.P.N.)

  14. Dynamics of hepatic gene expression and serum cytokine profiles in single and double-hit burn and sepsis animal models

    Directory of Open Access Journals (Sweden)

    Rohit Rao

    2015-06-01

    Full Text Available We simulate the pathophysiology of severe burn trauma and burn-induced sepsis, using rat models of experimental burn injury and cecal ligation and puncture (CLP either individually (singe-hit model or in combination (double-hit model. The experimental burn injury simulates a systemic but sterile pro-inflammatory response, while the CLP simulates the effect of polymicrobial sepsis. Given the liver׳s central role in mediating the host immune response and onset of hypermetabolism after burn injury, elucidating the alterations in hepatic gene expression in response to injury can lead to a better understanding of the regulation of the inflammatory response, whereas circulating cytokine protein expression, reflects key systemic inflammatory mediators. In this article, we present both the hepatic gene expression and circulating cytokine/chemokine protein expression data for the above-mentioned experimental model to gain insights into the temporal dynamics of the inflammatory and hypermetabolic response following burn and septic injury. This data article supports results discussed in research articles (Yang et al., 2012 [1,4]; Mattick et al. 2012, 2013 [2,3]; Nguyen et al., 2014 [5]; Orman et al., 2011, 2012 [6–8].

  15. Fuel burning and climate

    International Nuclear Information System (INIS)

    Emission of soot particles and other air pollution indoors constitutes a considerable health hazard for a major part of the population in many developing countries, one of them being China. In these countries problems relating to poverty are the most important risk factors, undernourishment being the dominating reason. Number four on the list of the most serious health hazards is indoor air pollution caused by burning of coal and biomass in the households. Very high levels of soot particles occur indoors because of incomplete combustion in old-fashioned stoves and by use of low quality fuel such as sticks and twigs and straw and other waste from agriculture. This leads to an increase in a series of acute and chronic respiratory diseases, including lung cancer. It has been pointed out in recent years that emissions due to incomplete combustion of coal and biomass can contribute considerably to climate changes

  16. Wanted: Clean Coal Burning Technology

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    China is intent on developing clean coal burning technology, an objective it can achieve through installing desulfurization facilities at coal-burning power plants that will control SO2 emissions and environmental pollution. According to kuo Yi, deputy director general of the Department of Science and Technology of the State Environmental Protection Agency, China is a major coal-buming country:

  17. Outlier detection and removal improves accuracy of machine learning approach to multispectral burn diagnostic imaging

    Science.gov (United States)

    Li, Weizhi; Mo, Weirong; Zhang, Xu; Squiers, John J.; Lu, Yang; Sellke, Eric W.; Fan, Wensheng; DiMaio, J. Michael; Thatcher, Jeffrey E.

    2015-12-01

    Multispectral imaging (MSI) was implemented to develop a burn tissue classification device to assist burn surgeons in planning and performing debridement surgery. To build a classification model via machine learning, training data accurately representing the burn tissue was needed, but assigning raw MSI data to appropriate tissue classes is prone to error. We hypothesized that removing outliers from the training dataset would improve classification accuracy. A swine burn model was developed to build an MSI training database and study an algorithm's burn tissue classification abilities. After the ground-truth database was generated, we developed a multistage method based on Z-test and univariate analysis to detect and remove outliers from the training dataset. Using 10-fold cross validation, we compared the algorithm's accuracy when trained with and without the presence of outliers. The outlier detection and removal method reduced the variance of the training data. Test accuracy was improved from 63% to 76%, matching the accuracy of clinical judgment of expert burn surgeons, the current gold standard in burn injury assessment. Given that there are few surgeons and facilities specializing in burn care, this technology may improve the standard of burn care for patients without access to specialized facilities.

  18. Serum albumin level as a risk factor for mortality in burn patients

    Directory of Open Access Journals (Sweden)

    Olivia Alejandra Aguayo-Becerra

    2013-07-01

    Full Text Available OBJECTIVE: Hypoalbuminemia is a common clinical deficiency in burn patients and is associated with complications related to increased extravascular fluid, including edema, abnormal healing, and susceptibility to sepsis. Some prognostic scales do not include biochemical parameters, whereas others consider them together with comorbidities. The purpose of this study was to determine whether serum albumin can predict mortality in burn patients. METHODS: We studied burn patients ≥16 years of age who had complete clinical documentation, including the Abbreviated Burn Severity Index, serum albumin, globulin, and lipids. Sensitivity and specificity analyses were performed to determine the cut-off level of albumin that predicts mortality. RESULTS: In our analysis of 486 patients, we found that mortality was higher for burns caused by flame (p = 0.000, full-thickness burns (p = 0.004, inhalation injuries (p = 0.000, burns affecting >30% of the body surface area (p = 0.001, and burns associated with infection (p = 0.008. Protein and lipid levels were lower in the patients who died (p80%, with 84% sensitivity and 83% specificity. At admission, the albumin level could be used as a sensitive and specific marker of burn severity and an indicator of mortality.

  19. Burn patient: emergency treatment and reanimation

    Directory of Open Access Journals (Sweden)

    Berrocal-Revueltas Manuela

    2011-12-01

    Full Text Available Burns are a worldwide public Health Problem. This matter mainly affects the populationsof developing countries, due to their vulnerability and the lack of statistical recordsavailable to acknowledge the truly dimensions of the problem, which are needed todevelop efficient prevention proposals. This trauma or injury of the tissue, produced bythe transference of energy from one body to another, severely affects the quality of lifeof the burn patient, with high risk of morbidity and mortality, if the emergency treatmentof resuscitation or reanimation procedure, performed by the medical or paramedical teamfails to operate in a efficient way. This Guidelines is an easy, updated, effective and safetysupport, designed for physicians and paramedics, since they are the first who go to theplace of the accident to offer the primary support to the burned patient.RESEUMEN:Las quemaduras son un problema de salud pública a nivel mundial, que afecta con mayorgravedad a las poblaciones vulnerables de los países en vías de desarrollo, por la falta deregistros estadísticos que permitan conocer la dimensión del problema, para desarrollarpropuestas eficientes en materia de prevención. Este trauma o lesión tisular, producidapor la transferencia de energía de un cuerpo a otro, puede afectar en forma severa lacalidad de vida del paciente y su familia, con alto riesgo de morbi-mortalidad, si no seaplica en forma oportuna y eficiente un tratamiento de emergencia para la reanimación óresucitación del paciente, por parte del equipo médico y paramédico, asignados en cadacaso. La presente guía de manejo de urgencia del paciente quemado, es de fácil aplicación,efectiva y actualizada, orientada a los médicos generales y paramédicos, quienes son losprimeros en acudir al lugar del accidente para ofrecer los primeros cuidados al pacientequemado.

  20. Rapidly developed squamous cell carcinoma after laser therapy used to treat chemical burn wound: a case report

    OpenAIRE

    Cho, Hyung-Rok; Kwon, Soon-Sung; Chung, Seum; Kie, Jeong-Hae

    2015-01-01

    Background In chronic wounds, especially burn scars, malignant tumors can arise. However, it is rare for a subacute burn injury to change to a malignant lesion within one month. Moreover, a case of squamous cell carcinoma arising from HeNe laser therapy after a chemical burn has never been reported. Case report In this report, we examine a rare case of squamous cell carcinoma arising from HeNe laser therapy after a chemical burn. Because pathologic investigations were made from the first oper...