Sample records for mattresses burned torn

  1. Comparative study of a foam mattress and a water mattress

    Groen, H.W.; Groenier, K.H.; Schuling, J.


    In order to determine the effectiveness of high-quality foam replacement mattresses in the treatment of pressure ulcers, one such mattress (TheraRest) was compared with a water mattress (Secutex). One hundred and twenty nursing home patients with pressure ulcers were randomised into two groups and n

  2. Mechanical Properties of Palm Fiber Mattress

    Li, Yu-Qian; Wu, Jia-Yu; Gu, Hao-Wei; Chen, Zong-Yong; Shi, Xiao-Bing; Liao, Ting-Mao; An, Cheng; Yuan, Hong; Liu, Ren-Huai


    Palm fiber mattress is increasingly accepted by many families. This study aims at evaluating the mechanical properties of palm fiber mattress. Two experiments were conduct to investigate the Young's modulus of palm fiber mattress in three directions. In addition, finite element models were established to characterize palm fiber mattress under uniform distributed pressure. Finally, results from finite element analysis are presented to illustrate that the thick mattress will stick with human body curve perfectly, which can support vertebral column effectively.

  3. Burns

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

  4. 21 CFR 880.5560 - Temperature regulated water mattress.


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Temperature regulated water mattress. 880.5560... Therapeutic Devices § 880.5560 Temperature regulated water mattress. (a) Identification. A temperature regulated water mattress is a device intended for medical purposes that consists of a mattress of suitable...

  5. Leegitsev torn - kaasaegne katastrooffilm / Timo Diener

    Diener, Timo


    Kuidas sündis Hollywoodi esimene suur katastrooffilm "Leegitsev torn" ("The Towering Inferno") : produtsent Irwin Allen : stsenarist Stirling Silliphant : režissöör John Guillermin : peaosades Paul Newman ja Steve McQueen : Ameerika Ühendriigid 1974. Järgneb 6., 13., 20. sept. 2004, lk. 38

  6. Leegitsev torn - kaasaegne katastrooffilm / Timo Diener

    Diener, Timo


    Kuidas sündis Hollywoodi esimene suur katastrooffilm "Leegitsev torn" ("The Towering Inferno") : produtsent Irwin Allen : stsenarist Stirling Silliphant : režissöör John Guillermin : peaosades Paul Newman ja Steve McQueen : Ameerika Ühendriigid 1974. Järgneb 6., 13., 20. sept. 2004, lk. 38

  7. 75 FR 67047 - Standard for the Flammability of Mattresses and Mattress Pads


    ... sleep products (for example, mattress pads, box springs, innerspring cushions, and air-flotation sleep... unconventional ] items such as futons, crib and juvenile mattresses, and sleep sofa inserts) shipped in the... variables. Using the baseline assumptions for new prototypes versus ticking substitutions, the 50...

  8. Burns

    To help prevent burns: Install smoke alarms in your home. Check and change batteries regularly. Teach children about fire safety and the danger of matches and fireworks. Keep children from climbing on top of a stove ...

  9. Arctic hiking mattress from processed reindeer pelt

    E. Mäntysalo


    Full Text Available Quality of clothing and equipment has always been the most important matter when hiking in extreme, arctic conditions. Reindeer (Rangifer tarandus hides were processed with the aid of irreversible tannage and careful hydrophobic treatment. As a result, a processed reindeer-pelt hiking mattress was obtained, superior to the best hiking mattresses on the market made of plastic materials. Its physical properties are: weight 1.7 kg, width 60 cm and length 190 cm. The reindeer pelt has a low initial isothermal compressibility, 0.71 Pa-1, a low thermal conductivity, 0.070 Wm-1°C-1, and an R-value of 0.35 m2°CW-1. The heat-flow experimenrs have been carried our at a pressure of 810 Pa. In addition, the reindeer pelt stays dry in use because of its good ventilation. In these respects the reindeer pelr is superior to plastic mattresses.

  10. Flame retardant cotton barrier nonwovens for mattresses

    According to regulation CPSC 16 CFR 1633, every new residential mattress sold in the United States since July 2007 must resist ignition by open flame. An environmentally benign “green”, inexpensive way to meet this regulation is to use a low-cost flame retardant (FR) barrier fabric. In this study, a...

  11. 16 CFR Figures 14 and 15 to Part 1633 - Label for Domestic Mattress Alone and with Foundation and Label for Imported Mattress Alone and...


    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Label for Domestic Mattress Alone and with Foundation and Label for Imported Mattress Alone and With Foundation 14 Figures 14 and 15 to Part 1633... Domestic Mattress Alone and with Foundation and Label for Imported Mattress Alone and With...

  12. An overview of polyurethane foams in higher specification foam mattresses.

    Soppi, Esa; Lehtiö, Juha; Saarinen, Hannu


    Soft polyurethane foams exist in thousands of grades and constitute essential components of hospital mattresses. For pressure ulcer prevention, the ability of foams to control the immersion and envelopment of patients is essential. Higher specification foam mattresses (i.e., foam mattresses that relieve pressure via optimum patient immersion and envelopment while enabling patient position changes) are claimed to be more effective for preventing pressure ulcers than standard mattresses. Foam grade evaluations should include resiliency, density, hardness, indentation force/load deflection, progressive hardness, tensile strength, and elongation along with essential criteria for higher specification foam mattresses. Patient-specific requirements may include optimal control of patient immersion and envelopment. Mattress cover characteristics should include breathability, impermeability to fluids, and fire safety and not affect mattress function. Additional determinations such as hardness are assessed according to the guidelines of the American Society for Testing and Materials and the International Organization for Standardization. At this time, no single foam grade provides an optimal combination of the above key requirements, but the literature suggests a combination of at least 2 foams may create an optimal higher specification foam mattress for pressure ulcer prevention. Future research and the development of product specification accuracy standards are needed to help clinicians make evidence-based decisions about mattress use.

  13. 21 CFR 880.5550 - Alternating pressure air flotation mattress.


    ... body pressure. The device is used to prevent and treat decubitus ulcers (bed sores). (b) Classification... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Alternating pressure air flotation mattress. 880... Personal Use Therapeutic Devices § 880.5550 Alternating pressure air flotation mattress. (a) Identification...

  14. Effects of lidocaine on torn rotator cuff tendons.

    Honda, Hirokazu; Gotoh, Masafumi; Kanazawa, Tomonoshin; Nakamura, Hidehiro; Ohta, Keisuke; Nakamura, Kei-Ichiro; Shiba, Naoto


    We determined lidocaine's action on torn rotator cuff tendons in vitro and in vivo. For in vitro experiments, cell proliferation and viability assays were performed using tenocytes derived from human torn rotator cuff tendons. For in vivo experiments, acute rotator cuff tears were made on the supraspinatus tendons in the rats' bilateral shoulders; before closure, lidocaine was injected into the shoulder and saline into the contralateral shoulder (control). After sacrifice, the specimens underwent biomechanical testing or histological analysis at 24 h and at 2, 4, and 8 weeks after surgery. The extent of collagen organization and apoptosis were semi-quantitatively evaluated using collagen picrosirius red staining. Apoptosis was examined using TUNEL staining and electron microscopy. Cell proliferation decreased dose-dependently. After exposure to 0.1% lidocaine for 24 h, cell viability decreased. Two and 4 weeks after surgery, the ultimate load to failure decreased more in the lidocaine group than in the control group, with significantly reduced stiffness in the lidocaine group 2 weeks after surgery. Collagen organization significantly decreased in the lidocaine group by 4 weeks after surgery but returned to baseline at 8 weeks. TUNEL staining detected numerous apoptotic tenocytes at the torn tendon edge exposed to lidocaine 24 h after surgery; electron microscopy confirmed the condensed cell nuclei. These changes were not observed in controls. Lidocaine caused cytotoxicity to tenocytes under both conditions, decreased biomechanical properties, and induced apoptosis and delay of collagen organization in this model. Subacromial lidocaine injections in patients with rotator cuff tears should be performed carefully. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1620-1627, 2016.

  15. Microcontrolled air-mattress for ulcer by pressure prevention

    Pasluosta, Cristian F; Fontana, Juan M; Beltramone, Diego A; Taborda, Ricardo A M [Universidad Nacional de Cordoba. Cordoba (Argentina)


    An ulcer by pressure is produced when a constant pressure is exerted over the skin. This generates the collapse of the blood vessels and, therefore, a lack in the contribution of the necessary nutrients for the affected zone. As a consequence, the skin deteriorates, eventually causing an ulcer. In order to prevent it, a protocol must be applied to the patient, which is reflected on time and cost of treatment. There are some air mattresses available for this purpose, but whose performance does not fulfill all requirements. The prototype designed in our laboratory is based on the principle of the air mattress. Its objective is to improve on existing technologies and, due to an increased automation, reduce time dedication for personnel in charge of the patient. A clinical experience was made in the local Emergencies Hospital and also in an institution dedicated to aged patients care. In both cases, the results obtained and the comments from the personnel involved were favorable.

  16. Microcontrolled air-mattress for ulcer by pressure prevention

    Pasluosta, Cristian F.; Fontana, Juan M.; Beltramone, Diego A.; Taborda, Ricardo A. M.


    An ulcer by pressure is produced when a constant pressure is exerted over the skin. This generates the collapse of the blood vessels and, therefore, a lack in the contribution of the necessary nutrients for the affected zone. As a consequence, the skin deteriorates, eventually causing an ulcer. In order to prevent it, a protocol must be applied to the patient, which is reflected on time and cost of treatment. There are some air mattresses available for this purpose, but whose performance does not fulfill all requirements. The prototype designed in our laboratory is based on the principle of the air mattress. Its objective is to improve on existing technologies and, due to an increased automation, reduce time dedication for personnel in charge of the patient. A clinical experience was made in the local Emergencies Hospital and also in an institution dedicated to aged patients care. In both cases, the results obtained and the comments from the personnel involved were favorable.

  17. 16 CFR 1632.4 - Mattress test procedure.


    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Mattress test procedure. 1632.4 Section 1632.4 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION FLAMMABLE FABRICS ACT REGULATIONS STANDARD...) / hr cm2 °C/cm (0.24±0.04 Btu/hr ft2 °F/in) at 23.9 °C (75 °F). 1 1 Glass fiberboard that meets Federal...

  18. Beds, mattresses and cushions for pressure sore prevention and treatment.

    Cullum, N; Deeks, J; Sheldon, T A; Song, F; Fletcher, A W


    To assess the effectiveness of pressure relieving beds, mattresses and cushions (support surfaces) in the prevention and treatment of pressure sores. Searches of 19 databases, hand searching of journals, conference proceedings, and bibliographies. Randomised controlled trials evaluating support surfaces for the prevention or treatment of pressure sores. There was no restriction on articles based on language or publication status. Data extraction and assessment of study quality was undertaken by two reviewers independently. Trials with similar patients, comparisons, and outcomes were pooled. Where pooling was inappropriate, trials are discussed in a narrative review. 29 RCTs of support surfaces for pressure sore prevention were identified. Some high specification foam mattresses were more effective than 'standard' hospital foam mattresses in moderate-high risk patients. Pressure relieving mattresses in the operating theatre reduced the incidence of pressure sores post-operatively. The relative merits of alternating and constant low pressure, and of the different alternating pressure devices are unclear. Seat cushions and simple, constant low-pressure devices have not been adequately evaluated. Limited evidence suggests that low air loss beds reduce the incidence of pressure sores in intensive care. 6 RCTs of support surfaces for pressure sore treatment were identified. There is good evidence that air-fluidised and low air loss beds improve healing rates. Seat cushions have not been adequately evaluated. 2 RCTs evaluated surfaces for both prevention and treatment in the same trial. PREVENTION - There is good evidence of the effectiveness of high specification foam over standard hospital foam, and pressure relief in the operating theatre. Treatment - There is good evidence of the effectiveness of air-fluidised and low air loss devices as treatments. Overall, however, it is impossible to determine the most effective surface for either prevention or treatment.

  19. Simplified Knotless Mattress Repair of Type II SLAP Lesions.

    Chia, Marcus Robert; Hatrick, Cameron


    Arthroscopic repair of lesions of the superior labrum and biceps anchor has been shown to provide good to excellent results. We describe a simplified arthroscopic surgical technique using a single knotless anchor with a mattress suture configuration. This technique provides an effective and reproducible method to reattach and re-create the normal appearance of the superior labrum and biceps anchor in a time-efficient manner without the need for knot tying.

  20. Repair of the torn distal biceps tendon by endobutton fixation

    Ravi K Gupta


    Full Text Available Background: A number of techniques have been described to reattach the torn distal biceps tendon to the bicipital tuberosity. We report a retrospective analysis of single incision technique using an endobutton fixation in sports persons. Materials and Methods: The present series include nine torn distal biceps tendons in eight patients, fixed anatomically to the radial tuberosity with an endobutton by using a single incision surgical technique; seven patients had suffered the injuries during contact sports. The passage of the endobutton was facilitated by using a blunt tipped pin in order to avoid injury to the posterior interosseous nerve. The patients were evaluated by Disabilities of the Arm, Shoulder and Hand (DASH score and Mayo elbow score. Results: The average age of the patients was 27.35 years (range 21-42 years. Average follow-up was 41.5 months (range 24-102 months. The final average flexion extension arc was 0°-143°, while the average pronation and supination angles were 77° (range 70°-82° and 81° (range 78°-85°, respectively at the last followup. All the patients had a Disabilities of the Arm, Shoulder and Hand (DASH score of 0 and a Mayo elbow score of 100 each. All the seven active sports persons were able to get back to their respective game. There was no nerve injury or any other complication. Conclusions: The surgical procedure used by us is a simple, safe and reproducible technique giving minimal morbidity and better cosmetic results.

  1. Spectral analysis of snoring events from an Emfit mattress.

    Perez-Macias, Jose Maria; Viik, Jari; Varri, Alpo; Himanen, Sari-Leena; Tenhunen, Mirja


    The aim of this study is to explore the capability of an Emfit (electromechanical film transducer) mattress to detect snoring (SN) by analyzing the spectral differences between normal breathing (NB) and SN. Episodes of representative NB and SN of a maximum of 10 min were visually selected for analysis from 33 subjects. To define the bands of interest, we studied the statistical differences in the power spectral density (PSD) between both breathing types. Three bands were selected for further analysis: 6-16 Hz (BW1), 16-30 Hz (BW2) and 60-100 Hz (BW3). We characterized the differences between NB and SN periods in these bands using a set of spectral features estimated from the PSD. We found that 15 out of the 29 features reached statistical significance with the Mann-Whitney U-test. Diagnostic properties for each feature were assessed using receiver operating characteristic analysis. According to our results, the highest diagnostic performance was achieved using the power ratio between BW2 and BW3 (0.85 area under the receiver operating curve, 80% sensitivity, 80% specificity and 80% accuracy). We found that there are significant differences in the defined bands between the NB and SN periods. A peak was found in BW3 for SN epochs, which was best detected using power ratios. Our work suggests that it is possible to detect snoring with an Emfit mattress. The mattress-type movement sensors are inexpensive and unobtrusive, and thus provide an interesting tool for sleep research.

  2. Physical Therapy to Treat Torn Meniscus Comparable to Surgery for Many Patients

    ... 1999 Spotlight on Research 2013 August 2013 (historical) Physical Therapy to Treat Torn Meniscus Comparable to Surgery for ... to avoid surgery and achieve comparable relief from physical therapy, according to a recent, multisite study funded by ...

  3. Lubricin distribution in the torn human anterior cruciate ligament and meniscus.

    Zhang, Dafang; Cheriyan, Thomas; Martin, Scott D; Gomoll, Andreas H; Schmid, Thomas M; Spector, Myron


    The objective of this study was to: (1) determine the distribution of lubricin in the human torn anterior cruciate ligament (ACL) and meniscus; (2) determine the distribution of lubricin in the human intact ACL and meniscus; (3) and identify potential cellular sources of lubricin in these tissues. Ten torn ACLs and six torn menisci were obtained from surgeries; for comparison, 11 intact ACLs and 13 intact menisci were obtained from total knee replacements. Samples were formalin fixed and processed for immunohistochemical staining with a monoclonal antibody for lubricin. In torn ACLs and menisci, lubricin was generally found as a discrete layer covering the torn surface. No surface lubricin staining was found on the transected edges produced during excision. Lubricin was also found on the native surfaces of intact ACLs and menisci. In all tissues, lubricin was found in the matrix and intracellularly. The surface layer of lubricin coating torn edges of ACLs and menisci may interfere with the integrative healing process needed for repair.

  4. Geographical variation and the determinants of domestic endotoxin levels in mattress dust in Europe

    Chen, C.M.; Thiering, E.; Doekes, G.|info:eu-repo/dai/nl/070079803; Zock, J.P.|info:eu-repo/dai/nl/095184309; Bakolis, I.; Norbäck, D.; Sunyer, J.; Villani, S.; Verlato, G.; Täubel, M.; Jarvis, D.


    Endotoxin exposures have manifold effects on human health. The geographical variation and determinants of domestic endotoxin levels in Europe have not yet been extensively described. To investigate the geographical variation and determinants of domestic endotoxin concentrations in mattress dust in

  5. Burn Pits

    ... Enter ZIP code here Enter ZIP code here Burn Pits Burn Pits Registry Studies Photo: U.S. Department ... the health of deployed Veterans. Health effects from burn pit smoke Toxins in burn pit smoke may ...

  6. Burn Institute

    ... Now Help keep local seniors safe from fire! Burn Survivor Support If you are reading this, chances ... year – a burn injury. Learn more Fire and Burn Prevention Each year, the Burn Institute provides fire ...

  7. A Study to Investigate the Sleeping Comfort of Mattress using Finite Element Method

    Yoshida, Hiroaki; Kamijo, Masayoshi; Shimizu, Yoshio

    Sleep is an essential physiological activity for human beings and many studies have so far investigated sleeping comfort of mattresses. The appropriate measurement of stress distribution within the human body would provide valuable information to us. For the appropriate measurement to estimate stress distribution within the human body, numerical analysis is considered one of the most desirable techniques, and Finite Element Method (FEM), which is widely accepted as a useful numerical technique, was utilized in this study. Since human body dimensions have individual differences, however, it is presumed that the way of the internal stress distribution also changes due to the differences and that the mattress preference varies among different body forms. Thus, we developed three human FEM models reproducing the body forms of three types of male subjects, and investigated the sleeping comfort of mattress based on the relationship between FEM analysis findings and sensory testing results. In comparison with the results of both FEM analysis and sensory testing in the neck region, we found, the sensory testing results corresponded to the FEM analysis findings, and it was possible to estimate subjects' preferences of mattress and comfort in the neck region using the FEM analysis. In this study, we believe, the FEM analysis managed to quantify the subjects' preferences for mattress and to prove itself that it is the valuable tools to examine the sleeping comfort of mattress.

  8. Hollywood lõikab filmidest purunenud torne välja / Malle Pajula

    Pajula, Malle, 1971-


    Seoses 11. septembri terrorirünnakuga lõigatakse ekraanile tulevatest filmidest välja lõike, mis kujutavad tänaseks kokku varisenud Kaubanduskeskuse torne ning hoitakse kinni esilinastusi, mis võiksid olla liiga valusad hukkunute omastele

  9. Hollywood lõikab filmidest purunenud torne välja / Malle Pajula

    Pajula, Malle, 1971-


    Seoses 11. septembri terrorirünnakuga lõigatakse ekraanile tulevatest filmidest välja lõike, mis kujutavad tänaseks kokku varisenud Kaubanduskeskuse torne ning hoitakse kinni esilinastusi, mis võiksid olla liiga valusad hukkunute omastele

  10. Does a foamy-block mattress system prevent pressure sores ? A prospective randomised clinical trial in 1729 patients.

    Berthe, J V; Bustillo, A; Mélot, C; de Fontaine, S


    Pressure ulcers are a frequent complication of bed rest. The development of an efficient and low cost pressure relieving system for the prevention of bed-sores would be of considerable hospital health and economic interest. Our study was designed to determine the effectiveness in pressure-sore prevention of an interface pressure-decreasing mattress, the Kliniplot mattress, used in our institution since 1978. In a prospective randomised controlled 7-month clinical trial we compared the Kliniplot mattress with our standard hospital mattress in 1729 patients admitted to medical and surgical departments (neurology, cardiology, oncology-haematology, neurosurgery, thoracic surgery and orthopaedic surgery). Two groups (Klinipot mattress and standard hospital mattress) were monitored for the prevention of pressure sores. The patients were evaluated on a daily basis from their admission until the eventual occurrence of a bed-sore. Patients' characteristics and pressure-sore risk factors were similar at the baseline in both groups. Patients presenting with a pressure sore at the time of admission were excluded. Forty-two of the 1729 patients (2.4%) who entered the study developed at least one pressure sore. Twenty-one of the 657 patients (3.2%) nursed on the Kliniplot mattress, and 21 of the 1072 patients (1.9%) on the standard mattress developed bed-sores (p = 0.154). The median time for the occurrence of pressure sores was 31 days (range 6-87) with the Kliniplot mattress and 18 days (range 2 to 38) with the standard mattress (p sores using the modified Ek's scale were no different at the baseline between both groups (p = 0.764). The severity of the pressure sores was no different between both groups (p = 0.918). Our results show that the occurrence of pressure sores is not reduced but is delayed when patients are nursed on a Kliniplot pressure-decreasing mattress.

  11. Simulation of temperature and humidity in mattresses to evaluate risks on house dust mite allergy

    Van Ginkel, J.T. [OTB Research Inst. for Housing, Urban and Mobility Studies, Delft (Netherlands). Dept. of Sustainable and Healthy Housing


    Mattresses and carpets in bedrooms are the main habitats of house dust mites in thermally well-insulated homes. The major source of allergens are the feces of house mites which feed on human skin scales and which extract vapour from the air by hygroscopic secretion. The critical equilibrium humidity (CEH) is the relative humidity at which the rate of water loss is equal to the rate of water uptake. House dust mites live in human habitats where the relative humidity is greater than the CEH. This paper presents a newly developed simulation model which shows the transient and spatial distribution of temperature and humidity levels in a mattress influenced by skin scales and ambient conditions. It was developed in an attempt to reduce risks on house dust mite allergy from mattresses and carpets. Preliminary results indicate that transmission of water vapour occurs much faster than the transmission of heat. It was suggested that a spring mattress has a lower risk for growth of house mites than a foam mattress. 21 refs., 1 tab., 3 figs.

  12. House dust mites and their allergens in Danish mattresses -- results from a population based study

    Sidenius, Kirsten E; Hallas, Thorkil E; Poulsen, Lars K.


    The purpose of this study was to identify the level of house dust mites (HDMs) and their allergens in mattresses, not selected on their owners atopic status, and to find associated factors. Dust was collected from 68 mattresses. The recruitment was population-based and conducted during the screen......The purpose of this study was to identify the level of house dust mites (HDMs) and their allergens in mattresses, not selected on their owners atopic status, and to find associated factors. Dust was collected from 68 mattresses. The recruitment was population-based and conducted during...... the screening phase of a HDM intervention study. The visited persons declared to have had a "cold" bedroom the previous winter. HDMs were counted and dust was analysed by ELISA for Der 1 (= Der f 1+ Der p 1+ Der m 1). Multiple regression analysis was carried out to find housing conditions associated with high...... HDM levels. Type of housing, mattress age and self-assessed winter bedroom-temperature explained 47% of Der 1. Median concentrations were 3.77 microg Der 1/g and 1 HDM/0.1 g dust. Both immunochemically and microscopically Dermatophagoides farinae was dominant; D. pteronyssinus less frequent...

  13. A 6 month evaluation of a non-powered hybrid mattress replacement system.

    Newton, Heather


    In 2013, the Royal Cornwall Hospitals NHS Trust undertook a 6-week evaluation of the AtmosAir 4000 non-powered reactive pressure redistribution mattress replacement system to determine its suitability in supporting the prevention of pressure ulcers in high-risk patients (phase one). The results demonstrated that the AtmosAir 4000 mattress system, together with skin assessment and repositioning regimes, met the pressure ulcer preventative needs of patients at high and very high risk of developing pressure ulcers. It also resulted in a notable reduction in the use of dynamic air mattresses. Consequently, 50 AtmosAir 4000 mattresses were purchased for two acute medical wards in the evaluation site, where the majority of patients are elderly with an acute medical condition. This article discusses the second phase where an audit compares the number of hospital-acquired pressure ulcers reported over a 6-month period with the equivalent time period in 2014. Results show that the number of pressure ulcers reduced by 65% and 50% in the two wards. The number of dynamic mattresses used on the two wards reduced significantly from 28 to 7, which represents a 75% reduction in usage.

  14. Isocyanate emissions from pyrolysis of mattresses containing polyurethane foam.

    Garrido, María A; Gerecke, Andreas C; Heeb, Norbert; Font, Rafael; Conesa, Juan A


    This study examined the emissions of powerful asthmatic agents called isocyanates from small-scale pyrolysis experiments of two common foams employed in mattress production such as flexible polyurethane foam (FPUF) and viscoelastic memory foam (VMF). A nitrogen atmosphere and five different temperatures, 300, 350, 400, 450 and 850 °C, were selected to carry out the experiments in order to evaluate the worst possible conditions for thermal degradation. A similar trend for both materials was found. At lower temperatures, diisocyanates were the most important products whereas at 850 °C monoisocyanates, and mainly isocyanic acid released mainly from the thermal cracking of diisocyanates evolved directly from the polymer chains. The total yields of isocyanates were in the range of 1.43-11.95 mg/m(3) for FPUF at 300-850 °C and 0.05-6.13 mg/m(3) for VMF, 300-850 °C. This difference could be a consequence of the lower amount of isocyanates employed in the VMF production which was confirmed by the nitrogen content of the foams, 5.95% FPUF vs. 3.34% in VMF. Additionally, a qualitative search for so far unknown isocyanates was performed in samples from the pyrolysis of FPUF at 300, 400 and 850 °C. It was confirmed that six different aminoisocyanates at 300 °C were evolved, whereas at 400 and 850 °C only five of them were detected. The general trend observed was a decrease of the aminoisocyanate levels with increasing pyrolysis temperature.

  15. 16 CFR Figure 8 to Part 1633 - Jig for Setting Mattresses and Foundation Sides in Same Plane


    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Jig for Setting Mattresses and Foundation Sides in Same Plane 8 Figure 8 to Part 1633 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION.... 8 Figure 8 to Part 1633—Jig for Setting Mattresses and Foundation Sides in Same Plane ER15MR06.007...

  16. A study of the behaviour of and the forces in a bed protecting mattress: the falling apron

    Vrijling, J.K.; Ravenstijn, P.


    In many cases the bottom around a structure that is exposed to current has to be protected by a mattress. The purpose of the mattress is to protect the soil besides the structure from erosion and scour, thus preserving the strength of the foundation of the structure. Examples are the bottom protecti

  17. Bedding on geotextile mattresses: how much is needed to improve cow comfort?

    Tucker, C B; Weary, D M


    The objective of our study was to evaluate how the amount of sawdust bedding on mattresses affects dairy cattle behavior and preferences. Eleven nonlactating, multiparous cows were housed individually in pens with access to 3 free stalls. Each stall was fitted with a geotextile mattress covered with either 0, 1, or 7.5 kg of kiln-dried sawdust. The experiment began with 7 d of acclimatization to all 3 stalls. Cows were then allowed access to only 1 of the 3 stalls at a time, each for 3 d (restriction phase). At the end of this restriction phase, cows were allowed free access to all 3 stalls for 3 d (free-choice phase). Time spent lying and the number of lying bouts increased significantly with the amount of bedding, from 12.3 +/- 0.53 h lying and 8.5 +/- 0.62 bouts per 24 h on bare mattresses to 13.8 +/- 0.53 h lying and 10.0 +/- 0.62 bouts per 24 h on mattresses with 7.5 kg of sawdust. In addition, the animals spent less time standing with only the front hooves in the stalls when more sawdust was present. When allowed free access to all 3 options, all 11 animals spent a majority of their time lying and standing in the 7.5-kg option. In conclusion, cows preferred mattresses bedded with 7.5 kg of sawdust, on which they spent more time lying down and less time standing with only the front hooves in stalls. These results indicate that more sawdust bedding improves cow comfort in stalls with geotextile mattresses.

  18. Evaluation of free-stall mattress bedding treatments to reduce mastitis bacterial growth

    Kristula, M.A.; Dou, Z.; Toth, J.D.; Smith, B.I.; Harvey, N.; Sabo, M. [University of Penn, Kennett Square, PA (United States)


    Bacterial counts were compared in free-stall mattresses and teat ends exposed to 5 treatments in a factorial study design on 1 dairy farm. Mattresses in five 30-cow groups were subjected to 1 of 5 bedding treatments every other day: 0.5 kg of hydrated limestone, 120 mL of commercial acidic conditioner, 1 kg of coal fly ash, 1 kg of kiln-dried wood shavings, and control (no bedding). Counts of coliforms, Klebsiella spp., Escherichia coli, and Streptococcus spp. were lowest on mattresses bedded with lime. Mattresses bedded with the commercial acidic conditioner had the next lowest counts for coliforms, Klebsiella spp., and Streptococcus spp. Wood shavings and the no-bedding control had the highest counts for coliform and Klebsiella spp. Compared with wood shavings or control, fly ash reduced the counts of coliforms, whereas for the other 3 bacterial groups, the reduction was not always significant. Streptococcus spp. counts were greatest in the control group and did not differ among the shavings and fly ash groups. Teat swab results indicated that hydrated lime was the only bedding treatment that significantly decreased the counts of both coliforms and Klebsiella spp. There were no differences in Streptococcus spp. numbers on the teats between any of the bedding treatments. Bacterial populations grew steadily on mattresses and were generally higher at 36 to 48 h than at 12 to 24 h, whereas bacterial populations on teats grew rapidly by 12 h and then remained constant. Hydrated lime was the only treatment that significantly reduced bacterial counts on both mattresses and teat ends, but it caused some skin irritation.

  19. Effect of mattress and pillow encasings on children with asthma and house dust mite allergy

    Halken, Susanne; Høst, Arne; Niklassen, Ulla


    BACKGROUND: House dust mite (HDM) allergy is a frequent cause of allergic asthma in children. Reduction of exposure seems to be the most logical way to treat these patients. OBJECTIVE: Our aim was to investigate whether mattress and pillow encasings resulted in an effective long-term control of HDM...... allergen levels, thereby reducing the need for asthma medication in children with asthma and HDM allergy. METHODS: In a prospective, double-blind, placebo-controlled study 60 children (age range, 6-15 years) with asthma and HDM allergy were randomized to active (allergy control) or placebo mattress...... children with asthma and HDM allergy....

  20. Effect of mattress and pillow encasings on children with asthma and house dust mite allergy

    Halken, Susanne; Høst, Arne; Niklassen, Ulla


    BACKGROUND: House dust mite (HDM) allergy is a frequent cause of allergic asthma in children. Reduction of exposure seems to be the most logical way to treat these patients. OBJECTIVE: Our aim was to investigate whether mattress and pillow encasings resulted in an effective long-term control of H...

  1. Geographical variation and the determinants of domestic endotoxin levels in mattress dust in Europe

    Chen, C.M.; Thiering, E.; Doekes, G.; Zock, J.P.; Bakolis, I.; Norbäck, D.; Sunyer, J.; Villani, S.; Verlato, G.; Täubel, M.; Jarvis, D.


    Endotoxin exposures have manifold effects on human health. The geographical variation and determinants of domestic endotoxin levels in Europe have not yet been extensively described. To investigate the geographical variation and determinants of domestic endotoxin concentrations in mattress dust in E

  2. Scald Burns

    Safety Tips & Info Scald Burns Thousands of scald burns occur annually, and ALL are preventable! The two high-risk populations are children under the age ... the single most important factor in preventing scald burns. Increased awareness is the key to scald prevention! ...

  3. The primary factor for suture configuration at rotator cuff repair: Width of mattress or distance from tear edge

    Onur Hapa


    Conclusion: Bite size from the edge of the tendon seems to be more important than the width of the mattress. The curve of the suture passing device may also have an effect on the strength of the suture tendon interface.

  4. Burn Rehabilitation

    Koray Aydemir


    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


    G. Babaee


    Full Text Available Evaluated under laboratory condition. The objective of the present study was to observe the effect of impregnated torn bednets on the number of bites by An. culicifacies A glass made tunnel test was designed to The effect of torn bednets treated with three dosages of cyfluthrin 5% EW, were induce hungry female mosquitoes to pass through holes cut in the pyrethroid treated nets. A guinea pig used as bait to attract mosquitoes through circular holes in the netting. With untreated netting, 72-87% of laboratory-reared females passed through the holes overnight, 64-92% blood-fed successfully and 0.3/9-4/3% died. When the netting was treated with cyfluthrin at doses of 25, 50 and 100 mg a.i./m2, the entry Index (the proportions that passed through the holes overnight were 43.37%, 42.82% and 24.72%; mortality rates were 66.31%, 81.45% and 95.99%; and the feeding rate were 45%, 27% and 3%. In conclusion it should be stressed that efficacy of pyrethroid impregnated bednets using “Tunnel Tests” showing acceptable protection rate both in lower and higher dosages as well as cause dead in the blood-fed mosquitoes. In addition, the higher dosages of these three dosages pyrethroid provided good levels of protection against An. culicifacies.

  6. Torn human rotator cuff tendons have reduced collagen thermal properties on differential scanning calorimetry.

    Chaudhury, Salma; Holland, Christopher; Porter, David; Tirlapur, Uday K; Vollrath, Fritz; Carr, Andrew J


    The cause of the high failure rates often observed following rotator cuff tendon repairs, particularly massive tears, is not fully understood. Collagen structural changes have been shown to alter tendon thermal and mechanical properties. This study aimed to form a quantitative rather than qualitative assessment, of whether differences in collagen structure and integrity existed between small biopsies of normal, small, and massive rotator cuff tears using differential scanning calorimetry. Thermal properties were measured for 28 human biopsies taken intra-operatively from normal, small, and massive rotator cuff tendon tears in this powered study. Denaturation temperatures are represented by T(onset) (°C) and T(peak) (°C). The T(onset) is proposed to represent water-amide hydrogen bond breakage and resulting protein backbone mobility. T(peak) reportedly corresponds to the temperature at which the majority of proteins fall out of solution. Denaturation enthalpy (ΔH) should correlate with the amount of triple helical structure that is denatured. Fluorescence and confocal microscopy allowed quantitative validation. Small and massive rotator cuff tears had significantly higher T(onset), T(peak), and ΔH compared to controls. Polarized light microscopy of torn tendons confirmed greater collagen structural disruption compared to controls. These novel findings suggest greater quantifiable collagen structural disruption in rotator cuff tears, compared to controls. This study offers insight into possible mechanisms for the reduced strength of torn tendons and may explain why repaired tendons fail to heal.

  7. Interpreting positive signs of the supraspinatus test in screening for torn rotator cuff.



    Full Text Available The purpose of this study was to investigate the validity of the supraspinatus test as a screening test for detecting torn rotator cuff and to determine what its valuable positive signs were. Both the empty-can test and full-can test were performed on 200 shoulders diagnosed by magnetic resonance imaging (MRI-and in some cases, surgical findings-to have full-thickness or partial-thickness torn rotator cuff s, or no tear in the rotator cuff . During the maneuver, the presence of pain or weakness or both pain and weakness were recorded as positive signs, and the distribution of these signs were analyzed according to the degree of tear. The predictive values were calculated in 2 ways by considering (1 only full-thickness tears as tears and (2 both full- and partial-thickness tears as tears. The 2 tests and the 2 ways of considering partial-thickness tears were compared. Pain and weakness were severity-dependent, and the empty-can test had a higher incidence of pain. The sensitivities of the 2 supraspinatus tests in all positive signs were higher when including partial-thickness tears in the tear group ; however, their specificities were higher when excluding partial-thickness tears. Both pain and weakness were interpretive for the supraspinatus test, and both tests were sensitive to full- and partial- thickness tears and specific for full-thickness tears.

  8. Facilitating mental health screening of war-torn populations using mobile applications.

    Hashemi, Bahar; Ali, Sara; Awaad, Rania; Soudi, Laila; Housel, Lawrence; Sosebee, Stephen J


    War-torn populations are often hard to screen for mental health disorders. Classical data collection approaches, such as paper-based, online, or SMS-operated, are either infeasible or lack accuracy due to a variety of challenges associated with dynamics and consequences of war. In this paper, we introduce a novel approach for accurate and fast screening using free open-source software, Open Data Kit (ODK) mobile application. This approach was developed by the Palestine Children's Relief Fund (PCRF) to assess the mental health symptoms of 986 Palestinian children (age 6-18) in the aftermath of Israel's Operation Protective Edge (OPE) in 2014. The organization developed assessment questionnaires and trained local field workers on the use of the mobile application, and on recruiting and interviewing war victims. War-affected children were found to suffer from several alarming symptoms associated with post-traumatic stress disorder (PTSD), depression, and somatic symptoms. Children with highest number of psychological symptoms were referred for further evaluation and treatment. The use of ODK mobile technologies facilitated efficient screening of affected children in war zones. The offline data collection capability was crucial for handling the difficult conditions associated with war-torn areas, enabling timely intervention for urgent cases. Further applications of the novel mobile technology are to be explored.

  9. A method of comparing effectiveness of mattresses for pressure management for pediatric patients.

    Milbrath, Christine D; Linroth, Ronna; Wilhelmy, Jennifer; Pate, April


    A systematic review of the pressure management performance of support surfaces (beds, mattresses, overlays, and the utilization of linens), using a standardized testing methodology, provided qualitative and quantitative information needed to support cost-effective purchasing decisions and resulted in the reduction of hospital-acquired pressure ulcers. In the 30 months since implementation of the new surfaces, use guidelines, and educational programs, zero surface-related stage 3, 4 and unstaged pressure ulcers have occurred despite a high-risk patient population.

  10. A randomized trial of exothermic mattresses for preterm newborns in polyethylene bags.

    McCarthy, Lisa K


    Hypothermia on admission to the NICU is associated with increased mortality in preterm infants. Many newborns are hypothermic on admission despite using polyethylene bags (PBs). Using exothermic mattresses (EMs) in addition to PBs may reduce hypothermia but increase hyperthermia. We wished to determine whether placing preterm newborns in PBs on EMs in the DR results in more infants with rectal temperature outside the range 36.5 to 37.5°C on NICU admission.

  11. An Enhanced Sensing Application Based on a Flexible Projected Capacitive-Sensing Mattress

    Wen-Ying Chang


    Full Text Available This paper presents a cost-effective sensor system for mattresses that can classify the sleeping posture of an individual and prevent pressure ulcers. This system applies projected capacitive sensing to the field of health care. The charge time (CT method was used to sensitively and accurately measure the capacitance of the projected electrodes. The required characteristics of the projected capacitor were identified to develop large-area applications for sensory mattresses. The area of the electrodes, the use of shielding, and the increased length of the transmission line were calibrated to more accurately measure the capacitance of the electrodes in large-size applications. To offer the users comfort in the prone position, a flexible substrate was selected and covered with 16 × 20 electrodes. Compared with the static charge sensitive bed (SCSB, our proposed system-flexible projected capacitive-sensing mattress (FPCSM comes with more electrodes to increase the resolution of posture identification. As for the body pressure system (BPS, the FPCSM has advantages such as lower cost, higher aging-resistance capability, and the ability to sense the capacitance of the covered regions without physical contact. The proposed guard ring design effectively absorbs the noise and interrupts leakage paths. The projected capacitive electrode is suitable for proximity-sensing applications and succeeds at quickly recognizing the sleeping pattern of the user.

  12. Sterilization using ozone-ion gas sterilization using ozone-ion gas for mattresses used by the elderly; Ozone ion kunjoho ni kansuru kenkyu. Ozone ion kunjoho no zaitaku kaigoyo mattress mekkin eno oyo

    Mikami, H.; Suzuki, A.; Hamasaki, H. [Shinryo Corp., Tokyo (Japan); Ishikawa, S.; Miyata, M.; Nanba, T. [Kitasato Univ., Tokyo (Japan); Sueyoshi, K. [Mitsubishi Research Institute Inc., Tokyo (Japan)


    The new generation of Japanese is facing an aging society: the number of young people is decreasing dramatically, while the number of elderly is increasing. Consequently, care for the elderly has become a big problem. One particular problem area we`ve investigated is the use of unclean mattresses by the bedridden elderly. These mattresses provide an all too excellent environments for the growth of microbes. We measured the density of microbes on the cover of mattresses at 775cfu/cm{sup 2} and in the bed filling at 136cfu/g. The dominant species of microbes were MRSA and Bacillus. We used MRSA, Bacillus subtilis and Escherichia coli as biological indicators and tested whether our system using ozone-ion fumigants was applicable for sterilization of mattresses. The survival ratio of MRSA were 10{sup -8} {approx} 10{sup -9}, 10{sup -7} {approx} 10{sup -8} for B. subtilis and below 10{sup -8} for E. coli. These experiments made it clear that our system is applicable for sterilization of the mattresses used by bedfast elderly. (author)

  13. Sit Down with Sabin: Margaret Torn: The Carbon Cycle Like You've Never Seen It (LBNL Summer Lecture Series)

    Russell, Sabin; Torn, Margaret


    Lawrence Berkeley National Laboratory soil scientist Margaret Torn appears July 6, 2011 on "Sit Down with Sabin," a weekly conversation in which former reporter Sabin Russell chats with Berkeley Lab staff about innovative science. Torn discusses how she travels the world to learn more about soil's huge role in the global carbon cycle. Brought to you by Berkeley Lab Public Affairs.

  14. In Vivo Shoulder Function After Surgical Repair of a Torn Rotator Cuff

    Bey, Michael J.; Peltz, Cathryn D.; Ciarelli, Kristin; Kline, Stephanie K.; Divine, George W.; van Holsbeeck, Marnix; Muh, Stephanie; Kolowich, Patricia A.; Lock, Terrence R.; Moutzouros, Vasilios


    Background Surgical repair of a torn rotator cuff is based on the belief that repairing the tear is necessary to restore normal glenohumeral joint (GHJ) mechanics and achieve a satisfactory clinical outcome. Hypothesis Dynamic joint function is not completely restored by rotator cuff repair, thus compromising shoulder function and potentially leading to long-term disability. Study Design Controlled laboratory study and Case series; Level of evidence, 4. Methods Twenty-one rotator cuff patients and 35 control participants enrolled in the study. Biplane radiographic images were acquired bilaterally from each patient during coronal-plane abduction. Rotator cuff patients were tested at 3, 12, and 24 months after repair of a supraspinatus tendon tear. Control participants were tested once. Glenohumeral joint kinematics and joint contact patterns were accurately determined from the biplane radiographic images. Isometric shoulder strength and patient-reported outcomes were measured at each time point. Ultrasound imaging assessed rotator cuff integrity at 24 months after surgery. Results Twenty of 21 rotator cuff repairs appeared intact at 24 months after surgery. The humerus of the patients’ repaired shoulder was positioned more superiorly on the glenoid than both the patients’ contralateral shoulder and the dominant shoulder of control participants. Patient-reported outcomes improved significantly over time. Shoulder strength also increased over time, although strength deficits persisted at 24 months for most patients. Changes over time in GHJ mechanics were not detected for either the rotator cuff patients’ repaired or contralateral shoulders. Clinical outcome was associated with shoulder strength but not GHJ mechanics. Conclusion Surgical repair of an isolated supraspinatus tear may be sufficient to keep the torn rotator cuff intact and achieve satisfactory patient-reported outcomes, but GHJ mechanics and shoulder strength are not fully restored with current

  15. [Mites in mattress dust and relevant environmental factors in student dormitories in Shenzhen].

    Wang, Bin; Wu, Jie; Liu, Zhi-gang; Ran, Pi-xin; Gao, Qiao; Luo, Chun-hui; Ai, Mei


    Three hundred and eight mattress dust samples were collected from college dormitories in Shenzhen with a mite prevalence of 88% (271/308). From the samples, 6163 mites were isolated and identified. Dermatophagoides farinae, D. pteronyssinus and Blomia tropicalis were three most abundant species, occupying 29.7%, 21.7% and 17.9%, respectively. It was found that sex of the students, mattress cover (bamboo mat or bed sheet), with or without air conditioner installation, and daily using of air conditioner (8 h) had no significant influence on the mite prevalence (P>0.05). However, logistic regression analysis revealed that the risk of mite sensitization in male student dormitory was significantly lower than that in female dormitory (OR=0.55, P=0.038), and the risk of using bed sheets was significantly higher than using bamboo mats (OR=2.13, P=0.040). Both mite prevalence and the risk of mite sensitization significantly decreased with higher floor of the dormitory building.

  16. Rehabilitation of a partially torn distal triceps tendon after platelet rich plasma injection: a case report.

    Cheatham, Scott W; Kolber, Morey J; Salamh, Paul A; Hanney, William J


    Platelet Rich Plasma (PRP) is an emerging non-surgical intervention used for the treatment of tendon and ligament pathology. Despite the growing popularity of PRP in musculoskeletal medicine, there is a paucity of research that describes appropriate rehabilitation procedures following this intervention. This case report presents the rehabilitation strategy used following a PRP injection for a patient with a partially torn distal triceps tendon who previously failed physical therapy interventions. The patient returned to light weight training and coaching activity after completing 15 visits over a 3 month period. One month after discharge, the patient reported pain-free activities of daily living and a return to previously performed gym activities. PRP presents a viable treatment option for individuals who are recalcitrant to conservative interventions yet elect to avoid more invasive surgical measures. Despite the growing popularity of PRP, a paucity of evidence exists to guide physical therapists in the rehabilitation process of these patients. The rehabilitation strategies used in a patient who had a PRP injection for a partial triceps tendon tear are outlined. Although this case report highlights a successful rehabilitation outcome, future research regarding the concomitant effects of PRP injection and rehabilitation for tendon pathology are needed. 4-Case Report.

  17. Stock-outs, uncertainty and improvisation in access to healthcare in war-torn Northern Uganda.

    Muyinda, Herbert; Mugisha, James


    Stock-outs, also known as shortages or complete absence of a particular inventory, in public health facilities have become a hallmark in Uganda's health system making the notions of persistent doubt in access to healthcare - uncertainty, and doing more with less - 'improvisation', very pronounced. The situation becomes more critical in post-conflict areas with an over whelming burden of preexisting and conflict-related ailments amidst weak health systems. Particularly in the war-torn Northern Uganda, the intersection between the effects of violent conflict and shortage of medications is striking. There are problems getting the right type of medications to the right people at the right time, causing persistent shortages and uncertainty in access to healthcare. With reference to patients on Antiretroviral Therapy (ART), we present temporal trends in access to healthcare in the context of medication shortages in conflict-affected areas. We examine uncertainties in access to care, and how patients, medical practitioners, and the state - the key actors in the domain of supplying and utilizing medicines, respond. Our observation is that, while improvisation is a feature of biomedicine and facilitates problem solving in daily life, it is largely contextual. Given the rapidly evolving contexts and social and professional sensitivities that characterize war affected areas, there is a need for deliberate healthcare programs tailored to the unique needs of people and to the shaping of appropriate policies in post-conflict settings, which call for more North-South collaboration on equal terms. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Visualization of torn anterior cruciate ligament using 3-dimensional computed tomography

    Hiroaki Uozumi


    Full Text Available Recently, a remnant-preserving anterior cruciate ligament (ACL reconstruction technique has been developed. However, the pre-operative condition of remnant ACL is occasionally difficult to evaluate by magnetic resonance imaging. The purpose of this study is to evaluate the accuracy of pre-operative visualization of remnant ACL using three-dimensional computed tomography (3D-CT. The remnant ACL in 25 patients was examined by 3D-CT before ACL reconstruction surgery. Findings on 3D-CT images and arthroscopy were compared. The 3D-CT images were classified into 4 groups: Group A, remnant fibers attached to the posterior cruciate ligament (PCL; Group B, those located between the PCL and the lateral wall; Group C, those attached to the lateral wall; and Group D, no identifiable remnant fibers on the tibial side. These groups were made up of 4, 3, 9 and 9 patients, respectively. Findings on 3D-CT images were identical to those during arthroscopy in 20 of 25 cases (80%. Remnant ACL can be accurately evaluated using 3D-CT in 80% of cases of torn ACL. This novel method is a useful technique for pre-operative assessment of remnant ACL.

  19. Mattress encasings and mite allergen levels in the Prevention and Incidence of Asthma and Mite Allergy study

    van Strien, RT; Koopman, LP; Kerkhof, M; Oldenwening, M; de Jongste, JC; Gerritsen, J; Neijens, HJ; Aalberse, RC; Smit, HA; Brunekreef, B


    Background Reduction of allergen exposure from birth may reduce sensitization and subsequent allergic disease. Objective To measure the influence of mite allergen-impermeable mattress encasings and cotton placebo encasings on the amount of dust and mite allergen in beds. Methods A total of 810 child

  20. Mattress encasings and mite allergen levels in the Prevention and Incidence of Asthma and Mite Allergy study

    van Strien, RT; Koopman, LP; Kerkhof, M; Oldenwening, M; de Jongste, JC; Gerritsen, J; Neijens, HJ; Aalberse, RC; Smit, HA; Brunekreef, B


    Background Reduction of allergen exposure from birth may reduce sensitization and subsequent allergic disease. Objective To measure the influence of mite allergen-impermeable mattress encasings and cotton placebo encasings on the amount of dust and mite allergen in beds. Methods A total of 810 child

  1. The 8-year follow-up of the PIAMA intervention study assessing the effect of mite-impermeable mattress covers

    Gehring, U.|info:eu-repo/dai/nl/304831344; de Jongste, J.C.; Kerkhof, M.; Oldewening, M.; Postma, D.; van Strien, R.T.; Wijga, A.H.; Willers, S.M.|info:eu-repo/dai/nl/304834696; Wolse, A.; Gerritsen, J.|info:eu-repo/dai/nl/336510160; Smit, H.A.; Brunekreef, B.|info:eu-repo/dai/nl/067548180


    Background: Exposure to high levels of house dust mite (HDM) allergens is associated with the development of allergic sensitization to HDM, a risk factor for the development of asthma, rhinitis, and allergic dermatitis. We studied the effect of an early intervention with mite-impermeable mattress co

  2. Finite element modeling for predicting the contact pressure between a foam mattress and the human body in a supine position.

    Lee, Wookjin; Won, Byeong Hee; Cho, Seong Wook


    In this paper, we generated finite element (FE) models to predict the contact pressure between a foam mattress and the human body in a supine position. Twenty-year-old males were used for three-dimensional scanning to produce the FE human models, which was composed of skin and muscle tissue. A linear elastic isotropic material model was used for the skin, and the Mooney-Rivlin model was used for the muscle tissue because it can effectively represent the nonlinear behavior of muscle. The contact pressure between the human model and the mattress was predicted by numerical simulation. The human models were validated by comparing the body pressure distribution obtained from the same human subject when he was lying on two different mattress types. The experimental results showed that the slope of the lower part of the mattress caused a decrease in the contact pressure at the heels, and the effect of bone structure was most pronounced in the scapula. After inserting a simple structure to function as the scapula, the contact pressure predicted by the FE human models was consistent with the experimental body pressure distribution for all body parts. These results suggest that the models proposed in this paper will be useful to researchers and designers of products related to the prevention of pressure ulcers.

  3. [Arthroscopic Bankart lesion repair by double-row vertical mattress suture with anchors for anteroinferior glenohumeral instability].

    Tang, Kang-Lai; Chen, Guang-Xing; Guo, Lin; Gong, Ji-Cheng; Zhou, Bing-Hua; Yang, Hui-Feng; Gu, Ling-Chuan; Li, Hong-Zhi; Yang, Liu; Xu, Jian-Zhong


    To introduce a new arthroscopic Bankart repair by vertical mattress suture with anchors, and to evaluate its clinical effectiveness. A new arthroscopic Bankart repair by vertical mattress suture with anchors was performed, including to insert only 2 anchors at 3 o'clock and 5 o'clock position and make vertical mattress suture of labrum-ligament complex at 2, 4 and 6 o'clock of labrum, and to shift up the anterior-inferior capsule. Nine cases of anterior glenohumeral instability without severe glenoid bone defect were followed-up for an average period of 14 months (range from 6 to 26 months). The average surgery age was 28 years (range from 21 to 46 years). The average surgery time was 51 min (40 - 75 min). Clinical scores as evaluated by the modified Rowe score advanced from 40 +/- 16 points to 92 +/- 19 points (75 - 94). There was no any recurrence and complication. External rotation was reduced by 5 degrees at 0 degrees adduction and by 3 degrees at 90 degrees of abduction. The arthroscopic Bankart repair by vertical mattress suture with anchors for anteroinferior glenohumeral instability is favorable as an easy, short-time surgery with excellent clinical results in short-term follow-up.

  4. Economic assessment of pressure sore prevention using a computerized mattress system in patients with spinal cord injury.

    Catz, Amiram; Zifroni, Avi; Philo, Ora


    To assess the economic profitability of a new computerized mattress system in patients with spinal cord injuries (SCI) by comparison with two other alternatives, as an example of the use of a quantitative approach for decision-making in choosing between alternatives for sore prevention. The cost of achieving one day without signs of impending pressure sore was compared between the alternative options using cost minimization analysis. Savings in nursing costs for the three options were calculated for cost-benefit analysis. A foam mattress system is significantly cheaper than the other examined alternatives, and if the nursing manpower cost is constant and the nursing staff is capable of performing sufficient repositioning, this system would achieve the desired medical outcome at a minimal cost. However, if the nursing staff cannot perform sufficient repositioning, or if the use of nursing manpower can be adjusted to the actual need, then it is the computerized mattress system that achieves the desired outcome at the minimal cost. In this case, less than 20 New Israeli Shekels (NIS) per day spent on the equipment save NIS 45 per day in labor costs. The economic evaluation indicates that the computerized mattress system is advisable for patients with SCI who require assistance for repositioning, but its profitability depends on the employment terms of the nursing manpower. In addition, other possible alternative pressure management systems should be examined, and additional research may be needed to determine the optimal combination of such systems for a spinal cord rehabilitation department.

  5. A quantitative analysis of microcirculation in sore-prone pressure areas on conventional and pressure relief hospital mattresses using laser Doppler flowmetry and tissue spectrophotometry.

    Rothenberger, Jens; Krauss, Sabrina; Held, Manuel; Bender, Dominik; Schaller, Hans-Eberhard; Rahmanian-Schwarz, Afshin; Constantinescu, Mihai Adrian; Jaminet, Patrick


    Pressure ulcers are associated with severe impairment for the patients and high economic load. With this study we wanted to gain more insight to the skin perfusion dynamics due to external loading. Furthermore, we evaluated the effect of different types of pressure relief mattresses. A total of 25 healthy volunteers were enrolled in the study. Perfusion dynamics of the sacral and the heel area were assessed using the O2C-device, which combines a laser light, to determine blood flow, and white light to determine the relative amount of hemoglobin. Three mattresses were evaluated compared to a hard surface: a standard hospital foam mattress bed, a visco-elastic foam mattress, and an air-fluidized bed. In the heel area, only the air-fluidized bed was able to maintain the blood circulation (mean blood flow of 13.6 ± 6 versus 3.9 ± 3 AU and mean relative amount of hemoglobin of 44.0 ± 14 versus 32.7 ± 12 AU.) In the sacral area, all used mattresses revealed an improvement of blood circulation compared to the hard surface. The results of this study form a more precise pattern of perfusion changes due to external loading on various pressure relief mattresses. This knowledge may reduce the incidence of pressure ulcers and may be an influencing factor in pressure relief mattress selection. Copyright © 2014 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

  6. The 8-year follow-up of the PIAMA intervention study assessing the effect of mite-impermeable mattress covers.

    Gehring, U; de Jongste, J C; Kerkhof, M; Oldewening, M; Postma, D; van Strien, R T; Wijga, A H; Willers, S M; Wolse, A; Gerritsen, J; Smit, H A; Brunekreef, B


    Exposure to high levels of house dust mite (HDM) allergens is associated with the development of allergic sensitization to HDM, a risk factor for the development of asthma, rhinitis, and allergic dermatitis. We studied the effect of an early intervention with mite-impermeable mattress covers on HDM allergen levels and the development of asthma and mite allergy throughout the first 8 years of life. High-risk children (allergic mother) were prenatally recruited and randomly allocated to two groups receiving mite allergen-impermeable (n = 416) and placebo mattress covers (n = 394) or no intervention (n = 472). Asthma and allergies were assessed yearly by questionnaire. Specific immunoglobulin E and bronchial hyper-responsiveness were measured at the age of 8 years. Mattress dust samples collected at different time points were analyzed for HDM allergens. At the age of 8 years, levels of HDM allergen Der f1 but not Der p1 were lower in the active than the placebo mattress cover group. In repeated measures analyses, we found a temporary decreased risk of asthma symptoms at the age of 2 years in the intervention group compared to the placebo group and a temporary association between higher HDM allergen exposure at the age of 3 months and more asthma symptoms. Early intervention with mite-impermeable mattress covers is successful in reducing exposure to Der f1; it only temporarily reduces the risk of asthma symptoms and does not reduce the risk of hay fever, eczema, and allergic sensitization. © 2011 John Wiley & Sons A/S.

  7. Burns (For Parents)

    ... Old Feeding Your 1- to 2-Year-Old Burns KidsHealth > For Parents > Burns A A A What's ... outlets, etc.) overexposure to the sun Types of Burns Burns are often categorized as first-, second-, or ...

  8. Epidemiology and Clinical Burden of Malaria in the War-Torn Area, Orakzai Agency in Pakistan.

    Asad Mustafa Karim


    Full Text Available Military conflict has been a major challenge in the detection and control of emerging infectious diseases such as malaria. It poses issues associated with enhancing emergence and transmission of infectious diseases by destroying infrastructure and collapsing healthcare systems. The Orakzai agency in Pakistan has witnessed a series of intense violence and destruction. Military conflicts and instability in Afghanistan have resulted in the migration of refugees into the area and possible introduction of many infectious disease epidemics. Due to the ongoing violence and Talibanization, it has been a challenge to conduct an epidemiological study.All patients were sampled within the transmission season. After a detailed clinical investigation of patients, data were recorded. Baseline venous blood samples were taken for microscopy and nested polymerase chain reaction (nPCR analysis. Plasmodium species were detected using nested PCR (nPCR and amplification of the small subunit ribosomal ribonucleic acid (ssrRNA genes using the primer pairs. We report a clinical assessment of the epidemic situation of malaria caused by Plasmodium vivax (86.5% and Plasmodium falciparum (11.79% infections with analysis of complications in patients such as decompensated shock (41%, anemia (8.98%, hypoglycaemia (7.3%, multiple convulsions (6.7%, hyperpyrexia (6.17%, jaundice (5%, and hyperparasitaemia (4.49%.This overlooked distribution of P. vivax should be considered by malaria control strategy makers in the world and by the Government of Pakistan. In our study, children were the most susceptible population to malaria infection while they were the least expected to use satisfactory prevention strategies in such a war-torn deprived region. Local health authorities should initiate malaria awareness programs in schools and malaria-related education should be further promoted at the local level reaching out to both children and parents.

  9. Changes in pennation angle in rotator cuff muscles with torn tendons.

    Zuo, Jianlin; Sano, Hirotaka; Itoi, Eiji


    Although several authors have reported on the pennation angles of intact rotator cuff muscles, the relationship between their alteration and rotator cuff tears has not been fully clarified. The purpose of this study was to measure the pennation angles of human cadaveric rotator cuff muscles with torn tendons. Twenty embalmed cadaveric shoulders were studied. Ten shoulders with various types of rotator cuff tears (tear group) were compared with ten shoulders that had intact rotator cuff tendons (control group). In seven shoulders with full-thickness tears, the area of the tear was determined by multiplying its length and width. After removing the muscles from the scapula, the superficial muscle fibers of each muscle were removed layer by layer until the entire intramuscular tendon was exposed. Photographs were taken and the pennation angles were then measured on digital images. The correlation between the size of the tear and the pennation angles of the supraspinatus and the infraspinatus muscles were determined statistically. The pennation angles of the supraspinatus and infraspinatus muscles in the tear group were significantly greater than those in the control group (P = 0.027 and 0.007, respectively). In seven shoulders with full-thickness rotator cuff tears, a positive correlation was found between the pennation angle of the supraspinatus muscle and the tear length (r = 0.854, P = 0.014). Moreover, a positive correlation was found between the pennation angle of the infraspinatus muscle and the tear area (r = 0.759, P = 0.048). On the other hand, the pennation angle was not affected by the presence of the partial-thickness tears in the remaining three shoulders. In rotator cuff tears, the pennation angles of the involved rotator cuff muscles increased with increasing size of the tear.

  10. Mark’s distinctive emphasis on the temple’s torn curtain

    Marius Nel


    Full Text Available This article asks several questions: What is distinctive about Mark’s description about the rending of the curtain in the Jerusalem Temple during Jesus’ crucifixion?; What is his rhetorical strategy in doing so?; What role does the temple play in Jewish religion? What role does the Temple play in Jesus’ ministry and message?; and What is the context of the narrative about the torn temple curtain? The conclusion is that Mark utilises the description to demonstrate God’s judgement on the worship at the temple, but at the same time illustrates how the way between heaven and earth is opened at the moment of the death of God’s Son.Markus se onderskeidende beskrywing van die geskeurde tempelgordyn. Verskeie vrae kom in hierdie artikel aan die bod: Wat is onderskeidend in Markus se beskrywing van die gordyn in die Jerusalemtempel wat tydens Jesus se kruisiging skeur?; Wat is die evangelis se retoriese strategie?; Watter rol speel die tempel in Joodse godsdiens?; Watter rol speel dit in Jesus se bediening en boodskap?; en Wat is die konteks vir die narratief binne die Evangelie oor die gordyn wat skeur? Die gevolgtrekking is dat Markus die beskrywing benut om God se oordeel oor die tempel te demonstreer, maar terselfdertyd illustreer dit ook hoe die weg tussen hemel en aarde oopgebreek word in die oomblikke toe God se Seun sterf.

  11. Dynamic bottleneck elimination in mattress manufacturing line using theory of constraints.

    Gundogar, Emin; Sari, Murat; Kokcam, Abdullah H


    There is a tough competition in the furniture sector like other sectors. Along with the varying product range, production system should also be renewed on a regular basis and the production costs should be kept under control. In this study, spring mattress manufacturing line of a furniture manufacturing company is analyzed. The company wants to increase its production output with new investments. The objective is to find the bottlenecks in production line in order to balance the semi-finished material flow. These bottlenecks are investigated and several different scenarios are tested to improve the current manufacturing system. The problem with a main theme based on the elimination of the bottleneck is solved using Goldratt and Cox's theory of constraints with a simulation based heuristic method. Near optimal alternatives are determined by system models built in Arena 13.5 simulation software. Results show that approximately 46 % capacity enhancements with 2 buffer stocks have increased average production by 88.8 %.

  12. Burning vasculitis.

    Chadha, Priyanka; Hobday, Dorian; O'Connor, Edmund Fitzgerald; D'Cruz, David


    We present the case of a 69-year-old man who was found collapsed close to a heat source and admitted to hospital for severe sepsis. He was also found to have widespread blistering and ulceration of his right leg; however, a history was unobtainable due to reduced consciousness levels. The leg lesions had the initial appearance of mixed depth burns and a management plan was made to transfer the patient to a burns unit for debridement. It was subsequently noted that the patient had a previous diagnosis of seropositive erosive rheumatoid arthritis. A biopsy of the leg lesion was performed and a diagnosis of rheumatoid vasculitis confirmed. Treatment with systemic steroids, intravenous antibiotics and intravenous immunoglobulin therapy for severe hypogammaglobulinaemia was started, and the patient was not transferred for surgical debridement. Rheumatoid vasculitis is a rare and extremely serious complication of rheumatoid arthritis that can manifest in a number of ways, occasionally mimicking other conditions. This case is essential to raise awareness of rare, severe rheumatoid vasculitis and of the potential for its misdiagnosis as a mixed depth burn.

  13. A prospective, longitudinal study to assess use of continuous and reactive low-pressure mattresses to reduce pressure ulcer incidence in a pediatric intensive care unit

    García Molina, Pablo; Balaguer López, Evelin; Torra i Bou, Joan Enric; Álvarez Ordiales, Adán; Quesada Ramos, Cristina; Verdú Soriano, José


    Pressure between bony prominences and sleep surfaces, as well as pressure from the use of medical devices, put children admitted to pediatric intensive care units (PICUs) at risk of developing pressure ulcers (PUs). To assess the effect of two pediatric-specific, continuous and reactive low-pressure mattresses on the incidence of PUs, an observational, descriptive, prospective, longitudinal (2009–2011) study was conducted among PICU patients. The two pediatric mattresses — one for children we...

  14. Texture analysis of torn rotator cuff on preoperative magnetic resonance arthrography as a predictor of postoperative tendon status

    Kang, Yeon Ah; Lee, Guen Young; Lee, Joon Woo; Lee, Eugene; Kim, Boh Young; Kim, Su Jin; Ahn, Joong Mo; Kang, Heung Sik [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)


    To evaluate texture data of the torn supraspinatus tendon (SST) on preoperative T2-weighted magnetic resonance arthrography (MRA) using the gray-level co-occurrence matrix (GLCM) for prediction of post-operative tendon state. Fifty patients who underwent arthroscopic rotator cuff repair for full-thickness tears of the SST were included in this retrospective study. Based on 1-year follow-up, magnetic resonance imaging showed that 30 patients had intact SSTs, and 20 had rotator cuff retears. Using GLCM, two radiologists measured independently the highest signal intensity area of the distal end of the torn SST on preoperative T2-weighted MRA, which were compared between two groups.The relationships with other well-known prognostic factors, including age, tear size (anteroposterior dimension), retraction size (mediolateral tear length), grade of fatty degeneration of the SST and infraspinatus tendon, and arthroscopic fixation technique (single or double row), also were evaluated. Of all the GLCM features, the retear group showed significantly higher entropy (p < 0.001 and p = 0.001), variance (p = 0.030 and 0.011), and contrast (p = 0.033 and 0.012), but lower angular second moment (p < 0.001 and p = 0.002) and inverse difference moment (p = 0.027 and 0.027), as well as larger tear size (p = 0.001) and retraction size (p = 0.002) than the intact group. Retraction size (odds ratio [OR] = 3.053) and entropy (OR = 17.095) were significant predictors. Texture analysis of torn SSTs on preoperative T2-weighted MRA using the GLCM may be helpful to predict postoperative tendon state after rotator cuff repair.

  15. Multicenter comparison of the efficacy on prevention of pressure ulcer in postoperative patients between two types of pressure-relieving mattresses in China

    Jiang, Qixia; Li, Xiaohua; Zhang, Aiqin; Guo, Yanxia; Liu, Yahong; Liu, Haiying; Qu, Xiaolong; Zhu, Yajun; Guo, Xiujun; Liu, Li; Zhang, Liyan; Bo, Suping; Jia, Jing; Chen, Yuejuan; Zhang, Rui; Wang, Jiandong


    Objective: Present study is designed to evaluate the effects of preventing pressure ulcer in surgical patients with two types of pressure-relieving mattresses. Methods: 1074 surgical patients from 12 hospitals in China were divided into A group (static air mattress with repositioning every 2 hours, n = 562) and B group (power pressure air mattress with repositioning every 2 hours, n = 512). The patient was subjected to a pressure-relieving mattress and observed from 0-5 days after surgery. Indications include the Braden scores, hospital-acquired pressure ulcers (HAPU) incidence and stage. Results: The Braden scores between two groups in five days after surgery were no significant (P > 0.05). The incidence of HAPU between two groups in same days also was no significant (1.07% vs. 0.98%, P > 0.05). The incidence of Stage I and stage II pressure ulcers in group A and B were 1.07% (6/562) and 0.98% (5/512), respectively (χ2 = 0.148, P = 0.882). Conclusion: The effects of preventing pressure ulcer in surgical patients with two types of pressure-relieving mattresses are similar, but the protocol by static air mattress with repositioning every 2 hours is benefit when no power. PMID:25356144

  16. The Influences of Human Design of Mattress on Sleeping%床垫的人性化设计对睡眠健康的影响

    陈玉霞; 中黎明; 郭勇; 潘颖玲; 胡天怡; 宋杰


    通过睡眠生理、睡眠行为、睡眠节律分析,论述了人对睡眠的需求特征和健康睡眠的重要性,结合人—床界面关系、卧姿脊柱形态、人体体型、床垫物理性能等,分析了睡眠质量和卧姿舒适性的影响因素以及不同人群对床垫需求的差异性,提出了床垫人性化设计的概念。在此基础上,总结了床垫人性化设计的原则,给出了基于床垫人性化设计的床垫性能检测的建议。%By analyzing sleep physiology, behaves and rhythm, it discussed sleeping demand characteristics and the importance of healthy sleep of people. And combined with human-bed interface with spinal morphology in lying position, anthropometry characteristics and physical property of mattress, it analyzed the factors of sleeping quality, lying comfort and different needs of different groups to mattresses, and put forward the concept of humanization design of mattress. On basis of that, it summarized the humanization design principles of mattress, and given suggestions of testing mattress properties on mattress humanization design.

  17. Alcaligenes xylosoxidans cholecystitis and meningitis acquired during bathing procedures in a burn unit: a case report.

    Fujioka, Masaki; Oka, Kiyoshi; Kitamura, Riko; Yakabe, Aka; Chikaaki, Nakamichi


    The information in this article was presented at the 37th Annual Meeting of the Japan Society of Burn, Nagoya, Japan, June 7-8, 2008. Alcaligenes xylosoxidans, a nonfermentative, Gram-negative rod often found in aqueous environments, has been isolated from respirators, incubators, and disinfectant solutions in the hospital environment. It is known to cause disease in immunocompromised (eg, burn) patients and represents a cross-contamination risk related to wound care. In the authors' burn unit, two patients, admitted with deep dermal burns during a 1-month time period, acquired serious A. xylosoxidans infections. The first involved A. xylosoxidans-associated cholecystitis in an adult with 32% total body surface area (TBSA) burns and the second involved A. xylosoxidans meningitis in an adult with 30% TBSA burns. Both patients received hydrotherapy (bathing) in the same bathing tub, one patient after the other. Culture from environmental sources isolated A. xylosoxidans from the bathing mattress. Bacterial analysis of the isolates, including antimicrobial susceptibility testing and pulsed-field gel electrophoresis, suggested the patients had been infected by the same strain - ie, cross-contaminated - probably during treatment of their burns. The isolated strains were resistant not only to broad-spectrum penicillins and cephalosporins, but also to imipenem, to which past A. xylosoxidans strains have been susceptible. These findings underscore the need for strict infection control to prevent cross-contamination and disease outbreak.

  18. First Aid: Burns

    ... Your 1- to 2-Year-Old First Aid: Burns KidsHealth > For Parents > First Aid: Burns A A A Scald burns from hot water and other liquids are the most common burns in early childhood. Because burns range from mild ...

  19. First Aid: Burns

    ... Old Feeding Your 8- to 12-Month-Old Feeding Your 1- to 2-Year-Old First Aid: Burns KidsHealth > For Parents > First Aid: Burns Print A A A Scald burns from hot water and other liquids are the most common burns in early childhood. Because burns range from mild to life threatening, ...

  20. Burns (For Parents)

    ... Child What Kids Say About: Handling Stress Anxiety, Fears, and Phobias Community Service: A Family's Guide to Getting ... What's in this article? Common Causes Types of Burns First-Degree Burns Second-Degree Burns ...

  1. Design of a Novel Flexible Capacitive Sensing Mattress for Monitoring Sleeping Respiratory

    Wen-Ying Chang


    Full Text Available In this paper, an algorithm to extract respiration signals using a flexible projected capacitive sensing mattress (FPCSM designed for personal health assessment is proposed. Unlike the interfaces of conventional measurement systems for poly-somnography (PSG and other alternative contemporary systems, the proposed FPCSM uses projected capacitive sensing capability that is not worn or attached to the body. The FPCSM is composed of a multi-electrode sensor array that can not only observe gestures and motion behaviors, but also enables the FPCSM to function as a respiration monitor during sleep using the proposed approach. To improve long-term monitoring when body movement is possible, the FPCSM enables the selection of data from the sensing array, and the FPCSM methodology selects the electrodes with the optimal signals after the application of a channel reduction algorithm that counts the reversals in the capacitive sensing signals as a quality indicator. The simple algorithm is implemented in the time domain. The FPCSM system is used in experimental tests and is simultaneously compared with a commercial PSG system for verification. Multiple synchronous measurements are performed from different locations of body contact, and parallel data sets are collected. The experimental comparison yields a correlation coefficient of 0.88 between FPCSM and PSG, demonstrating the feasibility of the system design.

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

    Kemalettin Koltka


    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

  3. Emergency in Burn; Burn in Emergency

    Yalcin Bayram


    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

  4. Analysis of ergonomics conditions of a brand of mattress and pillows. University-industry project, Medellín-Colombia.

    Sáenz Zapata, Luz M; Arias, Ana María L; Guzmán, Emilio C; Arias de L, Martha


    This project presents an analysis of the ergonomic conditions of three types of mattress and three types of pillow. The products are manufactured by a Colombian company which specializes in flexible polyurethane foam and other products designed for rest and relaxation. The project was developed through the University - Industry relationship: a strategic partnership based on the knowledge and strengths of each component. The conceptual theories that underpin the Ergonomics Research Division of the Design Studies Research Group (GED) provided the methodological approach for the project: the characteristics, the requirements and the relationships that are established between the components that constitute the User - Product - Context system (basic principles of the Ergonomics - Design relationship). An important factor in the project was the conception and measurement of comfort. Comfort can be measured on an objective level (quantitative measurement), and on a subjective level (a user's particular perceptions and tastes). What constitutes 'comfort' can vary from person to person, thus making the identification of criteria for the standardization of consumer products problematic. This project enabled design recommendations to be made to the Company vis-à-vis future proposals for mattress and pillow products. This experience of applied research was carried out by professors and students from the Faculty of Industrial Design at the UPB in Medellín, Colombia.

  5. Mycelial Mattress from a Sporangia Formation-Delayed Mutant of Rhizopus stolonifer as Wound Healing-Enhancing Biomaterial.

    Chien, Mei-Yin; Chen, Ling-Chun; Chen, Ying-Chen; Sheu, Ming-Thau; Tsai, Ya-Chi; Ho, Hsiu-O; Su, Ching-Hua; Liu, Der-Zen


    A mycelial mattress of Rhizopus stolonifer obtained from a liquid static culture was utilized for wound dressing and biomedical use. Following screening of mutants induced by UV radiation, F6, exhibiting delayed sporangium formation was selected because its sporangium maturation exhibited a 5-day delay without significant loss of mycelial weight compared to the wild type. The sporangium-free mycelial mattress from the sporangiospore culture of F6 was treated with 1N sodium hydroxide NaOH at 85°C for 2 h to produce a sponge-like membrane named Rhizochitin. The trifluoroacetic acid hydrolysate of Rhizochitin contained 36% N-acetylglucosamine and 53% hexose respectively detected by the Elson-Morgen and phenol-sulfuric acid methods. Results indicated the wound area in rats covered with Rhizochitin was 40% less than that of the uncovered group. Rhizochitin decreased the expression of PDGF in the proliferation stage, increased the expression of TGF-β in the inflammation and proliferation stages, and increased the expression of VEGF in the inflammation and proliferation stages. Rhizochitin inhibited secretion of matrix metalloproteinase-9 on days 1, 7, 9, and 12 and matrix metalloproteinase-2 on days 3, 7, 9, and 12. It was concluded that Rhizochitin has beneficial properties of biocompatible, biodegradable, and wound healing.

  6. Crude oil burning mechanisms

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


    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...... to the predictions of four conceptual models that describe the burning mechanism of multicomponent fuels. Based on the comparisons, hydrocarbon liquids were found to be best described by the Equilibrium Flash Vaporization model, showing a constant gas composition and gasification rate. The multicomponent fuels...... followed the diffusion-limited gasification model, showing a change in the hydrocarbon composition of the fuel and its evaporating gases, as well as a decreasing gasification rate, as the burning progressed. This burning mechanism implies that the residue composition and burning efficiency mainly depend...

  7. Learn Not To Burn.

    English, Nancy; Hendricks, Charlotte M.


    Describes the "Learn Not to Burn Preschool Program," a low-cost fire safety awareness and burn prevention curriculum for young children. The program promotes eight burn prevention methods--including practicing an escape plan--using developmentally appropriate learning objectives to increase children's fire safety knowledge, skill, and…

  8. Economics of pediatric burns.

    Bass, Michael J; Phillips, Linda G


    Sustaining a burn injury sets in motion a cycle of pain, disfigurement, and a search for survival. In pediatric burns, the injury extends to the parents where fear, ignorance, and helplessness forever change their lives. Pediatric burn injuries are caused by fire, hot liquids, clothing irons, hair curlers, caustic substances like drain cleaner, the grounding of an electrical source, and exposure to radiation. Efficiency in the delivery of pediatric burn care is critical. Maximizing resource utilization means continual self-evaluation and economic analysis of therapeutic modalities. Griffiths et al found that most childhood burns are due to scalds, which can be treated for $1061 per percent burn. Paddock et al reduced the cost of treating superficial pediatric burns and reduced the length of stay in hospital using silver-impregnated gauze over traditional methods. Barrett et al found improved cosmesis of skin grafts using cultured epithelial autografts but at a substantially increased cost. Corpron et al showed that pediatric burn units that treat burns >10% total body surface area and operative treatment of pediatric burns regardless of size generate positive revenue. There is a paucity of evidentiary pediatric burn economic data. More research is needed to address areas of pediatric burn care inefficiency. Improving knowledge of cost in all health care endeavors will create competition and drive down expenditures.

  9. Minor burns - aftercare

    ... the burn: Use cool water, not ice. The extreme cold from ice can injure the tissue even more. If possible, especially if the burn is caused by chemicals, hold the burned skin under cool running water for 10 to 15 minutes until it ...

  10. Optimization of burn referrals

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


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

  11. Epidemiology of burns

    Dokter, Jan


    The aim of this thesis is to understand the epidemiology, treatment and outcomes of specialized burn care in The Netherlands. This thesis is mainly based on historical data of the burn centre in Rotterdam from 1986, combined with historical data from the burn centres in Groningen and Beverwijk from

  12. Developmental Biology and Regenerative Medicine: Addressing the Vexing Problem of Persistent Muscle Atrophy in the Chronically Torn Human Rotator Cuff.

    Meyer, Gretchen A; Ward, Samuel R


    Persistent muscle atrophy in the chronically torn rotator cuff is a significant obstacle for treatment and recovery. Large atrophic changes are predictive of poor surgical and nonsurgical outcomes and frequently fail to resolve even following functional restoration of loading and rehabilitation. New insights into the processes of muscle atrophy and recovery gained through studies in developmental biology combined with the novel tools and strategies emerging in regenerative medicine provide new avenues to combat the vexing problem of muscle atrophy in the rotator cuff. Moving these treatment strategies forward likely will involve the combination of surgery, biologic/cellular agents, and physical interventions, as increasing experimental evidence points to the beneficial interaction between biologic therapies and physiologic stresses. Thus, the physical therapy profession is poised to play a significant role in defining the success of these combinatorial therapies. This perspective article will provide an overview of the developmental biology and regenerative medicine strategies currently under investigation to combat muscle atrophy and how they may integrate into the current and future practice of physical therapy. © 2016 American Physical Therapy Association.

  13. Partial Burn Laws in Propellant Erosive Burning

    S.V. Finjakov


    Full Text Available Experimental and computer methods were developed for investigating the combustion phenomena in the propellants which burn in streams of hot gas flowing along the burn surfaces of the propellants. The experimental investigations allowed establishment of different dependencies for erosive burning. Computer solutions of the problem for double-base (DB propellants showed a good agreement with the experimental results. The suggested variant of modified theory considers the change of heat release in solids, the real burn surface roughness, the nonisothermality of boundary layer and the effect of gas mass blow from the propellant burn surface into the gas stream. This modified theory was used for studying burn laws at 30-1000 atm and up to gas stream sound velocities for different DB propellants. It was found that gas stream leads to splitting of the propellant burn laws, m = bp/sup v/. Pressure power (v, in this case depends on gas stream velocity (W, diameter of the propellant tube canal (d and gas stream temperature (T/sub w/. It is because of this that these burn laws were named partial burn laws. They have the form (m = bp/sup w(omega/ w,d,T/sub w/ -const. The dependencies w(omega = f(w,d,T/sub w/ were obtained by the modified theory. It was found that omega values mainly decrease when pressure increases beginning from ~200 to 400 atm and they can decrease up to w(omega = 0,1- 0,3. Similar results can be obtained for composite propellants.

  14. Repair of Torn Avascular Meniscal Cartilage Using Undifferentiated Autologous Mesenchymal Stem Cells: From In Vitro Optimization to a First?in?Human Study

    Whitehouse, Michael; Howells, Nicholas; Parry, Michael; Austin, Eric; Kafienah, Wael; Brady, Kyla; Goodship, Allen; Eldridge, Jonathan; Blom, Ashley; Hollander, Anthony


    Abstract Meniscal cartilage tears are common and predispose to osteoarthritis (OA). Most occur in the avascular portion of the meniscus where current repair techniques usually fail. We described previously the use of undifferentiated autologous mesenchymal stem cells (MSCs) seeded onto a collagen scaffold (MSC/collagen?scaffold) to integrate meniscal tissues in vitro. Our objective was to translate this method into a cell therapy for patients with torn meniscus, with the long?term goal of del...

  15. A quantitative label-free analysis of the extracellular proteome of human supraspinatus tendon reveals damage to the pericellular and elastic fibre niches in torn and aged tissue.

    Hakimi, Osnat; Ternette, Nicola; Murphy, Richard; Kessler, Benedikt M; Carr, Andrew


    Tears of the human supraspinatus tendon are common and often cause painful and debilitating loss of function. Progressive failure of the tendon leading to structural abnormality and tearing is accompanied by numerous cellular and extra-cellular matrix (ECM) changes in the tendon tissue. This proteomics study aimed to compare torn and aged rotator cuff tissue to young and healthy tissue, and provide the first ECM inventory of human supraspinatus tendon generated using label-free quantitative LC-MS/MS. Employing two digestion protocols (trypsin and elastase), we analysed grain-sized tendon supraspinatus biopsies from older patients with torn tendons and from healthy, young controls. Our findings confirm measurable degradation of collagen fibrils and associated proteins in old and torn tendons, suggesting a significant loss of tissue organisation. A particularly marked reduction of cartilage oligomeric matrix protein (COMP) raises the possibility of using changes in levels of this glycoprotein as a marker of abnormal tissue, as previously suggested in horse models. Surprisingly, and despite using an elastase digestion for validation, elastin was not detected, suggesting that it is not highly abundant in human supraspinatus tendon as previously thought. Finally, we identified marked changes to the elastic fibre, fibrillin-rich niche and the pericellular matrix. Further investigation of these regions may yield other potential biomarkers and help to explain detrimental cellular processes associated with tendon ageing and tendinopathy.

  16. The use of alternating mattresses in the management and prevention of pressure ulcers in a community setting.

    Hampton, Sylvie


    The district nurse and community nurse has a duty of care to provide the most appropriate care for any individual who is at risk of pressure injury. This is often difficult as time constraints mean that education can be absent or reliant on other nurses who may not be up to date with the latest thinking on prevention. Also, district and community nurses cannot be in a patient's home 24 hours a day in order to provide the turning regime that is required for prevention of pressure ulcers. Therefore, they are reliant on education for the carers and provision of the most appropriate equipment for the individual patient. It is vital that the carer not only knows what to look for, but also what to do if any redness is noted and who to call. This article will provide tips on mattress types for the high-risk patient who may or may not have a pressure injury.

  17. [The pain from burns].

    Latarjet, J


    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.

  18. Feeling trapped and being torn: Physicians' narratives about ethical dilemmas in hemodialysis care that evoke a troubled conscience


    Background This study is part of a major study about difficulties in communicating ethical problems within and among professional groups working in hemodialysis care. Describing experiences of ethically difficult situations that induce a troubled conscience may raise consciousness about ethical problems and thereby open the way to further reflection. The aim of this study was to illuminate the meanings of being in ethically difficult situations that led to the burden of a troubled conscience, as narrated by physicians working in dialysis care. Method A phenomenological hermeneutic method was used to analyze the transcribed narrative interviews with five physicians who had varying lengths of experience in nephrology. Results The analysis shows that physicians working in hemodialysis care suffered from a troubled conscience when they felt torn by conflicting demands and trapped in irresolution. They faced ethical dilemmas where they were forced to make crucial decisions about life or death, or to prioritize when squeezed between time restraints and professional and personal demands. In these ethical dilemmas the physicians avoided arousing conflicts, were afraid of using their authority, were burdened by moral responsibility and felt devalued and questioned about their way of handling the situation. The findings point to another way of encountering ethical dilemmas, being guided by their conscience. This mean sharing the agony of deciding how to act, being brave enough to bring up the crucial problem, feeling certain that better ways of acting have not been overlooked, being respected and confirmed regarding decisions made. Conclusion The meanings of being in ethically difficult situations that led to the burden of a troubled conscience in those working in hemodialysis care, indicate the importance of increasing the level of communication within and among various professional groups - to transform being burdened by a troubled conscience into using conscience as a

  19. Burns and epilepsy.

    Berrocal, M


    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.

  20. The Burning Saints

    Xygalatas, Dimitris

    . Carrying the sacred icons of the saints, participants dance over hot coals as the saint moves them. The Burning Saints presents an analysis of these rituals and the psychology behind them. Based on long-term fieldwork, The Burning Saints traces the historical development and sociocultural context......, The Burning Saints presents a highly original analysis of how mental processes can shape social and religious behaviour....

  1. Management of Hand Burns

    Fatih Irmak


    Full Text Available Objective: The hand is one of the most frequently affected body parts by burn injuries with a rate of 80% among all burn wounds. Early and effective treatment ensures the best chance of survival as well as a good functional prognosis. The aim of this study was to determine the epidemiology, variation, relationship between etiology and hospital stay, clinical features, and management of hand burns. Material and Methods: This retrospective study was conducted the University of Health Sciences; Şişli Hamidiye Etfal Application and Research Center, Departmant of Plastic, Reconstructive and Aesthetic Surgery and the Intensive Burn Care Unit between April 2009 and April 2014. Burns were assessed based on etiology, anatomical location, percentage of total body surface area affected, and depth of injury. Treatment was categorized as conservative, elective operative, or urgent operative. Results: In the study period, 788 patients were admitted to our Burn Unit. Of these, 240 were females (30.5% and 548 were males (69.5%. The most common type of burn injury in this study was thermal injury (695 cases; 88.2%, followed by electrical injury (67 cases; 8.5%, and chemical, frictional or unknown injuries (26 cases; 3.3%. Majority (more than 85% of the patients had second-degree burns, and some had third-degree burns. Conclusions: Burns commonly affect the hands, and many functional problems may develop if appropriate basic treatments are neglected. The best treatment for burns is prevention. Appropriate indoor arrangement and simple but effective measures that can be taken at home can significantly reduce burn trauma exposure.

  2. Management of Outpatient Burns

    Waslen, G. D.


    The severity of burns depends on the depth and extent of body surface involved. The total body surface area (TBSA) involved can be estimated by the ‘rule of nines’; body locations are 9% of body surface or multiples of nine. Depth and TBSA can be used to classify burns as minor, moderate, or critical. Diagnosis depends on history and physical examination. Most burns can be treated in an outpatient setting. Treatment should include debriding necrotic tissue, preventing infection and encouragin...

  3. Burns in pregnancy.

    Maghsoudi, Hemmat; Samnia, Roya; Garadaghi, Abasad; Kianvar, Hadi


    A 9-year prospective study of burns in pregnant women hospitalized at the Sina hospital burn center was conducted to determine the etiology and outcome of pregnant patients. Fifty-one patients (27.45% self-inflicted, 72.55% unintentional) were identified and stratified by age, burn size, presence or absence of inhalation injury, trimester of pregnancy, maternal and fetal mortality, and cause of burn. The mean patient age was 24.2 years. There were 20 maternal deaths and 23 fetal deaths. The majority of which (maternal: 13 and fetal: 13) were among self-inflicted burned pregnant women. The mean burn size was 37.7%, and was significantly larger for nonsurvivors of mother than survivors (68.8% versus 17.6%; pburned body surface area exceeds 40%, both maternal and fetal mortality reaches 100%. Inhalation injuries were strongly associated with large burns, and were presents in all suicide patients. Kerosene ignition (68.6% of all patients, 100% of self-inflicted patients) was the most common type of burn. Large burn size was the strongest predictor of mortality of mother and fetus followed by the presence of inhalation injury.

  4. The lasso-loop, lasso-mattress and simple-cinch stitch for arthroscopic rotator cuff repair: are there biomechanical differences?

    Liodakis, Emmanouil; Dratzidis, Antonios; Kraemer, Manuel; Hurschler, Christof; Krettek, Christian; Hawi, Ahmed; Omar, Mohamed; Meller, Rupert; Hawi, Nael


    Various stitching techniques have been described to facilitate arthroscopic repair of rotator cuff tears. The aim of the present study was to compare the biomechanical properties of the lasso-loop, lasso-mattress and simple-cinch stitch for rotator cuff repair. Twelve infraspinatus tendons were harvested from sheep and split in half. The tendons were randomized into three different stitch configuration groups for biomechanical testing: lasso-loop, lasso-mattress and simple-cinch stitch. Each specimen was first cyclically loaded on a universal materials testing machine under force control from 5 to 30 N at 0.25 Hz for twenty cycles. Then, each specimen was loaded to failure under displacement control at a rate of 1 mm/s. Cyclic elongation, peak-to-peak displacement and ultimate tensile load were reported as mean ± standard error and compared using one way analysis of variance. The type of failure was recorded. No differences in cyclic elongation (1.31 ± 0.09 mm for the simple-cinch vs. 1.49 ± 0.07 mm for the lasso-mattress vs. 1.61 ± 0.09 mm for the lasso-loop stitch, p = 0.063) or peak-to-peak displacement (0.58 ± 0.04 mm for the simple-cinch, 0.50 ± 0.03 mm for the lasso-mattress and 0.62 ± 0.06 mm for the lasso-loop stitch, p = 0.141) were seen between all tested stitch configurations. In the load-to-failure test, the simple cinch stitch (149.38 ± 11.89 N) and the lasso-mattress (149.38 ± 10.33 N) stitch demonstrated significantly higher ultimate load than the lasso-loop stitch (65.88 ± 4.75 N, p < 0.001). All stitch configurations failed with suture pull out. The lasso-mattress and the simple-cinch stitch showed similar biomechanical properties with significant higher tensile loads needed for failure than the lasso-loop stitch.

  5. Burns and military clothing.

    McLean, A D


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

  6. Paabeli torn / Andri Maimets

    Maimets, Andri, 1979-


    Europarlamendi esimene filmipreemia Lux, mille materiaalseks ekvivalendiks on Paabeli torni kujutav kujuke ning filmi subtitreerimine 23 Euroopa keelde (lisaks üks koopia kurtidele). Sellise preemia otstarbekusest

  7. Critical issues in burn care.

    Holmes, James H


    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.

  8. Pain in burn patients.

    Latarjet, J; Choinère, M


    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.

  9. Nutrition of burned patients.

    Gudaviciene, Daiva; Rimdeika, Rytis; Adamonis, Kestutis


    Burns form 5-12% of all traumas. About 2,200 of patients are annually hospitalized in Lithuania. In most cases people of the employable age get burned. The treatment is often long-lasting, and afterwards recovered patients often have invalidity from burn sequels. The mortality of hospitalized burned patients is about 10%. The most common causes of death are pulmonary edema, pneumonia, sepsis and multiorgan failure. All these complications are related with insufficient nutrition. These complications are extremely frequent and dangerous for patients with more than 20% of body burned. The nutritional support of burned patient gives a possibility to increase the survival probability, to decrease complication rate and hospitalization time. Currently in Lithuania there are no standards for burned patient nutrition. More attention is given to strategy of surgical strategy and techniques, as well as antibiotic therapy. This article is the review of the different aspects of artificial nutrition of burned patient: indications, modes of nutrition, mixtures and terms of nutritional support.

  10. Burning mouth syndrome

    K A Kamala


    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.

  11. Hand chemical burns.

    Robinson, Elliot P; Chhabra, A Bobby


    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.

  12. [Chickenpox, burns and grafts].

    Rojas Zegers, J; Fidel Avendaño, L


    An outbreak of chickenpox that occurred at the Burns Repair Surgery Unit, Department of Children's Surgery, Hospital R. del Río, between June and November, 1975, is reported. 27 cases of burned children were studied, including analysis of correlations of the stages and outcome of the disease (varicela), the trauma (burns) and the graft (repair surgery). As a result, the authors emphasize the following findings: 1. Burns and their repair are not aggravating factors for varicella. In a small number of cases the exanthema looked more confluent in the graft surgical areas and in the first degree burns healing spontaneously. 2. Usually there was an uneventful outcome of graft repair surgery on a varicella patient, either during the incubation period, the acme or the convalescence. 3. The fact that the outmost intensity of secondary viremia of varicella occurs before the onset of exanthemia, that is, during the late incubation period, is confirmed.

  13. Crude oil burning mechanisms

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


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

  14. Validation and determination of the sensing area of the KINOTEX sensor as part of development of a new mattress with an interface pressure-sensing system.

    Sakai, Kozue; Nakagami, Gojiro; Matsui, Noriko; Sanada, Hiromi; Kitagawa, Atsuko; Tadaka, Etsuko; Sugama, Junko


    The purpose of the present study was to examine the validity of the KINOTEX sensor via comparison with an existing sensor and to determine the sensing areas for a new alternating-air mattress that incorporates an interface pressure-sensing system. The study design was an evaluation study to validate and determine the sensing area of the KINOTEX sensor in comparison with another sensor. Study participants were fifty-one healthy volunteers over eighteen years of age, and the two sensors were placed between participants and an alternating-air mattress. We measured the contact area, full weight load, and maximum pressure in the calcaneal region using two sensors and obtained a graphic pressure distribution of >40 mmHg in the lateral and supine positions. Correlation coefficients between sensors were r = 0.88 (p < 0.001) for the contact area, r = 0.89 (p < 0.001) for full weight load, and r = 0.72 (p < 0.001) at maximum pressure in the calcaneal region. Ninety-one percent of the pressure distribution was recorded in the central 50 cm of the bed, and 94.6% was recorded within an area 160 cm in length need the foot of the bed. We investigated the correlation between the KINOTEX sensor and an existing sensor and determined the necessary sensing area. Results suggested the feasibility of developing a new alternating-air mattress incorporating an interface pressure-sensing system to help prevent pressure ulcers.

  15. Effect of Sleeping Posture and Mattress on the Comfort of Sleeping%睡姿和床垫对人体睡眠舒适性的影响

    朱芋锭; 申黎明; 张晓春


    The study summarizes the position classiifcation, and analyzes the effect of different position on the human body pressure distribution and the form of spinal column, through body pressure distribution test and the spinal form measurement technology to evaluate body pressure distribution and spinal form on different mattress in different position. The results show that, different sleeping postures and mattress types have different effects on the human body pressure distribution and the spinal form; the body pressure distribution and spine morphology measurements can be used to evaluate the effect of different sleeping position on human comfort, and provide a theoretical basis for mattress design.%本文对人体睡姿进行了分类总结,分析了不同睡姿对体压分布和脊柱形态的影响,并通过人体压力分布测量和脊柱形态测量来评估不同睡姿在床垫上的体压分布和脊柱形态情况,结果表明:不同的睡姿和不同床垫类型对体压分布和脊柱形态有不同的影响;体压分布和脊柱形态测量可用来评估不同睡姿对人体舒适性的影响,为床垫设计提供理论依据。

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

    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...

  17. The influence of time and distance traveled by bed bugs, Cimex lectularius, on permethrin uptake from treated mattress liners.

    Kells, Stephen A; Hymel, Sabrina N


    Residual insecticides interrupt the dispersal of bed bugs (Cimex lectularius, L.), but one of the issues encountered with residual applications is understanding the uptake of active residues by the insect. This study determined permethrin uptake by bed bugs walking on the ActiveGuard(®) Mattress Liner product, via a combination of video recording in arenas and gas chromatography analyses. The best model for estimating permethrin uptake utilized a covariance model (r(2)  = 0.469) with two factors: time of exposure (F1,55 = 2.44, P < 0.001) and distance traveled (F1,55  = 0.30, P = 0.0460). Bed bug permethrin uptake was 15.1 (95% CI: 10.3-22.1) ng insect(-1) within 1 min exposure, 21.0 (15.0, 31.0) ng insect(-1) within 10 min and ≈ 42 (29.8, 60.6) ng insect(-1) within ≥50 min exposure. Correcting for percentage recovery, these values would be increased by a factor of 1.21. This permethrin-treated fabric provides a surface from which bed bugs begin rapidly to absorb permethrin on contact and within the first 1 cm of travel. Variability in uptake was likely a result of grooming and thigmotaxis, and future work should use quantitative methods to study behaviors and formulations that increase exposure to the toxicant. © 2016 Society of Chemical Industry. © 2016 Society of Chemical Industry.

  18. PBXN-110 Burn Rate Estimate

    Glascoe, E


    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.

  19. Management of burn wounds.

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


    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.

  20. Burn Wise Awareness Kit

    Health and safety outreach materials in the form of an awareness kit. Designed specifically for state, local, and tribal air agencies working to reduce wood smoke pollution, it includes best burn tips, social media m

  1. Molten Metal Burns

    Kahn, Arthur M.; McCrady-Kahn, Virginia L.


    Molten metal burns are a frequent industrial injury among workers in foundries. The injury is typically small but very deep. Usually the depth and seriousness of these injuries is not recognized immediately by emergency department or industrial clinic physicians.

  2. New Fashioned Book Burning.

    Gardner, Robert


    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)

  3. Accidental burns during surgery.

    Demir, Erhan; O'Dey, Dan Mon; Pallua, Norbert


    The purpose of this report is to increase awareness of intraoperative burns during standard procedures, to discuss their possible causes and warning signs and to provide recommendations for prevention and procedures to follow after their occurrence. A total of 19 patients associated with intraoperative burn accidents were treated surgically and analyzed after a mean follow-up of 5 +/- 3.5 months. Review included retrospective patient chart analysis, clinical examination, and technical device and equipment testing. A total of 15 patients recently underwent cardiac surgery, and 4 pediatric patients recovered after standard surgical procedures. A total of 15 patients had superficial and 4 presented with deep dermal or full-thickness burns. The average injured TBSA was 2.1 +/- 1% (range, 0.5-4%). Delay between primary surgery and consultation of plastic surgeons was 4.5 +/- 3.4 days. A total of 44% required surgery, including débridment, skin grafting or musculocutaneous gluteus maximus flaps, and the remaining patients were treated conservatively. Successful durable soft-tissue coverage of the burn region was achieved in 18 patients, and 1 patient died after a course of pneumonia. Technical analysis demonstrated one malfunctioning electrosurgical device, one incorrect positioned neutral electrode, three incidents occurred after moisture under the negative electrode, eight burns occurred during surgery while fluid or blood created alternate current pathways, five accidents were chemical burns after skin preparation with Betadine solution, and in one case, the cause was not clear. The surgical team should pay more attention to the probability of burns during surgery. Early patient examination and immediate involvement of plastic and burn surgeons may prevent further complications or ease handling after the occurrence.

  4. Smartphone applications in burns.

    Wurzer, Paul; Parvizi, Daryousch; Lumenta, David B; Giretzlehner, Michael; Branski, Ludwik K; Finnerty, Celeste C; Herndon, David N; Tuca, Alexandru; Rappl, Thomas; Smolle, Christian; Kamolz, Lars P


    Since the introduction of applications (apps) for smartphones, the popularity of medical apps has been rising. The aim of this review was to demonstrate the current availability of apps related to burns on Google's Android and Apple's iOS store as well as to include a review of their developers, features, and costs. A systematic online review of Google Play Store and Apple's App Store was performed by using the following search terms: "burn," "burns," "thermal," and the German word "Verbrennung." All apps that were programmed for use as medical apps for burns were included. The review was performed from 25 February until 1 March 2014. A closer look at the free and paid calculation apps including a standardized patient was performed. Four types of apps were identified: calculators, information apps, book/journal apps, and games. In Google Play Store, 31 apps were related to burns, of which 20 were calculation apps (eight for estimating the total body surface area (TBSA) and nine for total fluid requirement (TFR)). In Apple's App Store, under the category of medicine, 39 apps were related to burns, of which 21 were calculation apps (19 for estimating the TBSA and 17 for calculating the TFR). In 19 out of 32 available calculation apps, our study showed a correlation of the calculated TFR compared to our standardized patient. The review demonstrated that many apps for medical burns are available in both common app stores. Even free available calculation apps may provide a more objective and reproducible procedure compared to manual/subjective estimations, although there is still a lack of data security especially in personal data entered in calculation apps. Further clinical studies including smartphone apps for burns should be performed. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  5. Burn mouse models

    Calum, Henrik; Høiby, Niels; Moser, Claus


    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......-degree burn injury was induced with a hot-air blower. The third-degree burn was confirmed histologically. At 48 h, a decline in the concentration of peripheral blood leucocytes was observed in the group 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 of the skin showed an increased polymorphonuclear neutrophil granulocytes dominated inflammation in the group of mice...

  6. Burns Caused by Medical Therapy


    fear of litigation, patients with such injuries, even if the injuries are minor, arc often referred to a burn center for care. Burn injury...the potential burn hazards found elsewhere in the hospital. Even fewer studies have addressed the burn risks posed by medical therapy administered...35. Mills GH, Ralph S). Bums due to pulse oximetry [ letter ]. Anaesthesia 1992j47:276·7. 36. Shdlock: FG, Kana! E. Burns associated with the use of

  7. Psychiatric aspects of burn

    Dalal P


    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.

  8. Effect evaluation of a heated ambulance mattress-prototype on thermal comfort and patients’ temperatures in prehospital emergency care – an intervention study

    Jonas Aléx


    Full Text Available Background: The ambulance milieu does not offer good thermal comfort to patients during the cold Swedish winters. Patients’ exposure to cold temperatures combined with a cold ambulance mattress seems to be the major factor leading to an overall sensation of discomfort. There is little research on the effect of active heat delivered from underneath in ambulance care. Therefore, the aim of this study was to evaluate the effect of an electrically heated ambulance mattress-prototype on thermal comfort and patients’ temperatures in the prehospital emergency care. Methods: A quantitative intervention study on ambulance care was conducted in the north of Sweden. The ambulance used for the intervention group (n=30 was equipped with an electrically heated mattress on the regular ambulance stretcher whereas for the control group (n=30 no active heat was provided on the stretcher. Outcome variables were measured as thermal comfort on the Cold Discomfort Scale (CDS, subjective comments on cold experiences, and finger, ear and air temperatures. Results: Thermal comfort, measured by CDS, improved during the ambulance transport to the emergency department in the intervention group (p=0.001 but decreased in the control group (p=0.014. A significant higher proportion (57% of the control group rated the stretcher as cold to lie down compared to the intervention group (3%, p<0.001. At arrival, finger, ear and compartment air temperature showed no statistical significant difference between groups. Mean transport time was approximately 15 minutes. Conclusions: The use of active heat from underneath increases the patients’ thermal comfort and may prevent the negative consequences of cold stress.

  9. Effect evaluation of a heated ambulance mattress-prototype on thermal comfort and patients' temperatures in prehospital emergency care--an intervention study.

    Aléx, Jonas; Karlsson, Stig; Björnstig, Ulf; Saveman, Britt-Inger


    The ambulance milieu does not offer good thermal comfort to patients during the cold Swedish winters. Patients' exposure to cold temperatures combined with a cold ambulance mattress seems to be the major factor leading to an overall sensation of discomfort. There is little research on the effect of active heat delivered from underneath in ambulance care. Therefore, the aim of this study was to evaluate the effect of an electrically heated ambulance mattress-prototype on thermal comfort and patients' temperatures in the prehospital emergency care. A quantitative intervention study on ambulance care was conducted in the north of Sweden. The ambulance used for the intervention group (n=30) was equipped with an electrically heated mattress on the regular ambulance stretcher whereas for the control group (n=30) no active heat was provided on the stretcher. Outcome variables were measured as thermal comfort on the Cold Discomfort Scale (CDS), subjective comments on cold experiences, and finger, ear and air temperatures. Thermal comfort, measured by CDS, improved during the ambulance transport to the emergency department in the intervention group (p=0.001) but decreased in the control group (p=0.014). A significant higher proportion (57%) of the control group rated the stretcher as cold to lie down compared to the intervention group (3%, p<0.001). At arrival, finger, ear and compartment air temperature showed no statistical significant difference between groups. Mean transport time was approximately 15 minutes. The use of active heat from underneath increases the patients' thermal comfort and may prevent the negative consequences of cold stress.

  10. Bacteriological profile of burn patients at Yekatit 12 Hospital Burn ...


    injuries, creating a formidable public health problem. (3). Despite major ... change with time. Thus, to have an in-depth knowledge .... Table 4: Antibiotic resistance pattern of bacterial isolates from burn wound at Yekatit 12 hospital burn center.

  11. An assessment of burn care professionals' attitudes to major burn.

    Murphy, A D


    The resuscitation of severe burn remains a controversial area within the burn care profession. There is ongoing debate as to what percentage burn is associated with a sufficient quality of life to support initial resuscitation efforts. We conducted a survey of delegates at the 39th Annual Meeting of the British Burns Association (2005), regarding attitudes towards resuscitation following major burns. Respondents were asked the maximum percentage total body surface area (TBSA) burn beyond which they would not wish to be resuscitated. They were also asked what maximum TBSA they perceived to be commensurate with an acceptable quality of life (QOL). One hundred and forty three of 300 delegates responded to the questionnaire. Thirty three percent of respondents would not wish to be resuscitated with 50-75% TBSA burns or greater. A further 35% would not wish to have life-sustaining intervention with 75-95% TBSA burns or greater. The remaining 32% indicated that they would not want resuscitation with TBSA burns>95%. Regardless of TBSA affected, 16% would not wish resuscitation if they had full thickness facial burns, a further 10% did not want resuscitation if both their hands and faces were affected. Our survey demonstrates the diversity of personal preference amongst burn care professionals. This would suggest that a unifying philosophy regarding the resuscitation of extensive burns will remain elusive.

  12. Back Bay Wilderness burning support

    US Fish and Wildlife Service, Department of the Interior — This document is a memorandum concerning prescribed burns between members of the Bureau of Sport Fisheries and Wildlife. It states that burning should be supported...

  13. Phoenix Society for Burn Survivors

    ... Medical Professionals Phoenix Society is the leader in connecting the burn recovery community and creating resources for survivors. Since 1977, we have partnered with survivors, families, health care professionals, burn centers, and the fire ...

  14. Hair bleaching and skin burning

    Forster, K; Lingitz, R; Prattes, G; Schneider, G; Sutter, S; Schintler, M; Trop, M


    .... We report a unique case of a 16-yr-old girl who suffered full-thickness chemical and thermal burns to the nape of her neck and superficial burns to the occiput after her hair had been dyed blond...

  15. The year in burns 2008.

    Wolf, Steven E


    For 2008, approximately 1200 original burn research articles were published in scientific journals using the English language. This article reviews those with the most impact on burn treatment according to the Editor of one of the major journals (Burns). As in the previous year's review, articles were divided into the following topic areas: epidemiology, wound characterisation, critical care physiology, inhalation injury, infection, metabolism and nutrition, psychological considerations, pain management, rehabilitation, and burn reconstruction. Each selected article is mentioned briefly with editorial comment.


    The chapter describes available information on the health effects from open burning of rubber tires. It concentrates on the three known sources of detailed measurements: (1) a small-scale emissions characterization study performed by the U.S. EPA in a facility designed to simulat...

  17. Chemical burn or reaction

    ... this page: // Chemical burn or reaction To use the sharing features on this page, please enable JavaScript. Chemicals that touch skin can lead to a reaction on the skin, throughout the body, or both. ...



    Objective Endotoxin as the inciting agentof cytokines and other mediators, whose highlevel expression correlates with the septicshock and MOF, has been the one of leadingcauses of death in ICU. Methods For treatingsepsis and MOF caused by endotoxin, the anti-lipid A of LPS antibody was used. 19 burned

  19. Modern management of paediatric burns


    Mar 1, 2010 ... Jackson's. 3-dimensional burn wound model describes 3 zones: • a central zone ... the burn.7 Care must be taken not to induce hypothermia in larger burns – especially in .... Fluid therapy thereafter consists of 2 components ...

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

    Koç, Zeliha; Sağlam, Zeynep


    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.

  1. The year in burns 2011.

    Wolf, Steven E; Arnoldo, Brett D


    For 2011, approximately 1746 original research articles in burns were published in English in scientific journals. This article reviews those with the most potential impact on for burn therapeutics and outcomes according to the Editor of one of the major journals (Burns) and his colleague. As done previously, articles were found and divided into these topic areas: epidemiology of injury and burn prevention, wound and scar characterisation, acute care and critical care, inhalation injury, infection, psychological considerations, pain and itching management, rehabilitation and long-term outcomes, and burn reconstruction. Each selected article is mentioned briefly with editorial comment.

  2. Assessing burn depth in tattooed burn lesions with LASCA Imaging.

    Krezdorn, N; Limbourg, A; Paprottka, F J; Könneker; Ipaktchi, R; Vogt, P M


    Tattoos are on the rise, and so are patients with tattooed burn lesions. A proper assessment with regard to burn depth is often impeded by the tattoo dye. Laser speckle contrast analysis (LASCA) is a technique that evaluates burn lesions via relative perfusion analysis. We assessed the effect of tattoo skin pigmentation on LASCA perfusion imaging in a multicolour tattooed patient. Depth of burn lesions in multi-coloured tattooed and untattooed skin was assessed using LASCA. Relative perfusion was measured in perfusion units (PU) and compared to various pigment colours, then correlated with the clinical evaluation of the lesion. Superficial partial thickness burn (SPTB) lesions showed significantly elevated perfusion units (PU) compared to normal skin; deep partial thickness burns showed decreased PU levels. PU of various tattoo pigments to normal skin showed either significantly lower values (blue, red, pink) or significantly increased values (black) whereas orange and yellow pigment showed values comparable to normal skin. In SPTB, black and blue pigment showed reduced perfusion; yellow pigment was similar to normal SPTB burn. Deep partial thickness burn (DPTB) lesions in tattoos did not show significant differences to normal DPTB lesions for black, green and red. Tattoo pigments alter the results of perfusion patterns assessed with LASCA both in normal and burned skin. Yellow pigments do not seem to interfere with LASCA assessment. However proper determination of burn depth both in SPTB and DPTB by LASCA is limited by the heterogenic alterations of the various pigment colours.

  3. [Hydrofluoric acid burns].

    Holla, Robin; Gorter, Ramon R; Tenhagen, Mark; Vloemans, A F P M Jos; Breederveld, Roelf S


    Hydrofluoric acid is increasingly used as a rust remover and detergent. Dermal contact with hydrofluoric acid results in a chemical burn characterized by severe pain and deep tissue necrosis. It may cause electrolyte imbalances with lethal consequences. It is important to identify high-risk patients. 'High risk' is defined as a total affected body area > 3% or exposure to hydrofluoric acid in a concentration > 50%. We present the cases of three male patients (26, 31, and 39 years old) with hydrofluoric acid burns of varying severity and describe the subsequent treatments. The application of calcium gluconate 2.5% gel to the skin is the cornerstone of the treatment, reducing pain as well as improving wound healing. Nails should be thoroughly inspected and possibly removed if the nail is involved, to ensure proper healing. In high-risk patients, plasma calcium levels should be evaluated and cardiac monitoring is indicated.

  4. [Burning mouth syndrome (glossalgia)].


    Burning mouth syndrome (glossalgia) is manifested by oral pin and tingling sensations, numbness and even burning and severe pains, more frequently in the tongue. Unpleasant sensations may involve the anterior two thirds of the tongue or be extended to the front part of the hard palate and the mucous membrane of the lower lip. This condition is characterized by "mirror" and "food dominant" symptoms, disordered salivation, dysgeusia, or psychological disorders. The disease shows a chronic course. Its etiology may be multifactorial. There are no universally accepted diagnostic criteria; the diagnosis of glossalgia is made to rule out all other causes. A thorough examination should be conducted to establish a differential diagnosis. Glossalgia occurs primarily in middle-aged and elderly people. Women get sick much more frequently than men of the same age. Glossalgia remains difficult to treat. Continuous symptomatic treatment and follow-up help relieve its symptoms.

  5. Comparing ambient, air-convection, and fluid-convection heating techniques in treating hypothermic burn patients, a clinical RCT

    Sjöberg Folke


    Full Text Available Abstract Background Hypothermia in burns is common and increases morbidity and mortality. Several methods are available to reach and maintain normal core body temperature, but have not yet been evaluated in critical care for burned patients. Our unit's ordinary technique for controlling body temperature (Bair Hugger®+ radiator ceiling + bed warmer + Hotline® has many drawbacks e.g.; slow and the working environment is hampered. The aim of this study was to compare our ordinary heating technique with newly-developed methods: the Allon™2001 Thermowrap (a temperature regulating water-mattress, and Warmcloud (a temperature regulating air-mattress. Methods Ten consecutive burned patients (> 20% total burned surface area and a core temperature t-tests were used to assess the significance of differences between the treatments within the patients. ANOVA was used to assess the differences in temperature from the first to the last measurement among all treatments. Three-way ANOVA with the Tukey HSD post hoc test and a repeated measures ANOVA was used in the same manner, but included information about patients and treatment/measuring-cycles to control for potential confounding. Data are presented as mean (SD and (range. Probabilities of less than 0.05 were accepted as significant. Results The mean increase, 1.4 (SD 0.6°C; range 0.6-2.6°C in core temperature/treatment/measuring-cycle highly significantly favoured the Allon™2001 Thermowrap in contrast to the conventional method 0.2 (0.6°C (range -1.2 to 1.5°C and the Warmcloud 0.3 (0.4°C (range -0.4 to 0.9°C. The procedures for using the Allon™2001 Thermowrap were experienced to be more comfortable and straightforward than the conventional method or the Warmcloud. Conclusions The Allon™2001 Thermowrap was more effective than the Warmcloud or the conventional method in controlling patients' temperatures.

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

    Peters, W


    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. Assessment of burn depth and burn wound healing potential.

    Monstrey, Stan; Hoeksema, Henk; Verbelen, Jos; Pirayesh, Ali; Blondeel, Phillip


    The depth of a burn wound and/or its healing potential are the most important determinants of the therapeutic management and of the residual morbidity or scarring. Traditionally, burn surgeons divide burns into superficial which heal by rapid re-epithelialization with minimal scarring and deep burns requiring surgical therapy. Clinical assessment remains the most frequent technique to measure the depth of a burn wound although this has been shown to be accurate in only 60-75% of the cases, even when carried out by an experienced burn surgeon. In this article we review all current modalities useful to provide an objective assessment of the burn wound depth, from simple clinical evaluation to biopsy and histology and to various perfusion measurement techniques such as thermography, vital dyes, video angiography, video microscopy, and laser Doppler techniques. The different needs according to the different diagnostic situations are considered. It is concluded that for the initial emergency assessment, the use of telemetry and simple burn photographs are the best option, that for research purposes a wide range of different techniques can be used but that, most importantly, for the actual treatment decisions, laser Doppler imaging is the only technique that has been shown to accurately predict wound outcome with a large weight of evidence. Moreover this technique has been approved for burn depth assessment by regulatory bodies including the FDA.

  8. [The organization of burn care].

    Latarjet, Jacques


    In 2002, the organisation of burn care is confronted to a great deficiency in burn epidemiological datas. The main mechanisms of hospitalized burns are somehow wellknown in industrialized countries: about 60% scalds and 30% flame burns; as well as the place of occurrence (60% at home, and 20% at work), and the risk groups (3 times more important for the age group 0-4 years old). The incidence of burns needing medical care (all levels) (250/100,000 inh/yr) or hospitalization (15-20/100,000 inh/yr) is much more uncertain. The statistics of Diagnosis Related Groups (DRG), for hospitalized patients will allow in France very shortly to know more about the most rational ways of dispatching and treating them. They already show that only 30% of hospitalized burned patients are treated in specialized facilities.

  9. [Epidemiology of burns in France].

    Latarjet, Jacques; Ravat, François


    As with most traumas, the epidemiology of the "burn" health-event has long been neglected by public health doctors and rarely considered by burns specialists. There were therefore few verified data and many approximations and preconceived ideas. The gathering of information recently undertaken in France enables the reliability of the data to be improved and the diagnostic and demographic elements relating to hospitalised patients with burns to be established.

  10. Genital burns and vaginal delivery.

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


    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.

  11. Curbing Inflammation in Burn Patients

    Jayme A. Farina


    Full Text Available Patients who suffer from severe burns develop metabolic imbalances and systemic inflammatory response syndrome (SIRS which can result in multiple organ failure and death. Research aimed at reducing the inflammatory process has yielded new insight into burn injury therapies. In this review, we discuss strategies used to curb inflammation in burn injuries and note that further studies with high quality evidence are necessary.

  12. Nutrition Support in Burn Patients

    Cem Aydoğan


    Full Text Available Severe burn trauma causes serious metabolic derangements. Increased metabolic rate which is apart of a pathophysiologic characteristic of burn trauma results in protein-energy malnutrition. This situation causes impaired wound healing, muscle and fat tissue’s breakdown, growth retardation in children and infections. Nutrition support is vital in the treatment strategies of burn victims to prevent high mortal and disabling complications in this devastating trauma. Our aim in this study is to review management of nutrition in burn victims. (Journal of the Turkish Society Intensive Care 2012; 10: 74-83

  13. A primer on burn resuscitation

    Bacomo Ferdinand


    Full Text Available Since the early 1900s, the scope of burn resuscitation has evolved dramatically. Due to various advances in pre-hospital care and training, under-resuscitation of patients with severe burns is now relatively uncommon. Over-resuscitation, otherwise known as "fluid creep", has emerged as one of the most important problems during the initial phases of burn care over the past decade. To avoid the complications of over-resuscitation, careful hourly titration of fluid rates based on compilation of various clinical end points by a bedside provider is vital. The aim of this review is to provide a practical approach to the resuscitation of severely burned patients.

  14. Ice & Fire: the Burning Question

    van Gelderen, Laurens; Jomaas, Grunde


    With the Arctic opening up to new shipping routes and increased oil exploration and production due to climate change, the risk of an Arctic oil spill is increasing. Of the classic oil spill response methods (mechanical recovery, dispersants and in-situ burning), in-situ burning is considered...... to be particularly a suitable response method in the Arctic. In-situ burning aims to remove the oil from the marine environment by burning it from the water surface. A recent Ph.D. thesis from the Technical University of Denmark has provided some new insights with respect to the fire science behind this response...

  15. Marginally Stable Nuclear Burning

    Strohmayer, Tod E.; Altamirano, D.


    Thermonuclear X-ray bursts result from unstable nuclear burning of the material accreted on neutron stars in some low mass X-ray binaries (LMXBs). Theory predicts that close to the boundary of stability oscillatory burning can occur. This marginally stable regime has so far been identified in only a small number of sources. We present Rossi X-ray Timing Explorer (RXTE) observations of the bursting, high-inclination LMXB 4U 1323-619 that reveal for the first time in this source the signature of marginally stable burning. The source was observed during two successive RXTE orbits for approximately 5 ksec beginning at 10:14:01 UTC on March 28, 2011. Significant mHz quasi-periodic oscillations (QPO) at a frequency of 8.1 mHz are detected for approximately 1600 s from the beginning of the observation until the occurrence of a thermonuclear X-ray burst at 10:42:22 UTC. The mHz oscillations are not detected following the X-ray burst. The average fractional rms amplitude of the mHz QPOs is 6.4% (3 - 20 keV), and the amplitude increases to about 8% below 10 keV.This phenomenology is strikingly similar to that seen in the LMXB 4U 1636-53. Indeed, the frequency of the mHz QPOs in 4U 1323-619 prior to the X-ray burst is very similar to the transition frequency between mHz QPO and bursts found in 4U 1636-53 by Altamirano et al. (2008). These results strongly suggest that the observed QPOs in 4U 1323-619 are, like those in 4U 1636-53, due to marginally stable nuclear burning. We also explore the dependence of the energy spectrum on the oscillation phase, and we place the present observations within the context of the spectral evolution of the accretion-powered flux from the source.

  16. Exercise following burn injury.

    de Lateur, Barbara J; Shore, Wendy S


    Fatigue is a major barrier to recovery for burned individuals. Studies indicate that a slow return to normal or near-normal muscle strength is the natural course of recovery. With no special interventions, other than the "usual care" tailored to the needs of the individual, postburn patients will make gradual improvement in strength and aerobic capacity. Using the principle of initial condition (the worse the initial condition, the greater the response to exercise intervention) the authors outline an augmented exercise program that should result in a robust improvement in aerobic capacity.

  17. Oral Rehydration Therapy in Burn Patients


    Burn Any Degree Involving 20-29 Percent of Body Surface; Burn Any Degree Involving 30-39 Percent of Body Surface; Burn Any Degree Involving 40-49 Percent of Body Surface; Burn Any Degree Involving 50-59 Percent of Body Surface; Burn Any Degree Involving 60-65 Percent of Body Surface

  18. How to manage burns in primary care.

    Waitzman, A. A.; Neligan, P C


    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.

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

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


    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.

  20. Burn, thermal - close-up (image)

    ... first degree burns cause only reddening of the epidermis (outer layer of the skin), as seen in this photograph. Second degree burns cause blistering and extend into the dermis (lower layer of skin). Third degree burns cause ...

  1. Nutritional management of the burn patient

    role include: evaporative water loss from the burn wound, bacterial contamination of the burn ... leucocytes and fibroblasts in the burned area.2 Providing exogenous glucose ... immune function, poor wound healing and exacerbation of protein.

  2. Fires and Burns Involving Home Medical Oxygen

    ... Fires and Burns Involving Home Medical Oxygen The air is normally 21% oxygen. Oxygen is not flammable, but fire needs it to burn. ¾ When more oxygen is present, any fire that starts will burn ...

  3. Corneal Protection for Burn Patients


    Houston, TX Purpose:Patients with severe facial burns often suffer indirect damage to their eyes. Burn wound contracture of the periocular skin...periocular muscles , are injured and the protective blink reflex is lost. With loss of the blink reflex the patient quickly develops exposure keratitis

  4. Wanted: Clean Coal Burning Technology


    China is intent on developing clean coal burning technology, an objective it can achieve through installing desulfurization facilities at coal-burning power plants that will control SO2 emissions and environmental pollution. According to kuo Yi, deputy director general of the Department of Science and Technology of the State Environmental Protection Agency, China is a major coal-buming country:

  5. The year in burns 2013.

    Wolf, Steven E; Phelan, Herbert A; Arnoldo, Brett D


    Approximately 3415 research articles were published with burns in the title, abstract, and/or keyword in 2013. We have continued to see an increase in this number; the following reviews articles selected from these by the Editor of one of the major journals (Burns) and colleagues that in their opinion are most likely to have effects on burn care treatment and understanding. As we have done before, articles were found and divided into the following topic areas: epidemiology of injury and burn prevention, wound and scar characterization, acute care and critical care, inhalation injury, infection, psychological considerations, pain and itching management, rehabilitation and long-term outcomes, and burn reconstruction. The articles are mentioned briefly with notes from the authors; readers are referred to the full papers for details.

  6. The biology of burn injury.

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


    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.

  7. Functional Outcomes Following Burn Injury.

    Ryan, Colleen M; Parry, Ingrid; Richard, Reginald

    Major advances in functional recovery following burn injury over the last ten years include the development of conceptual framework for disability assessment and its application burn recovery, the description of the long-term outcomes in the burn population, and progress in basic science research leading to new treatments that improve long-term functional outcomes. Future tasks and challenges include the development of common data elements and standards for burn recovery in order to measure and optimize the path toward functional recovery. The development of patient-reported outcome measures with benchmarks for recovery over time has the potential to improve patient-provider communication and quality of patient-centered care. The study of burn recovery should include an examination of resiliency along with the study of disabilities following burn injury. Better understanding of the mechanisms, impact and modulation of hypermetabolism and inflammation following burn injury is essential to improve functional recovery. Continued basic science and clinical research must focus on scar modulation and skin replacements and address recalcitriant problems such as heterotopic ossification. Health tracking technologies should be leveraged to understand and optimize physical therapy interventions.

  8. Sedation and Analgesia in Burn

    Özkan Akıncı


    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

  9. Rehabilitation of the burn patient

    Procter Fiona


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

  10. Topical agents in burn care

    Momčilović Dragan


    Full Text Available Introduction Understanding of fluid shifts and recognition of the importance of early and appropriate fluid replacement therapy have significantly reduced mortality in the early post burn period. After the bum patient successfully passes the resuscitation period, the burn wound represents the greatest threat to survival. History Since the dawn of civilization, man has been trying to find an agent which would help burn wounds heal, and at the same time, not harm general condition of the injured. It was not until the XX century, after the discovery of antibiotics, when this condition was fulfilled. In 1968, combining silver and sulfadiazine, fox made silver-sulfadiazine, which is a 1% hydro-soluble cream and a superior agent in topical treatment of burns today. Current topical agents None of the topical antimicrobial agents available today, alone or combined, have the characteristics of ideal prophylactic agents, but they eliminate colonization of burn wound, and invasive infections are infrequent. With an excellent spectrum of activity, low toxicity, and ease of application with minimal pain, silver-sulfadiazine is still the most frequently used topical agent. Conclusion The incidence of invasive infections and overall mortality have been significantly reduced after introduction of topical burn wound antimicrobial agents into practice. In most burn patients the drug of choice for prophylaxis is silver sulfadiazine. Other agents may be useful in certain clinical situations.

  11. Colloids in Acute Burn Resuscitation.

    Cartotto, Robert; Greenhalgh, David


    Colloids have been used in varying capacities throughout the history of formula-based burn resuscitation. There is sound experimental evidence that demonstrates colloids' ability to improve intravascular colloid osmotic pressure, expand intravascular volume, reduce resuscitation requirements, and limit edema in unburned tissue following a major burn. Fresh frozen plasma appears to be a useful and effective immediate burn resuscitation fluid but its benefits must be weighed against its costs, and risks of viral transmission and acute lung injury. Albumin, in contrast, is less expensive and safer and has demonstrated ability to reduce resuscitation requirements and possibly limit edema-related morbidity. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Hair bleaching and skin burning.

    Forster, K; Lingitz, R; Prattes, G; Schneider, G; Sutter, S; Schintler, M; Trop, M


    Hairdressing-related burns are preventable and therefore each case is one too many. We report a unique case of a 16-yr-old girl who suffered full-thickness chemical and thermal burns to the nape of her neck and superficial burns to the occiput after her hair had been dyed blond and placed under a dryer to accelerate the highlighting procedure. The wound on the nape of the neck required surgical debridement and skin grafting. The grafted area resulted in subsequent scar formation.

  13. [Reconstruction of facial burn sequelae].

    Foyatier, J L; Comparin, J P; Boulos, J P; Bichet, J C; Jacquin, F


    The deep burns of the face can lead to horrible scars functionally and aesthetically. Treatment of these scars need several surgical interventions frequently and during many years. In our region we deal with this type of wounds as team work, multidisciplinary approach carrying out many process starting by emergency treatment of acute burns till the social rehabilitation. The expansion technique was great help in improving the shape of scars, by using the expanding skin as full thickness grafts. Reconstruction of the anatomical units and application of aesthetic techniques (like rhinoplasty, lifting, tattooing and autologous fat injections) participate equally in improving the quality of results. Many examples of treatments of burns scars are shown.

  14. A prospective, longitudinal study to assess use of continuous and reactive low-pressure mattresses to reduce pressure ulcer incidence in a pediatric intensive care unit.

    García-Molina, Pablo; Balaguer-López, Evelin; Torra I Bou, Joan Enric; Alvarez-Ordiales, Adan; Quesada-Ramos, Cristina; Verdú-Soriano, José


    Pressure between bony prominences and sleep surfaces, as well as pressure from the use of medical devices, put children admitted to pediatric intensive care units (PICUs) at risk of developing pressure ulcers (PUs). To assess the effect of two pediatric-specific, continuous and reactive low-pressure mattresses on the incidence of PUs, an observational, descriptive, prospective, longitudinal (2009-2011) study was conducted among PICU patients. The two pediatric mattresses - one for children weighing between 500 g and 6 Kg and another for children weighing more than 6 Kg - were provided to patients at risk for PUs (Braden-Q ≤16, Neonatal Skin Risk Assessment Scale [NSRAS] ≤13, or per nurse assessment of clinical need). Between 2009 and 2011, 30 children (13 [43.3%] girls and 17 [56.7%] boys), ages 0 to 10 years, at risk of developing PUs (NSRAS risk: n = 14 [13.2 ± 3.03] and Braden-Q risk: n = 10 [10.4 ± 2.4]) were placed on the study mattresses for a median of 4 (range 1 to 25) days. Primary reasons for PICU admission included disorders of the respiratory system (40%), infectious and parasitic diseases (23.3%), and illnesses of the musculoskeletal system and connective tissue (10%). All other PU prevention strategies (eg, repositioning, specialty devices) used as part of standard care protocols also were implemented. Of the 30 participants, only one (3.3%) (confidence interval [CI] 95% = 0.08 -17.2%) developed a nondevice-related PU. No adverse events occurred. A 2008 incidence study in the same PICU, before use of these special surfaces, found a cumulative incidence of 20% nondevice-related PUs. The observed incidence rate of nonmedical device-related PUs in this high-risk population placed on these mattresses is encouraging and warrants future research.

  15. Hair dryer burns in children.

    Prescott, P R


    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.

  16. The Burning Truth(s)

    The pathophysiology caused by a severe burn is complicated and involves changes in all ... The interstitial pressure and intravascular oncotic pressures decrease while the ... South African Family Practice 2014; 56(6):24-26. Open Access ...

  17. Chemistry of Cigarette Burning Processes

    Chen P


    Full Text Available Cigarette-burning and the smoke-formation processes and smoke composition are important topics for understanding cigarette performance. This paper proposes the molecular formulas representing the active components of bright, burley, and Oriental tobaccos and a basic chemistry model of the cigarette burning processes. Previous knowledge of the cigarette burning processes and smoke formation helped to establish parameters in deriving the basic chemistry equations. The proposed chemistry provides a brief view of the mechanisms of the cigarette burning during puffing and interpuff smoldering, and can be used to interpret and predict the smoke composition for cigarettes made from bright, burley, and Oriental tobaccos. Based on the proposed chemistry, the effect of ventilation on smoke component deliveries is discussed and the reaction heat of the puffing process is estimated.

  18. Burns, hypertrophic scar and galactorrhea.

    Karimi, Hamid; Nourizad, Samad; Momeni, Mahnoush; Rahbar, Hosein; Momeni, Mazdak; Farhadi, Khosro


    An 18-year-old woman was admitted to Motahari Burn Center suffering from 30% burns. Treatment modalities were carried out for the patient and she was discharged after 20 days. Three to four months later she developed hypertrophic scar on her chest and upper limbs. At the same time she developed galactorrhea in both breasts and had a disturbed menstrual cycle four months post-burn. On investigation, we found hyperprolactinemia and no other reasons for the high level of prolactin were detected.She received treatment for both the hypertrophic scar and the severe itching she was experiencing. After seven months, her prolactin level had decreased but had not returned to the normal level. It seems that refractory hypertrophic scar is related to the high level of prolactin in burns patients.

  19. Burns, hypertrophic scar and galactorrhea

    Hamid Karimi


    Full Text Available An 18-year old woman was admitted to Motahari Burn Center suffering from 30% burns. Treatment modalities were carried out for the patient and she was discharged after 20 days. Three to four months later she developed hypertrophic scar on her chest and upper limbs .At the same time she developed galactorrhea in both breasts and had a disturbed menstrual cycle four months post-burn. On investigation, we found hyperprolactinemia and no other reasons for the high level of prolactin were detected. She received treatment for both the hypertrophic scar and the severe itching she was experiencing. After seven months, her prolactin level had decreased but had not returned to the normal level. It seems that refractory hypertrophic scar is related to the high level of prolactin in burns patients.

  20. Regimes Of Helium Burning

    Timmes, F X


    The burning regimes encountered by laminar deflagrations and ZND detonations propagating through helium-rich compositions in the presence of buoyancy-driven turbulence are analyzed. Particular attention is given to models of X-ray bursts which start with a thermonuclear runaway on the surface of a neutron star, and the thin shell helium instability of intermediate-mass stars. In the X-ray burst case, turbulent deflagrations propagating in the lateral or radial directions encounter a transition from the distributed regime to the flamlet regime at a density of 10^8 g cm^{-3}. In the radial direction, the purely laminar deflagration width is larger than the pressure scale height for densities smaller than 10^6 g cm^{-3}. Self-sustained laminar deflagrations travelling in the radial direction cannot exist below this density. Similarily, the planar ZND detonation width becomes larger than the pressure scale height at 10^7 g cm^{-3}, suggesting that a steady-state, self-sustained detonations cannot come into exista...

  1. Estudio comparativo de microsutura vascular en ratas: punto simple y punto de colchonero horizontal Comparative study about vascular microsurgery on rats: classic interrupted suture versus horizontal mattress suture

    C. Casado Sánchez


    Full Text Available La Microcirugía es la técnica empleada para la realización de la microanastomosis vascular. El objetivo del presente estudio es comparar dos tipos de técnicas de microsutura: los puntos simples clásicos, de empleo habitual en la microcirugía vascular, y los puntos de colchonero horizontales, no evaluados habitualmente para este tipo de cirugía. Fueron intervenidas 20 ratas albinas de la cepa Wistar (peso medio de 250 - 300 gr. bajo anestesia general; realizamos sección transversal en la arteria femoral, procediendo a su reparación microquirúrgica inmediata. Se establecieron 2 grupos de animales: en el grupo A (n=10, la microsutura se hizo mediante 6 puntos sueltos simples, y en el grupo B (n=10, empleando 3 puntos de colchonero horizontal. Comprobamos la patencia en el desclampado inmediato y tras una hora del desclampado (para ambas técnicas fue positiva en el 100% de los casos, y la hemorragia en ambos tiempos (se registró un único caso de sangrado en el postoperatorio inmediato en el grupo B, que requirió la revisión de la microsutura. El tiempo medio de ejecución de la sutura en el grupo B, 15 minutos aproximadamente, fue más corto que en el grupo A, 21 minutos aproximadamente, diferencia estadísticamente significativa (p Microsurgery is the procedure of choice for vascular microanastamoses. The objective of this study was to compare two types of suture techniques: classic interrupted suture anastomoses, commonly used for vascular anastamoses in microsurgery, and another technique using horizontal mattress sutures, rarely evaluated in this type of surgery. Twenty albino Wistar rats were operated (average weight: 250 - 300 gr. under general anaesthesia. A transverse section of the femoral artery was performed and immediately followed by an anastamoses. The animals were placed into two groups of ten. The classic 6 interrupted suture anastomoses technique was performed in group A (n = 10 and another technique using 3

  2. Corneal Protection for Burn Patients


    Amniotic Membrane for the Treatment of Severe Exposure Keratopathy in the New Zealand White Rabbit Introduction: Patients with severe facial burns...often suffer indirect damage to their eyes as a sequela of ocular surface exposure keratopathy. Burn wound contracture of the periocular skin causes...inflammatory properties, amniotic membrane has developed into a mainstay of treatment to help maintain the ocular surface when skin grafting is delayed

  3. Treatment of Palm Burns in Children

    Argirova, M.; Hadzhiyski, O.


    The timing and methods of treatment of palm burns in children vary widely. From January 2002 to November 2004, 492 children with burns - 125 of them with hand burns or other body burns - were hospitalized and treated at the N.I. Pirogov Clinic for Burns and Plastic Surgery in Bulgaria. Fifty-four children (for a total of 73 burned hands) presented isolated palm burns.Twenty-two hands were operated on. In this review we present the incidence, causes, treatment methods, functional results, and ...

  4. Chemical and Common Burns in Children.

    Yin, Shan


    Burns are a common cause of preventable morbidity and mortality in children. Thermal and chemical burns are the most common types of burns. Their clinical appearance can be similar and the treatment is largely similar. Thermal burns in children occur primarily after exposure to a hot surface or liquid, or contact with fire. Burns are typically classified based on the depth and total body surface area, and the severity and onset of the burn can also depend on the temperature and duration of contact. Chemical burns are caused by chemicals-most commonly acids and alkalis-that can damage the skin on contact. In children, the most common cause of chemical burns is from household products such as toilet bowl cleaners, drain cleaners, detergents, and bleaches. Mild chemical burns generally cause redness and pain and can look similar to other common rashes or skin infections, whereas severe chemical burns are more extreme and may cause redness, blistering, skin peeling, and swelling.

  5. Burn treatment in the elderly.

    Keck, M; Lumenta, D B; Andel, H; Kamolz, L P; Frey, M


    The population of elderly patients is expected to rise continuously over the next decades due to global demographic changes. The elderly seem to be most vulnerable to burns and their management remains undoubtedly a challenge. A clear age margin for elderly patients is not yet defined, but most studies adhere to the inclusion of patients 65 years and above, but the general condition and social situation must be taken into account. The understanding of the physiological basis of aging and its related pathophysiological changes has only marginally influenced treatment and decision making in elderly burn patients. When looking at treatment regimens currently applied in elderly burn patients, the discussion of standards in intensive care as well as surgical strategies is ongoing. However, trends towards a moderate, non-aggressive resuscitation approach and careful inclusion of key parameters like physiological age, pre-burn functional status and premorbid conditions, seem to be useful guidelines for interdisciplinary treatment decisions. Once ordered for surgical treatment, the amount of body surface area operated in one session should be adapted to the general status of the patient. Even if older burn victims have a reported higher mortality rate than younger patients, improved therapeutic options have contributed to a reduced mortality rate even in the elderly over the last decades. As a result of improved outcome, more attention has to be given to a comprehensive rehabilitation program. This review will give an overview of the current literature and will draw attention to specific topics related to this important subpopulation of burn patients.

  6. Erosive burning of solid propellants

    King, Merrill K.


    Presented here is a review of the experimental and modeling work concerning erosive burning of solid propellants (augmentation of burning rate by flow of product gases across a burning surface). A brief introduction describes the motor design problems caused by this phenomenon, particularly for low port/throat area ratio motors and nozzleless motors. Various experimental techniques for measuring crossflow sensitivity of solid propellant burning rates are described, with the conclusion that accurate simulation of the flow, including upstream flow development, in actual motors is important since the degree of erosive burning depends not only on local mean crossflow velocity and propellant nature, but also upon this upstream development. In the modeling area, a brief review of simplified models and correlating equations is presented, followed by a description of more complex numerical analysis models. Both composite and double-base propellant models are reviewed. A second generation composite model is shown to give good agreement with data obtained in a series of tests in which composite propellant composition and heterogeneity (particle size distribution) were systematically varied. Finally, the use of numerical models for the development of erosive burning correlations is described, and a brief discussion of scaling is presented.


    Brahmaji Master


    Full Text Available One of the most challenging cases in forensic medicine is ascertaining the cause of death of burnt bodies under suspicious circumstances. The key questions that arise at the time of investigation include: 1  Was the person alive or dead prior to fire accident?  Did the victim die because of burn?  If death was not related to burns, could burns play a role in causing death?  Were the burns sustained accidentally, did the person commit suicide or was the person murdered?  Are the circumstances suggesting an attempt to conceal crime?  How was the fire started?  How was the victim identified?  In case of mass fatalities, who died first? Postmortem burning of corpses is supposed to be one of the ways to hide a crime. Differentiating the actual cause of death in burn patients is therefore important. Medical examiners usually focus on the defining the changes that occur in tissues while forensic anthropologists deal with the changes related to the bone with or without any the influence of other tissues. Under the circumstances of fire, differentiating the perimortem trauma from that of postmortem cause of bone fractures is vital in determining the cause and motive of death

  8. Iron metabolism in burned children.

    Belmonte, J A; Ibáñez, L; Ras, M R; Aulesa, C; Vinzo, J; Iglesias, J; Carol, J


    The administration of iron supplementation in children with burns has been a subject of controversy. Recent studies argue against its use in the acute phase of stress. To assess whether iron metabolism parameters show significant differences in the acute phase and the recovery phase of burn, 21 patients (age range: 17 months to 13 years) with burns of more than 10% of body surface who had not received blood transfusions or iron supplementation were studied. Sideraemia, ferritin, transferrin, transferrin saturation index (TSI) and C-reactive protein (CRP) were assessed both in the acute and the recovery phase after burn. Sideraemia, transferrin, and TSI were significantly lower in the acute than in the recovery phase (17.3 +/- 3 vs 53.8 +/- 6.6 microg/dL, 190.5 +/- 15 vs 287.9 +/- 14.3 mg/dL and 7.7 +/- 1.3 vs 15.4 +/- 1.6%, P 1.5 vs 0.7 +/- 0.2 mg/dL, P = 0.016 and P 2 years), the observed differences persisted. Hyposideraemia is a frequent finding in the acute phase of paediatric burns and is accompanied by increased ferritin levels and decreased transferrin concentrations. The low iron values tend to recover without the use of iron supplementation suggesting an endogenous block of iron release in the acute phase and indicates that iron therapy should be not recommended in the initial period of stress of the burned patient.

  9. Burn Injury Arise From Flying Balloon Toys

    Yalcin Kulahci; Fatih Zor; Mehmet Bozkurt; Serdar Ozturk; Mustafa Sengezer


    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 balloon...

  10. 磁力床垫对中长跑运动员心境状态和睡眠质量的影响%Effect of Magnetic Mattress on Mental State and Sleep Quality of Middle and Long Distance Runners

    徐文泉; 王智; 冯玲


    为检测磁力床垫对中长跑运动员心境状态和睡眠质量的影响,采用文献资料法、实验比较法、问卷调查法和数理统计法,以现役29名中长跑运动员为研究对象,其中15名为实验组(使用磁力床垫)、14名为对照组(使用普通床垫),对他们大运动量训练后的心境状态和睡眠质量展开调查,结果表明:(1)使用磁力床垫的实验组在调节心境状态方面明显优于使用普通床垫的对照组,它能够明显缓解运动员疲劳、恢复精力、抚平慌乱情绪和有效处理纷乱情绪;(2)磁力床垫在中长跑运动员提高睡眠质量方面,主要体现在能够延长睡眠的有效时间。%In order to test the effect of magnetic mattress on mental state and sleep quality of middle and long distance runners, the authors surveyed the athletes' mental state and sleep quality after intensive training by the methods of literature study, experimental comparison, questionnaire and statistics. 29 middle-distance runners were chosen as the subjects, among whom 15 were put into experiment group (using magnetic mattress) and 14 in control group (using ordinary mattress). The result shows that the mental state adjustment of the experiment group is obviously better than that of the control group. Magnetic mattress can help athletes to alleviate fatigue, recover energy and ease their mood. In terms of sleep quality improvement, magnetic mattress may effectively prolong the athletes' sleep time.

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

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


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

  12. Tweens feel the burn: "salt and ice challenge" burns.

    Roussel, Lauren O; Bell, Derek E


    To review our institution's experience with frostbite injury secondary to "salt and ice challenge" (SIC) participation. We conducted a retrospective analysis of intentional freezing burns from 2012 to 2014. Demographics, depth and location of burn, total body surface area of burn, treatment, time to wound healing, length of stay, complications, and motives behind participation were analyzed. Five patients were seen in the emergency department for intentional freezing burns that resulted from SIC (all females; mean age: 12.3 years; range age: 10.0-13.2 years). Mean total body surface area was 0.408%. Salt and ice was in contact with skin for >10 min for two patients, >20 min for two patients, and an unknown duration for one patient. Complications included pain and burn scar dyschromia. Four patients cited peer pressure and desire to replicate SIC as seen on the Internet as their motivation in attempting the challenge. SIC has become a popular, self-harming behavior among youths. Increased public education, and provider and parent awareness of SIC are essential to address this public health concern.

  13. Burn Patient Expectations from Nurses

    Sibel Yilmaz sahin


    Full Text Available AIM: Burn is a kind of painful trauma that requires a long period of treatment and also changes patients body image. For this reason, nursing care of burn patients is very important. In this study in order to provide qualified care to the burned patients, patient and #8217;s expectations from nurses were aimed to be established. METHODS: Patients and #8217; expectations were evaluated on 101 patients with burn in Ministry of Health Ankara Numune Education and Research Hospital Burn Service and Gulhane Military Medical Academy Education and Research Hospital Burn Center. A questionnaire which was developed by the researchers was used for collecting data. The questions on the questionnaire were classified into four groups to evaluate the patients and #8217; expectations about communication, information, care and discharge. Data was evaluated by using SPSS 12 package software. RESULTS: In this study, 48.5% of patients were at 18-28 age group, 79.2% were male and 51.5% of patients were employed. Almost all of patients expect nurses to give them confidence (98% and to give them information about latest developments with the disease. Patients prior expectation from nurses about care was to do their treatments regularly (100% and to take the necessary precautions in order to prevent infection (100%. 97% of patient expect nurses to give them information about the drugs, materials and equipment that they are going to use while discharge. CONCLUSION: As a result we found that burn patient expectations from nurses about communication, information, care and discharge were high. [TAF Prev Med Bull 2014; 13(1.000: 37-46

  14. Harborview burns--1974 to 2009.

    Loren H Engrav

    Full Text Available BACKGROUND: Burn demographics, prevention and care have changed considerably since the 1970s. The objectives were to 1 identify new and confirm previously described changes, 2 make comparisons to the American Burn Association National Burn Repository, 3 determine when the administration of fluids in excess of the Baxter formula began and to identify potential causes, and 4 model mortality over time, during a 36-year period (1974-2009 at the Harborview Burn Center in Seattle, WA, USA. METHODS AND FINDINGS: 14,266 consecutive admissions were analyzed in five-year periods and many parameters compared to the National Burn Repository. Fluid resuscitation was compared in five-year periods from 1974 to 2009. Mortality was modeled with the rBaux model. Many changes are highlighted at the end of the manuscript including 1 the large increase in numbers of total and short-stay admissions, 2 the decline in numbers of large burn injuries, 3 that unadjusted case fatality declined to the mid-1980s but has changed little during the past two decades, 4 that race/ethnicity and payer status disparity exists, and 5 that the trajectory to death changed with fewer deaths occurring after seven days post-injury. Administration of fluids in excess of the Baxter formula during resuscitation of uncomplicated injuries was evident at least by the early 1990s and has continued to the present; the cause is likely multifactorial but pre-hospital fluids, prophylactic tracheal intubation and opioids may be involved. CONCLUSIONS: 1 The dramatic changes include the rise in short-stay admissions; as a result, the model of burn care practiced since the 1970s is still required but is no longer sufficient. 2 Fluid administration in excess of the Baxter formula with uncomplicated injuries began at least two decades ago. 3 Unadjusted case fatality declined to ∼6% in the mid-1980s and changed little since then. The rBaux mortality model is quite accurate.

  15. Harborview burns--1974 to 2009.

    Engrav, Loren H; Heimbach, David M; Rivara, Frederick P; Kerr, Kathleen F; Osler, Turner; Pham, Tam N; Sharar, Sam R; Esselman, Peter C; Bulger, Eileen M; Carrougher, Gretchen J; Honari, Shari; Gibran, Nicole S


    Burn demographics, prevention and care have changed considerably since the 1970s. The objectives were to 1) identify new and confirm previously described changes, 2) make comparisons to the American Burn Association National Burn Repository, 3) determine when the administration of fluids in excess of the Baxter formula began and to identify potential causes, and 4) model mortality over time, during a 36-year period (1974-2009) at the Harborview Burn Center in Seattle, WA, USA. 14,266 consecutive admissions were analyzed in five-year periods and many parameters compared to the National Burn Repository. Fluid resuscitation was compared in five-year periods from 1974 to 2009. Mortality was modeled with the rBaux model. Many changes are highlighted at the end of the manuscript including 1) the large increase in numbers of total and short-stay admissions, 2) the decline in numbers of large burn injuries, 3) that unadjusted case fatality declined to the mid-1980s but has changed little during the past two decades, 4) that race/ethnicity and payer status disparity exists, and 5) that the trajectory to death changed with fewer deaths occurring after seven days post-injury. Administration of fluids in excess of the Baxter formula during resuscitation of uncomplicated injuries was evident at least by the early 1990s and has continued to the present; the cause is likely multifactorial but pre-hospital fluids, prophylactic tracheal intubation and opioids may be involved. 1) The dramatic changes include the rise in short-stay admissions; as a result, the model of burn care practiced since the 1970s is still required but is no longer sufficient. 2) Fluid administration in excess of the Baxter formula with uncomplicated injuries began at least two decades ago. 3) Unadjusted case fatality declined to ∼6% in the mid-1980s and changed little since then. The rBaux mortality model is quite accurate.

  16. Outcomes of outpatient management of pediatric burns.

    Brown, Matthew; Coffee, Tammy; Adenuga, Paul; Yowler, Charles J


    The literature surrounding pediatric burns has focused on inpatient management. The goal of this study is to characterize the population of burned children treated as outpatients and assess outcomes validating this method of burn care. A retrospective review of 953 patients treated the burn clinic and burn unit of a tertiary care center. Patient age, burn etiology, burn characteristics, burn mechanism, and referral pattern were recorded. The type of wound care and incidence of outcomes including subsequent hospital admission, infection, scarring, and surgery served as the primary outcome data. Eight hundred and thirty children were treated as outpatients with a mean time of 1.8 days for the evaluation of burn injury in our clinic. Scalds accounted for 53% of the burn mechanism, with burns to the hand/wrist being the most frequent area involved. The mean percentage of TBSA was 1.4% for the outpatient cohort and 8% for the inpatient cohort. Burns in the outpatient cohort healed with a mean time of 13.4 days. In the outpatient cohort, nine (1%) patients had subsequent admissions and three (0.4%) patients had concern for infection. Eight patients from the outpatient cohort were treated with excision and grafting. The vast majority of pediatric burns are small, although they may often involve more critical areas such as the face and hand. Outpatient wound care is an effective treatment strategy which results in low rates of complications and should become the standard of care for children with appropriate burn size and home support.

  17. LA50 in burn injuries.

    Seyed-Forootan, K; Karimi, H; Motevalian, S A; Momeni, M; Safari, R; Ghadarjani, M


    Burn injuries put a huge financial burden on patients and healthcare systems. They are the 8th leading cause of mortality and the 13th most common cause of morbidity in our country. We used data from our Burn Registry Program to evaluate risk factors for mortality and lethal area fifty percent (LA50) in all burn patients admitted over two years. We used multiple logistic regressions to identify risk factors for mortality. LA50 is a reliable aggregate index for hospital care quality and a good measure for comparing results, also with those of other countries. 28,690 burn patients sought medical attention in the Emergency Department, and 1721 of them were admitted. Male to female ratio was 1,75:1. 514 patients were under 15 years old. Median age was 25 (range: 3 months - 93 years). Overall, probability of death was 8.4%. LA50 was 62.31% (CI 95%: 56.57-70.02) for patients aged 15 and over and 72.52% (CI 95%: 61.01-100) for those under 15. In the final model, we found that Adjusted OR was significant for age, female sex, TBSA and inhalation injury (P age and inhalation injury were the main risk factors for death. Authorities should pay special attention to these variables, especially in prevention programs, to reduce mortality and improve patient outcome. Children have better outcome than adults given equal burn size. Suicide rates are higher for women than men in our country.

  18. Topical management of facial burns.

    Leon-Villapalos, Jorge; Jeschke, Marc G; Herndon, David N


    The face is the central point of the physical features of the human being. It transmits expressions and emotions, communicates feelings and allows for individual identity. It contains complex musculature and a pliable and unique skin envelope that reacts to the environment through a vast network of nerve endings. The face hosts vital areas that make phonation, feeding, and vision possible. Facial burns disrupt these anatomical and functional structures creating pain, deformity, swelling, and contractures that may lead to lasting physical and psychological sequelae. The management of facial burns may include operative and non-operative treatment or both, depending on the depth and extent of the burn. This paper intends to provide a review of the available options for topical management of facial burns. Topical agents will be defined as any agent applied to the surface of the skin that alters the outcome of the facial burn. Therefore, the classic concept of topical therapy will be expanded and developed within two major stages: acute and rehabilitation. Comparison of the effectiveness of the different treatments and relevant literature will be discussed.

  19. Telemedicine and burns: an overview.

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


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




    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.

  1. [Enteral nutrition in burn patients].

    Pereira, J L; Garrido, M; Gómez-Cía, T; Serrera, J L; Franco, A; Pumar, A; Relimpio, F; Astorga, R; García-Luna, P P


    Nutritional support plays an important role in the treatment of patients with burns. Due to the severe hypercatabolism that develops in these patients, oral support is insufficient in most cases, and this makes it essential to initiate artificial nutritional support (either enteral or parenteral). Enteral nutrition is more physiological than parenteral, and data exist which show that in patients with burns, enteral nutrition exercises a protective effect on the intestine and may even reduce the hypermetabolic response in these patients. The purpose of the study was to evaluate the effectiveness and tolerance of enteral nutritional support with a hypercaloric, hyperproteic diet with a high content of branched amino acids in the nutritional support of patients suffering from burns. The study included 12 patients (8 males and 4 females), admitted to the Burns Unit. Average age was 35 +/- 17 years (range: 21-85 years). The percentage of body surface affected by the burns was 10% in two cases, between 10-30% in three cases, between 30-50% in five cases and over 50% in two cases. Initiation of the enteral nutrition was between twenty-four hours and seven days after the burn. The patients were kept in the unit until they were discharged, and the average time spent in the unit was 31.5 days (range: 17-63 days). Total energetic requirements were calculated based on Harris-Benedict, with a variable aggression factor depending on the body surface burned, which varied from 2,000 and 4,000 cal day. Nitrogenous balance was determined on a daily basis, and plasmatic levels of total proteins, albumin and prealbumin on a weekly basis. There was a significant difference between the prealbumin values at the initiation and finalization of the enteral nutrition (9.6 +/- 2.24 mg/dl compared with 19.75 +/- 5.48 mg/dl; p diet was very good, and only mild complications such as diarrhoea developed in two patients. Enteral nutrition is a suitable nutritional support method for patients with

  2. American Burn Association Practice Guidelines: Burn Shock Resuscitation


    valid OMB control number. 1. REPORT DATE 01 JAN 2008 2. REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE American Burn Association...colloid or saline solutions. Clin Sci 1964; 26:429–43. 21. Markley K, Bocanegra M, Bazan A, et al. Clinical evaluation of saline solution therapy in

  3. Protect the Ones You Love: Burns Safety

    ... Child Abuse and Neglect Prevention Youth Violence Prevention Burn Prevention Recommend on Facebook Tweet Share Compartir We ... to prevent leading causes of child injury, like burns, is a step toward this goal. Every day, ...

  4. Topical Pain Relievers May Cause Burns

    ... Consumers Consumer Updates Topical Pain Relievers May Cause Burns Share Tweet Linkedin Pin it More sharing options ... rare, have ranged from mild to severe chemical burns with use of such brand-name topical muscle ...

  5. A review of hydrofluoric acid burn management.

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


    Hydrofluoric acid (HF) causes a unique chemical burn. Much of the current treatment knowledge of HF burns is derived from case reports, small case series, animal studies and anecdotal evidence. The management can be challenging because clinical presentation and severity of these burns vary widely. Plastic surgeons managing burn patients must have a basic understanding of the pathophysiology, the range of severity in presentation and the current treatment options available for HF burns. The present article reviews the current understanding of the pathophysiology and systemic effects associated with severe HF burns. Furthermore, it distinguishes between minor and life-threatening HF burns and describes several of the basic techniques that are available to treat patients with HF burns.

  6. Burn Prevention for Families with Children with Special Needs

    Full Text Available ... Burns and Scalds Burn Prevention for Families With Children With Special Needs Watch this video to learn ... know about burn prevention if you have a child with special needs. Read our burn prevention tips | ...

  7. Imaging acute thermal burns by photoacoustic microscopy

    Zhang, Hao F.; Maslov, Konstantin; Stoica, George; Wang, Lihong V.


    The clinical significance of a burn depends on the percentage of total body involved and the depth of the burn. Hence a noninvasive method that is able to evaluate burn depth would be of great help in clinical evaluation. To this end, photoacoustic microscopy is used to determine the depth of acute thermal burns by imaging the total hemoglobin concentration in the blood that accumulates along the boundaries of injuries as a result of thermal damage to the vasculature. We induce acute thermal ...

  8. Burns, metabolism and nutritional requirements.

    Mendonça Machado, N; Gragnani, A; Masako Ferreira, L


    To review the nutritional evaluation in burned patient, considering the literature descriptions of nutritional evaluation and energy requirements of these patients. Thermal injury is the traumatic event with the highest metabolic response in critically ill patients. Various mathematical formulas have been developed to estimate nutritional requirements in burned patient. Indirect Calorimetry is the only method considered gold standard for measuring caloric expenditure. A survey of the literature and data was collected based on official data bases, LILACS, EMBASE and PubMed. The metabolic changes involved in hypermetabolism are designed to supply energy to support immune function, brain activity, wound healing, and preservation of body tissues. Body weight is considered the easiest indicator and perhaps the best to assess the nutritional status. The most common formulas utilized in these patients are the Curreri, Pennisi, Schofield, Ireton-Jones, Harris-Benedict and the ASPEN recommendations. For children is the Mayes and World Health Organization formula. The majority of mathematical formulas overestimate the nutritional needs. The regular use of Indirect Calorimetry supplies adequate nutritional support to the burn patient. The traditional nutritional evaluation considers anthropometry, biochemical markers and estimation of nutritional requirements. The weight provides a basis for decisions that are established in the clinical context. Classic parameters can be adapted to intensive care environment. The use of Indirect Calorimetry is crucial to ensure the safety of the nutritional support of burn patients and this should be widely encouraged.

  9. Antibiotics and the burn patient.

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


    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. Copyright © 2009 Elsevier Ltd and ISBI. All rights reserved.

  10. Abdominal Complications after Severe Burns


    abdominal compartment syndrome, schemic bowel, biliary disease , peptic ulcer disease and astritis requiring laparotomy, small bowel obstruction, rimary fungal...complications in- luded trauma exploratory laparotomy, abdominal com- artment syndrome, ischemic bowel, biliary disease , peptic lcer disease and gastritis, large...because it was almost uniformly ssociated with serious lethal burns. This was in the period efore effective gastric acid control, explaining the high

  11. Use of previously burned skin as random cutaneous local flaps in pediatric burn reconstruction

    Barret, JP; Herndon, DN; McCauley, RL


    Reconstruction after post-burn scarring remains a challenge. It is especially true in the severely burned patient, who normally presents with a paucity of donor sites Healed skin from areas that had been burned and skin from grafted areas (termed as previously burned skin) have been occasionally use

  12. Use of previously burned skin as random cutaneous local flaps in pediatric burn reconstruction

    Barret, JP; Herndon, DN; McCauley, RL

    Reconstruction after post-burn scarring remains a challenge. It is especially true in the severely burned patient, who normally presents with a paucity of donor sites Healed skin from areas that had been burned and skin from grafted areas (termed as previously burned skin) have been occasionally

  13. 30 CFR 816.87 - Coal mine waste: Burning and burned waste utilization.


    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Coal mine waste: Burning and burned waste utilization. 816.87 Section 816.87 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT...-SURFACE MINING ACTIVITIES § 816.87 Coal mine waste: Burning and burned waste utilization. (a) Coal mine...

  14. 30 CFR 817.87 - Coal mine waste: Burning and burned waste utilization.


    ... 30 Mineral Resources 3 2010-07-01 2010-07-01 false Coal mine waste: Burning and burned waste utilization. 817.87 Section 817.87 Mineral Resources OFFICE OF SURFACE MINING RECLAMATION AND ENFORCEMENT...-UNDERGROUND MINING ACTIVITIES § 817.87 Coal mine waste: Burning and burned waste utilization. (a) Coal mine...

  15. MHD control in burning plasmas MHD control in burning plasmas

    Donné, Tony; Liang, Yunfeng


    Fusion physics focuses on the complex behaviour of hot plasmas confined by magnetic fields with the ultimate aim to develop a fusion power plant. In the future generation of tokamaks like ITER, the power generated by the fusion reactions substantially exceeds the external input power (Pfusion}/Pin >= 10). When this occurs one speaks of a burning plasma. Twenty per cent of the generated fusion power in a burning plasma is carried by the charged alpha particles, which transfer their energy to the ambient plasma in collisions, a process called thermalization. A new phenomenon in burning plasmas is that the alpha particles, which form a minority but carry a large fraction of the plasma kinetic energy, can collectively drive certain types of magneto-hydrodynamic (MHD) modes, while they can suppress other MHD modes. Both types of MHD modes can have desirable effects on the plasma, as well as be detrimental to the plasma. For example, the so-called sawtooth instability, on the one hand, is largely responsible for the transport of the thermalized alpha particles out of the core, but, on the other hand, may result in the loss of the energetic alphas before they have fully thermalized. A further undesirable effect of the sawtooth instability is that it may trigger other MHD modes such as neoclassical tearing modes (NTMs). These NTMs, in turn, are detrimental to the plasma confinement and in some cases may even lead to disruptive termination of the plasma. At the edge of the plasma, finally, so-called edge localized modes or ELMs occur, which result in extremely high transient heat and particle loads on the plasma-facing components of a reactor. In order to balance the desired and detrimental effects of these modes, active feedback control is required. An additional complication occurs in a burning plasma as the external heating power, which is nowadays generally used for plasma control, is small compared to the heating power of the alpha particles. The scientific challenge

  16. A review of hydrofluoric acid burn management

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


    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.

  17. Titanium tetrachloride burns to the eye.

    Chitkara, D K; McNeela, B. J.


    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.

  18. Intentional burns in Nepal: a comparative study.

    Lama, Bir Bahadur; Duke, Janine M; Sharma, Narayan Prasad; Thapa, Buland; Dahal, Peeyush; Bariya, Nara Devi; Marston, Wendy; Wallace, Hilary J


    Intentional burns injuries are associated with high mortality rates, and for survivors, high levels of physical and psychological morbidity. This study provides a comprehensive assessment of intentional burn admissions to the adult Burns Unit at Bir Hospital, Kathmandu, Nepal, during the period 2002-2013. A secondary data analysis of de-identified data of patients hospitalized at Bir Hospital, Kathmandu, with a burn during the period of 1 January 2002 to 31 August 2013. Socio-demographic, injury and psychosocial factors of patients with intentional and unintentional burns are described and compared. Chi-square tests, Fisher's exact test and Wilcoxon rank sum tests were used to determine statistical significance. There were a total of 1148 burn admissions of which 329 (29%) were for intentional burn, 293 (26%) were self-inflicted and 36 (3%) were due to assault. Mortality rates for intentional burns were approximately three times those for unintentional burns (60 vs. 22%). When compared to unintentional burns, patients with intentional burns were more likely to be female (79 vs. 48%), married (84 vs. 67%), younger (25 vs. 30 years), have more extensive burns (total body surface area, %: 55 vs. 25) and higher mortality (60 vs. 22%). Intentional burns were more likely to occur at home (95 vs. 67%), be caused by fire (96 vs. 77%), and kerosene was the most common accelerant (91 vs. 31%). A primary psychosocial risk factor was identified in the majority of intentional burn cases, with 60% experiencing adjustment problems/interpersonal conflict and 32% with evidence of a pre-existing psychological condition. A record of alcohol/substance abuse related to the patient or other was associated with a greater proportion of intentional burns when compared with unintentional burns (17 vs. 4%). The majority of intentional burn patients were female. Almost all intentional burns occurred in the home and were caused by fire, with kerosene the most common accelerant used. Underlying

  19. Incidence and characteristics of chemical burns.

    Koh, Dong-Hee; Lee, Sang-Gil; Kim, Hwan-Cheol


    Chemical burns can lead to serious health outcomes. Previous studies about chemical burns have been performed based on burn center data so these studies have provided limited information about the incidence of chemical burns at the national level. The aim of this study was to evaluate the incidence and characteristics of chemical burns using nationwide databases. A cohort representing the Korean population, which was established using a national health insurance database, and a nationwide workers' compensation database were used to evaluate the incidence and characteristics of chemical burns. Characteristics of the affected body region, depth of burns, industry, task, and causative agents were analyzed from two databases. The incidence of chemical burns was calculated according to employment status. The most common regions involving chemical burns with hospital visits were the skin followed by the eyes. For skin lesions, the hands and wrists were the most commonly affected regions. Second degree burns were the most common in terms of depth of skin lesions. The hospital visit incidence was 1.96 per 10,000 person-year in the general population. The compensated chemical burns incidence was 0.17 per 10,000 person-year. Employees and the self-employed showed a significantly increased risk of chemical burns undergoing hospital visits compared to their dependents. Chemical burns on the skin and eyes are almost equally prevalent. The working environment was associated with increased risk of chemical burns. Our results may aid in estimating the size of the problem and prioritizing prevention of chemical burns. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  20. Love burns: An essay about bride burning in India.

    Jutla, Rajni K; Heimbach, David


    Each year in countries like India, thousands of young women are burned to death or afflicted with fatal burns. They are victims of dowry deaths. The husband and/or in-laws have determined that the dowry, a gift given from the daughter's parents to the husband, was inadequate and therefore attempt to murder the new bride to make the husband available to remarry or to punish the bride and her family. Unfortunately, this is a domestic issue that is often ignored or minimized, and the prosecution is often inadequate. This review article illustrates various scenarios of dowry deaths, investigates different predispositions, summarizes the current legislation, and proposes solutions to this problem. One hopes that the exposure of this problem may curtail its rampant, yet well-hidden, prevalence.

  1. Observation on efficacy of mitek mini anchor in treatment of shoulder dislocation with torn rotator cuff%Anchor钉在肩关节脱位并肩袖损伤中应用的疗效观察

    徐圣康; 罗斌; 熊为; 查琨; 刘家国; 张劲松; 赵猛


    Objective To explore the efficacy of mitek mini anchor( MMA )in the treatment of shoulder dislocation with fracture greater tuberosity and torn rotator cuff. Methods From July 2008 to January 2011,13 cases of shoulder dislocation with fracture greater tuberosity and torn rotator cuff were enrolled. The fracture fragments were exposured via deltoid muscles and pectoralis major, and got fixed with MMAand Krackow suture. Range of motion, clinical stability, muscles strength of upper limb and radio-graphic appearance were analyzed. Results All the patients were followed up for 10 ~ 16 months( mean 12 months ). The bone healing was satisfactory in all the cases. According to Neer scoring system, 11 cases were excellent and 2 cases were good. Conclusion MMAand titanium screw for the treatment of shoulder dislocation with fracture greater tuberosity and torn rotator cuff could provide sufficient stability to perform early functional rehabilitation and promote the recovery of shoulder dislocation, which is an ideal method.%目的 探讨Anchor钉在肩关节脱位并肱骨大结节撕脱性骨折及肩袖损伤中应用的疗效.方法 13例肩关节脱位并肱骨大结节撕脱性骨折及肩袖损伤患者行经三角肌-胸大肌入路显露骨折端,以Anchor钉行Krackow缝合方法结合钛钉内固定进行治疗.随访评价其肩关节稳定性、活动范围、上肢肌力、影像学改变.结果 所有患者得到随访,随访时间10~16个月,平均12个月,骨折均愈合良好.肩关节功能按Neer评分法,优11例,良2例.结论 Anchor钉结合钛钉修复肱骨大结节撕脱性骨折及肩袖损伤固定牢固、术后可早期功能锻炼,肩关节功能恢复良好,是一种较理想的手术方法.

  2. Pediatric burn rehabilitation: Philosophy and strategies

    Shohei Ohgi


    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.

  3. Management of post burn hand deformities

    Sabapathy S


    Full Text Available The hand is ranked among the three most frequent sites of burns scar contracture deformity. One of the major determinants of the quality of life in burns survivors is the functionality of the hands. Burns deformities, although largely preventable, nevertheless do occur when appropriate treatment is not provided in the acute situation or when they are part of a major burns. Reconstructive procedures can greatly improve the function of the hands. Appropriate choice of procedures and timing of surgery followed by supervised physiotherapy can be a boon for a burns survivor.

  4. New type of sauna-related burn: conductive contact burn.

    Shin, Seung Jun; Yoo, Heon; Park, Myong Chul


    A 70-year-old woman visited a Korean-style hot dry sauna room. The patient had a medical history of hypertension and hyperlipidemia. During the sauna, the patient slept for 30 minutes. During the sleep, the right medial thigh was covered with a fully wet towel. The patient sustained a second-degree burn on the right medial thigh area with multiple bullas. On physical examination, erythema, heating sensation, and swelling around the bullas were noted. The patient was admitted and received intravenous antibiotics for 7 days. A dressing with Silmazine 1% cream (sulfadiazine) was applied twice a day for prevention of local infection. The patient was discharged on day 14 without complication. In this case, the mechanism of the burn was different. Hot air has much thermal energy but is not conducted to the skin directly. A wet towel will have a relatively higher thermal capacity or heat capacity than a dry or damp towel, and the sodden water might be a medium for the conduction of thermal energy. Owing to the global popularity of sauna bathing, it is important to recognize all sources of sauna-related burns.

  5. Modelling burned area in Africa

    V. Lehsten


    Full Text Available The simulation of current and projected wildfires is essential for predicting crucial aspects of vegetation patterns, biogeochemical cycling as well as pyrogenic emissions across the African continent. This study uses a data-driven approach to parameterize two burned area models applicable to dynamic vegetation models (DVMs and Earth system models (ESMs. We restricted our analysis to variables for which either projections based on climate scenarios are available, or that are calculated by DVMs, and we consider a spatial scale of one degree as the scale typical for DVMs and ESMs. By using the African continent here as an example, an analogue approach could in principle be adopted for other regions, for global scale dynamic burned area modelling.

    We used 9 years of data (2000–2008 for the variables: precipitation over the last dry season, the last wet season and averaged over the last 2 years, a fire-danger index (the Nesterov index, population density, and annual proportion of area burned derived from the MODIS MCD45A1 product. Two further variables, tree and herb cover were only available for 2001 as a remote sensing product. Since the effect of fires on vegetation depends strongly on burning conditions, the timing of wildfires is of high interest too, and we were able to relate the seasonal occurrence of wildfires to the daily Nesterov index.

    We parameterized two generalized linear models (GLMs, one with the full variable set (model VC and one considering only climate variables (model C. All introduced variables resulted in an increase in model performance. Model VC correctly predicts the spatial distribution and extent of fire prone areas though the total variability is underrepresented. Model VC has a much lower performance in both aspects (correlation coefficient of predicted and observed ratio of burned area: 0.71 for model VC and 0.58 for model C. We expect the remaining variability to be attributed to additional

  6. Methylated spirit burns: an ongoing problem.

    Jansbeken, J R H; Vloemans, A F P M; Tempelman, F R H; Breederveld, R S


    Despite many educational campaigns we still see burns caused by methylated spirit every year. We undertook a retrospective study to analyse the impact of this problem. We retrospectively collected data of all patients with burns caused by methylated spirit over twelve years from 1996 to 2008. Our main endpoints were: incidence, age, mechanism of injury, total body surface area (TBSA) burned, burn depth, need for surgery and length of hospital stay. Ninety-seven patients with methylated spirit burns were included. During the study period there was no decrease in the number of patients annually admitted to the burn unit with methylated spirit burns. 28% of the patients (n=27) were younger than eighteen years old, 15% (n=15) were ten years old or younger. The most common cause of burns was carelessness in activities involving barbecues, campfires and fondues. Mean TBSA burned was 16% (SD 12.4). 70% (n=68) had full thickness burns. 66% (n=64) needed grafting. Mean length of hospital stay was 23 days (SD 24.7). The use of methylated spirit is an ongoing problem, which continues to cause severe burns in adults and children. Therefore methylated spirit should be banned in households. We suggest sale only in specialised shops, clear labelling and mandatory warnings. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  7. Occupational burns treated in emergency departments.

    Reichard, Audrey A; Konda, Srinivas; Jackson, Larry L


    Despite reported declines, occupational burn injuries remain a workplace safety concern. More severe burns may result in costly medical treatment and long-term physical and psychological consequences. We used the National Electronic Injury Surveillance System-Occupational Supplement to produce national estimates of burns treated in emergency departments (EDs). We analyzed data trends from 1999 to 2008 and provided detailed descriptions of 2008 data. From 1999 to 2008 there were 1,132,000 (95% CI: ±192,300) nonfatal occupational burns treated in EDs. Burn numbers and rates declined approximately 40% over the 10 years. In 2008, men and younger workers 15-24 years old had the highest rates. Scalds and thermal burns accounted for more than 60% of burns. Accommodation and food service, manufacturing, and construction industries had the largest number of burns. Despite declining burn rates, emphasis is needed on reducing burn hazards to young food service workers and using job specific hazard analyses to prevent burns. © 2015 Wiley Periodicals, Inc.

  8. Perineal burn care: French working group recommendations.

    Bordes, Julien; Le Floch, Ronan; Bourdais, Ludovic; Gamelin, Alexandre; Lebreton, Françoise; Perro, Gérard


    Burns to the perineum are frequently exposed to faeces. Diverting colostomy is often described to prevent faecal soiling. Because this technique is invasive with frequent complications, use of non-surgical devices including specifically designed faecal management systems has been reported in perineal burns. In order to standardise the faecal management strategy in patients with perineal burns, a group of French experts was assembled. This group first evaluated the ongoing practice in France by analysing a questionnaire sent to every French burn centre. Based on the results of this study and on literature data, the experts proposed recommendations on the management of perineal burns in adults. Specifically designed faecal management systems are the first-line method to divert faeces in perineal burns. The working group proposed recommendations and an algorithm to assist in decisions in the management of perineal burns in four categories of patients, depending on total burn skin area, depth and extent of the perineal burn. In France, non-surgical devices are the leading means of faecal diversion in perineal burns. The proposed algorithm may assist in decisions in the management of perineal burns. The expert group emphasises that large clinical studies are needed to better evaluate these devices. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  9. [Current treatment strategies for paediatric burns].

    Küntscher, M V; Hartmann, B


    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.

  10. Septicemia: The Principal Killer of Burns Patients

    B. R. Sharma


    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.

  11. Adult campfire burns: two avenues for prevention.

    Klein, Matthew B; Heimbach, David M; Honari, Shari; Engrav, Loren H; Gibran, Nicole S


    Campfires are a common component of outdoor festivities. Pediatric campfire burns have been well described. Adult campfire injuries also are common and have several important distinguishing characteristics. We performed a retrospective review of adult patients admitted with campfire burns to our burn center from July 1998 to July 2003. Medical records were reviewed with attention to mechanism of injury, intoxication level, burn size, and surgeries performed. A total of 27 patients with this injury were treated as inpatients over the course of the study period. Two distinct mechanisms of injury emerged: 1) contact with the campfire and 2) flash/flame injuries from igniting the fire. Eighty-one percent (13/16) of patients who sustained contact burns were intoxicated, as compared with 11% (1/11) of those who sustained flash/flame injuries. Nearly half of the patients with contact burns and more than half the patients with flash/flame burns required excision and grafting.


    R. McKinley


    Full Text Available In 2009, the Victoria Department of Sustainability and Environment estimated approximately 430,000 hectares of Victoria Australia were burned by numerous bushfires. Burned Area Emergency Response (BAER teams from the United States were deployed to Victoria to assist local fire managers. The U.S. Geological Survey Earth Resources Observation and Science Center (USGS/EROS and U.S. Forest Service Remote Sensing Applications Center (USFS/RSAC aided the support effort by providing satellite-derived "soil burn severity " maps for over 280,000 burned hectares. In the United States, BAER teams are assembled to make rapid assessments of burned lands to identify potential hazards to public health and property. An early step in the assessment process is the creation of a soil burn severity map used to identify hazard areas and prioritize treatment locations. These maps are developed primarily using Landsat satellite imagery and the differenced Normalized Burn Ratio (dNBR algorithm.

  13. Pre-hospital care in burn injury

    Shrivastava Prabhat


    Full Text Available The care provided to the victims of burn injury immediately after sustaining burns can largely affect the extent and depth of the wound. Although standard guidelines have been formulated by various burn associations, they are still not well known to public at large in our country. In burn injuries, most often, the bystanders are the first care providers. The swift implementation of the measures described in this article for first aid in thermal, chemical, electrical and inhalational injuries in the practical setting, within minutes of sustaining the burn, plays a vital role and can effectively reduce the morbidity and mortality to a great extent. In case of burn disasters, triage needs to be carried out promptly as per the defined protocols. Proper communication and transport from the scene of the accident to the primary care centre and onto the burn care facility greatly influences the execution of the management plans

  14. Polarized Reflectance Measurement of Burned Skin Tissues

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


    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.

  15. Fluconazole Pharmacokinetics in Burn Patients

    Boucher, Bradley A.; King, Stephen R.; Wandschneider, Heidi L.; Hickerson, William L.; Hanes, Scott D.; Herring, Vanessa L.; Canada, Todd W.; Hess, Mary M.


    The pharmacokinetics of fluconazole in nine adult patients with severe (30 to 95% total body surface area) burns were studied. There was no significant difference in half-life (t1/2), clearance (CL), or volume of distribution (V) over time in five patients on days 3 and 8 of the study (P > 0.05). Combined parameter estimates (means ± standard deviations) for all nine patients for the two study periods were as follows: t1/2, 24.4 ± 5.8 h; CL, 0.36 ± 0.09 ml/min/kg; and V, 0.72 ± 0.12 liters/kg. These estimates of t1/2 and CL in burn patients were approximately 13% shorter and 30% more rapid, respectively, than the most extreme estimates reported for other populations. PMID:9559811

  16. Zinc supplementation in burn patients.

    Caldis-Coutris, Nancy; Gawaziuk, Justin P; Logsetty, Sarvesh


    Micronutrient supplementation is a common practice throughout many burn centers across North America; however, uncertainty pertaining to dose, duration, and side effects of such supplements persists. The authors prospectively collected data from 23 hospitalized patients with burn sizes ranging from 10 to 93% TBSA. Each patient received a daily multivitamin and mineral supplement, 50 mg zinc (Zn) daily, and 500 mg vitamin C twice daily. Supplements were administered orally or enterally. Albumin, prealbumin, C-reactive protein, serum Zn, and serum copper were measured weekly during hospital admission until levels were within normal reference range. Our study concluded that 50 mg daily dose of Zn resulted in normal serum levels in 19 of 23 patients at discharge; 50 mg Zn supplementation did not interfere with serum copper levels; and Zn supplements, regardless of administration route, did not result in gastrointestinal side effects.

  17. Southeast U.S. burns

    Maggs, William Ward

    Human beings were responsible for most of 12,000 forest fires in the southeastern United States that burned for 10 days in late October and early November 1987. 910 km2, mostly hardwood forest, were destroyed in the fires, with arson and carelessness as the primary causes, according to the U.S. Department of Agriculture Forest Service.Measured in monetary terms, the toll was more than $40 million in resource and property damage. While the amount of forest burned did not rival the 3390 km2 lost to fires in the western United States last summer, the human impact was severe in the southeast and all along the East Coast. Favorable winds blew smoke from the southern and central Appalachians as far north as New England and as far east as Delaware, and cool fall air close to the ground prevented the smoke from rising, thickening the air in many northeastern cities on November 8 and 9.

  18. Wood-burning stoves worldwide

    Luis Teles de Carvalho, Ricardo

    , the advanced gasifiers and automatic stoves (Digital and Forced air) were identified to be among the best performing technologies. In spite of the fact that the thermal efficiency of the most advanced type of heating stoves (Gasifier) is around twice larger than that achieved for the most advanced type......More than any time in our history, the wood-burning stove continues to be the most popular technology used for cooking and heating worldwide. According to the World Health Organization and recent scientific studies, the inefficient use of solid-fuels in traditional stoves constitutes the major...... global environmental health risk, since these sources are important contributors to fine particulate matter (PM2.5) in the ambient air that increase climate and health risks. This thesis explores the social-technical dimensions of both the use of wood-burning stoves (WBSs) and transition to the use...

  19. Corneoscleral burn during phacoemulsification surgery.

    Majid, M A; Sharma, M K; Harding, S P


    We report a case in which a severe corneoscleral burn occurred during phacoemulsification surgery. The equipment-tuning process was uneventful and routine surgery was expected. Severe tissue injury occurred because the anterior chamber collapsed momentarily and the phaco tip touched corneoscleral tissue. We discuss mechanisms by which this type of injury may occur and the likely cause in our case. We also suggest methods to reduce the incidence.

  20. Burn injuries related to suicide.

    Persley, G V; Pegg, S P


    Of 1060 admissions to the burns unit, Royal Brisbane Hospital, over a 12-year period, there were 30 cases (2.8%) of attempted suicide. Fourteen (47%) of these patients died. The psychosocial features of people using self-ignition as a method of suicide are consistent with those of suicide in general. The morbidity if high and the outcome is often fatal, especially for those using a flammable liquid.

  1. Candidemia in major burns patients.

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


    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. © 2016 Blackwell Verlag GmbH.

  2. American Burn Association Consensus Statements


    medications (eg, propranolol , morphine, sertraline)13,15,16 should be a research pri- ority. Improved pain management has also been sug- gested as a...2000;232:455–65. 2. Jeschke MG, Norbury WB, Finnerty CC, Branski LK, Herndon DN. Propranolol does not increase inflammation, sepsis, or infectious...SE, Matin S, Herndon DN, Wolfe RR. A submaximal dose of insulin promotes net skel- etal muscle protein synthesis in patients with severe burns. Ann

  3. Rehabilitation of the Burned Hand


    13 Mallet and swan-neck deformities Thermal injury to the terminal slip of the extensor tendon can result in loss of DIP joint extension or mallet...deformity. Injury to the terminal slip can be a result of direct thermal injury or tendon ischemia induced as the injured tendon is compressed between...elastic bandage or self-adherent wrap may be necessary. Cotton socks over the splint may prevent the child from removing the splint. Contact burns

  4. American Burn Association consensus conference to define sepsis and infection in burns.

    Greenhalgh, David G; Saffle, Jeffrey R; Holmes, James H; Gamelli, Richard L; Palmieri, Tina L; Horton, Jureta W; Tompkins, Ronald G; Traber, Daniel L; Mozingo, David W; Deitch, Edwin A; Goodwin, Cleon W; Herndon, David N; Gallagher, James J; Sanford, Art P; Jeng, James C; Ahrenholz, David H; Neely, Alice N; O'Mara, Michael S; Wolf, Steven E; Purdue, Gary F; Garner, Warren L; Yowler, Charles J; Latenser, Barbara A


    Because of their extensive wounds, burn patients are chronically exposed to inflammatory mediators. Thus, burn patients, by definition, already have "systemic inflammatory response syndrome." Current definitions for sepsis and infection have many criteria (fever, tachycardia, tachypnea, leukocytosis) that are routinely found in patients with extensive burns, making these current definitions less applicable to the burn population. Experts in burn care and research, all members of the American Burn Association, were asked to review the literature and prepare a potential definition on one topic related to sepsis or infection in burn patients. On January 20, 2007, the participants met in Tucson, Arizona to develop consensus for these definitions. After review of the definitions, a summary of the proceedings was prepared. The goal of the consensus conference was to develop and publish standardized definitions for sepsis and infection-related diagnoses in the burn population. Standardized definitions will improve the capability of performing more meaningful multicenter trials among burn centers.

  5. [Treatment of burns in infants].

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


    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.

  6. Epidemiologic evaluation of patients with major burns and recommendations for burn prevention.

    Ciftçi, Ilhan; Arslan, Kemal; Altunbaş, Zeynep; Kara, Fatih; Yilmaz, Hüseyin


    Burns are an important health problem in our country and in the world. In our study, we aimed to epidemiologically analyze the patients who were hospitalized in a burn unit that serves 3 million individuals in Central Anatolia. Records of 457 patients who had been hospitalized in the burn unit during the period 2008-2010 were analyzed retrospectively. Patients were assessed in terms of gender, age, burn area, burn depth, admission time to the health center, burn region, and factors causing burns. Most (44.6%) of the patients were in the 0-5 age group. Burn surface area was detected as 11.6 +/- 8.5%. Patients had reached the health center in 252.8 +/- 892.5 minutes. While 82.7% of the patients had second degree bums, 17.3% had third degree burns. Most burns were on the extremities (39.6%). The most common burn agent was scalds with hot liquids (54.1%). In our study, children in the 0-5 age group were found to be the most commonly affected group with respect to indoor burns. The basic contributing factor is that children spend more time in the house and are more active. Scalding burns may be prevented when greater care is taken when using hot liquids that may lead to indoor burns. Informing parents on this issue is of first priority.

  7. An in vivo comparison of the modified Mason-Allen suture technique versus an inclined horizontal mattress suture technique with regard to tendon-to-bone healing: a biomechanical and histologic study in sheep.

    Schlegel, Theodore F; Hawkins, Richard J; Lewis, Chad W; Turner, A Simon


    The purpose of this study is to examine long-term tendon-to-bone healing, by use of a sheep animal model, after rotator cuff repairs performed with 2 different suture techniques: an inclined horizontal mattress suture pattern placed with special arthroscopic instrumentation (HMS) and the modified Mason-Allen pattern (MMA). After a pre hoc power analysis, 18 skeletally mature sheep were randomly assigned to either the HMS or MMA repair technique, with contralateral limbs used for the control group. At 26 weeks, the animals were euthanized. Six sheep from each group underwent biomechanical testing. Load-to-failure and stiffness results indicated no statistically significant difference between the 2 groups. Avulsion of the tuberosity was the primary mode of failure for both groups. In the remaining 6 sheep, histologic evaluation demonstrated that, regardless of treatment, the tendon appeared completely healed in the bony trough. Because the long-term biomechanical and histologic properties of healed tendons repaired with an HMA technique are equal to those obtained with an MMA technique, the inclined horizontal mattress suture may be appropriate for arthroscopic rotator cuff repair. Short-term studies are necessary to determine whether these findings are true early after tendon repair, when failure may be most common.

  8. Self-inflicted burns in soldiers.

    Gronovich, Yoav; Binenboym, Rami; Tuchman, Izhak; Eizenman, Nirit; Golan, Jacob


    Self-inflicted burns are a multidisciplinary medical challenge. In contrast to the more common motive of attempted suicide in self-infliction of a burn, usually of a serious degree, a second motive is malingering. Motivation of this nature has been exhibited among Israeli soldiers who inflict on themselves low- to moderate-degree burns to obtain dismissal from mandatory military service. The purpose of our study is to investigate and define this phenomenon. A retrospective analysis was performed on a population of 75 soldiers admitted to our Medical Center during the year 2010 with the diagnosis of any sort of burn. We set up a database including all relevant information about the burns including date and time of occurrence, cause, body location, depth of burn injury, area and shape of burn, etiology, and prescribed treatment. The summer was found to be the season with the highest incidence of burns. As far as the day of the week was influential, we found that the greater percentage of burns occurred at the beginning of the week. Most of the burns involved a minor surface area on the dorsal aspect of the foot. Scalding with hot water was the most common cause of burn. Eighty-one percent of the burns were atypical, being well demarcated.Most of the burn cases happened at home with no witnesses to the event. Sixty-one percent of the patients were not admitted to the hospital and were conservatively treated. Israeli soldiers tend to inflict burns on themselves for ulterior motives. Such burns are almost always minor with a small trauma area and sharp demarcations, and hence can be differentiated from other self-inflicted burns described in the literature. We found that most of the burns occur when the soldiers are on vacation at home. This is probably because the privacy allows them to carry out their act undisturbed. It is important to raise the awareness of attending physicians to the characteristics of these burns. Such patients should be evaluated by medical teams

  9. Outcomes of digital zone IV and V and thumb zone TI to TIV extensor tendon repairs using a running interlocking horizontal mattress technique.

    Altobelli, Grant G; Conneely, Stacy; Haufler, Christina; Walsh, Maura; Ruchelsman, David E


    Biomechanical evidence has demonstrated that the running interlocking horizontal mattress (RIHM) repair for extensor tendon lacerations is significantly stronger, with higher ultimate load to failure and less tendon shortening compared with other techniques. We investigated the efficacy and safety of primary extensor tendon repair using the RIHM repair technique in the fingers followed by the immediate controlled active motion protocol, and in the thumb followed by a dynamic extension protocol. We conducted a retrospective review of all patients undergoing extensor tendon repair from August 2009 to April 2012 by single surgeon in an academic hand surgery practice. The inclusion criteria were simple extensor tendon lacerations in digital zones IV and V and thumb zones TI to TIV and primary repair performed using the RIHM technique. We included 8 consecutive patients with 9 tendon lacerations (3 in the thumb). One patient underwent a concomitant dorsal hand rotation flap for soft tissue coverage. We used a 3-0 nonabsorbable braided suture to perform a running simple suture in 1 direction to obtain a tension-free tenorrhaphy, followed by an RIHM corset-type suture using the same continuous strand in the opposite direction. Average time to surgery was 10 days (range, 3-33 d). Mean follow-up was 15 weeks (range, 10-26 wk). We applied the immediate controlled active motion protocol to all injuries except those in the thumb, where we used a dynamic extension protocol instead. Using the criteria of Miller, all 9 tendon repairs achieved excellent or good results. There were no tendon ruptures or extensor lags. No patients required secondary surgery for tenolysis or joint release. No wound complications occurred. The RIHM technique for primary extensor tendon repairs in zone IV and V and T1 to TIV is safe, allows for immediate controlled active motion in the fingers and an immediate dynamic extension protocol in the thumb, and achieves good to excellent functional outcomes

  10. Increasing the utility of the Functional Assessment for Burns Score: Not just for major burns.

    Smailes, Sarah T; Engelsman, Kayleen; Rodgers, Louise; Upson, Clara


    The Functional Assessment for Burns (FAB) score is established as an objective measure of physical function that predicts discharge outcome in adult patients with major burn. However, its validity in patients with minor and moderate burn is unknown. This is a multi-centre evaluation of the predictive validity of the FAB score for discharge outcome in adult inpatients with minor and moderate burns. FAB assessments were undertaken within 48 h of admission to (FAB 1), and within 48 h of discharge (FAB 2) from burn wards in 115 patients. Median age was 45 years and median burn size 4%. There were significant improvements in the patients' FAB scores (pburns.

  11. Acute pain management in burn patients

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


    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......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...

  12. Fluid management in major burn injuries

    Haberal Mehmet


    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.

  13. Vitamin E Supplementation in Burn Patients


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

  14. Infection control in severely burned patients

    Coban, Yusuf Kenan


    In the last two decades, much progress has been made in the control of burn wound infection and nasocomial infections (NI) in severely burned patients. The continiually changing epidemiology is partially related to greater understanding of and improved techniques for burn patient management as well as effective hospital infection control measures. With the advent of antimicrobial chemotherapeutic agents, infection of the wound site is now not as common as, for example, urinary and blood strea...

  15. Managing burn patients in a fire disaster: Experience from a burn unit in Bangladesh.

    Mashreky, S R; Bari, S; Sen, S L; Rahman, A; Khan, T F; Rahman, F


    Although burn disaster is not a frequent event, with urbanisation and industrialisation, burn disaster is becoming an emerging problem in Bangladesh. On 3 June 2010, a fire disaster killed 124 people in Neemtali, Dhaka, Bangladesh. This paper narrates the management of burn patients of this disaster in the burn unit of Dhaka Medical College Hospital. The burn unit managed 192 burn victims of the disaster. Forty-two victims were admitted and 150 of them received primary care at the emergency room and were sent back home. Ten patients among 42 in-patients died. The in-patient mortality was 23.8%. Burn unit in Dhaka Medical College Hospital is the only burn management centre in Bangladesh. Proper planning and coordinated effort by all sectors and persons concerned were the key elements in this successful management.

  16. Managing burn patients in a fire disaster: Experience from a burn unit in Bangladesh

    Mashreky S


    Full Text Available Although burn disaster is not a frequent event, with urbanisation and industrialisation, burn disaster is becoming an emerging problem in Bangladesh. On 3 June 2010, a fire disaster killed 124 people in Neemtali, Dhaka, Bangladesh. This paper narrates the management of burn patients of this disaster in the burn unit of Dhaka Medical College Hospital. The burn unit managed 192 burn victims of the disaster. Forty-two victims were admitted and 150 of them received primary care at the emergency room and were sent back home. Ten patients among 42 in-patients died. The in-patient mortality was 23.8%. Burn unit in Dhaka Medical College Hospital is the only burn management centre in Bangladesh. Proper planning and coordinated effort by all sectors and persons concerned were the key elements in this successful management.

  17. The Hand Burn Severity (HABS) score: A simple tool for stratifying severity of hand burns.

    Bache, Sarah E; Fitzgerald O'Connor, Edmund; Theodorakopoulou, Evgenia; Frew, Quentin; Philp, Bruce; Dziewulski, Peter


    Hand burns represent a unique challenge to the burns team due to the intricate structure and unrivalled functional importance of the hand. The initial assessment and prognosis relies on consideration of the specific site involved as well as depth of the burn. We created a simple severity score that could be used by referring non-specialists and researchers alike. The Hand Burn Severity (HABS) score stratifies hand burns according to severity with a numerical value of between 0 (no burn) and 18 (most severe) per hand. Three independent assessors scored the photographs of 121 burned hands of 106 adult and paediatric patients, demonstrating excellent inter-rater reliability (r=0.91, pburn depth alone. The HABS score is a simple to use tool to stratify severity at initial presentation of hand burns which will be useful when referring, and when reporting outcomes. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  18. Patient safety measures in burn care: do National reporting systems accurately reflect quality of burn care?

    Mandell, Samuel P; Robinson, Ellen F; Cooper, Claudette L; Klein, Matthew B; Gibran, Nicole S


    Recently, much attention has been placed on quality of care metrics and patient safety. Groups such as the University Health-System Consortium (UHC) collect and review patient safety data, monitor healthcare facilities, and often report data using mortality and complication rates as outcomes. The purpose of this study was to analyze the UHC database to determine if it differentiates quality of care across burn centers. We reviewed UHC clinical database (CDB) fields and available data from 2006 to 2008 for the burn product line. Based on the September 2008 American Burn Association (ABA) list of verified burn centers, we categorized centers as American Burn Association-verified burn centers, self-identified burn centers, and other centers that are not burn units but admit some burn patients. We compared total burn admissions, risk pool, complication rates, and mortality rates. Overall mortality was compared between the UHC and National Burn Repository. The UHC CDB provides fields for number of admissions, % intensive care unit admission, risk pool, length of stay, complication profiles, and mortality index. The overall numbers of burn patients in the database for the study period included 17,740 patients admitted to verified burn centers (mean 631 admissions/burn center/yr or per 2 years), 10,834 for self-identified burn centers (mean 437 admissions/burn center/yr or per 2 years), and 1,487 for other centers (mean 11.5 admissions/burn center/yr or per 2 years). Reported complication rates for verified burn centers (21.6%), self-identified burn centers (21.3%), and others (20%) were similar. Mortality rates were highest for self-identified burn centers (3.06%), less for verified centers (2.88%), and lowest for other centers (0.74%). However, these outcomes data may be misleading, because the risk pool criteria do not include burn-specific risk factors, and the inability to adjust for injury severity prevents rigorous comparison across centers. Databases such as the

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

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


    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.

  20. Burn site groundwater interim measures work plan.

    Witt, Jonathan L. (North Wind, Inc., Idaho Falls, ID); Hall, Kevin A. (North Wind, Inc., Idaho Falls, ID)


    This Work Plan identifies and outlines interim measures to address nitrate contamination in groundwater at the Burn Site, Sandia National Laboratories/New Mexico. The New Mexico Environment Department has required implementation of interim measures for nitrate-contaminated groundwater at the Burn Site. The purpose of interim measures is to prevent human or environmental exposure to nitrate-contaminated groundwater originating from the Burn Site. This Work Plan details a summary of current information about the Burn Site, interim measures activities for stabilization, and project management responsibilities to accomplish this purpose.

  1. Burn healing plants in Iranian Traditional Medicine

    Sh. Fahimi


    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.

  2. Aeromonas hydrophila in a burn patient.

    Yasti, Ahmet Cinar; Otan, Emrah; Doganay, Mutlu; Kama, Nuri A


    Infectious consequences are still a major problem and leading cause of mortality in burn patients. Among others, aeromonads need special concern because they mimic pseudomonal infections; however, they have a more rapid progression with considerable mortality if undiagnosed promptly. Here, we present a major burn case extinguished with tap water pooled in a tank. With the possibility of aeromonal infection in mind, the patient underwent aggressive debridement with proper antibiotic medication, which resulted in a successful patient management. Aeromonads should always be kept in mind in burn cases that contacted with tanked water or soil after the burn.

  3. Hospital costs associated with pediatric burn injury.

    Klein, Matthew B; Hollingworth, William; Rivara, Frederick P; Kramer, C Bradley; Askay, Shelley W; Heimbach, David M; Gibran, Nicole S


    Modern burn care is a resource intensive endeavor requiring specialized equipment, personnel, and facilities in order to provide optimum care. The costs associated with burn injury to both patients and society as a whole can be multifaceted and large. The purpose of this study was to evaluate the association between hospital costs, patient characteristics, and injury factors in a cohort of pediatric patients admitted to a regional burn center. We performed a review of the hospital charges accrued by pediatric patients (age dollar costs using an inflation index and a cost to charge ratio. Univariate and multivariate regressions were performed to identify the factors most significantly associated with cost. In addition, we performed a subset cost analysis for patients with burns more than 20% TBSA. A total of 1443 pediatric patients (age dollars was dollars 9026 (SD = dollars 25,483; median = dollars 2138). Area of full thickness burn was the only patient or injury factor significantly associated with greater hospital costs (P < .05) on multivariate analysis. No single anatomic area was associated with increased hospital costs when adjusted for total overall burn size. Injury severity was the most significant factor impacting index hospitalization costs following pediatric burn injury. Further studies defining the long-term societal costs impact of burn injury are needed as are studies that evaluate the impact of burn injury on quality of life.

  4. Renal failure in burn patients: a review.

    Emara, S S; Alzaylai, A A


    Burn care providers are usually challenged by multiple complications during the management of acute burns. One of the most common complications worldwide is renal failure. This article reviews the various aspects of renal failure management in burn patients. Two different types of renal failures develop in these patients. The different aetiological factors, incidence, suspected prognosis, ways of diagnosing, as well as prevention methods, and the most accepted treatment modalities are all discussed. A good understanding and an effective assessment of the problem help to reduce both morbidity and mortality in burn management.

  5. Cutaneous osteosarcoma arising from a burn scar

    Lee, Min A.; Yi, Jaehyuck [Kyungpook National University, Department of Radiology, College of Medicine, Daegu (Korea, Republic of); Kyungpook National University Hospital, Department of Radiology, Daegu (Korea, Republic of); Chae, Jong Min [Kyungpook National University, Department of Pathology, College of Medicine, Daegu (Korea, Republic of)


    Tumors that develop in old burn scars are usually squamous cell carcinomas. Sarcomas have also been reported, albeit rarely. To our knowledge, there has been only one case report of an extraskeletal osteosarcoma arising in a prior burn scar reported in the English-language literature, mainly discussing the clinicopathological features. Herein, we present a case of cutaneous osteosarcoma visualized as a mineralized soft-tissue mass arising from the scar associated with a previous skin burn over the back. This seems to be the first report describing the imaging features of a cutaneous osteosarcoma from an old burn scar. (orig.)

  6. High burn rate solid composite propellants

    Manship, Timothy D.

    High burn rate propellants help maintain high levels of thrust without requiring complex, high surface area grain geometries. Utilizing high burn rate propellants allows for simplified grain geometries that not only make production of the grains easier, but the simplified grains tend to have better mechanical strength, which is important in missiles undergoing high-g accelerations. Additionally, high burn rate propellants allow for a higher volumetric loading which reduces the overall missile's size and weight. The purpose of this study is to present methods of achieving a high burn rate propellant and to develop a composite propellant formulation that burns at 1.5 inches per second at 1000 psia. In this study, several means of achieving a high burn rate propellant were presented. In addition, several candidate approaches were evaluated using the Kepner-Tregoe method with hydroxyl terminated polybutadiene (HTPB)-based propellants using burn rate modifiers and dicyclopentadiene (DCPD)-based propellants being selected for further evaluation. Propellants with varying levels of nano-aluminum, nano-iron oxide, FeBTA, and overall solids loading were produced using the HTPB binder and evaluated in order to determine the effect the various ingredients have on the burn rate and to find a formulation that provides the burn rate desired. Experiments were conducted to compare the burn rates of propellants using the binders HTPB and DCPD. The DCPD formulation matched that of the baseline HTPB mix. Finally, GAP-plasticized DCPD gumstock dogbones were attempted to be made for mechanical evaluation. Results from the study show that nano-additives have a substantial effect on propellant burn rate with nano-iron oxide having the largest influence. Of the formulations tested, the highest burn rate was a 84% solids loading mix using nano-aluminum nano-iron oxide, and ammonium perchlorate in a 3:1(20 micron: 200 micron) ratio which achieved a burn rate of 1.2 inches per second at 1000

  7. Deciding Where to Burn: Stakeholder Priorities for Prescribed Burning of a Fire-Dependent Ecosystem

    Jennifer K. Costanza


    Full Text Available Multiagency partnerships increasingly work cooperatively to plan and implement fire management. The stakeholders that comprise such partnerships differ in their perceptions of the benefits and risks of fire use or nonuse. These differences inform how different stakeholders prioritize sites for burning, constrain prescribed burning, and how they rationalize these priorities and constraints. Using a survey of individuals involved in the planning and implementation of prescribed fire in the Onslow Bight region of North Carolina, we examined how the constraints and priorities for burning in the longleaf pine (Pinus palustris ecosystem differed among three stakeholder groups: prescribed burn practitioners from agencies, practitioners from private companies, and nonpractitioners. Stakeholder groups did not differ in their perceptions of constraints to burning, and development near potentially burned sites was the most important constraint identified. The top criteria used by stakeholders to decide where to burn were the time since a site was last burned, and a site's ecosystem health, with preference given to recently burned sites in good health. Differences among stakeholder groups almost always pertained to perceptions of the nonecological impacts of burning. Prescribed burning priorities of the two groups of practitioners, and particularly practitioners from private companies, tended to be most influenced by nonecological impacts, especially through deprioritization of sites that have not been burned recently or are in the wildland-urban interface (WUI. Our results highlight the difficulty of burning these sites, despite widespread laws in the southeast U.S. that limit liability of prescribed burn practitioners. To avoid ecosystem degradation on sites that are challenging to burn, particularly those in the WUI, conservation partnerships can facilitate demonstration projects involving public and private burn practitioners on those sites. In summary

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

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


    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]…

  9. Survey of care and evaluation of East African burn unit feasibility: an academic burn center exchange.

    Mitchell, Katrina B; Giiti, Geofrey; Gallagher, James J


    Weill Cornell Medical College in New York, partnered with Weill Bugando Medical College and Sekou Toure Regional Referral Hospital, in Mwanza, Tanzania, to consider the development of a burn unit there. This institutional partnership provided a unique opportunity to promote sustainable academic exchange and build burn care capacity in the East African region. A Weill Cornell burn surgeon and burn fellow collaborated with the Sekou Toure department of surgery to assess its current burn care capabilities and potential for burn unit development. All aspects of interdisciplinary burn care were reviewed and institutional infrastructure evaluated. Sekou Toure is a 375-bed regional referral center and teaching hospital of Weill Bugando Medical College. In 2010-2011, it admitted 5244 pediatric patients in total; 100 of these patients were burn-injured children (2% of admissions). There was no specific data kept on percentage of body surface burned, degree of burn, length of stay, or complications. No adult, operative, or outpatient burn data were available. There are two operating theaters. Patient's families perform wound care with nursing supervision. Rehabilitation therapists consult as needed. Meals are provided three times daily by a central kitchen. Public health outreach is possible through village-based communication networks. Infrastructure to support the development of a burn care unit exists at Sekou Toure, but needs increased clinical focus, human resource capacity building, and record-keeping to track accurate patient numbers. A multidisciplinary center could improve record-keeping and outcomes, encourage referrals, and facilitate outreach through villages.

  10. Electrical burns of the abdomen

    Rakesh Kumar Srivastava


    Full Text Available A 35-year-old male farmer came in contact with 11,000 volts high tension electric wire and sustained full thickness burn wounds over scapula, upper limb and anterior abdominal wall along with perforation of the intestine. Patient was initially managed conservatively in general surgery ward and was referred to us after 3 days with necrosis of the burned skin and muscles over the shoulder and abdomen. Patient was initially managed conservatively and then thorough debridement of the necrotic skin over the left shoulder and upper arm was done and the area was split skin grafted. Patient developed enterocutaneous fistula, which healed over a period of 8 weeks. The granulating wound over the abdomen was also skin grafted and patient was discharged after 18 days. About 4 months, after the discharge patient presented with ventral hernia. Repair of ventral hernia by synthetic mesh application and reconstruction of the abdominal wall with a free tensor fascia lata flap was done over the mesh, but the flap failed. Then after debridement two random pattern transposition skin flaps, one from the right upper and another from the left lower abdomen were transposed over the abdominal wound and donor area was skin grafted. Patient was discharged after 17 days.

  11. Moderate systemic hypothermia decreases burn depth progression.

    Rizzo, Julie A; Burgess, Pamela; Cartie, Richard J; Prasad, Balakrishna M


    Therapeutic hypothermia has been proposed to be beneficial in an array of human pathologies including cardiac arrest, stroke, traumatic brain and spinal cord injury, and hemorrhagic shock. Burn depth progression is multifactorial but inflammation plays a large role. Because hypothermia is known to reduce inflammation, we hypothesized that moderate hypothermia will decrease burn depth progression. We used a second-degree 15% total body surface area thermal injury model in rats. Burn depth was assessed by histology of biopsy sections. Moderate hypothermia in the range of 31-33°C was applied for 4h immediately after burn and in a delayed fashion, starting 2h after burn. In order to gain insight into the beneficial effects of hypothermia, we analyzed global gene expression in the burned skin. Immediate hypothermia decreased burn depth progression at 6h post injury, and this protective effect was sustained for at least 24h. Burn depth was 18% lower in rats subjected to immediate hypothermia compared to control rats at both 6 and 24h post injury. Rats in the delayed hypothermia group did not show any significant decrease in burn depth at 6h, but had 23% lower burn depth than controls at 24h. Increased expression of several skin-protective genes such as CCL4, CCL6 and CXCL13 and decreased expression of tissue remodeling genes such as matrix metalloprotease-9 were discovered in the skin biopsy samples of rats subjected to immediate hypothermia. Systemic hypothermia decreases burn depth progression in a rodent model and up-regulation of skin-protective genes and down-regulation of detrimental tissue remodeling genes by hypothermia may contribute to its beneficial effects. Published by Elsevier Ltd.

  12. Epidemiology of hospitalized burns patients in Taiwan.

    Chien, Wu-Chien; Pai, Lu; Lin, Chao-Cheng; Chen, Heng-Chang


    Previous studies based on either single hospital data or sampling of specific groups of hospitalized burns victims in Taiwan have provided only minimal epidemiological information. The study is designed to provide additional data on the epidemiology of hospitalized burns patients in Taiwan. Data were obtained from the Burn Injury Information System (BIIS), which brings together information supplied by 34 contracted hospitals. The study time course spanned a 2-year period from July 1997 to June 1999. Patient characteristics (age, sex, education level, etc.), causes and severity of injuries, and medical care measures were explored. A total of 4741 patients were registered with BIIS over the study period. The majority of hospitalized patients (67%) were male. The age distribution of burns patients showed peaks occurring at the age groups of 0-5 and 35-44 years. Over the time course of a day, burn injuries occurred more frequently from 10:00 to 12:00 h and 16:00 to 18:00 h. Injuries suspected as the result of suicide, homicide or child abuse accounted for 4.8% of hospitalized cases. More than 48% of the burns occurred in the home. The leading type of burn injury was scalding, followed by naked flame, explosion, electrical burns, and chemical burns due to caustic or corrosive substances. The mean percent total body surface area (%TBSA) for adults was 19%, and for young children was 12%. The average length of hospital stay was 18 days. In conclusion, children under 5 years and adults between 35 and 44 years of age are two high-risk groups for burn injuries. Corresponding to meal preparation time, hot substances such as boiling water, hot soup, etc. are the most common agents responsible for scalds. Prevention programs for reducing the risk of burn injuries during cooking and eating are required, especially for parents with young children.

  13. National programme for prevention of burn injuries

    Gupta J


    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.

  14. Management of Critical Burn Injuries: Recent Developments

    David J. Dries


    Full Text Available Background 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 vital organ function. Later complications of burn injury are dominated by infection. Burn centers are often called to manage problems related to thermal injury, including lightning and electrical injuries. Methods A selected review is provided of key management concepts as well as of recent reports published by the American Burn Association. Results The burn-injured patient is easily and frequently over resuscitated, with ensuing complications that include delayed wound healing and respiratory compromise. A feedback protocol designed to limit the occurrence of excessive resuscitation has been proposed, but no new “gold standard” for resuscitation has replaced the venerated Parkland formula. While new medical therapies have been proposed for patients sustaining inhalation injury, a paradigm-shifting standard of medical therapy has not emerged. Renal failure as a specific contributor to adverse outcome in burns has been reinforced by recent data. Of special problems addressed in burn centers, electrical injuries pose multisystem physiologic challenges and do not fit typical scoring systems. Conclusion Recent reports emphasize the dangers of over resuscitation in the setting of burn injury. No new medical therapy for inhalation injury has been generally adopted, but new standards for description of burn-related infections have been presented. The value of the burn center in care of the problems of electrical exposure, both manmade and natural, is demonstrated in recent reports.

  15. Increased admissions for diabetes mellitus after burn.

    Duke, Janine M; Randall, Sean M; Fear, Mark W; Boyd, James H; O'Halloran, Emily; Rea, Suzanne; Wood, Fiona M


    Currently, limited long-term data on hyperglycaemia and insulin sensitivity in burn patients are available and the data that do exist are primarily related to paediatric severe burns. The aim of this study was to assess if burn is associated with increased post-burn admissions for diabetes mellitus. A population-based longitudinal study using linked hospital morbidity and death data from Western Australia was undertaken of all persons hospitalized for a first burn (n=30,997) in 1980-2012 and a frequency matched non-injury comparison cohort, randomly selected from Western Australia's birth registrations and electoral roll (n=123,399). Crude admission rates and summed length of stay for diabetes mellitus were calculated. Negative binomial and Cox proportional hazards regression modelling were used to generate incidence rate ratios (IRR) and hazard ratios (HR), respectively. After adjustment for socio-demographic factors and pre-existing health status, the burn cohort had 2.21 times (95% Confidence Interval (CI): 1.36-1.56) as many admissions and almost three times the number of days in hospital with a diabetes mellitus diagnosis (IRR, 95% CI: 2.94, 2.12-4.09) than the uninjured cohort. Admission rates were significantly elevated for those burned during childhood (diabetes mellitus in the burn cohort provide evidence that burns have longer term effects on blood glucose and insulin regulation after wound healing. The first five years after burn discharge appears to be a critical period with significantly elevated incident admissions for diabetes mellitus during this time. Results would suggest prolonged clinical management after discharge and or wound healing to minimise post-burn admissions for diabetes mellitus is required. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  16. Burn Prevention for Families with Children with Special Needs

    ... Burn Prevention for Families With Children With Special Needs Watch this video to learn what you need to know about burn prevention if you have a child with special needs. Read our burn prevention tips | Visit our YouTube ...

  17. Burn Prevention for Families with Children with Special Needs

    Full Text Available ... Tips Video Special Needs Burns and Scalds Burn Prevention for Families With Children With Special Needs Watch ... learn what you need to know about burn prevention if you have a child with special needs. ...

  18. Burn Prevention for Families with Children with Special Needs

    Full Text Available ... Tips Video Special Needs Burns and Scalds Burn Prevention for Families With Children With Special Needs Watch ... learn what you need to know about burn prevention if you have a child with special needs. ...

  19. How Does the Freezer Burn Our Food?

    Schmidt, Shelly J.; Lee, Joo Won


    Freezer burn is a common problem that significantly affects the color, texture, and flavor of frozen foods. Food science students should be able to clearly explain the causes and consequences of freezer burn. However, it is difficult to find a modern, detailed, accurate, yet concise, explanation of the mechanism and factors influencing the rate of…

  20. Current approach to burn critical care.

    Sakallioglu, A E; Haberal, M


    Burn trauma is a frequent cause of morbidity and mortality all over the world. Advancements in resuscitation, surgical tecniques, infection control and nutritional/metaolic support decreased mortality and morbidity. This article intends to review current outlines for initial treatment and resuscitation nutritional/metabolic support and wound management peculiar to burn patients.

  1. Pathophysiologic Response to Burns in the Elderly.

    Jeschke, Marc G; Patsouris, David; Stanojcic, Mile; Abdullahi, Abdikarim; Rehou, Sarah; Pinto, Ruxandra; Chen, Peter; Burnett, Marjorie; Amini-Nik, Saeid


    Over the last decades advancements have improved survival and outcomes of severely burned patients except one population, elderly. The Lethal Dose 50 (LD50) burn size in elderly has remained the same over the past three decades, and so has morbidity and mortality, despite the increased demand for elderly burn care. The objective of this study is to gain insights on why elderly burn patients have had such a poor outcome when compared to adult burn patients. The significance of this project is that to this date, burn care providers recognize the extreme poor outcome of elderly, but the reason remains unclear. In this prospective translational trial, we have determined clinical, metabolic, inflammatory, immune, and skin healing aspects. We found that elderly have a profound increased mortality, more premorbid conditions, and stay at the hospital for longer, p 0.05, but a significant increased incidence of multi organ failure, p response, increased hyperglycemic and hyperlipidemic responses, inversed inflammatory response, immune-compromisation and substantial delay in wound healing predominantly due to alteration in characteristics of progenitor cells, p responses to burns when compared to adults associated with increased morbidity and mortality. This study indicates that these responses are complex and not linear, requiring a multi-modal approach to improve the outcome of severely burned elderly.

  2. Osteomyelitis in burn patients requiring skeletal fixation

    Barret, JP; Desai, MH; Herndon, DN


    Deep and severe burns often present with the exposure of musculoskeletal structures and severe deformities. Skeletal fixation, suspension and/or traction are part of their comprehensive treatment. Several factors put burn patients at risk for osteomyelitis, osteosynthesis material being one of them.

  3. Epidemiology of pediatric burn in southern Taiwan.

    Lin, Tsai-Ming; Wang, Kai-Hung; Lai, Cheng-Sheng; Lin, Sin-Daw


    A 5-year retrospective review of 157 pediatric patients admitted to burn center of Kaohsiung Medical University Hospital (Kaohsiung, Taiwan) was undertaken to identify the incidence, mechanism, and agents of pediatric burn. The highest incidence of pediatric burn was in children aged 1-6 years (57.3%), followed by age group 6-14 years (31.8%). Scald burn (75.2%) made up the major cause of this injury and was dominant in each age group compared to non-scald burn. The kitchen/dining area (57.3%) and living room (29.9%) accounted for the most frequent places where pediatric burns occurred. Among the agents of scald burn, hot drink (49.2%) and soup (32.2%) were the two leading causes. There were more pediatric burns reported in colder seasons (38.2% and 33.1% in winter and fall respectively) and during dining time (19.7% in 11 a.m.-1 p.m. and 35.0% in 5 p.m.-8 p.m.). The results of this report may be closely related to special culinary habits (use of chafing-dish and making hot tea) in the south of Taiwan.

  4. Eradicating Understory Hardwoods By Repeated Prescribed Burning

    Charles X. Grano


    In a loblolly-shorleaf pine stand contained abundant litter, one winter fire killed 94 percent of the stems of understory hardwoods up to 3.5 inches in diameter at teh base. Prolific sprouting ensued. Eleven annual summer burns eliminated sprouting on 85 percent of the rootstocks, and seven biennial summer burns eliminated sprouting on 59 percent of them.

  5. Treating burns caused by hydrofluoric acid.

    Summers, Anthony


    Hydrofluoric acid is an ingredient of many common household and industrial solutions. Even seemingly minor burns caused by this acid can have catastrophic effects if they are treated inappropriately or late. This article describes the signs and symptoms, the pathophysiology and the emergency management of hydrofluoric acid burns.

  6. Steam vaporizers: A danger for paediatric burns.

    Lonie, Sarah; Baker, Paul; Teixeira, Rodrigo


    Steam vaporizers are used to humidify air in dry environments. They are marketed to moisten children's airway secretions and thus to help relieve symptoms associated with upper respiratory tract infections. Unfortunately the steam emitted from the unit can also pose a significant risk of burns to children. Our study aimed to ascertain patterns of injury and treatment outcomes from steam burns resulting from these devices. Potential preventative measures are discussed. Children who had sustained vaporizer scald burns were identified at the outpatient burns clinic over a 10-month period (November 2014-August 2015). Medical records were reviewed retrospectively and data collected on pattern of injury, management and outcomes. Ten children were treated for vaporizer steam burns over the study period. The mean age was 1.6 years and 8 (80%) patients were male. Operative intervention was undergone in 5 (50%) cases; four acutely and one as a secondary reconstructive procedure. Hand burns accounted for 8 (80%) of cases. Steam vaporizers can cause significant burns in the paediatric population. Toddlers were most at risk, frequently sustaining hand burns that underwent skin grafting. Greater public awareness of the danger is indicated and measures to prevent such injuries should be addressed by appropriate authorities. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  7. Predictive Factors of Mortality in Burn Patients

    Fazeli; Karami-Matin; Kakaei; Pourghorban; Safari-Faramani


    Background: Burn injuries impose a considerable burden on healthcare systems in Iran. It is among the top ten causes of mortality and a main cause of disability. Objectives: This study aimed to examine factors influencing mortality in burn patients admitted to the main educational tertiary referral hospital in Kermanshah. Patients and Methods: All patients admitted to the Imam Khom...


    Jaiprakash, B.; Chandramohan,; Reddy, D. Narishma


    The Ethanolic extract of whole plant of Euphorbia hirta was screened for burn wound healing activity in rats as 2% W/W cream. The study was carried out based on the assessment of percentage reduction in original wound. It showed significant burn wound healing activity.

  9. 'Sabbath' electric plate burn: a ritual hazard.

    Benmeir, P; Sagi, A; Rosenberg, L; Picard, E; Ben Yakar, Y


    This report describes the burns caused by an electric hot plate which is used by orthodox Jews for keeping food and liquids warm during the Sabbath (Saturday). An illustrative case is presented and the preventable aspects of this particular burn are discussed.

  10. [Scalp burns due to hair bleach].

    Wagenblast, Lene


    We present two cases of scalp burn or possible chemical reaction due to use of hair highlight products. One case was treated with serial excision of the scarred bald area after the burn, and the other case was treated with implantation of expanders and subsequent excision of the bald area.

  11. Wind erosion of soils burned by wildfire

    N. S. Wagenbrenner; M. J. Germino; B. K. Lamb; R. B. Foltz; P. R. Robichaud


    Wind erosion and aeolian transport processes are largely unstudied in the post-wildfire environment, but recent studies have shown that wind erosion can play a major role in burned landscapes. A wind erosion monitoring system was installed immediately following a wildfire in southeastern Idaho, USA to measure wind erosion from the burned area (Figure 1). This paper...

  12. Burn Injury Arise From Flying Balloon Toys

    Yalcin Kulahci


    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


    王鸿利; 邵慧珍; 支立民; 肖玉瑞; 杨丽英; 史济湘


    Seventy-eight burned patients (53 males and 25 females) were classified into 4 groups (mild type: 14 cases, moderate type: 13 cases, severe type: 17 cases and super-severe type: 34 cases) in accordence with criteria established by the Chinese Society for burns. Twenty-two parameters related to platelet, coagulant and anticoagulant factors, fibrinolysis system and hemorrheology were determined at first 24 hours, on third and fifth post-burn days. The results were as follow: Fibrinogen antigen, von Willebrand factor antigen, plasminogen activitor inhibitor activity, thromboxane B2 and hematocrit and whole blood viscosity significantly increased, however antithrombin Ⅲ, protein C antigen, free protein S and 6-keto-prostaglandin F1α markedly decreased compared with normal control at first 24 hours post burn. In addition, fibrinogen antigen, von Willebrand factor antigen, plasminogen activitor inhibitor activity, thromboxane B2 and whole blood viscosity were persistently elevated, however, antithrombin Ⅲ, protein C, free protein S and 6-keto-prostaglandin F1α declined on third and fifth post burn days. These changes resulted in a prethrombotic state, being an important factor in genesis of microthrombosis on burn site and the cause of the deepening and aggravation of burn wound on the third and fifth days in burned patients.

  14. 7 CFR 29.6004 - Burn.


    ... 7 Agriculture 2 2010-01-01 2010-01-01 false Burn. 29.6004 Section 29.6004 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing... INSPECTION Standards Definitions § 29.6004 Burn. The duration of combustion or length of time that a...

  15. Pathophysiologic Response to Burns in the Elderly

    Marc G. Jeschke


    Full Text Available Over the last decades advancements have improved survival and outcomes of severely burned patients except one population, elderly. The Lethal Dose 50 (LD50 burn size in elderly has remained the same over the past three decades, and so has morbidity and mortality, despite the increased demand for elderly burn care. The objective of this study is to gain insights on why elderly burn patients have had such a poor outcome when compared to adult burn patients. The significance of this project is that to this date, burn care providers recognize the extreme poor outcome of elderly, but the reason remains unclear. In this prospective translational trial, we have determined clinical, metabolic, inflammatory, immune, and skin healing aspects. We found that elderly have a profound increased mortality, more premorbid conditions, and stay at the hospital for longer, p  0.05, but a significant increased incidence of multi organ failure, p < 0.05. These clinical outcomes were associated with a delayed hypermetabolic response, increased hyperglycemic and hyperlipidemic responses, inversed inflammatory response, immune-compromisation and substantial delay in wound healing predominantly due to alteration in characteristics of progenitor cells, p < 0.05. In summary, elderly have substantially different responses to burns when compared to adults associated with increased morbidity and mortality. This study indicates that these responses are complex and not linear, requiring a multi-modal approach to improve the outcome of severely burned elderly.

  16. Burn Injury Arise From Flying Balloon Toys

    Yalcin Kulahci


    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

  17. Burn Treatment: Annual Research Progress Report.


    positive for 127 a given species may be indicative of its importance in pathogenesis of pulmon - ary disease in burned patients. Table 6. Principal...pathogens. Pseudomonas aeruginosa is, of course, the conspicuous successful opportunist in burns, cancer wards, debilitated aged, newborns, and other

  18. Crusted Scabies in the Burned Patient

    Berg, Jais Oliver; Alsbjørn, Bjarne


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

  19. Modern trends in fluid therapy for burns.

    Tricklebank, Stephen


    The majority of burn centres use the crystalloid-based Parkland formula to guide fluid therapy, but patients actually receive far more fluid than the formula predicts. Resuscitation with large volumes of crystalloid has numerous adverse consequences, including worsening of burn oedema, conversion of superficial into deep burns, and compartment syndromes. Resuscitation fluids influence the inflammatory response to burns in different ways and it may be possible, therefore to affect this response using the appropriate fluid, at the appropriate time. Starches are effective volume expanders and early use of newer formulations may limit resuscitation requirements and burn oedema by reducing inflammation and capillary leak. Advanced endpoint monitoring may guide clinicians in when to 'turn off' aggressive fluid therapy and therefore avoid the problems of over-resuscitation.

  20. Long hair, smoking, and deep facial burns.

    Koljonen, Virve


    The purpose of this article is to describe deep facial burn injuries by cigarette lighters in longhaired adults and to report our experience in their treatment. Eight consecutive cigarette lighter burn victims are treated in the Helsinki Burn Center in the year 2006. Seven of the patients were women; their mean age was 50 years. All were under the influence of alcohol at the time of injury. The mean burnt area was 3.5% TBSA. The burnt areas were primarily forehead, cheek, and ipsilateral ear. After a conservative treatment, all the patients underwent an operation, whereby the nonhealing burns were excised and covered with autologous split thickness skin grafts. Postoperative period was uneventful in all the patients. Besides having severe detrimental effects on general health status and wound healing, smoking is the leading cause of residential and total fire deaths worldwide. The patients in this article suffered deep facial burns because of cigarette lighters.

  1. Sexual Function Following Burn Injuries: Literature Review.

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


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

  2. Psychosocial care of persons with severe burns.

    Blakeney, Patricia E; Rosenberg, Laura; Rosenberg, Marta; Faber, A W


    Treatment of people with burn injuries includes recovery of optimal function for survivors to fully participate in society, psychologically and physically. Increased likelihood of physical survival has led to greater concern for potential psychological morbidity for the burn survivor. Based on research and on many years of clinical experience in providing psychosocial care to burned children and adults, the authors outline their approach to assisting burn survivors and their families through the arduous process of recovery from admission through critical care, inpatient recuperation and reintegration upon hospital discharge. A philosophy of rehabilitation, a process that may occur for many months or years after patients' discharge from their acute hospitalization, is presented in the form of seven guidelines for working with burn survivors.

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

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


    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.

  4. 复合材料薄膜充气床垫的多物质ALE数值模拟%Numerical simulation of ALE Multi-material method for a composite membrane air-charge mattress

    杨颜志; 金先龙; 张伟伟


    某型充气床垫是典型的气囊结构,该床垫由新型柔性薄膜材料制成,力学性能复杂.目前,国内外气囊仿真研究多采用两种方法,一种是控制体积方法(CV),该方法比较简便计算需求较少,但计算精度只能满足一般的工程需要;另一种方法是基于有限元技术的ALE方法,该方法计算精度高,可用于气囊的详细仿真.针对充气床垫充气爆破工况和载人工况的复杂性,采用多物质ALE方法对其进行了详细数值模拟.充气爆破工况通过与物理试验对比,判断出床垫结构的薄弱位置,同时提出结构改进方案.载人工作工况通过参数分析方法,分析不同克气内压时床垫变形和应力状况,并判断出床垫最佳工作内压.最终的仿真结果可作为该型产品设计定型的重要依据,也为同类问题提供了参考.%An air-charge mattress is a typical air bag manufactured using new flexible film material with complex mechanical property.At present,two methods are used for air bag simulation in domestic and international studies.One is the control volume method (CV) needing less computing demands and being relatively simple,but its accuracy only meets the reguirements of common engineering projects.Another method is ALE method based on finite element technigue,it has good precision and can be used for the detailed simulation of air bags.Aiming at the complexity of two different load conditions,the detailed numerical simulation based on the multi ?material ALE method was pevfomed.The weak position of a mattress was estimated by contrasting the numerical simulation with the physical test in splitting load condition,and then a structural improvement plan was put forward.Parameter analysis method was used in man - carrying condition,and the stresses and vertical displacements of the mattress were compared under different interior pressures.Then,the optimal interior pressure of the mattress in man-carrying condition was determined

  5. Pediatric burns in Khuzestan Province, Iran.

    Houshyarikhah, Hojjat; Shayestehfard, Marzieh; Javaherizadeh, Hazhir; Cheraghian, Bahman; Latifzadeh, Shila; Madari, Zahra


    Burn injuries are the most frequently occurring injuries among pediatric populations worldwide, and they are significant pediatric injuries in Iran. This study was conducted to analyze the pattern of pediatric burns in Khuzestan province in the south-west of Iran from April 2006 to March 2007. The location of the study was Taleghani Hospital, a sole center for burn patients in Khuzestan province. The number of patients with burns admitted to the center in 1 year (from April 2006 to March 2007) was 211. Data were obtained by reviewing the medical records of patients hospitalized at the center. Of the patients, 85 (40.3%) were female and 126 (59.7%) were male. Of the 85 female patients, 50 were from urban areas and 35 were from rural areas. Of the 126 male patients, 68 (54%) were from urban areas and 58 (46%) were from rural areas. The mean ± SE age of the children ranging between 0 and 11 years was 3.20 ± 0.188. Scalding was the predominant cause of burns and caused 86.7% of the burns. The age of the patients with scald injuries (2.95 ± 2.56 years) was significantly lower than that of patients with flame injuries (4.28 ± 3.3 years) (P=0.007). Correlation analysis showed that younger children and urban residents are more vulnerable to scald injuries. The mean body surface area of burns was 20.5 ± 10.26 cm in all patients. Scalding was the most common cause of burns. Age burn accidents in children in Khuzestan. An appropriate burn prevention program, with focus on education, is needed to prevent this injury.

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

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


    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.

  7. [Quantification of crop residue burned areas based on burning indices using Landsat 8 image].

    Ma, Jian-hang; Song, Kai-shar; Wen, Zhi-dan; Shao, Tian-tian; Li, Bo-nan; Qi, Cai


    Crop residue burning leads to atmospheric pollution and is an enormous waste of crop residue resource. Crop residue burning can be monitored timely in large regions as the fire points can be recognized through remotely sensed image via thermal infrared bands. However, the area, the detailed distribution pattern and especially the severity of the burning areas cannot be derived only by the thermal remote sensing approach. The burning index, which was calculated with two or more spectral bands at where the burned and unburned areas have distinct spectral characteristics, is widely used in the forest fire investigation. However its potential application for crop residue burning evaluation has not been explored. With two Landsat 8 images that cover a part of the Songnen Plain, three burning indices, i.e., the normalized burned ratio (NBR), the normalized burned ratio incorporating the thermal band (NBRT), and the burned area index (BAI), were used to classify the crop residue burned and unburned areas. The overall classification accuracies were 91.9%, 92.3%, and 87.8%, respectively. The correlation analysis between the indices and the crop residue coverage indicated that the NBR and NBRT were positively correlated with the crop residue coverage (R2 = 0.73 and 0.64, respectively) with linear regression models, while the BAI was exponentially correlated with the crop residue coverage (R2 = 0.68). The results indicated that the use of burning indices in crop residue burning monitoring could quantify crop residue burning severity and provide valuable data for evaluating atmospheric pollution.

  8. The Ocular Surface Chemical Burns

    Medi Eslani


    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.

  9. Reactive burn models and ignition & growth concept

    Shaw M.S.


    Full Text Available Plastic-bonded explosives are heterogeneous materials. Experimentally, shock initiation is sensitive to small amounts of porosity, due to the formation of hot spots (small localized regions of high temperature. This leads to the Ignition & Growth concept, introduced by LeeTarver in 1980, as the basis for reactive burn models. A homo- genized burn rate needs to account for three meso-scale physical effects: (i the density of active hot spots or burn centers; (ii the growth of the burn fronts triggered by the burn centers; (iii a geometric factor that accounts for the overlap of deflagration wavelets from adjacent burn centers. These effects can be combined and the burn model defined by specifying the reaction progress variable λ = g(s as a function of a dimensionless reaction length s(t = rbc/ℓbc, rather than by specifying an explicit burn rate. The length scale ℓbc(Ps = [Nbc(Ps]−1/3 is the average distance between burn centers, where Nbc is the number density of burn centers activated by the lead shock. The reaction length rbc(t = ∫t0 D(P(t′dt′ is the distance the burn front propagates from a single burn center, where D(P is the deflagration speed as a function of the local pressure and t is the time since the shock arrival. A key implementation issue is how to determine the lead shock strength in conjunction with a shock capturing scheme. We have developed a robust algorithm for this purpose based on the Hugoniot jump condition for the energy. The algorithm utilizes the time dependence of density, pressure and energy within each cell. The method is independent of the numerical dissipation used for shock capturing. It is local and can be used in one or more space dimensions. The burn model has a small number of parameters which can be calibrated to fit velocity gauge data from shock initiation experiments.

  10. Ultrasound assessed thickness of burn scars in association with laser Doppler imaging determined depth of burns in paediatric patients.

    Wang, Xue-Qing; Mill, Julie; Kravchuk, Olena; Kimble, Roy M


    This study describes the ultrasound assessment of burn scars in paediatric patients and the association of these scar thickness with laser Doppler imaging (LDI) determined burn depth. A total of 60 ultrasound scar assessments were conducted on 33 scars from 21 paediatric burn patients at 3, 6 and 9 months after-burn. The mean of peak scar thickness was 0.39±0.032 cm, with the thickest at 6 months (0.40±0.036 cm). There were 17 scald burn scars (0.34±0.045 cm), 4 contact burn scars (0.61±0.092 cm), and 10 flame burn scars (0.42±0.058 cm). Each group of scars followed normal distributions. Twenty-three scars had original burns successfully scanned by LDI and various depths of burns were presented by different colours according to blood perfusion units (PU), with dark blue burns, with the thinnest scars for green coloured burns and the thickest for dark blue coloured burns. Within light blue burns, grafted burns healed with significantly thinner scars than non-grafted burns. This study indicates that LDI can be used for predicting the risk of hypertrophic scarring and for guiding burn care. To our knowledge, this is the first study to correlate the thickness of burns scars by ultrasound scan with burn depth determined by LDI.

  11. Prevention-oriented epidemiology of burns in Ardabil provincial burn centre, Iran.

    Sadeghi Bazargani, H; Arshi, S; Ekman, R; Mohammadi, R


    In preventing burns, it is essential to know how they occur and which population groups, environments and heating appliances can be targeted for prevention work. The aim of this study was to determine the epidemiological characteristics of burns leading to hospitalisation in the northwest of Iran with a focus on the pre-event phase of injury. Between 2007 and 2008, 237 burn victims hospitalised in Ardabil provincial burn centre were enrolled into a descriptive study. A questionnaire was filled in during hospital stay for all patients, with a focus on obtaining information necessary for prevention purposes. Males constituted 56% of victims. Mean age was 22 years. The most severe burns occurred between the ages of 18 and 32 years, and were mainly flame related. Both in case of flame and non-flame burns, women suffered more severe burns and mortality than men. However, with respect to non-flame burns of which most were scalds, the majority of the severe cases involved children under the age of 5 years. More than 80% of burns occurred at home. The kitchen was the main place of injury in 47% of cases, followed by living rooms in 28%. Nearly 45% of burns were scalds and 47% were flame burns. The main container was the samovar in 37%, followed by kettles in 32% and pots in 22%. The overturning of a container was the major mechanism of contact with hot liquids in 86%. Bumping into a container was the main scenario of a scald injury, constituting nearly 70% of the cases. The difference between flame and non-flame burns in the distribution of burns in extremities was not statistically significant, but head and neck burns were 3.7 times more likely to be caused by flame. The two most important injury patterns, more common among women, were getting burned while using a camping gas stove or while refilling the chamber of kerosene-burning appliances without first extinguishing them. Domestic burns among children and young women are a priority in injury-prevention programmes

  12. The progression of burn depth in experimental burns: a histological and methodological study.

    Papp, A; Kiraly, K; Härmä, M; Lahtinen, T; Uusaro, A; Alhava, E


    This study was designed to create a reproducible model for experimental burn wound research in pigs. Previously, the thicker paraspinal skin has been used. We used the more human-like ventral skin to create burns of different depths. Contact burns were created to 11 pigs using a brass plate heated to 100 degrees C in boiling water. Different contact times were used to create burns of different depths. In pigs 1-6, the follow-up time was 72 h and in pigs 7-11 24 h. Burn depth was determined by histology. Histologically, samples were classified into five anatomical layers: epidermis, upper one-third of the dermis, middle third of the dermis, deepest third of the dermis and subcutaneous fat. The location of both thromboses and burn marks were evaluated, respectively. The 1 s contact time lead to a superficial thermal injury, 3 s to a partial thickness and 9 s to a full thickness injury. A progression of burn depth was found until 48 h post-injury. The intra-observer correlation after repeated histological analyses of burn depths by the same histopathologist and the repeatability of burn depth creation yielded kappa coefficients 0.83 and 0.92, respectively. a reproducible burn model for further research purposes was obtained.

  13. The Application of Erosive Burning to Propellant Charge Interior Ballistics

    ZHANG Hong-lin


    Erosive burning is a common burning phenomenon of the gunpowder with inner holes. The actual combustion law of the gunpowder with inner holes can be changed by erosive burning. Pressure difference between the inner and the outer of hole caused by loading density variation of the propellant charge makes erosive burning occur at inner holes during in-bore burning. The effect of erosive burning on burning speed of the propellant is studied by using the effects of flow rate, heat transfer and erosion of the combustion gas in inner holes on burning rate. The mathematic model of erosive burning of the propellant is established. The effects of the factors such as loading density, inner hole size and grain length on erosive burning and interior ballistic performance are analyzed .The method to improve the bore pressure for small charge mass and small firing range by erosive burning is proposed.

  14. Infections in critically ill burn patients.

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


    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.

  15. Factors affecting mortality in patients with burns

    Halil Erbiş


    Full Text Available Objective: The increase in life quality and expectancy causes an increase in the elderly population. Improvements in burn treatment resulted in decreased mortality in children and young adults but in elderly patients burns are still an important trauma that should be handed differently than other age groups. The aim of this study was to evaluate the factors effecting mortality in patients with burns over 45 years old. Methods: Fifty-eight patients over 45 years of age, who were treated in our burns unit in the last 3 years were included in our study. Their age, burn percentage and depth, coexisting diseases and mortality rates were examined retrospectively. Results: The average age of surviving patients was 57.4 years while it was 70 years for nonsurviving patients (p=0.002. The width of burn area was 21.1 % in surviving and 50 % in nonsurviving patients (p<0.01. The effect of additional coexistent diseases on mortality was significant (p=0.001. The most common reasons of mortality were sepsis and congestive heart failure. Conclusion: We found out that the age, percentage of burns and coexistent diseases had a negative effect on success of treatment and mortality. Mortality rates will decrease in these cases with careful follow-up and a multidisciplinary approach. J Clin Exp Invest 2015; 6 (3: 240-243

  16. Management of Pain in Children with Burns

    M. Gandhi


    Full Text Available Burn injuries are common in children under 10 years of age. Thermal injury is the most common mechanism of injury and scalds account for >60% of such injuries. All children with burns will experience pain, regardless of the cause, size, or burn depth. Undertreated pain can result in noncompliance with treatment and, consequently, prolonged healing. It is acknowledged that the monitoring and reporting of pain in children with burns has generally been poor. Due to the adverse physiological and emotional effects secondary to pain, adequate pain control is an integral and requisite component in the management of children with burns. A multidisciplinary approach is frequently necessary to achieve a robust pain relief. Key to successful treatment is the continuous and accurate assessment of pain and the response to therapy. This clinical review article discusses the essential aspects of the pathophysiology of burns in children provides an overview of pain assessment, the salient principles in managing pain, and the essential pharmacodynamics of commonly used drugs in children with burn injuries. Both pharmacological and nonpharmacological treatment options are discussed, although a detailed review of the latter is beyond the scope and remit of this article.

  17. Burning characteristics of microcellular combustible objects

    Wei-tao Yang


    Full Text Available Microcellular combustible objects for application of combustible case, caseless ammunition or combustible detonator-holding tubes are fabricated through one-step foaming process, in which supercritical CO2 is used as foaming agent. The formulations consist of inert polymer binder and ultra fine RDX. For the inner porous structures of microcellular combustible objects, the cell sizes present a unimodal or bimodal distribution by adjusting the foaming conditions. Closed bomb test is to investigate the influence of both porous structure style and RDX content on burning behavior. The sample with bimodal distribution of cell sizes burns faster than that with unimodal distribution, and the concentration of RDX can influence the burning characteristics in a positive manner. In addition, the translation of laminar burning to convective burning is determined by burning rate versus pressure curves of samples at two different loading densities, and the resulting transition pressure is 30 MPa. Moreover, the samples with bigger sample size present higher burning rate, resulting in providing deeper convective depth. Dynamic vivacity of samples is also studied. The results show that the vivacity increases with RDX content and varies with inner structure.

  18. Pediatric burn wound impetigo after grafting.

    Aikins, Kimberly; Prasad, Narayan; Menon, Seema; Harvey, John G; Holland, Andrew J A


    Modern burn care techniques have reduced the risk of infection of the acute burn wound, resulting in more rapid healing and a lower incidence of graft loss. Secondary breakdown may still occur. The loss of epithelium in association with multifocal superficial abscesses and ulceration has been termed burns impetigo. This may result in considerable morbidity and require prolonged treatment. The events preceding development, the impact on the patient, and the ideal treatment appear unclear and poorly reported. In 5 years, between 2006 and 2011, 406 pediatric burns were treated with skin grafts, with 7% developing burns impetigo. Time to resolution ranged from 5 to 241 days: the mean time to complete healing was greatest with conservative management (96 days), followed by antibacterial dressings (37 days), oral antibiotics (36 days), topical steroids (16 days), and oral antibiotics in combination with topical steroids (13.5 days). Burns impetigo resulted in significant morbidity, requiring multiple visits to the treatment center and prolonged symptoms. Delay in diagnosis and treatment resulted in worse outcomes. Prompt consideration of burns impetigo should occur when postgraft patients present with suggestive clinical signs and treatment with oral antibiotics plus topical steroids should be considered.

  19. Dielectric measurement in experimental burns: a new tool for burn depth determination?

    Papp, Anthony; Lahtinen, Tapani; Härmä, Markku; Nuutinen, Jouni; Uusaro, Ari; Alhava, Esko


    There has been a lack of methods to provide quantitative information of local tissue edema after burn injury. Noninvasive dielectric measurements provide this information. The measured value, the dielectric constant, is directly related to the amount of water in tissue. Using probes of different sizes, the measurements give information from different tissue depths. The aim of this study was to characterize edema formation at different tissue depths and to examine whether the dielectric measurements could be used to distinguish partial- and full-thickness burns in pigs. An experimental animal study with pigs (n = 6) was performed in which dielectric measurements were taken of superficial, partial-thickness, and full-thickness burns for 72 hours. There was an increase in tissue water content in the superficial dermis in the partial-thickness burns at 48 hours. In whole dermis, the superficial burns resulted in increased tissue water content at 8 hours, and the partial-thickness burns resulted in increased tissue water content at 8, 24, and 72 hours. In deep burns, the water content was significantly decreased in the superficial dermis at 24 hours. All burns resulted in a considerable increase in fat water content. The dielectric probes could be used to differentiate partial- and full-thickness burns as early as 8 hours after burn. Receiver operating curve analysis of the measurements indicated 70 to 90 percent sensitivity and 80 to 100 percent specificity after 8 hours. The dielectric measurements provide a sensitive and noninvasive method for examining tissue edema and differentiate partial- and full-thickness burns in experimental burns. Thus, they are of clinical interest for early burn depth determination.

  20. Emotional associations with skin: differences between burned and non-burned individuals.

    Titscher, A; Lumenta, D B; Kamolz, L P; Mittlboeck, M; Frey, M


    The appearance of skin is crucial for our physical and psychological integrity, and is strongly associated with our emotional self-awareness. Burn victims have to cope with negative and even threatening sensations resulting from the changed appearance of their skin after injury and also linked to experiences during the treatment. The aim of this study was to analyse differences regarding the emotional associations with skin in burn victims (burn group) to persons not having subdued any burn (control group). In the first instance over 960 volunteers were recruited for the rating of emotional associations with skin in the control group and thereby a representative profile for non-injured individuals. In the second part, 44 burn patients of the Vienna Burn Center answered the same questionnaire. The quantitative rating of emotional associations with skin was performed with a newly designed questionnaire using a semantic differential on eight dimensions with a 5-point scale system. Both groups have positive associations with skin. One significant difference (p=0.0090, Chi-square test for trend) was the overall rating of the item "importance": for burn victims skin is more "important" than for controls. Patients with visible burns tended to put more emphasize on the possible exposure to danger ("threatened") of skin, and patients with >/=20% TBSA rated skin as more "noticeable" and "strong" as compared to small burns (<20% TBSA). Patients with burns to the face, hands and neck ("visible burns") were more likely to judge skin as threatened item. Our poll suggests that despite long treatment, rehabilitation and even near-death experiences burn patients continue to have positive associations with skin. This in turn, should encourage all specialists dealing with burns to engage in a continuous follow-up as well as enhance psychological and social support. 2010 Elsevier Ltd and ISBI. All rights reserved.

  1. Burn care professionals' attitudes and practices regarding discussions of sexuality and intimacy with adult burn survivors.

    Rimmer, Ruth Brubaker; Rutter, Cindy E; Lessard, Collette R; Pressman, Melissa Singer; Jost, Janet Cusick; Bosch, James; Foster, Kevin N; Caruso, Daniel M


    Burn injury survival means coping with more than just the physical changes and disabilities often encountered after burn injury. Overall quality of life is important, and issues such as sexuality and intimacy are significant facets of quality of life. A literature review revealed limited research regarding current burn center practices related to sexuality and intimacy concerns of burn survivors and their partners. A 28-item survey, designed by seasoned burn care professionals and survivors, was distributed to burn care practitioners attending general sessions at several burn conferences in the United States. Seventy-one (86%) of the invited respondents completed the survey, with nursing representing the majority (63%). Mean tenure working in burn care was 10 years. Mean age of respondents was 40.5 years, with 75% being female and 25% male. Nearly half (47%) reported that specific staff was not designated to discuss sexuality and intimacy with survivors in their center. Sixty-two percent reported that special training regarding sexuality and intimacy was not available at their burn center. Only 14% of respondents indicated that they were "very comfortable" initiating conversation regarding these topics. Fifty-five percent said they were only likely to discuss sexuality and intimacy if the patient/partner initiated the discussion; however, 95% agreed that the patient should not have this responsibility. Although results represent findings from only 37 burn centers, the issues of sexuality and intimacy are not being effectively addressed in the participating centers. Designated staff to provide education is lacking, and there is limited comfort on the part of health care providers in initiating such conversations. These factors seem to often prevent burn care professionals from adequately addressing burn survivor's sexuality and intimacy needs and establish the need for further development of training and educational materials specific to sexuality, intimacy, and

  2. Burning of droplets and particles of explosives

    Kondrikov, B.N. [Mendeleev University of Chemical Technology, Moscow (Russian Federation)


    Small droplets of organic diazides investigated by C.K. Law and coworkers burn in hot gas at 1 atm with rates inversely proportional to the droplet diameter presumably owing to leading chemical reaction proceeds in gas phase. These burning rates are obviously much lower than those obtained by extrapolation of the results measured for the some substances in glass tubes (at pressure of about 10{sup -2}-10{sup -1} atm, and temperature 0-100 deg C) on the burning conditions of the droplets. Kinetic constants estimated using Zel`dovich equation for the burning rate in gas phase and Semenov relation for delay time of the droplets micro-explosion in liquid phase are about the same: E {approx_equal} 0.17 MJ/mol, log{sub 10}k{sub o} {approx_equal} 15(S{sup -1}). In both of the cases the leading chemical reaction is supposed to be of the first order. Landau instability is assumed to be reflected in distortion of the droplets at burning but, as opposed to the liquids pools or columns burning, it is not followed by the burning rate augmentation or (as it is observed sometimes) by the combustion extinguishment. Simple dependence of burning rate of droplets of diazides of the row of normal alkanes on their enthalpy of formation is obtained. Burning rate of ball-shaped particles of polyvinyl-nitrate estimated by A. Merzhanov and collaborators is about the same as measured by the data E.I. Maximov, the member of the same team, for PVN strands, at extrapolation of his results on the suggested preheating temperature of the particle. Probably it is a result of the leading chemical reaction proceeding in condensed phase. (author) 10 refs.

  3. Childhood burns in south eastern Nigeria

    Okoro Philemon


    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.

  4. Ciguatera neurotoxin poisoning mimicking burning mouth syndrome.

    Heir, Gary M


    Burning mouth syndrome is a condition in which the patient perceives a sensation of intraoral burning, typically of the anterior tongue. This article presents a case report of a patient presenting for orofacial pain evaluation in whom ciguatera neurotoxin poisoning is diagnosed. The clinician should be aware of neurotoxin poisoning as a possible cause of symptoms of burning mouth, especially among patients who have recently traveled to a tropical area. Recognition of this condition in this case highlights the need for a detailed and accurate patient history.

  5. The initial management of acute burns.

    Treharne, L J; Kay, A R


    The initial management of burns, in common with all trauma, follows the ABCDE approach. The outline management plan detailed above assumes the availability of certain medical supplies but even simple measures are invaluable in burn care if they are all that are available. The most basic supplies required to resuscitate a casualty are oral salt and water in appropriate volumes. Similarly it should be possible in field conditions to monitor vital signs and urine output, dress the burns with clingfilm or plastic bags and wrap the casualty in absorbent materials.

  6. Burn Injury Caused by Laptop Computers

    Sharma, G


    Laptop burn is a real condition and medical reports indicate that using a laptop across the legs can indeed cause it. in very rare cases, the condition can cause damage leading to skin cancer. A 24-year-old man presented with an asymptomatic reddish brown pigmentation on the thighs. After an extensive work-up, burning caused by use of a laptop was observed. Burning was induced in 3 days by using laptop for 4 h daily. Laptop should be used in properly ventilated and air-conditioned rooms. The ...

  7. [Signal transduction mechanism in burn wound healing].

    Luo, Xiang-dong


    After 50 years of development in science of burns care in China, we have basically solved coverage of deep wounds of burn trauma, as well as role of multiple growth factors and stem cell in wound healing, making great contribution to improving the treatment of patients with large area of deep burns. Surgeons are paying close attention to problems of wound healing, especially in the fields of scarless healing and rehabilitation. To solve these problems, we need to do further investigation on multiple growth factors as well as proliferation/differentiation of stem cells in regulation of cell growth and differentiation in wound healing. Therefore, we are facing a even more serious challenge.

  8. Epidemiology of hospitalized female burns patients in a burn centre in Shiraz.

    Hosseini, R S; Askarian, M; Assadian, O


    During 2000 to 2001, all 170 female burn patients admitted to the Ghotbeddin Burn Centre in Shiraz were studied to determine the epidemiological characteristics and outcome of burn for these patients. The overall mortality rate was 64%. The highest frequency of burns (53.5%) occurred among 16-25-year-olds. The commonest cause of burn was flame (98.2%). The mean (SD) length of hospital stay was 13 (14.3) days. Mean (SD) of total body surface area (TBSA) burned among all patients was 56% (28.5%); among those who survived it was 29% (13.4%) and among those who died it was 72% (21.7%). The relation between TBSA and mortality was statistically significant.

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

    Jian Chen


    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.

  10. 49 CFR 195.226 - Welding: Arc burns.


    ... 49 Transportation 3 2010-10-01 2010-10-01 false Welding: Arc burns. 195.226 Section 195.226 Transportation Other Regulations Relating to Transportation (Continued) PIPELINE AND HAZARDOUS MATERIALS SAFETY... PIPELINE Construction § 195.226 Welding: Arc burns. (a) Each arc burn must be repaired. (b) An arc burn...

  11. 40 CFR 265.382 - Open burning; waste explosives.


    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Open burning; waste explosives. 265... DISPOSAL FACILITIES Thermal Treatment § 265.382 Open burning; waste explosives. Open burning of hazardous waste is prohibited except for the open burning and detonation of waste explosives. Waste explosives...

  12. Burned Microporous Alumina-Graphite Brick


    @@ 1 Scope This standard specifies the definition,classifica-tion,technical requirements,test methods,inspection rules,marking,packing,transportation and quality certificate of burned microporous alumina-graphite brick.

  13. Erosive Burning Study Utilizing Ultrasonic Measurement Techniques

    Furfaro, James A.


    A 6-segment subscale motor was developed to generate a range of internal environments from which multiple propellants could be characterized for erosive burning. The motor test bed was designed to provide a high Mach number, high mass flux environment. Propellant regression rates were monitored for each segment utilizing ultrasonic measurement techniques. These data were obtained for three propellants RSRM, ETM- 03, and Castor@ IVA, which span two propellant types, PBAN (polybutadiene acrylonitrile) and HTPB (hydroxyl terminated polybutadiene). The characterization of these propellants indicates a remarkably similar erosive burning response to the induced flow environment. Propellant burnrates for each type had a conventional response with respect to pressure up to a bulk flow velocity threshold. Each propellant, however, had a unique threshold at which it would experience an increase in observed propellant burn rate. Above the observed threshold each propellant again demonstrated a similar enhanced burn rate response corresponding to the local flow environment.

  14. Prescribed Burn Cycles 4-yr Rotation

    US Fish and Wildlife Service, Department of the Interior — This document contains a map and a table showing the number of acres and locations of planned burns and wildfires on St. Vincent National Wildlife Refuge between...

  15. On burning a lump of coal

    Alonso-Serrano, Ana; Visser, Matt


    Burning something, (e.g. the proverbial lump of coal, or an encyclopaedia for that matter), in a blackbody furnace leads to an approximately Planck emission spectrum with an average entropy/information transfer of approximately 3.9 ± 2.5 bits per emitted photon. This quantitative and qualitative result depends only on the underlying unitarity of the quantum physics of burning, combined with the statistical mechanics of blackbody radiation. The fact that the utterly standard and unitarity preserving process of burning something (in fact, burning anything) nevertheless has an associated entropy/information budget, and the quantitative size of that entropy/information budget, is a severely under-appreciated feature of standard quantum statistical physics.

  16. Burn Wise - What You Can Do

    Within this site you will find information for consumers to make informed decisions about what it means to burn wise. State & local agencies learn to improve air quality in their communities through changeout programs and education.

  17. On burning a lump of coal

    Alonso-Serrano, Ana


    Burning something, (e.g. the proverbial lump of coal, or an encyclopaedia for that matter), in a blackbody furnace leads to an approximately Planck emission spectrum with an average entropy/information transfer of approximately $3.9 \\pm 2.5$ bits per emitted photon. This quantitative and qualitative result depends only on the underlying unitarity of the quantum physics of burning, combined with the statistical mechanics of blackbody radiation. The fact that the utterly standard and unitarity preserving process of burning something (in fact, burning anything) nevertheless *has* an associated entropy/information budget, and the quantitative *size* of that entropy/information budget, is a severely under-appreciated feature of standard quantum statistical physics.



    The information obtained include age, sex, place of injury, month of injury, cause of ... However in developing countries like Nigeria, these ... problems : ignorance, poverty and disease, in ... of burn injury preventive measures to minimise the.

  19. Radioactivity released from burning gas lantern mantles.

    Luetzelschwab, J W; Googins, S W


    Gas lantern mantles contain thorium to produce incandescence when lantern fuel is burned on the mantle. Although only thorium is initially present on the mantle, the thorium daughters build up, some over a period of weeks and some over a period of years, and significant quantities of these daughters are present when the mantle is used. Some of these daughters are released when the lantern fuel is burned on the mantle. The amounts of radioactivity released during burning is studied by measuring the gamma radiation emitted by the daughters. Results of this study show that some of the radium (224Ra and 228Ra) and more than half the 212Pb and 212Bi is released during the first hour of a burn. The actual amounts release depend on the age of the mantle.

  20. Clay Improvement with Burned Olive Waste Ash

    Utkan Mutman


    Full Text Available Olive oil is concentrated in the Mediterranean basin countries. Since the olive oil industries are incriminated for a high quantity of pollution, it has become imperative to solve this problem by developing optimized systems for the treatment of olive oil wastes. This study proposes a solution to the problem. Burned olive waste ash is evaluated for using it as clay stabilizer. In a laboratory, bentonite clay is used to improve olive waste ash. Before the laboratory, the olive waste is burned at 550°C in the high temperature oven. The burned olive waste ash was added to bentonite clay with increasing 1% by weight from 1% to 10%. The study consisted of the following tests on samples treated with burned olive waste ash: Atterberg Limits, Standard Proctor Density, and Unconfined Compressive Strength Tests. The test results show promise for this material to be used as stabilizer and to solve many of the problems associated with its accumulation.

  1. Burns - Multiple Languages: MedlinePlus

    ... Translations Korean (한국어) Burn Care 화상 관리 - 한국어 ... Characters not displaying correctly on this page? See language display issues . Return to the MedlinePlus Health Information ...

  2. The ALMR actinide burning system

    Quinn, J.E. (General Electric Co., San Jose, CA (United States))


    The advanced liquid-metal reactor (ALMR) actinide burning system is being developed under the sponsorship of the US Department of Energy to bring its unique capabilities to fruition for deployment in the early 21st century. The system consists of four major parts: the reactor plant, the metal fuel and its recycle, the processing of light water reactor (LWR) spent fuel to extract the actinides, and the development of a residual waste package. This paper addresses the status and outlook for each of these four major elements. The ALMR is being developed by an industrial group under the leadership of General Electric (GE) in a cost-sharing arrangement with the US Department of Energy. This effort is nearing completion of the advanced conceptual design phase and will enter the preliminary design phase in 1994. The innovative modular reactor design stresses simplicity, economics, reliability, and availability. The design has evolved from GE's PRISM design initiative and has progressed to the final stages of a prelicensing review by the US Nuclear Regulatory Commission (NRC); a safety evaluation report is expected by the end of 1993. All the major issues identified during this review process have been technically resolved. The next design phases will focus on implementation of the basic safety philosophy of passive shutdown to a safe, stable condition, even without scram, and passive decay heat removal. Economic projections to date show that it will be competitive with non- nuclear and advanced LWR nuclear alternatives.

  3. TIGER Burned Brightly in JAMIC

    Olson, Sandra L.; Kashiwagi, Takashi


    The Transition From Ignition to Flame Growth Under External Radiation in 3D (TIGER- 3D) experiment, which is slated to fly aboard the International Space Station, conducted a series of highly successful tests in collaboration with the University of Hokkaido using Japan's 10-sec JAMIC drop tower. The tests were conducted to test engineering versions of advanced flight diagnostics such as an infrared camera for detailed surface temperature measurements and an infrared spectroscopic array for gas-phase species concentrations and temperatures based on detailed spectral emissions in the near infrared. Shown in the top figure is a visible light image and in the bottom figure is an infrared image at 3.8 mm obtained during the microgravity tests. The images show flames burning across cellulose samples against a slow wind of a few centimeters per second (wind is from right to left). These flow velocities are typical of spacecraft ventilation systems that provide fresh air for the astronauts. The samples are ignited across the center with a hot wire, and the flame is allowed to spread upwind and/or downwind. As these images show, the flames prefer to spread upwind, into the fresh air, which is the exact opposite of flames on Earth, which spread much faster downwind, or with the airflow, as in forest fires.

  4. Sediment availability on burned hillslopes

    Nyman, Petter; Sheridan, Gary J.; Moody, John A.; Smith, Hugh G.; Noske, Philip J.; Lane, Patrick N. J.


    describes the inherent resistance of soil to erosion. Hillslope erosion models typically consider erodibility to be constant with depth. This may not be the case after wildfire because erodibility is partly determined by the availability of noncohesive soil and ash at the surface. This study quantifies erodibility of burned soils using methods that explicitly capture variations in soil properties with depth. Flume experiments on intact cores from three sites in western United States showed that erodibility of fire-affected soil was highest at the soil surface and declined exponentially within the top 20 mm of the soil profile, with root density and soil depth accounting for 62% of the variation. Variation in erodibility with depth resulted in transient sediment flux during erosion experiments on bounded field plots. Material that contributed to transient flux was conceptualized as a layer of noncohesive material of variable depth (dnc). This depth was related to shear strength measurements and sampled spatially to obtain the probability distribution of noncohesive material as a function of depth below the surface. After wildfire in southeast Australia, the initial dnc ranged from 7.5 to 9.1 mm, which equated to 97-117 Mg ha-1 of noncohesive material. The depth decreased exponentially with time since wildfire to 0.4 mm (or < 5 Mg ha-1) after 3 years of recovery. The results are organized into a framework for modeling fire effects on erodibility as a function of the production and depletion of the noncohesive layer overlying a cohesive layer.

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

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


    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.

  6. Early Sequential Excision of Chemical Burns - our Experience in Riyadh Burns Unit

    Bhat, F.A.


    This paper reports on the treatment of chemical burns in a burns unit in Saudi Arabia in the 10-yr period 1993 to 2003. In 1993, in line with new approaches, the protocol for treating deep chemical burns in the first 48 h was modified to employ sequential excision followed by a second-look approach after 24 h, at which stage autografts/homografts were effected, depending upon the extent of the burn and having ascertained that the wound was bleeding and that there was no necrotic tissue. Resul...

  7. Disseminated intravascular coagulation in burn injury.

    Lippi, Giuseppe; Ippolito, Luigi; Cervellin, Gianfranco


    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

  8. [Treatment of pain in children burns].

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


    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.

  9. Stability of Rocket Flight during Burning

    T. N. Srivastava


    Full Text Available Stability of the rocket motion during burning is discussed taking into consideration gravity, aerodynamic forces and torques. Conditions for stabilizing the rocket motion are investigated. Analysis for initial and final phases of burning is given separately. Stability regions of the projected motions on two dimensional co-ordinate planes are obtained and thereby stability region of the actual motion is derived. Stability diagrams illustrate statically and dynamically stable and unstable regions.

  10. Segmentation and Classification of Burn Color Images


    2Grupo de Ingeniería Biomédica. Escuela Superior de Ingenieros. Universidad de Sevilla. Spain. e-mail:, aim of the algorithm described in this paper is to separate burned skin from normal skin in burn color images and to classify them...Segmentation Results To perform the segmentation, a previous characterization of the hue and saturation component histograms for both normal and burnt skin

  11. Violates stem wood burning sustainable development?

    Czeskleba-Dupont, Rolf


    friendly effects of substituting wood burning for fossil fuels. With reference to Bent Sørensen's classical work on 'Renewable Energy' the assumption of CO2-neutrality regarding incineration is problematised when applied to plants with long rotation periods as trees. Registered CO2-emissions from wood...... burning are characterised together with particle and PAH emissions. The positive treatment of wood stove-technology in the Danish strategy for sustainable development (draft 2007) is critically evaluated and approaches to better regulation are identified....

  12. Galactorrhea and amenorrhea in burn patients.

    Goyal, Navin; Gore, Madhuri A; Shankar, Ravi


    Galactorrhea and/or amenorrhea, although uncommonly reported in post-burn patients, is a complex problem to treat. Patient is reluctant to volunteer history of these symptoms, unless asked specifically. To study profile of adult female patients with galactorrhea and/or amenorrhea in post burn period. A prospective study of all adult female patients presenting with or detected to have galactorrhea and/or amenorrhea in post burn period was conducted over 6 month's period. Detailed clinical examination, estimation of LH, FSH, Prolactin levels and X-ray of skull was done in all patients. The data collected was analyzed. Patients with hyperprolactinemia and galactorrhea were treated with Bromocriptine for 3 weeks to 3 months. In all patients with amenorrhea, pregnancy was ruled out by gynecological examination and urine pregnancy test. During this period, 30 patients (15.15%) were detected to have galactorrhea and/or amenorrhoea. The extent of burn in these patients was 20-65%of body surface area. Out of 30 patients, 5 had galactorrhea and amenorrhea, 1 galactorrhea alone and 24 had amenorrhea alone. Analysis of voluntary disclosures and detection on interrogation was done. Till the end of study, 4 patients with galactorrhea had complete relief, 2 patients reported reduction in discharge. Galactorrhea was distressing for all and was always associated with high prolactine levels .The reverse was not true. All the patients had chest burns besides other body areas. Association was noted between menstrual aberration and ovulatory phase at the time of burn. Galactorrhea and menstrual disturbances do exist in female patients in reproductive age group in post burn period and patients should be especially interrogated for these symptoms by the burn care providers.

  13. The Correlation Between the Burning Features, the Burning Agent and Motivation in Burn Victims Attending Shahid Motahari Hospital in Tehran During 2009: letter to Editor

    Kamran Aghakhani M.D.


    Full Text Available Burning is one of the commonest causes of death. Due to the high rate of death among burn victims epidemiological investigation of burning, burning agents and the relevant motivations can be of great preventive value.1 In this cross-sectional study all the hospitalized patients in Shahid Motahari Burn Hospital at Tehran city in the year 2009 were included in the study. The collected data were analyzed by SPSS (ver. 17 software. Out of the 1548 hospitalized patients for burn, 1134 (73.3% left hospital in good conditions, 47 (3% left in relatively good conditions, 289 (18.7% died and 78 (5% persons left the Hospital satisfactorily on their own volition. About two-thirds of the patients were men. The mean age of the burn victims was 27.9±18.3 years, 16% of them being 5 years old or younger. The highest percentage of burn area was 30% of the total body surface which was seen in 20 to 30-year old patients. 58.7% of burns had been caused by fire. 94% of the burns had happened accidentally, 5% by suicidal and 1% by homicidal acts. The highest percentage of burn was observed in patients in whom the burn agent was fire. Six (4% persons had first degree, 820 (53% persons had second degree and 722 (46.6% had third degree burns. In patients who had committed suicide third degree burns were higher than second degree burns (7.7% vs. 2%. 24.4% of women and 16.6% of men died due to the burns. The rate of death in patients less than 50 years of age was 18% but the figure increased to 24% in those above 50. A burn area less than or more than 10% was, respectively correlated with 2.1% and 22.1% of deaths. 34.8% of the patients with third degree burns and 4.6% of those with second and first degree burns died. 58.3% of the suicidal patient died due to the severity of the burns relative to 16.7% due to other causes. 89 (5.7% patients had respiratory tract burns and the death rate was 58.4% among these patients while the death rate was 16.2% in patients without

  14. Orion Burn Management, Nominal and Response to Failures

    Odegard, Ryan; Goodman, John L.; Barrett, Charles P.; Pohlkamp, Kara; Robinson, Shane


    An approach for managing Orion on-orbit burn execution is described for nominal and failure response scenarios. The burn management strategy for Orion takes into account per-burn variations in targeting, timing, and execution; crew and ground operator intervention and overrides; defined burn failure triggers and responses; and corresponding on-board software sequencing functionality. Burn-to- burn variations are managed through the identification of specific parameters that may be updated for each progressive burn. Failure triggers and automatic responses during the burn timeframe are defined to provide safety for the crew in the case of vehicle failures, along with override capabilities to ensure operational control of the vehicle. On-board sequencing software provides the timeline coordination for performing the required activities related to targeting, burn execution, and responding to burn failures.

  15. Skin Burns Degree Determined by Computer Image Processing Method

    Li, Hong-yan

    In this paper a new method determining the degree of skin burns in quantities is put forward. Firstly, with Photoshop9.0 software, we analyzed the statistical character of skin burns images' histogram, and then turned the images of burned skins from RGB color space to HSV space, to analyze the transformed color histogram. Lastly through Photoshop9.0 software we get the percentage of the skin burns area. We made the mean of images' histogram,the standard deviation of color maps,and the percentage of burned areas as indicators of evaluating burns,then distributed indicators the weighted values,at last get the burned scores by summing the products of every indicator of the burns and the weighted values. From the classification of burned scores, the degree of burns can be evaluated.

  16. Psychiatric Assessment and Rehabilitation of Burn Patients

    Süleyman Akarsu


    Full Text Available Objective: Psychiatric rehabilitation has gained significance owing to improved healthcare facilities for burn injuries and decreased mortality/ morbidity rates. Burn traumas may result in psychiatric signs such as denial, anger, guilt, confusion, disgrace, anxiety, distress, and nervousness. Psychiatric disorders such as delirium, depression, anxiety, post-traumatic stress disorder, and sexual problems can also be encountered. Therefore, it is necessary to look for these signs and disorders through regular sessions with burn patients and appropriate psychometric tests. This study aims at examining the process of psychological rehabilitation for burn patients in light of the current literature. Material and Methods: This study has been carried out in the light of the main and current literature review. The study intends to put forth the data observed in the course of the psychological diagnosis, treatment and rehabilitation of burn patients. The study has been conducted in accordance with the Helsinki Declaration Guidelines. Results: Treatment and rehabilitation process requires a multidisciplinary teamwork that consists of physicians, dieticians, psychologists, social service specialists, and other healthcare workers who can meet the needs of burn patients and their families. It is necessary for the team to contribute both to the hospitalization process and the social environment of the patients and their families. Conclusion: It is observed that the quality of life of these patients can be considerably improved with the effective assessment of psychiatric signs that occur during or after the injury and with appropriate treatment methods.

  17. Alteration of biomechanical properties of burned skin.

    Held, M; Rahmanian-Schwarz, A; Rothenberger, J; Schiefer, J; Janghorban Esfahani, B; Schaller, H E; Jaminet, P


    The prevalence of burns in the general population is high. Despite new research findings, skin burns and its resulting tissue damage are still not entirely understood. In particular, little is known about the depth-dependent alteration of skin biomechanical properties of these wounds. Thirty-six burn wounds with six different depths were generated on the abdomen of six Göttingen minipigs. The alteration of skin biomechanical properties was evaluated objectively after 15 and 360 min using a Cutometer device. Biopsies for histological evaluation were taken and the depth of burn was correlated with biomechanical properties. Firmness of skin (R0), overall elasticity (R8) and calculated elasticity (Ue) demonstrated a continuous decrease with an increasing depth of burn 15 min after wound generation. Gross elasticity (R2), net elasticity (R5) and amount of elasticity of the whole curve (R7), however, showed an increase of values with increasing depth of injury. A further decrease of elasticity was demonstrated 360 min after wound generation. The alteration of skin biomechanical properties is a function of damaged tissue structures. The presented results demonstrate a depth-dependent decrease of principal elastic parameters with an increasing depth of burn and the results indicate progressive tissue damage over the time. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  18. Instrumented tube burns: theoretical and experimental observations

    Yarrington, Cole Davis [Los Alamos National Laboratory; Obrey, Stephen J [Los Alamos National Laboratory; Foley, Timothy J [Los Alamos National Laboratory; Son, Steven F [Los Alamos National Laboratory


    The advent of widely available nanoscale energetic composites has resulted in a flurry of novel applications. One of these applications is the use of nanomaterials in energetic compositions. In compositions that exhibit high sensitivity to stimulus, these materials are often termed metastable intermolecular composites (MIC). More generally, these compositions are simply called nanoenergetics. Researchers have used many different experimental techniques to analyze the various properties of nanoenergetic systems. Among these various techniques, the confined tube burn is a simple experiment that is capable of obtaining much data related to the combustion of these materials. The purpose of this report is to review the current state of the confined tube burn experiment, including the drawbacks of the technique and possible remedies. As this report is intended to focus on the specific experimental technique, data from many different energetic materials, and experimental configurations will be presented. The qualitative and quantitative data that can be gathered using confined tube burn experiments include burning rates, total impulse, pressure rise rate, and burning rate differences between different detector types. All of these measurements lend insight into the combustion properties and mechanisms of specific nanoenergetics. Finally, certain data indicates a more complicated flow scenario which may need to be considered when developing burn tube models.

  19. Mechanism of Burn Resistance of Alloy Ti40


    The Ti fire found in high performance engines promotes the development of burn resistant Ti alloys. The burn resistant mechanism of Ti40 alloy is investigated. Ti40 alloy reveals good burn resistance. Its interfacial products between burning products and the matrix are tenacious,which retard the diffusion of oxygen into the matrix. Two burn resistant mechanisms, that is, fast scatter dispersion of heat and suppression of oxygen diffusion, are proposed.

  20. Factors affecting the depth of burns occurring in medical institutions.

    Cho, Young Soon; Choi, Young Hwan; Yoon, Cheonjae; You, Je Sung


    Most cases of burns occurring in medical institutions are associated with activities involving heat. It is very difficult to detect these burns. To date, there are few reports on burns occurring in medical institutions. The purpose of this paper was to analyze the etiology of burns occurring in medical institutions and to elucidate the factors affecting burn depth. We conducted a retrospective analysis of the medical records of patients who visited our center from April 2008 to February 2013. This study enrolled all patients with burns occurring in the medical institution during or related to treatment. We excluded burn patients whose burns were not related to treatment (for example, we excluded patients with scalding burns that occurred in the hospital cafeteria and pediatric patients with hot water burns from the water purifier). However, patients with burns that occurred in the recovery room after general anesthesia were included. A total of 115 patients were enrolled in this study. The average patient age was 41.5 years, with more women than men (M:F=31:84). There were 29 cases (25.3%) of superficial burns (first-degree and superficial second-degree) and 86 cases (74.7%) of deep burns (deep second-degree and third-degree). Hot packs were the most common cause of burns (27 cases, 23.5%), followed by laser therapy, heating pads, and grounding pads, accounting for 15 cases each. There were 89 cases (77.4%) of contact burns and 26 cases (22.6%) of non-contact burns. The most common site of burns was the lower extremities (41 cases, 35.7%). The burn site and contact burns were both factors affecting burn depth. The rate of deep burns was higher in patients with contact burns than in those with non-contact burns (odds ratio 4.26) and was associated with lower body burns (odds ratio 2.85). In burns occurring in medical institutions, there is a high probability of a deep burn if it is a contact burn or occurs in the lower body. Therefore, safety guidelines are needed

  1. The epidemology of burn injuries of children and the importance of modern burn centre

    Janez Mohar


    Full Text Available Background: Burns represent the major percentage of injuries to children. Their incidence level, injury mechanisms and treatment often differ from the burn injuries of adults.Methods: From the medical records of the Department for Plastic and Reconstructive Surgery of the Ljubljana Medical Centre we gathered, analyzed and compared the burn injuries of children up to the age of 15 who were admitted to hospital in the year 2003 to those who were treated as outpatients. Moreover, we compared the burn injuries of hospitalized children at the same department in the years 2003, 1993 and 1983 respectively. We compared their gender, age, the total body surface area of burns, the depth of burns, frequency of the mechanisms of injury, the affected parts of the body and the length and mode of treatment. Finally, we compared our results with the results of similar studies from other burn centres.Results: The number of children treated for burns at the department has declined. In all the years studied, the injured children were younger than 5 and the majority of them were boys. The number of children admitted with substantial total body surface areas of burns was also declining. However, there was an increase in the number of children admitted with burns less than 10 % of their total body surface area. The number of burns treated by surgery slightly increased over the years studied. There was a similar sex and age distribution among the hospitalized children and those treated as outpatients.Conclusions: The number of children hospitalized with burns is in decline. In the years 1983, 1993 and 2003, there was no significant difference in the percentage of children who were treated surgically and those who were treated conservatively (P = 0.247. The Burn Centre at the Department for Plastic and Reconstructive Surgery of the Ljubljana Medical Centre which together with the Burn Department of the Maribor General Hospital covers the population of two million

  2. Epidemiology and outcome of burns: early experience at the country's first national burns centre.

    Iqbal, Tariq; Saaiq, Muhammad; Ali, Zahid


    This study aims to document the epidemiologic pattern and outcome of burn injuries in the country's first national burn centre. This case series study was conducted over a 2-year period at Burns Care Centre (BCC), Pakistan Institute of Medical Sciences (PIMS), Islamabad. The study included all burn injury patients who primarily presented to and were managed at the centre. Those patients who presented more than 24 h after injury or those who were initially managed at some other hospital were excluded from the study. Initial assessment and diagnosis was made by thorough history, physical examination and necessary investigations. Patients with major burns, high voltage electric burns and those needing any surgical interventions were admitted for indoor management. Patients with minor burns were discharged home after necessary emergency management, home medication and follow-up advice. The sociodemographic profile of the patients, site of sustaining burn injury, type and extent (total body surface area (TBSA), skin thickness involved and associated inhalational injury) of burn and outcome in terms of survival or mortality, etc., were all recorded on a proforma. The data were subjected to statistical analysis. Out of a total of 13,295 patients, there were 7503 (56.43%) males and 5792 (43.56%) females. The mean age for adults was 33.63±10.76 years and for children it was 6.71±3.47 years. The household environment constituted the commonest site of burns (68%). Among all age groups and both genders, scalds were the commonest burns (42.48%), followed by flame burns (39%) and electrical burns (9.96%). The affected mean TBSA was 10.64±11.45% overall, while for the hospitalised subset of patients the mean TBSA was 38.04±15.18%. Most of the burns were partial thickness (67%). Inhalation injury was found among 149 (1.12%) patients. Most of the burns were non-intentional and only 96 (0.72%) were intentional. A total of 1405 patients (10.58%) were admitted while the remainder

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

    Michael A. Dubick


    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

  4. Accuracy of early burn depth assessment by laser Doppler imaging on different days post burn.

    Hoeksema, Henk; Van de Sijpe, Karlien; Tondu, Thiery; Hamdi, Moustapha; Van Landuyt, Koenraad; Blondeel, Phillip; Monstrey, Stan


    Accurate diagnosis of burn depth is essential in selecting the most appropriate treatment. Early assessment of burn depth by clinical means only has been shown to be inaccurate, resulting in unnecessary operations or delay of grafting procedures. Laser Doppler imaging (LDI) was reported as an objective technique to determine the depth of a burn wound, but the accuracy on very early days post burn has never been investigated yet. In 40 patients with intermediate depth burns, we prospectively evaluated and compared the accuracy of the LDI measurements with the clinical assessments on days 0, 1, 3, 5, 8. Clinical evaluation of the depth of the burn was performed by two observers blinded to the LDI images. Accuracies were assessed by comparison with outcome: healing times longer than 21 days were considered to be equivalent to a biopsy finding of a deep dermal wound. Obviously superficial and full thickness wounds were excluded. LDI flux level was used for LDI prediction of outcome: less than 220PU to predict non-healing at day 21. The accuracies of burn depth assessments on the day of burn and post burn days 0, 1, 3, 5 and 8 using LDI were 54%, 79.5%, 95%, 97% and 100% compared with clinical assessment accuracies of 40.6%, 61.5%, 52.5%, 71.4% and 100%, respectively. LDI accuracy was significantly higher than clinical accuracy on day 3 (pBurn depth conversion was also considered. This is the first study to quantify the advantage of LDI scanning over clinical assessments during these important early after burn days.

  5. Association between depression, patient scar assessment and burn-specific health in hospitalized burn patients.

    Roh, Young Sook; Chung, Hyun Soo; Kwon, Boeun; Kim, Giyon


    Depression is one of the most common psychological problems arising after a burn, but its relationship with patient scar assessment and burn-specific health are poorly understood. The aim of this study was to identify the incidence of in-hospital symptoms of depression, compare level of patient scar assessment, and burn-specific health by depression cutoff point, and identify the relationship between depression and these variables. In a cross-sectional descriptive study, 113 burn patients from two inpatient burn centers were divided into two groups based on the cutoff point of the Korean Center for Epidemiologic Studies Depression Scale (Korean CES-D): ≥25 or Patient Scar Assessment Scale and Korean Burn-Specific Health Scale-Brief (BSHS-B-K) were used to identify associations with depression. Incidence of severe, definite depression as assessed by a score of 25 or above on the Korean CES-D was approximately 50% on an average at 60.9 days after injury. Burn patients with the Korean CES-D≥25 had significantly higher total mean patient scar assessment scores (43.34±11.49 vs. 36.84±9.56, t=3.265, p=.001), and lower burn-specific health subscale scores compared to patients with Korean CES-DPatient Scar Assessment, ranging from r=.196 to .335 except scar color. Depression was significantly correlated with all subscales of the BSHS-B-K, range from r=-.320 to -.725. Results indicate that incidence of symptoms of depression is relatively high, and depressed burn patients report worse burn scar or sensation and lower levels of burn-specific health. Early, timely recognition and management of depression in these patients are warranted. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  6. Burns in a major burns center in East China from 2005 to 2014: Incidence and outcome.

    Fan, Xiaoming; Ma, Bing; Zeng, Ding; Fang, Xiao; Li, Haihang; Xiao, Shichu; Wang, Guangyi; Tang, Hongtai; Xia, Zhaofan


    Information about epidemiology on burns is rare in China. The aim of this article is to describe the pattern of burns in East China during a 10-year time period. A retrospective data analysis was performed on all hospitalized patients to the burn center at the Changhai hospital, one of major burn centers in East China, from 2005 to 2014. We included 3376 patients in this study. Among them, 48.1% were from 27 provinces out of Shanghai and nearly 90% were from East China. August saw the most admissions and November saw the fewest. Spring and summer separately dominated in number of female and male patients. Children aged 2-5 and working-age adult were the most commonly treated. Home was the commonest place of injury, followed by industrial-related places, outdoors, public buildings, and vehicles or roads. Scalds remained the primary reason, followed by fire, contact burns, electricity, and chemicals. The average %TBSA of male patients was 14.2±21.3, significantly different from that of female patients (10.4±16.9). Extremities were the most vulnerable body region burned, followed by the trunk, face and hands. The average hospital length of stay in male patients was 25.4±72.4 days, significantly different from that of females' 19.9±27.6 days. The total mortality was 1.8% and the lethal area burned resulting in 50% mortality was 96.5% TBSA. Compared with published data, these result are encouraging, which demonstrate that burn care and treatment has made significant progress. Burn clinicians should bear not only the responsibility to treat and cure burns, but also the popularization of knowledge about burn precautions and emergency treatments. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

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

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


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

  8. Patterns of grease burn injury: development of a classification system.

    Klein, Matthew B; Gibran, Nicole S; Emerson, Dominic; Sullivan, Stephen R; Honari, Shari; Engrav, Loren H; Heimbach, David M


    Grease burns occur commonly in the home during food preparation. It has been our observation that grease burns follow a particular pattern of injury. The purpose of this study was to review our institutional experience in the management of these burns to develop a classification scheme. We performed a retrospective review of patients admitted to our burn center with grease burns. Subjects were identified through our database and their charts were reviewed with particular attention to burn distribution, TBSA and need for grafting. We excluded workplace burns and children under the age of six. A total of 249 patients who fit the above criteria were admitted with grease burns to our burn center from 1993 to 2003. The sequence of events leading to burn and its distribution followed a consistent pattern. The majority of patients (86%) had an isolated upper extremity burn or upper extremity burn in combination with a face, trunk or lower extremity burn. Forty percent of patients required at least one excision and grafting procedure. Grease burns associated with cooking at home follow predictable patterns of injury. Based on these patterns we proposed a classification system for domestic grease burns.


    廖党金; 曹冶; 王秋实; 张先惠; 于吉锋; 叶勇刚; 田浪; 王金江; 王文贵; 李江凌; 王建明; 杨清泉


    为了解发酵床养猪的疫病风险,采用细菌常规分离鉴定、小白鼠攻毒、寄生虫虫卵检测方法,分别对5个养猪发酵床垫料和养猪场常规圈舍粪污内的致病菌和寄生虫虫卵进行了检测。结果显示:在发酵床垫料内分离到25种(亚种、类)致病菌,而常规饲养圈舍粪污内分离到8种(亚种、类)致病菌;发酵床垫料和常规饲养圈舍粪污内的同种致病菌的致病比较,发酵床内致病菌的致病性高于常规饲养圈舍粪污内致病菌的致病性。3个发酵床养猪时间延长1年后,发酵床垫料中的致病菌增加了4~9种(亚种、类),其中1个发酵床的病原菌种类是1年前的3.25倍;5个养猪场的8个发酵床垫料中,有5个发酵床垫料内寄生虫虫卵呈阳性,即阳性率为62.5%,寄生虫种类为蛔虫和毛首线虫,其中,蛔虫虫卵有4个发酵床垫料呈阳性(阳性率50.0%),毛首线虫虫卵有4个发酵床垫料呈阳性(阳性率50.0%),对患寄生虫病最严重的1头猪进行解剖,其大肠黏膜上布满了毛首线虫。结果表明,发酵床养猪疫病风险高,不符合健康养殖范畴。%For understanding of the risks of epidemic diseases caused by fermentation beds, the pathogenic bacteria and parasite eggs from the fermentation mattress materials and wastewater samples in the breeding houses of 5 pig farms were examined using conventional bacterial culture, parasite egg count and mouse inoculation. As a results, 25 species of pathogenic bacteria were detected from fermentation mattress materials and 8 species of pathogenic bacteria from breeding pig houses. There was higher intensity of pathogenic bacteria in the fermentation mattress materials than wastewater samples. Additionally, there were 4~9 more bacterium species found in thefi rstyear than the secondyear on 3 pig farms. The parasite eggs from the 5 fermentation beds were positive, includingAscaris suum

  10. Harborview Burns – 1974 to 2009

    Engrav, Loren H.; Heimbach, David M.; Rivara, Frederick P.; Kerr, Kathleen F.; Osler, Turner; Pham, Tam N.; Sharar, Sam R.; Esselman, Peter C.; Bulger, Eileen M.; Carrougher, Gretchen J.; Honari, Shari; Gibran, Nicole S.


    Background Burn demographics, prevention and care have changed considerably since the 1970s. The objectives were to 1) identify new and confirm previously described changes, 2) make comparisons to the American Burn Association National Burn Repository, 3) determine when the administration of fluids in excess of the Baxter formula began and to identify potential causes, and 4) model mortality over time, during a 36-year period (1974–2009) at the Harborview Burn Center in Seattle, WA, USA. Methods and Findings 14,266 consecutive admissions were analyzed in five-year periods and many parameters compared to the National Burn Repository. Fluid resuscitation was compared in five-year periods from 1974 to 2009. Mortality was modeled with the rBaux model. Many changes are highlighted at the end of the manuscript including 1) the large increase in numbers of total and short-stay admissions, 2) the decline in numbers of large burn injuries, 3) that unadjusted case fatality declined to the mid-1980s but has changed little during the past two decades, 4) that race/ethnicity and payer status disparity exists, and 5) that the trajectory to death changed with fewer deaths occurring after seven days post-injury. Administration of fluids in excess of the Baxter formula during resuscitation of uncomplicated injuries was evident at least by the early 1990s and has continued to the present; the cause is likely multifactorial but pre-hospital fluids, prophylactic tracheal intubation and opioids may be involved. Conclusions 1) The dramatic changes include the rise in short-stay admissions; as a result, the model of burn care practiced since the 1970s is still required but is no longer sufficient. 2) Fluid administration in excess of the Baxter formula with uncomplicated injuries began at least two decades ago. 3) Unadjusted case fatality declined to ∼6% in the mid-1980s and changed little since then. The rBaux mortality model is quite accurate. PMID:22792216

  11. Honey oil burns: a growing problem.

    Jensen, Guy; Bertelotti, Robert; Greenhalgh, David; Palmieri, Tina; Maguina, Pirko


    There is an emerging mechanism of burn injury as a result of the ignition of butane, during the manufacture of a tetrahydrocannabinol concentrate known as butane honey oil. The authors report of a series of patients who presented with this mechanism of injury and a description of the process that causes these burns. Patient data were gathered from the medical records of eight patients treated at the University of California Davis Medical Center and Shriners Hospital of Northern California. Information on the manufacturing process of butane honey oil was gathered from Internet searches and published literature on the topic. The burns witnessed at the abovementioned institutions ranged from 16 to 95% TBSA, with an average of 49.9%. The average length of stay for the patients was 118.3 hospital days and 114.4 intensive care unit days, with an average of 43.8 days spent on mechanical ventilation. The average age of patients was 22 years, with only one patient above the age of 30 years. Accidents during honey oil production have resulted in a surge of burn injuries in our community during the past year. The manufacture of this product, which involves the use of volatile butane gas, is gaining in popularity. Although considered to be safer than previous methods, multiple casualties with extensive burn injuries have resulted from this process. Associated injuries from blast trauma or chemical burns are not likely to occur in these types of explosions and have not been observed in the series reported in this article. In light of the increasing popularity of honey oil, it is important for burn care providers to gain awareness and understanding of this problem and its growing presence in the community.

  12. Research in prevention of pressure ulcer for bed-ridden patients by simple turn-over pillow and turn-over mattress%简易翻身枕、翻身褥用于卧床患者预防压疮的效果研究



    Objective To study the prevention of pressure ulcer for bed-ridden patients by simple turn-over pillow and turn-over mattress.Methods Self-made simple turn-over pillow and turnover mattress were used in 1300 patients who had high risk of pressure ulcer,and the application effect was observed.Results No pressure ulcer occurred in 1300 patients when they were discharged.Conclusions Simple turn-over pillow and turn-over mattress showed definite effect to prevent pressure ulcer,they have application value,and are worthy of wide spread.%目的 探讨简易翻身枕、翻身褥用于卧床患者预防压疮的效果.方法 将自行研制的简易翻身枕、翻身褥用于1300例易患压疮患者,观察应用效果.结果 1300例患者出院时均皮肤完好,无压疮发生.结论 简易翻身枕、翻身褥确为一种预防压疮的有效方法,具有一定的应用价值,值得推广.

  13. Angiogenin expression in burn blister fluid: implications for its role in burn wound neovascularization.

    Pan, Shin-Chen; Wu, Li-Wha; Chen, Chung-Lin; Shieh, Shyh-Jou; Chiu, Haw-Yen


    Deep partial thickness burn (DPTB) wound fluids have a greater propensity for establishing neovascularization than did superficial partial thickness burn (SPTB) wound fluids in our previous study. To investigate the factors responsible for this activity, cytokine array and enzyme-linked immunosorbent assay were used to perform an expression analysis of angiogenic factors in burn fluid. Although present in approximately equal amounts in both SPTB and DPTB blister fluids from burn patients, angiogenin does appear to be involved in the ability of DPTB blister fluid to promote neovascularization in vitro and in vivo. Angiogenin alone was sufficient to induce endothelial differentiation of circulating angiogenic cells (CAC) without vascular endothelial growth factor A involvement. In addition, angiogenin was positively associated with CAC differentiation in the burn blister fluid. Blocking the effect of angiogenin in burn blister fluids resulted in a significant reduction of endothelial cell proliferation, CAC differentiation, and new blood vessels formation in vivo. Moreover, immunohistochemistry revealed that high angiogenin expression colocalizes with high vascularity in human burn wounds at day 7, further supporting our hypothesis that angiogenin is involved in burn wound neovascularization. © 2012 by the Wound Healing Society.

  14. Epidemiology of burns throughout the World. Part II: intentional burns in adults.

    Peck, Michael D


    A significant number of burns and deaths from fire are intentionally wrought. Rates of intentional burns are unevenly distributed throughout the world; India has a particularly high rate in young women whereas in Europe rates are higher in men in mid-life. Data from hospitalized burn patients worldwide reveal incidence rates for assault by fire and scalds ranging from 3% to 10%. The average proportion of the body surface area burned in an assault by fire or scalds is approximately 20%. In different parts of the world, attempted burning of others or oneself can be attributed to different motives. Circumstances under which assaults occur fall largely into the categories of interpersonal conflict, including spousal abuse, elder abuse, or interactions over contentious business transactions. Contributing social factors to assaults by burning include drug and alcohol abuse, non-constructive use of leisure time, non-participation in religious and community activities, unstable relationships, and extramarital affairs. Although the incidence of self-mutilation and suicide attempts by burning are relatively low, deliberate self-harm carries a significant risk of death, with an overall mortality rate of 65% worldwide. In those who resort to self-immolation, circumstantial themes reflect domestic discord, family dysfunction, and the social ramifications of unemployment. Preventing injurious burn-related violence requires a multifaceted approach, including legislation and enforcement, education, and advocacy. Better standardized assessment tools are needed to screen for risks of abuse and for psychiatric disorders in perpetrators. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  15. Beyond pediatric burns : a family perspective on the psychological consequences of burns in children

    Bakker, A.


    In this dissertation, we focused on the psychological consequences of pediatric burns on children and parents, relationships within the family (parent-child, mother-father subsystems), and potential benefits from burn camp participation. Results of a literature review study showed that many children

  16. Profile of self-inflicted burn patients treated at a tertiary burn center in Istanbul.

    Uygur, Fatih; Sever, Celalettin; Oksüz, Sinan; Duman, Haluk


    The factors and demographic features of self-inflicted burns in Eastern and Western cultures differ from each other. In this retrospective study, the authors' aim is to identify the epidemiologic features of self-inflicted burn patients treated at their Tertiary Burn Centre. The Burn Centre provides health care to a large population from Istanbul, which is located at the crossroads between Asia and Europe. The demographic data and information of 32 patients who were admitted to the GATA HEH Burn Center in Istanbul for attempted suicide were retrospectively reviewed over a 7-year period (2001-2008). Twenty-eight of the 32 patients were men, whereas the remaining four patients were women. The average age was 25.9 years. Seventeen patients had a previous history of self-harming and 22 patients were unemployed. History of a psychiatric illness was found in 20 patients. Mean total body burn surface area was 70%. The mortality rate was 43.4%. This study demonstrates that suicide attempts by burning differ from Eastern and Western cultures by factors and demographic features. It has been concluded that the solution to preventing self-inflicted burns calls for the joint efforts of physicians, psychologists, and sociologists. Furthermore, it is necessary to reinstate prevention programs and revise strategies for prevention based on the country and its culture.

  17. Vaporization order and burning efficiency of crude oils during in-situ burning on water

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


    of multicomponent fuels. The alkanes were tested as benchmark fuels with a uniform vaporization order, for which all components evaporate simultaneously. As expected, these pure fuels showed a steady state burning with a near-constant surface temperature, flame height and burning rate. The alkane mixture showed...... similar steady state results but became dominated by the heaviest component towards the end of the burning. These results indicate that the lightest components had been depleted from the mixture. A near-uniform vaporization order in which the lighter components evaporate preferably best matched......In order to improve the understanding of the burning efficiency and its observed size dependency of in-situ burning of crude oil on water, the vaporization order of the components in crude oils was studied. The vaporization order of such multicomponent fuels was assessed by studying the surface...

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

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


    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.


    Nagabathula Durga Prasad


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

  20. A New Metric for Quantifying Burn Severity: The Relativized Burn Ratio

    Sean A. Parks


    Full Text Available Satellite-inferred burn severity data have become increasingly popular over the last decade for management and research purposes. These data typically quantify spectral change between pre-and post-fire satellite images (usually Landsat. There is an active debate regarding which of the two main equations, the delta normalized burn ratio (dNBR and its relativized form (RdNBR, is most suitable for quantifying burn severity; each has its critics. In this study, we propose and evaluate a new Landsat-based burn severity metric, the relativized burn ratio (RBR, that provides an alternative to dNBR and RdNBR. For 18 fires in the western US, we compared the performance of RBR to both dNBR and RdNBR by evaluating the agreement of these metrics with field-based burn severity measurements. Specifically, we evaluated (1 the correspondence between each metric and a continuous measure of burn severity (the composite burn index and (2 the overall accuracy of each metric when classifying into discrete burn severity classes (i.e., unchanged, low, moderate, and high. Results indicate that RBR corresponds better to field-based measurements (average R2 among 18 fires = 0.786 than both dNBR (R2 = 0.761 and RdNBR (R2 = 0.766. Furthermore, the overall classification accuracy achieved with RBR (average among 18 fires = 70.5% was higher than both dNBR (68.4% and RdNBR (69.2%. Consequently, we recommend RBR as a robust alternative to both dNBR and RdNBR for measuring and classifying burn severity.

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

    V K Tiwari


    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.

  2. Childhood burns in Israel: a 7-year epidemiological review.

    Goldman, Sharon; Aharonson-Daniel, Limor; Peleg, Kobi


    Understanding the etiology of severe burns injuries and identifying high risk groups are essential for allotting resources for prevention and treatment. The objective of this study was to develop a profile of severe childhood burns in Israel. A retrospective study of children (ages 0-14) hospitalized with a burn, between 1998 and 2004. Data from all five burn units in Israel was retrieved from the National Trauma Registry. Two thousand seven hundred and five children were hospitalized with burns (51% of all burn admissions). Infants (ages 0-1) had the highest prevalence (45%). Scalds caused 68% of burns. Burn extent in 83% of the patients was less than 20% TBSA, 3% suffered 40%TBSA burns. Surgical intervention increased from 6% in 1998 to 21% in 2002. Non-Jewish children sustained proportionally more burn injuries (48%). Among Jewish children an increase in burn injuries was noted on Thursdays and Fridays. Infants, boys and non-Jewish children were found to be at greatest risk for a burn injury, while older children were at higher risk for severe burns. Prevention programs should target these high risk groups, with an emphasis on the unique characteristics of each group. Policy makers should reassess the benefits of a pediatric burn unit in Israel. The increase in rates of surgical intervention should be further investigated.

  3. Burning characteristics of chemically isolated biomass ingredients

    Haykiri-Acma, H.; Yaman, S.; Kucukbayrak, S. [Istanbul Technical University, Chemical and Metallurgical Engineering Faculty, Chemical Engineering Department, 34469 Maslak, Istanbul (Turkey)


    This study was performed to investigate the burning characteristics of isolated fractions of a biomass species. So, woody shells of hazelnut were chemically treated to obtain the fractions of extractives-free bulk, lignin, and holocellulose. Physical characterization of these fractions were determined by SEM technique, and the burning runs were carried out from ambient to 900 C applying thermal analysis techniques of TGA, DTG, DTA, and DSC. The non-isothermal model of Borchardt-Daniels was used to DSC data to find the kinetic parameters. Burning properties of each fraction were compared to those of the raw material to describe their effects on burning, and to interpret the synergistic interactions between the fractions in the raw material. It was found that each of the fractions has its own characteristic physical and thermal features. Some of the characteristic points on the thermograms of the fractions could be followed definitely on those of the raw material, while some of them seriously shifted to other temperatures or disappeared as a result of the co-existence of the ingredients. Also, it is concluded that the presence of hemicellulosics and celluloses makes the burning of lignin easier in the raw material compared to the isolated lignin. The activation energies can be arranged in the order of holocellulose < extractives-free biomass < raw material < lignin. (author)

  4. Ventilator associated pneumonia in major paediatric burns.

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


    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.

  5. Bilateral maculopathy following electrical burn: case report

    Leandro Dario Faustino

    Full Text Available CONTEXT: Electrical burns are an important etiology in dealing with patients suffering from burns. In situations of extensive deep lesions of multiple organs and systems affecting young and economically active people, there is a need for expensive multidisciplinary treatment, with a high socioeconomic cost for the community. Among the permanent injuries that explain this high cost, eye injuries stand out, since they are widely disabling. Although rare, lesions of the posterior segment of the eye are associated with higher incidence of major sequelae, and thus deserve special attention for dissemination and discussion of the few cases observed.CASE REPORT: The authors report the case of a patient who suffered high-voltage electrical burns and presented bilateral maculopathy, which evolved with a need for a surgical approach to repair retinal detachment and permanent low visual acuity.CONCLUSION: This report highlights the rarity of the etiology of maculopathy and the need for campaigns for prevention not only of burns in general, but also especially of electrical burns.

  6. Increased mortality in hypernatremic burned patients

    Lange, Thomas


    Full Text Available Introduction: In-hospital hypernatremia develops usually iatrogenically from inadequate or inappropriate fluid prescription. In severely burned patient an extensive initial fluid resuscitation is necessary for burn shock survival. After recovering of cellular integrity the circulating volume has to be normalized. Hereby extensive water and electrolyte shifts can provoke hypernatremia. Purpose: Is a hypernatremic state associated with increased mortality? Method: Retrospective study for the incidence of hypernatremia and survival in 40 patients with a totally burned surface area (TBSA >10%. Age, sex, TBSA, ABSI-Score and fluid resuscitation within the first 24 hours were analyzed. Patients were separated in two groups without (Group A or with (Group B hypernatremia. Results: Hypernatremia occurred on day 5±1.4. No significant difference for age, sex, TBSA, ABSI-Score and fluid resuscitation within the first 24 hours were calculated. In Group A all patients survived, while 3 of the hypernatremic patient in Group B died during ICU-stay (Odds-ratio = 1.25; 95% CI 0.971–1.61; p=0.046. Conclusion: Burned patients with an in-hospital acquired hypernatremia have an increased mortality risk. In case of a hypernatremic state early intervention is obligatory. There is a need of a fluid removal strategy in severely burned patient to avoid water imbalance.

  7. Spontaneous Healing and Treatment Alternatives in Burns

    Mehmet Bozkurt


    Full Text Available Tissue losses that may occur in certain burn wounds may heal spontaneously without requiring any surgical intervention. However, this spontaneous healing is usually observed in smaller and superficial burn wounds, whereas surgical intervention may be indispensable in the tissue damages that occur in deeper and larger-scale burns treated using classical methods. Although surgery is frequently applied in the treatment of burn wounds, the variety of methods that enhance spontaneous healing are increasing in number. For this purpose, these methods involve the prevention of the wound from drying and maintaining a physiological and aseptic moisturization. On the other hand, especially in burn wounds with extensive tissue loss, the lack of adequate skin donor areas gives rise to the need for a cover material alternative to the skin. For these reasons, efforts to develop equivalent materials that may replace the original skin are progressing rapidly nowadays. The increase in the variety and advantages of the materials, which are developed using state-of-the-art bioengineering methods in the light of modern technologies, is quite promising. [Arch Clin Exp Surg 2013; 2(3.000: 186-196

  8. Effects of Oxidizer Particle Size on Composite Solid Propellant Burning: Normal Burning, Plateau Burning and Intermediate Pressure Extinction


    butadiene Acrylic Acid Propellants 14 10 807 AP + 20% PBAA Data Plotted as (p/r) vs (p2/3) 14 11 DB and CMDB Propellant Data Plotted as (p/r) vs (p2/3...1.2% stabilizer causes a striking differ- ) ence in its burning behavior. This composite-modified double-base ( CMDB ) pro- pellant burns like a normal...dominated by a granular diffusion flame mechanism. It is to be noted that since the binder in a CMDB propellant is itself a monopropellant, there is no

  9. Epidemiology, etiology and outcomes of burn patients in a Referral Burn Hospital, Tehran

    Mohammad Mehdi Soltan Dallal


    Full Text Available Background: Burns and its complications are regarded as a major problem in the society. Skin injuries resulted from ultraviolet radiation, radioactivity, electricity or chemicals as well as respiratory damage from smoke inhalation are considered burns. This study aimed to determine the epidemiology and outcome of burn patients admitted to Motahari Hospital, Tehran, Iran. Methods: Two hundred patients with second-degree burns admitted to Motahari Referral Center of Burn in Tehran, Iran. They were studied during a period of 12 months from May 2012 to May 2013. During the first week of treatment swabs were collected from the burn wounds after cleaning the site with sterile normal saline. Samples were inoculated in blood agar and McConkey agar, then incubation at 37 C for 48 hours. Identification was carried out according to standard conventional biochemical tests. Treatment continued up to epithelial formation and wound healing. Results of microbial culture for each patient was recorded. Healing time of the burn wounds in patients was recorded in log books. Chi-square test and SPSS Software v.19 (IBM, NY, USA were used for data analysis. Results: Our findings indicate that the most causes of burns are hot liquids in 57% of cases and flammable liquid in 21% of cases. The most cases of burns were found to be in the range of 21 to 30 percent with 17.5% and 7% in male and female respectively. Gram-negative bacteria were dominated in 85.7% and among them pseudomonas spp. with 37.5% were the most common cause of infected burns, followed by Enterobacter, Escherichia coli, Staphylococcus aureus, Acinetobacter and Klebsiella spp. Conclusion: The results of this study showed that the most cause of burns in both sex is hot liquid. Men were more expose to burn than women and this might be due to the fact that men are involved in more dangerous jobs than female. Pseudomonas aeruginosa was the most common organism encountered in burn infection.

  10. Epidemiologic study of scald burns in victims in Tehran burn hospital

    Kamran Aghakhani


    Full Text Available Background: Damages caused by scald burns are common and can cause severe complications and death. The purpose of this study was to define risk groups and then methods of prevention and treatment is designed to fit. Methods: Data for this retrospective study of hospitalized patients in Shahid Motahari Hospital in Tehran from 2007-2011 were compiled. Data including age, sex, cause of burn, and degree of burn and ultimate fate of the victims were collected from scald burns. Burns caused by boiling water and hot food (Scald , in two age groups : 12 and under 12 years ( children and more than 12 years ( adults were compared in terms of statistics . Results: A total of 1150 patients consisting of males (57.9% and females (42.1% were studied. The most common age was 1 year old and 50% of patients were under 3 years of age. 87.9% burned with boiling water and 12.1% had experienced burns with hot food. Incentive to burn was 0.3% cross burning and 99.7% incident. A maximum number of burns in children 12 years and younger males (42.1% and a minimum number in men over 12 years (15.7% were observed. Mean percentage of burns was 11% in over 12 years group and 30.9% in 12 and under 12 years group. The average hospital stay was 11.4 days and the mortality rate was 4.8%. The final status of the patients was as fallows: full recovery 904 cases (78.6%, partial recovery 134 (11.7%, clearance with personal consent 41 (3.6%, death 55 (4.8% and 16 cases (3.1% were among other reasons. Conclusion: In general it can be said, scald burns incidence in individuals aged 12 and younger were more than the older ones and the mean of burns was lower in individuals with over 12 years old. There was a sexual preference for males under 12 years. Mortality rate in the two groups has not any statistically significant difference. There was no statistically significant association between sex and mortality rate. Some of our findings are depending on cultural, social and economic

  11. Analysis of hospitalized burned patients in bandar abbass, iran.

    Hasani, L; Aghamolei, T; Boushehri, E; Sabili, A


    This study was conducted to determine the causes and outcomes of burn in patients referred to Shahid Mohammadi Hospital in Bandar Abbass, southern Iran, in which 212 burned patients were assessed from March 2007 to March 2008 .Mean age of patients was 22.14 yr. Heat contact was the main cause of burn with 92.5%. 49.1% of total burns occurred among less than 20 yr old people. Mortality rate was 10.4%. Most of burns occurred at home. An educational program is necessary to prevent thermal burning at home.

  12. Severe metabolic acidosis following assault chemical burn

    Sophie De Roock


    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.

  13. [Ischemic cholangiopathy induced by extended burns].

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


    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.

  14. Severe metabolic acidosis following assault chemical burn.

    Roock, Sophie D; Deleuze, Jean-Paul; Rose, Thomas; Jennes, Serge; Hantson, Philippe


    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.

  15. Burning plasmas in ITER for energy source

    Inoue, Nobuyuki [Atomic Energy Commission, Tokyo (Japan)


    Fusion research and development has two aspects. One is an academic research on science and technology, i.e., discovery and understanding of unexpected phenomena and, development of innovative technology, respectively. The other is energy source development to realize fusion as a viable energy future. Fusion research has been made remarkable progress in the past several decades, and ITER will soon realize burning plasma that is essential for both academic research and energy development. With ITER, scientific research on unknown phenomena such as self-organization of the plasma in burning state will become possible and it contributes to create a variety of academic outcome. Fusion researchers will have a responsibility to generate actual energy, and electricity generation immediately after the success of burning plasma control experiment in ITER is the next important step that has to be discussed seriously. (author)

  16. Retinal Detachment: Torn or Detached Retina Symptoms

    ... Follow The Academy Professionals: Education Guidelines News Multimedia Public & Patients: Contact Us About the Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of Service For Advertisers For Media Ophthalmology Job Center © American Academy of ...

  17. Retinal Detachment: Torn or Detached Retina Diagnosis

    ... Follow The Academy Professionals: Education Guidelines News Multimedia Public & Patients: Contact Us About the Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of Service For Advertisers For Media Ophthalmology Job Center © American Academy of ...

  18. Kindlustuspakett kui Lego torn / Liina Leiten

    Leiten, Liina


    Koduse vara kindlustamise tingimused. Tabelid: 1999.a. 1. kvartali usaldusreiting varakindlustuse osas, valik koduse vara kindlustamise hinnapakkumisi. Kommenteerivad maaklerfirma In Bro & Partners kindlustusdirektor Jaak Rikson ja Kindlustusabi OÜ direktor Toivo Voit

  19. Skelleftea lennujaama puidust torn / Alar Just

    Just, Alar


    16. 09 2004 avatud lennujuhtimistorn, mille kandekonstruktsioonid on puidust. Arhitekt Ingemar Sjöstrand, inseneriarvutused tegi SP Trätek. Torni puitkonstruktsioonid valmisid AB-s Martinsons. 5 värv. ill

  20. Rahandusministeeriumi hoone taha kerkib teine torn


    Riigi Kinnisvara AS ehitab rahandusministeeriumi hoone taha ligi 50-meetrise torni, kuhu kolivad teisedki ministeeriumid. Linnaplaneerimise ameti hinnangul peaks hoone ehitusmahtu vähendama ja amet soovib uut eskiisi. Peatselt lõpeb konkurss hoone projekteerija leidmiseks

  1. Girl's Schooling in War-Torn Somalia

    Moyi, Peter


    A civil war has raged in Somalia since 1991. The civil war was the final blow to an already collapsed education system. Somalia has received little research and policy attention yet children, especially girls, are very vulnerable during times of conflict. The different gender roles, activities, and status in society create gender differentiated…

  2. Retinal Detachment: Torn or Detached Retina Treatment

    ... This procedure is performed in an operating room. Pneumatic retinopexy In this procedure, a gas bubble is ... to see your ophthalmologist regularly or at the first sign of any trouble with your vision. Previous ...

  3. Kindlustuspakett kui Lego torn / Liina Leiten

    Leiten, Liina


    Koduse vara kindlustamise tingimused. Tabelid: 1999.a. 1. kvartali usaldusreiting varakindlustuse osas, valik koduse vara kindlustamise hinnapakkumisi. Kommenteerivad maaklerfirma In Bro & Partners kindlustusdirektor Jaak Rikson ja Kindlustusabi OÜ direktor Toivo Voit

  4. Fungal infections in burns: Diagnosis and management

    Capoor Malini


    Full Text Available Burn wound infection (BWI is a major public health problem and the most devastating form of trauma worldwide. Fungi cause BWI as part of monomicrobial or polymicrobial infection, fungaemia, rare aggressive soft tissue infection and as opportunistic infections. The risk factors for acquiring fungal infection in burns include age of burns, total burn size, body surface area (BSA (30-60%, full thickness burns, inhalational injury, prolonged hospital stay, late surgical excision, open dressing, artificial dermis, central venous catheters, antibiotics, steroid treatment, long-term artificial ventilation, fungal wound colonisation (FWC, hyperglycaemic episodes and other immunosuppressive disorders. Most of the fungal infections are missed owing to lack of clinical awareness and similar presentation as bacterial infection coupled with paucity of mycology laboratories. Expedient diagnosis and treatment of these mycoses can be life-saving as the mortality is otherwise very high. Emergence of resistance in non-albicans Candida spp., unusual yeasts and moulds in fungal BWI, leaves very few fungi susceptible to antifungal drugs, leaving many patients susceptible. There is a need to speciate fungi as far as the topical and systemic antifungal is concerned. Deep tissue biopsy and other relevant samples are processed by standard mycological procedures using direct microscopy, culture and histopathological examination. Patients with FWC should be treated by aggressive surgical debridement and, in the case of fungal wound infection (FWI, in addition to surgical debridement, an intravenous antifungal drug, most commonly amphotericin B or caspofungin, is prescribed followed by de-escalating with voriconazole or itraconazole, or fluconazole depending upon the species or antifungal susceptibility, if available. The propensity for fungal infection increases, the longer the wound is present. Therefore, the development of products to close the wound more rapidly

  5. Soil heating and impact of prescribed burning

    Stoof, Cathelijne


    Prescribed burning is highly uncommon in the Netherlands, where wildfire awareness is increasing but its risk management does not yet include fuel management strategies. A major exception is on two military bases, that need to burn their fields in winter and spring to prevent wildfires during summer shooting practice. Research on these very frequent burns has so far been limited to effects on biodiversity, yet site managers and policy makers have questions regarding the soil temperatures reached during these burns because of potential impact on soil properties and soil dwelling fauna. In March 2015, I therefore measured soil and litter temperatures under heath and grass vegetation during a prescribed burn on military terrain in the Netherlands. Soil and litter moisture were sampled pre- and post-fire, ash was collected, and fireline intensity was estimated from flame length. While standing vegetation was dry (0.13 g water/g biomass for grass and 0.6 g/g for heather), soil and litter were moist (0.21 cm3/cm3 and 1.6 g/g, respectively). Soil heating was therefore very limited, with maximum soil temperature at the soil-litter interface remaining being as low as 6.5 to 11.5°C, and litter temperatures reaching a maximum of 77.5°C at the top of the litter layer. As a result, any changes in physical properties like soil organic matter content and bulk density were not significant. These results are a first step towards a database of soil heating in relation to fuel load and fire intensity in this temperate country, which is not only valuable to increase understanding of the relationships between fire intensity and severity, but also instrumental in the policy debate regarding the sustainability of prescribed burns.

  6. [Severe burns related to steam inhalation therapy].

    Belmonte, J A; Domínguez-Sampedro, P; Pérez, E; Suelves, J M; Collado, J M


    Despite lack of proven effectiveness and its potential to cause severe burns, steam inhalation therapy (SIT) is still used as a treatment for benign respiratory conditions. To characterize cases of burns related to steam inhalation therapy (BRSIT) in order to formulate appropriate preventive criteria. A review was conducted on cases of BRSIT admitted to a Burns Unit between 2006 and 2012, analysing epidemiological data, clinical aspects, severity and course. A total of 530 patients were admitted; 375 (70%) with scalds, and 15 with BRSIT (2.8% of burns; 4% of scalds). SIT was indicated in most cases for mild upper airway infections. The median age of patients was 7 years (2.5m-14 y). The burned area (BA) was ≥10% in 60% of cases (max. BA 22%). Injuries involved trunk, genital area, and extremities; only in one case was the face affected. The mean hospital length-of-stay was 14 days (3-30 d). Five patients (33%) were admitted to the PICU, most of them (60%) younger than 3 years. Eight patients (53%) underwent surgical treatment (skin grafting). In a 12-year-old patient whooping cough was diagnosed in the Burns Unit, and a 2.5-year-old patient developed staphylococcal toxic shock syndrome. No patient died. The final course was satisfactory in all patients. BRSIT can be severe and cause significant use of health resources. Professionals caring for children, particularly paediatricians, should seriously consider their prevention, avoiding treatments with SIT, and educating parents in order not to use it on their own. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  7. Burns in patients over 90: a fifteen-year series from a regional burns centre.

    Shariff, Zakir; Rodrigues, Jeremy N; Anwar, Umair; Austin, Orla; Phipps, Alan


    The elderly constitute an expanding subgroup within society, and may have differences in health needs compared to younger patients. The specific needs and outcomes of elderly patients with burns have been widely studied. However, the definition of elderly often used in previous studies is a cut off of 65 years old. Within this broadly defined group, the very elderly may have distinct health care needs and issues. This study investigated aetiology, management and outcome of burns in those over 90 years treated at a single UK burns service over a period of 15 years between 1998 and 2013, and compares these data to published data describing 'younger' elderly burns patients. Twenty two patients were included, with a 2:1 female:male ration, and a mean 9%TBSA burn. Six of the 22 died during their admission, and those who survived averaged 8 days inpatient stay per %TBSA. The very elderly with burns may fare worse than younger elderly patients. Although burns in the very elderly are relatively infrequent events, they require significant resource. Further work to optimise their outcome is required.

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

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


    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.

  9. On medications for burns in classical antiquity.

    Scarborough, J


    Egyptian, Greek, Roman, and early Byzantine medical pharmaceutical works show a fairly sophisticated array of simple and compound remedies for burns and scalds. Chief among ancient writings that provide specific botany, minerals, and similar substances used in burn treatment are several Egyptian papyri, the Hippocratic On Wounds, and writings by Celsus, Dioscorides, Pliny the Elder, and Paul of Aegina. Over 70 plants and minerals are identified according to modern nomenclatures. The ancients sought especially those ingredients that would promote rapid healing with a minimum of scarring.

  10. Biomass Burning Observation Project Science Plan

    Kleinman, KI [Brookhaven National Laboratory; Sedlacek, AJ [Brookhaven National Laboratory


    Aerosols from biomass burning perturb Earth’s climate through the direct radiative effect (both scattering and absorption) and through influences on cloud formation and precipitation and the semi-direct effect. Despite much effort, quantities important to determining radiative forcing such as the mass absorption coefficients (MAC) of light-absorbing carbon, secondary organic aerosol (SOA) formation rates, and cloud condensation nuclei (CCN) activity remain in doubt. Field campaigns in northern temperate latitudes have been overwhelmingly devoted to other aerosol sources in spite of biomass burning producing about one-third of the fine particles (PM2.5) in the U.S.

  11. Financial burden of burn injuries in iran: a report from the burn registry program.

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


    Understanding the cost of burn treatment is very important for patients, their families, governmental authorities and insurance companies. It alleviates patient and familial stress, provides a framework for better use of resources, and facilitates better performance between burn centers. Hospital burn costs can provide a basis for authorities to budget for acute burn treatment, for further management of chronic complications, and for planning prevention and public educational programs in Iran. To identify costs we used data from our burn registry program. Over the two-year assessment period, we treated roughly 28,700 burn patients, 1,721 of whom were admitted, with a mortality rate of 5.9%. The male to female ratio was 1.7:1 (63% male; 37% female). Flame burns were most frequent (49.8%) followed by scalds (35.7%). Mean hospital stay was 14.41 days (range 0-64 days). Mean TBSA was 17.39%. Skin grafts were carried out in 65.4% of the patients, with a mean of 5.2 surgeries per patient. The total cost of all patient admissions over the two years was US$ 4,835,000. The maximum treatment cost for one patient was US$ 91,000. The mean cost per patient was US$ 2,810 (29,500,000 Rials). The mean cost for each percent of burn was US$ 162. The mean cost for a one-day stay in hospital was US$ 195. The mean cost of each operation was US$ 540. Patients who contracted infections endured longer hospital stays, meaning increased costs of US$ 195 per day. With comparable outcome and results, the cost of burn treatment in Iran is cheaper than in the US and Europe.

  12. Study of Bacterial Infections among Burn Patients Hospitalized in Isfahan Burn Center

    J. Faghri


    Full Text Available Introduction & Objective: Burn patients are at risk of acquiring infection because of destroy skin barrier, suppression of immunity, prolonged hospitalization, and invasive therapeutic and diagnostic procedure, risk of acquiring infection is high among burned patients. The aim of this study was to assess the incidence rate of bacterial etiology and infections among burn patients in the burn center of Isfahan. Materials & Methods: The study was conducted descriptive – cross sectional during a period of one year, (from august 2004 until September 2005. A total of 106 patients presenting with no signs and symptoms of infection within the first 48 hours of admission were included. CDC definition for nosocomial infections was applied. Each patient’s clinical examinations and records investigated daily. Swab culture, blood culture (during fever time, tissue culture from biopsy specimen of burn wound and urine culture obtained. The data were analyzed and interpreted using SPSS 10 Software, using Chi – square and Kappa Coefficient. P.value < 0.05 was significant. Results: One-hundred and six patients met the inclusion criteria, 91 (85/8% acquired at least one type of infection, including, urinary tract 28 (26/4%, blood stream 30 (28/3%, and burn wound 91(85/8%. Pseudomonas aeroginosa was the most common causative agent isolated from blood culture and swab culture, 27/42% and 54/4% respectively. Also, E.coli was the major casautive agent of urinary tract infections (6.4% isolated from urine culture of these burn patients.Conclusion: The results indicated that, biopsy from burn wounds and study of histopathologic specimen day by other day depends on blood and urine culture conditions overall can be effective for early detection of burn wounds infections.

  13. Genital burns in the national burn repository: incidence, etiology, and impact on morbidity and mortality.

    Harpole, Bethany G; Wibbenmeyer, Lucy A; Erickson, Bradley A


    To better characterize national genital burns (GBs) characteristics using a large burn registry. We hypothesized that mortality and morbidity will be higher in patients with GBs. The National Burn Repository, a large North American registry of hospitalized burn patients, was queried for patients with GB. Burn characteristics and mechanism, demographics, mortality, and surgical interventions were retrieved. Outcomes of interest were mortality, hospital-acquired infection (HAI), and surgical intervention on the genitalia. Adjusted odds ratios (aOR) for outcomes were determined with binomial logistic regression controlling for age, total burn surface area, race, length of stay, gender, and inhalation injury presence. GBs were present in 1245 cases of 71,895 burns (1.7%). Patients with GB had significantly greater average total burn surface area, length of stay, and mortality. In patients with GB, surgery of the genitalia was infrequent (10.4%), with the aOR of receiving surgery higher among men (aOR 2.7, P burns (aOR 3.1, P <.002). Presence of a GB increased the odds of HAI (aOR 3.0, P <.0001) and urinary tract infections (aOR 3.4, P <.0001). GB was also an independent predictor of mortality (aOR 1.54) even after adjusting for the increased HAI risk. GBs are rare but associated with higher HAI rates and higher mortality after adjusting for well-established mortality risk factors. Although a cause and effect relationship cannot be established using these registry data, we believe this study suggests the need for special management considerations in GB cases to improve overall outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

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

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


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

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

    Quinn, Davin Kenneth


    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.

  16. Risk factors of burns among children in Mongolia.

    Khandarmaa, Tseren-Ochir; Harun-Or-Rashid, Md; Sakamoto, Junichi


    Burn is one of the leading causes of under-5 childhood injuries. Identification of risk factors and awareness level of caregivers could help reduction of burn-related morbidity. The objectives of this study were to identify general perceptions of risk factors of childhood burns, prevalence of burns among under-five Mongolian children, and to assess knowledge and practice of burn care and care seeking behaviors for care givers of those children. A household-based cross-sectional survey was conducted from September to October 2010 including 865 households with 1154 under-5 children. Data were collected by face-to-face interview using semi-structured questionnaire. Of total 1154 children, 291 (25.2%) had burn injury in their life-time. Above half of them had suffered a scald. Majority of burns occurred at home and urban children were at higher risk. The age up to 36 months, boys, and fewer children (burns. Caregivers' knowledge and practices on childhood burns were generally insufficient; most of them indicated the importance of physical environment at home. We concluded that burns were common among under-5 children, and caregivers' knowledge and practices on burns was inadequate. Specific interventions like "Caregivers education program" encouraging safe domestic environmental conditions should be undertaken to increase their awareness on burn-related issues to reduce childhood burns in Mongolia.

  17. Incidence and Bacteriology of Burn Infections at a Military Burn Center


    is independently associated with mortality in burn patients. Ann Surg 2007;245: 978–85. [27] Griffith ME, Lazarus DR, Mann PB, Boger JA, Hospenthal DR...SE. Effects of delayed wound excision and grafting in severely burned children. Arch Surg 2002;137(9):1049–54. [30] Hart DW, Wolf SE, Chinkes DL ...F, Thompson P, Linares HA, Stein M, Traber DL . Pulmonary injury in burned patients. Surg Clin North Am 1987;67(1):31–46. [42] Santucci SG, Gobara S

  18. Diagnostic dilemma: the enigma of an oral burning sensation

    Klasser, Gary D; Epstein, Joel B; Villines, Dana


    ...) and secondary burning mouth syndrome. The primary form is characterized by a burning sensation in the oral mucosa and perioral areas, typically with bilateral, symmetric distribution and an absence of relevant clinical and laboratory findings...

  19. Reality Therapy as an Antidote to Burn-Out.

    Wubbolding, Robert E.; Kessler-Bolotin, Else


    Counselor burn-out is characterized by feelings of frustration, rigidity, omnipotence, and the like. Reality therapy uses systematic plans to increase love, worth, fun, and self-discipline to deal effectively with burn-out. (Author)

  20. Reality Therapy as an Antidote to Burn-Out.

    Wubbolding, Robert E.; Kessler-Bolotin, Else


    Counselor burn-out is characterized by feelings of frustration, rigidity, omnipotence, and the like. Reality therapy uses systematic plans to increase love, worth, fun, and self-discipline to deal effectively with burn-out. (Author)

  1. Toddlers at High Risk of Chemical Eye Burns

    ... fullstory_160258.html Toddlers at High Risk of Chemical Eye Burns: Study Access to household cleaning products to blame, ... and 2 years have relatively high rates of chemical eye burns, with everyday cleaners a common cause, researchers say. ...

  2. The Combustion of HMX. [burning rate at high pressures

    Boggs, T. L.; Price, C. F.; Atwood, A. I.; Zurn, D. E.; Eisel, J. L.


    The burn rate of HMX was measured at high pressures (p more than 1000 psi). The self deflagration rate of HMX was determined from 1 atmosphere to 50,000 psi. The burning rate shows no significant slope breaks.

  3. In-Situ Burning of Crude Oil on Water

    van Gelderen, Laurens

    in the small scale water basin. Boilovers were also observed during the burning of a heavy crude oil with a substantial light fraction without a water layer, however, which suggests that water is not essential for boilover occurrence. Further studies are required to determine the conditions under which......The fire dynamics and fire chemistry of in-situ burning of crude oil on water was studied in order to improve predictions on the suitability of this oil spill response method. For this purpose, several operational parameters were studied to determine the factors that control the burning efficiency...... of in-situ burning, i.e. the amount of oil (in wt%) removed from the water surface by the burning process. The burning efficiency is the main parameter for expressing the oil removal effectiveness of in-situ burning as response method and is thus relevant for suitability predictions of in-situ burning...

  4. Burn Prevention for Families with Children with Special Needs

    Full Text Available ... Scalds Type Video Audience Parents You are here Home Safety Tips Video Special Needs Burns and Scalds Burn Prevention for Families With Children With Special Needs Watch this video to learn ...

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

    Neriman Akansel


    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.

  6. Current Treatment Options in Challenging Oral Diseases: Burning Mouth Syndrome

    Bilgen Erdoğan


    Full Text Available Burning mouth syndrome is a chronic condition characterized by burning pain without any signs of an oral mucosal pathology, that usually affects postmenopausal women. Burning sensation is often accompanied by dysgeusia and xerostomia. The pathogenesis of the disease is unknown and an effective treatment option for most of the patients has not been defined yet. The aim of this review is to present current pharmacological and physicological treatments of burning mouth syndrome.

  7. Continental cement trial burn strategy follow-up

    Woodford, J. [Gossman Consulting, Inc., Springboro, OH (United States); Winders, H. [Continental Cement Company, Hannibal, MO (United States); Constans, D.L. [Gossman Consulting, Inc., Peachtree City, GA (United States)


    The Continental Trial Burn strategy, presented at the 1995 BIF Conference, included the use of {open_quotes}data-in-lieu-of{close_quotes} from previous compliance testing conducted at the facility. Since the submission of the Trial Burn Plan and the 1995 presentation, Continental Cement has completed their two campaign trial burn. This paper will update the implementation of the Continental Trial Burn strategy. 1 fig., 1 tab.

  8. Seawater Immersion Aggravates Burn Injury Causing Severe Blood Coagulation Dysfunction


    This study aimed to investigate the endothelial function in a canine model of burn injury combined with seawater immersion. The model of burn injury was established. The dogs were randomly divided into four groups including dogs with burn injury (B group), or burn injury combined with seawater immersion (BI group), or only immersion in seawater (I group), or control animals with no injury or immersion (C group). The circulating endothelial cell (CEC) count and coagulation-fibrinolysis paramet...

  9. A Portable Burn Pan for the Disposal of Excess Propellants


    Engineering Laboratory (CRREL) developed and tested a prototype portable burn pan under SERDP that enabled artillery batteries to conduct training burns...prototype portable burn pan under SERDP that enabled artillery batteries to conduct training burns while minimizing the environmental impact of the...military truck and light enough to be handled by four or fewer personnel. The target propellant charge load is in the 120 kg range for a full- size

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

    Feng Guo


    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. Management of chemical burns of the canine cornea

    Christmas, Richard


    Significant clinical signs and general principles of treatment for chemical burns of the canine cornea are presented using three typical case studies for illustration. Alkali burns are more common in dogs than acid burns. The sources of alkali in this study were soap, cement, and mortar dust. Common signs of chemical burns are ocular pain, corneal ulceration, tear film inadequacy, corneal edema, and marked corneal neovascularity. Successful treatment requires thorough ocular lavage, treatment...

  12. A Hydrodynamical Analysis of the Burning of a Neutron Star

    Cho, H T; Speliotopoulos, Achilles D; 10.1016/0370-2693(94)91201-7


    The burning of a neutron star by strange matter is analyzed using relativistic combustion theory with a planar geometry. It is shown that such burning is probably neither slow combustion nor simple detonation. Fast combustion without detonation is possible under certain circumstances, but would involve very efficient heat transfer mechanisms. It is found, however, that the burning is most likely absolutely unstable with no well defined burn front.

  13. Burns B. Crookston: Life and Legacy

    Fried, Jane


    Burns B. Crookston was a man ahead of his times. He left a legacy to the student affairs profession that inspired the practice of student development education. His writings described a role for higher education in training students to become active citizens by learning about leadership, decision making, and conflict resolution in democratic…

  14. Validation of the burns itch questionnaire

    Van Loey, N E; Hofland, H W; Hendrickx, H; Van de Steenoven, J; Boekelaar, A; Nieuwenhuis, M K


    Itch (pruritus) is a common multidimensional complaint after burn that can persist for months to years. A questionnaire able to investigate itch and its consequences is imperative for clinical and research purposes. The current study investigated the factor structure, internal consistency and constr

  15. Long standing intra oral acid burn

    V.V. Kumar; S. Ebenezer; F. Lobbezoo


    Oral burn due to ingestion of corrosive substances can bring about debilitating consequences. It often brings mortality, and the survivors can have severe impairment of functions, especially in relation to the stomatognathic and gastrointestinal systems. This article presents a long-standing case (2

  16. Analysis of antibiotic consumption in burn patients

    Soleymanzadeh-Moghadam, Somayeh; Azimi, Leila; Amani, Laleh; Rastegar Lari, Aida; Alinejad, Faranak; Rastegar Lari, Abdolaziz


    Infection control is very important in burn care units, because burn wound infection is one of the main causes of morbidity and mortality among burn patients. Thus, the appropriate prescription of antibiotics can be helpful, but unreasonable prescription can have detrimental consequences, including greater expenses to patients and community alike. The aim of this study was to determine the effect of antibiotic therapy on the emergence of antibiotic-resistant bacteria. 525 strains of Pseudomonas aeruginosa, Acinetobacter baumannii and Staphylococcus aureus were isolated from 335 hospitalized burn patients. Antibiotic susceptibility tests were performed after identification the strains. The records of patients were audited to find the antibiotic used. The results indicated that P. aeruginosa is the most prevalent Gram-negative bacteria. Further, it showed a relation between abuse of antibiotics and emergence of antibiotic resistance. Control of resistance to antibiotics by appropriate prescription practices not only facilitates prevention of infection caused by multi-drug resistant (MDR) microorganisms, but it can also decrease the cost of treatment. PMID:26124986

  17. Analysis of antibiotic consumption in burn patients

    Soleymanzadeh-Moghadam, Somayeh


    Full Text Available Infection control is very important in burn care units, because burn wound infection is one of the main causes of morbidity and mortality among burn patients. Thus, the appropriate prescription of antibiotics can be helpful, but unreasonable prescription can have detrimental consequences, including greater expenses to patients and community alike. The aim of this study was to determine the effect of antibiotic therapy on the emergence of antibiotic-resistant bacteria. 525 strains of and were isolated from 335 hospitalized burn patients. Antibiotic susceptibility tests were performed after identification the strains. The records of patients were audited to find the antibiotic used.The results indicated that is the most prevalent Gram-negative bacteria. Further, it showed a relation between abuse of antibiotics and emergence of antibiotic resistance. Control of resistance to antibiotics by appropriate prescription practices not only facilitates prevention of infection caused by multi-drug resistant (MDR microorganisms, but it can also decrease the cost of treatment.

  18. Initial Burn Pan (JMTF) Testing Results


    With the assistance of the local fishing community and commercial responders, the USCG and British Petroleum (BP) conducted over 400 offshore burns... rain during the interim time also increased the disposal amount. The General Assessment of Risk (GAR) process was used in the morning planning

  19. Process and apparatus for burning solid fuel

    Lin, W.; Van den Bleek, C.M.


    Abstract of NL 9301828 (A) Described is a process for burning solid fuel, in which nitrogen in the form of NH3 is released from said fuel, for example by gasification, said NH3 being excluded from the combustion process but being admixed, together with CO likewise released, to the gases released

  20. Protect the Ones You Love From Burns


    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.

  1. Liaison psychiatry on a burn unit.

    Billowitz, A; Friedson, W; Schubert, D S


    Psychiatric liaison activities and intervention on a burn unit are described. The authors review the psychiatrist's interventions with regard to unhealthy staff denial; educating staff about psychiatric issues; facilitating improved staff-patient communication; and helping nurses manage patients' inappropriate sexual behavior.

  2. Analgesic effects of dexamethasone in burn injury

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


    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.......BACKGROUND AND OBJECTIVES: Glucocorticoids are well-known adjuvant analgesics in certain chronic pain states. There is, however, a paucity of data on their analgesic efficacy in acute pain. Therefore, the aim of the study was to examine the analgesic effects of dexamethasone in a validated burn...... model of acute inflammatory pain in humans. METHODS: Twenty-two volunteers were investigated in a double-blind, randomized, placebo-controlled cross-over study. Intravenous dexamethasone 8 mg or placebo was administered on 2 separate study days. Two hours after drug administration, a first-degree burn...


    The primary objective of this study was to improve the characterization of particulate matter emissions from burning incense. Emissions of particulate matter were measured for 23 different types of incense using a cyclone/filter method. Emission rates for PM2.5 (particulate matte...

  4. Silica Derived from Burned Rice Hulls

    M.F. de Souza


    Full Text Available Three new processes to obtain silica having high specific surface area from burned pre-treated rice hulls are presented and discussed. These procedures allow for the simultaneous recovery of biomass energy and the production of high quality silica at thermoelectric plants, without the risk of using corrosive substances in the burning process. The first method involves treatment of the hull with hot organic acid solutions before burning, the second with boiling water, both using an autoclave at temperatures close to150 °C, while the third method renders the hull fragile by treating it at 250 °C and reducing it to a fine powder before burning. The first two methods result in white amorphous silica that can show 500 m²/g of specific surface area. The third method, which does not remove the alkaline elements from the hull, produces an amorphous gray carbon-free powder whose specific surface area can be as high as 250 m²/g. An investigation of the specific surface area of the prepared silica indicates the alkaline elements are not mixed with silica in the hulls or combined as insoluble compounds. A comparison is made of these processes and the dissolution of silica by sodium hydroxide solutions is discussed.

  5. Burn Resuscitation Decision Support System (BRDSS)


    first year of the study and provided to USAISR with the BRDSS prototypes. Environmental test certifications (primarily: EMC and RFID testing) was...also conducted hardware based testing, such as electromagnetic compatibility (EMC) and radio-frequency identification ( RFID ) compatibility three areas could improve effectiveness of this technology . Field Feedback. The BRDSS / Burn Navigator™ devices are now in Full Rate Production

  6. Burning mouth syndrome: a review and update.

    Silvestre, Francisco J; Silvestre-Rangil, Javier; López-Jornet, Pía


    Burning mouth syndrome (BMS) is mainly found in middle aged or elderly women and is characterized by intense burning or itching sensation of the tongue or other regions of the oral mucosa. It can be accompanied by xerostomia and dysgeusia. The syndrome generally manifests spontaneously, and the discomfort is typically of a continuous nature but increases in intensity during the evening and at night. Although BMS classically has been attributed to a range of factors, in recent years evidence has been obtained relating it peripheral (sensory C and/or trigeminal nerve fibers) or central neuropathic disturbances (involving the nigrostriatal dopaminergic system). The differential diagnosis requires the exclusion of oral mucosal lesions or blood test alterations that can produce burning mouth sensation. Patient management is based on the avoidance of causes of oral irritation and the provision of psychological support. Drug treatment for burning sensation in primary BMS of peripheral origin can consist of topical clonazepam, while central type BMS appears to improve with the use of antidepressants such as duloxetine, antiseizure drugs such as gabapentin, or amisulpride.

  7. Thermoregulation in burn patients during exercise.

    Austin, K G; Hansbrough, J F; Dore, C; Noordenbos, J; Buono, M J


    The purpose of this study was to assess the ability of patients with burns on 30 to 40% and 60% or greater of their BSA to thermoregulate their core temperature during exercise in the heat. Two groups (n = 3 in each) of subjects with healed third-degree burns (34.0 +/- 1.4% and 77.7 +/- 12.4%, respectively) and a group of unburned subjects (n = 2) exercised for 1 hour on a cycle ergometer at 75 Watts in an environmental chamber set at 35 degrees C and 60% relative humidity. Subjects were monitored for rectal and skin temperatures, heart rate, whole body sweat rate, skin blood flow, and active sweat gland density (number per cm ) in unburned, burned, and harvested skin. The results demonstrated that patients with burns on 60% or greater BSA did not show an intolerance to moderate exercise in the heat, as evidenced by only a moderate rise in rectal temperature and heart rate. Furthermore, the responses were similar to those of the unburned subjects.

  8. Burn Injury Caused by Laptop Computers

    dry skin, with no blisters, on his left leg was reported [Figure 1]. ... can indeed cause it. in very rare cases, the condition can cause damage leading to skin cancer. ... After an extensive work‑up, burning caused by use of a laptop was observed.

  9. Clinker burning kinetics and mechanism

    Telschow, S.


    The industrial cement process is subject to several changes in order to reduce the high energy consumption and thereby increase the profitability of cement production. These changes also affect the core of the entire cement producing process: the clinker formation in the rotary kiln. Thus, in order to maintain or even improve clinker quality (and output), we need a better understanding of the development of clinker properties inside the kiln to react upon the impact of process changes. Clinker formation in industrial rotary kilns is very complex due to a vast number of interacting parameters: kiln dimensions, rotation velocity, temperature, gas composition, heat transfer phenomena, etc. These conditions can only be partly simulated in ordinary lab-scale experiments. Thus, the objectives of this project have been to establish test equipment to simulate the industrial clinker burning process on a laboratory scale and to conduct clinker formation experiments in order to derive knowledge on gradual clinker property development, as a function of different process parameters. A new lab-scale setup rotary kiln simulator (RKS) was designed and built for this purpose. It is assembled of two parts: an ordinary lab-scale heating furnace and a sample motion system. The motion system consists of a SiC tube, which moves the sample, placed in a Pt/Rh-crucible, at a chosen velocity through the heating furnace. Simultaneously, the sample is rotated around its horizontal axis with a chosen rotation velocity. The heating furnace consists of five individual heating zones, which are set to obtain a temperature ramp from {approx}00-1540 deg. C. Furthermore, the atmosphere in the system can be set to any mixture of N2, O2 and CO{sup 2}. Thus, the rotary kiln simulator features most important parameters of the industrial cement rotary kiln (ICRK): gradual temperature increase, rotation velocity and gas phase composition. An investigation of clinker formation vs. heating profile and

  10. Burning sensation in oral cavity--burning mouth syndrome in everyday medical practice

    Gerlinger, Imre


    .... It is observed principally in middle-aged patients and postmenopausal women. BMS is characterized by an intense burning or stinging sensation, typically on the tongue or in other areas of the oral mucosa...

  11. Burn Pre-Approval Area, Geographic NAD83, LOSCO (2000) [burn_preapproval_area_LOSCO_2000

    Louisiana Geographic Information Center — This is a region dataset delineating the areas of offshore Louisiana having Regional Response Team VI (RRT 6) pre-approval for the use of in-situ burning, according...

  12. Reactive burn models and ignition & growth concept

    Menikoff, Ralph S [Los Alamos National Laboratory; Shaw, Milton S [Los Alamos National Laboratory


    Plastic-bonded explosives are heterogeneous materials. Experimentally, shock initiation is sensitive to small amounts of porosity, due to the formation of hot spots (small localized regions of high temperature). This leads to the Ignition and Growth concept, introduced by Lee and Tarver in 1980, as the basis for reactive burn models. A homogeneized burn rate needs to account for three mesoscale physical effects (i) the density of burnt hot spots, which depends on the lead shock strength; (ii) the growth of the burn fronts triggered by hot spots, which depends on the local deflagration speed; (iii) a geometric factor that accounts for the overlap of deflagration wavelets from adjacent hot spots. These effects can be combined and the burn model defined by specifying the reaction progress variable {lambda}(t) as a function of a dimensionless reaction length {tau}{sub hs}(t)/{ell}{sub hs}, rather than by xpecifying an explicit burn rate. The length scale {ell}{sub hs} is the average distance between hot spots, which is proportional to [N{sub hs}(P{sub s})]{sup -1/3}, where N{sub hs} is the number density of hot spots activated by the lead shock. The reaction length {tau}{sub hs}(t) = {line_integral}{sub 0}{sup t} D(P(t'))dt' is the distance the burn front propagates from a single hot spot, where D is the deflagration speed and t is the time since the shock arrival. A key implementation issue is how to determine the lead shock strength in conjunction with a shock capturing scheme. They have developed a robust algorithm for this purpose based on the Hugoniot jump condition for the energy. The algorithm utilizes the time dependence of density, pressure and energy within each cell. The method is independent of the numerical dissipation used for shock capturing. It is local and can be used in one or more space dimensions. The burn model has a small number of parameters which can be calibrated to fit velocity gauge data from shock initiation experiments.

  13. 40 CFR 266.101 - Management prior to burning.


    ... (CONTINUED) STANDARDS FOR THE MANAGEMENT OF SPECIFIC HAZARDOUS WASTES AND SPECIFIC TYPES OF HAZARDOUS WASTE MANAGEMENT FACILITIES Hazardous Waste Burned in Boilers and Industrial Furnaces § 266.101 Management prior to burning. (a) Generators. Generators of hazardous waste that is burned in a boiler or industrial furnace...

  14. The trend of acute burns pre-hospital management

    Abubakar Hamdiya


    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.

  15. Epidermal-dermal crosstalk during burn wound scar maturation

    T.E. Hakvoort (Eveline)


    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

  16. Epidermal-dermal crosstalk during burn wound scar maturation

    T.E. Hakvoort (Eveline)


    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

  17. 14 CFR 33.79 - Fuel burning thrust augmentor.


    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Fuel burning thrust augmentor. 33.79... thrust augmentor. Each fuel burning thrust augmentor, including the nozzle, must— (a) Provide cutoff of the fuel burning thrust augmentor; (b) Permit on-off cycling; (c) Be controllable within the intended...

  18. Gram-negative bacterial infection in thigh abscess can migrate to distant burn depending on burn depth

    Hamrahi, Victoria; Hamblin, Michael R; Jung, Walter; Benjamin, John B; Paul, Kasie W; Fischman, Alan J; Tompkins, Ronald G; Carter, Edward A


    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...

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

    Hamrahi, Victoria; Hamblin, Michael R; Jung, Walter; Benjamin, John B; Paul, Kasie W; Fischman, Alan J; Tompkins, Ronald G; Carter, Edward A


    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...

  20. An epidemiological study of 1063 hospitalized burn patients in a tertiary burns centre in Hong Kong.

    Ho, W S; Ying, S Y


    A total of 1063 acute burn patients were admitted to the Burns Unit of Prince of Wales Hospital, Hong Kong between March 1993 and February 1999. There were 678 males and 385 females with a male to female ratio of 1.76:1. The median age was 13.1 year-old and the median burn size was 6% total body surface area (TBSA). Pediatric patients under the age of 15 year-old accounted for 550 (51.7%) admissions and 235 (42.7%) of them were toddlers patients of age above 15 year-old accounted for the other 513 (48.3%) admissions. There was no seasonal variation in admission. Domestic burns resulted in 756 (71.1%) injuries followed by industrial burns that caused 175 (16.5%) admissions. The median hospital stay was 9 days and 54 patients (5.1%) had inhalation injury requiring intubation and ventilatory support. Twenty-four patients died in this series which yielded a mortality rate of 2.3%. The median age for this mortality group was 46.6 year-olds with a median extent of burns of 68% TBSA. There were 16 males and 8 females with a male to female ratio of 2:1. Eighteen (75%) patients had flame burns and 15 (83.3%) of them had inhalation injury. The mortality group had significantly larger burn size (P<0.001), higher incidence of inhalation injury (P<0.001) and older age (P<0.001) compared to the survivors.

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

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


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

  2. A Goniometry Paradigm Shift to Measure Burn Scar Contracture in Burn Patients


    cost extension has been granted to extend the study period to September 14, 2017. Standard Goniometry (SG) Position to Measure Wrist Extension 42...1 AD______________ AWARD NUMBER: W81XWH-14-2-0148 TITLE: A Goniometry Paradigm Shift to Measure Burn Scar Contracture in Burn Patients...subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. PLEASE DO

  3. The partnership of the American Burn Association, Children's Burn Foundation, and the Pediatric Burn Team in Vellore, India - a progress report.

    Light, Timothy D; Latenser, Barbara A; Heinle, Jackie A; Stolpen, Margeret S; Quinn, Keely A; Ravindarin, Vinitha; Chacko, Jacob


    Foreign medical service trips, though worthy, raise questions about efficacy, durability, and cultural sensitivity. A structured intervention by a multidisciplinary team can lead to sustained and integrated changes in the delivery of burn care. The American Burn Association, Children's Burn Foundation, and other donors have sponsored four interventions with the Pediatric Burn Center at Christian Medical Center in Vellore, India. Using qualitative research methods, we report our interventions and changes in burn care in Vellore. Using a multifaceted intervention over 2 years, there are skilled and practiced changes in burn care in Vellore, India. These changes involved changes in medical care, nursing care, wound care, operative timing, patient activity, and rehabilitation. Protocols and student and staff education tools have been developed and implemented. Major changes in burn care were observed by the visiting burn team. These skills are practiced and routinely used. The Vellore burn team reports an improvement in nursing satisfaction, patient tolerance, cleanliness, decreased antibiotic use, earlier excision and grafting, and more efficient care. Educational partnerships to improve burn care can induce durable changes, regardless of local language, culture, resources, technology, and skill.

  4. Methoxyphenols in smoke from biomass burning

    Kjaellstrand, J.


    Wood and other forest plant materials were burned in laboratory experiments with the ambition to simulate the natural burning course in a fireplace or a forest fire. Smoke samples were taken and analysed with respect to methoxyphenols, using gas chromatography and mass spectrometry. Different kinds of bio pellets, intended for residential heating were studied in the same way. The aim of a first study was to establish analytical data to facilitate further research. Thirty-six specific methoxyphenols were identified, and gas chromatographic retention and mass spectrometric data were determined for these. In a subsequent study, the methoxyphenol emissions from the burning of wood and other forest plant materials were investigated. Proportions and concentrations of specific methoxyphenols were determined. Methoxyphenols and anhydrosugars, formed from the decomposition of lignin and cellulose respectively, were the most prominent semi-volatile compounds in the biomass smoke. The methoxyphenol compositions reflected the lignin structures of different plant materials. Softwood smoke contained almost only 2-methoxyphenols, while hardwood smoke contained both 2-methoxyphenols and 2,6-dimethoxyphenols. The methoxyphenols in smoke from pellets, made of sawdust, bark and lignin, reflected the source of biomass. Although smoke from incompletely burned wood contains mainly methoxyphenols and anhydrosugars, there is also a smaller amount of well-known hazardous compounds present. The methoxyphenols are antioxidants. They appear mainly condensed on particles and are presumed to be inhaled together with other smoke components. As antioxidants, phenols interrupt free radical chain reactions and possibly counteract the effect of hazardous smoke components. Health hazards of small-scale wood burning should be re-evaluated considering antioxidant effects of the methoxyphenols.

  5. New treatment strategies to reduce burn wound progression

    Schmauss, Daniel


    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

  6. Sexuality after burn in Brazil: survey of burn health-care workers.

    Piccolo, Monica Sarto; Daher, Ricardo Piccolo; Gragnani, Alfredo; Ferreira, Lydia Masako


    Patients who survive a major burn must live with emotional and physical sequela. In a literature review, we found that sexuality concerns of burn victims are rarely a focus of therapy. After suggestions from Rimmer et al. [12], using their questionnaire translated into Portuguese, we held a survey of burn-care professionals at the VII Brazilian Burn Congress. More than 120 practitioners from 41 centres, aged in average 41.2 years (1 standard deviation 10.96), completed the survey. A proportion of 63.7% were female, and 58.1% were Caucasians; 37.1% were physicians, 20.9% nurse practitioners and 16.9 were occupational therapists/physical therapists (OTs/PT)s. Psychologists made up 3.2%. Only 28% of the respondents felt comfortable in initiating a conversation about sexual intimacy with their patients. The vast majority believed it should be done by the psychologist. Only 38% felt their burn centre did an adequate job in that area. When compared with a study of our country's general population, we find similar results indicating that intimacy, sexuality and sexual intercourse are considered most important in a relationship. There is a significant lack of literature in sexuality after burn; most likely meaning it is ignored by most centres. There is a need for other similar surveys to be performed, as well as a collective consciousness of the need for discussions about sexuality with patients and their partners, providing counselling and treatment, when need.

  7. Bacteriological profile of burn wound isolates in a burns center of a tertiary hospital

    Amankwa Richcane


    Full Text Available Objective: To determine the bacteriological profile and antimicrobial susceptibility patterns of burn wound isolates. Methods: Swabs were taken from burn wound of patients admitted to Ward D2C and Burns Intensive Care Unit (BICU from December 2014 to November 2015. Samples were processed at the Microbiology Laboratory for identification and sensitivity. Bacteria isolated were identified using their morphological characteristics, Gram staining reaction and biochemical tests. The antimicrobial susceptibility testing was done using KirbyBauer disc diffusion method. Questionnaires were also administered to study participants to obtain information on demography, kind of first aid received, antibiotics received prior to culture and sensitivity. Results: A total of 86 patients comprising 45 patients from Ward D2C and 41 from BICU participated in the study. Males were 51(59.3% and females 35 (40.7%. Age of participants ranged from 0–56+ years. Pseudomonas aeruginosa was the commonest pathogen isolated 26(30.2%, followed by Pseudomonas spp. 21(24.4%, Escherichia coli 17(19.8%, Klebsiella spp. 12(14.0%. Coagulase negative Staphylococcus accounted for 2(2.3%. Overall prevalence of infection in the study was 90.7%. Conclusions: Burn wound infection continues to be a major challenge in burn centers. Regular surveillance of commonly identified pathogens in the ward and their antimicrobial susceptibility will guide proper empiric selection of antibiotics for management of burn wounds.

  8. The effect of burn rehabilitation massage therapy on hypertrophic scar after burn: a randomized controlled trial.

    Cho, Yoon Soo; Jeon, Jong Hyun; Hong, Aram; Yang, Hyeong Tae; Yim, Haejun; Cho, Yong Suk; Kim, Do-Hern; Hur, Jun; Kim, Jong Hyun; Chun, Wook; Lee, Boung Chul; Seo, Cheong Hoon


    To evaluate the effect of burn rehabilitation massage therapy on hypertrophic scar after burn. One hundred and forty-six burn patients with hypertrophic scar(s) were randomly divided into an experimental group and a control group. All patients received standard rehabilitation therapy for hypertrophic scars and 76 patients (massage group) additionally received burn scar rehabilitation massage therapy. Both before and after the treatment, we determined the scores of visual analog scale (VAS) and itching scale and assessed the scar characteristics of thickness, melanin, erythema, transepidermal water loss (TEWL), sebum, and elasticity by using ultrasonography, Mexameter(®), Tewameter(®), Sebumeter(®), and Cutometer(®), respectively. The scores of both VAS and itching scale decreased significantly in both groups, indicating a significant intragroup difference. With regard to the scar characteristics, the massage group showed a significant decrease after treatment in scar thickness, melanin, erythema, TEWL and a significant intergroup difference. In terms of scar elasticity, a significant intergroup difference was noted in immediate distension and gross skin elasticity, while the massage group significant improvement in skin distensibility, immediate distension, immediate retraction, and delayed distension. Our results suggest that burn rehabilitation massage therapy is effective in improving pain, pruritus, and scar characteristics in hypertrophic scars after burn. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  9. A clinico-epidemiological study of rescuer burns.

    Basra, Baljeet Kumar; Suri, Manav P; Patil, Nilesh; Atha, Ravish; Patel, Natvar; Sachde, Jayesh P; Shaikh, M F


    Rescuer burn is a relatively newer terminology introduced to define the burns sustained by a person attempting to rescue a primary burn victim. Few studies have been published thus far on this peculiar type of burns. Due to the general neglect of the rescuer burns victim and discontinuation of treatment in most cases, once the primary victim dies, the rescuer often ends up in badly infected wounds and has a delayed return to work. A prospective study was conducted at the B J Medical College and Civil Hospital, Ahmedabad from January 2009 to December 2012 on the rescuer burns patients treated in its burns and plastic surgery department. 3074 patients of burns received treatment during the period of study. Of these, 48 patients gave the history of sustaining burns while trying to rescue a burns victim. Male to female ratio of rescuers was approximately 7:1. It was significantly higher as compared to the ratio of 1:0.8 of females to male burn victims observed at our centre (p≤0.01). Average age of the rescuers was higher in males as compared to females but the difference was not significant (p≥0.05). Of the 45 cases of female primary burns victims, male rescuer was husband of the primary victim in 41/45 cases (91.1%), mother was rescuer in three cases (6.6% cases) and sister was rescuer in one case. Though multiple people came to rescue a burns victim, in all cases, it was seen that it was the first rescuer who sustained burns himself or herself. None of the rescuers had any knowledge of the techniques and precautions to be taken while performing a rescue operation irrespective of their education status, indirectly pointing to the lack of any teaching on burns rescue in the school education curriculum.

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

    Vulović Dejan


    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.

  11. Using online blogs to explore positive outcomes after burn injuries.

    Garbett, Kirsty; Harcourt, Diana; Buchanan, Heather


    This study uses blog analysis, a new and novel technique, to explore the positive outcomes experienced by burn survivors. This study examined 10 burn survivor blogs to offer a unique, longitudinal insight into burn survivor recovery. Using thematic analysis, three themes emerged: shift in self-perception, enhanced relationships and a change in life outlook. Many of these themes contained stories and experiences unique to a traumatic burn injury, suggesting that standardised trauma scales are not effectively measuring the impact of a burn in this population. Reflections on blog analysis are discussed, along with a recommendation that health researchers utilise the vast amount of data available from online blogs.

  12. Epidemiology of burns caused by moxibustion in Korea.

    Yoon, Cheonjae; Cho, Young Soon; Park, Seungchoon; Chung, Sung Phil; Choi, Young Hwan


    Moxibustion, a traditional Chinese treatment that uses dried Artemisia argyi, is a common cause of burns treated in Korean hospitals. We aimed to examine the characteristics of moxibustion-induced burns. This retrospective study examined the records of 59 patients who were treated for moxibustion-induced burns (April 2014-October 2015). All patients completed a questionnaire regarding their general characteristics and moxibustion use. The patients included 16 men and 43 women (average age: 49.1 years, 68 burn sites). Superficial second-degree burns were present at 21 sites, deep second- or third-degree burns at 44 sites, and unknown burns at 3 sites. The most common sites were the lower extremities, abdomen, and upper extremities. The most common practitioners were the patients (27/59, 45.7%) and Oriental medicine practitioners (23/59, 38.9%). The most common locations were the patient's home, Oriental medicine clinic, and moxibustion clinic. The most common reason for moxibustion was pain. Only the burn site was significantly associated with burn depth, and non-abdominal sites were 9.37-fold more likely to involve deep burns (vs. abdominal sites). Korean patients routinely undergo moxibustion, and care must be taken when using moxibustion at non-abdominal sites, due to the risk of deep burns. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  13. Pattern of unintentional burns: A hospital based study from Pakistan.

    Adil, Syed Omair; Ibran, Ehmer-Al; Nisar, Nighat; Shafique, Kashif


    Burns are major cause of morbidity and mortality in developing countries. Better understanding of the nature and extent of injury remains the major and only available way to halt the occurrence of the event. The present study was conducted to determine the prevalence of by self and by other unintentional burn, their comparison and the possible mode of acquisition by obtaining the history of exposure to known risk factors. A cross-sectional questionnaire based survey was conducted in Burns Centre of Civil Hospital Karachi, Pakistan and 324 hospitalized adult patients with unintentional burns were consecutively interviewed during August 2013 to February 2014. Information was collected on socio-demographic profile. The source of burn, affected body part and place of injury acquisition in terms of home, outside or work were also noted. Logistic regression model was conducted using SPSS software. Out of 324 patients, 295 (91%) had unintentional burn by self and 29 (9%) had unintentional burn by others. Male gender were 2.37 times and no schooling were 1.75 times more likely to have self-inflicted unintentional burn. Lower limb and head and neck were less likely to involve in unintentional burn by self. The burden of unintentional burn by self was considerably higher. Male gender and no schooling were found more at risk to have unintentional burn by self. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  14. Scaling of the burning efficiency for multicomponent fuel pool fires

    van Gelderen, Laurens; Farahani, Hamed Farmahini; Rangwala, Ali S.;

    In order to improve the validity of small scale crude oil burning experiments, which seem to underestimate the burning efficiency obtained in larger scales, the gasification mechanism of crude oil was studied. Gasification models obtained from literature were used to make a set of predictions...... for relevant burning related parameters which were then compared to experimental results. These parameters, the surface temperature, mass loss rate, flame height and residue composition, were studied for three hydrocarbon liquids (n-octane, dodecane and hexadecane) and two crude oils (DUC and REBCO). Based...... on the models-experiments comparison, it was suggested that crude oil burns according to a distillation-like mechanism, with the light components burning off first, followed by increasingly heavier components as the burning progresses. Thus, in order for the crude oil to burn near 100%, the surface temperature...

  15. Do burns increase the severity of terror injuries?

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


    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

  16. [Burns in children: child abuse or another cause?].

    van Ewijk, Roelof; op de Coul, Moniek E; Teeuw, A H Rian; Wolf, Bart H M


    Burns are common in children but it is not always clear whether the burn is accidental or not. Child abuse should always be considered. We present two children in which the diagnosis only became clear after admission and further investigation. Patient A, a 15-month-old boy, had a burn on his left shoulder. The burn was assumed suspect in view of the unclear history given by the parents and a possible delay in their seeking help. The patient was ultimately diagnosed with impetigo bullosa and successfully treated with antibiotics. Patient B, a 24-month-old girl, had burns on both feet and her right hand, which were infected as a result of the delay in seeking help. The burns were identified as abuse-related. The child was removed from her mother's care and sent to a foster home. A well-defined work-up should be followed in case of burns in children.

  17. Early diagnostics and treatment with acute burn sepsis

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


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

  18. An overview of acute burn management in the Emergency Centre

    Adaira Landry


    Full Text Available Despite the frequency and severity of burns in Low Income Countries, including many in Africa, there is a paucity of research and funding for these populations to aid in prevention, treatment and recovery of burn patients. The objectives of this paper are four-fold. First, by addressing the pathophysiology of burns the reader may strengthen understanding of the clinical progression of burns. Second, through describing proper assessment of burn patients one will learn how to decide if patients can be discharged, admitted or transferred to burn centre. Third, the inclusion of treatments solidifies the steps necessary to manage a patient in a hospital setting. Lastly, the overall goal of the paper, is to raise awareness that more research, publication and funding is required to create a better understanding of burns in Africa and why they continue to be devastating social and economic burdens.

  19. Pediatric Treadmill Burns: Assessing the effectiveness of prevention strategies.

    Goltsman, David; Li, Zhe; Connolly, Siobhan; Meyerowitz-Katz, Daniel; Allan, James; Maitz, Peter K M


    Legislative changes in 2008 in Australia mandated that all new treadmills display a warning sticker about the risk of friction burns in children. This was accompanied by a health promotion campaign advising of the risks of treadmills to children. Analyses of pediatric burns data identified all cases of treadmill burns occurring between 2005 and 2014. The incidence of treadmill burns, associations with age and gender, characteristics of the burns and the adequacy of first aid provided immediately after the burn was examined. There were 298 cases of treadmill burns over the 10-year period (3.5% of all pediatric burns). The incidence rose until the introduction of legislation and health promotion in 2008, and then declined over the remaining study period. The majority of treadmill burns in children were inflicted on the upper limbs (91%), and 93% involved the hands. Most burns were full thickness (62%, n=182) and 49% (n=148) required skin grafts. Approximately one-third of treadmill burns (35%, n=105) occurred while someone else was using the treadmill. In the vast majority of treadmill burn injuries (74%, n=223), there was either no first aid or inadequate first aid provided immediately after the injury. A significant number of treadmill burns occur in children, and these often result in serious injuries that are not treated with appropriate first aid. A reduction in the incidence of these burns was associated with the introduction of legislation and health promotion targeted at child safety around treadmills. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  20. 间断横褥式缝合对预防跟骨骨折术后切口并发症的作用%The preventative effect of discontinuous transverse mattress suture on postoperative incision complications of calcaneus fractures

    刘志久; 袁光辉


    Objective:To explore the preventative effect of discontinuous transverse mattress suture on postoperative incision complications of calcaneus fractures. Methods: The medical records of patients with calcaneus fractures treated by open reduction and plate internal fixation through the lateral approach were analyzed retrospectively. Ninety-two patients(107 feet) were included into the study,male 86 cases, while female 6 cases;ranging in age from 17 to 66 years with a median of 37. 5 years;ranging from 7 to 12 days with a median of 9. 5 days in time intervals from injury to surgery. Sixty-three feet of 55 patients ( group Ⅰ )were administrated with discontinuous transverse mattress suture,while 44 feet of 37 patients( group Ⅱ ) were administrated with layered suture. Such incision complications as tension blister around the incision, skin necrosis at the incision margin, cutting incision skin by sutures, plate exposure were recorded respectively. Results: After the operation, four feet with tension blister around the incision and one foot with skin necrosis at the incision margin were found in group Ⅰ , which were all healed after dressing change. For the patients in group Ⅱ ,four feet with skin necrosis at the incision margin, three feet with simultaneous signss of tension blister,skin necrosis at the incision margin and cutting incision skin by sutures and two feet with tension blister were found and were healed after dressing change, and one case with plate exposure was found and healed after flap transplantation. There were no statistical difference in incidence rate of tension blister, cutting incision skin by sutures and plate exposure between the two groups(x2 =0. 817,P =0. 366;P = 0. 067 ;P =0.411) ; while the incidence rate of skin necrosis at the incision margin and the overall incision complications of groupⅡ was higher than that of group Ⅰ (x2 = 5. 751 ,P=0. 017;x2 =6. 111 ,P= 0.013). Conclusion; The incidence rate of postoperative incision

  1. Biomass Burning Emissions from Fire Remote Sensing

    Ichoku, Charles


    Knowledge of the emission source strengths of different (particulate and gaseous) atmospheric constituents is one of the principal ingredients upon which the modeling and forecasting of their distribution and impacts depend. Biomass burning emissions are complex and difficult to quantify. However, satellite remote sensing is providing us tremendous opportunities to measure the fire radiative energy (FRE) release rate or power (FRP), which has a direct relationship with the rates of biomass consumption and emissions of major smoke constituents. In this presentation, we will show how the satellite measurement of FRP is facilitating the quantitative characterization of biomass burning and smoke emission rates, and the implications of this unique capability for improving our understanding of smoke impacts on air quality, weather, and climate. We will also discuss some of the challenges and uncertainties associated with satellite measurement of FRP and how they are being addressed.

  2. Parents’ experience confronting child burning situation

    Valdira Vieira de Oliveira


    Full Text Available Objective: to understand experiences of parents in a child burning situation during the hospitalization process. Methods: phenomenological research in view of Martin Heidegger, held with seven assisting parents at a pediatrics unit of a general hospital in Montes Claros. The information was obtained by phenomenological interview, containing the question guide: “What does it mean to you being with a son who is suffering with burns?”. Results: during the experience, parents revealed anguish, fear, helplessness, concerns and expectations of “being-in-the-world”. Conclusion: respect, understanding and care from the health team were fundamental for the adaptation and the confrontation demanded by the consequent suffering of the event.

  3. Modeling Deep Burn TRISO particle nuclear fuel

    Besmann, T.M., E-mail: [Oak Ridge National Laboratory, P.O. Box 2008, Oak Ridge, TN 37831 (United States); Stoller, R.E., E-mail: [Oak Ridge National Laboratory, P.O. Box 2008, Oak Ridge, TN 37831 (United States); Samolyuk, G., E-mail: [Oak Ridge National Laboratory, P.O. Box 2008, Oak Ridge, TN 37831 (United States); Schuck, P.C., E-mail: [Oak Ridge National Laboratory, P.O. Box 2008, Oak Ridge, TN 37831 (United States); Golubov, S.I., E-mail: [Oak Ridge National Laboratory, P.O. Box 2008, Oak Ridge, TN 37831 (United States); Rudin, S.P., E-mail: [Los Alamos National Laboratory, P.O. Box 1663, Los Alamos, NM 87545 (United States); Wills, J.M., E-mail: [Los Alamos National Laboratory, P.O. Box 1663, Los Alamos, NM 87545 (United States); Coe, J.D., E-mail: [Los Alamos National Laboratory, P.O. Box 1663, Los Alamos, NM 87545 (United States); Wirth, B.D., E-mail: [University of Tennessee, Knoxville, TN 37996-0750 (United States); Kim, S., E-mail: [University of Wisconsin, 1509 University Ave., Madison, WI 53706 (United States); Morgan, D.D., E-mail: [University of Wisconsin, 1509 University Ave., Madison, WI 53706 (United States); Szlufarska, I., E-mail: [University of Wisconsin, 1509 University Ave., Madison, WI 53706 (United States)


    Under the DOE Deep Burn program TRISO fuel is being investigated as a fuel form for consuming plutonium and minor actinides, and for greater efficiency in uranium utilization. The result will thus be to drive TRISO particulate fuel to very high burn-ups. In the current effort the various phenomena in the TRISO particle are being modeled using a variety of techniques. The chemical behavior is being treated utilizing thermochemical analysis to identify phase formation/transformation and chemical activities in the particle, including kernel migration. Density functional theory is being used to understand fission product diffusion within the plutonia oxide kernel, the fission product's attack on the SiC coating layer, as well as fission product diffusion through an alternative coating layer, ZrC. Finally, a multiscale approach is being used to understand thermal transport, including the effect of radiation damage induced defects, in a model SiC material.

  4. Biomass Burning Emissions from Fire Remote Sensing

    Ichoku, Charles


    Knowledge of the emission source strengths of different (particulate and gaseous) atmospheric constituents is one of the principal ingredients upon which the modeling and forecasting of their distribution and impacts depend. Biomass burning emissions are complex and difficult to quantify. However, satellite remote sensing is providing us tremendous opportunities to measure the fire radiative energy (FRE) release rate or power (FRP), which has a direct relationship with the rates of biomass consumption and emissions of major smoke constituents. In this presentation, we will show how the satellite measurement of FRP is facilitating the quantitative characterization of biomass burning and smoke emission rates, and the implications of this unique capability for improving our understanding of smoke impacts on air quality, weather, and climate. We will also discuss some of the challenges and uncertainties associated with satellite measurement of FRP and how they are being addressed.

  5. Extracorporeal blood purification in burns: a review.

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


    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.

  6. In-Situ Burn Gaps Analysis


    Allen and Ann Hayward Walker 8. Performing Report No. UDI # 1498 9. Performing Organization Name and Address U.S. Coast Guard Research and...On-Scene Coordinator’s Representative FTX Field Training Exercise GA Georgia GFI Government Furnished Information GOM Gulf of Mexico GSA General...N.J. Mabile, D. Jaeger, and D. Costanzo. 2011. The Use of Controlled Burning during the Gulf of Mexico Deepwater Horizon MC-252 Oil Spill Response

  7. Probing thermonuclear burning on accreting neutron stars

    Keek, L.


    Neutron stars are the most compact stars that can be directly observed, which makes them ideal laboratories to study physics at extreme densities. Neutron stars in low-mass X-ray binaries accrete hydrogen and helium from a lower-mass companion star through Roche lobe overflow. This matter undergoes thermonuclear burning in the neutron star envelope, creating carbon and heavier elements. The fusion process may proceed in an unstable manner, resulting in a thermonuclear runaway. Within one seco...

  8. [Physical rehabilitation in extensively burned patients].

    Martín Martínez, V; Díez Sanz, Ma J; Corona Fernández, O; García Aragón, A; González Fraile, L


    The rehabilitation of the extensively burned patient aims to prevent and minimize consequences of the own lesion this is supported by three pillars: 1) postural treatment to prevent contractures; 2) kinesiotherapy to maintain/restore joint range of movement and muscle strength; 3) functional recovery. Physical therapy is essential in the multidisciplinary team. A coordinated team assures better results and positively influences the quality of life of the patients.

  9. Current concepts on burn wound conversion-A review of recent advances in understanding the secondary progressions of burns.

    Salibian, Ara A; Rosario, Angelica Tan Del; Severo, Lucio De Almeida Moura; Nguyen, Long; Banyard, Derek A; Toranto, Jason D; Evans, Gregory R D; Widgerow, Alan D


    Burn wound conversion describes the process by which superficial partial thickness burns convert into deeper burns necessitating surgical intervention. Fully understanding and thus controlling this phenomenon continues to defy burn surgeons. However, potentially guiding burn wound progression so as to obviate the need for surgery while still bringing about healing with limited scarring is the major unmet challenge. Comprehending the pathophysiologic background contributing to deeper progression of these burns is an essential prerequisite to planning any intervention. In this study, a review of articles examining burn wound progression over the last five years was conducted to analyze trends in recent burn progression research, determine changes in understanding of the pathogenesis of burn conversion, and subsequently examine the direction for future research in developing therapies. The majority of recent research focuses on applying therapies from other disease processes to common underlying pathogenic mechanisms in burn conversion. While ischemia, inflammation, and free oxygen radicals continue to demonstrate a critical role in secondary necrosis, novel mechanisms such as autophagy have also been shown to contribute affect significantly burn progression significantly. Further research will have to determine whether multiple mechanisms should be targeted when developing clinical therapies.

  10. Opioid-induced hyperalgesia and burn pain.

    Holtman, Joseph R; Jellish, W Scott


    The treatment of pain produced during the management of burn injury has been an ongoing problem for physicians caring for these patients. The main therapeutic option for analgesia has been the repeated and prolonged use of opioids. The adverse effects of opioids are well known but the long term use of opioids which produces tolerance with accompanying dose escalation and dependence is most problematic. Another potentially important consequence of opioid exposure that sometimes masks as tolerance is that of opioid induced hyperalgesia. This syndrome is manifest as enhanced pain, sensitivity and loss of analgesic efficacy in patients treated with opioids who actually become sensitized to painful stimuli. This article focuses on the treatment of burn pain and how current analgesic therapies with opioids may cause hyperalgesia and affect the adequacy of treatment for burn pain. This article also provides possible modalities to help therapeutically manage these patients and considers future analgesic strategies which may help to improve pain management in this complicated patient population.

  11. A Model For The Burning of Teflon

    Waller, Jess M.; Wilson, D. Bruce; Beeson, Harold D.; Fries, Joseph (Technical Monitor)


    Teflon has been identified as suitable material for use in oxygen-enriched atmospheres because of its low specific enthalpy of combustion that is, less than 1500 cal/gram. However, once ignited, Teflon burns in a heterogeneous reaction until total consumption or depletion of oxygen occurs. A model is developed for the burning of Teflon in pure, high-pressure oxygen, 3.4 to 68.9 MPa. The Teflon polymer chain dissociates via monomer units due to pyrolysis. These monomer units diffuse to the surface due to free convection. The model consists of coupled mass and energy balances for the polymer and an energy balance for the free convection of product gases. The model is used to obtain appropriate kinetic parameters for the dissociation and surface reactions. The model is validated against experimental measurements of Teflon discs supported on aluminum rods (2216) at oxygen pressures of 3.4, 6.8, 34.4, and 68.9 MPa. The model simulates the temperature distribution in the product gases above burning Teflon.

  12. [Clinical and immunological criteria of burn sepsis].

    Shlyk, I V; Pivovarova, L P; Krylov, K M; Filippova, O V; Il'ina, V A; Krylov, P K


    A hundred and twenty-nine victims aged 16 to 60 years who had skin burns in the area of 15 to 60% of the body surface without severe concomitant somatic disease (SAPS less than 9 scores). The clinical symptoms of a systemic inflammatory response (SIR) and the signs of wound infection were recorded in all the examinees. The victims underwent a comprehensive clinical and laboratory examination, 55 of them were immunologically studied over time (on admission, on days 3 and 10). To reveal the predictive clinical and immunological criteria for sepsis, the examinees were divided into 3 groups. Group 1 comprised 33 burnt persons who were observed to have the symptoms of SIR and the signs of burn wound infections without impaired function of organs and systems. Group 2 included 46 victims with severe sepsis and a good outcome of burn disease. Group 3 consisted of 50 patients who had died from severe sepsis. Analysis of the results of the study has indicated that the count of formed blood elements by calculating the leukocytic intoxication index, the estimation of the level of lysosomal cation proteins in the neutrophilic granulocytes, the detection of populations of T helper cells, cytotoxic lymphocytes, as well as histomorphological and bacteriological findings are early and valid criteria for the development of infectious complications. Their use for the diagnosis and prediction of sepsis permits initiation of its treatment at early stages, without awaiting the appearance of the signs of a septic process.


    Raymond J. Fonck


    The national U.S. Burning Plasma Organization (USBPO) was formed to provide an umbrella structure in the U.S. fusion science research community. Its main purpose is the coordination of research activities in the U.S. program relevant to burning plasma science and preparations for participation in the international ITER experiment. This grant provided support for the continuing development and operations of the USBPO in its first years of existence. A central feature of the USBPO is the requirement for broad community participation in and governance of this effort. We concentrated on five central areas of activity of the USBPO during this grant period. These included: 1) activities of the Director and support staff in continuing management and development of the USBPO activity; 2) activation of the advisory Council; 3) formation and initial research activities of the research community Topical Groups; 4) formation of Task Groups to perform specific burning plasma related research and development activities; 5) integration of the USBPO community with the ITER Project Office as needed to support ITER development in the U.S.

  14. Hospital bioterrorism planning and burn surge.

    Kearns, Randy D; Myers, Brent; Cairns, Charles B; Rich, Preston B; Hultman, C Scott; Charles, Anthony G; Jones, Samuel W; Schmits, Grace L; Skarote, Mary Beth; Holmes, James H; Cairns, Bruce A


    On the morning of June 9, 2009, an explosion occurred at a manufacturing plant in Garner, North Carolina. By the end of the day, 68 injured patients had been evaluated at the 3 Level I trauma centers and 3 community hospitals in the Raleigh/Durham metro area (3 people who were buried in the structural collapse died at the scene). Approximately 300 employees were present at the time of the explosion, when natural gas being vented during the repair of a hot water heater ignited. The concussion from the explosion led to structural failure in multiple locations and breached additional natural gas, electrical, and ammonia lines that ran overhead in the 1-story concrete industrial plant. Intent is the major difference between this type of accident and a terrorist using an incendiary device to terrorize a targeted population. But while this disaster lacked intent, the response, rescue, and outcomes were improved as a result of bioterrorism preparedness. This article discusses how bioterrorism hospital preparedness planning, with an all-hazards approach, became the basis for coordinated burn surge disaster preparedness. This real-world disaster challenged a variety of systems, hospitals, and healthcare providers to work efficiently and effectively to manage multiple survivors. Burn-injured patients served as a focus for this work. We describe the response, rescue, and resuscitation provided by first responders and first receivers as well as efforts made to develop burn care capabilities and surge capacity.

  15. Acute burn during pregnancy: A retrospective study

    Ezzatollah Rezaei


    Full Text Available Background & aim: The incidence of acute burn injuries in pregnant women is very low. Burn injuries during pregnancy are often associated with a high rate of fetal and maternal mortality and morbidity. In this study, we aimed to review the cases of acute burn during pregnancy and evaluate the outcome of these patients in Mashhad, Iran. Methods:This retrospective study was performed using the medical records of 48 pregnant women with thermal injuries over a 13-year period. Results: The results showed that 8 (16.7%, 27 (56.3%, and 13 (27.1% patients were in the first, second, and third trimesters of pregnancy. Moreover, 14 mothers (29.2% died, 24 (50.0% were discharged without any fetal problems, eight (16.7% had fetal death, 13 (27.1% had abortion, two (4.2% had normal vaginal delivery, and one (2.1% underwent normal caesarean section. Conclusion: The rate ofmaternal survival in the first and second trimesters was higher than the third one. In the third trimester, pregnancy termination is indicated only after fetal maturation.

  16. Physical functional outcome assessment of patients with major burns admitted to a UK Burn Intensive Care Unit.

    Smailes, Sarah T; Engelsman, Kayleen; Dziewulski, Peter


    Determining the discharge outcome of burn patients can be challenging and therefore a validated objective measure of functional independence would assist with this process. We developed the Functional Assessment for Burns (FAB) score to measure burn patients' functional independence. FAB scores were taken on discharge from ICU (FAB 1) and on discharge from inpatient burn care (FAB 2) in 56 patients meeting the American Burn Association criteria for major burn. We retrospectively analysed prospectively collected data to measure the progress of patients' physical functional outcomes and to evaluate the predictive validity of the FAB score for discharge outcome. Mean age was 38.6 years and median burn size 35%. Significant improvements were made in the physical functional outcomes between FAB 1 and FAB 2 scores (ppatients were discharged home, 8 of these with social care. 8 patients were transferred to another hospital for further inpatient rehabilitation. FAB 1 score (≤ 9) is strongly associated with discharge outcome (pburn patients.

  17. Polycyclic aromatic hydrocarbons (PAHs) in burning and non-burning coal waste piles.

    Ribeiro, Joana; Silva, Tais; Mendonca Filho, Joao Graciano; Flores, Deolinda


    The coal waste material that results from Douro Coalfield exploitation was analyzed by gas chromatography with mass spectrometry (GC-MS) for the identification and quantification of the 16 polycyclic aromatic hydrocarbons (PAHs), defined as priority pollutants. It is expected that the organic fraction of the coal waste material contains PAHs from petrogenic origin, and also from pyrolytic origin in burning coal waste piles. The results demonstrate some similarity in the studied samples, being phenanthrene the most abundant PAH followed by fluoranthene and pyrene. A petrogenic contribution of PAHs in unburned samples and a mixture of PAHs from petrogenic and pyrolytic sources in the burning/burnt samples were identified. The lowest values of the sum of the 16 priority PAHs found in burning/burnt samples and the depletion LMW PAHs and greater abundance of HMW PAHs from the unburned coal waste material relatively to the burning/burnt material demonstrate the thermal transformation attributed to the burning process. The potential environmental impact associated with the coal waste piles are related with the release of petrogenic and pyrolytic PAHs in particulate and gaseous forms to soils, sediments, groundwater, surface water, and biodiversity. Copyright © 2011 Elsevier B.V. All rights reserved.

  18. Treatment strategies for mass burn casualties

    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


    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

  19. Rehabilitation and social adjustment of people with burns in society.

    Din, Sirajud; Shah, Mussawar; Asadullah; Jamal, Humera; Bilal, Muhammad


    The present study was conducted on rehabilitation and social adjustment of people with burns in society with the main objective to determine the relationship between social adjustment of people with burns and their psychosocial rehabilitation. The study was limited to the Burn Unit, Khyber Teaching Hospital, Peshawar, Pakistan. At bi-variate level, the following were observed: the relationship of psychosocial rehabilitation was highly significant (P=0.000) considering that people with burns feel shame in the society, a highly significant relation (P=0.000) was found between psychosocial rehabilitation and burn as the hurdle to contact other members of the society, a highly significant (P=0.000) relation was found between psychosocial rehabilitation and perception that society provides social support to people with burns, a highly significant (P=0.000) relationship between psychosocial rehabilitation and people with burns feel alienated from the society, a significant association (P=0.024) was found between psychosocial rehabilitation and loss of social network, and a significant (P=0.002) association between psychosocial rehabilitation and society insult toward people with burns. Regular provision of treatment, quota in job allocation for people with burns, initiation of stipend through Benazir Income Support Program, and keeping and updating record of burns at the district level in census centers were suggested as recommendations in light of the study.

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

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


    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.