WorldWideScience

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. The biology of burn injury.

    Science.gov (United States)

    Evers, Lars H; Bhavsar, Dhaval; Mailänder, Peter

    2010-09-01

    Burn injury is a complex traumatic event with various local and systemic effects, affecting several organ systems beyond the skin. The pathophysiology of the burn patient shows the full spectrum of the complexity of inflammatory response reactions. In the acute phase, inflammation mechanism may have negative effects because of capillary leak, the propagation of inhalation injury and the development of multiple organ failure. Attempts to mediate these processes remain a central subject of burn care research. Conversely, inflammation is a necessary prologue and component in the later-stage processes of wound healing. In this review, we are attempting to present the current science of burn wound pathophysiology and wound healing. We also describe the evolution of innovative strategies for burn management.

  5. 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.

  6. The hair color-highlighting burn: a unique burn injury.

    Science.gov (United States)

    Peters, W

    2000-01-01

    A unique, preventable, 2.8 x 3.7-cm, full-thickness scalp burn resulted after a woman underwent a professional color-highlighting procedure at a hair salon. The burn appeared to result from scalp contact with aluminum foil that had been overheated by a hair dryer during the procedure. The wound required debridement and skin grafting and 3 subsequent serial excisions to eliminate the resulting area of burn scar alopecia. The preventive aspects of this injury are discussed.

  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. Fluid management in major burn injuries

    Directory of Open Access Journals (Sweden)

    Haberal Mehmet

    2010-10-01

    Full Text Available It is a widely accepted fact that severe fluid loss is the greatest problem faced following major burn injuries. Therefore, effective fluid resuscitation is one of the cornerstones of modern burn treatment. The aim of this article is to review the current approaches available for modern trends in fluid management for major burn patients. As these current approaches are based on various experiences all over the world, the knowledge is essential to improve the status of this patient group.

  10. Burn Injury Arise From Flying Balloon Toys

    Directory of Open Access Journals (Sweden)

    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

  11. Burn Injury Arise From Flying Balloon Toys

    Directory of Open Access Journals (Sweden)

    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(4.000: 291-296

  12. Disseminated intravascular coagulation in burn injury.

    Science.gov (United States)

    Lippi, Giuseppe; Ippolito, Luigi; Cervellin, Gianfranco

    2010-06-01

    Disseminated intravascular coagulation (DIC) is a complex and multifaceted disorder characterized by the activation of coagulation and fibrinolytic pathways, consumption of coagulation factors, and depletion of coagulation regulatory proteins. The introduction into the circulation of cellular debris characterized by strong thromboplastic activity due to tissue factor exposition or release (in or from burned tissues), which can thereby activate extrinsic pathway of coagulation system and trigger massive thrombin generation when present in sufficient concentration, represents the most plausible biological explanation to support the development of intravascular coagulation in patients with burn injury. Severe burns left untreated might also lead to an immunological and inflammatory response (activation of the complement cascade), which can amplify fibrinolysis and blood clotting. Overall, the real prevalence of DIC in patients with burns is as yet unclear. Postmortem, retrospective, and even longitudinal investigations are in fact biased by several factors, such as the objective difficulty to establish whether DIC might have occurred as a primary complication of burns or rather as a consequence of other superimposed pathologies (e.g., sepsis, multiple organ failure), the different diagnostic criteria for assessing DIC, and the heterogeneity of the patient samples studied. Nevertheless, the current scientific evidence is consistent with the hypothesis that biochemical changes suggestive for DIC (hypercoagulability, hypo- and hyperfibrinolysis) are commonplace in patients with burn trauma, and their severity increases exponentially with the severity of injury. Overt DIC seems to occur especially in critically ill burn patients or in those with severe burns (up to third degree) and large involvement of body surface area, in whom an appropriate therapy might be effective to prevent the otherwise fulminant course. Although early prophylaxis with antithrombin concentrates

  13. Medical management of paediatric burn injuries: best practice.

    Science.gov (United States)

    Kim, Leo K P; Martin, Hugh C O; Holland, Andrew J A

    2012-04-01

    Burns commonly occur in children and their first aid remains inadequate despite burn prevention programmes. While scald injuries predominate, contact and flame burns remain common. Although typically less severe injuries overall than those in adults, hypertrophic scarring complicating both the burn wound and even donor sites occur more frequently in children. The heterogeneous nature of burn wounds, coupled with the difficulties associated with the early clinical assessment of burn depth, has stimulated the application of novel technologies to predict burn wound outcome. This review explores current best practice in the management of paediatric burns, with a focus on prevention, optimal first aid, resuscitation, burn wound prediction and wound management strategies.

  14. [Plastic reconstructive surgery for burn injuries].

    Science.gov (United States)

    Niederbichler, A D; Vogt, P M

    2009-06-01

    The stage-adjusted therapy of thermal injuries is based on pathophysiologic mechanisms as well as functional and aesthetic requirements. Plastic reconstructive surgical approaches are highly important in the prevention of the frequent grave sequelae of thermal trauma and to achieve optimal functional rehabilitation and favourable outcome. In reconstructive surgery of burns operative goals are subdivided into acute, secondary reconstructive, functional and aesthetic indications. The achievement of early wound closure to preserve functional skin and soft tissue components is an essential part of acute reconstructive procedures. Functional reconstructive and aesthetic procedures supplement the conservative treatment modalities of the secondary phase of burn care with physical therapy, ergotherapy and psychological support. PMID:19543874

  15. 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...

  16. 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...

  17. 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...

  18. 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

  19. Do burns increase the severity of terror injuries?

    Science.gov (United States)

    Peleg, Kobi; Liran, Alon; Tessone, Ariel; Givon, Adi; Orenstein, Arie; Haik, Josef

    2008-01-01

    The use of explosives and suicide bombings has become more frequent since October 2000. This change in the nature of terror attacks has marked a new era in the Israeli-Palestinian conflict. We previously reported that the incidence of thermal injuries has since risen. However, the rise in the incidence of burns among victims of terror was proportionate to the rise in the incidence of burns among all trauma victims. This paper presents data from the Israeli National Trauma Registry during the years 1997--2003, to compare the severity of injuries and outcome (mortality rates) in terror victims with and without burn injuries. We also compare the severity of injuries and outcome (mortality rates) for patients with terror-attack related burns to non terror-attack related burns during the same period. Data was obtained from the Israeli National Trauma Registry for all patients admitted to 8 to 10 hospitals in Israel between 1997 and 2003. We analyzed and compared demographic and clinical characteristics of 219 terror-related burn patients (terror/burn), 2228 terror patients with no associated burns (Terror/no-burn) and 6546 non terror related burn patients (burn/no-terror). Severity of injuries was measured using the injury severity score, and burn severity by total body surface percentage indices. Admission rates to Intensive Care Units (ICU) and total length of hospitalization were also used to measure severity of injuries. In-hospital mortality rates were used to indicate outcome. Of burn/terror patients, 87.2% suffered other accompanying injuries, compared with 10.4% of burn/no-terror patients. Of burn/terror patients, 49.8% were admitted to ICU compared with only 11.9% of burn/no-terror patients and 23.8% of no-burn/terror patients. Mean length of hospital stay was 18.5 days for the terror/burn group compared with 11.1 days for the burn/no-terror group and 9.5 days for the terror/no-burn group. Burn/terror patients had a significantly higher injury severity score

  20. 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.

  1. 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.

  2. 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

  3. 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

  4. Functional characterization of cultured keratinocytes after acute cutaneous burn injury.

    Directory of Open Access Journals (Sweden)

    Gerd G Gauglitz

    Full Text Available BACKGROUND: In addition to forming the epithelial barrier against the outside environment keratinocytes are immunologically active cells. In the treatment of severely burned skin, cryoconserved keratinocyte allografts gain in importance. It has been proposed that these allografts accelerate wound healing also due to the expression of a favourable--keratinocyte-derived--cytokine and growth factor milieu. METHODS: In this study the morphology and cytokine expression profile of keratinocytes from skin after acute burn injury was compared to non-burned skin. Skin samples were obtained from patients after severe burn injury and healthy controls. Cells were cultured and secretion of selected inflammatory mediators was quantified using Bioplex Immunoassays. Immunohistochemistry was performed to analyse further functional and morphologic parameters. RESULTS: Histology revealed increased terminal differentiation of keratinocytes (CK10, CK11 in allografts from non-burned skin compared to a higher portion of proliferative cells (CK5, vimentin in acute burn injury. Increased levels of IL-1α, IL-2, IL-4, IL-10, IFN-γ and TNFα could be detected in culture media of burn injury skin cultures. Both culture groups contained large amounts of IL-1RA. IL-6 and GM-CSF were increased during the first 15 days of culture of burned skin compared to control skin. Levels of VEGF, FGF-basic, TGF-ß und G-CSF were high in both but not significantly different. Cryoconservation led to a diminished mediator synthesis except for higher levels of intracellular IL-1α and IL-1ß. CONCLUSION: Skin allografts from non-burned skin show a different secretion pattern of keratinocyte-derived cytokines and inflammatory mediators compared to keratinocytes after burn injury. As these secreted molecules exert auto- and paracrine effects and subsequently contribute to healing and barrier restoration after acute burn injury therapies affecting this specific cytokine/growth factor

  5. 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

  6. 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.

  7. Burn Injury: A Challenge for Tissue Engineers

    Directory of Open Access Journals (Sweden)

    Yerneni LK

    2009-01-01

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

  8. 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.

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

    Science.gov (United States)

    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

  10. Effect of Topical Platelet-Rich Plasma on Burn Healing After Partial-Thickness Burn Injury.

    Science.gov (United States)

    Ozcelik, Umit; Ekici, Yahya; Bircan, Huseyin Yuce; Aydogan, Cem; Turkoglu, Suna; Ozen, Ozlem; Moray, Gokhan; Haberal, Mehmet

    2016-06-05

    BACKGROUND To investigate the effects of platelet-rich plasma on tissue maturation and burn healing in an experimental partial-thickness burn injury model. MATERIAL AND METHODS Thirty Wistar albino rats were divided into 3 groups of 10 rats each. Group 1 (platelet-rich plasma group) was exposed to burn injury and topical platelet-rich plasma was applied. Group 2 (control group) was exposed to burn injury only. Group 3 (blood donor group) was used as blood donors for platelet-rich plasma. The rats were killed on the seventh day after burn injury. Tissue hydroxyproline levels were measured and histopathologic changes were examined. RESULTS Hydroxyproline levels were significantly higher in the platelet-rich plasma group than in the control group (P=.03). Histopathologically, there was significantly less inflammatory cell infiltration (P=.005) and there were no statistically significant differences between groups in fibroblast development, collagen production, vessel proliferations, or epithelization. CONCLUSIONS Platelet-rich plasma seems to partially improve burn healing in this experimental burn injury model. As an initial conclusion, it appears that platelet-rich plasma can be used in humans, although further studies should be performed with this type of treatment.

  11. 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

  12. Coping with severe burns in the early stage after burn injury.

    Science.gov (United States)

    Bras, Marijana; Loncar, Zoran; Brajković, Lovorka; Gregurek, Rudolf; Micković, Vlatko

    2007-03-01

    This study examined the relationship between coping strategies, anxiety and depression levels and burn injury characteristics in the early phase of the treatment in burn-injured patients. Seventy patients with severe burns were interviewed within two weeks of their burn trauma. Coping strategies were measured by the coping with burns questionnaire (CBQ). Anxiety and depression levels were assessed with the Beck Depression Inventory and the Beck Anxiety Inventory. There were no statistically significant gender differences in various coping strategies. Avoidance was associated with higher levels of anxiety, depression and hopelessness. The percentage of total body surface area (TBSA) and localization of burns were not associated with coping patterns. Implications for the assessment and management of burn injured patients were discussed.

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

    Science.gov (United States)

    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

  14. Threshold age and burn size associated with poor outcomes in the elderly after burn injury.

    Science.gov (United States)

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

    2016-03-01

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

  15. 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...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    Maslow, Gary R; Lobato, Debra

    2010-01-01

    The first summer camps for children with burn injuries started over 25 years ago, and as of 2008, there were 60 camps worldwide. This review examines the literature on summer pediatric burn camps. The authors describe common characteristics of burn camp structure, activities, and staffing and then examine the scientific evidence regarding the effect of burn camp programs on campers and camp staff volunteers. A search of Pubmed and Psychinfo databases from 1970 to 2008 for articles related to pediatric burn summer camps identified 17 articles, of which 13 fit the inclusion criteria. Existing literature consists primarily of qualitative studies, suggesting that burn camp can decrease camper isolation, improve self-esteem, and promote coping and social skills. Studies examining volunteer staff at burn camp have consistently found that there are both personal and professional benefits. Quantitative studies of self-esteem have yielded equivocal results. No studies have examined safety or the effect of burn camp on medical or rehabilitation outcomes. For the past 25 years, pediatric summer camps for children with burn injuries have played an important rehabilitation role and provided a strong community that benefits both campers and staff. Future research using more rigorous research methods and examining a broader range of outcomes (eg, safety and medical/rehabilitation outcomes) is recommended. PMID:20644489

  18. 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.

  19. A five-year review of burn injuries in Irrua

    Directory of Open Access Journals (Sweden)

    Iyamu Christopher E

    2007-10-01

    Full Text Available Abstract Background The management of burns remains a challenge in developing countries. Few data exist to document the extent of the problem. This study provides data from a suburban setting by documenting the epidemiology of burn injury and ascertaining outcome of management. This will help in planning strategies for prevention of burns and reducing severity of complications. Methods A total of 72 patients admitted for burns between January 1st, 2002 and December 31st, 2006 at the Irrua specialist teaching hospital were studied retrospectively. Sources of information were the case notes and operation registers. Data extracted included demographics as well as treatment methods and outcome Results The results revealed male to female ratio of 2.1:1. Over 50% of the injuries occurred at home. There was a seasonal variation with over 40% of injuries occurring between November and January. The commonest etiologic agent was flame burn from kerosene explosion. There were 7 deaths in the series. Conclusion Burns are preventable. We recommend adequate supply of unadulterated petroleum products and establishment of burn centers.

  20. CHANGES OF IMMUNE FUNCTIONS AFTER RADIATION, BURNS AND COMBINED RADIATION-BURN INJURY IN RATS

    Institute of Scientific and Technical Information of China (English)

    阎永堂; 冉新泽; 魏书庆

    1995-01-01

    The changes ot several immune functions were observed in rats after they were inflicted with 6 Gy gamma rays irradiation, 15% TBSA full thickness hrun and the combination of the 2 injuries. It was found that the ftmcldons of thymocytes and epienocytes suffered the most severe suppressinn in the 24th to 72nd hour after radiation injury and began to recover on the 7th day. In the rats with burn injury, the suppression on thymocytes and splenocytes were significantly less severe than that after radiation and recovered more rapidly. The effects of combined rediation-bura injury showed several characteristics. The suppression on the thymocytes was more severe with slower recovery as compared with that after single radiation injury only. The suppression on the splenocytes as a whole was similar to that after single radiation injury, but in the early stage after combined injury, the suppression was far more severe than that after radiation. Escharectccny and skin grafting on the burn wounds on the lst day after combined injury could accelerate the recovery on both the thymocytes and eplenocytes. Our findings indicated that the severity of the suppression on the immune functions due to combined radiadon-burrt injury might depend on the size of the burn wounds.

  1. Evaluation of burn injuries related to liquefied petroleum gas.

    Science.gov (United States)

    Tarim, Mehmet Akin

    2014-01-01

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

  2. Oxidative stress and anti-oxidative mobilization in burn injury.

    Science.gov (United States)

    Parihar, Arti; Parihar, Mordhwaj S; Milner, Stephen; Bhat, Satyanarayan

    2008-02-01

    A severe burn is associated with release of inflammatory mediators which ultimately cause local and distant pathophysiological effects. Mediators including Reactive Oxygen Species (ROS) and Reactive Nitrogen Species (RNS) are increased in affected tissue, which are implicated in pathophysiological events observed in burn patients. The purpose of this article is to understand the role of oxidative stress in burns, in order to develop therapeutic strategies. All peer-reviewed, original and review articles published in the English language literature relevant to the topic of oxidative stress in burns in animals and human subjects were selected for this review and the possible roles of ROS and RNS in the pathophysiology of burns are discussed. Both increased xanthine oxidase and neutrophil activation appear to be the oxidant sources in burns. Free radicals have been found to have beneficial effects on antimicrobial action and wound healing. However following a burn, there is an enormous production of ROS which is harmful and implicated in inflammation, systemic inflammatory response syndrome, immunosuppression, infection and sepsis, tissue damage and multiple organ failure. Thus clinical response to burn is dependent on the balance between production of free radicals and its detoxification. Supplementation of antioxidants in human and animal models has proven benefit in decreasing distant organ failure suggesting a cause and effect relationship. We conclude that oxidative damage is one of the mechanisms responsible for the local and distant pathophysiological events observed after burn, and therefore anti-oxidant therapy might be beneficial in minimizing injury in burned patients.

  3. 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...

  4. 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.

  5. 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.

  6. Research progression of lung injury after burn-blast combined injury

    Directory of Open Access Journals (Sweden)

    Quan HU

    2013-05-01

    Full Text Available As a result of military conflict, terrorist attacks, industrial and traffic accidents, the incidence of burn-blast combined injury would be escalating. The burn-blast combined injury was a major clinical problem accompanied by multiple complications and high mortality. The lungs were the most severely injured organ in burn-blast combined injury. Dysfunction of ventilation and gas exchange produced by lung damage could affect oxygen supply to organs and systemic tissues, and is one of the pathophysiological changes resulting in shock and other complications. Previous research has indicated that most of alveolar walls were ruptured, capillaries ruptured, and pulmonary capillary endothelial cells were damaged in the lungs after burn-blast combined injury, and they were followed by pulmonary edema and hemorrhage followed by disorders in ventilation and gas exchange, ending in ischemia and hypoxia of systemic organs. So the treatment of lung injury is the major measure for the treatment of burn-blast combined injury. The pathogenesis and treatment of lung injury in burn-blast combined injury are briefly summarized in this article.

  7. 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

  8. 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...

  9. 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...

  10. The rapidly increasing trend of cannabis use in burn injury.

    Science.gov (United States)

    Jehle, Charles Christopher; Nazir, Niaman; Bhavsar, Dhaval

    2015-01-01

    The use of cannabis is currently increasing according to U.S. Department of Health and Human Services (HHS). Surprisingly, cannabis use among burn patients is poorly reported in literature. In this study, rates of cannabis use in burn patients are compared with general population. Data from the National Burn Repository (NBR) were used to investigate incidence, demographics, and outcomes in relation to use of cannabis as evidenced by urine drug screen (UDS). Thousands of patients from the NBR from 2002 to 2011 were included in this retrospective study. Inclusion criteria were patients older than 12 years of age who received a drug screen. Data points analyzed were patients' age, sex, UDS status, mechanism of burn injury, total body surface area, length of stay, ICU days, and insurance characteristics. Incidence of cannabis use in burn patients from the NBR was compared against national general population rates (gathered by Health and Human Services) using chi-square tests. Additionally, the burn patient population was analyzed using bivariate analysis and t-tests to find differences in the characteristics of these patients as well as differences in outcomes. Seventeen thousand eighty out of over 112,000 patients from NBR had information available for UDS. The incidence of cannabis use is increasing among the general population, but the rate is increasing more quickly among patients in the burn patient population (P = .0022). In 2002, 6.0% of patients in burn units had cannabis+ UDS, which was comparable with national incidence of 6.2%. By 2011, 27.0% of burn patients tested cannabis+ while national incidence of cannabis use was 7.0%. Patients who test cannabis+ are generally men (80.1%, P cannabis+ or cannabis- are similar. Flame injury makes up >60% of injuries, followed by scalds that are >15%. In comparing cannabis+/- patients, cannabis+ patients are more likely to be uninsured (25.2% vs 17.26%, P cannabis+ have larger burns (TBSA% of 12.94 vs 10.98, P cannabis

  11. Epidemiology of burn injuries in Singapore from 1997 to 2003.

    Science.gov (United States)

    Song, Colin; Chua, Alvin

    2005-01-01

    The Singapore General Hospital (SGH) Burn Centre receives more than 93% of burn cases occurring in Singapore. The Centre also received patients from the Southeast Asian region. The collection and analysis of burn epidemiology data in recent years from Singapore would provide insights into new prevention/management strategies in terms of population profile and economic activities. Data pertaining to burn patients admitted to SGH Burn Centre between January 1997 and December 2003 were studied retrospectively in terms of admissions' demographics, extent of burn (TBSA), causes of burns, length of hospital stay (LOS) and mortality. A total of 2019 burn patients were admitted with an annual admission of 288. This presented an incidence rate for burn injury (with admission) of 0.07 per 1000 general population. The male to female ratio is 2.2:1 and the mean age of admission is 32.5years. The mean extent of burn was 11.5% and patients with burn size 10% TBSA and less made up the majority of admissions at 70.7% while patients with burn size 30% TBSA and more made up 8.2%. The most common cause of burn injury is scald at 45.6% followed by flame at 35.2%. The overall mean LOS and mortality are 10.8days and 4.61%, respectively. An annual trend of falling mortality rate for admissions with burn size >30% TBSA was observed-60% in year 2000 to 30% in 2003. This is a result of massive early excision and grafting of severe burn patients. 17.6% of patients were children of 12years and below, showing a 11.9% reduction from previous study in the 80s. This is consistent with the city's demographics of falling fertility rate and improved living and social conditions. Occupational burn admissions account for 33.4% of total admissions, a reduction of 11.6% from a study in the early 90s. Occurrence of occupational flame burns decreased by 9.5% due to an improvement in fire prevention and management of the industrial sectors. However, chemical burns increased by 12.6% as the chemical sector

  12. Treatment of severe burn injury of 98% TBSA with 95% full-thickness burn and severe inhalation injury: a case report

    Institute of Scientific and Technical Information of China (English)

    杨磊; 王甲汉; 周一平

    2003-01-01

    @@ The treatment of extensive severe burn injury is very difficult, especially when some complications are involved. A burned patient sustained 98% total body surface area (TBSA) with 95% full thickness burn and severe inhalation injury was admitted to our hospital in 08- 2000. After aggressive treatment, the patient recovered fully. This paper reports the treatment of the patient.

  13. 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

  14. 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.

  15. [Some aspects worth concern in the management of burn injury].

    Science.gov (United States)

    Yang, Zong-cheng

    2007-10-01

    Although the outcome of burn patients has been improved, many aspects of management of severe burn patients remain controversial. Here we focus on the management of hypermetabolism and the resuscitation of respiratory function. Currently, the fluid resuscitation method shifts from insufficient fluid regimen to excessive fluid loading. The benefit of colloid infusion and restrictive blood transfusion need to be authenticated by further clinical trial, and the best form of fluid resuscitation has yet to be identified. The respiratory management of burn patients had been improved. Early tracheostomy, ventilation with low tidal volume and bronchoalveolar toilet are recommended. Many potential beneficial treatment strategies have been identified by recent research in the metabolic response to burn injury. Although immunomodulation therapy is promising, most of them are not clinical viable,and further clinical research is warranted.

  16. National trends in burn and inhalation injury in burn patients: results of analysis of the nationwide inpatient sample database.

    Science.gov (United States)

    Veeravagu, Anand; Yoon, Byung C; Jiang, Bowen; Carvalho, Carla M; Rincon, Fred; Maltenfort, Mitchell; Jallo, Jack; Ratliff, John K

    2015-01-01

    The aim of this study was describe national trends in prevalence, demographics, hospital length of stay (LOS), hospital charges, and mortality for burn patients with and without inhalational injury and to compare to the National Burn Repository. Burns and inhalation injury cause considerable mortality and morbidity in the United States. There remains insufficient reporting of the demographics and outcomes surrounding such injuries. The National Inpatient Sample database, the nation's largest all-payer inpatient care data repository, was utilized to select 506,628 admissions for burns from 1988 to 2008 based on ICD-9-CM recording. The data were stratified based on the extent of injury (%TBSA) and presence or absence of inhalational injury. Inhalation injury was observed in only 2.2% of burns with burns with 80 to 99% TBSA. Burn patients with inhalation injury were more likely to expire in-hospital compared to those without (odds ratio, 3.6; 95% confidence interval, 2.7-5.0; P Patients treated at rural facilities and patients with hyperglycemia had lower mortality rates. Each increase in percent of TBSA of burns increased LOS by 2.5%. Patients with burns covering 50 to 59% of TBSA had the longest hospital stay at a median of 24 days (range, 17-55). The median in-hospital charge for a burn patient with inhalation injury was US$32,070, compared to US$17,600 for those without. Overall, patients who expired from burn injury accrued higher in-hospital charges (median, US$50,690 vs US$17,510). Geographically, California and New Jersey were the states with the highest charges, whereas Vermont and Maryland were states with the lowest charges. The study analysis provides a broad sampling of nationwide demographics, LOS, and in-hospital charges for patients with burns and inhalation injury.

  17. 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...

  18. 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

  19. 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...

  20. 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.

  1. NITRIC OXIDE SYNTHESIS IN MYOCARDIUM FOLLOWING BURN INJURY IN RATS

    Institute of Scientific and Technical Information of China (English)

    王卫东; 陈宗荣; 李蓉; 楼淑芳

    1998-01-01

    The nitric oxide and cyclic GMP production in myocardium early after burn injury in tats were investigated. Nitric oxide synthase activity was measured in cytosols from the left ventricular wall of burned rats.Cytosols from the control group animals were shown to contain mainly Ca2+ dependent nitric oxide synthase (cNOS) with small amount of Ca2+ independent nitric oxide synthase (iNOS). Following burn injury,there was a marked increase in iNOS activity with a peak at 8h post-butyl, however, myocardial cNOS activity was found to decline obviously. Parallel to iNOS induction there was a significant increase in myocardial nitric oxide and cyelic GMP production. All these chenges were alleviated by treatment of the rats with dexamethasone. Since increases in cyclic GMP levels in the heart were associated with reduced myocardial contractility, it is possible that enhanced production of nitric oxide by a Ca2+ independent NO synthase accounts, at least in part, for the depression of myocardial contractility seen in burn animals and patients.

  2. [USE OF NNN LANGUAGE IN LOCAL CARE OF BURN INJURIES].

    Science.gov (United States)

    Piríz Campos, Rosa María; Martín Espinosa, Noelia María

    2016-04-01

    Burn injuries are tissue injuries originated as a result of a physical or chemical trauma. They can cause from a mild skin affectation to the total destruction of the affected tissues, depending on various levels of severity. Moreover, if the affected body surface is very large, patient life can seriously be compromised. In this chapter, the intention is to clarify the nursing care for the affected area, once patient's life risk is stabilized and controlled. This care should be based on an adequate approach to local handling of burn injuries, after their severity and prognosis have been stated. To do this, it will be used the standardized nursing language NNN, referring to Nursing Diagnosis NANDA (North American Nursing Diagnosis Association), Nursing Outcomes Classification (NOC) and Nursing Interventions Classification (NIC). This taxonomy is very useful to describe the Nursing clinical practice of burns care because it can easily be used by nurses participating in the care of this type of patients. Nursing plans using the NNN taxonomy can be designed using existing software applications. PMID:27349058

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

    NARCIS (Netherlands)

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

    2015-01-01

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

  4. 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

  5. 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.

  6. 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.

  7. 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

  8. Secondary hyperalgesia to heat stimuli after burn injury in man

    DEFF Research Database (Denmark)

    Pedersen, J L; Kehlet, H

    1998-01-01

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

  9. Burn injury in patients with early-onset neurological impairments: 2002 ABA paper.

    Science.gov (United States)

    Alden, N E; Rabbitts, A; Rolls, J A; Bessey, P Q; Yurt, R W

    2004-01-01

    Many patients suffer from sensorimotor deficits that may contribute to burn injury. This retrospective study examines burn injuries in the subgroup of patients that suffer from the early onset neurological impairments of mental retardation, cerebral palsy, spina bifida, autism, and attention deficit-hyperactivity disorder. Fifty-one patients who suffered from the above-mentioned early-onset neurological impairments were admitted to our burn center during a 4-year period. The average TBSA burned was 8.9% yet resulted in prolonged hospitalizations. This study describes our burn center's experience in treating patients admitted with early-onset neurological impairments. PMID:14726747

  10. 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

  11. 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

  12. Management of burn injuries – recent developments in resuscitation, infection control and outcomes research

    Directory of Open Access Journals (Sweden)

    Dries David J

    2009-03-01

    Full Text Available Abstract Introduction Burn injury and its subsequent multisystem effects are commonly encountered by acute care practitioners. Resuscitation is the major component of initial burn care and must be managed to restore and preserve remote organ function. Later complications of burn injury are dominated by infection. Burn centers are often called to manage soft tissue problems outside thermal injury including soft tissue infection and Toxic Epidermal Necrolysis. Methods A selected review of recent reports published by the American Burn Association is provided. Results The burn-injured patient is easily and frequently over resuscitated with complications including delayed wound healing and respiratory compromise. A feedback protocol is designed to limit the occurrence of excessive resuscitation has been proposed but no new "gold standard" for resuscitation has replaced the Parkland formula. Significant additional work has been included in recent guidelines identifying specific infectious complications and criteria for these diagnoses in the burn-injured patient. While new medical therapies have been proposed for patients sustaining inhalation injury, a new standard of medical therapy has not emerged. Renal failure as a contributor to adverse outcome in burns has been reinforced by recent data generated in Scandinavia. Of special problems addressed in burn centers, soft tissue infections and Toxic Epidermal Necrolysis have been reviewed but new treatment strategies have not been identified. The value of burn centers in management of burns and other soft tissue problems is supported in several recent reports. Conclusion Recent reports emphasize the dangers of over resuscitation in the setting of burn injury. No new medical therapy for inhalation injury exists but new standards for description of burn-related infections have been presented. The value of the burn center in care of soft tissue problems including Toxic Epidermal Necrolysis and soft tissue

  13. Decreased pulmonary inflammation after ethanol exposure and burn injury in intercellular adhesion molecule-1 knockout mice.

    Science.gov (United States)

    Bird, Melanie D; Morgan, Michelle O; Ramirez, Luis; Yong, Sherri; Kovacs, Elizabeth J

    2010-01-01

    Clinical and laboratory evidence suggests that alcohol consumption dysregulates immune function. Burn patients who consume alcohol before their injuries demonstrate higher rates of morbidity and mortality, including acute respiratory distress syndrome, than patients without alcohol at the time of injury. Our laboratory observed higher levels of proinflammatory cytokines and leukocyte infiltration in the lungs of mice after ethanol exposure and burn injury than with either insult alone. To understand the mechanism of the increased pulmonary inflammatory response in mice treated with ethanol and burn injury, we investigated the role of intercellular adhesion molecule (ICAM)-1. Wild-type and ICAM-1 knockout (KO) mice were treated with vehicle or ethanol and subsequently given a sham or burn injury. Twenty-four hours postinjury, lungs were harvested and analyzed for indices of inflammation. Higher numbers of neutrophils were observed in the lungs of wild-type mice after burn and burn with ethanol treatment. This increase in pulmonary inflammatory cell accumulation was significantly lower in the KO mice. In addition, levels of KC, interleukin-1beta, and interleukin-6 in the lung were decreased in the ICAM-1 KO mice after ethanol exposure and burn injury. Interestingly, no differences were observed in serum or lung tissue content of soluble ICAM-1 24 hours postinjury. These data suggest that upregulation of adhesion molecules such as ICAM-1 on the vascular endothelium may play a critical role in the excessive inflammation seen after ethanol exposure and burn injury.

  14. 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...

  15. 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 ...

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

    NARCIS (Netherlands)

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

    2012-01-01

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

  17. 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.

  18. Early pulmonary immune hyporesponsiveness is associated with mortality after burn and smoke inhalation injury.

    Science.gov (United States)

    Davis, Christopher S; Albright, Joslyn M; Carter, Stewart R; Ramirez, Luis; Kim, Hajwa; Gamelli, Richard L; Kovacs, Elizabeth J

    2012-01-01

    This prospective study aims to address mortality in the context of the early pulmonary immune response to burn and inhalation injury. The authors collected bronchoalveolar lavage fluid from 60 burn patients within 14 hours of their injury when smoke inhalation was suspected. Clinical and laboratory parameters and immune mediator profiles were compared with patient outcomes. Patients who succumbed to their injuries were older (P = .005), had a larger % TBSA burn (P burn on mortality, nonsurvivors also had reduced levels of IL-2, IL-4, granulocyte colony-stimulating factor, interferon-γ, macrophage inflammatory protein-1β, and tumor necrosis factor-α (P response to burn and smoke inhalation may be attenuated in patients who succumb to their injuries.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  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...... on 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...... (Presponses (Presponses (Pskin temperature (P>0...

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

    Directory of Open Access Journals (Sweden)

    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

  3. 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

  4. 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

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

    Directory of Open Access Journals (Sweden)

    Chuanli Chen

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

  6. 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...

  7. Characteristics of and strategies for patients with severe burn-blast combined injury

    Institute of Scientific and Technical Information of China (English)

    CHAI Jia-ke; SHEN Chuan-an; TUO Xiao-ye; LIANG Li-ming; WANG Shu-jun; SHENG Zhi-yong; LU Jiang-yang; WEN Zhong-guang; YANG Hong-ming; JIA Xiao-ming; LI Li-gen; CAO Wei-hong; HAO Dai-feng

    2007-01-01

    Background Severe burn-blast combined injury is a great challenge to medical teams for its high mortality. The aim of this study was to elucidate the clinical characteristics of the injury and to present our clinical experiences on the treatment of such cases.Methods Five patients with severe burn-blast combined injuries were admitted to our hospital 77 hours post-injury on June 7, 2005. The burn extent ranged from 80% to 97% (89.6%±7.2%) of TBSA (full-thickness burns 75%-92%(83.4%±7.3%)). All the patients were diagnosed as having blast injury and moderate or severe inhalation injury. Functions of the heart, liver, kidney, lung, pancreas and coagulation were observed. Autopsy samples of the heart, liver, and lungs were taken from the deceased. Comprehensive measures were taken during the treatment, including protection of organ dys function, use of antibiotics, early anticoagulant treatment, early closure of burn wounds, etc. All the data were analyzed statistically with t test.Results One patient died of septic shock 23 hours after admission (four days after injury), the others survived.Dysfunction of the heart, liver, lungs, pancreas, and coagulation were found in all the patients on admission, and the functions were ameliorated after appropriate treatments.Conclusions Burn-blast combined injury may cause multiple organ dysfunctions, especially coagulopathy. Proper judgment of patients' condition, energetic anticoagulant treatment, early closure of burn wounds, rational use of antibiotics, nutritional support, intensive insulin treatment, timely and effective support and protection of organ function are the most important contributory factors in successful treatment of burn-blast combined injuries.

  8. Pulmonary inflammation after ethanol exposure and burn injury is attenuated in the absence of IL-6.

    Science.gov (United States)

    Chen, Michael M; Bird, Melanie D; Zahs, Anita; Deburghgraeve, Cory; Posnik, Bartlomiej; Davis, Christopher S; Kovacs, Elizabeth J

    2013-05-01

    Alcohol consumption leads to an exaggerated inflammatory response after burn injury. Elevated levels of interleukin-6 (IL-6) in patients are associated with increased morbidity and mortality after injury, and high systemic and pulmonary levels of IL-6 have been observed after the combined insult of ethanol exposure and burn injury. To further investigate the role of IL-6 in the pulmonary inflammatory response, we examined leukocyte infiltration and cytokine and chemokine production in the lungs of wild-type and IL-6 knockout mice given vehicle or ethanol (1.11 g/kg) and subjected to a sham or 15% total body surface area burn injury. Levels of neutrophil infiltration and neutrophil chemoattractants were increased to a similar extent in wild-type and IL-6 knockout mice 24 h after burn injury. When ethanol exposure preceded the burn injury, however, a further increase of these inflammatory markers was seen only in the wild-type mice. Additionally, signal transducer and activator of transcription-3 (STAT3) phosphorylation did not increase in response to ethanol exposure in the IL-6 knockout mice, in contrast to their wild-type counterparts. Visual and imaging analysis of alveolar wall thickness supported these findings and similar results were obtained by blocking IL-6 with antibody. Taken together, our data suggest a causal relationship between IL-6 and the excessive pulmonary inflammation observed after the combined insult of ethanol and burn injury.

  9. 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...

  10. 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...

  11. Interleukin-18 delays neutrophil apoptosis following alcohol intoxication and burn injury.

    Science.gov (United States)

    Akhtar, Suhail; Li, Xiaoling; Kovacs, Elizabeth J; Gamelli, Richard L; Choudhry, Mashkoor A

    2011-01-01

    Studies have shown that burn patients who are intoxicated at the time of injury are more susceptible to infection and have a higher incidence of mortality. A major cause of death in burn and trauma patients regardless of their alcohol (EtOH) exposure is multiple organ dysfunction, which is driven in part by the systemic inflammatory response and activated neutrophils. Neutrophils are short lived and undergo apoptosis to maintain homeostasis and resolution of inflammation. A delay in apoptosis of neutrophils is one important mechanism which allows for their prolonged presence and the release of potentially harmful enzymes. The purpose of this study was to examine whether EtOH intoxication combined with burn injury influences neutrophil apoptosis and whether IL-18 plays any role in this setting. To accomplish this investigation, rats were gavaged with EtOH (3.2 g/kg) 4 h before being subjected to sham or burn injury of ~12.5% of the total body surface area, and then killed on d 1 after injury. Peripheral blood neutrophils were isolated and lysed. The lysates were analyzed for pro- and antiapoptotic proteins. We found that EtOH combined with burn injury prolonged neutrophil survival. This prolonged neutrophil survival was accompanied by a decrease in the levels of the neutrophil proapoptotic protein Bax, and an increase in antiapoptotic proteins Mcl-1 and Bcl-xl. Administration of IL-18 antibody following burn injury normalized the levels of Bax, Mcl-1 and Bcl-xl. The decrease in caspase-3 and DNA fragmentation observed following EtOH and burn injury was also normalized in rats treated with anti-IL-18 antibody. These findings suggest that IL-18 delays neutrophil apoptosis following EtOH and burn injury by modulating the pro- and antiapoptotic proteins.

  12. 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.

  13. Role of stanniocalcin1 in brain injury of coal-burning-borne fluorosis rats

    Institute of Scientific and Technical Information of China (English)

    陈旭义

    2013-01-01

    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,

  14. 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

  15. 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

  16. 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

  17. Inhalation injury in burn patients: establishing the link between diagnosis and prognosis.

    Science.gov (United States)

    You, Kicheol; Yang, Hyeong-Tae; Kym, Dohern; Yoon, Jaechul; HaejunYim; Cho, Yong-Suk; Hur, Jun; Chun, Wook; Kim, Jong-Hyun

    2014-12-01

    This study was to re-evaluate inhalation injury as a prognostic factor in burn patients and to determine the factors that should be considered when refining the definition of inhalation injury. A total of 192 burn patients (152 men, 40 women; mean age, 46.1±13.8 years) who were suspected to have an inhalation injury and underwent bronchoscopy between January 2010 and June 2012 were included in this prospective observational study. All patients underwent bronchoscopy within 24h of sustaining the burn. The bronchoscopic findings were classified as normal, mild, moderate, and severe. Mechanical ventilation was administered, when required. Age, percentage of TBSA burned, ABSI score, requirement of mechanical ventilation and PF ratio, but not inhalation injury, COHb level, and bronchoscopic grades, significantly differed between the survivors and non-survivors (pburns. Other components such as severity of inhalation injury determined using bronchoscopy, and administration of mechanical ventilation might help predict the morbidity and mortality of burn patients with inhalation injury and all of the factors should be considered when the definition of inhalation injury is refined.

  18. 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.

  19. 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

  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

    Directory of Open Access Journals (Sweden)

    Terence J Coderre

    2000-01-01

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

  2. 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

  3. The role of seizure disorders in burn injury and outcome in Sub-Saharan Africa.

    Science.gov (United States)

    Boschini, Laura P; Tyson, Anna F; Samuel, Jonathan C; Kendig, Claire E; Mjuweni, Stephano; Varela, Carlos; Cairns, Bruce A; Charles, Anthony G

    2014-01-01

    Patients with epilepsy have higher incidence and severity of burn injury. Few studies describe the association between epilepsy and burns in low-income settings, where epilepsy burden is highest. The authors compared patients with and without seizure disorder in a burn unit in Lilongwe, Malawi. The authors conducted a retrospective study of patients admitted to the Kamuzu Central Hospital burn ward from July 2011 to December 2012. Descriptive analysis of patient characteristics and unadjusted and adjusted analyses of risk factors for mortality were conducted for patients with and without seizure disorder. Prevalence of seizure disorder was 10.7% in the study population. Adults with burns were more likely to have seizure disorder than children. Flame injury was most common in patients with seizure disorder, whereas scalds predominated among patients without seizure disorder. Whereas mortality did not differ between the groups, mean length of stay was longer for patients with seizure disorder, 42.1 days vs 21.6 days. Seizure disorder continues to be a significant risk factor for burn injury in adults in Malawi. Efforts to mitigate epilepsy will likely lead to significant decreases in burns among adults in Sub-Saharan Africa and must be included in an overall burn prevention strategy in our environment.

  4. 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.

  5. 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...... of mice with burn wound. The reduction was ascribed to the decline in concentration of polymorphonuclear neutrophil leucocytes and monocytes. When infecting the skin with Pseudomonas aeruginosa, a dissemination of bacteria was observed only in the burn wound group. Histological characterization...

  6. 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

  7. 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

  8. [Burn injuries during MR scanning: a case report

    NARCIS (Netherlands)

    Vister, J.; Erning, L. van; Steens, S.C.A.; Meijer, F.J.A.

    2014-01-01

    In this paper we report one case of skin burns in MRI caused by induced electrical currents. Two second degree skin burns occurred during imaging, while operating within all current safety guidelines. The currents are induced by the magnetic-gradient field, as well as the radiofrequency pulses. A cl

  9. 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...

  10. 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...

  11. 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

  12. 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

  13. Coronary Flow Velocity Reserve in Burn Injury: A Prospective Clinical Cohort Study.

    Science.gov (United States)

    Caliskan, Mustafa; Turk, Emin; Karagulle, Erdal; Ciftci, Ozgur; Oguz, Hakan; Kostek, Osman; Moray, Gokhan; Haberal, Mehmet

    2016-01-01

    The authors sought to evaluate coronary microvascular function and left ventricular diastolic dysfunction using transthoracic Doppler echocardiography in burn patients. In this study, 32 adult burn patients with partial or full-thickness scald burns that were hospitalized and treated were included. The control group was matched for age and sex and was composed of otherwise healthy volunteers. Transthoracic Doppler echocardiography examinations and simultaneous laboratory tests for cardiac evaluation were performed on the sixth month after burn injury as well as with the control group. High-sensitivity C-reactive protein levels were significantly higher in the burn patients than in controls (5.17 ± 3.86 vs 2.42 ± 1.78; P = .001). Lateral isovolumic relaxation time was significantly higher in the burn injury group than in the control group (92.7 ± 15.7 vs 85.5 ± 8.3; P = .03). Baseline coronary diastolic peak flow velocity of the left anterior descending artery was similar in both groups. However, hyperemic diastolic peak flow velocity and coronary flow velocity reserve (2.26 ± 0.48 vs 2.94 ± 0.47; P < .001) were significantly lower in the burn injury group than in the control group. Coronary flow velocity reserve was significantly and inversely correlated with high-sensitivity C-reactive protein, burn ratio, creatinine, and mitral A-wave max velocity. At the sixth month of treatment, burn patients had high-sensitivity C-reactive protein levels during this period, suggesting that inflammation still exists. In addition, subclinical coronary microvascular and left ventricular diastolic dysfunction can occur in burn patients without traditional cardiovascular risk factors. However, these results must be supported by additional studies.

  14. 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 ...

  15. PLATELET COUNT, ITS SIGNIFICANCE IN BURN INJURY MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Shanti Prakash

    2015-07-01

    Full Text Available INTRODUCTION: Platelet count evaluation in a burn trauma patient has much significance because it has been studied in literature that decrease i n platelet count is an indicator of septicaemia in the patient and vice versa thus knowing the count level of platelets, the treatment of burn patients can be done accordingly. Septicaemia is most important cause of mortality in burn patients, the survival of the patients can only be assured if septicaemia is detected early and controlled. Platelet s play an important role in haemostaticdisorder and immune response impairment in burn patient . [1] The aim of study is to see the significance of platelet count i nvestigation in burn patient and then their outcome, whether survival or not survival. MATERIAL METHODS: We investigated 480 burn patients within the ages of 18 and 60 Years and the percentage of the burn was between 20% and 70%. Platelet count was investi gated by visual method in all patients. The investigation of the platelet count was done on day 1, 3, 7, 14 & 21 of the patients. Other parameters TLC , neutrophil count was done by visual methods. Serum creatinine estimation was also done in all patients. RESULT: In our study we found that the platelet count gradually increased towards normal count and maintained till the discharge in survival patients, and in non - survival the platelet count gradually declined. The statistical significant of difference in m ean platelet counts on different post burn days in survivors and non survivors were studied by using standard t test. It was observed that the actual difference between two means is more than double of the SED between two means in different post burn days – i . e. , (Day 1, 3, 7, 14 &, 21. So difference is significant (P<0.05. CONCLUSION: It can be concluded that platelet count decreases initially in all cases of burn sepsis. It gradually rises to normal in case of survivors and declines gradually in non surv ivors. So serial declining

  16. 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.

  17. Effect of insulin on the inflammatory and acute phase response after burn injury.

    Science.gov (United States)

    Jeschke, Marc G; Boehning, Darren F; Finnerty, Celeste C; Herndon, David N

    2007-09-01

    After a severe burn, the liver plays a pivotal role by modulating inflammatory processes, metabolic pathways, immune functions, and the acute phase response. Therefore, liver integrity and function are important for recovery. A thermal injury, however, causes hepatic damage by inducing hepatic edema, fatty infiltration, hepatocyte apoptosis, and metabolic derangements associated with insulin resistance and impaired insulin signaling. In preliminary studies, we found that these pathophysiological processes are related to hepatic inflammation, altered intracellular signaling, and mitochondrial dysfunction. We hypothesize that modulation of these processes with insulin could improve hepatic structure and function and, therefore, outcome of burned and critically ill patients. Insulin administration improves survival and decreases the rate of infections in severely burned and critically ill patients. Here, we show that insulin administration decreases the synthesis of proinflammatory cytokines and signal transcription factors and improves hepatic structure and function after a severe burn injury; insulin also restores hepatic homeostasis and improves hepatic dysfunction postburn via alterations in the signaling cascade.

  18. 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.

  19. 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...

  20. 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...

  1. 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

  2. Non-severe burn injury leads to depletion of bone volume that can be ameliorated by inhibiting TNF-α.

    Science.gov (United States)

    O'Halloran, Emily; Kular, Jasreen; Xu, Jiake; Wood, Fiona; Fear, Mark

    2015-05-01

    Bone loss after severe burn injury is well established, and is thought to be a consequence of the severe hyper-metabolic response as well as changes in cytokine and glucocorticoid levels that decrease bone synthesis and increase rate of loss. However, 90% of presentations are for non-severe burns which do not elicit this response. Little is known about whether these non-severe injuries may also affect bone tissue, and whether other mechanisms may be involved. To investigate whether bone loss occurs after a non-severe burn injury we used a mouse model of an approximately 8% total body surface area (TBSA) full-thickness burn and micro-CT. We also assessed whether blocking TNF-α after a burn injury by administration of an antibody could modulate the impacts of the burn on bone tissue. There was a significant loss of trabecular bone volume of (3.27% compared to 5.27%, p=0.0051) after non-severe burn injury. Trabecular number was significantly decreased (0.57/mm after injury compared to 1.02/mm controls, p=0.0051) and spacing increased after burn injury (0.40 compared to 0.28, p=0.0083). Anti-TNF-α antibodies significantly improved trabecular bone volume (8.53%, p=0.0034) and number after burn injury (1.28/mm, p=0.0034). There was no significant change observed in cortical bone after burn injury or administration of anti-TNF-α antibodies. These findings show that non-severe burn injury can lead to changes in bone metabolism. Monitoring bone density in patients with non-severe injuries and interventions to limit the impacts of the inflammatory storm may benefit patient recovery and outcomes.

  3. 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

  4. Burn injuries caused by a hair-dryer--an unusual case of child abuse.

    Science.gov (United States)

    Darok, M; Reischle, S

    2001-01-01

    About 1.4-26% burn injuries in children appear to be abusive in origin. A 2.5-year-old girl was referred to our institute because of suspected child abuse. Clinical examination and later interrogation of the mother revealed non-recent deep second degree burn injuries on both gluteal regions, caused by the partner of the mother by pressing a hand-held hair-dryer against the skin. The authors present the findings of this unusual method of child abuse.

  5. "Tetracycline hydrochloride chemical burn" as self-inflicted mucogingival injury: A rare case report

    Directory of Open Access Journals (Sweden)

    Mundoor Manjunath Dayakar

    2012-01-01

    Full Text Available Injuries to oral soft tissue can be accidental, iatrogenic, and factitious trauma. Chemical, thermal, and physical agents are the main causative agents for oral soft-tissue burns. The present case describes the chemical burn of oral mucosa caused by tetracycline hydrochloride and its management. Diagnosis was made on the basis of definitive history elicited from the patient. The early detection of the lesion by the patient and immediate institution of therapeutic measures ensure a rapid cure and possible prevention of further mucogingival damage. In addition, we believe that proper guidance and education of the patient is an important prophylactic measure in preventing this self-inflicting injury.

  6. Transfer of patients with severe burn injury%严重烧伤伤员的转运

    Institute of Scientific and Technical Information of China (English)

    彭毅志

    2015-01-01

    Transfer of patients with severe burn injury is an important issue during the rescue of mass casualties,as it may give rise to great influence on the prognosis of patients.Timing of transfer,preparation before transfer,and details for attention are elaborated in this article,aiming to further specify the procedures of transfer of patients with burn injury.

  7. Inflammatory and protein metabolism signaling responses in human skeletal muscle after burn injury.

    Science.gov (United States)

    Merritt, Edward K; Cross, James M; Bamman, Marcas M

    2012-01-01

    Severe burn injuries lead to a prolonged hypercatabolic state resulting in dramatic loss of skeletal muscle mass. Postburn muscle loss is well documented but the molecular signaling cascade preceding atrophy is not. The purpose of this study is to determine the response to burn injury of signaling pathways driving muscle inflammation and protein metabolism. Muscle biopsies were collected in the early flow phase after burn injury from the vastus lateralis of a noninjured leg in patients with 20 to 60% TBSA burns and compared with uninjured, matched controls. Circulating levels of proinflammatory cytokines were also compared. Immunoblotting was performed to determine the protein levels of key signaling components for translation initiation, proteolysis, and tumor necrosis factor/nuclear factor kappa B (NFκB)and interleukin (IL)-6/STAT3 signaling. Burn subjects had significantly higher levels of circulating proinflammatory cytokines, with no difference in muscle STAT3 activity and lower NFκB activity. No differences were found in any translational signaling components. Regarding proteolytic signaling in burn, calpain-2 was 47% higher, calpastatin tended to be lower, and total ubiquitination was substantially higher. Surprisingly, a systemic proinflammatory response 3 to 10 days postburn did not lead to elevated muscle STAT3 or NFκB signaling. Signaling molecules governing translation initiation were unaffected, whereas indices of calcium-mediated proteolysis and ubiquitin-proteasome activity were upregulated. These novel findings are the first in humans to suggest that the net catabolic effect of burn injury in skeletal muscle (ie, atrophy) may be mediated, at least during the early flow phase, almost entirely by an increased proteolytic activity in the absence of suppressed protein synthesis signaling.

  8. 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...

  9. 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...

  10. 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...

  11. Functional Characterization of Cultured Keratinocytes after Acute Cutaneous Burn Injury

    OpenAIRE

    Gauglitz, Gerd G; Siegfried Zedler; Felix von Spiegel; Jasmin Fuhr; Guido Henkel von Donnersmarck; Eugen Faist

    2012-01-01

    BACKGROUND: In addition to forming the epithelial barrier against the outside environment keratinocytes are immunologically active cells. In the treatment of severely burned skin, cryoconserved keratinocyte allografts gain in importance. It has been proposed that these allografts accelerate wound healing also due to the expression of a favourable--keratinocyte-derived--cytokine and growth factor milieu. METHODS: In this study the morphology and cytokine expression profile of keratinocytes fro...

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

    Directory of Open Access Journals (Sweden)

    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.

  13. Major burn injuries associated with Christmas celebrations: a 41-year experience from Switzerland.

    Science.gov (United States)

    Rohrer-Mirtschink, S; Forster, N; Giovanoli, P; Guggenheim, M

    2015-03-31

    In Switzerland it is customary to light candles on Christmas trees and advent wreaths. This tradition leads to an increased risk of home fires. We reviewed the records of patients who sustained burn injuries from a lit Christmas tree or advent wreath during the Christmas holidays between January 1971 and January 2012. We treated 28 patients and observed 4 fatalities (mortality rate: 14%). 61% of the patients were male, 39% were female. The mean abbreviated burn severity index (ABSI) was 6.5 points in the group of the survivors and 10.8 points in the group of the non-survivors. The mean total body surface area burned (TBSA) for survivors was 18.9%, with 14.1% having full thickness burns; for the non-survivors the mean TBSA was 45.2%, with 38% having full thickness burns. The Mann-Whitney U-test showed a significant difference between the survivors and the fatalities concerning the mean total and full thickness burned body surface area (p value 0.009 and 0.012). More than sixty percent of the fires occurred in January and the most severe accidents were seen after January 4th. Despite Christmas decoration-associated fires being relatively uncommon, they tend to cause more serious injuries than regular household fires. We recommend that in countries where it is customary to set up flammable Christmas decorations, state-issued information pamphlets with instructions on fire safety conduct should be distributed.

  14. Early and Late Acute Kidney Injury in Severely Burned Patients

    Science.gov (United States)

    Witkowski, Wojciech; Kawecki, Marek; Surowiecka-Pastewka, Agnieszka; Klimm, Wojciech; Szamotulska, Katarzyna; Niemczyk, Stanisław

    2016-01-01

    Background This study evaluated factors influencing early and late occurrence of AKI in severely burned patients and assessed the relationship between time of occurrence of AKI and mortality of AKI patients. Material/Methods Renal function was evaluated at 3 time points: at admission, at the critical point or middle point of hospitalization, and at the endpoint for which death or a discharge from the center was considered. AKI criteria were: decrease in GFR of less than 60 ml/min at admission, decrease in GFR of more than 75% compared to baseline, and decrease in the daily diuresis of less than 500 ml/24 h. Results At admission, 15.1% of the patients had eGFR burns, respiratory failure, low protein concentration (for all ppatients. Mortality was 100% with the initial GFR ≥60, 100% with the initial GFR patients and mortality in this group was 79.2%. Mortality in the entire group with AKI was 88.0% versus 24.5%. Conclusions The frequent occurrence of AKI, especially early, worsens the prognosis for survival. Assessment of renal function should be included in the prognostic scales for burned patients. PMID:27746455

  15. Epidemiology and outcome of burn injuries in tertiary care hospital of Northern India

    Directory of Open Access Journals (Sweden)

    Ram Kishan Abrol

    2015-10-01

    Conclusions: Burn injuries can be reduced by bringing about regulations to develop safer cooking appliances, promoting less inflammable fabrics to be worn out at home and educating the community especially women. [Int J Res Med Sci 2015; 3(10.000: 2711-2713

  16. 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.

  17. 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.

  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. 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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  2. 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

  3. 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

  4. 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

    2015-03-01

    The inflammatory response induced by burn injury contributes to increased incidence of infections, sepsis, organ failure, and mortality. Thus, monitoring postburn inflammation is of paramount importance but, so far, there are no reliable biomarkers available to monitor and/or predict infectious complications after burn. As interleukin 8 (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 postburn sepsis, infections, and mortality. Plasma cytokines, acute-phase proteins, constitutive proteins, and hormones were analyzed during the first 60 days after injury from 468 pediatric burn patients. Demographics and clinical outcome variables (length of stay, infection, sepsis, multiorgan failure [MOF], and mortality) were recorded. A cutoff level for IL-8 was determined using receiver operating characteristic analysis. Statistical significance is set at P Patients were grouped according to their average IL-8 levels relative to this cutoff 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 burned and incidence of MOF (P inflammatory and acute-phase responses compared with the L group (P burn patients.

  5. A prospective clinical study of flow-mediated dilatation in burn injury.

    Science.gov (United States)

    Turk, Emin; Caliskan, Mustafa; Karagulle, Erdal; Aydogan, Cem; Oguz, Hakan; Kulaksizoglu, Sevsen; Yildirim, Erkan; Moray, Gokhan; Haberal, Mehmet

    2014-01-01

    The authors investigated endothelial function using flow-mediated dilatation (FMD) in burn patients. This study was done in burn patients with specific criteria on admission. Blood lipid profile at 1st day, high-sensitivity C-reactive protein, and FMD were assessed at 1st and 7th days, as well as at 1st and 3rd months. The highest values of high-sensitivity C-reactive protein were detected on the 7th day, which were significantly higher than those at 1st and 3rd months. The lowest value of FMD was observed on the 7th day. FMD values were higher during the 1st month compared with the 7th day. The highest value of FMD was detected in the 3rd month. It was found that FMD values measured at 7th day and 1st month were significantly lower in patients with a burn percentage of 40 or greater. Our results suggest that inflammation is more prominent on 7th day following burn. The decrease in FMD values on 7th day after injury can be attributed to endothelial damage. The increase in FMD on 3rd month after burn is attributable to effective burn treatment and gradual decrease of inflammatory mediators. The data from this study suggest that there is endothelial dysfunction and low-grade inflammation in burn patients. This condition is more prominent in patients with a burn ratio greater than 40%. Burn patients more frequently have impaired FMD, which may be indicative of arterial endothelial dysfunction and a marker for increased atherosclerosis.

  6. 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

  7. Association between early airway damage-associated molecular patterns and subsequent bacterial infection in patients with inhalational and burn injury.

    Science.gov (United States)

    Maile, Robert; Jones, Samuel; Pan, Yinghao; Zhou, Haibo; Jaspers, Ilona; Peden, David B; Cairns, Bruce A; Noah, Terry L

    2015-05-01

    Bacterial infection is a major cause of morbidity affecting outcome following burn and inhalation injury. While experimental burn and inhalation injury animal models have suggested that mediators of cell damage and inflammation increase the risk of infection, few studies have been done on humans. This is a prospective, observational study of patients admitted to the North Carolina Jaycee Burn Center at the University of North Carolina who were intubated and on mechanical ventilation for treatment of burn and inhalational injury. Subjects were enrolled over a 2-yr period and followed till discharge or death. Serial bronchial washings from clinically indicated bronchoscopies were collected and analyzed for markers of tissue injury and inflammation. These include damage-associated molecular patterns (DAMPs) such as hyaluronic acid (HA), double-stranded DNA (dsDNA), heat-shock protein 70 (HSP-70), and high-mobility group protein B-1 (HMGB-1). The study population was comprised of 72 patients who had bacterial cultures obtained for clinical indications. Elevated HA, dsDNA, and IL-10 levels in bronchial washings obtained early (the first 72 h after injury) were significantly associated with positive bacterial respiratory cultures obtained during the first 14 days postinjury. Independent of initial inhalation injury severity and extent of surface burn, elevated levels of HA dsDNA and IL-10 in the central airways obtained early after injury are associated with subsequent positive bacterial respiratory cultures in patients intubated after acute burn/inhalation injury.

  8. 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

  9. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  11. HEME OXYGENASE-1 UPREGULATED BY MELATONIN: POTENTIAL PROTECTION AGAINST BURN-INDUCED OXIDATIVE GASTRIC MUCOSAL INJURY.

    Directory of Open Access Journals (Sweden)

    Minka Hristova

    2015-05-01

    Full Text Available Melatonin is indoleamine hormone derived from L-tryptophan. Due to its lipophilic nature, it is accessible to every cell. Melatonin has immunomodulatory and antioxidant activities thus protecting tissue injury. Heat shock proteins such as HSP32 known as heme oxygenase-1 (HO-1 possesses antioxidant, anti-inflammatory, and vasodilatory properties and plays an important role in the protecting of tissues from several stresses. The aim of study is to investigate the expression of HO-1 in gastric mucosa and its connection with oxidative stress and melatonin mediated protection after thermal injury. On rats back, under anesthesia, third degree burn was applied involving 30% of total body surface area (TBSA. Melatonin (10 mg per kg body mass was injected i.p. immediately and 12 hours after thermal skin injury. We used tissue malondialdehyde (MDA, lipid peroxidation product, as a marker of oxidative stress. Gastric mucosa histopathology were observed on light microscopy and light immunohistochemistry investigating the HO-1 too. Results: The levels of MDA in gastric mucosa were elevated (p< 0.05. The HO-1 expression was significantly increased in rats with trauma. Melatonin inhibited elevation in lipid peroxidation product and augmented the increase in expression of HO-1 in the gastric mucosa. In conclusion, our data suggest that HO-1 induction following burn injury is an adaptive response protecting gastric mucosal against further oxidative damage. Melatonin increased the antioxidant capacity and restricted burn-induced oxidative damage in gastric mucosa and thus could be used therapeutically in organ protection.

  12. 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

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

    Directory of Open Access Journals (Sweden)

    Mehtap Kavurmaci

    2016-04-01

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

  14. 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

  15. 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)

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

    DEFF Research Database (Denmark)

    Møller-Kristensen, Mette; Hamblin, MR; Thiel, Steffen;

    2007-01-01

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

  17. Management of a Patient With Faciocervical Burns and Inhalational Injury Due to Hydrofluoric Acid Exposure.

    Science.gov (United States)

    Yuanhai, Zhang; Xingang, Wang; Liangfang, Ni; Chunmao, Han

    2014-05-01

    Hydrofluoric acid, a highly dangerous substance, can cause tissue damage and systemic toxicity by its unique mechanisms. Many cases of severe faciocervical burns due to hydrofluoric acid exposure are lethal. Herein, we present a case of 37-year-old man who suffered from hydrofluoric acid burns to his face, anterior neck, lips, and nasal cavity. On admission, this patient coughed with much sputum, and the chest auscultation detected rough breath sounds, wheezes, and very weak heart sounds, indicating possible inhalation injury. This case highlights the extreme complexity of managing this kind of injury. Timely and accurate wound treatment and respiratory tract care, as well as active systematic support treatment, played vital roles in the management of this patient.

  18. 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...

  19. 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

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

    Directory of Open Access Journals (Sweden)

    Satar Rezaei

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ravi Kumar Chittoria

    2014-01-01

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

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

    Science.gov (United States)

    Chittoria, Ravi Kumar; Mohapatra, Devi Prasad; Friji, Meethale Thiruvoth; Kumar, S Dinesh; Asokan, Arjun; Pandey, Sandhya

    2014-05-01

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

  3. Thoracic Duct Chylous Fistula Following Severe Electric Injury Combined with Sulfuric Acid Burns: A Case Report

    Science.gov (United States)

    Chang, Fei; Cheng, Dasheng; Qian, Mingyuan; Lu, Wei; Li, Huatao; Tang, Hongtai; Xia, Zhaofan

    2016-01-01

    Patient: Male, 32 Final Diagnosis: Thoracic duct chylous fistula Symptoms: Fistula Medication: — Clinical Procedure: A boneless muscle flap transplantatio Specialty: — Objective: Rare disease Background: As patients with thoracic duct injuries often suffer from severe local soft tissue defects, integrated surgical treatment is needed to achieve damage repair and wound closure. However, thoracic duct chylous fistula is rare in burn patients, although it typically involves severe soft tissue damage in the neck or chest. Case Report: A 32-year-old male patient fell after accidentally contacting an electric current (380 V) and knocked over a barrel of sulfuric acid. The sulfuric acid continuously poured onto his left neck and chest, causing combined electrical and sulfuric acid burn injuries to his anterior and posterior torso, and various parts of his limbs (25% of his total body surface area). During treatment, chylous fistula developed in the left clavicular region, which we diagnosed as thoracic duct chylous fistula. We used diet control, intravenous nutritional support, and continuous somatostatin to reduce the chylous fistula output, and hydrophilic silver ion-containing dressings for wound coverage. A boneless muscle flap was used to seal the left clavicular cavity, and, integrated, these led to resolution of the chylous fistula. Conclusions: Patients with severe electric or chemical burns in the neck or chest may be complicated with thoracic duct injuries. Although conservative treatment can control chylous fistula, wound cavity filling using a muscle flap is an effective approach for wound healing. PMID:27725628

  4. 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...

  5. 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

  6. 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.

  7. The interaction between burn injury and vitamin D metabolism and consequences for the patient.

    Science.gov (United States)

    Klein, Gordon L

    2008-09-01

    The stress and inflammatory responses to burn injury are associated with bone loss. The stress response entails production of large amounts of endogenous glucocorticoids that decrease osteoblasts on the mineralization surface of bone and decreases differentiation of marrow stromal cells into osteoblasts, thereby decreasing the amount of bone formation. Deficiency of osteoblasts also blocks osteoclastogenesis thus leading to low bone turnover and bone loss. The inflammatory response generates cytokines such as interleukin 1-beta and interleukin-6, which normally increase osteoclastogenic bone resorption via stimulation of osteoblast production of RANK ligand. However, in the absence of osteoblasts as a target we postulate that they attack the parathyroid gland chief cells and up-regulate the calcium-sensing receptor. The consequence of this upregulation is the lowering of the circulating calcium necessary to suppress parathyroid hormone production and the development of hypocalcemia and urinary calcium wasting. It is the parathyroid hormone suppression that causes us to postulate acute deficiency of 1,25-dihydroxyvitamin D and the consequence of this for post-burn metabolism could include derepression of the gene that controls renin production, leading to elevated levels of angiotensin II, which can contribute to insulin resistance, as can vitamin D deficiency itself. Moreover, the skin from burned patients cannot synthesize vitamin D normally. Thus vitamin D supplementation is the only means by which to ensure vitamin D sufficiency for burn victims. The proper requirement for vitamin D in acutely burned patients remains unknown.

  8. Involvement of the p38 mitogen-activated protein kinase signal transduction pathway in burns-induced lung injury

    Institute of Scientific and Technical Information of China (English)

    CHEN Xu-lin; XIA Zhao-fan; WEI Duo; WANG Yong-jie; WANG Chang-rong

    2005-01-01

    @@ Acute lung injury (ALI) is a leading complication in extensively burned patients, especially those with inhalation injury.1 It can cause hypoxia resulting in injury of remote organs and dysfunction. P38 mitogen-activated protein kinase (p38 MAPK) is a stress activated protein kinase in the MAPK family.2 Most of the previous studies have demonstrated that p38 MAPK signal transduction pathway mediated ALI in rats with acute severe pancreatitis, sepsis etc.3-5 However, there is little information regarding the role of p38 MAPK signal transduction pathway in ALI after severe burn trauma.

  9. 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)

  10. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Ubiquitin and stromal cell-derived factor-1α in bronchoalveolar lavage fluid after burn and inhalation injury.

    Science.gov (United States)

    Baker, Todd A; Davis, Christopher S; Bach, Harold H; Romero, Jacqueline; Burnham, Ellen L; Kovacs, Elizabeth J; Gamelli, Richard L; Majetschak, Matthias

    2012-01-01

    The objective of the study was to determine whether the CXC chemokine receptor (CXCR) 4 ligands ubiquitin and stromal cell-derived factor (SDF)-1α are detectable in bronchoalveolar lavage fluid (BALF) after burn and inhalation injury and whether their concentrations in BALF are associated with injury severity, physiological variables, or clinical outcomes. BALF was obtained on hospital admission from 51 patients (48 ± 18 years) with burn (TBSA: 23 ± 24%) and inhalation injury (controls: 10 healthy volunteers, 42 ± 8 years). BALF was analyzed for total protein and for ubiquitin and SDF-1α by enzyme-linked immunosorbent assay. Ubiquitin/SDF-1α levels were normalized to total BALF protein content. The extent of inhalation injury was determined during bronchoscopy using a standardized scoring system. Percent TBSA, Baux scores, revised Baux scores, and clinical variables were documented. Ubiquitin and SDF-1α were detectable in 40% of normal BALF specimens. After injury, ubiquitin was detectable in 90% (P patients (P burn and inhalation injury. Increases in BALF ubiquitin after inhalation injury may maintain CXCR4-mediated lung protection and repair processes. The finding that BALF ubiquitin decreased with higher grades of inhalation injury may provide a biological correlate for an insufficient local inflammatory response after severe inhalation injury.

  13. 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 ...

  14. 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

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

    Science.gov (United States)

    Ebrahimi, Ali; Kalantar Motamedi, Mohammad Hosein

    2012-01-01

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

  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. Do fentanyl and morphine influence body temperature after severe burn injury?

    Science.gov (United States)

    Kahn, Steven Alexander; Beers, Ryan J; Lentz, Christopher W

    2011-01-01

    Fentanyl lacks the antiinflammatory properties of morphine. Morphine attenuates the inflammatory response through differential stimulation of μ-receptor subtypes. Patients who receive morphine during coronary artery bypass graft have been shown to experience less postoperative fever than those who receive fentanyl. Patients who receive continuous fentanyl infusions in increased room temperatures after thermal injury may be at increased risk to experience higher body temperature than those who receive morphine. The records of 28 patients with >20%TBSA burn in 30 intensive care unit rooms (13 received fentanyl and 15 received morphine or hydromorphone) and 12 trauma patients who received fentanyl in 22°C intensive care unit rooms were reviewed. Mean maximum core temperature and percentage of temperature recordings > 39°C in the first 48 hours of admission were compared between burn patients who received fentanyl, those who did not, and with trauma patients. Burn patients exposed to fentanyl experienced significantly higher temperatures (40.1 ± 0.9°C) compared with those given morphine (38.7 ± 0.8°C) and compared with trauma patients (37.5 ± 2.4°C), P Burn patients on fentanyl had temperatures > 39°C for a higher percentage of time (33 ± 27%) than those without fentanyl (7.2 ± 13%) and trauma patients (1 ± 2.8%), P Burn patients who receive fentanyl in 30°C rooms experience higher body temperatures and are febrile for a higher percentage of time than those receiving morphine only. Morphine has well-established antiinflammatory properties and likely attenuates the postburn inflammatory response more than fentanyl, resulting in lower body temperatures. This phenomenon needs to be further investigated in additional studies.

  18. 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

    2010-09-01

    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 approximately 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.

  19. Effect of artificial colloids on blood coagulation during shock stage of severe burn injury

    Institute of Scientific and Technical Information of China (English)

    ZHOU Jian-jun; XING Nan; CHEN Jiong; SHI Jian-wu; SU Guo-liang

    2013-01-01

    Background There are controversies about the use of artificial colloids.This research was aimed to determine the effect of various artificial colloids on blood coagulation in the shock stage of severe burn injury.Methods Totally,18 female Ba-Ma mini-pigs were subjected to a 40% total body surface third-degree flame burn under anesthesia.Resuscitation therapy was applied 2 hours after the injury,using the burn shock fluid resuscitation formula commonly accepted in the surgical treatment of burns.The Ba-Ma mini-pigs were randomly assigned to three groups (six pigs in each group):succinylated gelatin group (the artificial colloid used was succinylated gelatin Injection),hydroxyethyl starch group (the artificial colloid used was hydroxyethyl starch (130/0.4)),and allogeneic plasma group (the colloid used was allogeneic plasma).Blood samples were collected from the animals prior to the burn injury and again at intervals of 4,8,24 and 48 hours post-injury.The platelet count (PLT),prothrombin time (PT),international normalized ratio (INR),activated partial thromboplastin time (APTT),and fibrinogen (Fib) were measured,followed by a statistical analysis of all results.Results The PLT of succinylated gelatin group and hydroxyethyl starch group at intervals of 24 and 48 hours were (124.3±52.7),(78.8±16.4)×109/L and (159.0±62.8),(87.3±32.0)×109/L respectively.But in the allogeneic plasma group at intervals of 8,24,and 48 hours were (234.3±52.6),(136.0±47.4),(75.8±31.0)×109/L.The decrease were all statistically significant (P <0.05,P <0.01) when compared to pre-burn ((383.3±77.9),(382.7±65.7),(381.0±49.4)×109/L).The PLT among the three groups,at all the time points,had no statistical difference (P >0.05).Compared to pre-burn ((10.8±0.9),(11.4±0.8),(10.6±0.7) seconds),the PT of succinylated gelatin group and hydroxyethyl starch group at 24 hours were (14.5±1.5) and (16.2±1.3) seconds,whereas in the allogeneic plasma group at 8 and 24 hours the PT were

  20. 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.

  1. 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

  2. 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 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

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

    Science.gov (United States)

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

    2014-03-01

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

  4. The effects and mechanisms of insulin on systemic inflammatory response and immune cells in severe trauma, burn injury, and sepsis.

    Science.gov (United States)

    Deng, Hu-Ping; Chai, Jia-Ke

    2009-10-01

    Insulin resistance, hyperglycemia, inflammatory disorders and immune dysfunction cause high morbidity and mortality in patients with severe trauma, burn injuries, or sepsis. Many studies have shown that intensive insulin therapy can combat insulin resistance, decrease blood glucose levels, and induce anabolic processes, thus, decreasing morbidity and mortality. Moreover, in recent years, it has been proven that insulin can attenuate systemic inflammatory responses and modulate the proliferation, apoptosis, differentiation and immune functions of certain immune cells, especially monocytes/macrophages, neutrophils, and T cells associated with severe trauma, burn injury, or sepsis. This effect of insulin may expand our understanding of intensive insulin therapy in critically ill patients. This review attempts to summarize studies on the modulatory effects and mechanisms of insulin therapy on systemic inflammation and immune cells in severe trauma, burn injury and sepsis, and further propose some questions for future studies.

  5. 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

  6. 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

  7. 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.

  8. 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...

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

    Science.gov (United States)

    Willebrand, M; Sveen, J

    2016-03-01

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

  10. 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...

  11. 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.

  12. Macrophage migration inhibitory factor-A potential diagnostic tool in severe burn injuries?

    Science.gov (United States)

    Grieb, Gerrit; Simons, David; Piatkowski, Andrzej; Bernhagen, Jürgen; Steffens, Guy; Pallua, Norbert

    2010-05-01

    Serum macrophage migration inhibitory factor (MIF) and procalcitonin (PCT) concentrations as well as leucocyte numbers were evaluated in a retrospective study with 23 patients with severe burn injuries. The MIF and PCT concentrations as well as the number of leucocytes (LEU) were monitored over a period of 5 days. The total body surface area (TBSA) and sepsis-related organ failure assessment (SOFA) scores were also evaluated. The MIF, PCT concentrations and leucocyte counts were profoundly increased in all patients with severe burn wounds. At the time of admission into the intensive care unit, no significant differences were observed for the MIF and PCT levels between patients with a TBSApatients with a TBSA>60% (Group 2). After 48 h, however, the MIF and PCT levels reached very high levels in a subgroup of the patients, whereas these levels became normal again in other subgroups. The group of patients with a TBSA>60% was, therefore, subdivided in three groups (subgroups 2a-c). The MIF and PCT data pairs in these subgroups appeared to correlate in an inhomogeneous manner. These levels in the subgroup 2a (i.e., lethal within 5 days) were strongly elevated over those observed in Group 1 (TBSAburn inflammation and systemic inflammatory response syndrome (SIRS) or sepsis with lethal outcome.

  13. Burn injury induces histopathological changes and cellproliferation in liver of rats

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    AIM To investigate effects of severe burn injury (BI) inrat liver through the histopathological and inflammatorymarkers analysis.METHODS: Forty-two male Wistar rats were distributedinto two groups, control (C) and subjected to scaldBI (SBI). The animals were euthanized one, four and14 d post sham or 45% of the total body surface BI.Liver fragments were submitted to histopathological,morphoquantitative (hepatocyte area and cell density),ciclooxigenase-2 (COX-2) immunoexpression, and geneexpression [real-time polymerase chain reaction fortumor necrosis factor (TNF)-α, inducible nitric oxidesynthase (iNOS) and caspase-3] methods.RESULTS: Histopathological findings showed inflammatoryprocess in all periods investigated and hepatocytedegeneration added to increased amount of connectivetissue 14 d post injury. Hepatocyte area, the density ofbinucleated hepatocytes and density of sinusoidal cellsof SBI groups were increased when compared withcontrol. COX-2 immunoexpression was stronger in SBIgroups. No differences were found in TNF-α, iNOS andcaspase-3 gene expression.CONCLUSION: BI induces histopathological changes,upregulation of COX-2 immunoexpression, and cellproliferation in liver of rats.

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. 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.

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

    Science.gov (United States)

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

    2016-01-01

    The objective of this study was to describe knowledge of clothing flammability risk, public support for clothing flammability warning labels, and stronger regulation to reduce the risk. As part of a national survey of homeowners about residential sprinkler systems, the authors included questions about clothing flammability. The authors used an online web panel to sample homeowners and descriptive methods to analyze the resulting data. The sample included 2333 homeowners. Knowledge of clothing flammability and government oversight of clothing flammability risk was low. Homeowners were evenly split about the effectiveness of current standards; however, when presented with clothing-related burn injury and death data, a majority (53%) supported stricter standards. Most homeowners (64%) supported warning labels and indicated that such labels would either have no effect on their purchasing decisions (64%) or be an incentive (24%) to purchase an item. Owners of sprinkler-equipped homes were more likely to support these interventions than owners of homes without sprinkler systems. Public knowledge about clothing flammability risks is low. Most homeowners supported clothing labels to inform consumers of this risk and increased government intervention to reduce the risk. PMID:25501786

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

    Science.gov (United States)

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

    2016-01-01

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

  2. A case of chemical scalp burns after hair highlights: experimental evidence of oxidative injuries.

    Science.gov (United States)

    Bertani, Roberta; Sgarbossa, Paolo; Pendolino, Flavio; Facchin, Giangiacomo; Snenghi, Rossella

    2016-12-01

    Hair highlights are quite common procedures carried out in hair salons by using a mixture of a lightening powder containing persulfates with a suspension containing hydrogen peroxide: a representative case of chemical scalp burns is described as a consequence of this treatment. The aim of the paper is to demonstrate the strict relationship between the scalp damage and the commercial products used in a case of hair highlighting. The results of some chemical analyses have been reported, showing, in particular, that the chemical reactivity of the mixture changes in the time, thus strongly suggesting that the procedure for the application of the mixture is critical for the occurrence of possible accidents. The presence in the powder of chemical compounds bearing aliphatic chains as surfactants explains the appearance of dramatic symptoms after days due to a slow dissolution of the oxidant compounds in the stratum corneum of skin with no effect in reducing injury of palliative treatments. Safety suggestions and recommendations for producers and workers are also included.

  3. 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

  4. 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 ...

  5. 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...

  6. 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

  7. 电灼伤的神经系统损伤%Nervous system injury of electrical burn

    Institute of Scientific and Technical Information of China (English)

    吴远; 李光勤

    2014-01-01

    因日常生活用电越来越广泛,电灼伤的发生率逐渐上升,具有较高的致死率和致残率。神经系统损伤是电灼伤常见的并发症,主要包括周围神经系统损伤、中枢神经系统损伤。周围神经系统损伤较多见,支配区出现无力、感觉异常、感觉缺失、神经痛、反射性交感神经营养不良症等;中枢神经系统损伤包括脊髓损伤和脑神经损伤,主要表现为电休克和各种神经系统后遗症。早期出现的神经系统损伤往往能被认识并加以治疗,而晚期出现的神经系统损伤常得不到重视。%With more use of electricity in daily life,the incidence rate of electrical burn is rising gradually,and electri-cal burn has higher mortality and disability.Nervous system injury is the common complication of electric burn and mainly includes the peripheral nervous system injury and central nervous system injury.The peripheral nervous system injury is more common,and it appears weakness,paresthesia,loss of sensation,neuralgia,reflex sympathetic dystrophy in control area and so on;the central nervous system injury mainly includes the brain and spinal cord injury,mainly for electrical shock and a variety of neurologic sequelae.The early emergence of nervous system injury can often be recog-nized and treated,the late emergence of nervous system injury can often be neglected.

  8. 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...

  9. 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...

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

    Science.gov (United States)

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

    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

  11. 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

  12. 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

  13. The Effects of Alcohol Intoxication and Burn Injury on the Expression of Claudins and Mucins in the Small and Large Intestines.

    Science.gov (United States)

    Hammer, Adam M; Khan, Omair M; Morris, Niya L; Li, Xiaoling; Movtchan, Nellie V; Cannon, Abigail R; Choudhry, Mashkoor A

    2016-01-01

    Alcohol intoxication at the time of burn injury exacerbates postburn pathogenesis. Recent findings suggest gut barrier integrity is compromised after combined alcohol and burn insult, which could contribute to these complications. Tight junction proteins and mucins play critical roles in keeping the gut barrier intact. Therefore, the goal of this study was to examine the effects of alcohol and burn injury on claudin and mucin expression in the intestines. We also evaluated if the combined insult differentially influences their expression in the small and large intestines. Male C57BL/6 mice were given a single dose of 2.9 g/kg ethanol before an approximately 12.5% body area burn. One and three days after injury, we profiled expression of several tight junction proteins, mucin, and bacterial 16S rRNA genes in the small and large intestines, using qPCR. We observed >50% decrease in claudin-4 and claudin-8 genes in both ileal and colonic epithelial cells 1 day after injury. Claudin-2 was significantly upregulated, and occludin was downregulated in the small intestine 1 day after injury. Mucin-3 expression was substantially elevated (>50%) in the small intestine, whereas mucin-2 and mucin-4 were considerably diminished in the colon (>50%) 1 day after injury. Most of the parameters were normalized to sham levels on day 3, except for mucin-3 and claudin-8, which remained decreased in the large intestine. Neither alcohol nor burn alone resulted in changes in junction or mucin gene expression compared to shams. This was accompanied with increases in the family of Gram-negative bacteria, Enterobacteriaceae, in both the small and the large intestines 1 day after injury. These findings suggest that alcohol and burn injury disrupts the normal gut microbiota and alters tight junction and mucin expression in the small and large intestines.

  14. Effect of burn injury on relative anaplerosis and gluconeogenesis in rats by 13C magnetic resonance spectrum

    Institute of Scientific and Technical Information of China (English)

    夏照帆; 田建广; 王光毅; 葛绳德; 唐洪泰

    2002-01-01

    Objective: To introduce a safe and specific approachof 13C magnetic resonance spectrum (13C MRS )spectroscopy and investigate the alterations in hepaticanabolism.Methods: Relative anaplerotic, pyruvate recyclingand gluconeogenic fluxes were measured by 13C MRSisotopomer analysis of blood glucose from rats with 40%body surface area burn injury, and from rats exposed tosham injury. A short chain fatty acid, [U-13C] propionatewhich was avidly extracted by the liver, was infusedintravenously to deliver 13C into the citric acid cycle.Proton-decoupled 13C MRS of deproteinized plasma orextracts of the freeze-clamped liver were used to determinethe distribution of 13C in blood or hepatic glucose.Results: There was no difference in the multipletsdetected in the glucose carbon-2 anomer from blood or liverafter 45 or 60 minutes of the infusion of the propionate,indicating that steady-state isotopic conditions wereachieved. Gluconeogenesis relative to citric acid cycle fluxwas not altered by burn injury; in both sham and burngroups the rate of glucose production was about equal toflux through citrate synthase. In the sham group ofanimals, the rate of entry of carbon skeletons into the citricacid cycle was about 4 times than that in the burn group.Similarly, flux through pyruvate kinase (again relative tocitrate synthase) was significantly increased after the burninjury.Conclusions: Since results from analysis of the bloodglucose are the same as that of the hepatic glucose, 13Cdistribution in the glucose and hepatic metabolism can beassessed based on the 13C MRS analysis of the bloodglucose.

  15. 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

  16. Current situation and reflection on rehabilitation after burn injury in China%中国烧伤康复治疗的现状与思考

    Institute of Scientific and Technical Information of China (English)

    吴军; 陈建

    2013-01-01

    After over 50 years'development,the modern burn care system of China has made remarkable progress,however,we still lack ample attention to functional rehabilitation and quality of life of burn patients recovering from burn injury.The burn rehabilitation in China is still in juvenile stage,but it is really encouraging that more and more burn care facilities are paying attention to it.To further promote the development of burn rehabilitation in China,more emphasis must be stressed on the formation of multidisciplinary team in our burn care system,the concept of early and integral rehabilitation should be promoted,and therapeutic regimens and research work on function and aesthetics related body parts like hand and face should be emphasized.Moreover,we should also carry out rehabilitation on pediatric burn patients and promulgate the idea of burn rehabilitation in the society at large with the purpose of seeking supports for burn rehabilitation from all sectors of the society.

  17. 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

  18. 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 C; Sbrana, Elena; Elijah, Itoro; Gerö, Domokos; Herndon, David N; Szabó, Csaba

    2011-07-01

    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 inhibition. The aims of the current study were 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. Poly(ADP-ribose) polymerase 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 after 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.

  19. The challenges of dysphagia management and rehabilitation after extensive thermal burn injury: a complex case.

    Science.gov (United States)

    Rumbach, Anna F; Ward, Elizabeth C; Cornwell, Petrea L; Bassett, Lynell V; Muller, Michael J

    2009-01-01

    The role of the speech pathologist in the burns population is still emerging, with detailed discussion of the assessment and management of dysphagia limited to date. This report describes the case of a 60-year-old man who developed severe contractures of the head and neck and oropharyngeal dysphagia after sustaining 53.5% deep partial- and full-thickness burns. Although some aspects of rehabilitation were confounded by a preexisting mild intellectual disability, the patient was able to participate in an intensive regimen of active and passive exercise to rehabilitate his oropharyngeal dysphagia. Significant oral contractures remained; however, the patient was discharged without tracheostomy and consuming a texture-modified diet with no signs of aspiration. To our knowledge, this is one of a small handful of reports that document speech pathology management of the burns population, and a first that identifies and outlines specific characteristics of, and rehabilitation strategies for, dysphagia in a burned individual.

  20. 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...... identified 16,903 patients from the Danish Hospital Discharge Register who had been admitted to a hospital with a thermal or chemical burn during 1978 to 1993. The cohort was followed for cancer in the Danish Cancer Registry through 2002, and the cancer incidence in the cohort was compared...... with that in the general population of Denmark. RESULTS: Patients with burn had 139 skin cancers, with 189 expected, yielding a standardized incidence ratio of 0.7 (95% confidence interval = 0.6-0.9). This reduced risk was due mainly to deficits of basal cell carcinoma and malignant melanoma, whereas the number...

  1. 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...

  2. How to manage burns in primary care.

    OpenAIRE

    Waitzman, A. A.; Neligan, P. C.

    1993-01-01

    Burns are common injuries; more than 200,000 occur in Canada annually. Nearly all burn injuries can be managed on on outpatient basis. Appropriate treatment depends on burn depth, extent, and location. Special types of burns, such as chemical, tar, and electrical injuries, need specific management strategies. Prevention through education is important to reduce the incidence of burns.

  3. 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...

  4. The epidemiology and characteristics of burn injuries in pediatric patients%小儿烧伤流行病学特点及预防

    Institute of Scientific and Technical Information of China (English)

    邹晓防; 宋卫平; 李斌; 何兰; 蔡景宁; 曹卫红

    2013-01-01

    目的分析小儿烧伤的原因及临床表现,以减少和预防小儿烧伤的发生。方法对空军总医院烧伤整形科自2009年9月~2012年9月收治的432例0~14岁烧伤患儿病例资料,包括发病率、患儿的年龄、性别、致伤原因、季节分布、烧伤程度、发生的地点进行回顾总结及分析。结果小儿烧伤患者占本院同期烧伤患者的60.2%,男性占56.3%,0~3岁小儿发病率最高,为68.9%,致伤原因主要是热液烫伤为81.7%,春季发病率最高为33.3%,烧伤程度以轻、中度为主占,两者合计为74.3%,农村患儿为76.6%。结论小儿烧伤的发生有其特点,应针对小儿烧伤发生特点采取有效的措施,降低小儿烧伤的发生。%Objective To investigate epidemiology and characteristics of burn injuries in pediatric patients, and reduce the incidence of pediatric burn. Method Retrospective statistical description of incidence of burn injuries, sexual ratio, children’s age, cause of burn, seasonal distribution, severity of burn, distribution of season, geographic location for 432 burn case of 0~14 years old in the hospital from Sep. 2009 to 2012 Sep. were performed with. Result Pediatric burn accounted for 60.2% among the patients with burns at the same period in hospital. Incidence rate 0f male children is 56.3%. The highest incidence of burn during 0~3 years children accounted for 68.9%. The incidence rate of burn is 33%in summer. Scald burn were the most frequent form of burn. The burn injuries were mostly minor and moderate. 76.6%of burn in children is occurred in rural area.

  5. 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

  6. 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

  7. Severe Burn Injury Induces Thermogenically Functional Mitochondria in Murine White Adipose Tissue.

    Science.gov (United States)

    Porter, Craig; Herndon, David N; Bhattarai, Nisha; Ogunbileje, John O; Szczesny, Bartosz; Szabo, Csaba; Toliver-Kinsky, Tracy; Sidossis, Labros S

    2015-09-01

    Chronic cold exposure induces functionally thermogenic mitochondria in the inguinal white adipose tissue (iWAT) of mice. Whether this response occurs in pathophysiological states remains unclear. The purpose of this study was to determine the impact of severe burn trauma on iWAT mitochondrial function in mice. Male BALB/c mice (10-12 weeks) received full-thickness scald burns to ∼30% of the body surface area. Inguinal white adipose tissue was harvested from mice at 1, 4, 10, 20, and 40 days postinjury. Total and uncoupling protein 1 (UCP1)-dependent mitochondrial thermogenesis were determined in iWAT. Citrate synthase activity was determined as a proxy of mitochondrial abundance. Immunohistochemistry was performed to assess iWAT morphology and UCP1 expression. Uncoupling protein 1-dependent respiration was significantly greater at 4 and 10 days after burn compared with sham, peaking at 20 days after burn (P white adipose tissue in vivo and may offer a mechanistic explanation for the chronic hypermetabolism observed in burn victims.

  8. Current status in rehabilitation of burn injury in China%中国烧伤康复的发展现状

    Institute of Scientific and Technical Information of China (English)

    贾赤宇; 邹晓防

    2015-01-01

    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 rate 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 muhidisciplinary 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.

  9. Thermal injuries induce gene expression of endogenous c-fos, c-myc and bFGF in burned tissues

    Institute of Scientific and Technical Information of China (English)

    付小兵; 顾小曼; 孙同柱; 杨银辉; 孙晓庆; 盛志勇

    2003-01-01

    Objective To investigate the expression sequence and distribution characteristics of the protooncogenes c-fos, c-myc and endogenous basic fibroblast growth factor (bFGF ) genes in burned tissues, and to explore the possible effects of changes in the se genes' functions on wound healing. Methods Partial-thickness burns of 30% TBSA were established on backs of Wistar rats. Insitu hybridization and histological methods were used to detect expression of c-fos, c-myc and bFGF genes in normal and burned tissue at 3 h, 6 h, 1 d, 3 d , 7 d and 14 d postburn. Results Although expression of c-fos and c-myc genes and bFGF gene could be found in normal skin, the expression of all three were markedly induced by burn wounds and the expression models in sequence and distribution were quite different. Expre ssion of c-fos gene increased and peaked at 6 h. Signals were mainly localiz ed in both nuclei of dermal fibroblasts and monocytes. The expression of bFGF gene increased at 6 h and peaked at 1 d postburn, and was distributed in the cyt oplasm of fibroblasts. C-myc gene peaked 3 d postburn and was also distributed in the cytoplasm of fibroblasts. Conclusions These results indicated that thermal injury could induce the expression of c-fos, c-myc and bFGF at gene level, showing phasic control and regional distributi on. The phasic expression of these genes suggests that there is an interaction between protooncogenes and bFGF, which may play an important role in wound heali ng. The different expressions of c-fos and c-myc play an inducing role in reg ulating bFGF, and in turn affect wound healing.

  10. MEBO for Treating Compound Burn Injury by Dust Explosion%MEBO治疗粉尘爆炸复合烧伤

    Institute of Scientific and Technical Information of China (English)

    李志刚; 黄合超

    2000-01-01

    目的:克服常规方法治疗粉尘爆炸复合烧伤的繁杂程序、处置带来的痛苦。方法:采用MEBO外涂及特制带刃不锈钢压舌板反复多次刮除液化物及创面粉尘,共治疗24例。结果:嵌于创面的粉尘异物随液化物分期分批清除,加速创面愈合,无瘢痕形成,亦无外伤性纹身形成。结论:利用MEBT/MEBO治疗粉尘爆炸复合烧伤,可彻底清除创面粉尘,消除粉尘残留给患者身心造成的损害。且方法简便易行,无痛苦,具有传统治疗方法无法替代的作用。%Objective: To avoid pains caused by the complicated procedure of the conventional therapy in treating compound dust explosion burn injury. Method: MEBO was applied externally and a specially made stainless steel spatula with knife edge was used to remove repeatedly the residual dust on the wounds and the liquefaction product. Results: 24 cases were healed. Residual dust and liquefaction product were removed in batches and wound healing was accelerated. No scar and no traumatic tattoo formed. Conclusion: MEBO is an ideal remedy for treating compound burn injury by dust explosion. It helps to remove residual dust thoroughly from the wounds and thus the psychosomatic injury of the patient is avoided. It is easy and simple to use.

  11. 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.

  12. Phytocontact Dermatitis due to Mustard Seed Mimicking Burn Injury: Report of a Case

    Directory of Open Access Journals (Sweden)

    Hakan Yabanoglu

    2012-01-01

    Full Text Available Mustard seeds have been used in traditional folk medicine as a stimulant, diuretic, and purgative and to treat a variety of ailments including peritonitis and neuralgia. Mustards are still used today in mustard plasters to treat rheumatism, arthritis, chest congestion, aching back, and sore muscles. To make a mustard plaster, mix equal parts of flour and powdered mustard and spread it as a paste on a doubled piece of soft cloth. Apply mustard plaster to the affected area for a maximum of 15 minutes. Prolonged application can result in burns to the skin and nerve damage. Skin lesions occur within hours after exposure, and there is no significant therapy procedure. This case report is about a patient with second-degree burn, occurred when a mixture including mustard seed was exposed to her skin in the pain therapy of the osteoarthritis in her left knee. There are no studies analyzing treatment of skin burns induced by mustard seed in the literature. While in this type of burns our experience is limited, we think that conservative approach should be first choice of treatment.

  13. Pediatric Burn Resuscitation.

    Science.gov (United States)

    Palmieri, Tina L

    2016-10-01

    Children have unique physiologic, physical, psychological, and social needs compared with adults. Although adhering to the basic tenets of burn resuscitation, resuscitation of the burned child should be modified based on the child's age, physiology, and response to injury. This article outlines the unique characteristics of burned children and describes the fundamental principles of pediatric burn resuscitation in terms of airway, circulatory, neurologic, and cutaneous injury management. PMID:27600126

  14. PATTERN OF DISTRIBUTION AND DEMOGRAPHIC PROFILE OF BURN INJURIES WITH ASSESSMENT OF VARIOUS FACTORS AFFECTING MORBIDITY AND MORTALITY IN VINDHYA REGION, SGM HOSPITAL REWA, MADHYA PRADESH, INDIA

    Directory of Open Access Journals (Sweden)

    Mayank

    2016-04-01

    Full Text Available BACKGROUND Burn injuries are one of the most devastating injuries resulting into higher morbidity and mortality rates. Its higher incidence in developing countries like India creating a formidable health problem. OBJECTIVE To study the pattern of distribution of burn injuries in relation to various epidemiological, demographic and socio-cultural aspect and their impact assessment on mortality and morbidity. MATERIAL AND METHODS It was a prospective 1-year study conducted in all patients (n=499 admitted in Burn Unit of Dept. of Surgery, SGMH, Rewa (M.P., during the period August 2014-July 2015. The data regarding sex, age predisposition, geographical origin, mode and nature of injury were obtained by questionnaire-interview with the patient themselves. Clinical assessment was done in the form of depth and extent of injury. The information obtained was tabulated and analysed, mean, Standard Deviation (SD were calculated where applicable. Chi-square test was used as a test of significance. RESULTS Incidence of burn injury was 6.02% out of total surgical ward admission. Females were 59.31%, while males were 40.68%. Majority 45.9% of patients were from 15-29 years’ age group; 83.5% victims belonged to rural areas and 88.37% patients were below poverty line. Housewives 39.67% followed by students 23.24%; 87.7% was accidental followed by suicidal 9%, homicidal 3.2%. Flame burn 71.74% was commonest and chimney 28.1% was most common source of heat. 54.7% of cases were hospitalized within 5-12 hours of injury. Mean TBSA was 45.3%, it was higher in intentional burns and females. Kitchen 67.53% was the commonest place. 67.13% of burns were superficial to deep. Mean hospital stay was 11.63 days. Overall mortality was 39.47%, septicemia 56.85% was the most common cause of death. CONCLUSION Female sex, accidental, extensive burn, young age, low socioeconomic status, rural area were the factors associated with increased mortality and morbidity. Preventive

  15. 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...

  16. 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....

  17. 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

  18. 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...

  19. 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...

  20. 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...

  1. 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

  2. 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

  3. 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

  4. 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

  5. Ceftriaxone-induced toxic epidermal necrolysis mimicking burn injury: a case report

    Directory of Open Access Journals (Sweden)

    Billig Allan

    2009-12-01

    Full Text Available Abstract Introduction Toxic epidermal necrolysis is a rare exfoliative disorder with a high mortality rate. Case presentation We present a 70-year-old woman of Iranian descent who presented with toxic epidermal necrolysis that was initially diagnosed as a scald burn. Further anamnesis prompted by spread of the lesions during hospitalization revealed that the patient had been receiving ceftriaxone for several days. To the best of our knowledge, this is the first case of ceftriaxone-induced toxic epidermal necrolysis in the English literature. Conclusion Toxic epidermal necrolysis is an acute, life-threatening, exfoliative disorder with a high mortality rate. High clinical suspicion, prompt recognition, and initiation of supportive care is mandatory. Thorough investigation of the pathogenetic mechanisms is fundamental. Optimal treatment guidelines are still unavailable.

  6. The effect of virtual reality on pain and range of motion in adults with burn injuries.

    Science.gov (United States)

    Carrougher, Gretchen J; Hoffman, Hunter G; Nakamura, Dana; Lezotte, Dennis; Soltani, Maryam; Leahy, Laura; Engrav, Loren H; Patterson, David R

    2009-01-01

    Few studies have empirically investigated the effects of immersive virtual reality (VR) on postburn physical therapy pain control and range of motion (ROM). We performed a prospective, randomized controlled study of the effects of adding VR to standard therapy in adults receiving active-assisted ROM physical therapy, by assessing pain scores and maximal joint ROM immediately before and after therapy on two consecutive days. Thirty-nine inpatients, aged 21 to 57 years (mean 35 years), with a mean TBSA burn of 18% (range, 3-60%) were studied using a within-subject, crossover design. All patients received their regular pretherapy pharmacologic analgesia regimen. During physical therapy sessions on two consecutive days (VR one day and no VR the other day; order randomized), each patient participated in active-assisted ROM exercises with an occupational or physical therapist. At the conclusion of each session, patients provided 0 to 100 Graphic Rating Scale measurements of pain after each 10-minute treatment condition. On the day with VR, patients wore a head-position-tracked, medical care environment-excluding VR helmet with stereophonic sound and interacted in a virtual environment conducive to burn care. ROM measurements for each joint exercised were recorded before and after each therapy session. Because of nonsignificant carryover and order effects, the data were analyzed using simple paired t-tests. VR reduced all Graphic Rating Scale pain scores (worst pain, time spent thinking about the pain, and pain unpleasantness by 27, 37, and 31% respectively), relative to the no VR condition. Average ROM improvement was slightly greater with the VR condition; however, this difference failed to reach clinical or statistical significance (P = .243). Ninety-seven percent of patients reported zero to mild nausea after the VR session. Immersive VR effectively reduced pain and did not impair ROM during postburn physical therapy. VR is easily used in the hospital setting and

  7. THE EFFECT OF SKIN GRAFTING AT DIFFERENT TIME POST BLOOD TRANSFUSION AND BONE MARROW TRANSPLANTATION ON RATS COMBINED RADIATION--BURN INJURY

    Institute of Scientific and Technical Information of China (English)

    冉新泽; 阎永堂; 程天民; 林远; 郑怀恩; 魏书庆

    1998-01-01

    After the rats were iufficted with 8Gy total body gamma ray irradiation and 15% total body surface area (TBSA) full thickness burn injury, they were treated with blood transfusion (BT) and bone marrow transplantation (BMT). Then the survival of allografts grafted on the eschareetomized burn wounds in the 24, 48 and 72 h postinjury was observed. It was found that when the burn wounds were closed with allografts in the 24h postinjury, there were an early elevation of leucocytes, the appearance of the donor''s cells and a significantly higher survival rate of the rats on the 30 day postinjury. The allogaafts could survive longer and wounds showed no signs of infection and healed quicker. When the allografts were grafted in the 48 h or 72 h postinjury, only harmful effects to hasten the death of rats were observed.

  8. 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.

  9. Lineage -CD34+CD31+ cells that appear in association with severe burn injury are inhibitory on the production of antimicrobial peptides by epidermal keratinocytes.

    Directory of Open Access Journals (Sweden)

    Shohei Yoshida

    Full Text Available Antimicrobial peptides are major host defense effectors against Pseudomonas aeruginosa skin infections. Due to the lack of such peptide production, severely burned hosts are greatly susceptible to P. aeruginosa burn wound infection. β-Defensin (HBD production by normal human epidermal keratinocytes (NHEK was inhibited by lineage(-CD34(+ cells isolated from peripheral blood of severely burned patients. Lineage(-CD34(+ cells obtained from severely burned patients were characterized as CD31(+, while healthy donor lineage(-CD34(+ cells were shown to be CD31(- cells. Lineage(-CD34(+CD31(- cells did not show any inhibitory activities on HBD-1 production by NHEK. CCL2 and IL-10 released from lineage(-CD34(+CD31(+ cells were shown to be inhibitory on the peptide production by NHEK, while these soluble factors were not produced by lineage(-CD34(+CD31(- cells. After treatment with a mixture of mAbs for CCL2 and IL-10, the culture fluids of lineage(-CD34(+CD31(+ cells did not show any inhibitory activities on HBD-1 production by NHEK. Lineage(-CD34(+CD31(+ cells that appear in association with burn injuries play a role on the inhibition of antimicrobial peptide production by skin keratinocytes through the production of CCL2 and IL-10.

  10. 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), Denmark....... METHODS: We included burn patients referred to the NBC in a three-months period. Patient records were systematically analyzed and compared with the national guidelines for referral of burn injured patients. RESULTS: A total of 97 burn injured patients were transferred for treatment at the NBC and the most...... common reason for referral was partial thickness burn exceeding 3% estimated area of burn (55% of the patients) while facial burns (32%) and inhalational injury (25%) were other common reasons. We found that 29 (30%) of the referrals were considered potentially unnecessary according to the guidelines...

  11. A Statistical Analysis of 2537 Cases of Burn Injuried Patients%2537例烧伤患者统计分析

    Institute of Scientific and Technical Information of China (English)

    韩利坤; 肖三麦

    2013-01-01

      目的了解烧伤的发病规律、特点,以减少或者预防烧伤的发生.方法根据我院2009年10月-2011年10月收治的2537例烧伤患者的性别、年龄、职业、烧伤面积、烧伤原因等特征,揭示烧伤的特点.结果2537例烧伤患者中,男性1698人,女性839人,男女性别比为2.02∶1;年龄段0~6岁的儿童发病构成比最高,达到40.01%,其中1~3岁儿童的发病构成比占到该组68.37%;职业分布上在岗工人的发病构成比最高,达到43.52%;烧伤面积以1%~10%的烧伤患者最多;烧伤原因中所占比例最高的为热液烧伤,为50.93%.结论烧伤重在预防,加强对儿童的监护和看管,加强对在岗工人的安全生产意识和预防措施.%Objective To understand the occurrence rule ,characteristics of burn injury ,so as to reduce or prevent the occurrence of it .Methods By investigating the sex ,age ,occupation ,burn area ,burn reason ,et al of the 2537 cases of burn injuried patients in our hospital from October ,2009 to October ,2011 ,this paper reveals the characteristics of burn injury .Results There were 1698 males whereas 839 females in the 2537 cases of burn injuried patients ,which shows sex ratio is 2 .02 :1 .Aged from 0 to 6 years old children got the highest incidence - up to 40 .01% ,in which 1 to 3 years old children got 68 .37% incidence .On the distribution of vocation ,workers on duty got the highest incidence ,which is 43 .52% .Most of patients’ burned area is 1% to 10% .The most fre-quent reason is hydrothermal burn injury ,which is 50 .93% .Conclusion The most important of reducing the occurrance of burn in -jury is prevention .We should pay more attention to children’s care and custody as well as strengthen the safe production consciousness and take preventive measures to workers on the job .

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

    Science.gov (United States)

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

    2016-01-01

    Management of burn injury is an onerous clinical task since it requires continuous monitoring and extensive usage of specialized facilities. Despite rapid improvizations and investments in burn management, >30% of victims hospitalized each year face severe morbidity and mortality. Excessive loss of body fluids, accumulation of exudate, and the development of septic shock are reported to be the main reasons for morbidity in burn victims. To assist burn wound management, a novel polyurethane (PU)-based bio-nanofibrous dressing loaded with honey (HN) and Carica papaya (PA) fruit extract was fabricated using a one-step electrospinning technique. The developed dressing material had a mean fiber diameter of 190±19.93 nm with pore sizes of 4–50 µm to support effective infiltration of nutrients and gas exchange. The successful blending of HN- and PA-based active biomolecules in PU was inferred through changes in surface chemistry. The blend subsequently increased the wettability (14%) and surface energy (24%) of the novel dressing. Ultimately, the presence of hydrophilic biomolecules and high porosity enhanced the water absorption ability of the PU-HN-PA nanofiber samples to 761.67% from 285.13% in PU. Furthermore, the ability of the bio-nanofibrous dressing to support specific protein adsorption (45%), delay thrombus formation, and reduce hemolysis demonstrated its nontoxic and compatible nature with the host tissues. In summary, the excellent physicochemical and hemocompatible properties of the developed PU-HN-PA dressing exhibit its potential in reducing the clinical complications associated with the treatment of burn injuries. PMID:27621626

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

    Science.gov (United States)

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

    2016-01-01

    Management of burn injury is an onerous clinical task since it requires continuous monitoring and extensive usage of specialized facilities. Despite rapid improvizations and investments in burn management, >30% of victims hospitalized each year face severe morbidity and mortality. Excessive loss of body fluids, accumulation of exudate, and the development of septic shock are reported to be the main reasons for morbidity in burn victims. To assist burn wound management, a novel polyurethane (PU)-based bio-nanofibrous dressing loaded with honey (HN) and Carica papaya (PA) fruit extract was fabricated using a one-step electrospinning technique. The developed dressing material had a mean fiber diameter of 190±19.93 nm with pore sizes of 4-50 µm to support effective infiltration of nutrients and gas exchange. The successful blending of HN- and PA-based active biomolecules in PU was inferred through changes in surface chemistry. The blend subsequently increased the wettability (14%) and surface energy (24%) of the novel dressing. Ultimately, the presence of hydrophilic biomolecules and high porosity enhanced the water absorption ability of the PU-HN-PA nanofiber samples to 761.67% from 285.13% in PU. Furthermore, the ability of the bio-nanofibrous dressing to support specific protein adsorption (45%), delay thrombus formation, and reduce hemolysis demonstrated its nontoxic and compatible nature with the host tissues. In summary, the excellent physicochemical and hemocompatible properties of the developed PU-HN-PA dressing exhibit its potential in reducing the clinical complications associated with the treatment of burn injuries. PMID:27621626

  14. 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...

  15. 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.

  16. 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

  17. Effects of fluid resuscitation methods on the pro- and anti-inflammatory cytokines and expression of adhesion molecules after burn injury.

    Science.gov (United States)

    Foldi, Viktor; Lantos, Janos; Bogar, Lajos; Roth, Elizabeth; Weber, Gyorgy; Csontos, Csaba

    2010-01-01

    Fluid resuscitation management can influence inflammatory response after burn injury. The aim of this study was to analyze the effects of two fluid resuscitation methods on the cytokine production and on the expression of the leukocyte surface markers. Thirty patients were included in this prospective randomized study with burn injury affecting more than 20% of the body surface area. Fluid resuscitation was guided by hourly urine output (HUO, n = 15) or by intrathoracic blood volume index (ITBVI, n = 15). Blood samples were taken on admission and on the next five consecutive mornings. Concentrations of interleukin (IL)-1beta, IL-6, IL-8, IL-10, IL-12p70, and tumor necrosis factor-alpha were measured in phorbol myristate acetate-stimulated and -nonstimulated samples. Leukocyte surface marker expressions (CD11a, CD11b, CD14, CD18, CD49d, and CD97) were also determined. In the ITBVI group, IL-6 levels on days 2 to 3 and IL-6/IL-10 ratios on days 2 to 3, and the IL-8/IL-10 ratios on days 3 to 5 were significantly higher than those in HUO group (P burned patients suppresses the shift toward anti-inflammatory imbalance and the expression of leukocyte surface markers more than HUO-guided resuscitation.

  18. 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

  19. 吸入性损伤气管切开问题的临床讨论%Clinical Discussion on Tracheotomy in Burn Patients with Inhalation Injury

    Institute of Scientific and Technical Information of China (English)

    孙志刚; 李占军

    2000-01-01

    Purpose: The opportunity and indication of tracheotomy in burn patients with complicated inhalation injury were discussed. Method: 173 patients with inhalation injury treated during 1981~1998 were reviewed. The severity of injury were 94 minor, 53 moderate and 27 severe. Tracheotomy was performed on 57 patients. Result: 56 patients died. Though mortality had close correlation with burn severity, the main reason for death was attributable to severity of inhalation injury. For patients being performed with tracheotomy within 24 hours postburn, the mortality was relatively low. Conclusion: The earliest tracheotomy is recommended for moderate and severe inhalation injuries.%目的:为了进一步探讨吸入性损伤病人的气管切开时机与指征。方法:回顾性总结分析了1981~1998年173例吸入性损伤的处理方法。他们中轻、中、重度吸入性损伤分别为94.53和27例,行气管切开者57例。结果:全组死亡56例,病死率与烧伤伤情有一定关系,但主要死因仍为吸入性损伤程度,24小时之内行气管切开者病死率偏低。结论:中、重度吸入性损伤宜尽早实行气管切开治疗,并有预防意义。

  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. Emergency in Burn; Burn in Emergency

    Directory of Open Access Journals (Sweden)

    Yalcin Bayram

    2012-06-01

    Full Text Available Physicians who first meet with burned patients are often emergency service employees. When the patient was admitted to emergency service, especially in patients with major burn injury, is a matter should be dealt with strongly. Before sending the patients to a burn center, some interventions could became life saving which should be done as a first line treatment. Herein, review of the literature related to emergency burn treatment was performed and presented to all physicians as a summary guide. In addition, some questions such as how should be physician, who first meet with the burned patient, evaluated the patient, what should be physician paid attention, which principles should be employed for fluid replacement, how should be approached to burn wound are tried to be addressed. [TAF Prev Med Bull 2012; 11(3.000: 365-368

  3. Critical issues in burn care.

    Science.gov (United States)

    Holmes, James H

    2008-01-01

    Burn care, especially for serious burn injuries, represents a considerable challenge for the healthcare system. The American Burn Association has established a number of strategies for the management of burn patients and dedicates its efforts and resources to promoting and supporting burn-related research, education, care, rehabilitation, and prevention, often in collaboration with other organizations. The American Burn Association has recommended that patients with serious burns be referred to a designated burn center, ie, a hospital outfitted with specialized personnel and equipment dedicated to burn care. Burn centers have been operational for over 50 years, but the complexity and costs of providing specialized burn care have given rise to a number of critical administrative and political issues. These include logistical limitations imposed by the uneven national distribution of burn centers and a potential shortage of burn beds, both during everyday conditions and in the event of a mass disaster. Burn surgeon shortages have also been identified, stemming, in part, from a lack of specialized burn care training opportunities. There is currently a lack of quality outcome data to support evidence-based recommendations for burn care, and burn care centers are compromised by problems obtaining reimbursement for the care of uninsured and publicly insured out-of-state burn patients. Initiatives are underway to maintain efficient burn care facilities that are fully funded, easily accessible, and most importantly, provide optimal, evidence-based care on a daily basis, and are well-equipped to handle a surge of patients during a disaster situation.

  4. 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...

  5. 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, ...

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    Balaji A

    2016-09-01

    Full Text Available Arunpandian Balaji,1 Saravana Kumar Jaganathan,2–4 Ahmad Fauzi Ismail,5 Rathanasamy Rajasekar6 1Faculty of Biosciences and Medical Engineering, Universiti Teknologi Malaysia, Johor Bahru, Malaysia; 2Department for Management of Science and Technology Development, Ton Duc Thang University, Ho Chi Minh City, Vietnam; 3Faculty of Applied Sciences, Ton Duc Thang University, Ho Chi Minh City, Vietnam; 4IJNUTM Cardiovascular Engineering Centre, Department of Clinical Sciences, Faculty of Biosciences and Medical Engineering, Universiti Teknologi Malaysia, Johor Bahru, Malaysia; 5Advanced Membrane Technology Research Center, Universiti Teknologi Malaysia, Johor Bahru, Malaysia; 6Department of Mechanical Engineering, School of Building and Mechanical Sciences, Kongu Engineering College, Tamil Nadu, India Abstract: Management of burn injury is an onerous clinical task since it requires continuous monitoring and extensive usage of specialized facilities. Despite rapid improvizations and investments in burn management, >30% of victims hospitalized each year face severe morbidity and mortality. Excessive loss of body fluids, accumulation of exudate, and the development of septic shock are reported to be the main reasons for morbidity in burn victims. To assist burn wound management, a novel polyurethane (PU-based bio-nanofibrous dressing loaded with honey (HN and Carica papaya (PA fruit extract was fabricated using a one-step electrospinning technique. The developed dressing material had a mean fiber diameter of 190±19.93 nm with pore sizes of 4–50 µm to support effective infiltration of nutrients and gas exchange. The successful blending of HN- and PA-based active biomolecules in PU was inferred through changes in surface chemistry. The blend subsequently increased the wettability (14% and surface energy (24% of the novel dressing. Ultimately, the presence of hydrophilic biomolecules and high porosity enhanced the water absorption ability of the PU

  8. 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.

  9. Hand chemical burns.

    Science.gov (United States)

    Robinson, Elliot P; Chhabra, A Bobby

    2015-03-01

    There is a vast and ever-expanding variety of potentially harmful chemicals in the military, industrial, and domestic landscape. Chemical burns make up a small proportion of all skin burns, yet they can cause substantial morbidity and mortality. Additionally, the hand and upper extremity are the most frequently involved parts of the body in chemical burns, and therefore these injuries may lead to severe temporary or permanent loss of function. Despite this fact, discussion of the care of these injuries is sparse in the hand surgery literature. Although most chemical burns require only first response and wound care, some require the attention of a specialist for surgical debridement and, occasionally, skin coverage and reconstruction. Exposure to certain chemicals carries the risk of substantial systemic toxicity and even mortality. Understanding the difference between thermal and chemical burns, as well as special considerations for specific compounds, will improve patient treatment outcomes.

  10. 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...

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

    Directory of Open Access Journals (Sweden)

    Juliann G. Kiang

    2014-01-01

    Full Text Available 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.

  12. Management of burn wounds.

    Science.gov (United States)

    Schiestl, Clemens; Meuli, Martin; Trop, Marija; Neuhaus, Kathrin

    2013-10-01

    Small and moderate scalds in toddlers are still the most frequent thermal injuries the pediatric surgeons have to face today. Over the last years, surgical treatment of these patients has changed in many aspects. Due to new dressing materials and new surgical treatment strategies that are particularly suitable for children, today, far better functional and aesthetic long-term results are possible. While small and moderate thermal injuries can be treated in most European pediatric surgical departments, the severely burned child must be transferred to a specialized, ideally pediatric, burn center, where a well-trained multidisciplinary team under the leadership of a (ideally pediatric) burn surgeon cares for these highly demanding patients. In future, tissue engineered full thickness skin analogues will most likely play an important role, in pediatric burn as well as postburn reconstructive surgery.

  13. 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

  14. 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.

  15. 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]…

  16. 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...

  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. 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...

  19. 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...

  20. Hair dryer burns in children.

    Science.gov (United States)

    Prescott, P R

    1990-11-01

    Three children with burn injuries caused by home hair dryers are described. In one patient the injury was believed to be accidental, and in the other two cases the injuries were deliberately caused by a caretaker. The lack of prior experience with hair dryer burns initially led to suspicion of other causes. The characteristics of each case aided in the final determination of accidental vs nonaccidental injury. These cases prompted testing of home hair dryers to determine their heat output. At the highest heat settings, the dryers rapidly generated temperatures in excess of 110 degrees C. After the dryers were turned off, the protective grills maintained sufficient temperatures to cause full-thickness burns for up to 2 minutes. These cases and the results of testing demonstrate that hair dryers must be added to the list of known causes of accidental and nonaccidental burns in children.

  1. Tiotropium bromide suppresses smoke inhalation and burn injury-induced ERK 1/2 and SMAD 2/3 signaling in sheep bronchial submucosal glands.

    Science.gov (United States)

    Jacob, Sam; Zhu, Yong; Asmussen, Sven; Ito, Hiroshi; Herndon, David N; Enkhbaatar, Perenlei; Hawkins, Hal K; Cox, Robert A

    2014-05-01

    The effects of tiotropium bromide on ERK 1/2, SMAD 2/3 and NFκB signaling in bronchial submucosal gland (SMG) cells of sheep after smoke inhalation and burn injury (S + B) were studied. We hypothesized that tiotropium would modify intracellular signaling processes within SMG cells after injury. Bronchial tissues were obtained from uninjured (sham, n = 6), S + B injured sheep 48 h after injury (n = 6), and injured sheep nebulized with tiotropium (n = 6). The percentage (mean ± SD) of cells showing nuclear localization of phosphorylated ERK 1/2, pSMAD 2/3, and NFκB (p65) was determined by immunohistochemistry. Nuclear pERK 1/2 staining was increased in injured animals as compared to sham, (66 ± 20 versus 14 ± 9), p = 0.0022, as was nuclear pSMAD, 84 ± 10 versus 20 ± 10, p = 0.0022. There was a significant decrease in pERK 1/2 labeling in the tiotropium group compared to the injured group (31 ± 20 versus 66 ± 20, p = 0.013), and also a decrease in pSMAD labeling, 62 ± 17 versus 84 ± 10, p = 0.04. A significant increase for NFκB (p65) was noted in injured animals as compared to sham (73 ± 16 versus 7 ± 6, p = 0.0022). Tiotropium-treated animals showed decreased p65 labeling as compared to injured (35 ± 17 versus 74 ± 16, p = 0.02). The decrease in nuclear expression of pERK, pSMAD and NFκB molecules in SMG cells with tiotropium treatment is suggestive that their activation after injury is mediated in part through muscarinic receptors.

  2. Pain in burn patients.

    Science.gov (United States)

    Latarjet, J; Choinère, M

    1995-08-01

    While severe pain is a constant component of the burn injury, inadequate pain management has been shown to be detrimental to burn patients. Pain-generating mechanisms in burns include nociception, primary and secondary hyperalgesia and neuropathy. The clinical studies of burn pain characteristics reveal very clear-cut differences between continuous pain and pain due to therapeutic procedures which have to be treated separately. Some of the main features of burn pain are: (1) its long-lasting course, often exceeding healing time, (2) the repetition of highly nociceptive procedures which can lead to severe psychological disturbances if pain control is inappropriate. Pharmaco-therapy with opioids is the mainstay for analgesia in burned patients, but non-pharmacological techniques may be useful adjuncts. Routine pain evaluation is mandatory for efficient and safe analgesia. Special attention must be given to pain in burned children which remains too often underestimated and undertreated. More educational efforts from physicians and nursing staff are necessary to improve pain management in burned patients.

  3. [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

  4. Genital burns and vaginal delivery.

    Science.gov (United States)

    Pant, R; Manandhar, V; Wittgenstein, F; Fortney, J A; Fukushima, C

    1995-07-01

    Obstetric complications may result from burn scarring in the genital area. Women in developing countries typically squat around cooking fires, and burns are common. This recent case in Nepal describes obstructed labor in a young woman whose genital area had extensive scarring from a cooking fire injury. Proper antenatal assessment by health care providers can reduce the risk to mothers and infants of the consequences of a birth canal damaged or obstructed by burn scarring.

  5. 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...

  6. 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

  7. 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...

  8. Advancement in the research of mechanism of endogenous cellular injury in visceral complications as complications after severe burn%严重烧伤脏器并发症的内源性细胞损伤机制研究进展

    Institute of Scientific and Technical Information of China (English)

    罗鹏飞; 王光毅; 夏照帆

    2012-01-01

    It is of great importance to know the endogenous mechanism in burn-induced organ injuries,not only for the understanding of pathophysiological processes after burn,but also for guiding the clinical treatment.Recent studies have widened and deepened our scope and understanding of secondary injuries to various organs.However,a unaminous understanding of molecular pathway involved in all burn-induced organ injuries has not been attained.Relatively,the mechanism of endogenous cellular injuries as a result of burn injury could be regarded as a common one to explain the causation of cellular injury,and to guide the prevention and treatment for the burn-induced complications using cytoprotection strategy. This review summarized four aspects of the mechanism of endogenous cellular injuries,including cellular injuries induced by ischemic/hypoxic-oxidative stress,excessive inflammatory factors released by inflammatory cells,immunosuppression caused by suppression of function of adaptive immune cells,and dysfunction of important supportive cells of various organs.

  9. A review of hydrofluoric acid burn management

    OpenAIRE

    McKee, Daniel; Thoma, Achilleas; Bailey, Kristy; Fish, Joel

    2014-01-01

    The clinical presentation and severity of hydrofluoric acid burns vary considerably, making management particularly challenging. Given that current knowledge of HF burns is derived from small case series, case reports, animal studies and anecdotal evidence, this narrative review discusses the current understanding of the effects associated with severe hydrofluoric acid burns, describing the mechanism of injury, systemic toxicity and treatment options.

  10. Titanium tetrachloride burns to the eye.

    OpenAIRE

    Chitkara, D K; McNeela, B. J.

    1992-01-01

    We present eight cases of chemical burns of the eyes from titanium tetrachloride, an acidic corrosive liquid. However it causes severe chemical burns which have a protracted course and features more akin to severe alkali burns. Injuries related to titanium tetrachloride should be treated seriously and accordingly appropriate management is suggested.

  11. 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.

  12. 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

  13. 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...

  14. 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.

  15. [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

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

    Science.gov (United States)

    Van Loey, Nancy E; Oggel, Anne; Goemanne, Anne-Sofie; Braem, Leen; Vanbrabant, Leonard; Geenen, Rinie

    2014-10-01

    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 regulation styles as possible influencing factors. Data from 242 patients with burns were analyzed employing latent growth modeling. The level of depressive symptoms across the 2-year interval was associated with burn severity, higher levels of neuroticism and rumination, and lower levels of positive refocusing. Notably, rumination partly mediated the effect of neuroticism on the course of depressive symptoms. Correlational analysis suggested a specific effect of burn severity on rumination. The results indicate that screening for symptoms of depression, rumination, and neuroticism in burn patients is useful. Early interventions focusing on cognitive restructuring could assist in improving the cognitive emotional adaptation process following a burn event.

  17. 昆山爆炸事故成批烧冲复合伤患者的抢救调配及护理%Rescue, allocation and nursing of multiple- patient burn- blast combined injury in Kunshan explosive accident

    Institute of Scientific and Technical Information of China (English)

    朱利红; 赵朋; 华皎; 袁琴芳; 王芳; 任颖伟; 孙丹; 周竞奋; 吕国忠

    2016-01-01

    目的:探讨突发成批烧冲复合伤患者的护理及各个环节的配合及质量控制情况。方法对35例烧冲复合伤患者在第一时间启动应急预案,其中包括人员调配、物资调配、护理质量控制、病区监控等。结果35例烧冲复合伤患者在第一时间得到了及时有效的烧伤抗休克治疗及护理。成批烧冲复合伤患者抢救成功率达77.14%(27/35),无一例护理并发症。结论护理人员及时调配到位,其数量与结构合理和组织协调有力,物资配备齐全及时,护理应急质量管理控制规范和措施得力,是确保此次突发成批烧冲复合伤危重患者救治成功的关键,是护理质量保障的体现。%Objective To discuss on nursing of patients multiple- patient burn- blast combined injury, the cooperation of processes and quality control. Methods For 35 cases of burn- blast combined injury, emergency plan was initiated immediately, including staffing allocation, supplies allocation, nursing quality control and monitoring the inpatient areas, etc. Results 35 cases of burn- blast combined injury acquired immediate treatment of burn shock and nursing. Rescue rate of multiple- patient burn blast arrived 77.14%(27/35), with no case of nursing complication. Conclusions Timely allocation of nursing staff, rational quantity and structure, forceful organization and coordination, complete and timely supplies, correct quality control of emergence nursing and beneficial solutions are keys to ensure successive nursing of intensive patients of burn-blast combined injury, and also reflection of nursing quality guarantee.

  18. Burn epidemiology and cost of medication in paediatric burn patients.

    Science.gov (United States)

    Koç, Zeliha; Sağlam, Zeynep

    2012-09-01

    Burns are common injuries that cause problems to societies throughout the world. In order to reduce the cost of burn treatment in children, it is extremely important to determine the burn epidemiology and the cost of medicines used in burn treatment. The present study used a retrospective design, with data collected from medical records of 140 paediatric patients admitted to a burn centre between 1 January 2009 and 31 December 2009. Medical records were examined to determine burn epidemiology, medication administered, dosage, and duration of use. Descriptive statistical analysis was completed for all variables; chi-square was used to examine the relationship between certain variables. It was found that 62.7% of paediatric burns occur in the kitchen, with 70.7% involving boiling water; 55.7% of cases resulted in third-degree burns, 19.3% required grafting, and mean duration of hospital stay was 27.5 ± 1.2 days. Medication costs varied between $1.38 US dollars (USD) and $14,159.09, total drug cost was $46,148.03 and average cost per patient was $329.63. In this study, the medication cost for burn patients was found to be relatively high, with antibiotics comprising the vast majority of medication expenditure. Most paediatric burns are preventable, so it is vital to educate families about potential household hazards that can be addressed to reduce the risk of a burn. Programmes are also recommended to reduce costs and the inappropriate prescribing of medication.

  19. Aerodigestive tract burn from ingestion of microwaved food.

    Science.gov (United States)

    Silberman, Michael; Jeanmonod, Rebecca

    2013-01-01

    Aerodigestive tract burns represent a rare but potentially devastating injury pattern throughout the world. Although the majority of these injuries do not require intervention, these burns have the potential for poor outcomes. Traditionally this disease has been caused by superheated gases found in explosions or fire-related injury. However, as technology advances, it brings novel methods for injury that require physician awareness of potential hazards. We describe a case of laryngeal and esophageal thermal burn caused by a microwave heated food bolus.

  20. Extensive burns and inhalation injuries tracheotomy nursing of 24 cases%大面积烧伤合并吸入性损伤气管切开24例护理体会

    Institute of Scientific and Technical Information of China (English)

    赵伟

    2016-01-01

    Objective:To summarize the large-area burns complicated by inhalation injury patients with tracheotomy respiratory tract nursing experience.Methods:the I branch a total of 24 cases of severe burns complicated by inhalation injury treated patients, tracheotomy as soon as possible, various methods for airway moist, oxygen was provided for reasonable, timely sputum suction and promote expectoration, prevention and treatment of complications. Results:22 cases cured,1 case death, automatic discharge in 1 case.Conclusion:Large area burn dry tracheotomy, scientific and meticulous airway management can effectively reduce the occurrence of complications, improve the cure rate of large area burns complicated by inhalation injury.%目的:总结大面积烧伤合并吸入性损伤气管切开患者的呼吸道护理经验。方法:对收治的24例严重烧伤合并吸入性损伤患者,尽早气管切开,多种方法进行气道湿化,持续合理给氧,及时吸痰并促进咳痰,防治并发症。结果:治愈22例,死亡1例,自动出院1例。结论:大面积烧伤尽早气管切开、科学细致的呼吸道管理能有效减少并发症的发生,提高大面积烧伤合并吸入性损伤的治愈率。

  1. 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...

  2. Epidermal-dermal crosstalk during burn wound scar maturation

    NARCIS (Netherlands)

    T.E. Hakvoort (Eveline)

    1999-01-01

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

  3. Fluorescence Measurement of Burned Skin Tissues

    Science.gov (United States)

    de Pedro, Hector Michael; Chang, Chuan-I.; Nguyen, Hue; Malko, Anton; Zarnani, Faranak; Glosser, Robert; Maas, D.; Idris, A.

    2011-03-01

    Early removal of affected tissues from burn patients can significantly increase the success of their recovery, since burns continue to spread and damage surrounding tissues after hours of injury. The rationale behind this procedure is that burns trigger the body's immune system to overreact, causing additional damage. Therefore it is important to locate and identify the burn (area and thickness) so that it can be removed as quickly as possible. Our project explores the use of autofluorescence as a tool to identify the burned tissues from healthy ones. Here we present that our fluorescence results show differences between burned and normal skin in both its spectra and lifetime.

  4. 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

  5. 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

  6. 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

  7. 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

  8. 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...

  9. 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

  10. 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

  11. 涌泉穴烧山火针法治疗脊髓损伤临床观察%Clinical Observations on Mountain-burning Fire Acupuncture at Point Yongquan(KI1) for the Treatment of Spinal Cord Injury

    Institute of Scientific and Technical Information of China (English)

    余鸿斌; 于柏清; 杜振欢; 杨汉晖

    2015-01-01

    目的:观察采用涌泉穴烧山火针法治疗脊髓损伤的疗效。方法将30例脊髓损伤患者随机分为观察组和对照组,每组15例。对照组仅采用现代康复治疗,观察组采用涌泉穴烧山火针法配合运动康复治疗。结果观察组总有效率为93.3%,对照组总有效率为73.3%,观察组总有效率明显优于对照组(P<0.05)。结论涌泉穴烧山火针法治疗脊髓损伤疗效显著,有效提高患者大小便功能、性功能及肢体活动能力。%ObjectiveTo investigate the efficacy of mountain-burning fire acupunctureat point Yongquan(KI1)in treating spinal cord injury.MethodThirty patients with spinal cord injury were randomly allocated to observation and control groups, 15 cases each. The control group received modern rehabilitation therapy and the observationgroup, mountain-burning fire acupuncture at point Yongquan plus exercise rehabilitation therapy.ResultThe total efficacy rate was 93.3% in the observation group and 73.3% in the control group. The total efficacy rate increased significantly in the observation group and was significantly higher than in the control group(P<0.05).ConclusionMountain-burning fire acupuncture at point Yongquan has a marked therapeutic effect on spinal cord injury and effectively improves urinary and fecal voiding, sexual and limb motor functions in the patients.

  12. 接触性电烧伤的致伤机理和急诊治疗原则分析%Analyze the injury mechanism and emergency treatment principle of electric burn contact

    Institute of Scientific and Technical Information of China (English)

    王文

    2014-01-01

    Objective: To analyze the contact electric burn injury mechanism and emergency treatment principle.Methods:Retrospective analysis of clinical data of 75 cases of contact electric burn patients, to explore the injury mechanism and emergency treatment principle, to ensure that patients get better treatment.Results: 75 cases of patients with treatment, by saving actively targeted therapy, the cure rate was 93.3%; 1 patients with cardiac damage should be died; 4 cases of patients with amputation.Conclusion: Through the analysis of contact burn injury mechanism and emergency treatment principle, take targeted measures to improve patient treatment, the therapeutic effect, reduce the rate of disability, mortality, morbidity played a signiifcant.%目的:分析接触性电烧伤的致伤机理和急诊治疗原则。方法:回顾分析75例接触性电烧伤患者临床资料,探究其致伤机理及急诊治疗原则,确保患者得到更好治疗。结果:75例患者经针对性治疗,经积极抢救针对性治疗,治愈率93.3%;1例患者应心脏损伤抢救无效死亡;4例患者截肢。结论:通过分析接触性烧伤的致伤机理及急诊治疗原则,采取针对性治疗措施,对提高患者治疗效果,降低致残率、致死率、致病率起到显著意义。

  13. 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).

  14. 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...

  15. Bad advice; bad burn: a new problem in burn prevention.

    Science.gov (United States)

    Deans, L; Slater, H; Goldfarb, I W

    1990-01-01

    Deep partial-thickness burns had been inflicted on the perineal area of an infant who was recently treated in our Burn Center. The burns were a result of advice to the patient's mother by a pediatrician. The doctor told her to use a hair dryer to prevent diaper rash. We surveyed pediatricians, well-baby clinics, and pediatric nurse practitioners in our area and found that approximately half of them advised the use of hair dryers to treat or prevent diaper rash. We tested four widely available hand-held hair dryers to determine potential for inflicting burn injury. All of the dryers are capable of delivering air heated to at least 53 degrees C after 2 minutes of use. We believe that warnings against the use of hair dryers for perineal hygiene should be included in burn prevention programs.

  16. 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

  17. 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...

  18. The changes of intestinal trefoil factor expression in rat small intestine after severe burn injury%严重烧伤对大鼠肠三叶因子表达的影响

    Institute of Scientific and Technical Information of China (English)

    彭曦; 谭银玲; 陶麟辉; 王凤君; 赵云; 汪仕良

    2001-01-01

    Objective To explore the changes of intestinal trefoil factor(ITF) as well as ITF mRNA expression in rat small intestine after severe burn injury .  Methods The distribution and the content of ITF in intestine were quantitatively determined with in situ hybridization (ISH), immunohistochemistry and high performance liquid chromatography (HPLC).  Results ITF and ITF mRNA were distributed in whole small intestine and most of them localized in goblet cell of intestinal villus. After burn injury, the structure of intestinal mucosa was severely damaged and ITF mRNA expression was lessened. Moreover, the ability of goblet cell synthesis and ITF secretion, especially ITF dimmer were significantly decreased, i.e., from (369.33±65.56) ng/g before burn injury to (15.83±4.40) ng/g 7 days after burn injury, only accounting for 4% of that before injury. Conclusions The post burn damage to intestinal structure is the main cause for the declination in ability of goblet cell synthesis and ITF secretion; and ITF drop especially ITF dimmer can enhance intestinal mucosa injury and delay intestinal mucosa repair.%目的 探讨严重烧伤对大鼠肠三叶因子(ITF)及其mRNA表达的影响及意义。 方法 48只健康成年Wistar大鼠,制成30%TBSAⅢ度烧伤模型并随机分成正常对照组及伤后1,2,3,5,7 d共6组,每组8只。采用原位杂交、免疫组化等手段观察伤后ITF 及ITF mRNA表达的变化,并使用高效液相色谱仪对肠黏膜ITF含量进行定量检测。 结果 正常对照组大鼠小肠中ITF及ITF mRNA均有一定表达,它们主要分布于肠绒毛杯状细胞中。烧伤后肠黏膜组织结构受损,ITF mRNA表达明显减少,肠杯状细胞合成和分泌ITF的能力大幅下降(P<0.01),特别是ITF二聚体的含量远远低于伤前[(369.33±65.56) ng/g],伤后7 d[(15.83±4.40) ng/g]仅为伤前的4%。 结论 严重烧伤后肠黏膜组织结构受损是ITF合成

  19. Future Therapies in Burn Resuscitation.

    Science.gov (United States)

    Hodgman, Erica I; Subramanian, Madhu; Arnoldo, Brett D; Phelan, Herb A; Wolf, Steven E

    2016-10-01

    Since the 1940s, the resuscitation of burn patients has evolved with dramatic improvements in mortality. The most significant achievement remains the creation and adoption of formulae to calculate estimated fluid requirements to guide resuscitation. Modalities to attenuate the hypermetabolic phase of injury include pharmacologic agents, early enteral nutrition, and the aggressive approach of early excision of large injuries. Recent investigations into the genomic response to severe burns and the application of computer-based decision support tools will likely guide future resuscitation, with the goal of further reducing mortality and morbidity, and improving functional and quality of life outcomes. PMID:27600132

  20. 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

  1. Burn Resuscitation in the Austere Environment.

    Science.gov (United States)

    Peck, Michael; Jeng, James; Moghazy, Amr

    2016-10-01

    Intravenous (IV) cannulation and sterile IV salt solutions may not be options in resource-limited settings (RLSs). This article presents recipes for fluid resuscitation in the aftermath of burns occurring in RLSs. Burns of 20% total body surface area (TBSA) can be resuscitated, and burns up to 40% TBSA can most likely be resuscitated, using oral resuscitation solutions (ORSs) with salt supplementation. Without IV therapy, fluid resuscitation for larger burns may only be possible with ORSs. Published global experience is limited, and the magnitude of burn injuries that successfully respond to World Health Organization ORSs is not well-described. PMID:27600127

  2. 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.

  3. 严重烧伤合并吸入性损伤的呼吸道护理管理110例分析%Analysis of 110 Cases of Respiratory Care Management of Severely Burned Patients with Inhalation Injury

    Institute of Scientific and Technical Information of China (English)

    张银花; 袁晓敏

    2013-01-01

    目的:探讨对严重烧伤合并吸入性损伤进行气道护理的措施。方法:选取110例严重烧伤合并吸入性损伤患者的临床资料进行回顾分析,对患者行积极抗休克治疗,对创面合并外伤进行清创修复处理,并做好呼吸道管理,做好气管切开排痰等护理措施。结果:本组110例严重烧伤合并吸入性损伤患者,治愈102例,放弃治疗4例,死亡4例,治愈率为92.7%。结论:恰当又细心的呼吸道管理,是成功治疗大面积烧伤患者的关键。%Objective:Discussion on severe burns complicated by inhalation injury of airway nursing measures.Method:Clinical data of 110 cases of severe burn with inhalation injury patients were retrospectively analyzed,patients were treated with positive anti-shock,combined trauma wound debridement and repair process,meanwhile,patients need to be given good management of the respiratory tract and the nursing care measures of tracheotomy expectoration.Result:Select 110 cases of severe burn combined retrospective analysis the clinical data of patients with inhalation injury,to patients with positive anti shock,debridement was carried out on the wound with trauma repair processing,and make the respiratory tract management,completes the tracheotomy nursing measures such as row of phlegm.Conclusion:Appropriate and careful respiratory management play a key on successful treatment of severe burn patients.

  4. 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

  5. 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

  6. 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 ...

  7. 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...

  8. 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 ...

  9. [Treatment of pain in children burns].

    Science.gov (United States)

    Latarjet, J; Pommier, C; Robert, A; Comparin, J P; Foyatier, J L

    1997-03-01

    Burn injury is considered by children as one of the most painful traumas (just after bone factures). Burn pain in children can and must be controlled as well as for adult patients, with almost identical techniques. Continuous pain from injury and intermittent pain caused by therapeutic procedures must be evaluated and treated separately. Due to very high levels of nociception, satisfactory management of procedural pain requires the use of opioid therapy. Non pharmacological methods are meaningless if pharmacological treatment is not optimal.

  10. 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

  11. 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)

  12. Polarized Reflectance Measurement of Burned Skin Tissues

    Science.gov (United States)

    de Pedro, Hector Michael; Chang, Chuan-I.; Zarnani, Faranak; Glosser, Robert; Maas, D.; Idris, A.

    2011-10-01

    In the US, there are over 400,000 burn victims with 3,500 deaths in 2010. Recent evidence suggests that early removal of burn tissues can significantly increase the success of their recovery, since burns continue to spread and damage surrounding tissues after hours of injury. The rationale behind this procedure is that burns trigger the body's immune system to overreact, causing additional damage. Therefore, it is important to distinguish burn areas so that it can be removed. The problem with this is that it is difficult to recognize the margins of the burn area. In our project, we use polarized reflectance as a tool to identify the burned tissues from unburned ones.

  13. [Current treatment strategies for paediatric burns].

    Science.gov (United States)

    Küntscher, M V; Hartmann, B

    2006-06-01

    Paediatric burns occupy the third place in the severe accident statistics in Germany after traffic injuries and drowning. The paper reviews current treatment concepts of pre-hospital management, fluid resuscitation and surgical therapy in paediatric burned patients. Specific features in the approximation of the total body surface area burn and indications for transfer of paediatric burn victims to specialized units are discussed. The therapy of severe paediatric burns requires an interdisciplinary team consisting of especially skilled plastic or paediatric surgeons,anaesthetists, psychiatrists or psychologists, specifically trained nurses, physiotherapists and social workers. The rehabilitation process starts basically with admission to the burn unit. A tight cooperation between therapists and the relatives of the paediatric burn victim is needed for psychological recovery and reintegration into society.'The adaptation to the suffered trauma resulting in life-long disability and disfigurement is the main task of psychotherapy.

  14. Septicemia: The Principal Killer of Burns Patients

    Directory of Open Access Journals (Sweden)

    B. R. Sharma

    2005-01-01

    Full Text Available Burn injury is a major problem in many areas of the world and it has been estimated that 75% of all deaths following burns are related to infection. Burns impair the skin’s normal barrier function thus allowing microbial colonization of the burn wounds and even with the use of topical antimicrobial agents, contamination is almost unavoidable. It is therefore essential for every burn institution to determine its specific pattern of burn wound microbial colonization, time related changes in predominant flora and antimicrobial resistance profiles. This would allow early management of septic episodes with proper empirical systemic antibiotics before the results of microbiologic culture becomes available, thus improving the overall infection-related morbidity and mortality. We attempted to examine the factors affecting risk of infection; strategies for infection control and prevention in burn victims.

  15. 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...

  16. 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...

  17. 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 ...

  18. 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

  19. 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

  20. 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。

  1. 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.

  2. Aerodigestive Tract Burn from Ingestion of Microwaved Food

    Directory of Open Access Journals (Sweden)

    Michael Silberman

    2013-01-01

    Full Text Available Aerodigestive tract burns represent a rare but potentially devastating injury pattern throughout the world. Although the majority of these injuries do not require intervention, these burns have the potential for poor outcomes. Traditionally this disease has been caused by superheated gases found in explosions or fire-related injury. However, as technology advances, it brings novel methods for injury that require physician awareness of potential hazards. We describe a case of laryngeal and esophageal thermal burn caused by a microwave heated food bolus.

  3. The Physiologic Basis of Burn Shock and the Need for Aggressive Fluid Resuscitation.

    Science.gov (United States)

    Rae, Lisa; Fidler, Philip; Gibran, Nicole

    2016-10-01

    Burn trauma in the current age of medical care still portends a 3% to 8% mortality. Of patients who die from their burn injuries, 58% of deaths occur in the first 72 hours after injury, indicating death from the initial burn shock is still a major cause of burn mortality. Significant thermal injury incites an inflammatory response, which distinguishes burns from other trauma. This article focuses on the current understanding of the pathophysiology of burn shock, the inflammatory response, and the direction of research and targeted therapies to improve resuscitation, morbidity, and mortality.

  4. 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

  5. Burns treatment in ancient times.

    Science.gov (United States)

    Pećanac, Marija; Janjić, Zlata; Komarcević, Aleksandar; Pajić, Milos; Dobanovacki, Dusanka; Misković, Sanja Skeledzija

    2013-01-01

    Discovery of fire at the dawn of prehistoric time brought not only the benefits to human beings offering the light and heat, but also misfortune due to burns; and that was the beginning of burns treatment. Egyptian doctors made medicines from plants, animal products and minerals, which they combined with magic and religious procedures. The earliest records described burns dressings with milk from mothers of male babies. Goddess Isis was called upon to help. Some remedies and procedures proved so successful that their application continued for centuries. The Edwin Smith papyrus (1500 BC) mentioned the treatment of burns with honey and grease. Ebers Papyrus (1500 BC) contains descriptions of application of mud, excrement, oil and plant extracts. They also used honey, Aloe and tannic acid to heal burns. Ancient Egyptians did not know about microorganisms but they knew that honey, moldy bread and copper salts could prevent infections from dirt in burns healing. Thyme, opium and belladona were used for pain relief. In the 4th century BC, Hippocrates recorded that Greek and Roman doctors used rendered pig fat, resin and bitumen to treat burns. Mixture of honey and bran, or lotion of wine and myrrh were used by Celsus. Honey was also known in Ayurveda (Indian medicine) time. Ayurvedic records Characa and Sushruta included honey in their dressing aids to purify sores and promote the healing. Burn treatment in Chinese medicine was traditional. It was a compilation of philosophy, knowledge and herbal medicine. The successful treatment of burns started in recent time and it has been made possible by better knowledge of the pathophysiology of thermal injuries and their consequences, medical technology advances and improved surgical techniques. PMID:23888738

  6. Burns treatment in ancient times.

    Science.gov (United States)

    Pećanac, Marija; Janjić, Zlata; Komarcević, Aleksandar; Pajić, Milos; Dobanovacki, Dusanka; Misković, Sanja Skeledzija

    2013-01-01

    Discovery of fire at the dawn of prehistoric time brought not only the benefits to human beings offering the light and heat, but also misfortune due to burns; and that was the beginning of burns treatment. Egyptian doctors made medicines from plants, animal products and minerals, which they combined with magic and religious procedures. The earliest records described burns dressings with milk from mothers of male babies. Goddess Isis was called upon to help. Some remedies and procedures proved so successful that their application continued for centuries. The Edwin Smith papyrus (1500 BC) mentioned the treatment of burns with honey and grease. Ebers Papyrus (1500 BC) contains descriptions of application of mud, excrement, oil and plant extracts. They also used honey, Aloe and tannic acid to heal burns. Ancient Egyptians did not know about microorganisms but they knew that honey, moldy bread and copper salts could prevent infections from dirt in burns healing. Thyme, opium and belladona were used for pain relief. In the 4th century BC, Hippocrates recorded that Greek and Roman doctors used rendered pig fat, resin and bitumen to treat burns. Mixture of honey and bran, or lotion of wine and myrrh were used by Celsus. Honey was also known in Ayurveda (Indian medicine) time. Ayurvedic records Characa and Sushruta included honey in their dressing aids to purify sores and promote the healing. Burn treatment in Chinese medicine was traditional. It was a compilation of philosophy, knowledge and herbal medicine. The successful treatment of burns started in recent time and it has been made possible by better knowledge of the pathophysiology of thermal injuries and their consequences, medical technology advances and improved surgical techniques.

  7. 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...

  8. 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...

  9. 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...

  10. An unusual burn caused by hot argy wormwood leaf water

    Directory of Open Access Journals (Sweden)

    Feng Guo

    2011-09-01

    Full Text Available An unusual burn case caused by hot wormwood leaf water was discussed. A 29-year-old woman sustained a 7% second-degree burn on both buttocks and left thigh. This case report highlights a rare cause of a chemical burn that may become more common with increasing use of this Chinese traditional medicine. The prevention measures of this burn injury were also presented.

  11. 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...... report of a burned patient with CS in the English language literature. CS is also highly contagious and may lead to a nosocomial outbreak. Furthermore, CS seems to have a detrimental impact on the burned patient's course of treatment. A scabicide treatment is necessary to guarantee successful treatment...

  12. 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...... management addresses and alleviates these complications. The aim of our study was to compare clinical guidelines for pain management in burn patients in selected European and non-European countries. We included pediatric guidelines due to the high rate of children in burn units. METHOD: The study had...... patients. The most highly recommended guidelines provided clear and accurate recommendations for the nursing and medical staff on pain management in burn patients. We recommend the use of a validated appraisal tool such as the AGREE instrument to provide more consistent and evidence-based care to burn...

  13. Influence of hydrogen sulfide on the intestinal biological barrier of rats with severe burn injury%硫化氢对严重烧伤大鼠肠道生物屏障的影响

    Institute of Scientific and Technical Information of China (English)

    李毅; 王洪瑾; 吴晓伟; 王来红

    2015-01-01

    Objective To explore the influence of hydrogen sulfide on the intestinal biological barrier,by applying exogenous hydrogen sulfide and hydrogen sulfide synthase inhibitor for the treatment of rats with severe burn injury.Methods One hundred and four SD rats were divided into sham injury (SI,n =8),burn control (BC,n =32),sodium hydrosulfide (SH,n =32),and propargylglycine groups (PPG,n =32) according to the random number table.Rats in group SI were sham injured without fluid resuscitation.Rats in the latter 3 groups were inflicted with 30% TBSA full-thickness scald (referred to as burn below) on the back and intraperitoneally injected with 40 mL/kg balanced salt solution immediately after injury.Rats in groups SH and PPG were respectively intraperitoneally injected with SH (56 μmol/kg) and PPG (45 mg/kg) within 1 hour post injury.From post injury day (PID) 2,SH (56 μmol/kg) and PPG (45 mg/kg) were respectively intraperitoneally injected once a day to rats in groups SH and PPG.Eight rats from groups BC,SH,and PPG were sacrificed on PID 2,7,14 and 21,and ceca samples were collected.Ceca samples were added to the appropriate culture medium after being homogenized and diluted,for the culture of Bifidobacterium,Lactobacillus,Enterococcus,Enterobacter,and Candida albicans.The content of bacteria was calculated after the bacteria number was counted.The same procedure was performed for rats in group SI.Data were processed with logarithmic function,one-way analysis of variance,analysis of variance of factorial design,and SNK-q test.Results On each PID,the content of Bifidobacterium and Lactobacillus in the ceca of each group with burned rats was less than that of group SI (with q values from 4.12 to 20.74,P values below 0.05) ; while the content of Enterococcus,Enterobacter,and Candida albicans was more than that of group SI (with q values from 2.84 to 68.29,P values below 0.05).Compared with that of group BC,the content of Bifidobacterium and Lactobacillus in the ceca

  14. 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

  15. 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

    Directory of Open Access Journals (Sweden)

    Beier Justus P

    2005-11-01

    Full Text Available Abstract Background 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. Case presentation 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. Conclusion 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.

  16. The clinical effectiveness of permissive hypotension in blunt abdominal trauma with hemorrhagic shock but without head or spine injuries or burns: a systematic review

    Directory of Open Access Journals (Sweden)

    Alsawadi A

    2012-05-01

    Full Text Available Abdulrahman AlsawadiColchester Hospital University NHS Foundation Trust, Colchester, Essex, United KingdomBackground: Trauma is a major cause of death and disability. The current trend in trauma management is the rapid administration of fluid as per the Advanced Trauma Life Support guidelines, although there is no evidence to support this and even some to suggest it might be harmful. Some guidelines, protocols, and recommendations have been established for the use of permissive hypotension although there is reluctance concerning its application in blunt injuries.Objectives: The aim of this review is to determine whether there is evidence of the use of permissive hypotension in the management of hemorrhagic shock in blunt trauma patients. This review also aims to search for any reason for the reluctance to apply permissive hypotension in blunt injuries.Methods: This systematic review has followed the steps recommended in the Cochrane Handbook for Systematic Reviews of Interventions. It is also being reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement and checklist. Database searches of MEDLINE, EMBASE, the Centre for Reviews and Dissemination databases and the Cochrane Library were made for eligible studies as well as journal searches. Inclusion criteria included systematic reviews that have similar primary questions to this review and randomized controlled trials where patients with blunt torso injuries and hemorrhagic shock were not excluded. Rapid or early fluid administration was compared with controlled or delayed fluid resuscitation and a significant outcome was obtained.Results: No systematic reviews attempting to answer similar questions were found. Two randomized controlled trials with mixed types of injuries in the included patients found no significant difference between the groups used in each study. Data concerning the question of this review was sought after these papers were

  17. 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

  18. 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.

  19. 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

  20. 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

  1. Characteristics of burn deaths from 2003 to 2009 in a burn center: A retrospective study

    Directory of Open Access Journals (Sweden)

    Jian Chen

    2013-09-01

    Full Text Available Mortality remains one of the most important end-point quality control parameters to evaluate a burn care system. We retrospectively reviewed the characteristics and multiple organ dysfunction syndrome (MODS patterns of burn deaths in our center from January 2003 to December 2009. The mortality rate during this time period was 2.3%. Fifty-six patients died, including 49 males and 7 females. The mean survival time was 28.45 ± 24.60 days. The burn percentage was (76.70 ± 26.86 % total burn surface area (TBSA, with (27.74 ± 24.95 % deep-partial thickness burns and (46.88 ± 33.84 % full-thickness burns. Inhalation injury was diagnosed in 36 (64.29% patients. Patients who had undergone an operation, particularly in the first week post-burn, had a significantly longer survival time. An average of 5.50 ± 1.35 malfunctioning organs per patient and a mean sequential organ failure assessment (SOFA score of 13.91 ± 3.65 were observed. The most frequently malfunctioning organs were involved in the respiratory, hematologic, circulatory, and central nervous systems. Most of the organ damage occurred during the first week post-burn, followed by 4 weeks later, with relatively less organ damage observed in the third week. Among patients with a TBSA over 50%, non-survivors had larger burn sizes (particularly larger full-thickness burns and a higher incidence of inhalation injury compared with survivors; non-survivors were also more likely to have microorganism-positive blood and sputum cultures. In conclusion, burn deaths are related to a higher burn percentage, inhalation injury, MODS, and infection. Early operation may help improve survival duration.

  2. 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.

  3. 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 ...

  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. 脂肪间充质干细胞对烧伤脓毒症小鼠肾脏损伤的作用%Effects of adipose-derived stem cells on renal injury in burn mice with sepsis

    Institute of Scientific and Technical Information of China (English)

    李娜; 胡大海; 王耀军; 胡晓龙; 张月; 李小强; 石继红; 白晓智; 蔡维霞

    2013-01-01

    Objective To investigate the effect of adipose-derived stem cells (ADSC) on renal injury in mice with burn injury and sepsis and its underlying mechanism.Methods (1) Adipose tissue was collected from both inguinal regions of 5 C57BL/6J mice to isolate,culture and purify ADSC through enzyme digestion,density gradient centrifugation,and adherence method.Cells of the third passage were used in the experiment.The morphologic change in cells was observed and the growth curve of cells was determined.The expression of cell surface antigen phenotype was analyzed by flow cytometry,and the cells were identified by adipogenic and osteogenic differentiation.(2) Another 37 C57BL/6J mice were divided into normal control group (n =5),saline group (n =16),and group ADSC (n =16) according to the random number table.The mice in saline group and group ADSC were injected with Pseudomonas aeruginosa after being subjected to 15% TBSA full-thickness burn on the back to reproduce septic burn model.Then the mice were injected with saline and ADSC through tail vein respectively.At post burn hour (PBH) 12,24,48,and 72,the pathological change in kidney tissue was observed,tie levels of blood urea nitrogen and serum creatinine were determined,and the levels of TNF-α,IL-12,IL-10,and cyclooxygenase-2 (COX2) mRNA were determined with real-time fluorescence quantitative PCR in both groups.Above-mentioned indexes were also examined in the normal control group (without burn).Data were processed with multifactor analysis of variance and LSD-t test.Results (1) Cells in the third passage were orderly arranged with the shape similarto fibroblasts.The percentages of CD90 +,CD105 +,CD34-,and CD45-cells were all above 90%.The cells could differentiate into osteoblasts and adipocytes.The cells were identified to be ADSC.(2) From PBH 12 to PBH 72,the neutrophil infiltration gradually increased,and the structure of kidney tubules and glomeruli were deranged in saline group.The pathological change in

  6. [Treatment of burns in infants].

    Science.gov (United States)

    Foyatier, J L; Latarjet, J; Comparin, J P; Zaragori, M; Robert, A; Braye, F; Weill, E; Masson, C L

    1995-10-01

    Because of the potential severity of their residual deformities, burn injuries in infants justify an early management in specialized centres when they cover more than 5% of body surface and in every case when hands, face, or external genitalia are concerned. Cooling with cold water is the first aid treatment to be performed as early as possible after the injury. The treatment in specialized centres must be both general and surgical. General treatment includes fluid and electrolyte therapy, temperature control, appropriate nutrition and pain suppression. Pain suppression is a major part of the treatment and morphine must be largely used. Surgical treatment starts as soon as the patient arrives in the centre and is eventually performed under general anesthesia: all the burned areas are covered with occlusive dressings. Infections are prevented by systematic cultures and adjusted antibiotic therapy. A vigorous rehabilitation program must be instituted as soon as possible: massages, compressive clothes, splints, physical therapy, plastic surgery. Primary prevention by sustained parental education is important in order to reduce the frequency of burn injuries in infants.

  7. 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...

  8. 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

  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.

  10. [Ischemic cholangiopathy induced by extended burns].

    Science.gov (United States)

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

    2013-04-01

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

  11. 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

  12. Burns and injuries from non-electric-appliance fires in low- and middle-income countries Part II. A strategy for intervention using the Haddon Matrix.

    Science.gov (United States)

    Peck, Michael D; Kruger, Gerebreg E; van der Merwe, Anna E; Godakumbura, Wijaya; Oen, Irma M M; Swart, Dehran; Ahuja, Rajeev B

    2008-05-01

    A large proportion of burns in developing countries are related to the nature of domestic appliances used for cooking, heating, and lighting. Our overview of the problem elucidated the need for better surveillance with epidemiologic studies, which will more accurately assess the true incidence in vulnerable populations. This paper will create a framework for envisaging new approaches to the problem and begin to evaluate the strengths and weaknesses of proposed interventions. We used the Haddon Matrix to accumulate proposed interventions that encompass a pre-event, event, and post-event timeline. We propose an initial strategic outline plan for interventions based on values that are suited to the problem and the setting, are culturally appropriate, and can be employed in a reasonable period of time for a sustained period to ensure success. Recommended action steps include promoting the use of alternative energy sources, encouraging an integrated approach to finding interdisciplinary solutions, devising a better system of kerosene containerization, re-engineering appliance designs, legislating for enforcement of health and safety standards, taking a holistic approach through government inter-departmental collaboration, formally discouraging corruption, encouraging ventilation of cooking or living areas, implementing building codes, educating consumers, and training caregivers and health and emergency workers.

  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. 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 (−...

  15. 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...

  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. [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

  18. Qualitative research on posttraumatic growth in patients with severe burn injuries%严重烧伤患者创伤后成长的质性研究

    Institute of Scientific and Technical Information of China (English)

    翟建霞; 蒋红; 吴菁; 刘晓虹

    2011-01-01

    Objective To explore the dimensions of posttraumatic growth in patients with severe bum injuries. Methods Phenomenological methodology was used in the study. A depth interveiw was conducted on 10 patients with severe bum injuries recruited by purposive sampling method. Results The factors which could contribute to posttraumatic growth were personal strength,new life philosophy,sharing of self with significant others and altruism born of sufferings. Conclusion There are commonalities and differences between the Chinese sample and Tedeschi and Calhoun's model on the process and outcomes of posttraumatic growth.%目的 探索严重烧伤患者创伤后成长的心路历程。方法 采用现象学研究方法,以目的抽样法抽取10例康复后期的严重烧伤患者,进行深度访谈。结果 多种因素可促进患者创伤后成长过程,主要体现在个人力量、新生活哲学、与亲密的人分享自我情感、苦难衍生的利他4个维度。结论 访谈获得的严重烧伤患者创伤后成长维度,与美国Tedeschi和Calhoun提出的创伤后成长维度既有共性,也存在文化差异。

  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. Infections in critically ill burn patients.

    Science.gov (United States)

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

    2016-04-01

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

  1. Importance of proper initial treatment of moderate and major burns

    Directory of Open Access Journals (Sweden)

    Vulović Dejan

    2008-01-01

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

  2. 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...

  3. 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

  4. 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...

  5. 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.

  6. Effects of resuscitating fluid volume changes on internal organ functions after burn-blast combined injury%不同补液量对重度烧冲复合伤犬脏器功能的影响

    Institute of Scientific and Technical Information of China (English)

    张东海; 柴家科; 李百玲; 张旭龙; 胡泉; 马丽; 郁永辉; 刘玲英

    2015-01-01

    40±0.19)L/min,增量20%组高于增量30%组,差异具有统计学意义(t =3.890,P <0.05)。伤后对照组和增量30%组谷丙转氨酶高于增量20%组,伤后24 h(t =2.745、3.864)、48 h(t =5.080、6.869)和72 h(t =4.195、5.143),差异均有统计学意义(P <0.05)。伤后4 h 和8 h 时,增量20%组、增量30%组血尿素氮低于对照组,伤后4 h(t =4.372、7.429),伤后8 h(t =3.719、6.171),差异均有统计学意义(均 P <0.05),增量20%组、增量30%组低于增量10%组,伤后4 h(t =3.519、6.508)、伤后8 h(t =3.922、6.835),差异均有统计学意义(均 P <0.05)。伤后各组间血肌酐比较差异均无统计学意义(均 P >0.05)。四组伤后较伤前,血管外肺水指数均上升,动脉氧分压下降,组间比较差异均无统计学意义(均 P >0.05)。结论犬Ⅲ度烧伤35%总体表面积并中度冲击伤休克适宜的补液量应按 Parkland 公式补液量增量20%计算,即第一个24 h 内4.8 mL·kg -1·h -1,第二个24 h 内2 mL·kg -1·h -1,与 Parkland 公式补液量及增量10%相比,可在伤后早期显著改善尿输出量和心输出量,且不会引起肺水肿的加重;增量30%与增量20%相比,尿输出量提升过高,早期容量负荷过重。%Objective To figure out an optimal resuscitating fluid volume after burn-blast combined injury by determining effects of gradient volume changes on internal organ functions.Methods Thirty-two healthy male beagle dogs were subjected to a burn-blast combined injury (35% total body surface area full thickness burn combined with middle severity blast injury)and randomLy assigned into 4 groups,namely, the controlled group,volume increasing group 1 0%,20% and 30%,with 8 dogs in each group.The controlled group was resuscitated with the Parkland formula

  7. Effects of glutamine combined with ulinastatin on inflammatory response of patients with severe burn injury%谷氨酰胺联合乌司他丁对严重烧伤患者炎症反应的影响

    Institute of Scientific and Technical Information of China (English)

    孙勇; 王良喜; 周宜芳; 孙曙光; 毛学飞; 邓向东; 张盼

    2013-01-01

    Objective To observe the effects of glutamine combined with ulinastatin on inflammatory response of patients with severe burn injury.Methods Sixty patients with severe burn injury admitted to our burn wards from January 2010 to December 2011 conforming to the study criteria were divided into control group (C,n =20),glutamine group (G,n =20),and glutamine combined with ulinastatin group (G + U,n =20) according to the random number table.Another l0 healthy volunteers were chosen as normal control group (NC).Isonitrogenous and isocaloric nutrition supports were given to patients in groups C,G,and G + U from post burn day (PBD) 2.0.3 g/kg protein in the form of glutamine dipeptide was given to patients in group G for 10 days.0.3 g/kg protein was given to patients in group G + U for 10 days with the same amount of glutamine dipeptide as that in group G,followed by intravenous injection of 100 kU ulinastatin (once per 8 hours) for 7 days during 10 days.The nitrogen concentration of 24 h urine was determined with Kieldahl nitrogen determination method,and nitrogen balance was calculated one day before treatment and ten days after treatment.Meanwhile,the levels of D-lactate in serum was determined by colorimetric method,the levels of diamine oxidase (DAO),TNF-α,and IL-6 by enzyme-linked immunosorbent assay,and LPS level by kinetic turbidimetric assay with TAL.Above-mentioned indexes were also examined in group NC.The wound healing rate on PBD 30,total hospital stay days,and the incidence of burn sepsis of all burn patients were recorded.Data were processed with one-way analysis of variance,LSD test,t test,and chi-square test.Results Compared with that in group C [(-5.40 + 1.67) g/d],nitrogen balance in group G was significantly increased ten days after treatment [(-1.35 ±0.59) g/d,P <0.01].The serum levels of D-lactate,DAO,LPS,TNF-α,and IL-6 in group G ten days after treatment were significantly lower than those in group C (P <0.05 orP <0.01).No statistically

  8. [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

  9. An evaluation of nutritional practice in a paediatric burns unit

    NARCIS (Netherlands)

    S. Vijfhuize; M. Verburg (Melissa); L. Marino; M. van Dijk (Monique); H. Rode (Heinz)

    2010-01-01

    textabstractIntroduction. Burn injuries evoke a systemic metabolic response with profound effects on organ function, susceptibility to infection, wound healing, growth and development, and mortality. Children are especially vulnerable to nutritional deficiencies owing to their limited energy reserve

  10. 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

  11. "Burn catatonia": a case report and literature review.

    Science.gov (United States)

    Quinn, Davin Kenneth

    2014-01-01

    Thermal injuries have been recognized to cause significant neuropsychiatric symptoms and disability in their sufferers since the middle of the 20th century, when Drs. Stanley Cobb and Erich Lindemann of the Massachusetts General Hospital (Boston, MA) studied survivors of the Cocoanut Grove nightclub fire in Boston. Although "burn encephalopathy" or burn-induced delirium is a common occurrence in the acute phase, catatonia in burn patients is not often reported. This report describes a case of malignant catatonia occurring in a 51-year-old male patient acutely suffering from burns acquired in a chemical explosion, effectively treated with reinstitution of a selective serotonin reuptake inhibitor. The literature on burn encephalopathy and catatonia in burns is reviewed. Few examples of burn catatonia exist. Burn encephalopathy is common, and may occur in patients with low TBSA burns such as described in the case above. Descriptions of burn encephalopathy are numerous, but have not included catatonia as a possible etiology. Catatonia in burn patients as an etiology of burn encephalopathy is likely underrecognized. Clinicians should be aware of the possibility of catatonia when a patient's confusional state after a burn does not respond to usual care.

  12. 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.

  13. EFFECT OF PSYCHOLOGICAL NURSING IN A LARGE AREA BURN INJURY COMBINED WITH RESPIRATORY%心理护理在大面积烧伤合并呼吸道损伤患者的应用效果观察

    Institute of Scientific and Technical Information of China (English)

    卢秀芬

    2011-01-01

    [Objective] To explore the curative effect of psychological nursing intervention of large area burn patients combined with respiratory damage and summarize the nursing experience. [Methods] Selected the data of 30 cases of large area burn combined with respiratory tract injuries in our hospital from September 2006-May 2009, carried out targeted psychological nursing to patients, according to the changes of patients, investigated the patient's psychological needs, thus made patient get early recovery from the hospital. [ Results ] 30 cases of large area bum combined respiratory tract damage had positive attitude to clinical treatment and the hospitalization time was shorten after systematic treatment and targeted psychological nursing. [Conclusion] Psychological nursing for the large area bum combined respiratory tract damage patients could relieve patients' mental pressure, form a positive, optimistic attitude to face treatment, which clinical effect is good, worth in clinical promotion.%[目的]探讨对大面积烧伤合并呼吸道损伤患者进行心理护理干预的临床疗效并总结护理经验.[方法]选取某院2006年9月~2009年5月收治的30例大面积烧伤合并呼吸道损伤患者的资料,对患者进行针对性心理护理,根据患者治疗各个时期的变化,了解患者的心理需求,从而使患者的尽早康复出院.[结果]30例大面积烧伤合并呼吸道损伤患者在经过临床系统治疗,并进行针对性心理干预护理后,患者均能正确对待临床治疗,缩短住院的时间.[结论]对大面积烧伤合并呼吸道损伤的患者进行针对性心理护理,能够患者患者的心理压力,能够以积极乐观的态度面对治疗,临床效果好,值得在临床推广.

  14. 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...

  15. 乌司他丁对吸入性损伤患者早期肺功能的保护作用%Protective effects of ulinastatin on early pulmonary function of patients with burn and smoke inhalation injury

    Institute of Scientific and Technical Information of China (English)

    丁伟; 吕大伦; 徐祥; 王合丽; 王箴

    2014-01-01

    Objective:To observe the effects of ulinastatin on inflammatory response and early pulmonary function in the patients with burn and smoke in-halation injury.Methods:Forty-three patients with severe inhalation injury were randomly allocated to the experimental group (n=21) and control group ( n=22 ) .Two groups of patients received conventional therapy of burn injury ,and the experimental group were given additional intravenous drip of ulinas-tatin in dose of 10 000 U/(kg· d) for 7 days.Before treatment and at day 1,4 and 7 after treatment,blood samples were taken from peripheral veins for determination of C-reactive protein (CRP),TNF-α,IL-6,IL-10 and SOD activities.Besides,APACHEⅡ scoring was maintained at day 1,4,7 and 14,re-spectively,for evaluation of the incidence of pulmonary infection in the two groups.Results:By comparison with the control group at day 4 and 7 after treat-ment,significantly elevated PaO2,PaO2/FiO2,IL-10 and SOD,yet markedly reduced TNF-αand IL-6 levels were observed in patients from experimental group,and the CRP level was also significantly lowed,which showed statistical difference(P<0.05).Although the APACHEⅡ scores had no significant difference between two groups, the experimental group had lower incidence rate and delayed occurrence of pneumonia within 14 days of therapy. Conclusion:Complementary therapy with ulinastatin during the early phase may effectively inhibit the inflammatory response ,improve the pulmonary func-tion and reduce the incidence of pneumonia for patients with burn and smoke-induced inhalation injury.%目的:研究乌司他丁( ulinastatin)对吸入性损伤患者早期炎症反应的影响及肺功能保护作用。方法:43例重症烧伤合并吸入性损伤患者,随机分为乌司他丁治疗组(21例)和对照组(22例),两组常规治疗一致,乌司他丁组在此基础上给予1万U/( kg· d)静脉滴注,连续用药7 d。分别于治疗开始前、治疗后第1天、第4

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

    Directory of Open Access Journals (Sweden)

    Michael A. Dubick

    2015-03-01

    Full Text Available Objective: Normal iron handling appears to be disrupted in critically ill patients leading to hypoferremia that may contribute to systemic inflammation. Ceruloplasmin (Cp, an acute phase reactant protein that can convert ferrous iron to its less reactive ferric form facilitating binding to ferritin, has ferroxidase activity that is important to iron handling. Genetic absence of Cp decreases iron export resulting in iron accumulation in many organs. The objective of this study was to characterize iron metabolism and Cp activity in burn and non-burn trauma patients to determine if changes in Cp activity are a potential contributor to the observed hypoferremia. Material and Methods: Under Brooke Army Medical Center Institutional Review Board approved protocols, serum or plasma was collected from burn and non-burn trauma patients on admission to the ICU and at times up to 14 days and measured for indices of iron status, Cp protein and oxidase activity and cytokines. Results: Burn patients showed evidence of anemia and normal or elevated ferritin levels. Plasma Cp oxidase activity in burn and trauma patients were markedly lower than controls on admission and increased to control levels by day 3, particularly in burn patients. Plasma cytokines were elevated throughout the 14 days study along with evidence of an oxidative stress. No significant differences in soluble transferrin receptor were noted among groups on admission, but levels in burn patients were lower than controls for the first 5 days after injury. Conclusion: This study further established the hypoferremia and inflammation associated with burns and trauma. To our knowledge, this is the first study to show an early decrease in Cp oxidase activity in burn and non-burn trauma patients. The results support the hypothesis that transient loss of Cp activity contributes to hypoferremia and inflammation. Further studies are warranted to determine if decreased Cp activity increases the risk of

  17. [Immediate cooling with water: emergency treatment of burns].

    Science.gov (United States)

    Latarjet, J

    1990-01-01

    Experimental data have demonstrated that prolonged immediate cooling with cold water is the best first-aid treatment for burn injuries. However in France, this treatment is rarely applied; instead old, inefficient and aggravating methods are still very popular. Pediatricians must help to change this practice by recommending immediate cold water treatment for burns in children.

  18. 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.

  19. 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 he...

  20. 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

  1. Burn care in South Africa: a micro cosmos of Africa.

    Science.gov (United States)

    Rode, H; Cox, S G; Numanoglu, A; Berg, A M

    2014-07-01

    Burn injuries in Africa are common with between 300,000 and 17.5 million children under 5 years sustaining burn injuries annually, resulting in a high estimated fatality rate. These burns are largely environmentally conditioned and therefore preventable. The Western Cape Province in South Africa can be regarded as a prototype of paediatric burns seen on the continent, with large numbers, high morbidity and mortality rates and an area inclusive of all factors contributing to this extraordinary burden of injury. Most of the mechanisms to prevent burns are not easily modified due to the restraint of low socio-economic homes, overcrowding, unsafe appliances, multiple and complex daily demands on families and multiple psycho-social stressors. Children burns with an average annual rate of 6.0/10,000 child-years. Burn care in South Africa is predominantly emergency driven and variable in terms of organization, clinical management, facilities and staffing. Various treatment strategies were introduced. The management of HIV positive children poses a problem, as well as the conflict of achieving equity of burn care for all children. Without alleviating poverty, developing minimum standards for housing, burn education, safe appliances and legislation, we will not be able to reduce the "curse of poor people" and will continue to treat the consequences.

  2. Burn patients' experience of pain management: a qualitative study.

    Science.gov (United States)

    Yuxiang, Li; Lingjun, Zhou; Lu, Tang; Mengjie, Liu; Xing, Ming; Fengping, Shen; Jing, Cui; Xianli, Meng; Jijun, Zhao

    2012-03-01

    Pain is a major problem after burns and researchers continue to report that pain from burns remains undertreated. The inadequate pain control results in adverse sequalae physically and psychologically in the burn victims. A better understanding of a burn patient's experience is important in identifying the factors responsible for undertreated pain and establishing effective pain management guidelines or recommendation in the practice of pain relief for burn injuries. This study sought to explore and describe the experience that patients have about pain related to burn-injury during hospitalization. Semi-structured interviews were conducted on eight patients with moderate to severe pain from burn injuries recruited from a Burn Centre in Northwest China. Data was collected by in-depth interviews and qualitative description after full transcription of each interview. Analysis involved the identification of themes and the development of a taxonomy of patients' experience of burn pain and its management. Three themes were indentified: (1) patients' experience of pain control, (2) patients' perception on burn pain management, and (3) patients' expectation of burn pain management. Findings from this study suggested that patients experience uncontrolled pain both physically and psychologically which may serve as an alert for awareness of health professionals to recognize and establish a multidisciplinary pain management team for burn victims, including surgeons, critical care specialists, anesthesiologists, nurses, psychologists, and social workers to accomplish safe and effective strategies for pain control to reach an optimal level of pain management in burn patients. It also provides insights and suggestions for future research directions to address this significant clinical problem.

  3. 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

  4. 连续性肾脏替代治疗对危重烧冲伤患者肺功能的影响%Continuous Renal Replacement Therapy on lung Function in Patients with Severe burn - blast Injury

    Institute of Scientific and Technical Information of China (English)

    吕苏一; 孟建中; 于颖; 葛彦明; 景颖; 贾凤玉; 王素霞; 刘文渊; 岳冀

    2011-01-01

    To observe the effect of continuous renal replacement therapy on 19 cases of burn - blast injury in patients with pulmonary function.In the base of life - saving treatments that conventional fluid and - shock, preventive tracheotomy, anti - infection, based on the condition of patients, they were treated with CRRT 8~28 h, continuous 5 ~ 7d,The changes of vital signs, blood pressure, arterial oxygen saturation, chest radiograph and serum endothelin (ET), von Willebrand factor (von Willebr and Factor, vWF) and blood lactate (lac) concentration before and after treatment were investigated. Result showed that (1) After treatment with CRRT, heart rate, respiratory rate decrease, blood pressure, arterial oxygen saturation of bum - blast injury patients increased significantly; however, serum ET, vWF, lac concentration, pulmonary vascular resistance index and the value of the synchronization ALI score decreased. (2) 12 patients in the implementation of CRRT were successful accepted escharectomy,skin taking, skin grafting, and 39- 65 d after injury,the wound closed, then discharged. After 120 h after treatment, 5 cases with AKI were out of from oliguria. 7 cases were died of disseminated intravascularcoagulation, sepsis, multiple organ failure. It proves that: (1) Bum - blast injury, the damaged endothelial cells can start "the immune, coagulation", the release of a large number of FT, vWF into blood, can contribute to pulmonary vasoconstriction, and further activate platelets and endothelial adhesion, thereby increasing the lung tissue ischemia and hypoxia, in the ARDS, DIC, sepsis, MODS in the progression. (2) CRRT can remove ET, vWF and other inflammatory mediators, thereby reducing pulmonary interstitial edema, improve tissue oxygen uptake capacity, increasing oxygenation index, decrease pulmonary vascular resistance index and All score values. (3)Uae of CRRT for the treatment of patients with burn - blast injury to create conditions for skin grafting, and can shorten

  5. 中西医结合治疗小儿烧伤后惊厥的临床疗效观察%Therapeutic Effect of Combination of Traditional Chinese Medicine and West Medicine for Convulsion after Burn Injury in Children

    Institute of Scientific and Technical Information of China (English)

    孟凡勇

    2014-01-01

    Objective To investigate the therapeutic effect of the combination of traditional Chinese medicine( TCM) and west medicine for convulsion after burn injury in children. Methods 96 children with convulsion after burn injury,admitted to our hospital from January 2005 to December 2013,were randomly divided into control group and observation group with each group 48 cases. The control group was given west medicine treatment,including opening air passages,oxygen uptake,sedation, relieving convulsion and abatement of fever. While the observation group was given additional drip-feed of Qingkailing Injection, oral Bezoar Bolus,oral and packed Zixue Pellet.χ2 was used to compare the therapeutic effect of the two groups. Results After treatment,32 cases were significantly improved,14 cases were improved and 2 cases were invalid in the observation group,with a total therapeutic effect of 95. 8%;26 cases were significantly improved,8 cases were improved and 14 cases were invalid in the control group,with a total therapeutic effect of 70. 8%,which was significantly higher than the control group(χ2 =11. 56, P<0. 05). Conclusion The therapeutic effect is fairly good by combining TCM and west medicine,which is conducive to the childrenˊs immediate rehabilitation.%目的:观察中西医结合治疗小儿烧伤后惊厥的临床疗效。方法选取2005年1月-2013年12月本院烧伤科收治的烧伤后惊厥患儿96例,将其随机分为对照组和观察组,各48例。对照组患儿给予西医治疗,包括通畅呼吸道、吸氧、镇静、止痉、退热等常规治疗。观察组在对照组治疗的基础上,另给予清开灵注射液静脉滴注,安宫牛黄丸口服,紫雪丹口服、外敷。采用χ2检验比较两组患儿治疗后的总有效率。结果治疗后观察组显效32例,有效14例,无效2例,总有效率为95.8%;对照组显效26例,有效8例,无效14例,总有效率为70.8%。观察组患儿总

  6. 坏死组织对深二度烧伤创面进行性加深的影响%Effect of necrotic tissue on progressive injury in deep partial thickness burn wounds

    Institute of Scientific and Technical Information of China (English)

    陆树良; 向军; 青春; 金曙雯; 廖镇江; 史济湘

    2002-01-01

    目的 为探讨深二度烧伤创面坏死组织持续存在对创面组织进行性损害的影响。方法 将7例施行削痂手术的深Ⅱ度烧伤患者创面分为手术前、手术后、和坏死组织存在的未手术创面,并分别获取创面组织标本,测定创面组织释放IL-8、EGF、bFGF、PDGF-AB水平以及观察组织形态学变化。结果 7例未手术创面组织在体外组织培养中释放IL-8水平较削痂手术后创面水平有明显升高(P<0.001);同时,未手术创面EGF、bFGF、PDGF-AB水平与其配对的削痂手术后创面比较均呈明显降低(P<0.05-<0.005)。局部组织形态学观察亦显示,坏死组织存在的未手术创面除有大量中性粒细胞浸润外,坏死范围较手术前扩大,残留的少量皮肤附件因炎症扩大而消失,而削痂后创面的炎性反应较未手术和手术前有明显减轻,无坏死范围的进一步扩大,甚至可见新生肉芽形成和部分表皮修复。结论 创面坏死组织持续存在不仅是创面愈合过程的抑制因素,而且还可能因炎症反应加强或持续存在而导致创面进一步加深,使创面愈合更为延迟。削痂手术作为一种去除坏死组织的主动手段,对促进创面愈合有积极意义。%Objective To evaluate the influence of necrotic tissue on progressive injury in deep partial thickness burn wounds.Methods Tissue specimens were cultured both for estimation of IL-8, EGF, bFGF, PDGF-AB and histopathological examination, from the pre-operation, post-operation, and non-operation wounds from seven patients with deep partial thickness burn.Results In seven specimens from the non-operation group, IL-8 release increased compared with those in the post-operation group (P<0.001), while the levels of EGF, bFGF, PDGF-AB release were lower than those in the post-operation group. Histopathological examination revealed that in the non-operation group, the degree of neutrophil

  7. 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.

  8. A modified surgical technique in the management of eyelid burns: a case series

    Directory of Open Access Journals (Sweden)

    Sun Shudong

    2011-08-01

    Full Text Available Abstract Introduction Contractures, ectropion and scarring, the most common sequelae of skin grafts after eyelid burn injuries, can result in corneal exposure, corneal ulceration and even blindness. Split-thickness or full-thickness skin grafts are commonly used for the treatment of acute eyelid burns. Plasma exudation and infection are common early complications of eyelid burns, which decrease the success rate of grafts. Case presentation We present the cases of eight patients, two Chinese women and six Chinese men. The first Chinese woman was 36 years old, with 70% body surface area second or third degree flame burn injuries involving her eyelids on both sides. The other Chinese woman was 28 years old, with sulfuric acid burns on her face and third degree burn on her eyelids. The six Chinese men were aged 21, 31, 38, 42, 44, and 55 years, respectively. The 38-year-old patient was transferred from the ER with 80% body surface area second or third degree flame burn injuries and third degree burn injuries to his eyelids. The other five men were all patients with flame burn injuries, with 7% to 10% body surface area third degree burns and eyelids involved. All patients were treated with a modified surgical procedure consisting of separation and loosening of the musculus orbicularis oculi between tarsal plate and septum orbital, followed by grafting a large full-thickness skin graft in three days after burn injury. The use of our modified surgical procedure resulted in 100% successful eyelid grafting on first attempt, and all our patients were in good condition at six-month follow-up. Conclusions This new surgical technique is highly successful in treating eyelid burn injuries, especially flame burn injuries of the eyelid.

  9. Healing the Burn: Advances in Burn Treatment Technology Aim to Save Lives, Lessen Pain and Scarring.

    Science.gov (United States)

    Allen, Summer E

    2016-01-01

    When brothers Jamie and Glen Selby, aged 5 and 7, arrived at the Shriners Burns Institute in Denver, Colorado, in July 1983, more than 97% of their skin had been destroyed by a fire they had accidentally started while playing in an abandoned house. The boys were so badly burned that their outlook was grim-a 6-year-old friend who was also in the fire died from his injuries?but Jamie and Glen were lucky. Not only did they survive, but they were also some of the first patients to benefit from a new burn treatment nicknamed test-tube skin. PMID:27414631

  10. Pediatric Burns in the Bedouin Population in Southern Israel

    Directory of Open Access Journals (Sweden)

    Arnon D. Cohen

    2007-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Jiang Rui M

    2011-09-01

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

  12. 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.

  13. 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.

  14. 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-

  15. 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.

  16. [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

  17. 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.

  18. [Advances in the research of treatment of hydrofluoric acid burn].

    Science.gov (United States)

    Wang, Xin-gang; Zhang, Yuan-hai; Han, Chun-mao

    2013-08-01

    Hydrofluoric acid (HF) is one of the most common inorganic acids used widely in industrial circle. HF not only causes cutaneous burn, but also induces systemic toxicity by its unique injury mechanism. Accurate and timely diagnosis and treatment are critical after HF burns. To date, the strategies for treating HF burns have been developed, mainly including topical treatments and systematic support. However, there is no standard treatment strategy with wide acceptance in the world. This paper presents a comprehensive overview of the advances in the research of strategies for the treatment of HF burns.

  19. Burns and epilepsy--review and case report.

    Science.gov (United States)

    Gragnani, Alfredo; Müller, Bruno Rafael; Oliveira, Andrea Fernandes; Ferreira, Lydia Masako

    2015-03-01

    Decompensation of epilepsy in burned patients may be caused by several factors. Burn is a classic etiology of systemic inflammatory response syndrome, and evolves into two physiological phases. The first 48h after injury corresponds to the first phase involving severe hypovolemic shock. The second phase corresponds to the hypermetabolic response to burns. Altered pharmacokinetics of anticonvulsant drugs is observed. Albumin and other plasma proteins are reduced, leading to increased free fraction of phenytoin, resulting in greater clearance and a lower total drug concentration. Associated with metabolic changes of burned patient, this fact predisposes to seizures in epileptic burned patients. The authors present the case of an epileptic 36-year-old-woman who developed recurrent seizures after a thermal injury, despite using the same medications and doses of anticonvulsant drugs of last 12 years, with controlled epilepsy.

  20. Autoextraction of Permanent Incisors and Self-Inflicted Orodental Trauma in a Severely Burned Child

    Directory of Open Access Journals (Sweden)

    Sultan Keles

    2015-01-01

    Full Text Available Autoextraction is one type of self-injurious behaviour. In the literature, self-injurious behaviours are observed in syndromes and genetic conditions. However, to the best of our knowledge, SIB and autoextraction in a severely burned patient have not been reported to date. This report describes the self-inflicted trauma and autoextraction in a severely burned child, and the management of the child during and after burn treatment.

  1. 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 ...

  2. 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 ...

  3. 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

  4. 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

  5. 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)

  6. 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

  7. 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 ...

  8. 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

  9. 烧伤高代谢机制的再认识及调控策略%Further understanding of the hypermetabolism mechanism in burn injury and the strategy of regulation and control

    Institute of Scientific and Technical Information of China (English)

    彭曦

    2013-01-01

    The pattern of metabolism changes obviously after severe burn trauma,and it is characterized by an immensely increase in energy consumption,persistent strengthening in catabolism,and impediment of utilization of nutrient substrate.It will lead to autophagy,continuous consumption,and progressive emaciation,etc.If these pathological phenomena can not be effectively corrected,the prognosis of patients with serious burn will be poor,with complications of organ damage,immune dysfunction,and delayed wound healing,etc.Hypermetabolism after burn has become one of the leading causes of multiple organ dysfunction and even death.After many years' research,we have a certain understanding of burn hypermetabolism,but it is still difficult to clearly explain the mechanism up to now.Moreover,the measures of regulating hypermetabolism are still not perfect,hampering the advance of treatment of serious burn trauma.The purpose of the article is to analyze and discuss the essential mechanism of hypermetabolism after burn,basing on the new literature and a series of our experimental and clinical studies.Meanwhile the regulation strategy concerning burn hypermetabolism is proposed.It focuses on regulation of endocrine and inflammatory mediators,as well as maintenance of gastrointestinal structure and function.

  10. 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...

  11. Is the Target of 1 Day of Stay per 1% Total Body Surface Area Burned Achieved in Chemical Burns?

    Science.gov (United States)

    Tan, Teresa; Wong, David S Y

    2016-02-01

    The length of hospital stay (LOS) is a standard parameter used to reflect quality and evaluate outcomes in acute burn care. This study aims to assess whether the target of 1 day of stay per 1% total body surface area (TBSA) burned was achieved in acute chemical burns management and factors affecting the LOS. A retrospective analysis of the records of patients who suffered from chemical burn injuries admitted to a university burn center over a continuous 14-year period was performed.A total of 118 patients were admitted over the period for chemical burns. Only 14% of cases achieved the target stated. Factors associated with lengthening of the hospital stay included TBSA, ocular involvement, the cause of injury, and the need for surgery during the same admission.The LOS in chemical burns frequently exceeds 1 day of stay per 1% TBSA burned. Many factors can contribute to a patient's LOS and are worth exploring in order to see if the impact of these factors could be minimized. Early surgical intervention should help to reduce the LOS if reliable methods of burn wound depth assessment are available.

  12. Prognostic indicators in acute burned patients-a review

    Institute of Scientific and Technical Information of China (English)

    Sherif Emara

    2015-01-01

    Burn trauma is in need for prognostic indicators or admission scores. This aims for realistic documentation of the burn injury, expectation of the prognosis, and to facilitate a patient stratification to evaluate therapeutic strategies. A computer search through different medical websites was performed looking for articles correlating prognosis with different burn indices. These were carefully summarized and analyzed for this review. Variable studies were found related to that issue; the reliable indicators found had been classified as general or specific. All of them had certain clinical importance, but limitations are a common feature. All the listed indices are useful to serve in the only special clinical situations. We couldn't claim that they are actual prognostic indicator in burn victims. We believe that we still lack the proper prognostic indicator in burn patients. Researchers are invited for more effort to organize a more reliable prognostic indicator and scoring system for burn patients.

  13. Prognostic indicators in acute burned patients–a review

    Directory of Open Access Journals (Sweden)

    Sherif Emara

    2015-06-01

    Full Text Available Burn trauma is in need for prognostic indicators or admission scores. This aims for realistic documentation of the burn injury, expectation of the prognosis, and to facilitate a patient stratification to evaluate therapeutic strategies. A computer search through different medical websites was performed looking for articles correlating prognosis with different burn indices. These were carefully summarized and analyzed for this review. Variable studies were found related to that issue; the reliable indicators found had been classified as general or specific. All of them had certain clinical importance, but limitations are a common feature. All the listed indices are useful to serve in the only special clinical situations. We couldn't claim that they are actual prognostic indicator in burn victims. We believe that we still lack the proper prognostic indicator in burn patients. Researchers are invited for more effort to organize a more reliable prognostic indicator and scoring system for burn patients.

  14. 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

  15. 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

  16. 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

  17. Comprehensive rehabilitation of burn-induced dysfunctions in China%烧伤功能障碍综合康复治疗的国内现状

    Institute of Scientific and Technical Information of China (English)

    孙天宝; 郭钦; 黄伟艺; 方璐; 饶伶娟

    2013-01-01

    Burn patients often suffer from different degrees of dysfunction,such as residual burn wounds,formation of hyperplastic scar,scar itching,cardiopulmonary dysfunction,limitation of motion,and psychological disorders,which exert severe impact on their daily life.This article reviews various rehabilitation treatments for dysfunction after burn injury to promote rehabilitation of burn patients.

  18. Electrical burns in sports fishing: a case report.

    Science.gov (United States)

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

    2014-11-01

    Electrical burns are among the most devastating types of burns, with wide-ranging injuries. They can sometimes occur in the context of fishing, usually involving high voltages. The authors present the case of a 59-year-old-man who suffered a sports accident during a fishing competition, with the formation of an electrical arc due to proximity of the fishing rod and high voltage cables. He presented burns affecting 3% of TBSA, third degree deep burns on trunk and left hand; no signs of cardiac injury. He was admitted to our Burn Unit for monitoring, care dressing and surgical treatment; complete wound healing was achieved after 24 days. Due to its relatively small share among burns, published data on electrical injuries and fishing remain scarce, and differ in patient collectives due to infrastructural or environmental differences. The authors are not aware of published specific reports on electrical burns in sports fishing practice, like the case here presented. The authors want to alert for potential medical, social and economic consequences of this type of sports accidents that could be entirely avoidable with some preventive measures. PMID:24704363

  19. Update on the critical care management of severe burns.

    Science.gov (United States)

    Kasten, Kevin R; Makley, Amy T; Kagan, Richard J

    2011-01-01

    Care of the severely injured patient with burn requires correct diagnosis, appropriately tailored resuscitation, and definitive surgical management to reduce morbidity and mortality. Currently, mortality rates related to severe burn injuries continue to steadily decline due to the standardization of a multidisciplinary approach instituted at tertiary health care centers. Prompt and accurate diagnoses of burn wounds utilizing Lund-Browder diagrams allow for appropriate operative and nonoperative management. Coupled with diagnostic improvements, advances in resuscitation strategies involving rates, volumes, and fluid types have yielded demonstrable benefits related to all aspects of burn care. More recently, identification of comorbid conditions such as inhalation injury and malnutrition have produced appropriate protocols that aid the healing process in severely injured patients with burn. As more patients survive larger burn injuries, the early diagnosis and successful treatment of secondary and tertiary complications are becoming commonplace. While advances in this area are exciting, much work to elucidate immune pathways, diagnostic tests, and effective treatment regimens still remain. This review will provide an update on the critical care management of severe burns, touching on accurate diagnosis, resuscitation, and acute management of this difficult patient population.

  20. The epidemiology of geriatric burns in Iran: A national burn registry-based study.

    Science.gov (United States)

    Emami, Seyed-Abolhassan; Motevalian, Seyed Abbas; Momeni, Mahnoush; Karimi, Hamid

    2016-08-01

    Defining the epidemiology and outcome of geriatric burn patients is critical for specialized burn centers, health-care workers, and governments. Better resource use and effective guidelines are some of the advantages of studies focusing on this aspect. The outcome of these patients serves as an objective criterion for quality control, research, and preventive programs. We used data from the burn registry program in our country. For 2 years, >28,700 burn patients were recorded, 1721 of whom were admitted. Among them, 187 patients were ≥55 years old. Sixty-nine percent of patients were male and 31% female, with a male to female ratio of 2.22:1. The mean±standard deviation (SD) of age was 63.4±8.1. The cause of burns was flame (58.2%) and scalds (20.3%). Most of the burns were sustained at home. The mean duration of hospital stay was 19.5 days (range 3-59 days). The mean (SD) of the total body surface area (TBSA) was 20.3% (8.4%). The median hospital stay (length of stay (LOS)) was 11 days (SD=14). The increase in TBSA was related to a longer LOS (pBurn wound infection developed in 44.3% of patients. The presence of inhalation injury was significantly related to mortality (ppatients, 9% recovered completely, 74.9% recovered partially (requiring further treatment), 1% underwent amputation, and 12.8% died. The lack of insurance coverage did not affect the survival of our geriatric burn patients. However, being alone or single, ignition of clothing, cause of burn, comorbid illnesses, complications following the burn, TBSA, age, and sepsis were positively correlated with mortality. The mean cost of treatment for each patient was about $7450.

  1. [The pain from burns].

    Science.gov (United States)

    Latarjet, J

    2002-03-01

    The painful events associated with the treatment of a severe burn can, because of their long-lasting and repetitive characteristics, be one of the most excruciating experiences in clinical practice. Moreover, burn pain has been shown to be detrimental to burn patients. Although nociception and peripheral hyperalgesia are considered the major causes of burn pain, the study of more hypothetical mechanisms like central hyperalgesia and neuropathic pain may lead to a better understanding of burn pain symptoms and to new therapeutic approaches. Continuous pain and intermittent pain due to therapeutic procedures are two distinct components of burn pain. They have to be evaluated and managed separately. Although continuous pain is by far less severe than intermittent pain, the treatment is, in both cases, essentially pharmacological relying basically on opioids. Because of wide intra- and inter-individual variations, protocols will have to leave large possibilities of adaptation for each case, systematic pain evaluation being mandatory to achieve the best risk/benefit ratio. Surprisingly, the dose of medication decreases only slowly with time, a burn often remaining painful for long periods after healing. Non pharmacological treatments are often useful and sometimes indispensable adjuncts; but their rationale and their feasibility depends entirely on previous optimal pharmacological control of burn pain. Several recent studies show that burn pain management is inadequate in most burn centres.

  2. The burn wound inflammatory response is influenced by midazolam.

    Science.gov (United States)

    Babcock, George F; Hernandez, Laura; Yadav, Ekta; Schwemberger, Sandy; Dugan, Amy

    2012-02-01

    Burn patients requiring hospitalization are often treated for anxiety with benzodiazepines (BDZs). Benzodiazepines are reported to influence immune system function. Immune system alterations are a major cause of burn-induced mortality. We wanted to determine whether the BDZ, midazolam given daily at an anxiolytic dose, had any influence on the burn injury-induced inflammatory response in the blood and wound. Mice received a 15% total body surface area flame burn and received either midazolam 1 mg/kg i.p. or saline 0.1 ml daily. Blood and skin wounds were harvested 24 h after injection on post-burn day 2, 3, 7, or 8. Mice treated with midazolam had significantly lower serum IL-1β (p=0.002), TNF-α (p=0.002), IL-6 (p=0.016), IL-10 (p=0.009), and TGF-β (p=0.004) than saline-treated mice, with little impact on serum chemokine levels. In the wound, TNF-α and IL-10 were the only cytokines significantly influenced by the drug, being lower (p=0.018) and higher (p=0.006), respectively. The chemokines in the wound influenced significantly by midazolam were MIP-1α, MIP-1β, and MIP-2 while MCP-1 and KC were not. There were more inflammatory cells at the burn wound margin in midazolam-treated mice on post-burn day 3. Although serum nitrate/nitrite was significantly increased by midazolam (p=0.03), both eNOS and iNOS mRNA expression in the wound were similar to the saline group. We found that midazolam given daily after burn injury significantly influenced the inflammatory response. The clinical implications of these findings on wound healing and shock following burn injury, especially larger burns, deserve further investigation.

  3. History of burns: The past, present and the future

    Directory of Open Access Journals (Sweden)

    Kwang Chear Lee

    2014-10-01

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

  4. 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.

  5. Severe metabolic acidosis following assault chemical burn

    Directory of Open Access Journals (Sweden)

    Sophie De Roock

    2012-01-01

    Full Text Available Assault chemical burns are uncommon in northern Europe. Besides local toxicity, systemic manifestations are possible after strong acid exposure. A 40-year-old woman was admitted 1 h after a criminal assault with sulfuric acid. The total burned surface area was 35%, third degree. Injury was due to sulfuric acid (measured pH 0.9 obtained from a car battery. Immediate complications were obstructive dyspnea and metabolic acidosis. The admission arterial pH was 6.92, with total bicarbonate 8.6 mEq/l and base deficit 23.4 mEq/l. The correction of metabolic acidosis was achieved after several hours by the administration of bicarbonate and lactate buffers. The patient developed several burns-related complications (sepsis and acute renal failure. Cutaneous projections of strong acids may cause severe metabolic acidosis, particularly when copious irrigation and clothes removal cannot be immediately performed at the scene.

  6. Dual therapeutic functions of F-5 fragment in burn wounds: preventing wound progression and promoting wound healing in pigs.

    Science.gov (United States)

    Bhatia, Ayesha; O'Brien, Kathryn; Chen, Mei; Wong, Alex; Garner, Warren; Woodley, David T; Li, Wei

    2016-01-01

    Burn injuries are a leading cause of morbidity including prolonged hospitalization, disfigurement, and disability. Currently there is no Food and Drug Administration-approved burn therapeutics. A clinical distinction of burn injuries from other acute wounds is the event of the so-called secondary burn wound progression within the first week of the injury, in which a burn expands horizontally and vertically from its initial boundary to a larger area. Therefore, an effective therapeutics for burns should show dual abilities to prevent the burn wound progression and thereafter promote burn wound healing. Herein we report that topically applied F-5 fragment of heat shock protein-90α is a dual functional agent to promote burn wound healing in pigs. First, F-5 prevents burn wound progression by protecting the surrounding cells from undergoing heat-induced caspase 3 activation and apoptosis with increased Akt activation. Accordingly, F-5-treated burn and excision wounds show a marked decline in inflammation. Thereafter, F-5 accelerates burn wound healing by stimulating the keratinocyte migration-led reepithelialization, leading to wound closure. This study addresses a topical agent that is capable of preventing burn wound progression and accelerating burn wound healing.

  7. 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

  8. 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.

  9. 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

  10. 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...

  11. Extracorporeal blood purification in burns: a review.

    Science.gov (United States)

    Linden, Katharina; Stewart, Ian J; Kreyer, Stefan F X; Scaravilli, Vittorio; Cannon, Jeremy W; Cancio, Leopoldo C; Batchinsky, Andriy I; Chung, Kevin K

    2014-09-01

    A prolonged and fulminant inflammatory state, with high levels of pro- and anti-inflammatory mediators, is seen after extensive thermal injury. Blood purification techniques including plasma exchange, continuous venovenous hemofiltration, and adsorbing membranes have the potential to modulate this response, thereby improving outcomes. This article describes the scientific rationale behind blood purification in burns and offers a review of literature regarding its potential application in this patient cohort.

  12. Mole gun injury.

    Science.gov (United States)

    Pistré, V; Rezzouk, J

    2013-09-01

    A mole gun is a weapon, which is used to trap and kill moles. This report provides an overview of the state of knowledge of mole gun injuries, comparable to blast injuries caused by fireworks, explosive or gunshot. Over a 2-year period, the authors reported their experience with ten hand injuries caused by mole gun. Radial side of the hand was often concerned, particularly the thumb. The authors explain their choices in the management of such lesions. Surgery was performed primarily and a large debridement currently seemed to offer the best outcome for the patient. Blast, crush, burns and lacerations may explain the higher rate of amputation to the digits. A long period of physiotherapy, specifically of the hand, was needed before the patient could return to work. This ballistic hand trauma encountered by surgeons requires knowledge and understanding of these injuries. It should be in accordance with firearms law because of severe injuries encountered and possible lethal wounds.

  13. Electromyographic studies regarding denervation potentials in skeletal muscles at sites near and distant from the burn in rats.

    Science.gov (United States)

    Sajadi, Simin; Mansoori, Korosh; Forogh, Bijan; Fatemi, Mohammad Javad; Ahadi, Tannaz; Chahardoli Razji, Mahnaz

    2016-04-01

    Changes in membrane AChRs in skeletal muscles located near or distant from burn injury similar to denervated muscles may make electrodiagnostic features indistinguishable from true neuropathic changes. The aim of this study was to examine electrodiagnostic changes of muscles at sites local and distant from the burn after thermal injuries due to neuromuscular junction dysfunction. A total of 40 adult male rats were randomly allocated to four groups. Rats in group 1 received thermal burn injury over gastrocnemius muscle of one leg and sham burn on the other leg. A 20-25% and 30-35% surface body area burn and also 30-35% surface body area sham burn were produced at distant site from gastrocnemius muscle in group 2, 3 and 4, respectively. To explore any fibrillation potential, the rats underwent serial electromyographic studies of bilateral gastrocnemius muscles over 5 weeks after burn injury. There were no denervation potentials either in muscles at sites distant from 20-25% and 30-35% of total body surface area burns or in muscles beneath the burn. In the present study on rats, thermal burn injury could not make fibrillation potentials in the electrodiagnostic study of muscles located near and distant from the burn site.

  14. Urban-Rural Dichotomy of Burn Patients in Georgia and South Carolina: A Geographic Information System Study.

    Science.gov (United States)

    Mian, Mohammad Anwarul Huq; Haque, Akhlaque; Mullins, Robert Fred; Fiebiger, Barbara; Hassan, Zaheed

    2015-01-01

    This study uses a 4-year (2006-2009) cross-section of epidemiological burn injury data from Georgia and South Carolina. The results from the study show that the burn patients from rural areas differ from their urban counterparts in terms of relative burn injury incidence. Younger population groups that live in lower socioeconomic status communities especially in the urban areas are at a higher risk than other population groups. The differences in the types of burns in the urban-rural communities can give us further insights to the patients' association with injury sites. The presence of fewer burn injury treatment and care facilities in rural areas and the high incidence of burn in low-income communities in the urban areas should carry important policy implications for health planners. This study will enable researchers to understand the epidemiology of burn injuries at the local and national levels in the United States. It also carries important implications for using Geographic Information Systems for studying spatial distribution of burn injuries for disaster planning and mitigation of burn injuries.

  15. A review of the specialties that care for inpatient burns and smoke inhalation in the English counties of Lancashire and South Cumbria.

    Science.gov (United States)

    Rajpura, Arif

    2002-03-01

    Prevention is by far the best strategy to minimise the burden of burns and smoke inhalation injuries on public health. However, it is inevitable that some injuries will occur despite the best attempts to prevent them. We must, therefore, optimise treatment in order to restore individuals to the best possible condition. Previous experience has shown that a wide range of specialties, many of which are untrained in burn care medicine, are involved in the care of inpatient burns/smoke inhalation victims in the UK. In light of this, a local review of which specialties care for such injuries was conducted for the population of Lancashire and South Cumbria in the north-west of England. Using population-based health authority data from 1997 to 1999, all Hospital Episodes relating to a primary diagnosis of burns or smoke inhalation were ascertained. The results showed that 41% of all burns episodes were treated by specialties other than burns/plastics. The short lengths of stay in non-plastics/burns specialties suggest that relatively minor injuries are being admitted to these units. Analysis of smoke inhalation injuries showed admission to various different specialties. Admission to burn services ensures that key specialties are available for the care of complex burn injuries. These multidisciplinary teams include burn nurses, burn surgeons and burn anaesthetists/intensivists. From the data available, it was not possible to assess the appropriateness of admission of burns and smoke inhalation injuries to the various branches of medicine. In order to assess appropriateness, we need information on severity of injury and outcome of treatment in each specialty. Further research in this area is required since it is concerning that many burns/smoke inhalation injuries are being treated by specialties with no formal training in burn care medicine. This may have major implications for service planning alongside changes in referral patterns.

  16. 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.

  17. 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.

  18. 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

  19. 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.

  20. 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...

  1. 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.

  2. The Ocular Surface Chemical Burns

    Directory of Open Access Journals (Sweden)

    Medi Eslani

    2014-01-01

    Full Text Available Ocular chemical burns are common and serious ocular emergencies that require immediate and intensive evaluation and care. The victims of such incidents are usually young, and therefore loss of vision and disfigurement could dramatically affect their lives. The clinical course can be divided into immediate, acute, early, and late reparative phases. The degree of limbal, corneal, and conjunctival involvement at the time of injury is critically associated with prognosis. The treatment starts with simple but vision saving steps and is continued with complicated surgical procedures later in the course of the disease. The goal of treatment is to restore the normal ocular surface anatomy and function. Limbal stem cell transplantation, amniotic membrane transplantation, and ultimately keratoprosthesis may be indicated depending on the patients’ needs.

  3. Incidence of flap procedures in the management of burn patients.

    Science.gov (United States)

    Lineaweaver, William C; Craft-Coffman, Beretta; Oswald, Tanya M

    2015-03-01

    Increased survival of burn patients presents opportunities for reconstructive strategies to improve outcomes in management of acute and secondary burn injuries. To assess one such strategy, namely flap reconstruction, we reviewed cases performed during the first 4.5 years of the JMS Burn and Reconstruction Center. We found that flap procedures accounted for 0.8% of acute cases (23 of 2723 procedures) and 33% of secondary cases (260 of 790 procedures). This initial finding shows that in this practice flap procedures are applied to a small number of acute problems while flap procedures comprise 33% of secondary procedures. Reconstructive flap surgery plays a measurable role in burn treatment at this center. Further study of outcomes and timing could lead to better understanding of optimal strategies for flap reconstruction in burns.

  4. 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...

  5. 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.

  6. 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.

  7. 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

  8. 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

  9. 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.

  10. 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

  11. 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

  12. 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.

  13. 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

  14. 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...

  15. 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...

  16. 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

  17. New Fashioned Book Burning.

    Science.gov (United States)

    Gardner, Robert

    1997-01-01

    Reports on results of a teacher's experiment in book burning as a lesson accompanying the teaching of Ray Bradbury's "Fahrenheit 451." Discusses student reactions and the purpose of or justification for the experimental lesson. (TB)

  18. 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?

  19. 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....

  20. 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...

  1. 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

  2. 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...

  3. 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...

  4. 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 ...

  5. 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...

  6. 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.

  7. Development of a Vascularized Skin Construct Using Adipose-Derived Stem Cells from Debrided Burned Skin

    OpenAIRE

    Chan, Rodney K.; Zamora, David O.; Wrice, Nicole L.; Baer, David G.; Renz, Evan M.; Christy, Robert J.; Shanmugasundaram Natesan

    2012-01-01

    Large body surface area burns pose significant therapeutic challenges. Clinically, the extent and depth of burn injury may mandate the use of allograft for temporary wound coverage while autografts are serially harvested from the same donor areas. The paucity of donor sites in patients with burns involving large surface areas highlights the need for better skin substitutes that can achieve early and complete coverage and retain normal skin durability with minimal donor requirements. We have i...

  8. 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.

  9. 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...

  10. 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...

  11. 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 .

  12. PBXN-110 Burn Rate Estimate

    Energy Technology Data Exchange (ETDEWEB)

    Glascoe, E

    2008-08-11

    It is estimated that PBXN-110 will burn laminarly with a burn function of B = (0.6-1.3)*P{sup 1.0} (B is the burn rate in mm/s and P is pressure in MPa). This paper provides a brief discussion of how this burn behavior was estimated.

  13. 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].

  14. Neuropsychological outcomes of pediatric burn patients who sustained hypoxic episodes.

    Science.gov (United States)

    Rosenberg, Marta; Robertson, Carrie; Murphy, Kevin D; Rosenberg, Laura; Mlcak, Ronald; Robert, Rhonda S; Herndon, David N; Meyer, Walter J

    2005-11-01

    The neuropsychological outcomes of children who suffered hypoxic episodes following their burns are not completely understood and vary depending on the nature and severity of the episode. A retrospective review of youth that were admitted to this acute burn care facility over the past 20 years was conducted to identify the extent of cognitive and affective difficulties. Thirty-nine children who sustained hypoxic injuries related to their burns were compared with 21 controls that were matched for age, TBSA, and time of injury. Approximately a third of the children who survived from the hypoxia group continued to have long-term cognitive and emotional difficulties. For those who recovered reasonably well, no differences were found from the matched burned controls. These results probably underestimate the true extent of neuropsychological difficulties experienced by these youth given that detailed cognitive testing was not routinely performed. Prospective studies are needed to further characterize the full nature of difficulties and outcomes associated with burn related hypoxic injuries.

  15. Bronchoscopy-derived correlates of lung injury following inhalational injuries: a prospective observational study.

    Directory of Open Access Journals (Sweden)

    Samuel W Jones

    Full Text Available BACKGROUND: Acute lung injury (ALI is a major factor determining morbidity following burns and inhalational injury. In experimental models, factors potentially contributing to ALI risk include inhalation of toxins directly causing cell damage; inflammation; and infection. However, few studies have been done in humans. METHODS: We carried out a prospective observational study of patients admitted to the NC Jaycees Burn Center who were intubated and on mechanical ventilation for burns and suspected inhalational injury. Subjects were enrolled over an 8-month period and followed till discharge or death. Serial bronchial washings from clinically-indicated bronchoscopies were collected and analyzed for markers of cell injury and inflammation. These markers were compared with clinical markers of ALI. RESULTS: Forty-three consecutive patients were studied, with a spectrum of burn and inhalation injury severity. Visible soot at initial bronchoscopy and gram negative bacteria in the lower respiratory tract were associated with ALI in univariate analyses. Subsequent multivariate analysis also controlled for % body surface area burns, infection, and inhalation severity. Elevated IL-10 and reduced IL-12p70 in bronchial washings were statistically significantly associated with ALI. CONCLUSIONS: Independently of several factors including initial inhalational injury severity, infection, and extent of surface burns, high early levels of IL-10 and low levels of IL-12p70 in the central airways are associated with ALI in patients intubated after acute burn/inhalation injury. Lower airway secretions can be collected serially in critically ill burn/inhalation injury patients and may yield important clues to specific pathophysiologic pathways.

  16. 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

  17. 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

  18. 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.

  19. 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.

  20. 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.