WorldWideScience

Sample records for satellite-inferred burn severity

  1. Burn severity and areas of daily fire growth for 42 forest fires in Idaho and Montana, 2005 - 2011

    Science.gov (United States)

    Birch, Donovan Shayne

    This work consisted of two studies of burn severity using infrared perimeter maps and satellite-inferred burn severity data, differenced Normalized Burn Ratio, from 42 wildland fires from central Idaho and western Montana from 2005 to 2007, and 2011. Study 1 examined the proportion of burn severity categories for individual daily areas burned. We defined 2,697 areas, from which we calculated the proportion of three burn severity classes. The proportion of high severity was weakly correlated with size of area burned. Large areas burned do not consistently produced larger proportions of high severity. Study 2 analyzed burn severity relative to 20 environmental variables using the Random Forest machine learning algorithm. We used ten daily weather observations, eight 34-yr climate percentiles, seven topographical index measurements, and four vegetation characteristics from 10,819 randomly located points. We found that higher percentage existing vegetation cover had larger influences on changes in burn severity.

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

    Directory of Open Access Journals (Sweden)

    Sean A. Parks

    2014-02-01

    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.

  3. BURN SEVERITY MAPPING IN AUSTRALIA 2009

    Directory of Open Access Journals (Sweden)

    R. McKinley

    2012-07-01

    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.

  4. Abdominal Complications after Severe Burns

    Science.gov (United States)

    2009-05-01

    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

  5. Infection control in severely burned patients

    OpenAIRE

    Coban, Yusuf Kenan

    2012-01-01

    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...

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

    Science.gov (United States)

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

    2017-02-01

    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.

  7. Severe metabolic acidosis following assault chemical burn

    Directory of Open Access Journals (Sweden)

    Sophie De Roock

    2012-01-01

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

  8. Severe metabolic acidosis following assault chemical burn.

    Science.gov (United States)

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

    2012-04-01

    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.

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

    Science.gov (United States)

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

    2015-02-01

    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.

  10. Psychosocial care of persons with severe burns.

    Science.gov (United States)

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

    2008-06-01

    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.

  11. Do burns increase the severity of terror injuries?

    Science.gov (United States)

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

    2008-01-01

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

  12. Relations between soil hydraulic properties and burn severity

    NARCIS (Netherlands)

    Moody, J.A.; Ebel, B.A.; Stoof, C.R.; Nyman, P.; Martin, D.A.; McKinley, R.

    2016-01-01

    Wildfire can affect soil hydraulic properties, often resulting in reduced infiltration. The magnitude of change in infiltration varies depending on the burn severity. Quantitative approaches to link burn severity with changes in infiltration are lacking. This study uses controlled laboratory measure

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

    Science.gov (United States)

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

    2007-03-01

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

  14. US Forest Service Monitoring Trends in Burn Severity

    Data.gov (United States)

    US Forest Service, Department of Agriculture — The Monitoring Trends in Burn Severity (MTBS) project maps the location, extent, and severity of all large fires in the conterminous United States (CONUS), Alaska,...

  15. Does fire severity influence shrub resprouting after spring prescribed burning?

    Science.gov (United States)

    Fernández, Cristina; Vega, José A.; Fonturbel, Teresa

    2013-04-01

    Prescribed burning is commonly used to reduce the risk of severe wildfire. However, further information about the associated environmental effects is required to help forest managers select the most appropriate treatment. To address this question, we evaluated if fire severity during spring prescribed burning significantly affects the resprouting ability of two common shrub species in shrubland under a Mediterranean climate in NW Spain. Fire behaviour and temperatures were recorded in tagged individuals of Erica australis and Pterospartum tridentatum during prescribed burning. The number and length of resprouted shoots were measured three times (6, 12 and 18 months) after the prescribed burning. The influence of a series of fire severity indicators on some plant resprouting vigour parameters was tested by canonical correlation analysis. Six months and one year after prescribed burning, soil burn severity (measured by the absolute reduction in depth of the organic soil layer, maximum temperatures in the organic soil layer and the mineral soil surface during burning and the post-fire depth of the organic soil layer) reduced the resprouting vigour of E. australis and P. tridentatum. In contrast, direct measurements of fire effects on plants (minimum branch diameter, duration of temperatures above 300 °C in the shrub crown and fireline intensity) did not affect the post-fire plant vigour. Soil burn severity during spring prescribed burning significantly affected the short-term resprouting vigour in a mixed heathland in Galicia. The lack of effects eighteen months after prescribed burning indicates the high resilience of these species and illustrates the need to conciliate fire prevention and conservation goals.

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

    Science.gov (United States)

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

    2011-01-01

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

  17. Live Skin Allograft in the Management of Severe Burns

    African Journals Online (AJOL)

    disease, the eventual rejection by the host and its handling ... Methods. Patients with severe burns of more than 40% surface area admitted at the Nyeri Provincial General Hospital .... of donors and patients it can have a wide acceptance.

  18. Burn Severity Estimation Using MERIS Full Resolution Imagery

    Science.gov (United States)

    Oliva, Patricia; De Santis, Angela

    2010-12-01

    This paper presents the first results of Fire Effects Modelling and Mapping (FEMM) project carried out in the framemark of the Changing Earth Science Network. The objective of this study is to test the performance of the inversion of Radiative Transfer Models (RTMs) in ENVISA T-MERIS Full Resolution data to estimate burn severity levels in terms of Composite Burn Index (CBI) levels. Nevertheless, as the RTM model was calibrated in Landsat-TM images, evaluation of its performance in MERIS imagery was needed. We tested the performance of the RTM model in several study sites located in two large fires occurred in Spain during 2009 fire season. The results were validated by comparison with burn severity maps computed from Landsat-TM imagery. The results obtained showed values of the coefficient of determination of 0.92 and 0.95 thus, the estimation of burn severity was accurate and consistent, in spite of the different spatial and spectral resolutions.

  19. [Analysis of respiratory complications in 922 severely burned patients].

    Science.gov (United States)

    Zhang, Tao; Li, Xiaojian; Deng, Zhongyuan; Zhang, Zhi; Tang, Wenbin; Chen, Bin; Bao, Qiang; He, Menglong

    2014-06-01

    To discuss the distribution of the respiratory complications in severely burned patients and the prevention and treatment experience against them. Medical records of 922 adult patients with severe or extremely severe burn hospitalized in our burn ICU from January 2005 to December 2012 were screened and retrospectively analyzed, including patients transferred from other hospitals, patients with total burn area above 50% TBSA, the distribution and treatment of respiratory complications, and the mortality. Data were processed with chi-square test. The constituent ratio of patients transferred to our hospital was 71.1% in 2007 and 40.2% in 2010, while it remained about 50.0% in the other years. The ratios of patients with total burn area larger than 50% TBSA and that of patients with respiratory complications (χ(2) = 2.637, P > 0.05) showed no significant changes each year. Among these 922 burn patients, 523 patients suffered respiratory complications, among which laryngeal edema (50.9%, 266 cases), pulmonary infection (21.6%, 113 cases), and ARDS (11.9%, 62 cases) were the main components, with no significant change each year (with χ(2) values respectively 6.132, 6.319, 0.016, P values above 0.05). Among the patients with respiratory complications, except for 36 were not treated actively, 487 were treated by ventilator among which 228 had undergone tracheostomy, and the constituent ratios in the 8 years were close. Fifteen patients died, with 2 died of laryngeal edema, 3 of ARDS, and 10 of sepsis or MODS as a result of sepsis. Patients with severe burns were at high risk of respiratory complications, among which laryngeal edema was common, followed by pulmonary infection and ARDS. Prophylactic tracheostomy, mechanical ventilation, wound therapy, and anti-infection were all effective measures of prevention and treatment against these complications.

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

    OpenAIRE

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

    2014-01-01

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

  1. 1984–2010 trends in fire burn severity and area for the conterminous US

    Science.gov (United States)

    Picotte, Joshua J.; Peterson, Birgit E.; Meier, Gretchen; Howard, Stephen M.

    2016-01-01

    Burn severity products created by the Monitoring Trends in Burn Severity (MTBS) project were used to analyse historical trends in burn severity. Using a severity metric calculated by modelling the cumulative distribution of differenced Normalized Burn Ratio (dNBR) and Relativized dNBR (RdNBR) data, we examined burn area and burn severity of 4893 historical fires (1984–2010) distributed across the conterminous US (CONUS) and mapped by MTBS. Yearly mean burn severity values (weighted by area), maximum burn severity metric values, mean area of burn, maximum burn area and total burn area were evaluated within 27 US National Vegetation Classification macrogroups. Time series assessments of burned area and severity were performed using Mann–Kendall tests. Burned area and severity varied by vegetation classification, but most vegetation groups showed no detectable change during the 1984–2010 period. Of the 27 analysed vegetation groups, trend analysis revealed burned area increased in eight, and burn severity has increased in seven. This study suggests that burned area and severity, as measured by the severity metric based on dNBR or RdNBR, have not changed substantially for most vegetation groups evaluated within CONUS.

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

    Institute of Scientific and Technical Information of China (English)

    杨磊; 王甲汉; 周一平

    2003-01-01

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

  3. Disruption of bone and skeletal muscle in severe burns

    Institute of Scientific and Technical Information of China (English)

    Gordon L Klein

    2015-01-01

    Severe burn injury triggers the body’s nonspecific adaptive responses to acute insult, including the systemic inflammatory and stress responses, as well as the sympathetic response to immobilization. These responses trigger inflammatory bone resorption followed by glucocorticoid-induced apoptosis of osteoblasts and probably osteocytes. Because these patients are catabolic, they suffer concomitant muscle wasting and negative nitrogen balance. The use of anabolic agents such as recombinant human growth hormone and oxandrolone results in improved bone mineral content and muscle strength after approximately 1 year. Use of bisphosphonates within the first 10 days of a severe burn completely blocks the resorptive bone loss and has the added advantage of appearing to preserve muscle protein from excessive breakdown. The mechanism for the protective effect on muscle is not currently known. However, if the effect of bisphosphonates on muscle can be confirmed, it raises the possibility that bone communicates with muscle.

  4. Mapping burned areas and burn severity patterns across the Mediterranean region

    Science.gov (United States)

    Kalogeropoulos, Christos; Amatulli, Giuseppe; Kempeneers, Pieter; Sedano, Fernando; San Miguel-Ayanz, Jesus; Camia, Andrea

    2010-05-01

    The Mediterranean region is highly susceptible to wildfires. On average, about 60,000 fires take place in this region every year, burning on average half a million hectares of forests and natural vegetation. Wildfires cause environmental degradation and affect the lives of thousands of people in the region. In order to minimize the consequences of these catastrophic events, fire managers and national authorities need to have in their disposal accurate and updated spatial information concerning the size of the burned area as well as the burn severity patterns. Mapping burned areas and burn severity patterns is necessary to effectively support the decision-making process in what concerns strategic (long-term) planning with the definition of post-fire actions at European and national scales. Although a comprehensive archive of burnt areas exists at the European Forest Fire Information System, the analysis of the severity of the areas affected by forest fires in the region is not yet available. Fire severity is influenced by many variables, including fuel type, topography and meteorological conditions before and during the fire. The analysis of fire severity is essential to determine the socio-economic impact of forest fires, to assess fire impacts, and to determine the need of post-fire rehabilitation measures. Moreover, fire severity is linked to forest fire emissions and determines the rate of recovery of the vegetation after the fire. Satellite imagery can give important insights about the conditions of the live fuel moisture content and can be used to assess changes on vegetation structure and vitality after forest fires. Fire events occurred in Greece, Portugal and Spain during the fire season of 2009 were recorded and analyzed in a GIS environment. The Normalized Difference Vegetation Index (NDVI), the Enhanced Vegetation Index (EVI) and the Normalized Burn Ratio (NBR) were calculated from 8-days composites MODIS/TERRA imagery from March to October 2009. In

  5. Microvascular regeneration in meshed skin transplants after severe burns.

    Science.gov (United States)

    Meier, T O; Guggenheim, M; Vetter, S T; Husmann, M; Haile, S R; Amann-Vesti, B R

    2011-09-01

    Function of the skin lymphatics as well as blood perfusion of a meshed transplant is crucial for the healing. The lymphatic regeneration and arterial perfusion of skin transplants after severe burns of the extremities had been studied in eight patients by microlymphography, laser doppler perfusion imaging and transcutaneous oxygen pressure measurements 1, 6 and 18 months after transplantation. One month after transplantation, only fragmented as well as many giant lymphatic skin vessels were present in the transplant. After 6 months a normal lymphatic network had developed in all grafts. The extension of the dye in the lymphatics decreased from 4.5 (0-16) at 1 month to 3.0 (1-6) mm after 18 months, indicating improved lymph drainage capacity. The permeability of the lymphatics in the graft was normal. After 1 month, median laser flux in the transplant was 155.6% (105-246%) of the normal skin but it normalised within 18 months. By contrast, transcutaneous oxygen measurement (TcPO(2)) increased from 44 (21-47) to 55 (50-76) mmHg. In meshed transplants used to cover severely burned skin morphological and functional normal lymphatics develop within 6 months and the initially increased laser flux due to inflammatory reaction normalises. Our results provide important insights into the healing process of skin transplants after burn. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

  6. [Multicenter epidemiological investigation of hospitalized children with severe burn].

    Science.gov (United States)

    Tang, Y; Wang, L X; Chen, J J; Liu, J Q; Ren, L C; Liu, X S; Yin, M F; Zhang, D X; Huang, Y S; Zhang, J P

    2016-10-20

    Objective: To analyze the epidemiological characteristics of hospitalized children with severe burn from several regions in China during 3 years, so as to provide evidence for prevention of burns in children. Methods: Relying on the entry system of epidemiology data and biological sample of severe burn from multicenter in clinic, medical records of children with severe burn, aged 18 and under, hospitalized in 6 burn wards from February 2012 to February 2015 were collected. The children were divided into 5 age brackets: less than or equal to 1 year old, more than 1 year old and less than or equal to 3 years old, more than 3 years old and less than or equal to 6 years old, more than 6 years old and less than or equal to 12 years old, more than 12 years old and less than or equal to 18 years old. Meanwhile the children were divided into rural and urban children according to their residences. Data of gender and residence of children in the 5 age brackets, cause of injury, location of injury, total burn area, wound site, inhalation injury and combined injury, and source of hospitalization expenses of children in the 5 age brackets and two types of residence, and outcome and length of hospital stay of the children were analyzed. The cause of injury of children in different location of injury was analyzed. In addition, they were divided into 2 age brackets: less than or equal to 6 years old and more than 6 years old and less than or equal to 18 years old, and then incidences of hand and foot burn injury were compared. Data were processed with chi-square test, and the correlation between age and total burn area was processed with Spearman correlation analysis. Results: Four hundred and forty out of 1 106 inpatients with severe burn were children, accounting for 39.8% who were included in the system. (1) The majority of children were male (270, 61.4%). The number of children more than 1 year old and less than or equal to 3 years old ranked the first (222, 50.5%) in the 5

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

    Science.gov (United States)

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

    2016-01-01

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

  8. Contamination of burn wounds by Achromobacter Xylosoxidans followed by severe infection: 10-year analysis of a burn unit population

    Science.gov (United States)

    Schulz, A.; Perbix, W.; Fuchs, P.C.; Seyhan, H.; Schiefer, J.L.

    2016-01-01

    Summary Gram-negative infections predominate in burn surgery. Until recently, Achromobacter species were described as sepsis-causing bacteria in immunocompromised patients only. Severe infections associated with Achromobacter species in burn patients have been rarely reported. We retrospectively analyzed all burn patients in our database, who were treated at the Intensive Care Burn Unit (ICBU) of the Cologne Merheim Burn Centre from January 2006 to December 2015, focusing on contamination and infection by Achromobacter species.We identified 20 patients with burns contaminated by Achromobacter species within the 10-year study period. Four of these patients showed signs of infection concomitant with detection of Achromobacter species. Despite receiving complex antibiotic therapy based on antibiogram and resistogram typing, 3 of these patients, who had extensive burns, developed severe sepsis. Two patients ultimately died of multiple organ failure. In 1 case, Achromobacter xylosoxidans was the only isolate detected from the swabs and blood samples taken during the last stage of sepsis. Achromobacter xylosoxidans contamination of wounds of severely burned immunocompromised patients can lead to systemic lethal infection. Close monitoring of burn wounds for contamination by Achromobacter xylosoxidans is essential, and appropriate therapy must be administered as soon as possible. PMID:28149253

  9. Severity of burn and its related factors: A study from the developing country Pakistan.

    Science.gov (United States)

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

    2016-06-01

    Burns are leading cause of fatal injuries and major cause of morbidity and mortality in developing countries. The major obstacle in controlling severity is factors related to burn. This study determines frequency of burns and the factors related to it in Karachi, Pakistan. A cross-sectional study was conducted and 384 hospitalized adult patients with burns were consecutively interviewed during August 2013 to February 2014. Information was collected on socio-demographic profile, intent of burn, severity of burn, health hazards, physical and psychological characteristics. TBSA burn of >15% was considered as higher severity of burn. Higher severity of burns was found in 76.3% patients. Multivariate analysis showed that higher severity of burns were significantly associated with age less than 25 years (OR 2.7, 95% CI 1.5-4.9), never had been to school (OR 3.1, 95% CI 1.7-5.9) and intentional burn (OR 20.6, 95% CI 5.0-84.9). Majority of patients had higher severity of burn. The intent of injury was intentional, age less than 25 years and no schooling were found significantly associated with higher severity of burns. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

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

    OpenAIRE

    2016-01-01

    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...

  11. Vegetation, topography and daily weather influenced burn severity in central Idaho and western Montana forests

    Science.gov (United States)

    Donovan S. Birch; Penelope Morgan; Crystal A. Kolden; John T. Abatzoglou; Gregory K. Dillon; Andrew T. Hudak; Alistair M. S. Smith

    2015-01-01

    Burn severity as inferred from satellite-derived differenced Normalized Burn Ratio (dNBR) is useful for evaluating fire impacts on ecosystems but the environmental controls on burn severity across large forest fires are both poorly understood and likely to be different than those influencing fire extent. We related dNBR to environmental variables including vegetation,...

  12. [Severe ocular burns by calcium carbide in a speleologist: a case report].

    Science.gov (United States)

    Testud, F; Voegtlé, R; Nordmann, J P; Descotes, J

    2002-03-01

    A case of severe ocular burns in an amateur speleologist is reported. The explosion of his acetylene lamp caused the projection of calcium carbide particles, which induced burning of the cornea and conjunctiva in both eyes. He slowly recovered in several months. The pathophysiology of the burns, linked to the in situ production of lime, and their management are discussed.

  13. Developing a burn injury severity score (BISS): adding age and total body surface area burned to the injury severity score (ISS) improves mortality concordance.

    Science.gov (United States)

    Cassidy, J Tristan; Phillips, Michael; Fatovich, Daniel; Duke, Janine; Edgar, Dale; Wood, Fiona

    2014-08-01

    There is limited research validating the injury severity score (ISS) in burns. We examined the concordance of ISS with burn mortality. We hypothesized that combining age and total body surface area (TBSA) burned to the ISS gives a more accurate mortality risk estimate. Data from the Royal Perth Hospital Trauma Registry and the Royal Perth Hospital Burns Minimum Data Set were linked. Area under the receiver operating characteristic curve (AUC) measured concordance of ISS with mortality. Using logistic regression models with death as the dependent variable we developed a burn-specific injury severity score (BISS). There were 1344 burns with 24 (1.8%) deaths, median TBSA 5% (IQR 2-10), and median age 36 years (IQR 23-50). The results show ISS is a good predictor of death for burns when ISS≤15 (OR 1.29, p=0.02), but not for ISS>15 (ISS 16-24: OR 1.09, p=0.81; ISS 25-49: OR 0.81, p=0.19). Comparing the AUCs adjusted for age, gender and cause, ISS of 84% (95% CI 82-85%) and BISS of 95% (95% CI 92-98%), demonstrated superior performance of BISS as a mortality predictor for burns. ISS is a poor predictor of death in severe burns. The BISS combines ISS with age and TBSA and performs significantly better than the ISS. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  14. The role of exercise in the rehabilitation of patients with severe burns.

    Science.gov (United States)

    Porter, Craig; Hardee, Justin P; Herndon, David N; Suman, Oscar E

    2015-01-01

    Severe burn trauma results in persistent skeletal muscle catabolism and prolonged immobilization. We hypothesize that structured rehabilitative exercise is a safe and efficacious strategy to restore lean body mass and physical function in burn victims. Here, we review the evidence for the utility of rehabilitative exercise training in restoring physiological function in burn survivors.

  15. Predictors of muscle protein synthesis after severe pediatric burns

    Science.gov (United States)

    Objectives: Following a major burn, muscle protein synthesis rate increases but in most patients, this response is not sufficient to compensate the also elevated protein breakdown. Given the long-term nature of the pathophysiologic response to burn injury, we hypothesized that skeletal muscle prot...

  16. Quantifying soil burn severity for hydrologic modeling to assess post-fire effects on sediment delivery

    Science.gov (United States)

    Dobre, Mariana; Brooks, Erin; Lew, Roger; Kolden, Crystal; Quinn, Dylan; Elliot, William; Robichaud, Pete

    2017-04-01

    Soil erosion is a secondary fire effect with great implications for many ecosystem resources. Depending on the burn severity, topography, and the weather immediately after the fire, soil erosion can impact municipal water supplies, degrade water quality, and reduce reservoirs' storage capacity. Scientists and managers use field and remotely sensed data to quickly assess post-fire burn severity in ecologically-sensitive areas. From these assessments, mitigation activities are implemented to minimize post-fire flood and soil erosion and to facilitate post-fire vegetation recovery. Alternatively, land managers can use fire behavior and spread models (e.g. FlamMap, FARSITE, FOFEM, or CONSUME) to identify sensitive areas a priori, and apply strategies such as fuel reduction treatments to proactively minimize the risk of wildfire spread and increased burn severity. There is a growing interest in linking fire behavior and spread models with hydrology-based soil erosion models to provide site-specific assessment of mitigation treatments on post-fire runoff and erosion. The challenge remains, however, that many burn severity mapping and modeling products quantify vegetation loss rather than measuring soil burn severity. Wildfire burn severity is spatially heterogeneous and depends on the pre-fire vegetation cover, fuel load, topography, and weather. Severities also differ depending on the variable of interest (e.g. soil, vegetation). In the United States, Burned Area Reflectance Classification (BARC) maps, derived from Landsat satellite images, are used as an initial burn severity assessment. BARC maps are classified from either a Normalized Burn Ratio (NBR) or differenced Normalized Burned Ratio (dNBR) scene into four classes (Unburned, Low, Moderate, and High severity). The development of soil burn severity maps requires further manual field validation efforts to transform the BARC maps into a product more applicable for post-fire soil rehabilitation activities

  17. Endogenous endophthalmitis after severe burn: A case report

    Directory of Open Access Journals (Sweden)

    Seyedeh Maryam Hosseini

    2017-01-01

    Conclusion: Burn patients treated with broad-spectrum antibiotics are at risk of candidemia and its complications, including endogenous endophthalmitis. Early diagnosis of endogenous endophthalmitis in high risk patients could prevent visual loss.

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

    Directory of Open Access Journals (Sweden)

    Peeyush Dahal

    2016-01-01

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

  19. Performance of Burn-Severity Metrics and Classification in Oak Woodlands and Grasslands

    Directory of Open Access Journals (Sweden)

    Michael C. Stambaugh

    2015-08-01

    Full Text Available Burn severity metrics and classification have yet to be tested for many eastern U.S. deciduous vegetation types, but, if suitable, would be valuable for documenting and monitoring landscape-scale restoration projects that employ prescribed fire treatments. Here we present a performance analysis of the Composite Burn Index (CBI and its relationship to spectral data (differenced Normalized Burn Ratio (dNBR and its relative form (RdNBR across an oak woodland - grassland landscape in southwestern Oklahoma, USA. Correlation and regression analyses were used to compare CBI strata, assess models describing burn severity, and determine thresholds for burn severity classes. Confusion matrices were used to assess burn severity classification accuracy. Our findings suggest that dNBR and RdNBR, thresholded using total CBI, can produce an accurate burn severity map in oak woodlands, particularly from an initial assessment period. Lower accuracies occurred for burn severity classifications of grasslands and raises questions related to definitions and detection of burn severity for grasslands, particularly in transition to more densely treed structures such as savannas and woodlands.

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

    Directory of Open Access Journals (Sweden)

    Sultan Keles

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Marc G Jeschke

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

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

    Directory of Open Access Journals (Sweden)

    Hong Yan

    2016-01-01

    Full Text Available 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 parameters were measured. The CEC count in B group increased at 4 h, 7 h, and 10 h after injury and then reduced, whereas it continuously increased to a greater extent in BI group (P<0.05. The von Willebrand factor (vWF activity, plasminogen activator inhibitor (PAI-1, and the ratio of thromboxane B2 (TXB2 to 6-keto-prostaglandin F1α (6-K-PGF1α in BI group had a marked increase after injury, and the tissue-type plasminogen activator (tPA in the BI group decreased. Microscope observations revealed thrombus formation in lungs of the animals in BI group, but not in C, I, or B groups. Burn injury causes endothelial dysfunction, and seawater immersion lastingly aggravates this injury, leading to a higher risk of developing thrombosis.

  3. Psychological impact of burns on children treated in a severe burns unit.

    Science.gov (United States)

    Delgado Pardo, Gracia; Moreno García, Inmaculada; Marrero, Francisca Del Rosario Miralles; Gómez Cía, Tomás

    2008-11-01

    The aims of this study were to analyse the types of incident which cause children's burns, to investigate emotional reactions and associated behaviour afterward and to ascertain post-admission sequelae. A total of 83 young people took part, aged 1-17 years, with a mean 12% (range 1.5-47%, S.D. 8.0) total body surface area burned. According to the results from the psychometric scales and questionnaire used, most burns were the result of domestic incidents. Older children scored higher in anxiety. The most common behavioural reactions observed (attachment, wish to go back home) reflect the particularity of these patients compared with other samples of children in hospital. With respect to post-admission sequelae, no relevant results were obtained.

  4. Determining relative contributions of vegetation and topography to burn severity from LANDSAT imagery.

    Science.gov (United States)

    Wu, Zhiwei; He, Hong S; Liang, Yu; Cai, Longyan; Lewis, Bernard J

    2013-10-01

    Fire is a dominant process in boreal forest landscapes and creates a spatial patch mosaic with different burn severities and age classes. Quantifying effects of vegetation and topography on burn severity provides a scientific basis on which forest fire management plans are developed to reduce catastrophic fires. However, the relative contribution of vegetation and topography to burn severity is highly debated especially under extreme weather conditions. In this study, we hypothesized that relationships of vegetation and topography to burn severity vary with fire size. We examined this hypothesis in a boreal forest landscape of northeastern China by computing the burn severity of 24 fire patches as the difference between the pre- and post-fire Normalized Difference Vegetation Index obtained from two Landsat TM images. The vegetation and topography to burn severity relationships were evaluated at three fire-size levels of small (1,000 ha, n = 3). Our results showed that vegetation and topography to burn severity relationships were fire-size-dependent. The burn severity of small fires was primary controlled by vegetation conditions (e.g., understory cover), and the burn severity of large fires was strongly influenced by topographic conditions (e.g., elevation). For moderate fires, the relationships were complex and indistinguishable. Our results also indicated that the pattern trends of relative importance for both vegetation and topography factors were not dependent on fire size. Our study can help managers to design fire management plans according to vegetation characteristics that are found important in controlling burn severity and prioritize management locations based on the relative importance of vegetation and topography.

  5. Pressure ulcers and risk assessment in severe burns.

    Science.gov (United States)

    Lewis, Giavonni M; Pham, Tam N; Robinson, Ellen; Otto, Andrew; Honari, Shari; Heimbach, David M; Klein, Matthew B; Gibran, Nicole S

    2012-01-01

    Risk and incidence of pressure ulcers (PUs) in the burn population remain poorly understood. The purpose of this study was to determine the timing and incidence of PUs at our regional burn center and to identify early risk factors for PU development in burn patients. A retrospective review of 40 charts was performed from among the 1489 patients admitted to our regional burn center between January 2008 and December 2009. Twenty patients acquired PUs during their admission and were identified on the basis of International Classification of Diseases, ninth revision, designation, hospital stay >7 days, and thermal injury (excluding toxic epidermal necrolysis and purpura fulminans). The remaining 20 patients were matched controls based on ±5 years in age and ±8% TBSA. Patient, injury, and outcome characteristics were compared among patient groups using χ for categorical variables and Mann-Whitney for continuous variables. The incidence of PU was 1.3% of all admissions. PU most commonly occurred at the sacrum/coccyx (eight), lower extremity (seven), and occiput (six). A majority of PU presented at stage 2 (33%), stage 3 (26%), and unstageable (30%). Thirteen were splint or device related and reportable. Ninety percent of patients with PUs presented with a Braden score of 16 or less (P = .03), although 60% of controls also had admission Braden scores less than 16. On an average, PUs were acquired within 17 days of admission. Data suggest burn patients are particularly at risk of developing PU based on admission Braden scores. However, low Braden scores do not necessarily correlate with eventual development of PU. Therefore, early and aggressive PU prevention and risk assessment tools must be used to diagnose PUs at an early and reversible stage.

  6. Enzymatic debridement for the treatment of severely burned upper extremities – early single center experiences

    OpenAIRE

    Cordts, Tomke; Horter, Johannes; Vogelpohl, Julian; Kremer, Thomas; Kneser, Ulrich; Hernekamp, Jochen-Frederick

    2016-01-01

    Background Severe burns of hands and arms are complex and challenging injuries. The Standard of care (SOC) – necrosectomy with skin grafting – is often associated with poor functional or aesthetic outcome. Enzymatic debridement (ED) is considered one promising alternative but, until recently, results proved to be highly variable. Methods Between 04/2014 and 04/2015, 16 patients with deep partial- to full-thickness burns of the upper extremities underwent enzymatic debridement (ED) in our Burn...

  7. [Plasma gelsolin level and its relationship with the prognosis of patients with severe burns].

    Science.gov (United States)

    Huang, Li-feng; Yao, Yong-ming; Dong, Ning; He, Li-xin; Zhang, Qing-hong; Yu, Yan; Sheng, Zhi-yong

    2013-04-01

    To observe the changes in plasma gelsolin (pGSN) level of patients with severe burn and to explore its relationship with sepsis and death of patients. One hundred and two patients with total burn area equal to or larger than 30% TBSA hospitalized from May 2010 to May 2012 were included as burn group. Twenty-five healthy volunteers were recruited as healthy control group. Peripheral venous blood of patients was harvested on post burn day (PBD) 1, 3, 7, 14, and 21 to determine the pGSN level with double antibody sandwich ELISA kits, and the same maneuver was carried out in healthy volunteers. (1) Patients in burn group were divided into three groups by burn size: small burn area group (30% - 49% TBSA, n = 39), medium burn area group (larger than 49% and smaller than or equal to 69% TBSA, n = 33), and large burn area group (larger than 69% and smaller than or equal to 99% TBSA, n = 30). (2) According to diagnostic criteria of burn sepsis, patients in burn group were divided into sepsis group (n = 43) and non-sepsis group (n = 59). (3) According to the prognosis of patients with sepsis, patients in sepsis group were further divided into non-survival sepsis group (n = 14) and survival sepsis group (n = 29). The levels of pGSN in above groups were compared, and their relationship with sepsis and death of patients was analyzed. Data were analyzed with analysis of variance, LSD test and one-way Logistic regressions. (1) Levels of pGSN in burn group were obviously lower than those of healthy control group on PBD 1, 3, 7, 14, and 21 (with F values respectively 140.01, 369.52, 702.15, 360.14, 84.16, P values all below 0.01). (2) The mean levels of pGSN in large, medium, and small burn area groups at five time points were (43 ± 11), (85 ± 23), (124 ± 38) mg/L, showing statistically significant differences among them (F = 367.76, P burn patients. Severe burn injury could down-regulate the pGSN level of patients, and it decreases along with the increase in the area and

  8. Burn Severity Dominates Understory Plant Community Response to Fire in Xeric Jack Pine Forests

    Directory of Open Access Journals (Sweden)

    Bradley D. Pinno

    2016-04-01

    Full Text Available Fire is the most common disturbance in northern boreal forests, and large fires are often associated with highly variable burn severities across the burnt area. We studied the understory plant community response to a range of burn severities and pre-fire stand age four growing seasons after the 2011 Richardson Fire in xeric jack pine forests of northern Alberta, Canada. Burn severity had the greatest impact on post-fire plant communities, while pre-fire stand age did not have a significant impact. Total plant species richness and cover decreased with disturbance severity, such that the greatest richness was in low severity burns (average 28 species per 1-m2 quadrat and plant cover was lowest in the high severity burns (average 16%. However, the response of individual plant groups differed. Lichens and bryophytes were most common in low severity burns and were effectively eliminated from the regenerating plant community at higher burn severities. In contrast, graminoid cover and richness were positively related to burn severity, while forbs did not respond significantly to burn severity, but were impacted by changes in soil chemistry with increased cover at pH >4.9. Our results indicate the importance of non-vascular plants to the overall plant community in this harsh environment and that the plant community is environmentally limited rather than recruitment or competition limited, as is often the case in more mesic forest types. If fire frequency and severity increase as predicted, we may see a shift in plant communities from stress-tolerant species, such as lichens and ericaceous shrubs, to more colonizing species, such as certain graminoids.

  9. Burns

    Science.gov (United States)

    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 ...

  10. Two new risk factors for heterotopic ossification development after severe burns

    OpenAIRE

    Thefenne, Laurent; de Brier, Gratiane; Leclerc, Thomas; Jourdan, Claire; Nicolas, Claire; Truffaut, Stéphanie; Lapeyre, Eric; Genet, Francois

    2017-01-01

    Objectives Life after severe burns is conditioned by the remaining sequelae. The pathophysiology and risk factors of Heterotopic Ossification (HO) after burns are still poorly understood. The aim of this study was to determine: 1) the incidence of HO after burns and 2) the risk factors associated with HO development, in a large retrospective study. Methods A case-control study of patients admitted to the burns intensive care unit of Percy Hospital, Paris, from the 1st January 2009 to the 31st...

  11. Gut microbiota trajectory in patients with severe burn: A time series study.

    Science.gov (United States)

    Wang, Xinying; Yang, Jianbo; Tian, Feng; Zhang, Li; Lei, Qiucheng; Jiang, Tingting; Zhou, Jihong; Yuan, Siming; Wang, Jun; Feng, Zhijian; Li, Jieshou

    2017-08-12

    This time series experiments aimed to investigate the dynamic change of gut microbiomes after severe burn and its association with enteral nutrition (EN). Seven severely burned patients who suffered from a severe metal dust explosion injury were recruited in this study. The dynamic changes of gut microbiome of fecal samples at six time points (1-3days, 2, 3, 4, 5 and 6weeks after severe burn) were detected using 16S ribosomal RNA pyrosequencing technology. Following the post-burn temporal order, gut microbiota dysbiosis was detected in the gut microbiome after severe burn, then it was gradually resolved. The bio-diversity of gut bacteria was initially decreased, and then returned to normal level. In addition, at the early stage (from 2 to 4weeks), the majority of those patients' gut microbiome were opportunistic pathogen genus, Enterococcus and Escherichia; while at the end of this study, the majority was a beneficial genus, Bacteroides. EN can promote the recovery of gut microbiota, especially in EN well-tolerated patients. Severe burn injury can cause a dramatic dysbiosis of gut microbiota. A trend of enriched beneficial bacteria and diminished opportunistic pathogen bacteria may serve as prognosis microbiome biomarkers of severe burn patients. Copyright © 2017. Published by Elsevier Inc.

  12. Landsat-Based Detection and Severity Analysis of Burned Sugarcane Plots in Tarlac, Philippines Using Differenced Normalized Burn Ratio (dNBR)

    Science.gov (United States)

    Baloloy, A. B.; Blanco, A. C.; Gana, B. S.; Sta. Ana, R. C.; Olalia, L. C.

    2016-09-01

    The Philippines has a booming sugarcane industry contributing about PHP 70 billion annually to the local economy through raw sugar, molasses and bioethanol production (SRA, 2012). Sugarcane planters adapt different farm practices in cultivating sugarcane, one of which is cane burning to eliminate unwanted plant material and facilitate easier harvest. Information on burned sugarcane extent is significant in yield estimation models to calculate total sugar lost during harvest. Pre-harvest burning can lessen sucrose by 2.7% - 5% of the potential yield (Gomez, et al 2006; Hiranyavasit, 2016). This study employs a method for detecting burn sugarcane area and determining burn severity through Differenced Normalized Burn Ratio (dNBR) using Landsat 8 Images acquired during the late milling season in Tarlac, Philippines. Total burned area was computed per burn severity based on pre-fire and post-fire images. Results show that 75.38% of the total sugarcane fields in Tarlac were burned with post-fire regrowth; 16.61% were recently burned; and only 8.01% were unburned. The monthly dNBR for February to March generated the largest area with low severity burn (1,436 ha) and high severity burn (31.14 ha) due to pre-harvest burning. Post-fire regrowth is highest in April to May when previously burned areas were already replanted with sugarcane. The maximum dNBR of the entire late milling season (February to May) recorded larger extent of areas with high and low post-fire regrowth compared to areas with low, moderate and high burn severity. Normalized Difference Vegetation Index (NDVI) was used to analyse vegetation dynamics between the burn severity classes. Significant positive correlation, rho = 0.99, was observed between dNBR and dNDVI at 5% level (p = 0.004). An accuracy of 89.03% was calculated for the Landsat-derived NBR validated using actual mill data for crop year 2015-2016.

  13. Prehospital cooling of severe burns: Experience of the Emergency Department at Edendale Hospital, KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Fiandeiro, D; Govindsamy, J; Maharaj, R C

    2015-06-01

    Early cooling with 10 - 20 minutes of cool running water up to 3 hours after a burn has a direct impact on the depth of the burn and therefore on the clinical outcome of the injury. An assessment of the early cooling of burns is essential to improve this aspect of burns management. To assess the rates and adequacy of prehospital cooling received by patients with severe burns before presentation to the Emergency Department (ED) at Edendale Hospital, Pietermaritzburg, South Africa. Patients with inadequate prehospital cooling who presented to the ED within 3 hours were also identified. A retrospective reviewof the burns database for all the patients with severe burns admitted from the ED at Edendale Hospital from September 2012 to August 2013 was undertaken. Demographic details, characteristics and timing of the burns, and presentation were correlated with burn cooling. Ninety patients were admitted with severe burns. None received sufficient cooling of their burns, 25.6% received cooling of inadequate duration, and 32.3% arrived at the ED within 3 hours after the burn with either inadequate or no cooling. The median time to presentation to the ED after the burn was 260 minutes. Appropriate cooling of severe burns presenting to Edendale Hospital is inadequate. Education of the community and prehospital healthcare workers about the iiportance of early appropriate cooling of severe burns is required. Many patients would benefit from cooling of their burns in the ED, and facilities should be provided for this vital function.

  14. Burn Severity Dominates Understory Plant Community Response to Fire in Xeric Jack Pine Forests

    OpenAIRE

    Pinno, Bradley D.; Ruth C. Errington

    2016-01-01

    Fire is the most common disturbance in northern boreal forests, and large fires are often associated with highly variable burn severities across the burnt area. We studied the understory plant community response to a range of burn severities and pre-fire stand age four growing seasons after the 2011 Richardson Fire in xeric jack pine forests of northern Alberta, Canada. Burn severity had the greatest impact on post-fire plant communities, while pre-fire stand age did not have a significant im...

  15. Successful skin homografting from an identical twin in a severely burned patient.

    Science.gov (United States)

    Turk, Emin; Karagulle, Erdal; Turan, Hale; Oguz, Hakan; Abali, Ebru Sakallioglu; Ozcay, Necdet; Moray, Gokhan; Haberal, Mehmet

    2014-01-01

    Flame burns are a serious condition and usually have high morbidity and mortality because they affect large areas of the body surface as well as the lungs. In these patients, it is especially difficult to find healthy skin for grafting if they have more than 70% third-degree burns. Repeated autografting or synthetic wound care materials are the only treatment options to cover burned areas. Partial-thickness skin grafting from the patient's identical twin sibling may be an alternative treatment option, if possible. Here, we report a patient with severe flame injury treated with skin from his identical twin. The patient had third-degree burns covering 70% of his body surface. Initial treatment consisted of fluid and electrolyte replacement, daily wound care, and surgical debridements, as well as nutritional support. After initial treatment, we performed a successful skin grafting from his identical twin. Skin grafting between identical twins might be an alternate method for severely burned patients.

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

    Science.gov (United States)

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

    2016-07-01

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

  17. Comparative observation with MRI and pathology of brain edema at the early stage of severe burn

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Objective: To investigate the correlation between MRI features and pathology in brain edema at the early stage of severe burn (50% TBSA Ⅲ degree) in dogs.Methods: Fifty-two dogs were randomized into control, simple burn (SB), burn plus sodium lactate (BSL), and burn plus glucose solution groups (BGS). The manifestation of the brain of control group was compared with that of burn groups at 6, 12, 18 and 24 hours postburn with MRI and pathological examination (gross appearance, electron microscopy and light microscopy).Results: The earliest findings of brain edema were seen at 12 hours after burn in BGS group, in which brain swelling was the main feature of MRI. The decrease of SIR on T1WI was not observed until it was exceeded 10%.Signal of T2WI increased by 8.29% at 24 hours after burn.It was difficult to distinguish the gray matter from the white matter at the boundary line, which became blurred later. Histological changes of brain edema were observed as early as 6 hours after burn, being accompanied by swelling of endothelial cells and peri-vescular astrocytes, and vacuolation took place in neurons at 12 hours after burn, with different degrees of necrosis of capillary endothelimn,neurons, and axons. These changes became more marked with elapse of time. The BGS group showed the most obvious changes mentioned above at 24 hours after burn.Conclusions: The model of the brain edema after severe burn has the feature of both vasogenic edema and cytotoxic edema on the MRI and pathology. Positive MRI findings lagged behind that of the pathomorphological changes.ed

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

    Directory of Open Access Journals (Sweden)

    Xun Liang

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

  19. Nurse Understanding on 1 Case of Severe Burn Complicated with Diabetes

    Institute of Scientific and Technical Information of China (English)

    LAI Lihong

    2002-01-01

    @@ There was one diabetic with severe burn complicated with diabetes received satified effect after treated and nursed timely from December, 1997to April, 1998 in our hospital. Now the nurse work is following.

  20. LandCarbon Conterminous United States Burned Area and Severity Mosaics 2001-2050 Metadata

    Data.gov (United States)

    U.S. Geological Survey, Department of the Interior — The burn area and severity data were stochastically generated using a probabilistic ignition model and mechanistic fire-spread model. The ignition model consisted of...

  1. Structural Equation Modeling on Life-world Integration in People with Severe Burns

    Directory of Open Access Journals (Sweden)

    Gyeong Suk Lee, PhD, RN

    2013-09-01

    Conclusion: Physical function should be directly improved to adjust to life-world integration. A comprehensive integration approach is also necessary to help people with severe burns successfully return to society.

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

    Directory of Open Access Journals (Sweden)

    George Kuo

    2016-12-01

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

  3. Vegetation burn severity mapping using Landsat-8 and WorldView-2

    Science.gov (United States)

    Wu, Zhuoting; Middleton, Barry R.; Hetzler, Robert; Vogel, John M.; Dye, Dennis G.

    2015-01-01

    We used remotely sensed data from the Landsat-8 and WorldView-2 satellites to estimate vegetation burn severity of the Creek Fire on the San Carlos Apache Reservation, where wildfire occurrences affect the Tribe's crucial livestock and logging industries. Accurate pre- and post-fire canopy maps at high (0.5-meter) resolution were created from World- View-2 data to generate canopy loss maps, and multiple indices from pre- and post-fire Landsat-8 images were used to evaluate vegetation burn severity. Normalized difference vegetation index based vegetation burn severity map had the highest correlation coefficients with canopy loss map from WorldView-2. Two distinct approaches - canopy loss mapping from WorldView-2 and spectral index differencing from Landsat-8 - agreed well with the field-based burn severity estimates and are both effective for vegetation burn severity mapping. Canopy loss maps created with WorldView-2 imagery add to a short list of accurate vegetation burn severity mapping techniques that can help guide effective management of forest resources on the San Carlos Apache Reservation, and the broader fire-prone regions of the Southwest.

  4. Detection of Burn Area and Severity with MODIS Satellite Images and Spatial Autocorrelation Techniques

    Science.gov (United States)

    Kaya, S.; Kavzoglu, T.; Tonbul, H.

    2014-12-01

    Effects of forest fires and implications are one of the most important natural disasters all over the world. Statistical data observed that forest fires had a variable structure in the last century in Turkey, but correspondingly the population growth amount of forest fires and burn area increase widely in recent years. Depending on this, erosion, landslides, desertification and mass loss come into existence. In addition; after forest fires, renewal of forests and vegetation are very important for land management. Classic methods used for detection of burn area and severity requires a long and challenging process due to time and cost factors. Thanks to advanced techniques used in the field of Remote Sensing, burn area and severity can be determined with high detail and precision. The purpose of this study based on blending MODIS (Moderate Resolution Imaging Spectradiometer) satellite images and spatial autocorrelation techniques together, thus detect burn area and severity absolutely. In this context, spatial autocorrelation statistics like Moran's I and Get is-Ord Local Gi indexes were used to measure and analyze to burned area characteristics. Prefire and postfire satellite images were used to determine fire severity depending on spectral indexes corresponding to biomass loss and carbon emissivity intensities. Satellite images have used for identification of fire damages and risks in terms of fire management for a long time. This study was performed using prefire and postfire satellite images and spatial autocorrelation techniques to determining and analyzing forest fires in Antalya, Turkey region which serious fires occurred. In this context, this approach enables the characterization of distinctive texture of burned area and helps forecasting more precisely. Finally, it is observed that mapping of burned area and severity could be performed from local scale to national scale. Key Words: Spatial autocorrelation, MODIS, Fire, Burn Severity

  5. Successful treatment of severe burn patients with multiple organ dysfunction syndrome:A case rep ort

    Institute of Scientific and Technical Information of China (English)

    Lingfeng Wang ∗; Yongdong Li; Xiyuan Xu; Ji Chen; Weiqing Wang; Zaiqing Huang; Lihua Zhang

    2014-01-01

    Multiple organ dysfunction syndrome is the presence of altered organ function of two or more organ systems in acute ill patients with severe trauma, burn, shock and infection. In this case, the patient with burn area amounted to 95%and the third-degree burn was up to 90%. He underwent gastrointestinal tract, blood clotting, lung, brain, heart, liver dysfunction, and cardiac arrest for 30 minutes during the courses of treatment, and was discharged from the hospital after 108 days on the basis of comprehensive treatment and repeated skin grafting.

  6. SENTINEL-2A red-edge spectral indices suitability for discriminating burn severity

    Science.gov (United States)

    Fernández-Manso, Alfonso; Fernández-Manso, Oscar; Quintano, Carmen

    2016-08-01

    Fires are a problematic and recurrent issue in Mediterranean ecosystems. Accurate discrimination between burn severity levels is essential for the rehabilitation planning of burned areas. Sentinel-2A MultiSpectral Instrument (MSI) record data in three red-edge wavelengths, spectral domain especially useful on agriculture and vegetation applications. Our objective is to find out whether Sentinel-2A MSI red-edge wavelengths are suitable for burn severity discrimination. As study area, we used the 2015 Sierra Gata wildfire (Spain) that burned approximately 80 km2. A Copernicus Emergency Management Service (EMS)-grading map with four burn severity levels was considered as reference truth. Cox and Snell, Nagelkerke and McFadde pseudo-R2 statistics obtained by Multinomial Logistic Regression showed the superiority of red-edge spectral indices (particularly, Modified Simple Ratio Red-edge, Chlorophyll Index Red-edge, Normalized Difference Vegetation Index Red-edge) over conventional spectral indices. Fisher's Least Significant Difference test confirmed that Sentinel-2A MSI red-edge spectral indices are adequate to discriminate four burn severity levels.

  7. Integrating satellite imagery with simulation modeling to improve burn severity mapping.

    Science.gov (United States)

    Karau, Eva C; Sikkink, Pamela G; Keane, Robert E; Dillon, Gregory K

    2014-07-01

    Both satellite imagery and spatial fire effects models are valuable tools for generating burn severity maps that are useful to fire scientists and resource managers. The purpose of this study was to test a new mapping approach that integrates imagery and modeling to create more accurate burn severity maps. We developed and assessed a statistical model that combines the Relative differenced Normalized Burn Ratio, a satellite image-based change detection procedure commonly used to map burn severity, with output from the Fire Hazard and Risk Model, a simulation model that estimates fire effects at a landscape scale. Using 285 Composite Burn Index (CBI) plots in Washington and Montana as ground reference, we found that an integrated model explained more variability in CBI (R (2) = 0.47) and had lower mean squared error (MSE = 0.28) than image (R (2) = 0.42 and MSE = 0.30) or simulation-based models (R (2) = 0.07 and MSE = 0.49) alone. Overall map accuracy was also highest for maps created with the Integrated Model (63 %). We suspect that Simulation Model performance would greatly improve with higher quality and more accurate spatial input data. Results of this study indicate the potential benefit of combining satellite image-based methods with a fire effects simulation model to create improved burn severity maps.

  8. [Preclinical treatment of severe burn trauma due to an electric arc on an overhead railway cable].

    Science.gov (United States)

    Spelten, O; Wetsch, W A; Hinkelbein, J

    2013-09-01

    Severe burns due to electrical accidents occur rarely in Germany but represent a challenge for emergency physicians and their team. Apart from extensive burns cardiac arrhythmia, neurological damage caused by electric current and osseous injury corresponding to the trauma mechanism are also common. It is important to perform a survey of the pattern of injuries and treat acute life-threatening conditions immediately in the field. Furthermore, specific conditions related to burns must be considered, e.g. fluid resuscitation, thermal management and analgesia. In addition, a correct strategy for further medical care in an appropriate hospital is essential. Exemplified by this case guidelines for the treatment of severe burns and typical pitfalls are presented.

  9. Burn Severities, Fire Intensities, and Impacts to Major Vegetation Types from the Cerro Grande Fire

    Energy Technology Data Exchange (ETDEWEB)

    Balice, Randy G. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Bennett, Kathryn D. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Wright, Marjorie A. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2004-12-15

    The Cerro Grande Fire resulted in major impacts and changes to the ecosystems that were burned. To partially document these effects, we estimated the acreage of major vegetation types that were burned at selected burn severity levels and fire intensity levels. To accomplish this, we adopted independently developed burn severity and fire intensity maps, in combination with a land cover map developed for habitat management purposes, as a basis for the analysis. To provide a measure of confidence in the acreage estimates, the accuracies of these maps were also assessed. In addition, two other maps of comparable quality were assessed for accuracy: one that was developed for mapping fuel risk and a second map that resulted from a preliminary application of an evolutionary computation software system, called GENIE.

  10. Circulating Microvesicles Are Elevated Acutely following Major Burns Injury and Associated with Clinical Severity.

    Science.gov (United States)

    O'Dea, Kieran P; Porter, John R; Tirlapur, Nikhil; Katbeh, Umar; Singh, Suveer; Handy, Jonathan M; Takata, Masao

    2016-01-01

    Microvesicles are cell-derived signaling particles emerging as important mediators and biomarkers of systemic inflammation, but their production in severe burn injury patients has not been described. In this pilot investigation, we measured circulating microvesicle levels following severe burns, with severe sepsis patients as a comparator group. We hypothesized that levels of circulating vascular cell-derived microvesicles are elevated acutely following burns injury, mirroring clinical severity due to the early onset and prevalence of systemic inflammatory response syndrome (SIRS) in these patients. Blood samples were obtained from patients with moderate to severe thermal injury burns, with severe sepsis, and from healthy volunteers. Circulating microvesicles derived from total leukocytes, granulocytes, monocytes, and endothelial cells were quantified in plasma by flow cytometry. All circulating microvesicle subpopulations were elevated in burns patients on day of admission (day 0) compared to healthy volunteers (leukocyte-microvesicles: 3.5-fold, p = 0.005; granulocyte-microvesicles: 12.8-fold, pmicrovesicles: 20.4-fold, pmicrovesicles: 9.6-fold, p = 0.01), but decreased significantly by day 2. Microvesicle levels were increased with severe sepsis, but less consistently between patients. Leukocyte- and granulocyte-derived microvesicles on day 0 correlated with clinical assessment scores and were higher in burns ICU non-survivors compared to survivors (leukocyte MVs 4.6 fold, p = 0.002; granulocyte MVs 4.8 fold, p = 0.003). Mortality prediction analysis of area under receiver operating characteristic curve was 0.92 (p = 0.01) for total leukocyte microvesicles and 0.85 (p = 0.04) for granulocyte microvesicles. These findings demonstrate, for the first time, acute increases in circulating microvesicles following burns injury in patients and point to their potential role in propagation of sterile SIRS-related pathophysiology.

  11. Relation between proteinuria and acute kidney injury in patients with severe burns

    Science.gov (United States)

    2012-01-01

    Introduction Proteinuria in burn patients is common, and may be associated with acute kidney injury (AKI) and adverse outcomes. We evaluated the incidences, outcomes, characteristics and determinants of proteinuria and its influence on AKI and outcomes in burn patients. Methods This retrospective study was carried out in a hospital's burn department. The study population consisted of patients with burn injuries admitted during a five-year period. Positive urine dipstick readings were defined as mild (± or 1+) or heavy (≥ 2+) proteinuria, and AKI was diagnosed and staged according to the Risk, Injury, Failure, Loss, End Stage (RIFLE) classification system. Patient characteristics, management and outcomes were evaluated for associations with proteinuria using nonparametric tests, chi-square (χ2) tests and binary logistic regression. Results Of the patients admitted to the burn unit during the study period (n = 2,497), 865 (34.64%) were classified as having proteinuria. In the patients whose total burn surface areas (TBSA) were > 30% (n = 396), 271 patients (68.43%) had proteinuria and 152 of these patients (56.09%) met AKI criteria. No patients without proteinuria developed AKI. Intensive care unit (ICU) mortality rates were 0.8%, 16.67% and 30.77% (P proteinuria, respectively. Logistic regression analysis identified proteinuria (OR 4.48; 95% CI, 2.824 to 7.108; P proteinuria in patients with severe burns (> 30% TBSA). Severely burned patients with proteinuria had a high risk of developing AKI and a poor prognosis for survival. This suggests that proteinuria should be used for identifying burn patients at risk of developing AKI. PMID:23021407

  12. Propranolol attenuates hemorrhage and accelerates wound healing in severely burned adults

    OpenAIRE

    Ali, Arham; Herndon, David N.; Mamachen, Ashish; Hasan, Samir; Andersen, Clark R; Grogans, Ro-Jon; Brewer, Jordan L.; Lee, Jong O.; Heffernan, Jamie; Suman, Oscar E.; Finnerty, Celeste C

    2015-01-01

    Introduction Propranolol, a nonselective β-blocker, exerts an indirect effect on the vasculature by leaving α-adrenergic receptors unopposed, resulting in peripheral vasoconstriction. We have previously shown that propranolol diminishes peripheral blood following burn injury by increasing vascular resistance. The purpose of this study was to investigate whether wound healing and perioperative hemodynamics are affected by propranolol administration in severely burned adults. Methods Sixty-nine...

  13. Use of a radiative transfer model to simulate the postfire spectral response to burn severity

    Science.gov (United States)

    Chuvieco, E.; RiañO, D.; Danson, F. M.; Martin, P.

    2006-12-01

    Burn severity is related to fire intensity and fire duration and provides a quantitative measure related to fire impact and biomass consumption. Traditional field-based methods to estimate burn severity are time consuming, labor intensive, and normally limited in spatial extent. Remotely sensed data may provide a means to estimate severity levels across large areas, but it is critical to understand the causes of variability in spectral response with variations in burn severity. To address this issue, a combined leaf (Prospect) and canopy (Kuusk) reflectance model was used to simulate the spectral response of a range of vegetation canopies with different burn severity levels. The key aspects examined in the simulations were change in soil color, change in foliage color from green to brown (burned), and change in leaf area index (LAI). For each simulation the composite burn index (CBI) was determined using the same rules used in the field to estimate burn severity levels. Statistical analyses examined the strength of the correlations between CBI and reflectance in individual wave bands in the 400-2500 nm range and CBI and a range of spectral indices combining pairs of wave bands. The results showed that wave bands in the near infrared (NIR) were most strongly related to the CBI of the simulated canopies because of their sensitivity to reduction in LAI. Spectral indices combining reflectance in wave bands in the NIR and shortwave infrared and red edge region showed stronger correlations with CBI. Forward stepwise regression with two to six terms selected wave bands in these regions and accounted for more than 90% of the variation in CBI.

  14. Burns

    Science.gov (United States)

    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 ...

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

    Institute of Scientific and Technical Information of China (English)

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

    2007-01-01

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

  16. An evaluation of Emergency Management of Severe Burn (EMSB) course in Bangladesh: a strategic direction.

    Science.gov (United States)

    Biswas, Animesh; Rahman, Fazlur; Maitz, Peter; Baset, Kamran Ul; Hossain, Jahangir; Mashreky, Saidur Rahman

    2017-01-01

    Burn is one of the major public health problems in Bangladesh. Specialized personnel and technologies are required, however, in many cases they are not readily available. Taking the situation into account, Interplast Australia and New Zealand, Australia & New Zealand Burn Association (ANZBA), and Centre for Injury Prevention and Research, Bangladesh (CIPRB) initiated Emergency Management of Severe Burn (EMSB) training programme for Bangladeshi physicians in 2008 to help improving their burn management skill. The study was designed to evaluate the effect of EMSB programme in Bangladesh. Both qualitative and quantitative methods were adopted. A cross-sectional survey was conducted to obtain quantitative information from 38 randomly selected EMSB-trained doctors among 380 trained physicians based on a five year database of EMSB (2008-2012). In-depth interviews (IDIs) and focus group discussion (FGD) were used as data collection techniques to get information. A total of 32 participants completed the interview. It was found that 87.5% (n=28) doctors were using their skill in burn management that they learnt from the EMSB course. About 43.8% (n=14) doctors felt that the course largely helped improve their confidence. Majority (56.2%, n=18) of doctors stated EMSB is essential for the Bangladeshi doctors to learn better management of burns. Qualitative findings show that the courses were organized successfully with an excellent coordination, maintaining same quality and standard as running anywhere in the world. For its effectiveness, the course has been recommended to train graduate nurses and junior doctors from the periphery of the country. EMSB has already created a large doctor community who are able to effectively manage burn patients. It also has proven its indispensability for learning burn management skill. The EMSB established a platform to serve the burn victims and reduce the burden of injuries in Bangladesh.

  17. Vegetation structure and fire weather influence variation in burn severity and fuel consumption during peatland wildfires

    Directory of Open Access Journals (Sweden)

    G. M. Davies

    2015-09-01

    Full Text Available Temperate peatland wildfires are of significant environmental concern but information on their environmental effects is lacking. We assessed variation in burn severity and fuel consumption within and between wildfires that burnt British moorlands in 2011 and 2012. We adapted the Composite Burn Index (pCBI to provide semi-quantitative estimates of burn severity. Pre- and post-fire surface (shrubs and graminoids and ground (litter, moss, duff fuel loads associated with large wildfires were assessed using destructive sampling and analysed using a Generalised Linear Mixed Model (GLMM. Consumption during wildfires was compared with published estimates of consumption during prescribed burns. Burn severity and fuel consumption were related to fire weather, assessed using the Canadian Fire Weather Index System (FWI System, and pre-fire fuel structure. pCBI varied 1.6 fold between, and up to 1.7 fold within, wildfires. pCBI was higher where moisture codes of the FWI System indicated drier fuels. Spatial variation in pre- and post-fire fuel load accounted for a substantial proportion of the variance in fuel loads. Average surface fuel consumption was a linear function of pre-fire fuel load. Average ground fuel combustion completeness could be predicted by the Buildup Index. Carbon release ranged between 0.36 and 1.00 kg C m−2. The flammability of ground fuel layers may explain the higher C release-rates seen for wildfires in comparison to prescribed burns. Drier moorland community types appear to be at greater risk of severe burns than blanket-bog communities.

  18. Effects of Burn Severity and Environmental Conditions on Post-Fire Regeneration in Siberian Larch Forest

    Directory of Open Access Journals (Sweden)

    Thuan Chu

    2017-03-01

    Full Text Available Post-fire forest regeneration is strongly influenced by abiotic and biotic heterogeneity in the pre- and post-fire environments, including fire regimes, species characteristics, landforms, hydrology, regional climate, and soil properties. Assessing these drivers is key to understanding the long-term effects of fire disturbances on forest succession. We evaluated multiple factors influencing patterns of variability in a post-fire boreal Larch (Larix sibirica forest in Siberia. A time-series of remote sensing images was analyzed to estimate post-fire recovery as a response variable across the burned area in 1996. Our results suggested that burn severity and water content were primary controllers of both Larch forest recruitment and green vegetation cover as defined by the forest recovery index (FRI and the fractional vegetation cover (FVC, respectively. We found a high rate of Larch forest recruitment in sites of moderate burn severity, while a more severe burn was the preferable condition for quick occupation by vegetation that included early seral communities of shrubs, grasses, conifers and broadleaf trees. Sites close to water and that received higher solar energy during the summer months showed a higher rate of both recovery types, defined by the FRI and FVC, dependent on burn severity. In addition to these factors, topographic variables and pre-fire condition were important predictors of post-fire forest patterns. These results have direct implications for the post-fire forest management in the Siberian boreal Larch region.

  19. [Influence of educational status, burn area and coping behaviors on the complication of psychological disorders in severely burned patients].

    Science.gov (United States)

    Cheng, Hua; Li, Xiao-jian; Cao, Wen-juan; Chen, Li-ying; Zhang, Zhi; Liu, Zhi-he; Yi, Xian-feng; Lai, Wen

    2013-04-01

    To discuss how the educational status, burn area and coping behaviors influence the psychological disorders in severely burned patients. Sixty-four severely burned patients hospitalized in Guangzhou Red Cross Hospital, Guangdong Provincial Work Injury Rehabilitation Center, and Guangdong General Hospital were enrolled with cluster random sampling method. Data of their demography and situation of burns were collected. Then their coping behavior, psychological disorders including anxiety, depression and post-traumatic stress disorder (PTSD) plus its core symptoms of flashback, avoidance, and hypervigilance were assessed by medical coping modes questionnaire, self-rating anxiety scale (SAS), self-rating depression scale (SDS), PTSD checklist-civilian version (PCL-C) respectively. Correlation was analyzed between demography, burn area, coping behavior and psychological disorders. The predictive powers of educational status, burn area and coping behaviors on the psychological disorders were analyzed. The qualitative variables were assigned values. Data were processed with t test, Spearman rank correlation analysis, and multiple linear regression analysis. (1) The patients scored (19.0 ± 3.4) points in confrontation coping behavior, which showed no statistically significant difference from the domestic norm score (19.5 ± 3.8) points (t = -1.13, P > 0.05). The patients scored (16.6 ± 2.4) and (11.0 ± 2.2) points in avoidance and resignation coping behaviors, which were significantly higher than the domestic norm score (14.4 ± 3.0), (8.8 ± 3.2) points (with t values respectively 7.06 and 7.76, P values both below 0.01). The patients' standard score of SAS, SDS, PCL-C were (50 ± 11), (54 ± 11), and (38 ± 12) points. Respectively 89.1% (57/64), 60.9% (39/64), 46.9% (30/64) of the patients showed anxiety, depression, and PTSD symptoms. (2) Four independent variables: age, gender, marital status, and time after burns, were correlated with the psychological disorders

  20. A clinical observation of early short-term use of potent antibiotics in severely burned patients

    Institute of Scientific and Technical Information of China (English)

    RONG Xin-zhou; ZHANG Wen-zhen; REN Jia-liang; ZHOU Wei-ming

    2001-01-01

    Objective: To evaluate the effect of early and short-term use of potent antibiotics following extensive severe burn injury. Methods: Seventeen severely burned patients hospitalized in the same period (Nov.,1998 to Oct., 2000) wer esame treatment in Group 2 (n=8) was discontinued until day 15 postburn. The survival rate, blood bacterial culture, body temperature and white blood cell and platelet counts were compared between the 2 groups. Results: All the 17 patients survived and all blood bacterial cultures were negative. No significant difference of body temperature and white blood cell and platelet counts between the 2 groups was observed (P>0.05). Conclusion: Early use of high-potency antibiotics at short treatment course after extensive severe burn is effective to prevent infection and reduce the cost.

  1. [Effect of severe burn on growth and development and the level of growth hormone in mice].

    Science.gov (United States)

    Wang, Fei; Qiu, Lin; Liu, Cuiping; Tian, Xiaofei; Xiao, Jun

    2014-02-01

    To analyze the changes in body growth, learning and memory capabilities, exercise capacity, and the level of growth hormone (GH) in mice suffering from severe burn. One hundred and four healthy BALB/c mice aged from 3 to 4 weeks were divided into normal control group (NC, without treatment) , 7 s burn group (inflicted with 20%TBSA deep partial-thickness burn on the back), 10 s burn group (inflicted with 20%TBSA full-thickness burn on the back), and negative control group (simulating the treatment of two burn groups without injury) according to the random number table, with 26 mice in each group. The body weight, body length, and tail length of 8 mice in each group were measured before burn. Respectively 6 mice of two burn groups were sacrificed on post burn day (PBD) 1, 3, and 7 for determination of serum level of GH with enzyme-linked immunosorbent assay kit. The remaining 8 mice in each of the two burn groups were raised to adulthood. The body weight, body length, and tail length were measured on PBD 62, and the increased percentages of body weight, body length, and tail length were calculated. Morris water maze tests, including escape latency on PBD 66, 67, and 68, frequency of stepping over the platform location and proportion of staying time in the target quadrant on PBD 69, were used to examine the learning and memory capabilities. The time of loaded swimming and the time of pole-climbing on PBD 70 were used to assess the exercise capacity. Above-mentioned indexes were also determined in the two control groups at the same time points. Data were processed with one-way analysis of variance; Welch test was applied when equal variance was not assumed; independent samples t test was applied for paired comparison. (1) The level of GH of mice in 7 s burn group on PBD 1 [(3 021 ± 506) pg/mL] was lower than that of group NC [(3 728 ± 412) pg/mL, t = 2.656, P 0.05), while the increased percentages of other indexes of mice in the two burn groups were lower than those

  2. Effects of glycine supplementation on myocardial damage and cardiac function after severe burn.

    Science.gov (United States)

    Zhang, Yong; Lv, Shang-jun; Yan, Hong; Wang, Lin; Liang, Guang-ping; Wan, Qian-xue; Peng, Xi

    2013-06-01

    Glycine has been shown to participate in protection from hypoxia/reoxygenation injury. However, the cardioprotective effect of glycine after burn remains unclear. This study aimed to explore the protective effect of glycine on myocardial damage in severely burned rats. Seventy-two Wistar rats were randomly divided into three groups: normal controls (C), burned controls (B), and glycine-treated (G). Groups B and G were given a 30% total body surface area full-thickness burn. Group G was administered 1.5 g/(kg d) glycine and group B was given the same dose of alanine via intragastric administration for 3d. Serum creatine kinase (CK), lactate dehydrogenase (LDH), aspartate transaminase (AST), and blood lactate, as well as myocardial ATP and glutathione (GSH) content, were measured. Cardiac contractile function and histopathological changes were analyzed at 12, 24, 48, and 72 hours. Serum CK, LDH, AST, and blood lactate increased, while myocardial ATP and GSH content decreased in both burned groups. Compared with group B, the levels of CK, LDH, and AST significantly decreased, whereas blood lactate as well as myocardial ATP and GSH content increased in group G. Moreover, cardiac contractile function inhibition and myocardial histopathological damage in group G significantly decreased compared with group B. Myocardial histological structure and function were damaged significantly after burn. Glycine is beneficial to myocardial preservation by improving cardiomyocyte energy metabolism and increasing ATP and GSH abundance. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  3. Impact of facial burns: relationship between depressive symptoms, self-esteem and scar severity.

    Science.gov (United States)

    Hoogewerf, Cornelis Johannes; van Baar, Margriet Elisabeth; Middelkoop, Esther; van Loey, Nancy Elisa

    2014-01-01

    This study assessed the role of self-reported facial scar severity as a possible influencing factor on self-esteem and depressive symptoms in patients with facial burns. A prospective multicentre cohort study with a 6 months follow-up was conducted including 132 patients with facial burns. Patients completed the Patient and Observer Scar Assessment Scale, the Rosenberg Self-esteem Scale and the Hospital Anxiety and Depression Scale. Structural Equation Modeling was used to assess the relations between depressive symptoms, self-esteem and scar severity. The model showed that patient-rated facial scar severity was not predictive for self-esteem and depressive symptoms six months post-burn. There was, however, a significant relationship between early depressive symptoms and both patient-rated facial scar severity and subsequent self-esteem. The variables in the model accounted for 37% of the variance in depressive symptoms six months post-burn and the model provided a moderately well-fitting representation of the data. The study suggests that self-esteem and depressive symptoms were not affected by self-reported facial scar severity but that earlier depressive symptoms were indicative for a more severe self-reported facial scar rating. Therefore, routine psychological screening during hospitalisation is recommended in order to identify patients at risk and to optimise their treatment. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. [Improving myocardial mechanics parameters of severe burn rabbits with oral fluid resuscitation].

    Science.gov (United States)

    Ruan, Jing; Zhang, Bing-qian; Wang, Guang; Luo, Zhong-hua; Zheng, Qing-yi; Zheng, Jian-sheng; Huang, Yue-sheng; Xiao, Rong

    2008-08-01

    To investigate the protective effect of oral fluid resuscitation on cardiac function in severe burn rabbits. One hundred and fifty rabbits were randomly divided into normal control group (NC group, n = 6, without treatment), burn group (B group, n = 42, without fluid therapy), immediate oral fluid resuscitation group (C group, n = 42), delayed oral fluid resuscitation group (D group, n = 30) and delayed and rapid oral fluid resuscitation group (E group, n = 30). The rabbits in B, C, D, E groups were subjected to 40% TBSA full-thickness burn, then were treated with fluid therapy immediately after burn (C group), at 6 hour after burn (D, E groups). The myocardial mechanics parameters including mean arterial pressure (MAP), left ventricular systolic pressure (LVSP), left ventricular end diastolic pressure (LVEDP), LV +/- dp/dt max were observed at 2, 6, 8, 12, 24, 36 and 48 post burn hour (PBH). Urine output was also examined. The level of LVSP, LV +/- dp/dt max in B roup were significantly lower than those in NC group. The level of LVSP, LV +/- dp/dt max in the C and E group were singnificantly increased during 24 hour after burn. The level of LV + dp/dt max and LV-dp/dt max in C group peaked at 8 PBH (892 +/- 116 kPa/s) and at 6PBH (724 +/- 149 kPa/s) respectively. The levels of LV +/- dp/dt max, LVSP in D group at each time point were similar to B group (P > 0.05). Both the levels of LV +/- dp/dt max in E group peaked at 8 PBH. The level of LVEDP was no obvious difference between B and other groups at each time point (P > 0.05). The changes of MAP and urine output on 24 PBH in each group were similar to above indices. Effective oral fluid therapy in severe burn rabbits during 24 hours after burn can ameliorate myocardial mechanics parameters. The amount of fluid resuscitation can be estimated according to relevant formula for delayed fluid resuscitation in burn rabbits.

  5. Treatment of patients with severe burns-costs and health-related quality of life outcome.

    Science.gov (United States)

    Koljonen, Virve; Laitila, Markku; Rissanen, Anne M; Sintonen, Harri; Roine, Risto P

    2013-01-01

    To study the effectiveness of the treatment of patients with severe burns, the authors collected health-related quality of life (HRQoL) data with the 15D instrument, 17 to 29 months after treatment had commenced at the national burns unit. The costs of each patient's secondary care treatment were followed for a mean of 66 months. During the 1-year study period, 107 patients were treated at the burns unit, eight for scar surgery, the remainder for primary treatment of a burn injury; 19 had died or could not be located during the time of the HRQoL survey. Of the remaining 88 patients, 43 (49%; mean [SD] age 45.7 [14.8] years; 70% men) returned the questionnaire. Their mean (SD) HRQoL score (0.909[0.113]) was only slightly, and not significantly, lower than that of the age- and sex- standardized general population (0.928[0.080]). The mean (SD) secondary care cost of burn treatment of for all the 107 patients, over the 60- to 72-month observation time, was 42,838 USD (73,569 USD; range 1319-34,8741 USD). The largest portion of the total cost was because of inpatient treatment (61%) followed by operations (22%), and outpatient visits. In addition to the costs of burns treatment, the patients consumed other secondary care services to a value of nearly 12,229 USD. The HRQoL in patients treated for severe burns is good, thus the observed high-treatment costs can be considered acceptable.

  6. Continuous Venovenous Hemofiltration in Severely Burned Patients with Acute Kidney Injury: A Cohort Study

    Science.gov (United States)

    2009-05-01

    tailed , with P < 0.05 considered significant. Kaplan-Meier esti- mate of survival was constructed to compare one-year survival between the CVVH group...Jeschke MG, Dziewulski P, Barrow RE, Herndon DN: Acute renal dysfunction in severely burned adults. J Trauma 1999, 46:141-144. 2. Coca SG, Bauling P

  7. A systematic review on intra-abdominal pressure in severely burned patients

    NARCIS (Netherlands)

    K.D. Strang; E.M.M. van Lieshout (Esther); R.S. Breederveld (Roelf S.); O.J.F. van Waes (Oscar)

    2014-01-01

    textabstractObjective Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are complications that may occur in severely burned patients. Evidenced based medicine for these patients is in its early development. The aim of this study was to provide an overview of literature rega

  8. Impact of facial burns : relationship between depressive symptoms, self-esteem and scar severity

    NARCIS (Netherlands)

    Hoogewerf, Cornelis Johannes; van Baar, Margriet Elisabeth; Middelkoop, Esther; Van Loey, N.E.E.

    2014-01-01

    OBJECTIVE: This study assessed the role of self-reported facial scar severity as a possible influencing factor on self-esteem and depressive symptoms in patients with facial burns. METHOD: A prospective multicentre cohort study with a 6 months follow-up was conducted including 132 patients with faci

  9. Impact of facial burns : relationship between depressive symptoms, self-esteem and scar severity

    NARCIS (Netherlands)

    Hoogewerf, Cornelis Johannes; van Baar, Margriet Elisabeth; Middelkoop, Esther; Van Loey, N.E.E.

    2014-01-01

    OBJECTIVE: This study assessed the role of self-reported facial scar severity as a possible influencing factor on self-esteem and depressive symptoms in patients with facial burns. METHOD: A prospective multicentre cohort study with a 6 months follow-up was conducted including 132 patients with

  10. Impact of facial burns : relationship between depressive symptoms, self-esteem and scar severity

    NARCIS (Netherlands)

    Hoogewerf, Cornelis Johannes; van Baar, Margriet Elisabeth; Middelkoop, Esther; Van Loey, N.E.E.

    2014-01-01

    OBJECTIVE: This study assessed the role of self-reported facial scar severity as a possible influencing factor on self-esteem and depressive symptoms in patients with facial burns. METHOD: A prospective multicentre cohort study with a 6 months follow-up was conducted including 132 patients with faci

  11. Selective decontamination of the digestive tract in severely burned pediatric patients

    NARCIS (Netherlands)

    Barret, JP; Jeschke, MG; Herndon, DN

    2001-01-01

    Infection is still one of the leading causes of morbidity and mortality in severely burned patients. Evidence suggests that many of the responsible organisms are endogenous. Systemic antibiotic prophylaxis is not effective, and produces resistant strains of microorganisms. SDD has been postulated to

  12. Safe method for release of severe post burn neck contracture under tumescent local anaesthesia and ketamine

    Directory of Open Access Journals (Sweden)

    Agarwal Pawan

    2004-01-01

    Full Text Available Severe post burn neck contracture results in difficult intubation, which can be life threatening and can result in multiple serious complications and sequels. Thirty patients with age ranging from 12 to 50 years were operated under local tumescent anesthesia supplemented with intravenous ketamine for release of post burn neck contracture and split skin grafted. This technique obviates the need for endotracheal intubation. There were no complications attributed to this anesthesia technique. There was no graft loss and blood loss was minimal.

  13. Human umbilical cord mesenchymal stem cells transplantation promotes cutaneous wound healing of severe burned rats.

    Directory of Open Access Journals (Sweden)

    Lingying Liu

    Full Text Available BACKGROUND: Severe burns are a common and highly lethal trauma. The key step for severe burn therapy is to promote the wound healing as early as possible, and reports indicate that mesenchymal stem cell (MSC therapy contributes to facilitate wound healing. In this study, we investigated effect of human umbilical cord MSCs (hUC-MSCs could on wound healing in a rat model of severe burn and its potential mechanism. METHODS: Adult male Wistar rats were randomly divided into sham, burn, and burn transplanted hUC-MSCs. GFP labeled hUC-MSCs or PBS was intravenous injected into respective groups. The rate of wound closure was evaluated by Image Pro Plus. GFP-labeled hUC-MSCs were tracked by in vivo bioluminescence imaging (BLI, and human-specific DNA expression in wounds was detected by PCR. Inflammatory cells, neutrophils, macrophages, capillaries and collagen types I/III in wounds were evaluated by histochemical staining. Wound blood flow was evaluated by laser Doppler blood flow meter. The levels of proinflammatory and anti-inflammatory factors, VEGF, collagen types I/III in wounds were analyzed using an ELISA. RESULTS: We found that wound healing was significantly accelerated in the hUC-MSC therapy group. The hUC-MSCs migrated into wound and remarkably decreased the quantity of infiltrated inflammatory cells and levels of IL-1, IL-6, TNF-α and increased levels of IL-10 and TSG-6 in wounds. Additionally, the neovascularization and levels of VEGF in wounds in the hUC-MSC therapy group were markedly higher than those in other control groups. The ratio of collagen types I and III in the hUC-MSC therapy group were markedly higher than that in the burn group at indicated time after transplantation. CONCLUSION: The study suggests that hUC-MSCs transplantation can effectively improve wound healing in severe burned rat model. Moreover, these data might provide the theoretical foundation for the further clinical application of hUC-MSC in burn areas.

  14. [Decrease of the incidence of sepsis syndrome after early enteral nutrition of patients with severe burns].

    Science.gov (United States)

    Pereira, J L; Gómez-Cia, T; Garrido, M; Parejo, J; Jódar, E; Serrano, P; Romero, H; Fraile, J; Franco, A; García-Luna, P P

    1996-01-01

    The objective of this study was to evaluate the effect of early enteral nutrition on the incidence of the septic syndrome as well as its tolerance, in patients with severe burns. We retrospectively studied 64 patients older than 15 years of age, with a greater than 20% burned body surface area. They were divided into 2 groups as a function of the time elapsed between the beginning of Enteral Nutrition and the time of the burning: 23 patients were given Enteral Nutrition within 24 hours after the burn, and in 41 patients the enteral nutrition was started later than 24 hours after sustaining the thermal injury. Both groups were similar with respect to age, sex, percentage of 2nd and 3rd degree burns, incidence of inhalation, and deaths. All patients received the Enteral Nutrition through a nasogastric tube, with administration of a polymeric, hyperprotein and hypocaloric formula through a continuous infusion pump. In our study we saw a reduction of the incidence of the septic syndrome in the patients who received early enteral Nutrition (26%; 6 patients of a total of 23), with respect to those who did non receive early Enteral Nutrition (54%; 22 patients of a total of 41), with a statistical significance of p > 0.05. There were no differences between both groups with respect to the digestive tolerance to Enteral Nutrition. From our study we can deduce that early Enteral Nutrition reduces the incidence of septic complications, without this increasing the digestive intolerance to the same.

  15. Association between PAI-1 polymorphisms and plasma PAI-1 level with sepsis in severely burned patients.

    Science.gov (United States)

    Chi, Y F; Chai, J K; Yu, Y M; Luo, H M; Zhang, Q X; Feng, R

    2015-08-21

    We investigated the association between plasminogen activator inhibitor-1 (PAI-1) polymorphisms and plasma PAI-1 level with sepsis in severely burned patients. A total of 182 patients with burn areas lager than 30% of the body surface area were enrolled in this study. Peripheral blood samples were obtained from 103 patients with sepsis (sepsis group) and 79 patients without sepsis (control group). An allele-specific polymerase chain reaction assay was used to determine PAI-1 polymorphism 4G/5G distribution. Plasma PAI-1 levels were detected using an enzyme-linked immunosorbent assay. The frequency of the 4G/4G genotype and the 4G allele frequency in the sepsis group were 42.7 and 62.1% respectively, which were significantly higher than those in the control group (P PAI-1 level than the control group (P PAI-1 concentrations were significantly higher in the 4G/4G genotype (P PAI-1 gene may be related to the susceptibility to burn sepsis and that the 4G/4G genotype may be an important genetic risk factor of burn sepsis. Additionally, PAI-1 concentrations in the serum are increased in patients with burn sepsis.

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

    Science.gov (United States)

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

    2015-09-01

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

  17. Detecting post-fire burn severity and vegetation recovery using multitemporal remote sensing spectral indices and field-collected composite burn index data in a ponderosa pine forest

    Science.gov (United States)

    Chen, X.; Vogelmann, J.E.; Rollins, M.; Ohlen, D.; Key, C.H.; Yang, L.; Huang, C.; Shi, H.

    2011-01-01

    It is challenging to detect burn severity and vegetation recovery because of the relatively long time period required to capture the ecosystem characteristics. Multitemporal remote sensing data can providemultitemporal observations before, during and after a wildfire, and can improve the change detection accuracy. The goal of this study is to examine the correlations between multitemporal spectral indices and field-observed burn severity, and to provide a practical method to estimate burn severity and vegetation recovery. The study site is the Jasper Fire area in the Black Hills National Forest, South Dakota, that burned during August and September 2000. Six multitemporal Landsat images acquired from 2000 (pre-fire), 2001 (post-fire), 2002, 2003, 2005 and 2007 were used to assess burn severity. The normalized difference vegetation index (NDVI), enhanced vegetation index (EVI), normalized burn ratio (NBR), integrated forest index (IFI) and the differences of these indices between the pre-fire and post-fire years were computed and analysed with 66 field-based composite burn index (CBI) plots collected in 2002. Results showed that differences of NDVI and differences of EVI between the pre-fire year and the first two years post-fire were highly correlated with the CBI scores. The correlations were low beyond the second year post-fire. Differences of NBR had good correlation with CBI scores in all study years. Differences of IFI had low correlation with CBI in the first year post-fire and had good correlation in later years. A CBI map of the burnt area was produced using regression tree models and the multitemporal images. The dynamics of four spectral indices from 2000 to 2007 indicated that both NBR and IFI are valuable for monitoring long-term vegetation recovery. The high burn severity areas had a much slower recovery than the moderate and low burn areas. ?? 2011 Taylor & Francis.

  18. Acute insulin resistance mediated by advanced glycation endproducts in severely burned rats.

    Science.gov (United States)

    Zhang, Xing; Xu, Jie; Cai, Xiaoqing; Ji, Lele; Li, Jia; Cao, Bing; Li, Jun; Hu, Dahai; Li, Yan; Wang, Haichang; Xiong, Lize; Xiao, Ruiping; Gao, Feng

    2014-06-01

    Hyperglycemia often occurs in severe burns; however, the underlying mechanisms and importance of managing postburn hyperglycemia are not well recognized. This study was designed to investigate the dynamic changes of postburn hyperglycemia and the underlying mechanisms and to evaluate whether early glycemic control is beneficial in severe burns. Prospective, randomized experimental study. Animal research laboratory. Sprague-Dawley rats. Anesthetized rats were subjected to a full-thickness burn injury comprising 40% of the total body surface area and were randomized to receive vehicle, insulin, and a soluble form of receptor for advanced glycation endproducts treatments. An in vitro study was performed on cultured H9C2 cells subjected to vehicle or carboxymethyllysine treatment. We found that blood glucose change presented a distinct pattern with two occurrences of hyperglycemia at 0.5- and 3-hour postburn, respectively. Acute insulin resistance evidenced by impaired insulin signaling and glucose uptake occurred at 3-hour postburn, which was associated with the second hyperglycemia and positively correlated with mortality. Mechanistically, we found that serum carboxymethyllysine, a dominant species of advanced glycation endproducts, increased within 1-hour postburn, preceding the occurrence of insulin resistance. More importantly, treatment of animals with soluble form of receptor for advanced glycation endproducts, blockade of advanced glycation endproducts signaling, alleviated severe burn-induced insulin resistance. In addition, early hyperglycemic control with insulin not only reduced serum carboxymethyllysine but also blunted postburn insulin resistance and reduced mortality. These findings suggest that severe burn-induced insulin resistance is partly at least mediated by serum advanced glycation endproducts and positively correlated with mortality. Early glycemic control with insulin or inhibition of advanced glycation endproducts with soluble form of receptor

  19. [Surgical therapy and critical care medicine in severely burned patients - Part 2: the basics in definite care].

    Science.gov (United States)

    Deisz, Robert; Kauczok, Jens; Dembinski, Rolf; Pallua, Norbert; Marx, Gernot

    2013-01-01

    Critical care medicine in severely burned patients should be adapted to the different pathophysiological phases. Accordingly, surgical and non-surgical therapy must be coordinated adequately. Initial stabilization of the burn victim during the first 24 hours (Surgical therapy and critical care medicine in severely burned patients - Part 1: the first 24 ours, AINS 9/12) is followed by a long lasting reconstructive period. During this time calculated fluid replacement to compensate evaporative losses by large bourn wounds is as essential as reconstruction of the integrity of the skin and the modulation of metabolic consequences following severe burn injury. Special attention has to be paid to local and systemic infections.

  20. [Effects of lappaconitine on pain and inflammatory response of severely burned rats and the mechanism].

    Science.gov (United States)

    Yang, C L; Wei, Z R; Zhang, T H; Zeng, X Q; Wu, B H

    2017-06-20

    Objective: To explore the effects of lappaconitine (LA) on pain and inflammatory response of severely burned rats and the mechanism. Methods: Forty SD rats were divided into healthy+ normal saline group, sham injury+ normal saline group, pure burn group, burn+ LA group, and healthy+ LA group according to the random number table (the same dividing method below), with 8 rats in each group. Rats in pure burn and burn+ LA groups were inflicted with about 32% total body surface area deep partial-thickness scald (hereinafter referred to as burn) on the back and right hind. Rats in sham injury+ normal saline group were sham injured. Rats in burn+ LA group were intraperitoneally injected with 1 g/L LA solution in the dosage of 4 mL/kg at 2.0 h before injury and post injury hour (PIH) 0 (immediately), 24.0, 48.0, and 72.0. Rats in healthy+ LA group were intraperitoneally injected with LA solution in the same dose at the same time points as above, and rats in healthy+ normal saline and sham injury+ normal saline groups were intraperitoneally injected with normal saline in the dose of 4 mL/kg at the same time points as above. At 1.5 h before injury and PIH 12.5, 24.5, 36.5, 48.5, and 72.5, the paw withdrawal mechanical threshold (PWMT) of injured rats was detected, and their pain behaviors were observed. The same observation and detection were conducted in rats without injury in the two groups at the same time points as above. Another 32 SD rats were divided into normal saline group, trinitrophenyl (TNP)-ATP group, minocyline group, pyridoxal-phosphate-6-azophenyl-2', 4'-disulfonic acid (PPADS) group, with 8 rats in each group, and all the rats were inflicted with the same burn injury as above. At PIH 48.0, rats in normal saline group were intrathecally injected with 10 μL normal saline; rats in TNP-ATP group were intrathecally injected with 10 μL TNP-ATP in the concentration of 30 nmol/μL; rats in minocyline group were intrathecally injected with 10 μL minocyline in the

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

    Science.gov (United States)

    Kuo, George; Yang, Shih-Yi; Chuang, Shiow-Shuh; Fan, Pei-Chun; Chang, Chih-Hsiang; Hsiao, Yen-Chang; Chen, Yung-Chang

    2016-12-01

    Acute kidney injury (AKI) is a frequent complication of severe burn injury and is associated with mortality. The definition of AKI was modified by the Kidney Disease Improving Global Outcomes Group in 2012. So far, no study has compared the outcome accuracy of the new AKI staging guidelines with that of the complex score system. Hence, we compared the accuracy of these approaches in predicting mortality. This was a post hoc analysis of prospectively collected data from an intensive care burn unit in a tertiary care university hospital. Patients admitted to this unit from July 2004 to December 2006 were enrolled. Demographic, clinical, and laboratory data and prognostic risk scores were used as predictors of mortality. A total of 145 adult patients with a mean age of 41.9 years were studied. Thirty-five patients (24.1%) died during the hospital course. Among the prognostic risk models, the Acute Physiology and Chronic Health Evaluation III system exhibited the strongest discriminative power and the AKI staging system also predicted mortality well (areas under the receiver operating characteristic curve: 0.889 vs. 0.835). Multivariate logistic regression analysis identified total burn surface area, ventilator use, AKI, and toxic epidermal necrolysis as independent risk factors for mortality. Our results revealed that AKI stage has considerable discriminative power for predicting mortality. Compared with other prognostic models, AKI stage is easier to use to assess outcome in patients with severe burn injury. Copyright © 2016. Published by Elsevier B.V.

  2. [Surgical therapy and critical care medicine in severely burned patients - Part 1: the first 24 ours].

    Science.gov (United States)

    Dembinski, Rolf; Kauczok, Jens; Deisz, Robert; Pallua, Norbert; Marx, Gernot

    2012-09-01

    Critical care medicine in severely burned patients should be adapted to the different pathophysiological phases. Accordingly, surgical and non-surgical therapy must be coordinated adequately. Initial wound care comprises topical treatment of less severely injured skin and surgical debridement of severely burned areas. The first 24 hours of intensive care are focused on calculated fluid delivery to provide stable hemodynamics and avoid progression of local edema formation. In the further course wound treatment with split-thickness skin grafts is the major aim of surgical therapy. Critical care is focused on the avoidance of complications like infections and ventilator associated lung injury. Therefore, lung-protective ventilation strategies, weaning and sedation protocols, and early enteral nutrition are important cornerstones of the treatment.

  3. 77 FR 70389 - Eligibility of Disabled Veterans and Members of the Armed Forces With Severe Burn Injuries for...

    Science.gov (United States)

    2012-11-26

    ... Severe Burn Injuries for Financial Assistance in the Purchase of an Automobile or Other Conveyance and... INFORMATION CONTACT: Nancy Copeland, Consultant, Regulations Staff (211D), Compensation Service, Veterans... adding ``severe burn injury (as determined pursuant to regulations prescribed by the Secretary)'' as...

  4. 77 FR 66419 - Eligibility of Disabled Veterans and Members of the Armed Forces With Severe Burn Injuries for...

    Science.gov (United States)

    2012-11-05

    ...'' as severe burn injuries. We believe that VA's definition of severe burn injury for purposes of... consistent with congressional intent. This definition generally reflects the purpose found at 38 U.S.C. 3901... affect in a material way the economy, a sector of the economy, productivity, competition, jobs,...

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

    Science.gov (United States)

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

    2015-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Rogers AD

    2016-06-01

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

  7. Absence of exertional hyperthermia in a 17-year-old boy with severe burns.

    Science.gov (United States)

    McEntire, Serina J; Lee, Jong O; Herndon, David N; Suman, Oscar E

    2009-01-01

    An important safety concern when exercising burned patients is the potential for an excessive increase in core body temperature (hyperthermia=body core temperature>39 degrees C) during exercise. We examined the thermoregulatory response to exercise in the heat (31 degrees C, relative humidity 40%) in a 17-year-old boy with a 99% TBSA burn. A 30-minute exercise test was performed at an intensity of 75% of his peak aerobic capacity. Intestinal temperature was assessed via telemetry with an ingestible capsule. Intestinal temperature was measured before, during, and postexercise. The patient completed 12 minutes of the 30-minute exercise test. Starting core temperature was 36.98 degrees C and increased 0.69 degrees C during exercise. After exercise, intestinal temperature continued to increase, but no hyperthermia was noted. It has been reported that burned children can safely exercise at room temperature; however, the response in the heat is unknown. This patient did not develop exertional hyperthermia, which we propose is due to his low-fitness level and heat intolerance. However, the potential for hyperthermia would be increased if he was forced to maintain a high relative workload in the heat. We propose that severely burned individuals should be able to safely participate in physical activities. However, the decision to stop exercising should be accepted to avoid development of exertional hyperthermia.

  8. Severe burns as a consequence of seizures in patients with epilepsy.

    Science.gov (United States)

    Spitz, M C

    1992-01-01

    We report 10 seizure-related thermal injuries severe enough to require hospitalization in patients with epilepsy. Eight of the ten incidents were with patients who had had seizures with impaired consciousness two or more times a month. This suggests that seizure frequency is a risk factor and implies the importance of striving for optimal seizure control. Two burns each occurred from an electric iron, a hand-held hair dryer, and stove-top cooking. Minimizing these activities, especially in patients with frequent consciousness-altering seizures, may be useful. Three burns occurred while showering; these resulted in the most severe injuries, with hospital stays of 29, 30, and 41 days. Simple plumbing devices may have prevented these injuries.

  9. A soil burn severity index for understanding soil-fire relations in tropical forests

    Science.gov (United States)

    Jain, T.B.; Gould, W.A.; Graham, R.T.; Pilliod, D.S.; Lentile, L.B.; Gonzalez, G.

    2008-01-01

    Methods for evaluating the impact of fires within tropical forests are needed as fires become more frequent and human populations and demands on forests increase. Short- and long-term fire effects on soils are determined by the prefire, fire, and postfire environments. We placed these components within a fire-disturbance continuum to guide our literature synthesis and develop an integrated soil burn severity index. The soil burn severity index provides a set of indicators that reflect the range of conditions present after a fire. The index consists of seven levels, an unburned level and six other levels that describe a range of postfire soil conditions. We view this index as a tool for understanding the effects of fires on the forest floor, with the realization that as new information is gained, the index may be modified as warranted. ?? Royal Swedish Academy of Sciences 2008.

  10. Oxandrolone Coadministration Does Not Alter Plasma Propranolol Concentrations in Severely Burned Pediatric Patients

    OpenAIRE

    Guillory, Ashley N.; Herndon, David N.; Silva, Michael B.; Andersen, Clark R; Suman, Oscar E.; Finnerty, Celeste C

    2017-01-01

    The systemic impact of severe burn injury results in a variety of disorders that require therapeutic intervention. Propranolol, a nonselective β1, β2-adrenergic receptor antagonist, reduces resting heart rate and cardiac work caused by elevated circulating catecholamines. Oxandrolone, a testosterone mimetic, promotes protein synthesis and anabolism to counter muscle wasting. Coadministration of these drugs is expected to synergistically improve patient outcomes. Testosterone administration is...

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

    Science.gov (United States)

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

    2016-01-01

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

  12. [Consequent use of the Aachen therapy concept after severe chemical burns of both eyes].

    Science.gov (United States)

    Herboth, T; Geerling, G; Duncker, G; Bastian, G O; Seiler, T

    1998-03-01

    Severe chemical burn and its complications still are a serious threat to the afflicted eye, particularly in case of insufficient treatment. Rehabilitation of visual acuity can be achieved only in the minority of cases. We present a 49-year-old female patient, who suffered a severe chemical burn in both eyes by alcaline detergent. Visual acuity was OD 20/50, OS light perception. After directly started acute treatment as well as peritomy, peridectomy, tenon plasty and application of a PMMA contact lens a stabilization was achieved. Complete rehabilitation of visual acuity was gained by EDTA abrasion, excimer treatment, penetrating keratoplasty and cataract surgery. Last examination showed a visual acuity of 25/20 in both eyes. Even in severe chemical burn an optimal result can be achieved by using an adequate treatment conception. Immediate beginning of therapy is important as well as persistent and persevering application of the treatment. Repeated, if necessary daily, excisions of necrotic tissue associated with tenon plasty and application of a PMMA contact lens have special importance.

  13. Prevalence and resistance of Pseudomonas aeruginosa in severely burned patients: a 10-year retrospective study.

    Science.gov (United States)

    Lipový, B; Rihová, H; Hanslianová, M; Gregorová, N; Suchánek, I; Brychta, P

    2010-01-01

    Infection complications caused by gram-negative bacteria nowadays constitute the dominant mortality cause in severely burned patients. Pseudomonas aeruginosa is the most feared nosocomial pathogen among burn centers worldwide, with the highest mortality. The study involved adult patients hospitalized at the Intensive Care Unit at the Department of Burns and Reconstructive Surgery, University Hospital Brno, between the years 2000 and 2009. These patients were hospitalized for thermal injuries. Retrospectively we have evaluated the extent of the burned areas, ages, depth of injury at admission and at discharge or in dissection (histology) and length of hospitalization on the Intensive Care Unit. By completing regular swabs we monitored and evaluated the microbiological situation not only at the burned areas but also in the lower respiratory system, in the urinary tract and in the blood stream. The study involved a total of 640 adults hospitalized at the Intensive Care Unit at the Department of Burns and Reconstructive Surgery, University Hospital Brno, for burn trauma between the years 2000 and 2009. The average extent of the burned area in patients was 36.2% TBSA (2-97% TBSA), average age was 36.7% years (18-92 years), average length of hospitalization at the Intensive Care Unit was 27.1 days (1-151 days). We isolated a total of 2,958 strains of Pseudomonas aeruginosa (including repeated isolation of pseudomonas strains in the same patients) in these patients. The most frequently found of these was Pseudomonas aeruginosa isolated from the burned area (1,301 strains), from the lower respiratory system (651) and from the urinary tract (592 strains). During the monitored period the number of strains isolated in our patients increased (146 strains in 2000, 521 strains in 2009). Furthermore, we noticed increased resistance to all available antibiotics except Polymyxins. All of the Pseudomonas aeruginosa strains in the monitored years maintained 100% sensitivity to

  14. Application of a Four-dimensional Mathematical Model in the Establishment of an Early Post-burn Cerebral Oedema Model in Severely Burned Dogs.

    Science.gov (United States)

    Haitao, L; Dajun, Y; Kaifa, W; Xiuwu, B; Jiansen, S; Zongchen, Y

    2005-06-30

    The aim of this study was to explore the spatiotemporal development of cerebral oedema in the early stage of severe burn (50% TBSA, third degree), using a four-dimensional (4D) mathematical model. Twenty-six male mongrel dogs were randomly divided into control and 6, 12, 18, and 24 post-burn hour (PBH) groups. The manifestation of magnetic resonance imaging (MRI) and histopathology, changes of brain water content, and intracranial pressure were observed in each group respectively. A 4D mathematical model was established on the basis of the results of MRI scanning. Two turning points (6 and 18 PBH) and three phases of pathological change were displayed by the 4D mathematical model of cerebral oedema in the early stage of severe burn. The first phase was in the subclinical period, and effective treatment should therefore be performed as quickly as possible in order to prevent deterioration of post-burn cerebral oedema. The second phase (6-18 PBH), with pathological characteristics of cytotoxic cerebral oedema, was in the apoptosis period. The third stage (18-24 PBH) was the danger period of cerebral oedema. Intracranial pressure increased rapidly owing to the limitation of the cranial cavity. As a result, cerebral hernia could easily occur. An S-shape curve in the pathological process of cerebral oedema occurred in the early post-burn stage following severe burn.

  15. Live sibling skin allografts for severe burns in a paediatric patient: A viable option in developing countries

    Directory of Open Access Journals (Sweden)

    Basil Leodoro

    2014-11-01

    Full Text Available Severe burns in the paediatric population are associated with high mortality and morbidity in any developing countries. Children with more than 40% total body surface area burns in Fiji will succumb from complications and as a direct result of inadequate treatment and lack of resources. The surgical treatment of any severely burnt patient is not only laborious but very costly to the Fiji health system and depletes existing resources with few options for skin coverage. This is the first case report of live sibling skin allograft for severe paediatric burns and one of only few patients to have survived more than 50% burns in Fiji. We describe the technique and the role of using live sibling skin allograft as an option to improve survival in patients with severe burns in a developing country.

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

    Science.gov (United States)

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

    2014-01-01

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

  17. Maggot therapy for repairing serious infective wound in a severely burned patient

    Directory of Open Access Journals (Sweden)

    WU Jun-cheng

    2012-04-01

    Full Text Available 【Abstract】The larvae of musca domestica were put in use to discard the dead tissue of a case of severe burn. A total of 50 000 aseptic maggots were put onto the infective wound surface, and aseptic dressings overlaid the surface. Three days later, another 20 000 maggots were put onto the wound for the second therapy. After twice maggot debridement, most necrotic muscle tissues of the wound were cleaned up, and eventually fresh granulation tissue grew and later the wound was covered and healed by 3 times of skin grafting. The result demonstrates that maggot therapy is safe and effective with no adverse complications except pain. Key words: Biological therapy; Wound infection; Burns; Wound healing; Debridement

  18. The effects of exercise programming vs traditional outpatient therapy in the rehabilitation of severely burned children.

    Science.gov (United States)

    Cucuzzo, N A; Ferrando, A; Herndon, D N

    2001-01-01

    The purpose of this study was to compare the efficacy and effects of exercise programming (Study group, n = 11) vs traditional outpatient therapy (Home group, n = 10) in burned children (> 40% body surface area). This was a prospective, randomized, controlled trial in a hospital-based children's wellness center. Twenty-one patients (13 boys and 8 girls) averaging 10.6 +/- 0.9 years and TBSA = 59.7 +/- 3.1% were evaluated 6 and 9 months postburn. Moderate intensity, progressive resistance and aerobic exercise conducted 3 times weekly for 1 hour were a supplement to standard therapy over 12 weeks. Muscular strength and functional outcome significantly increased in both groups (P exercise programming may be safely included in rehabilitation programs for severely burned children and can be effective in increasing muscular strength and functional outcome.

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

    Institute of Scientific and Technical Information of China (English)

    彭毅志

    2015-01-01

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

  20. Normalized burn ratios link fire severity with patterns of avian occurrence

    Science.gov (United States)

    Rose, Eli T.; Simons, Theodore R.; Klein, Rob; McKerrow, Alexa

    2016-01-01

    ContextRemotely sensed differenced normalized burn ratios (DNBR) provide an index of fire severity across the footprint of a fire. We asked whether this index was useful for explaining patterns of bird occurrence within fire adapted xeric pine-oak forests of the southern Appalachian Mountains.ObjectivesWe evaluated the use of DNBR indices for linking ecosystem process with patterns of bird occurrence. We compared field-based and remotely sensed fire severity indices and used each to develop occupancy models for six bird species to identify patterns of bird occurrence following fire.MethodsWe identified and sampled 228 points within fires that recently burned within Great Smoky Mountains National Park. We performed avian point counts and field-assessed fire severity at each bird census point. We also used Landsat™ imagery acquired before and after each fire to quantify fire severity using DNBR. We used non-parametric methods to quantify agreement between fire severity indices, and evaluated single season occupancy models incorporating fire severity summarized at different spatial scales.ResultsAgreement between field-derived and remotely sensed measures of fire severity was influenced by vegetation type. Although occurrence models using field-derived indices of fire severity outperformed those using DNBR, summarizing DNBR at multiple spatial scales provided additional insights into patterns of occurrence associated with different sized patches of high severity fire.ConclusionsDNBR is useful for linking the effects of fire severity to patterns of bird occurrence, and informing how high severity fire shapes patterns of bird species occurrence on the landscape.

  1. Calibrating Satellite-Based Indices of Burn Severity from UAV-Derived Metrics of a Burned Boreal Forest in NWT, Canada

    Directory of Open Access Journals (Sweden)

    Robert H. Fraser

    2017-03-01

    Full Text Available Wildfires are a dominant disturbance to boreal forests, and in North America, they typically cause widespread tree mortality. Forest fire burn severity is often measured at a plot scale using the Composite Burn Index (CBI, which was originally developed as a means of assigning severity levels to the Normalized Burn Ratio (NBR computed from Landsat satellite imagery. Our study investigated the potential to map biophysical indicators of burn severity (residual green vegetation and charred organic surface at very high (3 cm resolution, using color orthomosaics and vegetation height models derived from UAV-based photographic surveys and Structure from Motion methods. These indicators were scaled to 30 m resolution Landsat pixel footprints and compared to the post-burn NBR (post-NBR and differenced NBR (dNBR ratios computed from pre- and post-fire Landsat imagery. The post-NBR showed the strongest relationship to both the fraction of charred surface (exponential R2 = 0.79 and the fraction of green crown vegetation above 5 m (exponential R2 = 0.81, while the dNBR was more closely related to the total green vegetation fraction (exponential R2 = 0.69. Additionally, the UAV green fraction and Landsat indices could individually explain more than 50% of the variance in the overall CBI measured in 39 plots. These results provide a proof-of-concept for using low-cost UAV photogrammetric mapping to quantify key measures of boreal burn severity at landscape scales, which could be used to calibrate and assign a biophysical meaning to Landsat spectral indices for mapping severity at regional scales.

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

    Directory of Open Access Journals (Sweden)

    A. V. Solovieva

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    A. V. Solovieva

    2014-07-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2013-01-01

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

  5. Changes in burn scar contracture: utilization of a severity scale and predictor of return to duty for service members.

    Science.gov (United States)

    Niedzielski, Lt Stephanie; Chapman, Maj Ted

    2015-01-01

    A medical records review of Operation Iraqi Freedom and Operation Enduring Freedom burn injury survivors admitted to the U.S. Army Institute of Surgical Research Burn Center from April 2003 to August 2005 was conducted. The study proposed the use of a newly developed scale, the Burn Scar Contracture Severity Scale, to potentially provide standardization in quantifying burn scar contracture severity. Changes in the active range of motion from in-patient discharge to out-patient follow-up of individuals with upper extremity burn injuries were compared. Changes in the impairment via American Medical Association impairment scores and perceived disability using the disabilities of the arm, shoulder, and hand questionnaire scores from the in-patient discharge to the out-patient follow-up were also compared. A weak, yet positive correlation (r = .417, .451, P ≤ .001) between the proposed scale and the disabilities of the arm, shoulder, and hand questionnaire and the American Medical Association impairment scores was found, respectively. A receiver operating characteristic curve analysis revealed a cut-off score of 6.5 for the burn scar contracture severity scale, indicating that individuals scoring below a 6.5 returned to duty and those scoring above 6.5 did not return to duty. Results suggest that the burn scar contracture severity scale is able to discriminate between the individuals who returned to duty and those who did not return to duty.

  6. 重度烧伤病人的睡眠管理%Sleep management of severe burn patients

    Institute of Scientific and Technical Information of China (English)

    刘志宣

    2013-01-01

    Based on the observation and analysis of the factors of severe burn patients sleep effect, summed up the effective management method of sleep quality of severe burn patients. To improve the sleep quality of patients with severe burn, promote early recovery of patients with severe burn, and decrease the rate of disability, and even death, has a very important significance.%本文通过对重度烧伤病人睡眠影响因素的观察与分析,总结出对重度烧伤病人睡眠质量的有效管理方法。对提高重度烧伤病人的睡眠质量,促进重度重度烧伤病人早日康复,并降低其致残率,甚至死亡率,具有非常重要的意义。

  7. Bispectral index for monitoring anesthetic depth in patients with severe burns receiving target-controlled infusion of remifentanil and propofol.

    Science.gov (United States)

    Guo, Z G; Jia, X P; Wang, X Y; Li, P; Su, X J; Hao, J H

    2015-07-13

    This study evaluated the feasibility and effectiveness of using the bispectral index (BIS) to monitor anesthetic depth in patients with severe burns receiving intravenous target-controlled infusion (TCI) of remifentanil and propofol. We randomly assigned 80 patients undergoing elective escharectomy (depth in patients with severe burns receiving TCI of remifentanil and propofol during the perioperative period reduces propofol consumption and shortens the consciousness recovery time in patients.

  8. Application of a Four-dimensional Mathematical Model in the Establishment of an Early Post-burn Cerebral Oedema Model in Severely Burned Dogs

    OpenAIRE

    Haitao, L.; Dajun, Y.; Kaifa, W.; Xiuwu, B.; Jiansen, S.; Zongchen, Y.

    2005-01-01

    The aim of this study was to explore the spatiotemporal development of cerebral oedema in the early stage of severe burn (50% TBSA, third degree), using a four-dimensional (4D) mathematical model. Twenty-six male mongrel dogs were randomly divided into control and 6, 12, 18, and 24 post-burn hour (PBH) groups. The manifestation of magnetic resonance imaging (MRI) and histopathology, changes of brain water content, and intracranial pressure were observed in each group respectively. A 4D mathem...

  9. Increased expression of atrogenes and TWEAK family members after severe burn injury in nonburned human skeletal muscle.

    Science.gov (United States)

    Merritt, Edward K; Thalacker-Mercer, Anna; Cross, James M; Windham, Samuel T; Thomas, Steven J; Bamman, Marcas M

    2013-01-01

    Severe burn induces rapid skeletal muscle proteolysis after the injury, which persists for up to 1 year and results in skeletal muscle atrophy despite dietary and rehabilitative interventions. The purpose of this research was to determine acute changes in gene expression of skeletal muscle mass regulators postburn injury. Specimens were obtained for biopsy from the vastus lateralis of a nonburned leg of eight burned subjects (6M, 2F: 34.8 ± 2.7 years: 29.9 ± 3.1% TBSA burn) at 5.1 ± 1.1 days postburn injury and from matched controls. mRNA expression of cytokines and receptors in the tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) families, and the ubiquitin proteasome E3 ligases, atrogin-1 and MuRF-1, was determined. TNF receptor 1A was over 3.5-fold higher in burn. Expression of TNF-like weak inducer of apoptosis and its receptor were over 1.6 and 6.0-fold higher in burn. IL-6, IL-6 receptor, and glycoprotein 130 were elevated in burned subjects with IL-6 receptor over 13-fold higher. The level of suppressor of cytokine signaling-3 was also increased nearly 6-fold in burn. Atrogin-1 and MuRF-1 were more than 4- and 3-fold higher in burn. These results demonstrate for the first time that severe burn in humans has a remarkable impact on gene expression in skeletal muscle of a nonburned limb of genes that promote inflammation and proteolysis. Because these changes likely contribute to the acute skeletal muscle atrophy in areas not directly affected by the burn, in the future it will be important to determine the responsible systemic cues.

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

    Science.gov (United States)

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

    2010-05-01

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

  11. Simulating Local and Intercontinental Pollutant Effects of Biomass Burning: Integration of Several Remotely Sensed Datasets

    Science.gov (United States)

    Chatfield, Robert B.; Vastano, John A.; Guild, Liane; Hlavka, Christine; Brass, James A.; Russell, Philip B. (Technical Monitor)

    1994-01-01

    Burning to clear land for crops and to destroy pests is an integral and largely unavoidable part of tropical agriculture. It is easy to note but difficult to quantify using remote sensing. This report describes our efforts to integrate remotely sensed data into our computer model of tropical chemical trace-gas emissions, weather, and reaction chemistry (using the MM5 mesoscale model and our own Global-Regional Atmospheric Chemistry Simulator). The effects of burning over the continents of Africa and South America have been noticed in observations from several satellites. Smoke plumes hundreds of kilometers long may be seen individually, or may merge into a large smoke pall over thousands of kilometers of these continents. These features are related to intense pollution in the much more confined regions with heavy burning. These emissions also translocate nitrogen thousands of kilometers in the tropical ecosystems, with large fixed-nitrogen losses balanced partially by locally intense fertilization downwind, where nitric acid is rained out. At a much larger scale, various satellite measurements have indicated the escape of carbon monoxide and ozone into large filaments which extend across the Tropical and Southern Atlantic Ocean. Our work relates the source emissions, estimated in part from remote sensing, in part from conventional surface reports, to the concentrations of these gases over these intercontinental regions. We will mention work in progress to use meteorological satellite data (AVHRR, GOES, and Meteosat) to estimate the surface temperature and extent and height of clouds, and explain why these uses are so important in our computer simulations of global biogeochemistry. We will compare our simulations and interpretation of remote observations to the international cooperation involving Brazil, South Africa, and the USA in the TRACE-A (Transport and Atmospheric Chemistry near the Equator - Atlantic) and SAFARI (Southern Africa Fire Atmosphere Research

  12. LONG-TERM ASSESSMENT OF ECCENTRIC, ISOMETRIC, CONCENTRIC MUSCLE STRENGTH AND FUNCTIONAL CAPACITY AFTER SEVERELY BURNED ADULT

    Directory of Open Access Journals (Sweden)

    Anwar Abdelgayed Ebid

    2015-06-01

    Full Text Available Background: Severe burn leads to marked and prolonged skeletal muscle catabolism and weakness. Objective: The aim of this study was to investigate the long term effect of severe burn injury on eccentric, concentric, isometric muscle torque, average power, lean body mass, six minute walk and 8-foot walk. Design: Eccentric, isometric and concentric muscle torque and average power were assessed at 24 months in burned adult with 40%-50% total body surface area (TBSA at 150 o/s by using isokinetic dynamometry, Total lean body mass (TLBM and lower limb mass (LLM measurements were assessed for both groups using dual energy X-ray absorptiometry. Functional capacity was assessed using six minute walk test (6MWT and 8-Feet walk test. Lean body mass (LBM was determined via dual energy X-ray absorptiometry. Nonburned adult was assessed similarly, and served as controls. Results: severely burned adult (n=35, relative to nonburned adult (n=42 had significantly lower peak torque of eccentric, isometric, concentric muscle strength, average power and functional capacity. The most affected type of muscle strength after burn was concentric, isometric then eccentric. Conclusions: Our results serve as an objective data for assessing the three modes of muscle strength and functional capacity in severely burned adult population.

  13. Effects of glycyl-glutamine dipeptide supplementation on myocardial damage and cardiac function in rats after severe burn injury.

    Science.gov (United States)

    Zhang, Yong; Yan, Hong; Lv, Shang-Gun; Wang, Lin; Liang, Guang-Ping; Wan, Qian-Xue; Peng, Xi

    2013-01-01

    Glutamine decreases myocardial damage in ischemia/reperfusion injury. However, the cardioprotective effect of glutamine after burn injury remains unclear. Present study was to explore the protective effect of glycyl-glutamine dipeptide on myocardial damage in severe burn rats. Seventy-two Wistar rats were randomly divided into three groups: normal control (C), burned control (B) and glycyl-glutamine dipeptide-treated (GG) groups. B and GG groups were inflicted with 30% total body surface area of full thickness burn. The GG group was given 1.5 g/kg glycyl-glutamine dipeptide per day and the B group was given the same dose of alanine via intraperitoneal injection for 3 days. The serum CK, LDH, AST, and, blood lactic acid levels, as well as the myocardium ATP and GSH contents, were measured. The indices of cardiac contractile function and histopathological change were analyzed at 12, 24, 48, and 72 post-burn hours (PBH). The serum CK, LDH, AST and blood lactic acid levels increased, and the myocardium ATP and GSH content decreased in both burned groups. Compared with B group, the CK, LDH, AST and blood lactic acid levels reduced, myocardium ATP and GSH content increased in GG group. Moreover, the inhibition of cardiac contractile function and myocardial histopathological damage were reduced significantly in GG group. We conclude that myocardial histological structure and function were damaged significantly after burn injury, glycyl-glutamine dipeptide supplementation is beneficial to myocardial preservation by improving cardiocyte energy metabolism, increasing ATP and glutathione synthesis.

  14. Characterizing demographics, injury severity, and intubation status for patients transported by air or ground ambulance to a rural burn center.

    Science.gov (United States)

    Ahmed, Azeemuddin; Van Heukelom, Paul; Harland, Karisa; Denning, Gerene; Liao, Junlin; Born, Janelle; Latenser, Barbara

    2014-01-01

    Our study was designed to characterize intubation status among patients transported by air or ground ambulance to a rural burn center. A retrospective chart review of patients arriving at our burn center from January 1, 2005 to December 31, 2009 was completed. Descriptive and multivariate analyses were performed. During the study period, 259 air and 590 ground ambulance patients met inclusion criteria. Air ambulance patients were older and had higher total body surface area burned, lower Glasgow Coma scores, longer lengths of stay, and more frequent inhalation injuries. Approximately 10% of patients arriving by air were intubated after burn center admission, and 49% of intubated patients were extubated within 24 hours of admission. These values were 2% and 40%, respectively, for patients transported by ground. Increasing age and air ambulance transport increased the overall likelihood of change in intubation status. The likelihood of intubation by burn center providers increased with age, with suspicion of inhalation injury, and for patients transported by air. The likelihood of extubation within 24 hours of burn center admission increased with age, decreased with suspected inhalation injury, and was independent of transport mode. Among our patient population, more severely injured patients were being transported by air ambulance. However, age, suspicion of inhalation injury, and mode of transport showed a complex pattern of associations with changes in intubation status, and illustrate the need to develop better prehospital guidelines for intubation in burn patients.

  15. Oxandrolone induced lean mass gain during recovery from severe burns is maintained after discontinuation of the anabolic steroid.

    Science.gov (United States)

    Demling, Robert H; DeSanti, Leslie

    2003-12-01

    Weight loss and lean mass loss from burn induced catabolism can be more rapidly restored when the anabolic steroid oxandrolone is added to optimum nutrition compared to nutrition alone. Our purpose in this study was to determine whether the regained lean body mass (LBM) is retained 6 months after stopping oxandrolone. Forty-five severe burn patients, entering the recovery phase were randomized into a nutrition group alone or with the addition of oxandrolone, 20mg per day upon admission to the acute burn rehabilitation (RH) unit. Oxandrolone was discontinued after at least 80% of the involuntary weight loss occurring in the acute burn period, was restored. Body composition was measured using bioelectric impedence analysis (BIA). We found that patients receiving oxandrolone, in the rehabilitation unit, regained weight and lean mass two to three times faster than with nutrition alone. The difference was statistically significant (Ppatients were discharged from RH on a nutrition and exercise program and monitored in the outpatient burn center. After 6 months, body weight and body composition were again measured. We found that the body weight and lean mass which was restored during RH, was maintained 6 months after discontinuation of oxandrolone. Lost lean mass was not yet restored in the nutrition alone group. We can conclude that body weight and lean mass which is lost, due to burn induced catabolism, can be effectively restored in the post-burn recovery period with oxandrolone. The body weight and lost lean mass which is regained, is maintained 6 months after stopping the drug.

  16. [Standardisation of the Initial Treatment of Severely Burned Patients: The Necessary Transfer of Concepts from Trauma Care].

    Science.gov (United States)

    Münzberg, M; Harbers, T; Kneser, U; Grützner, P A; Reichert, B; Kremer, T; Wölfl, C G; Horter, J; Hirche, C

    2016-12-01

    The initial treatment of severely burned patients remains a huge challenge for first responders in emergency services as well as emergency doctors who do not work in a centre for severe burn injuries. The reason for this is the low number of cases in developed countries and a lack of training concepts for the specific aspects of the initial treatment of severe burn injuries. Because of guidelines with limited evidence (S1, S2k) and a lack of structured treatment approaches, uncertainties with respect to initial treatment are still visible. Even within the professional societies and on international comparison, controversial aspects remain. In contrast, optimised and standardised procedures are available for the treatment of severely injured (trauma) patients, based on PHTLS® (Pre Hospital Trauma Life Support) for preclinical and ATLS® (Advanced Trauma Life Support) for in-hospital first aid. This article takes stock of the current structure of care and the relevant evidence for the initial treatment of severe burns. Also it discusses a possible transfer and further development of concepts for primary trauma care by all disciplines involved. Nine essential steps in the primary care of burned patients are identified and evaluated. The need for the introduction of a uniform treatment algorithm is illustrated. The treatment algorithm presented in this article addresses all first responders who are faced with initial treatment in the first 24 hours outside of burn centres. As an essential, new aspect, it offers a transfer and adaptation of concepts from trauma care to standardise the care of severely burned patients.

  17. Maggot therapy for repairing serious infective wound in a severely burned patient

    Institute of Scientific and Technical Information of China (English)

    WU Jun-cheng; LU Ren-rong; HUO Ran; FU Hong-bin

    2012-01-01

    The larvae of musca domestica were put in use to discard the dead tissue of a case of severe burn.A total of 50 000 aseptic maggots were put onto the infective wound surface,and aseptic dressings overlaid the surface.Three days later,another 20 000 maggots were put onto the wound for the second therapy.After twice maggot debridement,most necrotic muscle tissues of the wound were cleaned up,and eventually fresh granulation tissue grew and later the wound was covered and healed by 3 times of skin grafting.The result demonstrates that maggot therapy is safe and effective with no adverse complications except pain.

  18. Severe Burns and Amputation of Both Arms in the First Psychotic Episode of a Schizophrenic Patient

    Directory of Open Access Journals (Sweden)

    Lizardo Cruzado

    2015-01-01

    Full Text Available An alleged reduction of sensitivity to pain in people with schizophrenia has been reported, but the nature of this complex phenomenon has not been elucidated yet. Reports of insensitivity to burns from people with schizophrenia are extremely rare. We report the case of a 24-year-old man who set both of his arms on fire during the first break of paranoid schizophrenia. As a result of severe tissue damage, both of his limbs had to be amputated. Today, at the age of 59, the patient is physically and mentally rehabilitated and is adherent to treatment. Additionally, given the uncertainty about the true nature of the alleged hypoalgesia in schizophrenia, we postulate the need for a comprehensive phenomenological approach in the study of embodiment in people with this condition.

  19. Upper gastrointestinal bleeding in severely burned patients: a case-control study to assess risk factors, causes, and outcome.

    Science.gov (United States)

    Kim, Young Jin; Koh, Dong Hee; Park, Se Woo; Park, Sun Man; Choi, Min Ho; Jang, Hyun Joo; Kae, Sea Hyub; Lee, Jin; Byun, Hyun Woo

    2014-01-01

    To determine the risk factors, causes, and outcome of clinically important upper gastrointestinal bleeding that occurs in severely burned patients. The charts of all patients admitted to the burn intensive care unit were analyzed retrospectively over a 4-year period (from January 2006 to December 2009). Cases consisted of burned patients who developed upper gastrointestinal bleeding more than 24 hours after admission to the burn intensive care unit. Controls were a set of patients, in the burn intensive care unit, without upper gastrointestinal bleeding matched with cases for age and gender. Cases and controls were compared with respect to the risk factors of upper gastrointestinal bleeding and outcomes. During the study period, clinically important upper gastrointestinal bleeding occurred in 20 patients out of all 964 patients. The most common cause of upper gastrointestinal bleeding was duodenal ulcer (11 of 20 cases, 55%). In the multivariate analysis, mechanical ventilation (p = 0.044) and coagulopathy (p = 0.035) were found to be the independent predictors of upper gastrointestinal bleeding in severely burned patients. Upper gastrointestinal hemorrhage tends to occur more frequently after having prolonged mechanical ventilation and coagulopathy.

  20. Plasma proteome response to severe burn injury revealed by 18O-labeled "universal" reference-based quantitative proteomics.

    Science.gov (United States)

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

    2010-09-01

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

  1. Computerized Decision Support System Improves Fluid Resuscitation Outcomes Following Severe Burns: An Original Study

    Science.gov (United States)

    2011-01-01

    stantial plasma volume deficit during the initial 48 hrs post burn, which engenders hypovolemic shock and generalized edema formation (4). These include a...3). Burn manage- ment requires specialized expertise and treatment options that may not normally be available at nonburn centers. In addi- tion...principal fluid shift into the surrounding interstitial space (i.e., third-spacing) that has to be treated to avoid burn shock conditions (5–6). *See

  2. Multispectral imaging burn wound tissue classification system: a comparison of test accuracies between several common machine learning algorithms

    Science.gov (United States)

    Squiers, John J.; Li, Weizhi; King, Darlene R.; Mo, Weirong; Zhang, Xu; Lu, Yang; Sellke, Eric W.; Fan, Wensheng; DiMaio, J. Michael; Thatcher, Jeffrey E.

    2016-03-01

    The clinical judgment of expert burn surgeons is currently the standard on which diagnostic and therapeutic decisionmaking regarding burn injuries is based. Multispectral imaging (MSI) has the potential to increase the accuracy of burn depth assessment and the intraoperative identification of viable wound bed during surgical debridement of burn injuries. A highly accurate classification model must be developed using machine-learning techniques in order to translate MSI data into clinically-relevant information. An animal burn model was developed to build an MSI training database and to study the burn tissue classification ability of several models trained via common machine-learning algorithms. The algorithms tested, from least to most complex, were: K-nearest neighbors (KNN), decision tree (DT), linear discriminant analysis (LDA), weighted linear discriminant analysis (W-LDA), quadratic discriminant analysis (QDA), ensemble linear discriminant analysis (EN-LDA), ensemble K-nearest neighbors (EN-KNN), and ensemble decision tree (EN-DT). After the ground-truth database of six tissue types (healthy skin, wound bed, blood, hyperemia, partial injury, full injury) was generated by histopathological analysis, we used 10-fold cross validation to compare the algorithms' performances based on their accuracies in classifying data against the ground truth, and each algorithm was tested 100 times. The mean test accuracy of the algorithms were KNN 68.3%, DT 61.5%, LDA 70.5%, W-LDA 68.1%, QDA 68.9%, EN-LDA 56.8%, EN-KNN 49.7%, and EN-DT 36.5%. LDA had the highest test accuracy, reflecting the bias-variance tradeoff over the range of complexities inherent to the algorithms tested. Several algorithms were able to match the current standard in burn tissue classification, the clinical judgment of expert burn surgeons. These results will guide further development of an MSI burn tissue classification system. Given that there are few surgeons and facilities specializing in burn care

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

    Science.gov (United States)

    Deng, Hu-Ping; Chai, Jia-Ke

    2009-10-01

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

  4. Role of Central American biomass burning smoke in increasing tornado severity in the US

    Science.gov (United States)

    Saide, P. E.; Spak, S.; Pierce, R.; Otkin, J.; Rabin, R.; Schaack, T.; Heidinger, A. K.; da Silva, A.; Kacenelenbogen, M. S.; Redemann, J.; Carmichael, G. R.

    2013-12-01

    Violent tornadoes in the Southeast and Central US during spring are often accompanied by smoke from biomass burning in Central America. We analyzed the effect of smoke on a historic severe weather outbreak that occurred 27 April 2011 using a coupled aerosol, chemistry and weather model (WRF-Chem) and a suite of satellite and ground-based observations. Smoke from Central American biomass burning was present in the boundary layer and lower free troposphere before and during the storm outbreak. Simulations show that adding smoke to the environment already conducive to severe thunderstorm development increases the likelihood of significant tornado occurrence, which is assessed by analyzing effects of smoke on meteorological conditions (tornado parameters) used by prediction centers to forecast tornado occurrence and severity. Smoke effects generate slightly lower rain rates and cloud top heights, indicating no evidence of storm invigoration for these storms and instead pointing towards convection inhibition. Further analysis shows that there are two mechanisms responsible for the parameter intensification: First, through indirect effects, stratiform clouds present during and before the outbreak became optically thicker, which reduced the amount of solar radiation reaching the ground and produced more stable conditions and higher low-level shear in the mixed layer. Second, through semi-direct effects, soot contained in the smoke heated the aerosol layer stabilizing the atmosphere and enhancing cloud cover below the aerosol layer, producing a more stable boundary layer and conditions leading to higher probability of violent tornadoes. The inclusion of aerosol-cloud-radiation interactions in weather forecasts may help improve the predictability of these extreme events, which can improve the timeliness and accuracy of severe weather alerts within future operational forecast systems. Left panel: Back trajectories from the beginning of violent tornado tracks, with circles

  5. Using High Spatial Resolution Satellite Imagery to Map Forest Burn Severity Across Spatial Scales in a Pine Barrens Ecosystem

    Science.gov (United States)

    Meng, Ran; Wu, Jin; Schwager, Kathy L.; Zhao, Feng; Dennison, Philip E.; Cook, Bruce D.; Brewster, Kristen; Green, Timothy M.; Serbin, Shawn P.

    2017-01-01

    As a primary disturbance agent, fire significantly influences local processes and services of forest ecosystems. Although a variety of remote sensing based approaches have been developed and applied to Landsat mission imagery to infer burn severity at 30 m spatial resolution, forest burn severity have still been seldom assessed at fine spatial scales (less than or equal to 5 m) from very-high-resolution (VHR) data. We assessed a 432 ha forest fire that occurred in April 2012 on Long Island, New York, within the Pine Barrens region, a unique but imperiled fire-dependent ecosystem in the northeastern United States. The mapping of forest burn severity was explored here at fine spatial scales, for the first time using remotely sensed spectral indices and a set of Multiple Endmember Spectral Mixture Analysis (MESMA) fraction images from bi-temporal - pre- and post-fire event - WorldView-2 (WV-2) imagery at 2 m spatial resolution. We first evaluated our approach using 1 m by 1 m validation points at the sub-crown scale per severity class (i.e. unburned, low, moderate, and high severity) from the post-fire 0.10 m color aerial ortho-photos; then, we validated the burn severity mapping of geo-referenced dominant tree crowns (crown scale) and 15 m by 15 m fixed-area plots (inter-crown scale) with the post-fire 0.10 m aerial ortho-photos and measured crown information of twenty forest inventory plots. Our approach can accurately assess forest burn severity at the sub-crown (overall accuracy is 84% with a Kappa value of 0.77), crown (overall accuracy is 82% with a Kappa value of 0.76), and inter-crown scales (89% of the variation in estimated burn severity ratings (i.e. Geo-Composite Burn Index (CBI)). This work highlights that forest burn severity mapping from VHR data can capture heterogeneous fire patterns at fine spatial scales over the large spatial extents. This is important since most ecological processes associated with fire effects vary at the less than 30 m scale and

  6. Analysis of Climate and Topographic Controls on Burn Severity in the Western United States (1984-2005)

    Science.gov (United States)

    Holden, Z. A.; Crimmins, M.; Luce, C.; Heyerdahl, E. K.; Morgan, P.

    2008-12-01

    Fire activity in the western US is likely to increase with climate warming. However, relationships between climate and the magnitude of vegetation change (severity) associated with recent fires have not been quantified. The magnitude of change associated with fires is a critical component of understanding fire- induced emissions carbon loss and ecosystem change. We present statistical analyses of 22-year climate- burn severity relationships for more than 1200 major wildfires in the Pacific Northwest region of the western U.S. Using stream gage, soil moisture, temperature, precipitation data and North American Regional Reanalysis data, we examine the relative influences of climate (precipitation and temperature) and fire weather (wind, relative humidity) on burn severity of individual fires, and regional analyses of area burned severely. Our results show statistically significant relationships between temperature, precipitation and the proportion of each fire classified as high-severity. Using Fragstats metrics for each fire, we show increasingly large patch sizes and homogenous patch distributions associated with warmer, drier conditions. Using topographic variables and the random forest machine learning algorithm, we analyze the occurrence of severely burned areas relative to 12 topographic variables. Classification accuracy results are high (greater than 70 percent) suggesting that there is some predictability in where fires are likely to occur.

  7. Long-term skeletal muscle mitochondrial dysfunction is associated with hypermetabolism in severely burned children

    Science.gov (United States)

    The long-term impact of burn trauma on skeletal muscle bioenergetics remains unknown. Here, we determined respiratory capacity and function of skeletal muscle mitochondria in healthy individuals and in burn victims for up to two years post-injury. Biopsies were collected from the m. vastus lateralis...

  8. Missense Variant in MAPK Inactivator PTPN5 Is Associated with Decreased Severity of Post-Burn Hypertrophic Scarring.

    Directory of Open Access Journals (Sweden)

    Ravi F Sood

    Full Text Available Hypertrophic scarring (HTS is hypothesized to have a genetic mechanism, yet its genetic determinants are largely unknown. The mitogen-activated protein kinase (MAPK pathways are important mediators of inflammatory signaling, and experimental evidence implicates MAPKs in HTS formation. We hypothesized that single-nucleotide polymorphisms (SNPs in MAPK-pathway genes would be associated with severity of post-burn HTS.We analyzed data from a prospective-cohort genome-wide association study of post-burn HTS. We included subjects with deep-partial-thickness burns admitted to our center who provided blood for genotyping and had at least one Vancouver Scar Scale (VSS assessment. After adjusting for HTS risk factors and population stratification, we tested MAPK-pathway gene SNPs for association with the four VSS variables in a joint regression model. In addition to individual-SNP analysis, we performed gene-based association testing.Our study population consisted of 538 adults (median age 40 years who were predominantly White (76% males (71% admitted to our center from 2007-2014 with small-to-moderate-sized burns (median burn size 6% total body surface area. Of 2,146 SNPs tested, a rare missense variant in the PTPN5 gene (rs56234898; minor allele frequency 1.5% was significantly associated with decreased severity of post-burn HTS (P = 1.3×10-6. In gene-based analysis, PTPN5 (P = 1.2×10-5 showed a significant association and BDNF (P = 9.5×10-4 a borderline-significant association with HTS severity.We report PTPN5 as a novel genetic locus associated with HTS severity. PTPN5 is a MAPK inhibitor expressed in neurons, suggesting a potential role for neurotrophic factors and neuroinflammatory signaling in HTS pathophysiology.

  9. Missense Variant in MAPK Inactivator PTPN5 Is Associated with Decreased Severity of Post-Burn Hypertrophic Scarring.

    Science.gov (United States)

    Sood, Ravi F; Arbabi, Saman; Honari, Shari; Gibran, Nicole S

    2016-01-01

    Hypertrophic scarring (HTS) is hypothesized to have a genetic mechanism, yet its genetic determinants are largely unknown. The mitogen-activated protein kinase (MAPK) pathways are important mediators of inflammatory signaling, and experimental evidence implicates MAPKs in HTS formation. We hypothesized that single-nucleotide polymorphisms (SNPs) in MAPK-pathway genes would be associated with severity of post-burn HTS. We analyzed data from a prospective-cohort genome-wide association study of post-burn HTS. We included subjects with deep-partial-thickness burns admitted to our center who provided blood for genotyping and had at least one Vancouver Scar Scale (VSS) assessment. After adjusting for HTS risk factors and population stratification, we tested MAPK-pathway gene SNPs for association with the four VSS variables in a joint regression model. In addition to individual-SNP analysis, we performed gene-based association testing. Our study population consisted of 538 adults (median age 40 years) who were predominantly White (76%) males (71%) admitted to our center from 2007-2014 with small-to-moderate-sized burns (median burn size 6% total body surface area). Of 2,146 SNPs tested, a rare missense variant in the PTPN5 gene (rs56234898; minor allele frequency 1.5%) was significantly associated with decreased severity of post-burn HTS (P = 1.3×10-6). In gene-based analysis, PTPN5 (P = 1.2×10-5) showed a significant association and BDNF (P = 9.5×10-4) a borderline-significant association with HTS severity. We report PTPN5 as a novel genetic locus associated with HTS severity. PTPN5 is a MAPK inhibitor expressed in neurons, suggesting a potential role for neurotrophic factors and neuroinflammatory signaling in HTS pathophysiology.

  10. TNF-α/IL-10 ratio correlates with burn severity and may serve as a risk predictor of increased susceptibility to infections

    Directory of Open Access Journals (Sweden)

    Amy Tsurumi

    2016-10-01

    Full Text Available Severe burn injury renders patients susceptible to multiple infection episodes, however identifying specific patient groups at high risk remains challenging. Burn-induced inflammatory response dramatically modifies the levels of various cytokines. Whether these changes could predict susceptibility to infections remains unknown. The aim of this study was to determine the early changes in the pro- to anti-inflammatory cytokine ratio and investigate its ability to predict susceptibility to repeated infections after severe burn trauma. The patient population consisted of 34 adult patients having early (≤48 hours since injury blood draws following severe (≥20% total burn surface area (TBSA burn injury, and suffering from a first infection episode at least one day after blood collection. Plasma TNF-α and IL-10 levels were measured to explore the association between the TNF-α/IL-10 ratio, hypersusceptibility to infections, burn size (TBSA, and common severity scores (Acute Physiology and Chronic Health Evaluation (APACHEII, Baux, modified Baux (R-Baux, Ryan Score, Abbreviated Burn Severity Index (ABSI. TNF-α/IL10 plasma ratio measured shortly after burn trauma was inversely correlated with burn size and the injury severity scores investigated, and was predictive of repeated infections (≥3 infection episodes outcome (AUROC [95%CI] of 0.80 [0.63–0.93]. Early measures of circulating TNF-α/IL10 ratio may be a previously unidentified biomarker associated with burn injury severity and predictive of the risk of hypersusceptibility to repeated infections.

  11. Cost of nursing most frequent procedures performed on severely burned patients

    Directory of Open Access Journals (Sweden)

    Talita de Oliveira Melo

    Full Text Available ABSTRACT Objective: to identify the mean direct cost (MDC of the most frequent procedures performed by nursing professionals on severely burned patients in an Intensive Care Unit. Method: exploratory-descriptive quantitative single-case study. The MDC was calculated by multiplying time (timed spent by nursing professionals in the performance of the procedures by the unit cost of direct labor, and adding the costs of material and medicine/solutions. Results: a MDC of US$ 0.65 (SD=0.36 was obtained for "vital signs monitoring"; US$ 10.00 (SD=24.23 for "intravenous drug administration"; US$ 5.90 (SD=2.75 for "measurement of diuresis"; US$ 0.93 (SD=0.42 for "capillary blood glucose monitoring"; and US$ 99.75 (SD=129.55 for "bandaging". Conclusion: the knowledge developed can support managerial decision-making, contribute to the efficiency distribution of the resources involved and, when possible, provide cost-containment or cost-minimization strategies without impairing the quality of nursing care.

  12. Nutritional and Pharmacological Modulation of the Metabolic Response of Severely Burned Patients: Review of the Literature (Part II)*.

    Science.gov (United States)

    Atiyeh, B S; Gunn, S W A; Dibo, S A

    2008-09-30

    Severe burn patients are some of the most challenging critically ill patients, with an extreme state of physiological stress and an overwhelming systemic metabolic response. Increased energy expenditure to cope with this insult necessitates mobilization of large amounts of substrate from fat stores and active muscle for repair and fuel, leading to catabolism. The hypermetabolic response can last for as long as nine months to one year after injury and is associated with impaired wound healing, increased infection risks, erosion of lean body mass, hampered rehabilitation, and delayed reintegration of burn survivors into society. Reversal of the hypermetabolic response by manipulating the patient's physiological and biochemical environment through the administration of specific nutrients, growth factors, or other agents, often in pharmacological doses, is emerging as an essential component of the state of the art in severe burn management. Early enteral nutritional support, control of hyperglycaemia, blockade of catecholamine response, and use of anabolic steroids have all been proposed to attenuate hypermetabolism or to blunt catabolism associated with severe burn injury. The present study is a literature review of the proposed nutritional and metabolic therapeutic measures in order to determine evidence-based best practice. Unfortunately, the present state of our knowledge does not allow the formulation of clear-cut guidelines. Only general trends can be outlined which will certainly have some practical applications but above all will dictate future research in the field.

  13. Nutritional and pharmacological modulation of the metabolic response of severely burned patients: review of the literature (part 1).

    Science.gov (United States)

    Atiyeh, B S; Gunn, S W A; Dibo, S A

    2008-06-30

    Severe burn patients are some of the most challenging critically ill patients, with an extreme state of physiological stress and an overwhelming systemic metabolic response. Increased energy expenditure to cope with this insult necessitates mobilization of large amounts of substrate from fat stores and active muscle for repair and fuel, leading to catabolism. The hypermetabolic response can last for as long as nine months to one year after injury and is associated with impaired wound healing, increased infection risks, erosion of lean body mass, hampered rehabilitation, and delayed reintegration of burn survivors into society. Reversal of the hypermetabolic response by manipulating the patient's physiological and biochemical environment through the administration of specific nutrients, growth factors, or other agents, often in pharmacological doses, is emerging as an essential component of the state of the art in severe burn management. Early enteral nutritional support, control of hyperglycaemia, blockade of catecholamine response, and use of anabolic steroids have all been proposed to attenuate hypermetabolism or to blunt catabolism associated with severe burn injury. The present study is a literature review of the proposed nutritional and metabolic therapeutic measures in order to determine evidence-based best practice. Unfortunately, the present state of our knowledge does not allow the formulation of clear-cut guidelines. Only general trends can be outlined which will certainly have some practical applications but above all will dictate future research in the field.

  14. Nutritional and Pharmacological Modulation of the Metabolic Response of Severely Burned Patients: Review of the Literature (Part III)*.

    Science.gov (United States)

    Atiyeh, B S; Gunn, S W A; Dibo, S A

    2008-12-31

    Severe burn patients are some of the most challenging critically ill patients, with an extreme state of physiological stress and an overwhelming systemic metabolic response. Increased energy expenditure to cope with this insult necessitates mobilization of large amounts of substrate from fat stores and active muscle for repair and fuel, leading to catabolism. The hypermetabolic response can last for as long as nine months to one year after injury and is associated with impaired wound healing, increased infection risks, erosion of lean body mass, hampered rehabilitation, and delayed reintegration of burn survivors into society.Reversal of the hypermetabolic response by manipulating the patient's physiological and biochemical environment through the administration of specific nutrients, growth factors, or other agents, often in pharmacological doses, is emerging as an essential component of the state of the art in severe burn management. Early enteral nutritional support, control of hyperglycaemia, blockade of catecholamine response, and use of anabolic steroids have all been proposed to attenuate hypermetabolism or to blunt catabolism associated with severe burn injury. The present study is a literature review of the proposed nutritional and metabolic therapeutic measures in order to determine evidence-based best practice. Unfortunately, the present state of our knowledge does not allow the formulation of clear-cut guidelines. Only general trends can be outlined which will certainly have some practical applications but above all will dictate future research in the field.

  15. 重度烧伤22例临床分析%Clinical Analysis of 22 Patients with Severe Burn

    Institute of Scientific and Technical Information of China (English)

    杨宏伟

    2013-01-01

    目的:总结重度烧伤及特重度烧伤的救治经验,寻找存在的问题,为进一步实施救治提供依据.方法:对通辽市科尔沁区第一人民医院自2010年10月-2012年10月收治的22例重度及特重度烧伤患者的临床资料进行回顾性分析.结果:22例中除2例死于多器官衰竭外,其余均治愈,治愈率90.90%.结论:如何减少或避免烧伤早期损害及并发症的防治仍是烧伤救治的关键.%Objective:To provide a basis for clinical treatment through summarizing the experience in treatment of se-vere burn and extraordinarily severe burn patients, finding out the existing problems. Methods: The general clinical data of 22 patients with severe burn and extraordinarily severe burn who were treated in the First People’s Hospital of Korqin District from October 2010 to October 2012 were retrospectively analyzed. Results: In 22 cases, 2 died of multi-organ failure, the others were cured, the cure rate was 90.90%. Conclusion:How to reduce or avoid early dam-age, prevent complications is the key to treat burn.

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

    Directory of Open Access Journals (Sweden)

    Mohammad Javad Fatemi

    2013-01-01

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

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

    Science.gov (United States)

    Fatemi, Mohammad Javad; Salehi, Hamid; Akbari, Hossein; Alinejad, Faranak; Saberi, Mohsen; Mousavi, Seyed Jaber; Soltani, Majid; Taghavi, Shahrzad; Payandan, Hossein

    2013-01-01

    Background: Burn injuries are one of the main causes of mortality and morbidity throughout the world and burn patients have higher chances for infection due to their decreased immune resistance. Levamisole, as an immunomodulation agent, stimulates the immune response against infection. Materials and Methods: This randomized clinical trial was conducted in Motahari Burn Center, Tehran, Iran. Patients who had second- or third-degree burn with involvement of more than 50% of total body surface area (TBSA) were studied. The levamisole group received levamisole tablet, 100 mg per day. Meantime, both the levamisole and control groups received the standard therapy of the Burn Center, based on a standard protocol. Then, the outcome of the patients was evaluated. Results: 237 patients entered the study. After excluding 42 patients with inhalation injury, electrical and chemical burns, and the patients who died in the first 72 h, 195 patients remained in the study, including 110 patients in the control group and 85 in the treatment group. The mean age of all patients (between 13 to 64 years) was 33.29 ± 11.39 years (Mean ± SD), and it was 33.86 ± 11.45 years in the control group and 32.57 ± 11.32 years in the treatment group. The mean percentage of TBSA burn was 64.50 ± 14.34 and 68.58 ± 14.55 for the levamisole and control groups, respectively, with the range of 50-100% and 50-95% TBSA. The mortality rate was 68 (61.8%) patients in the control group and 50 (58.8%) patients in the treatment group (P = 0.8). Conclusion: According to this study, there was no significant relationship between improvement of mortality and levamisole consumption. PMID:24381625

  18. Predictive Value of IL-8 for Sepsis and Severe Infections After Burn Injury: A Clinical Study.

    Science.gov (United States)

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

    2015-03-01

    The inflammatory response induced by burn injury contributes to increased incidence of infections, sepsis, organ failure, and mortality. Thus, monitoring postburn inflammation is of paramount importance but, so far, there are no reliable biomarkers available to monitor and/or predict infectious complications after burn. As interleukin 8 (IL-8) is a major mediator for inflammatory responses, the aim of our study was to determine whether IL-8 expression can be used to predict postburn sepsis, infections, and mortality. Plasma cytokines, acute-phase proteins, constitutive proteins, and hormones were analyzed during the first 60 days after injury from 468 pediatric burn patients. Demographics and clinical outcome variables (length of stay, infection, sepsis, multiorgan failure [MOF], and mortality) were recorded. A cutoff level for IL-8 was determined using receiver operating characteristic analysis. Statistical significance is set at P Patients were grouped according to their average IL-8 levels relative to this cutoff and stratified into high (H) (n = 133) and low (L) (n = 335) groups. In the L group, regression analysis revealed a significant predictive value of IL-8 to percent of total body surface area burned and incidence of MOF (P inflammatory and acute-phase responses compared with the L group (P burn patients.

  19. Surgical treatment and management of the severely burn patient: Review and update.

    Science.gov (United States)

    Gacto-Sanchez, P

    Since one of the main challenges in treating acute burn injuries is preventing infection, early excising of the eschar and covering of the wound becomes critical. Non-viable tissue is removed by initial aggressive surgical debridement. Many surgical options for covering the wound bed have been described, although split-thickness skin grafts remain the standard for the rapid and permanent closure of full-thickness burns. Significant advances made in the past decades have greatly improved burns patient care, as such that major future improvements in survival rates seem to be more difficult. Research into stem cells, grafting, biomarkers, inflammation control, and rehabilitation will continue to improve individualized care and create new treatment options for these patients. Copyright © 2017 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  20. Clinical application and viability of cryopreserved cadaveric skin allografts in severe burn: a retrospective analysis.

    Science.gov (United States)

    Cleland, Heather; Wasiak, Jason; Dobson, Hannah; Paul, Michelle; Pratt, George; Paul, Eldho; Herson, Marisa; Akbarzadeh, Shiva

    2014-02-01

    Cadaveric cutaneous allografts are used in burns surgery both as a temporary bio-dressing and occasionally as definitive management of partial thickness burns. Nonetheless, limitations in the understanding of the biology of these grafts have meant that their role in burns surgery continues to be controversial. A review of all patients suffering 20% or greater total body surface area (TBSA) burns over an eight year period that received cadaveric allografts were identified. To investigate whether tissue viability plays a role in engraftment success, five samples of cryopreserved cadaveric cutaneous allograft processed at the Donor Tissue Bank of Victoria (DTBV) were submitted to our laboratory for viability analysis using two methods of Trypan Blue Exclusion and tetrazolium salt (MTT) assays. During the study period, 36 patients received cadaveric allograft at our institution. The average total burn surface area (TBSA) for this group of patients was 40% and all patients received cadaveric skin as a temporizing measure prior to definitive grafting. Cadaveric allograft was used in complicated cases such as wound contamination, where synthetic dressings had failed. Viability tests showed fewer than 30% viability in processed allografts when compared to fresh skin following the thawing process. However, the skin structure in the frozen allografts was histologically well preserved. Cryopreserved cutaneous cadaveric allograft has a positive and definite role as an adjunct to conventional dressing and grafting where available, particularly in patients with large TBSA burns. The low viability of cryopreserved specimens processed at DTBV suggests that cell viability in cadaveric allograft may not be essential for its clinical function as a wound dressing or even as permanent dermal substitute. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  1. Severe cast burn after bunionectomy in a patient who received peripheral nerve blocks for postoperative analgesia

    Directory of Open Access Journals (Sweden)

    Joelle W Boeve

    2011-03-01

    Full Text Available Patrick K Boyle, John J Badal, Joelle W BoeveDepartment of Anesthesiology, Arizona Health Sciences Center, Tucson, AZ, USAAbstract: Although regional anesthesia offers advantages for intraoperative and postoperative pain relief, it is not possible without complications. A case of a significant burn injury after splint placement is described after a peripheral nerve block was performed for postoperative pain management. It is our hope that this case alerts physicians and others involved in the management of postoperative patients to the challenges of managing a blocked extremity after thermal cast placement and offers solutions that can be standardized.Keywords: Peripheral nerve block, cast burn, postoperative complication

  2. [Effects of activating silent information regulator 1 on early kidney damage in rats with severe burn].

    Science.gov (United States)

    Bai, X Z; He, T; Liu, Y; Zhang, W; Han, F; Yang, C; Cai, W X; Jia, Y H; Shi, J H; Han, J T; Su, L L; Hu, D H

    2017-06-20

    Objective: To investigate the effects of activating silent information regulator 1 (SIRT1) on the early kidney damage in rats with severe burn. Methods: Thirty healthy male SD rats were divided into sham injury group (SI), pure burn group (PB), and SIRT1 activator group (SA) according to the random number table, with 10 rats in each group. Rats in groups PB and SA were inflicted with 30% total body surface area full-thickness scald (hereinafter referred to as burn) on the back. Immediately after injury, rats in group PB were intraperitoneally injected with normal saline in the dosage of 50 mL/kg, and those in group SA with 1 mg/mL (final mass concentration) resveratrol in the dosage of 50 mL/kg. Rats in group SI were sham injured and intraperitoneally injected with normal saline in the dosage of 50 mL/kg immediately after injury. Kidney tissue and abdominal aorta blood of rats in the three groups were collected at 24 hours after injury. The morphology of kidney tissue was observed after HE staining. The serum content of creatinine and urea nitrogen was determined with enzyme-linked immunosorbent assay. Protein expressions of SIRT1, Bax, and Bcl-2 in kidney tissue were determined with Western blotting. mRNA expressions of tumor necrosis factor-alpha (TNF-α), interleukin-1 beta (IL-1β), and IL-10 in kidney tissue were determined with real-time fluorescent quantitative reverse transcription polymerase chain reaction. Data were processed with one-way analysis of variance and LSD-t test. Results: (1) In rats of group SI, structures of kidney tubules and glomeruli were intact. In rats of group PB, structures of kidney tubules were not clear with casts in them, and glomeruli showed pyknosis. In rats of group SA, structures of kidney tubules were relatively intact, and the pyknosis of glomeruli were slighter as compared with that of group PB with fewer glomeruli showing pyknosis. (2) The serum content of creatinine and urea nitrogen in rats of group PB was (67±14)

  3. Fatty infiltration of the liver in severely burned pediatric patients : Autopsy findings and clinical implications

    NARCIS (Netherlands)

    Barret, JP; Jeschke, MG; Herndon, DN

    2001-01-01

    Background. Trauma induces hypermetabolic responses that are characterized by the mobilization of all available substrates. The marked increase of peripheral lipolysis after a burn can lead to the development of fatty liver, which has been associated with immunodepression and increased mortality. Me

  4. SELECTIVE INTESTINAL DECONTAMINATION FOR PREVENTION OF WOUND COLONIZATION IN SEVERELY BURNED PATIENTS - A RETROSPECTIVE ANALYSIS

    NARCIS (Netherlands)

    MANSON, WL; KLASEN, HJ; SAUER, EW; OLIEMAN, A

    1992-01-01

    In this study the effect of selective intestinal decontamination of the digestive tract (SDD) on wound colonization was investigated. Ninety-one patients with at least 25 per cent total burned surface area (TBSA) were included in this study. All patients received oral polymyxin. In 63 patients oral

  5. FOETAL MUMMIFICATION OWING TO SEVERE THERMAL BURN IN AN INDIGENOUS COW

    Directory of Open Access Journals (Sweden)

    Debasis Jana

    2014-06-01

    Full Text Available A very rare incidence of bovine foetal mummification owing to thermal burn injury and its successful obstetrical treatment and management with the extraction of an inert mummified foetus diagnosed to be an atypical amorphous globocephalus foetal monster at its 2nd trimester of development is reported.

  6. Signals from Fat After Injury: Plasma Adipokines and Ghrelin Concentrations in the Severely Burned

    Science.gov (United States)

    2012-09-26

    hor- mones , beta blockers and intensive insulin therapy. Furthermore, Table 1 Demographics of control and burn subjects. Values in the table are mean...possibilities to assess the status of the patient through the use of these hor- mones as biomarkers. This work also provides the basis on which to

  7. Incidence of non-candidal fungal infections in severe burn injury: an Australian perspective.

    Science.gov (United States)

    Katz, T; Wasiak, J; Cleland, H; Padiglione, A

    2014-08-01

    Infection remains the primary cause of morbidity and mortality in the burns patient population. While candidal infection in burns patients is well described, there is dearth of information regarding non-candidal fungal infections in this setting. All adult burns patients who developed non-candidal fungal infections over a period of 10 years (between January 2001 and June 2011) were included. Retrospective data analyzed included patient demographics, organisms cultured, antibiotic susceptibility patterns, treatment, length of stay and overall mortality. The incidence of non-candidal fungal infections at our centre over the time period studied was 0.04%. A total of 12 patients had a fungus other than Candida isolated. Of these 12 patients, seven were thought to have clinically significant fungal infections and were treated with targeted anti-fungal therapy. Between them, seven species of fungus were isolated: Aspergillus fumigatus (n=7), Scedosporium prolificans (n=2), Fusarium solani (n=2), Mucor spp. (n=2), Absydia corymbifera (n=1), Penicillium (n=1) and Alternaria spp. (n=1). Of those definitively treated, two died, although fungal infection was not believed to be a contributing factor to these deaths. We demonstrate a low incidence and attributable mortality of non-candidal fungal infections in the setting of early antifungal therapy and extensive surgical debridement at our state-wide Burns Service. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

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

    Institute of Scientific and Technical Information of China (English)

    谢卫兴; 李秀芝

    1995-01-01

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

  9. Assessment of vitamin and trace element supplementation in severely burned patients undergoing long-term parenteral and enteral nutrition.

    Science.gov (United States)

    Perro, G; Bourdarias, B; Cutillas, M; Higueret, D; Sanchez, R; Iron, A

    1995-10-01

    The efficacy of an oral supplement of vitamins and trace elements during a longterm artificial parenteral and enteral nutrition was investigated for 3 months in patients with extensive burns. Thirty severely burned patients (22 male, 8 female, age 41 +/- 18 years, range 23-59 years, 33 +/- 12% total body surface area burn, 22% +/- 8 full thickness burn surface area) were included. Every 10 days, from day 10 until day 90, we determined serum levels of: *vitamins B1, B12, A, E, *folic acid, *copper, zinc, iron, *transferrin, albumin, prealbumin, total proteins, *fibronectin, retinol binding protein (RBP), *calcium, *phosphorus, *triglycerides, *total cholesterol, *C reactive protein (CRP), *erythrocyte folic acid. The mean daily nutritional support was 60 Kcals and 0.4 g N per kg of body weight, 70% enterally and 30% parenterally administered, with enteral vitamin and trace element supplementation. On day 10, there was a decrease of the serum level of 19/20 parameters. For 8 parameters (vitamin A, total cholesterol, iron, transferrin, fibronectin, phosphorus, RBP, total proteins), the level was lower than usual. Between day 10 and day 20, a significant normalization of 6 of them was noted, the average levels of transferrin and iron remaining below normal values until day 50. There was a significant decrease in C-reactive protein levels, however above normal limits. No deficiency in vitamins or trace elements was found. Cyclic variations of serum levels occurred which may be more related to volemic, hydroelectrolytic, endocrine and inflammatory disorders than to nutritional problems.

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

    Directory of Open Access Journals (Sweden)

    Ssentongo Robert

    2011-06-01

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

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

    Science.gov (United States)

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

    2013-01-01

    The transition of pediatric burn survivors into adulthood is accompanied by a reformulation of their self-concept. To anticipate the need for and guide development of appropriate psychosocial interventions, this study examines how young adults who were burned as children perceive themselves and how this perception might affect their self-esteem. Eighty-two young adult burn survivors (45 male, 37 female) were assessed using the Tennessee Self-Concept Scale, 2nd edition (TSCS2) to determine how the participants perceive themselves and their interaction with society. To gain insight into the possible effects of these self-concept scores, relationships were analyzed between self-concept, a behavioral assessment (Young Adult Self-Report [YASR]), and a psychiatric symptom assessment (Structured Clinical Interview for DSM-IV Axis I Disorders [SCID I]). This group of burn survivors scored significantly lower in self-concepts, reflected in TSCS2 subscale scores of physical function, appearance, and sexuality, moral conduct, personal values, academics and work, and identity, than did the reference population. Pearson correlation coefficients showed that as moral, personal, family, and social aspects of self-concept decreased, clinical problems endorsed on the YASR subscales increased, including anxiety, somatic, attention, intrusive, and aggressive. Persons with lower self-concept scores on the TSCS2 personal, family, and social scales were more withdrawn on the YASR. Similarly, those with lower TSCS2 scores on the personal and family scales endorsed significantly more thought problems on the YASR. TSCS2 total self-concept, personal, and all of the supplementary scale scores were significantly lower for the group with an affective disorder. Those whose SCID I scores were consistent with a current anxiety disorder had significantly lower scores for the TSCS2 total self-concept and personal. Lower self-concept was associated with endorsement of SCID symptoms. In summary, the

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

    Science.gov (United States)

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

    2011-01-01

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

  13. Cost of nursing most frequent procedures performed on severely burned patients.

    Science.gov (United States)

    Melo, Talita de Oliveira; Lima, Antônio Fernandes Costa

    2017-01-01

    to identify the mean direct cost (MDC) of the most frequent procedures performed by nursing professionals on severely burned patients in an Intensive Care Unit. exploratory-descriptive quantitative single-case study. The MDC was calculated by multiplying time (timed) spent by nursing professionals in the performance of the procedures by the unit cost of direct labor, and adding the costs of material and medicine/solutions. a MDC of US$ 0.65 (SD=0.36) was obtained for "vital signs monitoring"; US$ 10.00 (SD=24.23) for "intravenous drug administration"; US$ 5.90 (SD=2.75) for "measurement of diuresis"; US$ 0.93 (SD=0.42) for "capillary blood glucose monitoring"; and US$ 99.75 (SD=129.55) for "bandaging". the knowledge developed can support managerial decision-making, contribute to the efficiency distribution of the resources involved and, when possible, provide cost-containment or cost-minimization strategies without impairing the quality of nursing care. identificar o custo direto médio (CDM) dos procedimentos realizados, com maior frequência, por profissionais de enfermagem, em uma Unidade de Terapia Intensiva, aos pacientes grandes queimados. pesquisa quantitativa, exploratório-descritiva, do tipo estudo de caso único. O CDM foi calculado multiplicando-se o tempo (cronometrado) despendido por profissionais de enfermagem na execução dos procedimentos, objeto de estudo, pelo custo unitário da mão de obra direta, somando-se ao custo dos materiais e soluções/medicamentos. obteve-se o CDM de US$ 0.65 (SD=0.36) para "controle dos sinais vitais"; US$ 10.00 (SD=24.23) para "administração de medicamentos via intravenosa"; US$ 5.90 (SD=2.75) para "mensuração de diurese"; US$ 0.93 (SD=0.42) para "verificação de glicemia capilar"; e US$ 99.75 (SD=129.55) para "curativo". o conhecimento desenvolvido pode fundamentar as tomadas de decisão gerenciais subsidiando a eficiência alocativa dos recursos envolvidos e, quando possível, indicar estratégias de conten

  14. Targeted Prevention or Treatment of Bacterial Biofilm Infections of Severe Burns and Wounds

    Science.gov (United States)

    2011-04-01

    for P. aeruginosa and accelerates the formation of biofilms. neutrophil accumulation Normal epidermis Burn Biofilm neutrophil necrosis NMHC-II F...actin + DNA dermis 4 Body: Over the 18 months of this proposal, we have completed all of the stated Aims within the approved Statement of Work. Results...methods. Associated with decreased neutrophil accumu- lation to the dermis was a decrease in burden of P. aeru- ginosa. This effect was greatest at the

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

    Science.gov (United States)

    2013-01-01

    injuries of≥40% total body surface area (TBSA) has markedly reduced bone formation in both adults and children [1]. Burn induces a systemic catabolic...injury can also be a significant contributing factor to loss of bone density and strength [8]. Bed rest causes an uncoupling of resorption and...the reduction in bone formation [3,5,15] and thusmay be associated with a higher incidence of fractures and osteoporosis [3,16,17]. Using two and

  16. Genetically Modified Porcine Skin Grafts for Treatment of Severe Burn Injuries

    Science.gov (United States)

    2010-07-01

    artif act of m igration of peripheral s kin cells into the wound area durin g healing. In addition, full-th ickness wounds bette r represent the...and Rutan RL, Early burn wound excision significantly reduces blood loss. Ann Surg 211: 753-759, 1990. 3. Nakazawa H and Nozaki M, [Experience of...immunosuppressant. By the time of this skin experiment, the baboon was healthy, and its blood cell counts and phenotypes had returned to baseline. On

  17. Burn Rehabilitation

    Directory of Open Access Journals (Sweden)

    Koray Aydemir

    2011-07-01

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

  18. [Observation on the fluid resuscitation and the change in blood sodium of severely burned patients in the early stage].

    Science.gov (United States)

    Zhang, Hong-hui; Li, Yue-jun; Li, Xue-yong; Chen, Shao-zong; Lü, Xiao-xing; Feng, Jian; Li, Jing; Jiang, Li

    2010-10-01

    To study the necessary amount of fluid consisting of electrolyte and colloid, the ratio of electrolyte and colloid used, and the change of blood sodium during early resuscitation in severely burned patients. Sixty-seven patients with total burn surface area (TBSA) equal to or over 70% and full-thickness area equal to or over 50%TBSA, hospitalized from March 2004 to March 2009, were resuscitated with fluid. The infusion amount of electrolyte, colloid, and water, and urinary output of patients at post injury hour (PIH) 24, 48, and 72 were analyzed retrospectively. The variation in blood sodium and fluid infusion at different time points was recorded. Data were processed with SPSS 13.0 software. Among the 67 patients, hyponatremia occurred in 9 cases, hypernatremia occurred in 5 cases, and 53 patients had normal blood sodium level. The urinary output of patients within PIH 72 was above 70 mL/h. K value was calculated through the formula: actual total infusion amount of electrolyte and colloid (mL) = burn area (%TBSA) x body weight (kg) x K. In the first 24 PIH, K value was about 1.7, and the ratio of electrolyte and colloid was 1.4. In the second 24 PIH, K value was about 1.3 with electrolyte and colloid ratio 1.6. K value in the third 24 PIH was about 0.9 with electrolyte and colloid ratio 2.0. The actual amount of resuscitation fluid is slightly larger than that calculated from traditional formula during the early stage in severely burned patients. The amount of electrolytes and the proportion of electrolyte and colloid will influence blood sodium level of patients.

  19. Observation of anesthesia depth in severe burn patients with target controlled infusion of propofol and remifentanil by bispectral index

    Directory of Open Access Journals (Sweden)

    Zheng-gang GUO

    2012-04-01

    Full Text Available Objective To evaluate the feasibility and efficiency of bispectral index (BIS for monitoring the anesthesia depth of severe burn patients with target controlled infusion (TCI of propofol and remifentanil. Methods A total of 80 severe burns patients undergoing eschar excision ( < 1week were randomly divided into BIS group (group A and control group (group B, with 40 cases assigned in each group. These patients were 18 years to 65 years old, ASAⅡ-Ⅲ. Their total burn surface areas (TBSA were from 31% to 50%, or 11% to 20% with three-degree burns. All patients received remifentanil and propofol for TCI intravenous anesthesia. The mean arterial pressure (MAP and heart rate (HR were determined at following time points, namely, entrance to the operation room, loss of consciousness, 2min after intubation, before surgery, 2, 15, and 30min after the start of surgery, end of surgery, eye opening, and period when Aldrete score reaching 9 points, as well as the target concentrations of remifentanil and propofol. The time frames from stoppage of drug infusion to eye opening and the period when Aldrete score reaching 9 points were also recorded. Results Compared with group B, the target concentrations of remifentanil (2.12±0.35ng/ml vs. 2.50±0.21ng/ml and propofol (2.54±0.22μg/ml vs. 2.86±0.31μg/ml were significantly lower in group A during anesthetic maintenance (P < 0.01. The time interval from stoppage of drug infusion to eye opening (7.90±0.58min vs. 8.35±0.66min and period when Aldrete score reaching 9 points (9.15±0.69min vs. 11.13±0.96min were significantly reduced in group A. The MAP of both groups from loss of consciousness at all time points, except 2min after intubation, was significantly lower than the basic values upon entrance into the operation room (P < 0.05. The HR at all time points were significantly lower compared with the basic data (P < 0.05. Conclusion BIS for monitoring the anesthetic depth of severe burns patients

  20. Emergency percutaneous tracheostomy in a severely burned patient with upper airway obstruction and circulatory arrest.

    Science.gov (United States)

    Schlossmacher, Pascal; Martinet, Olivier; Testud, Richard; Agesilas, Fabrice; Benhamou, Léon; Gauzëre, Bernard Alex

    2006-02-01

    We report the life-saving use of Griggs percutaneous tracheostomy in an arrested patient with complex upper airway obstruction, as a result of burns, smoke injuries and iterative tracheal intubation attempts. The technique was performed blindly at bedside to treat an acute episode of failed ventilation and intubation and cardiac arrest in a patient with altered neck anatomy. The intervention salvaged the situation, leaving a definitive airway. The feasibility of using an emergency Griggs percutaneous tracheostomy versus cricothyroidotomy is suggested in selected cases.

  1. Prevention and treatment of gastrointestinal dysfunction following severe burns:A summary of recent 30-year clinical experience

    Institute of Scientific and Technical Information of China (English)

    Shi-Chu Xiao; Shi-Hui Zhu; Zhao-Fan Xia; Wei Lu; Guang-Qing Wang; Dao-Feng Ben; Guang-Yi Wang; Da-Sheng Cheng

    2008-01-01

    AIM:To sum up the recent 30-year experience in the prevention and treatment of gastrointestinal dysfunction in severe burn patients,and propose practicable guidelines for the prevention and treatment of gastrointestinal (GI) dysfunction.METHODS= From 1980 to 2007,a total of 219 patients with large area and extraordinarily large area burns (LAB) were admitted,who were classified into three stages according the therapeutic protocols used at the time:Stage 1 from 1980 to 1989,stage 2 from 1990 to 1995,and stage 3 from 1996 to 2007.The occurrence and mortality of GI dysfunction in patients of the three stages were calculated and the main causes were analyzed.RESULTS:The occurrence of stress ulcer in patients with LAB was 8.6% in stage 1,which was significantly lower than that in stage 1 (P < 0.05).No massive hemorrhage from severe stress ulcer and enterogenic infections occurred in stages 2 and 3.The occurrence of abdominal distension and stress ulcer and the mortality in stage 3 patients with extraordinarily LAB was 7.1%,21.4% and 28.5%,respectively,which were significantly lower than those in stage 1 patients (P < 0.05 or P < 0.01),and the occurrence of stress ulcer was also significantly lower than that in stage 2 patients (P < 0.05).CONCLUSION:Comprehensive fluid resuscitation,early excision of necrotic tissue,staged food ingestion,and administration of specific nutrients are essential strategies for preventing gastrointestinal complications and lowering mortality in severely burned patients.

  2. Resuscitation after severe burn injury using high-dose ascorbic acid: a retrospective review.

    Science.gov (United States)

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

    2011-01-01

    Resuscitation of burn victims with high-dose ascorbic acid (vitamin C [VC]) was reported in Japan in the year 2000. Benefits of VC include reduction in fluid requirements, resulting in less tissue edema and body weight gain. In turn, these patients suffer less respiratory impairment and reduced requirement for mechanical ventilation. Despite these results, few burn centers resuscitate patients with VC in fear that it may increase the risk of renal failure. A retrospective review of 40 patients with greater than 20% TBSA between 2007 and 2009 was performed. Patients were divided into two groups: one received only lactated Ringer's (LR) solution and another received LR solution plus 66 mg/kg/hr VC. Both groups were resuscitated with the Parkland formula to maintain stable hemodynamics and adequate urine output (>0.5 ml/kg/hr). Patients with >10-hour delay in transfer to the burn center were excluded. Data collected included age, gender, weight, %TBSA, fluid administered in the first 24 hours, urine output in the first 24 hours, and Acute Physiology and Chronic Health Evaluation II score. PaO2 in millimeters mercury:%FIO2 ratio and positive end-expiratory pressure were measured at 12-hour intervals, and hematocrit was measured at 6-hour intervals. Comorbidities, mortality, pneumonia, fasciotomies, and renal failure were also noted. After 7 patients were excluded, 17 patients were included in the VC group and 16 in the LR group. VC and LR were matched for age (42 ± 16 years vs 50 ± 20 years, P = .2), burn size (45 ± 21%TBSA vs 39 ± 15%TBSA, P = .45), Acute Physiology and Chronic Health Evaluation II (17 ± 7 vs 18 ± 8, P = .8), and gender. Fluid requirements in the first 24 hours were 5.3 ± 1 ml/kg/%TBSA for VC and 7.1 ± 1 ml/kg/%TBSA for LR (P < .05). Urine output was 1.5 ± 0.4 ml/kg/hr for VC and 1 ± 0.5 ml/kg/hr for LR (P < .05). Vasopressors were needed in four VC patients and nine LR patients (P = .07). VC patients required vasopressors to maintain mean

  3. The early enteral feeding and rehabilitation of severely burned patients%严重烧伤患者的早期肠道营养与康复

    Institute of Scientific and Technical Information of China (English)

    邢德荣

    2002-01-01

    Objective To explore the effect of rehabilitation through analysis the early enteral feeding on the prevention of enteral infection in severely burned patients .Method A total of 22 patients with severe burns were randomly divided into an early enteral feeding group (EF) and a delayed enteral feeding group (DF). The levels of serum endotoxin were detected in the members of both groups in 1, 3, and 5 days .Result The levels of serum endotoxin in severely burned patients were significantly higher than in normal subjects (P< 0.01) . The levels of serum endotoxin in the EF group were significantly lower than in the DF group (P< 0.01). Conclusion Early enteral feeding may decrease enterogenic infection and it helps the nutrition support, improve the patient resistance, facilitate the repair of damaged tissue , so it contributes to the rehabilitation of burned patients.

  4. Yellow pine regeneration as a function of fire severity and post-burn stand structure in the southern Appalachian Mountains

    Science.gov (United States)

    Michael A. Jenkins; Robert N. Klein; Virginia L. McDaniel

    2011-01-01

    We used pre- and post-burn fire effects data from six prescribed burns to examine post-burn threshold effects of stand structure (understory density, overstory density, shrub cover, duff depth, and total fuel load) on the regeneration of yellow pine (Pinus subgenus Diploxylon) seedlings and cover of herbaceous vegetation in six prescribed-fire management units located...

  5. Health-related quality of life 6 months after burns among hospitalized patients: Predictive importance of mental disorders and burn severity.

    Science.gov (United States)

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

    2015-06-01

    Major burns are likely to have a strong impact on health-related quality of life (HRQoL). We investigated the level of and predictors for quality of life at 6 months after acute burn. Consecutive acute adult burn patients (n=107) admitted to the Helsinki Burn Centre were examined with a structured diagnostic interview (SCID) at baseline, and 92 patients (86%) were re-examined at 6 months after injury. During follow-up 55% (51/92) suffered from at least one mental disorder. The mean %TBSA was 9. TBSA of men did not differ from that of women. Three validated instruments (RAND-36, EQ-5, 15D) were used to evaluate the quality of life at 6 months. All the measures (RAND-36, EQ-5, 15D) consistently indicated mostly normal HRQoL at 6 months after burn. In the multivariate linear regression model, %TBSA predicted HRQoL in one dimension (role limitations caused by physical health problems, p=0.039) of RAND-36. In contrast, mental disorders overall and particularly major depressive disorder (MDD) during follow-up (p-values of 0.001-0.002) predicted poor HRQoL in all dimensions of RAND-36. HRQoL of women was worse than that of men. Self-perceived HRQoL among acute burn patients at 6 months after injury seems to be mostly as good as in general population studies in Finland. The high standard of acute treatment and the inclusion of small burns (%TBSAburn itself on HRQoL. Mental disorders strongly predicted HRQoL at 6 months. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

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

    Science.gov (United States)

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

    2011-07-01

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

  7. [The relationship between rhGH and blood sugar on different ages of severe degree burned patients].

    Science.gov (United States)

    Chen, Jiong; Xia, Shi-chun; Xie, Bing; Tang, Zhi-jian; Su, Guo-liang; Shi, Jian-wu; Lu, Xue-mian

    2009-08-01

    Probe the effects of rhGH on severe degree burned patients' blood sugar in different age of years. Elected 210 patients hospitalized in the Third Affiliated Hospital of Wenzhou Medical College from January 2005 to December 2008, who were burned in 48 h, older than 18 years, ever had no diabetes and tumor history and placidly pull through shock stage. Among the patients there were 132 males and 78 females. The age was from 18 to 65 years old, average (40.7 +/- 7.2) years old. The extent of burn were form TBSA 25% to TBSA 86%, average TBSA (40.4 +/- 12.5)%. The depths of burn were from superficial second degree to third degree. All of the total divided into A (18 - 44 years old) and B (> 45 years old)groups. Each group had 105 patients. Two groups were randomly divided into A(1), A(2), A(0) and B(1), B(2), B(0) groups. Each group had 35 patients. The A(1) and B(1) groups were used 0.15 U/(kg.d) growth hormone (Somatropin, S19990021), A(2) and B(2) groups were used 0.2 U/(kg.d) growth hormone, A(0) and B(0) groups were used NS as control. Observed and analyzed the change of blood sugar and insulin amount used in 210 patients. Of all the patients in 6 groups, there were 190 patients finished the experimentation in four weeks. The insulin amount of A(1), A(2), A(0) groups used were (2123.3 +/- 152.3), (2885.6 +/- 148.5), (724.1 +/- 31.1) U, B(1), B(2), B(0) group were (2715.1 +/- 95.3), (3652.2 +/- 198.1), (801.8 +/- 22.2) U. The consequence showed that the number need insulin to control blood sugar in B group was more than A group, as well as using 0.2 U/(kg.d) does to 0.15 U/(kg.d) does, and using growth hormone to no using(P 0.05). The blood sugar's alteration has positive correlation with the age of years and the does of rhGH. As long as normative using rhGH it doesn't induce diabetes.

  8. Effects of nutritional support route on intestinal structure and function in the early stage of severe burn injury

    Institute of Scientific and Technical Information of China (English)

    CHEN Zhong-yong; WANG Shi-liang; YU Bin; LI Ao

    2001-01-01

    To assess the clinical effects ofenteral nutrition on intestinal structure and function in the early stage of severe burns. Methods: Nineteen cases of severe burn injury were divided randomly into enteral nutrition group (EN) and parenteral nutrition group (PN). Gastrin, motilin, malondialdehyde (MDA), superoxide dismutase (SOD), endotoxin, rumor necrosis (TNF), diamine oxidase (DAO) and lactulose/mannitol (L/M) were determined on postburn day 1, 4, 8, 14 (PBD) respectively. Results: Serum gastrin and motilin on PBD 4 and 8 were significantly higher in EN group than in PN group (P<0.05-0.01). Plasma MDA on PBD4 and PBD8 was obviously lower in EN group than in PN group (P<0.01). Plasma SOD on PBD4 and PBD8 was significantly higher in EN group than in PN group (P<0.01). At the most time points, endotoxin and TNF were significantly lower in EN group than in PN group (P<0.01). Serum DAO tended to decrease in EN group, and on PBD4 it was obviously lower in EN group than in PN group (P<0.01). Gut permeability L/M on PBD4, PBD8 was obviously in EN group lower than in PN group (P<0.05-0.01). There was positive correlation between L/M and DAO, and between MDA and TNF (P<0.05-0.01), and negative correlation between L/M and SOD (P<0.01). Conclusion: On the basis of the findings, it is considered that the early enteral nutrition is more effective to preserve the secretion and motility of gastrointestinal tract, decrease intestinal ischemia and reperfusion injury, reduce intestinal permeability, decrease plasma endotoxin and mediators,and maintain mucosa barrier function. Enteral nutrition is superior to parenteral nutrition in the early stage of severe bum injury.

  9. Control of Thermoregulatory Sweating during Exercise in Patients with Severe Burns

    OpenAIRE

    秦, 祐子; 林, 隆宏; 宮本, 隆志; 辛島, 修二; 山口, 昌夫; 花山, 耕三; 永坂, 鉄夫; 桜田, 惣太郎; 田辺, 実

    1995-01-01

    全身の広範囲な皮膚汗腺破壊をともなう重症熱傷患者の, 運動時の発汗能に着目し, 体温調節能力と運動耐久性について検討した。Burn Index 70以上で日常生活動作の自立した2症例を対象に, 自転車エルゴメーターによる運動負荷試験をおこない, 呼気ガス分析・発汗量・深部体温・皮膚温・皮膚血流量・心拍数を経時的に測定した。その結果, 両者とも予想最大酸素摂取量に対する実測の酸素摂取量のピーク値の割合は低く, 運動耐久性は低下していると推察された。一方, III度熱傷値皮部からの発汗は認められなかったが, 運動中の体温の恒常性はかなり保たれたものであった。したがって, 熱傷により広範囲に皮膚汗腺破壊が生じても, 運動中の体温調節能力は比較的維持されると言え, この汗腺破壊が, 運動遂行能力の制限因子となるとは考え難いことが示唆された。 Thermoregulatory capacity and exercise endurance during exercise were studied in patients with impaired sweating capacity ...

  10. 重度烧伤液体复苏的研究进展%Advances in the Research of Fluid Resuscitation Following Severe Burn

    Institute of Scientific and Technical Information of China (English)

    王碧莹(综述); 葛茂星(审校)

    2015-01-01

    Burn shock is the first hurdle in patients with severe burn injury.Fluid resuscitation is an important treatment of burn shock.Reasonable fluid resuscitation can not only avoid burn shock,but also reduce the death risk and complications incidence.Here is to make a review of the research of severe burn fluid infusion volume,infusion method,inhalation injury,wound depth,delayed resuscitation and etc.,for the sake of providing some thoughts for fluid resuscitation of severe burn patients .%烧伤休克是重度烧伤患者伤后面临的第一道难关。液体复苏是休克期救治的重要措施,合理的补液不仅能避免烧伤休克的发生,也将降低后续并发症的发生率及死亡的风险。该文就目前国内外对重度烧伤液体复苏的补液量、补液途径、吸入性损伤、创面深度及延迟复苏等方面的相关研究进行综述,以期为临床重度烧伤的液体复苏提供一个简要的总结和一些思考。

  11. Topical application of docosanol- or stearic acid-containing creams reduces severity of phenol burn wounds in mice.

    Science.gov (United States)

    Khalil, M H; Marcelletti, J F; Katz, L R; Katz, D H; Pope, L E

    2000-08-01

    Because of their reported antiviral and anti-inflammatory activities, cream formulations containing n-docosanol (docosanol) or stearic acid were tested for effects on chemically-induced burns in mice. In this model, injury was induced by painting the abdomens of mice with a chloroform solution of phenol. This was followed by the topical application of test substances 0.5, 3, and 6 h later. Progression of the wounds was assessed by a single evaluator after 8 h, using a numerical score of gross morphology. Docosanol- and stearic acid-containing creams substantially and reproducibly lessened the severity and progression of skin lesions compared to untreated sites with a 76% and 57% reduction in mean lesion scores, respectively. Untreated wounds appeared red and ulcerated; docosanol cream-treated wounds showed only slight erythema.

  12. Interactive effects of burn severity and canopy cover on ecophysiology of tree seedlings in boreal forests

    Science.gov (United States)

    Wildfires are an important disturbance because they improve habitat conditions for establishing plants. Fires of differing severity can have dramatically different impacts on habitat, particularly when coupled with canopy-level disturbances. In a boreal forest, we outplanted seedlings of four specie...

  13. Soil water repellency within a burned pinon-juniper woodland: spatial distribution, severity, and ecohydrologic implications

    Science.gov (United States)

    Post-fire recovery of juniper-dominated ecosystems is dependent on the extent that ecological processes have been altered. Soil water repellency is a common condition in these ecosystems that may limit site recovery. In this study we examined the extent, severity, and ecohydrologic implications of p...

  14. X-ray analysis of 80 patients with severe endemic fluorosis caused by coal burning

    Energy Technology Data Exchange (ETDEWEB)

    Zhao, Z.P.; Yuan, M.B.; Liu, G.F. [Luzhou Medical College, Luzhou (China)

    1996-05-01

    Radiographs of 80 patients with severe endemic fluorosis of coalburning type (CBFF) - 49 males and 31 females aged 30 to 70 years - were analysed to examine the changes to the bone substance, peripheral structure of bone, and joints. The changes to bone substance were: (1) osteosclerosis type, 62 cases (77.5%); (2) mixed type, 16 cases (21.25%); (3) osteoporosis type, one case (1.25%); (4) osteomalacia type, one case (1.25%). The changes to the joints were found in the hips and elbows in 79 cases (98.75%), and in the knees in 75 cases (93.75%). When combinations of the above three changes occur, the classification of the disease is according to the most severe one of the three. Our findings can increase the accuracy of X-ray diagnosis, making it more consistent with clinical diagnosis, thus improving prevention and treatment of CBEF.

  15. Increased B-type natriuretic peptide and decreased proteinuria might reflect decreased capillary leakage and is associated with a better outcome in patients with severe burns

    NARCIS (Netherlands)

    de Leeuw, Karina; Nieuwenhuis, Marianne K; Niemeijer, Anuschka S; Eshuis, Hans; Beerthuizen, Gerard I J M; Janssen, Wilbert M

    2011-01-01

    INTRODUCTION: It is difficult to adjust fluid balance adequately in patients with severe burns due to various physical changes. B-type natriuretic peptide (BNP) is emerging as a potential marker of hydration state. Proteinuria is used as a predictor of outcome in severe illness and might correlate t

  16. A randomized controlled trial to compare the effects of liquid versus powdered recombinant human growth hormone in treating patients with severe burns

    Science.gov (United States)

    CHEN, GUOXIAN; SHAO, HUAWEI; PAN, XUANLIANG

    2016-01-01

    Recombinant human growth hormone (rhGH) promotes protein utilization and synthesis, and is widely used as a therapy to treat severe burns. The present randomized controlled trial evaluated the effects of different forms of rhGH on patients with severe burns. A total of 29 adult severe burns patients were enrolled between February 2009 and November 2011, and randomly assigned to either treatment group (T, liquid rhGH) or control group (C, powder rhGH). From days 5 to 7 following the infliction of burns, both patient groups received rhGH at 0.067 mg/kg/d, once for 10 days. Median serum pre-albumin levels increased in both groups following treatment, the elevation from baseline was significantly higher in the T group on day 10 compared to the C group (88 mg/l vs. 65 mg/l, P=0.046). C-reactive protein, fasting plasma glucose and body weight decreased in both groups. Body weight was significantly lower in the T compared to the C group at baseline, Day 5 and Day 10 (P=0.046, P=0.018 and P=0.006, respectively), however the decrease from baseline levels were not significantly different. Wound healing time was similar between groups (P=0.270). In conclusion the early use of liquid rather than powder rhGH may be more beneficial for treating adult patients with severe burns. PMID:27123246

  17. 也谈严重烧伤感染治疗%To intensify our understanding about management of severe burn infection

    Institute of Scientific and Technical Information of China (English)

    张勤; 廖镇江

    2009-01-01

    Nowadays, it is necessary to emphasize the three basic inseparable elements in the treatment of severe burn infection, which are systemic care, burn wound care, and ra-tional use of antimicrobia/s topically or systematically. Systemic care has been shifted from simple nutritional support to maintai-ning the systemic homeostasis, including balancing immune-in-flammatory response, and protecting organs from dysfunction.Some work focused on regulating systemic immune response in the initial phase and the balance of inflammatory response after occurrence of severe burn infection have been reported. These results at least broaden our thinking to recognize that treatment should not only destroy microbes, but also balance the response of the body. Escharectomy in earlier phase has been a consen-sus. Currently, we turn our vision into how to use "damage con-trol surgery (DCS)" concept in management of severe burn.DCS in burn care includes the evaluation of perioperative situa-tion more accurate to make a more appropriate surgical decision. Meanwhile, an overall strategy should be established to confront the rapidly increasing drug resistance of the pathogens. The re-lease of endotoxin after use of antimicrobials, which has been studied widely, should be explored further.

  18. Severity of symptoms of depression among burned patients one week after injury, using Beck Depression Inventory-II (BDI-II).

    Science.gov (United States)

    Ahrari, Farideh; Salehi, Seyyed Hamid; Fatemi, Mohammad Javad; Soltani, Madjid; Taghavi, Shahrzad; Samimi, Roghayeh

    2013-03-01

    This study was done to determine the severity of symptoms of depression in burned patients and to assess the effect of burn related factors on depression. This is a descriptive cross-sectional survey, performed in Burn center, Motahhari hospital, Tehran University of Medical Sciences, Iran. The population of the study included 300 hospitalized patients from April 2010 to May 2011 who were assessed for symptoms of depression one week after burn injury by Beck Depression Inventory-II. Three hundred subjects (50% female and 50% male) participated in the study. Age ranged from 13 to 75 with the mean of 35.06±12.79 years. 184 (61.3%) had symptoms of depression, 58 (19.3%) of them mild, 52 (17.3%) moderate and 74 (24.7%) severe depression symptoms. There was a significant relationship between symptoms of depression and age, gender, educational level, TBSA%, number of burn sites and amputation (p valueburned patients suggests that depression should be screened in such patients and treat if indicated. Copyright © 2012 Elsevier Ltd and ISBI. All rights reserved.

  19. [Effects of different doses of L-arginine on the serum levels of helper T lymphocyte 1 (Th1)/Th2 cytokines in severely burned patients].

    Science.gov (United States)

    Yan, Hong; Peng, Xi; Wang, Pei; Huang, Yue-sheng; Wang, Shi-liang

    2009-10-01

    To investigate the effects of L-arginine in different doses on the serum levels of helper T lymphocyte1 (Th1)/Th2 cytokines in severely burned patients. Twenty-nine severely burned patients, with total burn surface area from 50% to 80%TBSA, hospitalized within 20 hours after burn, were randomly divided into control group (10 cases, fed with 5% glucose saline 500 mL), L-arginine 200 mg group (10 cases, fed with 5% glucose saline 500 mL + 200 mg/kg L-arginine), L-arginine 400 mg group (9 cases, fed with 5% glucose saline 500 mL + 400 mg/kg L-arginine). All patients received enteral feeding through nasointestinal tube, started within 22 hours after burn. Fasting venous blood of all patients was harvested on post burn day (PBD) 1 (before enteral feeding), 3, 5, and 7 to determine serum contents of TNF-alpha, IL-1beta, TGF-beta(1) and IL-4 by radio-immunity method and enzyme-linked immunosorbent assay. Serum contents of TNF-alpha and IL-1beta of patients in all groups increased rapidly after burn, and although contents of TNF-alpha (318 +/- 57) ng/mL and IL-1beta (218 +/- 47) pg/mL of patients in L-arginine 200 mg group peaked on PBD 5, they were still significantly lower than those of patients in control group [(389 +/- 34) ng/mL, (272 +/- 40) pg/mL, P 0.05). Serum contents of TGF-beta(1) and IL-4 of patients in each group increased slowly after burn, and content of TGF-beta(1) (110 +/- 16) pg/mL of patients in L-arginine 200 mg group was significantly higher than that of patients in control group [(83 +/- 20) pg/mL, P 0.05). Compared with the dosage of 400 mg/kg L-arginine, the 200 mg/kg dose is more effective in reducing the release of Th1 cytokines and increasing Th2 cytokines production, hence maintaining Th1/Th2 cytokine ratio to produce better immune opsonization during the infection phase of severe burn.

  20. Emphasize the diagnosis and treatment of infective endocarditis in patients with severe burn%重视严重烧伤患者感染性心内膜炎的诊断和治疗

    Institute of Scientific and Technical Information of China (English)

    郇京宁

    2016-01-01

    The incidence and mortality of infective endocarditis (IE) in patients with severe burn remain high,which are attributed to invasive procedures,bacteremia,and wound infection after burns.Clinical clues for IE in burns are usually masked by burn-related manifestations,so the diagnosis of IE may be delayed or missed.For burned patients with persistent bacteremia of unknown source,especially Staphylococcus aureus -induced bacteremia,the diagnosis of IE should be considered according to the Duke criteria,and early echocardiography performance is particularly important.Antibiotic therapy is the mainstay initial management,and early surgical intervention is strongly recommended once IE is clearly diagnosed in patients with burns.In order to lower the incidence and mortality of IE in burns,it is very important to take prophylactic procedures along with the whole course of burn management.

  1. 成批重度烧伤患者相关感染的个体化治疗%Individualized treatment of infection on mass severe burn casualties

    Institute of Scientific and Technical Information of China (English)

    巴特

    2016-01-01

    Successful treatment of mass severe burn casualties is one of the important criteria to test the emergency response ability of department. Burn sepsis, pulmonary infection, local wound infection, enterogenous infection, and a series of infections in the process of mass burn casualties are seriously threatening the life of the patients. In addition to the routine treatment of patients with severe burn, this article focuses on the individual treatment programs for patients with different infections, and achieved good results. Mass burn casualties with severe burn treatment, need to adjust the specific circumstances, in order to maximize the success rate of treatment.%成批重度烧伤患者的成功救治是考验科室对突发事件应急能力的重要标准之一。成批烧伤患者救治的过程中,烧伤脓毒症、肺部感染、局部创面感染以及肠源性感染等一系列感染问题严重地威胁着患者的生命。除了对重度烧伤患者的常规治疗以外,本文着重介绍了针对患者不同感染情况进行的个体化治疗方案,并且取得良好效果。成批重度烧伤患者的治疗,需要针对具体情况进行调整,才能最大程度地提高救治成功率。

  2. Predicting severity of pathological scarring due to burn injuries: a clinical decision making tool using Bayesian networks.

    Science.gov (United States)

    Berchialla, Paola; Gangemi, Ezio Nicola; Foltran, Francesca; Haxhiaj, Arber; Buja, Alessandra; Lazzarato, Fulvio; Stella, Maurizio; Gregori, Dario

    2014-06-01

    It is important for clinicians to understand which are the clinical signs, the patient characteristics and the procedures that are related with the occurrence of hypertrophic burn scars in order to carry out a possible prognostic assessment. Providing clinicians with an easy-to- use tool for predicting the risk of pathological scars. A total of 703 patients with 2440 anatomical burn sites who were admitted to the Department of Plastic and Reconstructive Surgery, Burn Center of the Traumatological Hospital in Torino between January 1994 and May 2006 were included in the analysis. A Bayesian network (BN) model was implemented. The probability of developing a hypertrophic scar was evaluated on a number of scenarios. The error rate of the BN model was assessed internally and it was equal to 24·83%. While classical statistical method as logistic models can infer only which variables are related to the final outcome, the BN approach displays a set of relationships between the final outcome (scar type) and the explanatory covariates (patient's age and gender, burn surface area, full-thickness burn surface area, burn anatomical area and wound-healing time; burn treatment options such as advanced dressings, type of surgical approach, number of surgical procedures, type of skin graft, excision and coverage timing). A web-based interface to handle the BN model was developed on the website www.pubchild.org (burns header). Clinicians who registered at the website could submit their data in order to get from the BN model the predicted probability of observing a pathological scar type. © 2012 The Authors. International Wound Journal © 2012 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

  3. Development and in vivo evaluation of silver sulfadiazine loaded hydrogel consisting polyvinyl alcohol and chitosan for severe burns

    Directory of Open Access Journals (Sweden)

    S R Chakavala

    2012-01-01

    Full Text Available A new Hydrogel containing silver Sulfadiazine (SSD was developed for enhanced burns wound healing. The hydrogel was prepared by cross-linking of PVA and Chitosan by freeze thawing method. Their gel properties, moisture retaining capacity, fluid uptake capacity, in vitro release study, in vivo burn healing effect were evaluated. Chitosan and PVA cross linking decreased gel fraction upto 70% determined the good gel properties. This cross linked hydrogel increased the Swelling ratio and Water vapour transmission rate (WVTR which provides the sustained release of drug and moist environment for healing respectively. The hydrogel containing 7.5% of PVA, 0.75% of chitosan found to have increased gel strength, higher water vapour transmission rate and fluid uptake capacity suitable for faster healing of burns. This hydrogel also sustained the release of 1% SSD required for longer antimicrobial activity and found better in vivo burn healing capacity as compared to marketed preparation. Thus hydrogel containing 7.5% of PVA, 0.75% of chitosan and 1% SSD is a potential burns dressing with better gel properties and excellent burns healing capacity.

  4. Use of the Beck Depression Inventory for assessing depression in patients hospitalized with severe burn. Disentangling symptoms of depression from injury and treatment factors.

    Science.gov (United States)

    Thombs, Brett D

    2007-08-01

    The objective of this study was to assess whether scores on the Beck Depression Inventory (BDI) are biased by injury severity among hospitalized survivors of burn (N=262). A confirmatory factor analysis (CFA) model was developed with a general depression factor that loaded on all items and somatic and cognitive factors that were orthogonal to the general factor and to each other. The model fit the data well and substantially better than an alternative three-factor model with correlated factors. Percent total body surface area burned (TBSA) was significantly associated with the general depression factor (p=.04), but also with the orthogonal somatic factor (pburn injury. Analysis of item communalities, however, suggested that only approximately 2% of total predicted item variance was associated with bias related to injury severity. It was concluded that, despite a small amount of bias, the BDI is a reasonably accurate clinical tool even in the context of severe burn. Appropriate adjustments for bias, however, should be made in research with the BDI among patients with acute burn.

  5. The Application of Gastrocnemius Flap in Severe Electrical Burns of the Knees%腓肠肌肌瓣在修复严重膝部电烧伤中的应用

    Institute of Scientific and Technical Information of China (English)

    朱维平; 陈国华; 赵琳

    2003-01-01

    Objective To investigate the repairing methods of severe electrical burns of the knees. Methods 10pateints with severe electrical burns of the knees were enrolled in this study. After local debridement, gastrocnemius flap and netskin graft immediately. Results The entire flap survived very well with satisfactory results. Conclusion Early debridementfollowed by gastrocnemius flap and net skin graft could be simple, safe and reliable treatment strategies in the patients withsevere electrical burns of the knees.

  6. 特重度烧伤患儿一体化救治与康复%Integration of burn treatment and rehabilitation for a child with extremely severe burn

    Institute of Scientific and Technical Information of China (English)

    李鸿明; 张家平; 陈建; 宋华培; 刘秋石; 范鑫; 彭毅志; 吴军

    2015-01-01

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

  7. 重度烧伤患者烧伤初期内环境改变及输血治疗的探讨%Investigation of internal environment changes and transfusion therapy at early burn stage of severe burn patients

    Institute of Scientific and Technical Information of China (English)

    陈妙婵; 蔡葵

    2015-01-01

    Objective To explore the clinical significance of internal environment changes and transfusion therapy at early burn stage of severe burn patients.Methods From January 2010 to May 2014,forty-three early extensive severe burn patients who hospitalized in Foshan First People's Hospital of Guangdong Province were enrolled into this study,as study group.Detect the internal environment changes at different time during treatment,such as routine blood test,blood coagulation function,blood gas analysis,blood biochemical indicators and so on.Except of conventional burn treatment,appropriate component transfusion therapy was conducted on patients at the same time,according to its burn surface area and burn degree,volume of surgical hemorrhage,blood oozing from the wound surface and the progression of disease.Analyze the blood transfusion and internal environment changes of early severe burn patients.Forty-three cases of healthy who took health examination in the same hospital during the same period were chose as control group.Statistical analysis was performed on two groups of routine blood test,blood coagulation function,arterial blood gas analysis,blood biochemical indicator and so on.The study protocol was approved by the Ethical Review Board of Investigation in Human Being of Foshan First People's Hospital of Guangdong Province.Informed consent was obtained from all participants.There were no significant differences about age and gender between two groups (P>0.05).Results ① At the early stage of burn,sever burn patients had different degree of coagulation dysfunction.Within one day after burning,the prothrombin time (PT),international normalized ratio (INR) and activated partial thromboplastin time (APTT) of study group were higher than t.hose of control group,and the differences were statistically significant (P<0.05) ; At the time of admission,thrombin time (TT) of study group was higher than that of control group,and the difference was statistically significant

  8. Cografts of artificial dermis matrix and autogenetic split-thickness of repaired skin in severe hand wounds in patients with deep burns

    Directory of Open Access Journals (Sweden)

    Liu Hongqi

    2014-01-01

    Full Text Available The aim of this paper was to evaluate the effect of using artificial dermis matrix plus autologous split-thickness skin (ADM and ASTS in the treatment of deep-burns in hands of severely burned patients.We recruited a total of 58 patients with large area burns greater than 80% that were eschar-excised. Twenty-eight of them were treated with ADM and ASTS (test group; 30 were treated with autologous medium-thickness skin (AMTS (control group. The healing time of the hand wound was noted, clinical and photographic evaluations were performed, and a Jebsen-Taylor hand function test was compared and analyzed in the two groups. The wound healing time in the test group (24.22±3.34 days were longer than that of the control group (13.42±3.36 days and statistically significant. The healing time of skin graft donor sites was shorter than that of the control group (7.14±1.63 vs. 14.28±2.37 days and statistically significant (P<0.05. The 3rd and 6th month follow-up with clinical and functional evaluations revealed no differences between the two groups. In addition, there was no obvious scar formation and less pigmentation in either group. The repair of deeply burned hands with artificial dermis matrix was beneficial to both wound healing and the donor site, and was beneficial to the whole body rehabilitation of severely burned patients.

  9. Ingesta de antioxidantes y poliaminas en pacientes con quemaduras graves Ingestion of antioxidants and polyamines in patients with severe burns

    Directory of Open Access Journals (Sweden)

    M. Farriol

    2004-10-01

    Full Text Available El objetivo del estudio fue valorar el aporte energético, de antioxidantes y de poliaminas de la ingesta, iniciándose desde las primeras 24 horas inmediatas a la quemadura. La valoración nutricional se realizó a los 7, 15 y 21 días y se comparó con el grupo control (n = 30. La edad de los pacientes (n = 25; 20 hombres y 5 mujeres fue de 45,6 ± 20,4 años. Veintiún pacientes presentaron una superficie corporal quemada (SQC entre el 20-50% y en 4 casos fue superior al 50%. Se observó un descenso del aporte energético medio de ~40% vs el teórico calculado en los 3 períodos: 1.186 ± 32, 1.117 ± 589 y 1.331 ± 578 kcal. En los primeros 15 días la ingesta de antioxidantes fue ligeramente inferior a las RDA para la vitamina C: 60 mg vs 57 ± 32, 57 ± 53 y 75 ± 53 mg, e inferior durante todo el período para la vitamina E: 10 mg vs 5,0 ± 2,9; 4,5 ± 3,0 y 5,3 ± 3,4 mg, selenio: 40 µg vs 22,8 ± 13,7, 22,5 ± 9,8 y 25,7 ± 11,2 µg y zinc: 12 mg vs 7.3 ± 3.0; 6,8 ± 4,8 y 8.4 ± 5,3 mg. La ingesta de taurina descendió en el día 15 y se incrementó significativamente en el día 21: 65,7 ± 30 mg, 50,9 ± 25 y 72,0 ± 29 mg (p Starting the first 24 hours after burn injury, energy supply, antioxidants and polyamines were assessed in 25 severe burn patients (20 men and 5 women with a mean age of 45.6 ± 20.4 years. Nutritional assessment was performed at 7, 15 and 21 days and was compared with a control group (n = 30. In 21 patients the burned body surface area was 20%-50% and in four patients it was greater than 50%. A mean decrease in energy supply of ~40% versus the calculated theoretical value was found in the three periods: 1,186 ± 32; 1,117 ± 589 and 1,331 ± 578 kcal. In the first 15 days antioxidant ingestion was slightly lower than the recommended daily allowance for vitamin C: 60 mg versus 57 ± 32, 57 ± 53 and 75 ± 53 mg, and was lower during the entire period for vita-min E: 10 mg versus 5.0 ± 2.9; 4.5 ± 3.0 and 5.3

  10. Optimization of burn referrals

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  11. Use of a pediatric oxygenator integrated in a veno-venous hemofiltration circuit to remove CO2: a case report in a severe burn patient with refractory hypercapnia.

    Science.gov (United States)

    Rousseau, Anne-Françoise; Damas, Pierre; Renwart, Ludovic; Amand, Théo; Erpicum, Marie; Morimont, Philippe; Dubois, Bernard; Massion, Paul B

    2014-11-01

    Acute respiratory distress syndrome management is currently based on lung protective ventilation. Such strategy may lead to hypercapnic acidosis. We report a case of refractory hypercapnia in a severe burn adult, treated with simplified veno-venous extracorporeal carbon dioxide removal technique. We integrated a pediatric oxygenator in a continuous veno-venous hemofiltration circuit. This technique, used during at least 96h, was feasible, sure and efficient with carbon dioxide removal rate up to 32%.

  12. Burn Pits

    Science.gov (United States)

    ... 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 ...

  13. Burn Institute

    Science.gov (United States)

    ... 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 ...

  14. Effects of a 12-week rehabilitation program with music & exercise groups on range of motion in young children with severe burns.

    Science.gov (United States)

    Neugebauer, Christine Tuden; Serghiou, Michael; Herndon, David N; Suman, Oscar E

    2008-01-01

    Previous studies indicate that rehabilitation programs supplemented with a strength and endurance-based exercise program improve lean body mass, pulmonary function, endurance, strength, and functional outcomes in severely burned children over the age of 7-years when compared with standard of care (SOC). To date, supplemental exercise programming for severely burned children under the age of 7-years has not yet been explored. The purpose of this study was to determine if a 12-week rehabilitation program supplemented with music & exercise, was more effective in improving functional outcomes than the SOC alone. This is a descriptive study that measured elbow and knee range of motion (ROM) in 24 severely burned children between ages 2 and 6 years. Groups were compared for demographics as well as active and passive ROM to bilateral elbows and knees. A total of 15 patients completed the rehabilitation with supplemental music and exercise, and data was compared with 9 patients who received SOC. Patients receiving the 12-week program significantly improved ROM in all joints assessed except for one. Patients receiving SOC showed a significant improvement in only one of the joints assessed. Providing a structured supplemental music and exercise program in conjunction with occupational and physical therapy seems to improve both passive and active ROM to a greater extent than the SOC alone.

  15. Five-Lumen Antibiotic-Impregnated Femoral Central Venous Catheters in Severely Burned Patients: An Investigation of Device Utility and Catheter-Related Bloodstream Infection Rates.

    Science.gov (United States)

    Friedman, Bruce C; Mian, Mohammad A H; Mullins, Robert F; Hassan, Zaheed; Shaver, Joseph R; Johnston, Krystal K

    2015-01-01

    The objective of this study is to determine the catheter-related bloodstream infection (CRBSI) rate in a severely burned patient population, many of whom required prolonged use of central venous catheters (CVCs). Between January 2008 and June 2012, 151 patients underwent placement of 455 five-lumen minocycline/rifampin-impregnated CVCs. CRBSI was defined as at least one blood culture (>100,000 colonies) and one simultaneous roll-plate CVC tip culture (>15 colony forming units) positive for the same organism. Most patients had accidental burns (81.5%) with a mean TBSA of 50%. A mean of three catheters were inserted per patient (range, 1-25). CVCs were inserted in the femoral vein (91.2%), subclavian vein (5.3%), and internal jugular vein (3.3%). Mean overall catheter indwell time was 8 days (range, 0-39 days). The overall rate of CRBSI per 1000 catheter days was 11.2; patients with a TBSA >60% experienced significantly higher rates of CRBSI than patients with a TBSA ≤60% (16.2 vs 7.3, P = .01). CVCs placed through burned skin were four times more likely to be associated with CRBSI than CVCs placed through intact skin. The most common infectious organism was Acinetobacter baumannii. Deep venous thrombosis developed in eleven patients (7%). The overall rate of CRBSI was 11.2, consistent with published rates of CRBSI in burn patients. Thus, femoral placement of 5-lumen CVCs did not result in increased CRBSI rates. These data support the safety of femoral CVC placement in burn patients, contrary to the Centers for Disease Control recommendation to avoid femoral CVC insertion.

  16. Effects of a Hospital Based Wellness and Exercise Program on Quality of Life of Children with Severe Burns

    Science.gov (United States)

    Rosenberg, Marta; Celis, Mario M; Meyer, Walter; Tropez-Arceneaux, Lisa; McEntire, Serina J.; Fuchs, Helen; Richardson, Lisa; Holzer, Charles; Herndon, David N.; Suman, Oscar E.

    2012-01-01

    Objective To examine the effect of a 12-week Wellness and Exercise (W&E) program on the quality of life of pediatric burn survivors with burns of ≥ 40% total body surface area. We hypothesized this comprehensive regimen would improve physical and psychosocial outcomes. Methods Children were recruited for participation upon their discharge from the ICU. They were not taking anabolic/cardiovascular agents. Seventeen children participated in the W&E group and 14 children in the Standard of Care (SOC) group. Quality of life was assessed with the Child Health Questionnaire (CHQ) at discharge and 3 months. Children completed the CHQ-CF 87 and caregivers completed the CHQ-PF 28. Results The mean age of children in the W&E group was 14.07y±3.5 and mean TBSA was 58%±11.8. The mean age of children in the SOC group was 13.9y±3.1 and mean TBSA was 49%±7.8. ANOVA did not reveal statistically significant differences between the groups. Matched paired t-tests revealed that parents with children in the W&E group reported significant improvements with their children’s physical functioning, role/social physical functioning, mental health, overall physical and psychosocial functioning post-exercise. Conclusions These results are clinically relevant in that a comprehensive W&E program may be beneficial in promoting physical and psychosocial outcomes. PMID:22985974

  17. Burning vasculitis.

    Science.gov (United States)

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

    2016-04-26

    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.

  18. Effect of vitamin D supplementation and isokinetic training on muscle strength, explosive strength, lean body mass and gait in severely burned children: A randomized controlled trial.

    Science.gov (United States)

    Ebid, Anwar Abdelgayed; El-Shamy, Shamekh Mohamed; Amer, Maysa Abbas

    2017-03-01

    To determine the effects of vitamin D (VD) supplementation and isokinetic training on muscle strength, explosive strength (counter movement jump) (ES), lean body mass (LBM) and gait parameters in severe pediatric burn. Forty-eight burned children with circumferential lower extremity burns covering 40-55% of the total body surface area (TBSA), aged 10-16 years (Mean±SD 13.01±1.75), were randomized into the standard of care (n=16), isokinetic (n=17) and VD (n=15) groups. Unburned children (n=20) served as matched controls. All burned children received 12 weeks of routine physical therapy program (RPTP). In addition, the isokinetic group received isokinetic training for the quadriceps dominant limb 3 times per week at angular velocity 150°/s, and the VD group received the isokinetic training plus an oral daily dose of vitamin D3 1000 IU (Cholecalciferol). The primary measures, assessed at baseline and 12 weeks, included quadriceps strength by isokinetic dynamometer, ES, LBM by dual-energy X-ray absorptiometry (DEXA) and gait parameters by GAITRite system. The VD and isokinetic groups showed significant improvement in quadriceps strength, ES, LBM and gait parameters compared with the standard of care, and VD group show significant improvement in the VD level as compared with the other groups. The outcome measures (and percent of improvement where applicable) for the VD, isokinetic and standard of care are as follows: quadriceps strength, 85.25±0.93Nm (85%), 64.25±0.93 (36%) and 51.88±1.31Nm (12%); stride length, 94.00±2.69 (7%), 110.60±2.87 (25%) and 139.56±2.57 (60%); step length, 67.26±2.45 (72%), 55.25±2.49 (43%) and 43.76±1.34 (18%); velocity, 133.94±1.65 (82%), 99.94±1.65 (35%) and 80.11±1.91 (9%); and cadence, 140.63±1.36 (68%), 132.63±1.36 (58%) and 90.35±1.32 (9%), VD level 43.33±7.48 (75%), 24.77±7.38 (5%) and 25.63±8.39 (4%) respectively. VD supplementation combined with exercise training significantly increased muscle strength, ES, LBM

  19. Assessment of post-fire changes in land surface temperature and surface albedo, and their relation with fire-burn severity using multitemporal MODIS imagery

    OpenAIRE

    Veraverbeke, Sander; Verstraeten, Willem W.; Lhermitte, Stefaan; Van De Kerchove, Ruben; Goossens, Rudi

    2012-01-01

    This study evaluates the effects of the large 2007 Peloponnese (Greece) wildfires on changes in broadband surface albedo (a), daytime land surface temperature (LSTd) and night-time LST (LSTn) using a 2-year post-fire time series of Moderate Resolution Imaging Spectroradiometer satellite data. In addition, it assesses the potential of remotely sensed a and LST as indicators for fire-burn severity. Immediately after the fire event, mean a dropped up to 0.039 (standard deviation = 0.012) (P < 0....

  20. [The pain from burns].

    Science.gov (United States)

    Latarjet, J

    2002-03-01

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

  1. Management of Outpatient Burns

    OpenAIRE

    Waslen, G. D.

    1986-01-01

    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...

  2. Mechanisms of skeletal muscle wasting after severe burn and its treatment%严重烧伤后骨骼肌消耗的机制与治疗前景思考

    Institute of Scientific and Technical Information of China (English)

    柴家科

    2009-01-01

    Most of the major advances in burn treatment were made within the last five decades. However, hyperrnetabol-ic response after severe burn remains a problem in the treatment of patients with massive burn. As skeletal muscle accounts for o-ver 50% of body cell dry weight, its catabolism exerts profound effect on body metabolism as a whole. Main mechanisms under-lying skeletal muscle wasting induced by severe burn include ac-tivation of ubiquitin-proteasome pathway, bringing about break-down of muscle protein, and myonuclear apoptosis. Therapeutic strategies for skeletal muscle wasting after burn mainly include maintenance of room temperature at (31.5±0.7)℃, early ac-tive and passive exercise of skeletal muscles, administration of β adrenergic receptor blocker such as Prnpranolol, recombinant growth hormone, androgen, and insulin, which has lately been proven to possess the effect of suppressing myonuclear apoptosis after burn. Combination of multiple therapeutic strategies is ben-eficial in reducing complications of burn patients, particularly wide ranged skeletal muscle atrophy, to achieve a better clinical outcome.

  3. 烧伤脓毒症发病机制与防治对策%The pathogenesis and management of severe sepsis after burns

    Institute of Scientific and Technical Information of China (English)

    姚咏明; 盛志勇; 柴家科

    2008-01-01

    Sepsis and septic shock as a result of an invasire infection are challenging problems in extensively burned patients, and frequently end in multiple organ dysfunction syndrome (MODS).It is of great significance to further elucidate the pathogenetic mechanisms, and to seek novel intervention strategies to prevent and treat sepsis/MODS secondary to severe bums. A more complete understanding of the pathogenetic mechanisms of postburn sepsis would certainly elicit a number of potential therapeutic strategies for it. It is our belief that compre hensive clinical measures for management of severe sepsis should include rapid, adequate fluid resuscitation for bum shock, early feeding, effective control of infection, early escharectomy, and reinforcement of organ support. Once bum wound sepsis occurs, prompt removal of infected necrotic tissue is the key procedure to ensure a successful result. Further study is necessary to determine the precise mechanisms of these protective effects and the clinical advantages for postburn sepsis using evidence-based methodology system.

  4. Object-based assessment of burn severity in diseased forests using high-spatial and high-spectral resolution MASTER airborne imagery

    Science.gov (United States)

    Chen, Gang; Metz, Margaret R.; Rizzo, David M.; Dillon, Whalen W.; Meentemeyer, Ross K.

    2015-04-01

    Forest ecosystems are subject to a variety of disturbances with increasing intensities and frequencies, which may permanently change the trajectories of forest recovery and disrupt the ecosystem services provided by trees. Fire and invasive species, especially exotic disease-causing pathogens and insects, are examples of disturbances that together could pose major threats to forest health. This study examines the impacts of fire and exotic disease (sudden oak death) on forests, with an emphasis on the assessment of post-fire burn severity in a forest where trees have experienced three stages of disease progression pre-fire: early-stage (trees retaining dried foliage and fine twigs), middle-stage (trees losing fine crown fuels), and late-stage (trees falling down). The research was conducted by applying Geographic Object-Based Image Analysis (GEOBIA) to MASTER airborne images that were acquired immediately following the fire for rapid assessment and contained both high-spatial (4 m) and high-spectral (50 bands) resolutions. Although GEOBIA has gradually become a standard tool for analyzing high-spatial resolution imagery, high-spectral resolution data (dozens to hundreds of bands) can dramatically reduce computation efficiency in the process of segmentation and object-based variable extraction, leading to complicated variable selection for succeeding modeling. Hence, we also assessed two widely used band reduction algorithms, PCA (principal component analysis) and MNF (minimum noise fraction), for the delineation of image objects and the subsequent performance of burn severity models using either PCA or MNF derived variables. To increase computation efficiency, only the top 5 PCA and MNF and top 10 PCA and MNF components were evaluated, which accounted for 10% and 20% of the total number of the original 50 spectral bands, respectively. Results show that if no band reduction was applied the models developed for the three stages of disease progression had relatively

  5. The Protective Effects of Epigallocatechin Gallate Against Distant Organ Damage After Severe Skin Burns--Experimental Study Using a Rat Model of Thermal Trauma.

    Science.gov (United States)

    Hosnuter, Mubin; Melikoglu, Cenk; Aslan, Cem; Saglam, Gulcan; Sutcu, Recep

    2015-01-01

    Epigallocatechin gallate (EGCG), a green tea polyphenol, has potent antioxidant properties. The purpose of the present study was to examine the possible preventative effects of EGCG against internal organ injury due to large-surface skin burns in a rat model. The study design involved three groups of rats: a sham group and two groups with 25-30% full-thickness burns: (a) the sham group without burns or treatment (n=18); (b) the control burn group (burns+sterile saline, n=18); and (c) the burn treatment group (burns+treatment with EGCG, n=18). EGCG was administered intraperitoneally immediately after the thermal injury, and daily in 100 μmol/kg doses. Kidney and lung tissue samples were taken to determine the levels of malondialdehyde (MDA), superoxide dismutase (SOD), tumor necrosis factor-α (TNF-α), and glutathione peroxidase (GPX) after the first, third and seventh post-burn days. In the EGCG-treated burn group, SOD and GPX activity were significantly higher than in the burn control group. Additionally, MDA and TNF-α levels were significantly lower in the EGCG-treated burn group. Based on this study, it might be anticipated that EGCG treatment may be beneficial in burn injury cases.

  6. Transplantation of reconstructed corneal layer composed of corneal epithelium and fibroblasts on a lyophilized amniotic membrane to severely alkali-burned cornea.

    Science.gov (United States)

    Jang, In-Keun; Ahn, Jae-Il; Shin, Jun-Seop; Kwon, Young-Sam; Ryu, Yang-Hwan; Lee, Jeong-Kyu; Park, Jung-Keug; Song, Kye-Yong; Yang, Eun-Kyung; Kim, Jae-Chan

    2006-06-01

    The purpose of this article was to evaluate the graft efficacy of reconstructed corneal layer, composed of autologous corneal epithelium and fibroblasts on a lyophilized amniotic membrane (LAM), in a severely alkali-burned corneal model. After biopsy specimens were obtained from the left eyes of 24 rabbits, the corneal epithelial cells and fibroblasts were expanded in vitro and the corneal layer was reconstructed on LAM. Thirty-six eyes of rabbits underwent alkali burn (1 N NaOH, 30 s) to create a limbal deficiency and a deeply damaged corneal stroma. Four weeks later, group 1 underwent a graft of the reconstructed corneal layer composed of autologous corneal epithelium and fibroblasts on LAM. Group 2 was transplanted with a graft of the reconstructed autologous corneal epithelium, and group 3 served as a control without surgery. Wound healing and stabilization of the ocular surfaces occurred much faster in group 1 than in groups 2 and 3. The eyes in group 3 revealed typical limbal deficiencies with conjuctivalization and persistent corneal epithelial defects. However, the corneas in group 1 developed only mild peripheral neovascularization. Immunohistochemical staining in group 1 demonstrated that p63, cytokeratin 3, E-cadherin, transforming growth factor (TGF)-beta1, and collagen IV were expressed strongly in the corneal epithelium and basement membrane. On the basis of these results, transplantation of the reconstructed corneal layer, composed of autologous corneal epithelium and fibroblasts on LAM, partially accelerated the recovery of the alkali-injured rabbit ocular surface, and might be useful therapeutically for the treatment of patients with severely damaged cornea.

  7. CLINICAL TREATMENT OF 183 CASES OF SEVERE AND EXTREMELY SEVERE BURN CHILDREN%183例小儿重度、特重度烧伤的临床治疗方法分析

    Institute of Scientific and Technical Information of China (English)

    康群军; 余群洪; 胡安根; 林冬梅; 黄卫虎; 李勇铁

    2012-01-01

      Objective: To study the clinical treatment of the children with severe and extremely severe burn. Methods: Treating processes and clinical data of 183 patients with severe and extremely severe burn, from January 2006 to December 2011 were analyzed retrospectively in the hospital. Results: 167 patients among 183 ones were healed, the recovery rate was 91.26%. Conclusion: Valid anti-shock treat timely in early stage are important assurance for successful treatment, reasonably applying antibiotics all over the body was important measure for prevent wound infection, positively preventing side effects, maintaining airway patency and correct wound management, sealing wound surface with cutting scab and skin grafting in early stage were the key steps of successful treatment.%  目的研究小儿重度、特重度烧伤的临床救治.方法对我院2006年1月至2011年12月收治的183例重度、特重度小儿烧伤临床资料进行回顾总结及分析.结果183例患儿中治愈167例,治愈率为91.26%.结论早期及时有效的抗休克治疗是成功救治的重要保证,全身合理使用抗生素是防治烧伤感染的重要措施,积极预防烧伤并发症、维持气道通畅及合理创面外用药物、早期切削痂植皮封闭创面,是成功救治的重要环节

  8. Deep sole burns in several participants in a traditional festival of the firewalking ceremony in Kee-lung, Taiwan--clinical experiences and prevention strategies.

    Science.gov (United States)

    Chang, Shun-Cheng; Hsu, Chih-Kang; Tzeng, Yuan-Sheng; Teng, Shou-Cheng; Fu, Ju-Peng; Dai, Niann-Tzyy; Chen, Shyi-Gen; Chen, Tim-Mo; Feng, Chun-Che

    2012-11-01

    Firewalking is a common Taoist cleansing ceremony in Taiwan, but burns associated with the practice have rarely been reported. We analyzed the patients with plantar burns from one firewalking ceremony. In one firewalking ceremony, 12 Taoist disciples suffered from contact burns to the soles of their feet while walking over burning coals. Eight of them had at least second-degree burns over areas larger than 1% of their total body surface areas (TBSAs). The age, sex, medical history, date of injury, time taken to traverse the fire pit, depth and TBSA of the burns, treatment, length of stay, and outcome were recorded and analyzed. Deep, disseminated second- to third-degree burns were noted and healing took as long as three weeks in some patients. Because disseminated hypertrophic scars form after burns, the soles involved regain much of their tensile strength while walking. The patients experienced only a few difficulties in their daily lives three months after injury. From our experience treating patients with deep disseminated second- to third-degree plantar burns caused by firewalking, we conclude that they should be treated conservatively, with secondary healing rather than a skin graft. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

  9. Pain in burn patients.

    Science.gov (United States)

    Latarjet, J; Choinère, M

    1995-08-01

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

  10. Scald Burns

    Science.gov (United States)

    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! ...

  11. 严重烧伤病人的综合康复疗效分析%Synthetic rehabilitation effects analysis of severe burn patients

    Institute of Scientific and Technical Information of China (English)

    杜永军; 冯祥生; 沈锐; 阮树斌

    2002-01-01

    Background:Appearance and function damage after burn are caused by scar hyperplasia after wound repair.So main task of burn rehabilitation is prevention and treatment of hypertrophic scar. Pressure therapy can promote scar maturation;decrease itching,consistency and thick of scar.

  12. Hand chemical burns.

    Science.gov (United States)

    Robinson, Elliot P; Chhabra, A Bobby

    2015-03-01

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

  13. The Use of Virtual Reality Facilitates Dialectical Behavior Therapy® "Observing Sounds and Visuals" Mindfulness Skills Training Exercises for a Latino Patient with Severe Burns: A Case Study.

    Science.gov (United States)

    Gomez, Jocelyn; Hoffman, Hunter G; Bistricky, Steven L; Gonzalez, Miriam; Rosenberg, Laura; Sampaio, Mariana; Garcia-Palacios, Azucena; Navarro-Haro, Maria V; Alhalabi, Wadee; Rosenberg, Marta; Meyer, Walter J; Linehan, Marsha M

    2017-01-01

    Sustaining a burn injury increases an individual's risk of developing psychological problems such as generalized anxiety, negative emotions, depression, acute stress disorder, or post-traumatic stress disorder. Despite the growing use of Dialectical Behavioral Therapy® (DBT®) by clinical psychologists, to date, there are no published studies using standard DBT® or DBT® skills learning for severe burn patients. The current study explored the feasibility and clinical potential of using Immersive Virtual Reality (VR) enhanced DBT® mindfulness skills training to reduce negative emotions and increase positive emotions of a patient with severe burn injuries. The participant was a hospitalized (in house) 21-year-old Spanish speaking Latino male patient being treated for a large (>35% TBSA) severe flame burn injury. Methods: The patient looked into a pair of Oculus Rift DK2 virtual reality goggles to perceive the computer-generated virtual reality illusion of floating down a river, with rocks, boulders, trees, mountains, and clouds, while listening to DBT® mindfulness training audios during 4 VR sessions over a 1 month period. Study measures were administered before and after each VR session. Results: As predicted, the patient reported increased positive emotions and decreased negative emotions. The patient also accepted the VR mindfulness treatment technique. He reported the sessions helped him become more comfortable with his emotions and he wanted to keep using mindfulness after returning home. Conclusions: Dialectical Behavioral Therapy is an empirically validated treatment approach that has proved effective with non-burn patient populations for treating many of the psychological problems experienced by severe burn patients. The current case study explored for the first time, the use of immersive virtual reality enhanced DBT® mindfulness skills training with a burn patient. The patient reported reductions in negative emotions and increases in positive emotions

  14. The Use of Virtual Reality Facilitates Dialectical Behavior Therapy® “Observing Sounds and Visuals” Mindfulness Skills Training Exercises for a Latino Patient with Severe Burns: A Case Study

    Science.gov (United States)

    Gomez, Jocelyn; Hoffman, Hunter G.; Bistricky, Steven L.; Gonzalez, Miriam; Rosenberg, Laura; Sampaio, Mariana; Garcia-Palacios, Azucena; Navarro-Haro, Maria V.; Alhalabi, Wadee; Rosenberg, Marta; Meyer, Walter J.; Linehan, Marsha M.

    2017-01-01

    Sustaining a burn injury increases an individual's risk of developing psychological problems such as generalized anxiety, negative emotions, depression, acute stress disorder, or post-traumatic stress disorder. Despite the growing use of Dialectical Behavioral Therapy® (DBT®) by clinical psychologists, to date, there are no published studies using standard DBT® or DBT® skills learning for severe burn patients. The current study explored the feasibility and clinical potential of using Immersive Virtual Reality (VR) enhanced DBT® mindfulness skills training to reduce negative emotions and increase positive emotions of a patient with severe burn injuries. The participant was a hospitalized (in house) 21-year-old Spanish speaking Latino male patient being treated for a large (>35% TBSA) severe flame burn injury. Methods: The patient looked into a pair of Oculus Rift DK2 virtual reality goggles to perceive the computer-generated virtual reality illusion of floating down a river, with rocks, boulders, trees, mountains, and clouds, while listening to DBT® mindfulness training audios during 4 VR sessions over a 1 month period. Study measures were administered before and after each VR session. Results: As predicted, the patient reported increased positive emotions and decreased negative emotions. The patient also accepted the VR mindfulness treatment technique. He reported the sessions helped him become more comfortable with his emotions and he wanted to keep using mindfulness after returning home. Conclusions: Dialectical Behavioral Therapy is an empirically validated treatment approach that has proved effective with non-burn patient populations for treating many of the psychological problems experienced by severe burn patients. The current case study explored for the first time, the use of immersive virtual reality enhanced DBT® mindfulness skills training with a burn patient. The patient reported reductions in negative emotions and increases in positive emotions

  15. The Use of Virtual Reality Facilitates Dialectical Behavior Therapy® “Observing Sounds and Visuals” Mindfulness Skills Training Exercises for a Latino Patient with Severe Burns: A Case Study

    Directory of Open Access Journals (Sweden)

    Jocelyn Gomez

    2017-09-01

    Full Text Available Sustaining a burn injury increases an individual's risk of developing psychological problems such as generalized anxiety, negative emotions, depression, acute stress disorder, or post-traumatic stress disorder. Despite the growing use of Dialectical Behavioral Therapy® (DBT® by clinical psychologists, to date, there are no published studies using standard DBT® or DBT® skills learning for severe burn patients. The current study explored the feasibility and clinical potential of using Immersive Virtual Reality (VR enhanced DBT® mindfulness skills training to reduce negative emotions and increase positive emotions of a patient with severe burn injuries. The participant was a hospitalized (in house 21-year-old Spanish speaking Latino male patient being treated for a large (>35% TBSA severe flame burn injury.Methods: The patient looked into a pair of Oculus Rift DK2 virtual reality goggles to perceive the computer-generated virtual reality illusion of floating down a river, with rocks, boulders, trees, mountains, and clouds, while listening to DBT® mindfulness training audios during 4 VR sessions over a 1 month period. Study measures were administered before and after each VR session.Results: As predicted, the patient reported increased positive emotions and decreased negative emotions. The patient also accepted the VR mindfulness treatment technique. He reported the sessions helped him become more comfortable with his emotions and he wanted to keep using mindfulness after returning home.Conclusions: Dialectical Behavioral Therapy is an empirically validated treatment approach that has proved effective with non-burn patient populations for treating many of the psychological problems experienced by severe burn patients. The current case study explored for the first time, the use of immersive virtual reality enhanced DBT® mindfulness skills training with a burn patient. The patient reported reductions in negative emotions and increases in

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

    LENUS (Irish Health Repository)

    Murphy, A D

    2008-06-01

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

  17. Functional training after acellular dermis graft relieving scar in 53 patients with severe burn%脱细胞真皮植皮后功能训练减轻重烧伤患者瘢痕53例

    Institute of Scientific and Technical Information of China (English)

    苏永涛; 邢晓萍; 吕陟; 赵继东

    2003-01-01

    @@ BACKGROUND:Fingers with a large area of burn often necroses due to infection and dehydration and amputation of finger is often forced to perform or severe contracture of scar,stiffness of joints occurred leading to dysfunction hard to repair.

  18. 严重烧伤患者的早期治疗与功能恢复%Early Treatment and Physical Function Recovery of Severe Burn Patients

    Institute of Scientific and Technical Information of China (English)

    陈璧; 贾赤宇; 苏映军; 徐明达; 朱雄翔

    2001-01-01

    目的 探讨严重烧伤患者早期治疗与功能训练的最佳方案。方法 9例烧伤面积>90%,Ⅲ度>70%患者采用同一部位反复供皮和Ⅱ度烧伤愈合后供皮以扩大皮源,以异体与自体皮相间移植和大片筛状皮移植为主,同时在创面愈合后即开始物理治疗和功能训练。结果 9例患者中3例恢复工作,6例能做些家务劳动,生活完全自理。结论 严重烧伤患者早期采取有效的植皮措施和功能训练是提高治愈率、减少并发症,促进患者功能恢复的有效保证。%Objective To investigate the optimal scheme for early treatmentand the physical function restoration. Methods Nine burn patients with burnt area >90 % of total body surface area (TBSA) and full thickness burnt area >70 % of TBSA were studied. In each of the skin grafts, donor cutaneous sheets were harvested repeatedly from the same sites or from healed area of partial thickness burnt wounds to enlarge the donor areas. For most of the wounds large autogenic mesh sheets grafting and modified Jackson's technique of autogenic-allogenic skin strip grafting were adopted. At the same time, physical therapy and function training were performed after wounds healed. Results Of the 9 patients, 3 restored to work and 6 could engage in the housework. Conclusion Early skin transplantation and function training in the patients with severe burn could increase the curative rate, decrease the incidence of the complications and promote the function recovery.

  19. Chemical and Common Burns in Children.

    Science.gov (United States)

    Yin, Shan

    2017-05-01

    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.

  20. Effects of recombinant human growth hormone on glucose and protein metabolism in severe burn patients%严重烧伤病人应用重组人生长激素对糖和蛋白质代谢的影响

    Institute of Scientific and Technical Information of China (English)

    曹丽萍; 邓诗琳; 高志刚; 谢宇钢; 梁彦辉

    2001-01-01

    目的分析rhGH对严重烧伤病人血糖及蛋白质代谢的影响。方法对24例应用rhGH严重烧伤病人的血清总蛋白、白蛋白及血糖升高发生率进行比较分析。并对同期未应用rhGH患者血糖及蛋白质的变化进行总结分析。结果严重烧伤病人应用rhGH后血清总蛋白、白蛋白较用药前明显升高,并高于同期对照组。伤后2周内血糖升高,特别伤后1周内明显升高,伤后2周内血糖升高发生率分别为52.38%、50.00%、20.00%。伤后一周内、二周内及二周后开始应用rhGH其血糖升高发生率分别为100%、50%、0%。结论严重烧伤病人应用rhGH能促进机体蛋白质合成,但伤后早期应用rhGH对血糖影响较大,伤后2周后应用rhGH是较合适的时机。%Objective To investigate the influence of rhGH on blood sugar andprotein synthesis in severe burn patients. Methods 24 severe burn patients were enrolled in this study.The rhGH was administered subcutaneously in the dose of 0.2~0.25 IU/kg*d-1 at 10pm every day for 10 to 14 days.Serum total pertein,albumin and blood sugar concentrations were determined and analyzed before treatment with rhGH and after. Results Serum total protein and albumin levels were sygnificantly increased of the rhGH provided than before and placebo control in the same stage.The bolld sugar level was enhanced in 2 weeks after burn injury,especially in a week after burn injury.The incidences of hyperglycemia were 52.38% in 3 days after burn injury,50.00% in a week nd 20.00% in two weeks in severe burn patients.When rhGH was administered in a week,two weeks and more than two weeks after burn injury,the incidences of hyperglycemia were 100%,50% and 0% respectively. Conclusions The rhGH could promote protein synthesis in severe burn patients.The rhGH could cause blood sugar increasing in early stage after burn injury,so it was in good time that the rhGH was provided rof severe burn patients during more than two weeks after

  1. 烧伤患者血小板微粒的变化及临床意义%Changes of platelet microparticles and its clinical significance in severely burned patients

    Institute of Scientific and Technical Information of China (English)

    唐佳俊; 郇京宁

    2012-01-01

    Objective To investigate the clinical significance of changes of platelet microparticles (PMPs) in burn and burn infection patients.Methods The patients were divided into burn shock group (n =44),burn infection group (n =33) and control group (n =11 ).Plasma PMPs were determined by flow cytometry and were recorded in absolute value and in particle proportion.Also,the frequently used biochemical indicators were detected and analyzed for their relationship with PMPs.Results CD41 + PMPs levels in the burn shock and burn infection groups were higher than those in the control group (P < 0.01 ) and they showed positive relation with extent of burn ( r =0.258,P < 0.05 ).Stepwise regression analysis indicated that r-glutamyltranspeptidase (r-GT),extent of burn and alanine aminotransferase (ALT) entered CD41 + PMPs level regression equation.Conclusion The increase of PMPs levels may be closely correlated with the pathological coagulation state in severe burn patients.%目的 探讨烧伤和烧伤感染患者血小板微粒( platelet microparticles,PMPs)的变化及临床意义. 方法 选择烧伤休克期组(44例)、烧伤感染组(33例)和对照组(11例)患者,用流式细胞仪等方法检测血浆中PMPs水平,以绝对值和所占细胞微粒比例表示,同时检测临床常用生化指标,并分析与PMPs的相关性. 结果 烧伤休克期组和烧伤感染组CD41+ PMPs水平高于对照组(P<0.01),且与烧伤面积呈正相关(r =0.258,P<0.05).多元逐步回归分析进入CD41+ PMPs水平回归方程的有γ-谷氨酰转肽酶(γ-GT)、烧伤面积和谷丙转氨酶(ALT).结论 烧伤患者PMPs水平升高可能与烧伤后凝血状态密切相关.

  2. Application of Kangxiuke apozem in the treatment of severe burn shock%抗休克煎剂在烧伤休克治疗中的应用

    Institute of Scientific and Technical Information of China (English)

    蔡良良; 谢龙炜; 虞俊杰; 吕国忠; 陆金根; 丁羚涛

    2012-01-01

    Objective To observe the clinical effect of Kangxiuke apozem in the treatment of severe bum shock.Methods 40 patients of severe burn shock were randomly divided into a treatment group and a control group,with 20 patients in each group.All the patients were treated by the same route of counter-shock therapy,and the treatment group was additionally given Kangxiuke apozem (nasal feeding,qd,150 ml/d).Level of blood lactic acid,heart rate and urinary volume were evaluated by time.Main shock symptoms,including restlessness,hydrodipsia,perspiration and coldness,were observed.Results The treatment group was significantly superior to the control group in the amelioration of blood lactic acid,heart rate and urinary volume ( t =10.485、3.219、7.429,P< 0.01 ).The symptomatic extinction of restlessness,hydrodipsia,perspiration and coldness in the extremities in the treatment group were significantly superior to those in the control group (x2=10.16、7.37、5.63、4.29,P<0.05).Conclusion At the same time of routine counter-shock therapy,thereby prompt burn patients to smoothly go through shock period and decreas late complications.%目的 观察抗休克煎剂治疗烧伤休克的临床效果.方法 将2008年3月至2010年10月江苏省无锡市中西医结合医院收治的40例重度烧伤休克患者以随机数据表法分为两组各20例,对照组患者采用常规抗休克治疗,治疗组在对照组治疗基础上鼻饲抗休克煎剂,1剂/d,150 ml/剂.观察并记录两组患者复苏前、复苏后24、48、72 h的血乳酸值,心率、尿量及烦躁、口渴、汗出、肢厥等体征和临床症状的变化情况.结果 入院72 h时,治疗组血乳酸值、心率、尿量改善均优于对照组(t值分别为10.485、3.219、7.429,P均<0.01),烦躁、口渴、汗出、肢厥休克症状的消失优于对照组(x2值分别为10.16、7.37、5.63、4.29,P均<0.05).结论 抗休克煎剂配合治疗重度烧伤休克,可使患者平稳度过休克期,减少后期并发症.

  3. A primer on burn resuscitation

    Directory of Open Access Journals (Sweden)

    Bacomo Ferdinand

    2011-01-01

    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.

  4. Management of burn wounds.

    Science.gov (United States)

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

    2013-10-01

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

  5. Burn mouse models

    DEFF Research Database (Denmark)

    Calum, Henrik; Høiby, Niels; Moser, Claus

    2014-01-01

    Severe thermal injury induces immunosuppression, involving all parts of the immune system, especially when large fractions of the total body surface area are affected. An animal model was established to characterize the burn-induced immunosuppression. In our novel mouse model a 6 % third-degree b......Severe thermal injury induces immunosuppression, involving all parts of the immune system, especially when large fractions of the total body surface area are affected. An animal model was established to characterize the burn-induced immunosuppression. In our novel mouse model a 6 % third......-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. Use of previously burned skin as random cutaneous local flaps in pediatric burn reconstruction

    NARCIS (Netherlands)

    Barret, JP; Herndon, DN; McCauley, RL

    2002-01-01

    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

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

    NARCIS (Netherlands)

    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

  8. Curbing Inflammation in Burn Patients

    Directory of Open Access Journals (Sweden)

    Jayme A. Farina

    2013-01-01

    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.

  9. A review of hydrofluoric acid burn management

    OpenAIRE

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

    2014-01-01

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

  10. Titanium tetrachloride burns to the eye.

    OpenAIRE

    Chitkara, D K; McNeela, B. J.

    1992-01-01

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

  11. Topical Pain Relievers May Cause Burns

    Science.gov (United States)

    ... 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 ...

  12. A review of hydrofluoric acid burn management.

    Science.gov (United States)

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

    2014-01-01

    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.

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

    Science.gov (United States)

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

    2012-04-01

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

  14. Nutrition Support in Burn Patients

    Directory of Open Access Journals (Sweden)

    Cem Aydoğan

    2012-08-01

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

  15. Corneal Protection for Burn Patients

    Science.gov (United States)

    2013-10-01

    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

  16. The Role of Nutrition Support Therapy in Treatment of Severe Burns%营养支持疗法在严重烧伤治疗中的作用

    Institute of Scientific and Technical Information of China (English)

    田甜; 常春娟; 胡国栋; 王瑞晨; 贾赤宇

    2013-01-01

    烧伤救治是一个复杂的系统工程,涉及急救、复苏、感染、创面、营养、康复及心理等.营养支持已成为中度以上烧伤患者的重要治疗措施之一:积极正确的营养支持,可促进合成、增强免疫和加速创面愈合,对烧伤救治疗效有明显的改善作用.相反,营养不良可使创面愈合延缓、降低身体抵抗力、易并发感染等并发症,严重影响预后.给予合理的营养支持治疗来维持烧伤患者的营养是严重烧伤治疗中重要措施之一.因此,重视营养支持,相关治疗措施才会发挥应有疗效,烧伤的整体治疗水平才可能提高.%Burn treatment is a complicated system engineering,involving of first aid,resuscitation,infection,wound,nutrition,rehabilitation and psychology,and so on.Nutritional support has become one of the important treatment of severe burn patients.The positive right of nutritional support,can promote synthesis,enhance immunity and accelerating wound healing,and has obvious improving effect to burn treatment efficacy.Instead,poor nutrition can make the wound healing delay,lower body resistance,easy intercurrent infection complications,and so on,seriously affect the prognosis.Reasonable nutrition support treatment for burn patients nutrtion is one of important measures in severe burn treatment.Therefore,only paying more attention to nutritional support therapy,it's possible that the relevant treatment measures can play the efficacy and the overall levels of burn treatments can be improved.

  17. 特重度烧伤并发急性肾功能衰竭的因素分析%Analysis of the factors of severe burn complicated with acute renal failure

    Institute of Scientific and Technical Information of China (English)

    王野; 朱志军; 边曦

    2014-01-01

    目的:探讨特重度烧伤并发急性肾功能衰竭(acute renal failure,ARF)的相关因素,为临床早期防治ARF提供依据。方法分析我科2003年1月至2012年12月收治的特重度烧伤362例烧伤后开始接受液体复苏治疗的时间和方法,并结合测定的生化指标,分析特重度烧伤与ARF的相关性。结果362例特重度烧伤中有27例并发ARF,烧伤面积>90%组ARF发生比例明显高于其他各组(P<0.05)。烧伤面积>70%组,伤后2 h以后开始接受液体复苏治疗组发生ARF明显高于伤后2 h以内开始治疗组(P<0.05)。发生ARF者,血尿素氮(BUN)在伤后14 d明显高于无ARF者(P<0.05),血肌酐(Scr)在伤后7 d明显高于无ARF者(P<0.05),胱抑素C(CysC)在伤后2 d明显高于无ARF者(P<0.05)。结论烧伤面积和伤后液体复苏开始治疗时间均与烧伤并发ARF呈正相关,发生ARF时患者BUN、Scr、CysC均明显升高,CysC测定可能成为早期检测ARF的敏感指标。%Objective Through investigation the related factors of acute renal failure(ARF) with severely thermal burn, and provide evidence for clinical early prevention and treatment of ARF. Methods 362 cases data with ARF admitted into our department during January 2003 to December 2012 with severely thermal burn were enrolled to analyze the time and method began to receive fluid resuscitation therapy, combined with their biochemical index determination, to analyze the correlation of severely thermal burn with ARF. Results In 362 cases of severely thermal burn patients were 27 cases complicated with ARF, and the ARF incidence of burn area more than 90%was significantly higher than the other groups (P<0.05). In burn area more than 70%group, the ARF incidence of 2 hours after injury began to accept fluid resuscitation group was significantly higher than within 2 hours after injury to the treatment group (P<0.05). In 27 cases of ARF, blood urea

  18. Status of post-traumatic growth of severe burn patients and its influencing factors%严重烧伤患者创伤后成长状况及对策

    Institute of Scientific and Technical Information of China (English)

    梁英; 肖文芳; 焦丹丹

    2016-01-01

    Objective To understand the status of post-traumatic growth of severe burn patients and analyze its influencing factors. Methods General information questionnaire and post-traumatic growth inventory (PTGI) were used to investigate thirty patients with severe burn. Multi-linear regression method was used to analyze the post-traumatic influencing factors. Results The average score of PTGI was (68.30 ± 10.90), which was in media level. The main influencing factors included burn area, active exercise, time and expense of treatment, marital status and sear proliferation. Conclusion In order to improve the post-traumatic growth,nurses should enhance psychological intervention, teach effective coping strategies and increase the social level to the burn patients.%目的 了解严重烧伤患者创伤后成长水平状况及探讨其护理对策.方法 采用一般情况调查表,创伤后成长量表(posttraumatic growth inventory,PTGI)对30例严重烧伤患者进行调查.结果 本组30例严重烧伤患者PTGI总分为(68.30±10.90)分,处于中等水平.结论 护理人员应加强对严重烧伤患者心理的疏导,指导其采取积极有效的应对策略,提高其创伤后成长水平.

  19. 抗内毒素Fab'对严重烧伤早期炎症细胞因子的影响%Effects of Fab' against LPS on inflanunatory cytokines during the early stage of severe burns in mice

    Institute of Scientific and Technical Information of China (English)

    庄颖; 张雅萍; 马思远

    2008-01-01

    目的 观察抗内毒素Fab'对严重烧伤早期肠源性内毒素血症小鼠肠道损伤的保护作用.方法 采用严重烧伤早期肠源性内毒素血症小鼠模型,分为烧伤组、治疗组及对照组,分别于6、12、24、48 h四个时相点测定血清肿瘤坏死因子(TNF)-α、白细胞介素(IL)-lβ、IL-10的浓度.结果 与正常对照组比较,烧伤后血清TNF-α、IL-1β、IL-10水平增高,差异有统计学意义(P<0.01);治疗组血清TNF-α、IL-1β、IL-10水平较烧伤组显著降低(P<0.01).病理检查结果提示治疗组较烧伤组肠黏膜损伤明显减轻.结论 抗内毒素Fab'能抑制内毒素所诱导的TNF-α、IL-1β产生,同时调节血清中的IL-10水平,减轻内毒素对机体的损害,从而起到对严重烧伤后肠源性脓毒症的防治作用.%Objective To investigate the effect of the Fab' against LPS on intestinal mucosa during the early stage of severe bums in mice. Methods The gut-derived endotoximia mice model in the early stage of severe burn was created. The mice were randomly divided into three groups: burn group, control group and treatment group. At 6,12,24 and 48 h after burns ,levels of serum TNF-a,IL-1β and IL-10 were detenninated by enzyme linked immunosorbant assay. Results After burns,levels of serum TNF-α,IL-1 β and IL-10 in burn group were significantly higher than those in the control group (P<0.01). The levels of serum TNF-α,IL-β and IL-10 in treatment group were significantly lowere than in the burn group (P < 0.01 ). Pathological examinations revealed that the damage to the intestinal mucosa in treatment group was obviously alleviated as compared with bum group. Conclusion The Fab' against LPS can significantly decrease the levels of serum TNF-α,IL-1β and IL-10 during the early stage in severely burned gut-derived endotoximia mice, and inhibit injury by LPS,then prevent and cure burn sepsis.

  20. 严重烧伤后恐怖症患者的心理状态相关因素分析%Analysis the related factors of psychological state in phobia patient after severely burn

    Institute of Scientific and Technical Information of China (English)

    韩小燕

    2011-01-01

    Objective: To investigate the terrorist severely burned patients related to psychological factors. Methods: In our hospital from January 2006 -June 2009, 324 cases of severe burn treated patients as research subjects, the use of mental health self - assessment questionnaire and clinical questions and answers for phobia diagnosis, occurrence of those factors phobia Statistical analysis. Results: The group of 324 severely burned patients after diagnosis of phobia after burning were 157 cases of nerve, the rate was 48.5%. The sex, age, bum size, bum location, marital status and wound treatment and burns were the occurrence of neurological phobia, with statistical significance. Conclusion: The incidence of bum phobia is higher, and with a variety of factors related to clinical treatment should be targeted based on this psychological counseling and treatment to reduce the incidence of bum phobia.%目的:探讨严重烧伤患者发生恐怖心理状态的相关因素.方法:选取我院2006年1月~2009年6月收治的324例严重烧伤患者作为研究对象,采用心理健康自评问卷和临床问答的方式进行恐怖症诊断,对恐怖症发生者的相关因素进行分析统计.结果:本组324例严重烧伤患者经确诊为烧伤后恐怖神经症者157例,发生率为48.5%.性别、年龄、烧伤面积、烧伤部位、婚姻状况及创面处理方法均与烧伤后恐怖性神经症的发生有关,具有统计学意义.结论:烧伤后恐怖症的发生率较高,且与多种因素相关,临床治疗中应根据此进行有针对性的心理辅导和治疗,降低烧伤后恐怖症的发生.

  1. Burns (For Parents)

    Science.gov (United States)

    ... 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 ...

  2. Energy and nitrogen balances in 24 severely burned patients receiving 4 isocaloric diets of about 10 MJ/m2/day (2392 Kcalories/m2/day).

    Science.gov (United States)

    Serog, P; Baigts, F; Apfelbaum, M; Guilbaud, J; Chauvin, B; Pecqueur, M L

    1983-07-01

    Twenty-four subjects with burns ranging from 25-70 per cent received for 12 days exclusively per os a series of 4 isocaloric diets of about 4000 Kcal--'normal', or hyperproteic, or hyperlipidic, or hyperglucidic according to a randomized schedule. Oxygen consumptions were measured at the end of each diet and nitrogen balance was determined every day. Though patients were not massively overfed there remained a positive energy gap. The nitrogen balance was found to be equilibrated on the whole but clearly positive with the hyperproteic diet and clearly negative with the hyperlipidic-normoproteic diet. Thus there is no rationale for the huge energy overfeeding classically used.

  3. The Burning Truth(s)

    African Journals Online (AJOL)

    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 ...

  4. Corneal Protection for Burn Patients

    Science.gov (United States)

    2014-11-01

    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

  5. The biology of burn injury.

    Science.gov (United States)

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

    2010-09-01

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

  6. Study Burning Performance of Several Different Insulation Materials%几种不同保温材料燃烧性能的研究

    Institute of Scientific and Technical Information of China (English)

    马烨红; 李建新; 罗振海; 刘轩; 高金墙

    2012-01-01

    Insulation materials as the main materials of the existing building energy efficiency, has been widely used in the construction industry, but a wide range of insulation materials, there are still large differences in their fire performance. In the study, randomly selected from the project site to use various types of insulation materials, using the latest burning performance test methods and test equipment to detect the burning properties of inorganic, organic, composite insulation materials and thermal insulation. The result showed that organic insulation materials burning poor performance and inorganic insulation materials were non-combustible materials, composite insulation materials suggestions on the combustion properties of composite materials. In the thesis, the above results had decided to make relevant comments and recommendations around the use of insulation materials.%保温材料作为国内现有建筑节能的主要材料,已在建筑行业得到广泛的应用,但保温材料种类繁多,其防火性能仍然存在较大的差异,本研究随机选取工程现场使用的各类保温材料,采用最新的燃烧性能试验方法以及试验仪器,对无机、有机、复合保温材料以及保温浆料的燃烧性能进行检测;试验得出有机保温材料燃烧性能差,无机保温材料属下不燃材料,复合保温材料决定于复合材料的燃烧性能。同时本论文综合以上实验结果对保温材料的使用提出相关意见和建议。

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

    Institute of Scientific and Technical Information of China (English)

    张银花; 袁晓敏

    2013-01-01

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

  8. Clinical study of prevention of infections in severe burn patients during shock stage%重度烧伤患者休克期感染防治的临床研究

    Institute of Scientific and Technical Information of China (English)

    杨帆; 姚忠军; 周伟; 徐风瑞; 李江华; 李亢

    2015-01-01

    OBJECTIVE To explore the prevention measures for infections in the severe burn patients during shock stage so as to provide guidance for clinical treatment of infections .METHODS A total of 106 severe burn patients who were treated in the hospital from Apr 2010 to May 2013 were enrolled in the study ,the patients were compli‐cated with different degrees of hypovolemic shock symptoms at the admission to hospital ,and they were treated with body fluid resuscitation ,gastrointestinal nutrition ,wound sealing ,and protection of functions of multiple or‐gans .RESULTS The length of hospital stay of the 106 severe burn patients ranged between 25 and 76 days ,75 ca‐ses were cured or remarkably improved ,and 31 cases died ,among whom 10 cases died of sepsis ,9 cases died of gastrointestinal hemorrhage ,9 cases died of pulmonary infections ,2 cases died of acute renal failure ,and 1 case died of heart failure .CONCLUSION It is necessary for the severe burn patients complicated with shock to perform effective body fluid resuscitation ,gastrointestinal nutrition ,wound sealing ,and protection of functions of multiple organs .%目的:探讨重度烧伤患者休克期的感染防治措施,为临床抗感染提供参考依据。方法选取2010年4月-2013年5月在医院收治的106例重度烧伤患者,入院时伴不同程度的低血容量休克症状,对其进行体液复苏、胃肠道营养、创面封闭及多器官功能的保护治疗。结果106例重度烧伤患者,住院时间25~76 d ,75例治愈或明显好转,占70.8%,31例死亡,其中死于脓毒血症10例、消化道出血9例、肺部感染9例、急性肾功能衰竭2例、心力衰竭1例。结论对于重度烧伤伴休克患者需及时进行有效的体液复苏、胃肠道营养、创面的封闭和多器官功能的保护。

  9. Surgical treatment of severe or moderate axillary burn scar contracture with transverse island scapular flap and expanded transverse island scapular flap in adult and pediatric patients--A clinical experience of 15 cases.

    Science.gov (United States)

    Chen, Baoguo; Xu, Minghuo; Chai, Jiake; Song, Huifeng; Gao, Quanwen

    2015-06-01

    Axillary burn scar contracture is common and troublesome. With the aim of restoring the function of the upper extremities, a proper local flap with minor damage and preclusion from recurrence should be developed to guarantee satisfactory results. A minor webbed scar contracture was rectified by Z-plasty. However, severe or moderate contracture must be constructed by a local flap. An island scapular flap has been used in pediatric patients for repairing axillary contracture. However, no detailed description of the use of a transverse island scapular flap (TISF) was reported to correct the deformity. Moreover, an expanded transverse island scapular flap (ETISF) used for increasing the volume of skin for severe axillary contracture in adults and developing children was also not presented. From 2006 to 2013, TISFs were harvested for 12 pediatric patients (5-12 years of age) with 15 sides of severe or moderate axillary burn scar contractures. Four ETISFs were designed for two adult patients (38 and 32 years of age). The flap size was between 10 cm×5 cm and 20 cm×10 cm. In one pediatric patient, a cicatrix was observed on the surface of the flap's donor site. Handheld Doppler was applied to detect the pedicle. The patients were required to lift their upper arms regularly each day after the operation. All 19 flaps survived completely. Axillary burn scar contractures were corrected successfully in 11 patients with no expander implantation. The lifting angle was enhanced considerably with 1-3 years of follow-up in the 11 patients. Only one pediatric patient with cicatrix on the donor site displayed tight skin on the back and a little restraint on the shoulder. The patient's parents were told to intensify the chin-up movement on the horizontal bar. She was in the process of a 3-month follow-up. The lifting angle was also improved significantly in the latter three cases of expander implantation although they were followed up for a short duration of 3 months. Due to poor

  10. Osteomyelitis in burn patients requiring skeletal fixation

    NARCIS (Netherlands)

    Barret, JP; Desai, MH; Herndon, DN

    2000-01-01

    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.

  11. [Current treatment strategies for paediatric burns].

    Science.gov (United States)

    Küntscher, M V; Hartmann, B

    2006-06-01

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

  12. Sedation and Analgesia in Burn

    Directory of Open Access Journals (Sweden)

    Özkan Akıncı

    2011-07-01

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

  13. Pediatric burn rehabilitation: Philosophy and strategies

    Directory of Open Access Journals (Sweden)

    Shohei Ohgi

    2013-09-01

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

  14. [Reconstruction of facial burn sequelae].

    Science.gov (United States)

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

    2001-06-01

    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.

  15. [Hydrofluoric acid burns].

    Science.gov (United States)

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

    2016-01-01

    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.

  16. First Aid: Burns

    Science.gov (United States)

    ... 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 ...

  17. First Aid: Burns

    Science.gov (United States)

    ... 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, ...

  18. 重返工作岗位对重度烧伤患者身心健康的影响%Influence of Returning to Work on Health-Related Quality of Life on Patients after Severe Burn Inj ury

    Institute of Scientific and Technical Information of China (English)

    李东文; 王红梅; 孙瑛; 崔琳; 刘文清

    2014-01-01

    Objective To investigate the influence of returning to work on life quality of patients with se-vere burn injury.Methods By convenience sampling,76 patients suffered severe burns were randomly se-lected from one city general hospital during January 2007 to January 2011.The data of patients were collected by SF-36、BSHS-B、IES- R、HADS.Results Within 76 patients with severe burn injury,54 of them had returned to work.The score of physiological function,physical role,physical pain,general health status and social function in those patients who did not return to work were lower than general scale of Si-chuan Province and group of patients who had returned to work.IES-R score and each dimension of BSHS-B (except body image,interpersonal relationship and sex life)were significantly lower than group of patients who had not return to work (P0.05).Conclusion Returning to work can promote the health-related quality of life and psychological health of severe burn patients.%探讨重返工作岗位对重度烧伤患者康复期身心健康的影响.方法采用目的抽样法选择2007年1月至2011年1月在成都市某三级甲等医院住院的76例重度烧伤患者为研究对象,采用 SF-36健康调查量表、精简烧伤健康量表(burn specific health scale-brief,BSHS-B)、事件影响量表修订版(impact of event scale-revised,IES-R)、医院焦虑抑郁量表(hospital anxiety and depression scale,HADS)等对其身心健康进行测评.结果76例重度烧伤患者中,54例重返工作岗位,未返工作岗位组患者的生理功能、生理职能、躯体疼痛、总体健康及社会功能得分均低于四川省常模和重返工作岗位组,重返工作岗位组 IES-R得分、BSHS-B 各维度(除体像、人际关系及性生活外)得分明显低于未返工作岗位组(P<0.05或P<0.01),两组HADS得分差异无统计学意义(P>0.05).结论重返工作岗位有助于促进重度烧伤患者的身心康复.

  19. Rehabilitation of the burn patient

    Directory of Open Access Journals (Sweden)

    Procter Fiona

    2010-10-01

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

  20. Adult campfire burns: two avenues for prevention.

    Science.gov (United States)

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

    2005-01-01

    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.

  1. Burns (For Parents)

    Science.gov (United States)

    ... 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 ...

  2. 严重烧伤后应激性溃疡的发病机制及防治策略%The Pathogenesis and Prevention Strategies of Stress Ulcer after Severe Burn

    Institute of Scientific and Technical Information of China (English)

    张杨杨; 邱啸臣; 周国勇; 刘真; 贾赤宇

    2013-01-01

    With the development of things,principal contradiction is dominant and play a decisive role,while secondary contradiction in a subordinate position,play a secondary role.The pathogenesis of stress ulcer after severe burns,such as neuroendocrine disorders,gastric mucosal barrier miopragia,infection,and psychological stress,etc,as well as its prevention and treatment strategies,such as countershock therapy,manage burn wound actively,improve gastric mucosal ischemia,early enteral nutritional,prevention of infection and so on,are concrete manifestation of this principle.%在事物发展的过程中,主要矛盾处于支配地位、对事物发展起决定作用,次要矛盾处于从属地位、对事物发展起次要作用.烧伤后应激性溃疡的发病机制如:神经-内分泌失调、胃黏膜屏障功能减弱、感染和心理应激等,以及防治方法,如:抗休克治疗、积极处理创面,改善胃黏膜缺血,早期肠内营养和防治感染等是这一原理的具体体现.

  3. Intentional burns in Nepal: a comparative study.

    Science.gov (United States)

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

    2015-09-01

    psychosocial risk factors were identified in most cases. Intentional burns resulted in severe burns with high mortality. Intentional burns are not only a serious medical issue; they represent significant public health and gender issues in Nepal. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  4. Effects of Surgical and Physical Therapy on Functional Reconstruction post Severe Burn%外科手术结合物理治疗对严重烧伤后功能重建的效果

    Institute of Scientific and Technical Information of China (English)

    陈静; 王甲汉; 杨磊; 李志清; 任加良

    2013-01-01

    Objective To evaluate the effects of surgical and physical therapy on functional reconstruction post severe burn. Methods 21 patients with severe burn accepted comprehensive rehabilitation, while the other 18 cases accepted surgical therapy only. Modified Barthel Index and Vancouver Scar Scale were applied to assess their activities of daily living (ADL) and scar recovery 3 months, 1 year or 2 years post injury. Results Compared with the control group, the observation significantly improved in ADL and scar recovery with fewer opera-tions (P<0.01). Conclusion The surgical and physical therapy facilitates to improve the functional recovery post severe burn.%目的:评估外科手术结合物理治疗对严重烧伤后功能重建的影响。方法39例严重烧伤患者中,21例(观察组)接受规范化功能康复体系治疗,18例(对照组)仅定期返院接受外科手术治疗。手术和物理治疗分别在烧伤治疗中心和医学康复中心完成。采用改良Barthel指数和温哥华瘢痕量表观测患者伤后3个月、1年和2年的日常生活活动能力及体表瘢痕康复情况。结果与对照组相比,观察组日常生活活动能力明显提高(P<0.01),体表瘢痕明显改善(P<0.01),整形手术总次数明显减少(P<0.01)。结论外科手术结合物理治疗可提高严重烧伤后期功能障碍矫正效果。

  5. The causes and prevention methods of severe burn patients complicated with stress ulcer bleeding%重度烧伤并发应激性溃疡出血的原因及防治

    Institute of Scientific and Technical Information of China (English)

    李峥; 张兵; 李巍; 王强

    2014-01-01

    目的:探讨重度烧伤并发应激性溃疡出血发生的原因及防治方法。方法我院2008年1月至2013年12月共收治892例重度烧伤患者,回顾分析其中53例并发应激性溃疡出血患者的临床资料。结果重度烧伤并发应激性溃疡出血的53例患者中,经积极治疗,显效24例,有效22例,总有效率为87%;休克患者出血发生率明显高于无休克患者(χ2=138.20,P<0.05),应激性溃疡出血与休克之间存在较强关联性(χ2=62.82,P<0.05,r=0.65)。结论对于存在休克的重度烧伤患者需提高警惕,注意监测有无应激性溃疡出血发生,早期行综合治疗,防治休克是预防应激性溃疡出血的有利措施。%Objective To study the causes and prevention methods of severe burn patients complicated with stress ulcer bleed -ing.Methods From January 2001 to December 2012 , a total of 892 cases of severe burn patients were treated in our hospital .Clinical data of 53 cases complicated with stress ulcer bleeding were retrospectively analyzed .Results Of the 53 patients, therapy was marked-ly effective in 24 cases and effective in 22 patients.The total effective rate was 87%.The incidence of bleeding in shock patients was significantly higher than that in non-shock patients (χ2=138.20 , P<0.05 ) .There was a significant correlation between shock and stress ulcer bleeding (χ2=62.82 ,P<0.05 ,r=0.65 ) .Conclusion It should be wary of severe burn patients with shock to monitor the presence of stress ulcer hemorrhage , so that to carry out early comprehensive treatment .The prevention and treatment of shock are fa-vorable measures for stress ulcer bleeding .

  6. Analysis of Influencing Factors for the Occurence of Delirium in Patients with Severe Burns and Related Nursing Research%重度烧伤患者谵妄发生影响因素分析及护理研究

    Institute of Scientific and Technical Information of China (English)

    张海英; 曾郞平; 麦秋芳

    2014-01-01

    目的:分析重度烧伤患者谵妄发生的影响因素,并进行针对性的护理;研究针对性护理的效果。方法200例谵妄患者用传统护理的方法,并研究谵妄发生的影响因素。100例谵妄患者采用针对性护理,比较传统护理和针对性护理的效果。结果年龄、病因以及受损重要部位三者是重度烧伤患者谵妄发生的影响因素(P<0.05)。针对性护理的护理效果优于传统护理(P<0.05)。结论年龄、病因以及受损重要部位三者是重度烧伤患者谵妄发生的影响因素,而针对性护理为最佳护理策略。%Objective To analyze influencing factors of the occurrence of delirium in patients with severe burns, and to explore the efficacy of targeted care. Methods We assigned 200 cases of patients with delirium to traditional nursing care and studied the delirium risk factors. Another 100 cases of patients with delirium received targeted nursing care. The primary outcome was the comparison of the efficacy of traditional nursing and targeted care. Results Age, pathogenic factors, and damaged parts influenced the occurence of delirium in patients with severe burns (P <0.05). Targeted care was superior to the traditional nursing (P <0.05). Conclusions Age, pathogenic factors, and damaged parts influenced the occurence of delirium in patients with severe burns. Targeted nursing is the best care strategy to choose.

  7. [Burning mouth syndrome (glossalgia)].

    Science.gov (United States)

    2014-01-01

    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.

  8. Burns, hypertrophic scar and galactorrhea.

    Science.gov (United States)

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

    2013-07-01

    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.

  9. Burns, hypertrophic scar and galactorrhea

    Directory of Open Access Journals (Sweden)

    Hamid Karimi

    2013-07-01

    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.

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

    Institute of Scientific and Technical Information of China (English)

    彭曦; 谭银玲; 陶麟辉; 王凤君; 赵云; 汪仕良

    2001-01-01

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

  11. Methylated spirit burns: an ongoing problem.

    Science.gov (United States)

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

    2012-09-01

    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.

  12. Occupational burns treated in emergency departments.

    Science.gov (United States)

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

    2015-03-01

    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.

  13. Psychological Nursing Care for 64 Patients with Severe Burn Complicated by Psychological Disorder%重度烧伤并发心理障碍64例心理护理体会

    Institute of Scientific and Technical Information of China (English)

    陈远芳

    2013-01-01

    Objective To analyze and investigate the psychological disorders and psychological status of patients with severe burn, and to summarize the effective psychological nursing care. Methods Various degree of fear and tension existed in 64 patients with severe burn in this study. All patients had a strong fear in the face of pain and many other psychological disorders such as fear for disability and despair. Appropriate psychological nursing care was carried out in accordance with specific conditions. The patients were randomly divided into two groups, with 32 cases in each group. The routine nursing care was carried out in one group, while that combined with psychological nursing care was given to the other group. Then the effects on two groups were compared. Results The indicators such as anxiety and depression of patients in the combined nursing care group were significantly lower than those in the routine nursing care group (P<0.05). Conclusion The psychological nursing care for psychological disorders of patients with severe burn is conducive to the rehabilitation of patient. To some extent, it is very important to improve the psychological status, and ease the anxious and depressive mood of patients with severe burn.%  目的针对重度烧伤患者出现的心理障碍以及心理状况进行分析与研究,总结行之有效的心理护理体会。方法本文选择64例重度烧伤患者,都在不同程度上存在恐惧以及紧张心理,在面对疼痛时有非常强烈的畏惧心理以及害怕伤残、悲观失望等等诸多心理障碍。我们根据具体情况进行相应心理护理,将患者随机分成两组,各32例,其中一组行常规护理法,另一组在接受常规护理的基础上,结合心理护理进行护理,之后对比两组疗效。结果采用常规护理结合心理护理一组患者在焦虑、抑郁等方面的指标明显低于常规护理组(P<0.05)。结论对于重度烧伤患者的心理障碍所

  14. Effect of psychological intervention on the quality of life during convalescence in patients with severe burn%心理干预对重度烧伤患者康复期生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    谢丽珍; 叶小兰; 杨芳

    2014-01-01

    Objective:To explore the effect of psychological intervention on the quality of life during convalescence in patients with se -vere burn.Methods:52 patients with severe burn were randomly divided into the intervention group and the control group (26 cases in each group).The patients in the control group were only given routine treatment ,nursing care and functional exercise and the extra psychological intervention was given to the patients in the intervention group .The anxiety state and the changes of quality of life of the patients were com-pared between the two groups befroe and after the intervention .Results:The scores of SDS and SAS were significantly lower after the inter-vention for one month than those before the intervention in the intervention group (P<0.05);the total score of quality of life of the patients was significantly higher in the intervention group than the control group (P<0.05).Conclusion:The psychological intervention can effec-tively alleviate the anxiety and pessimism of patients with severe burn so as to improve their quality of life .%目的:探讨心理干预对重度烧伤患者康复期生活质量的影响。方法:将52例重度烧伤患者随机分为干预组和对照组各26例,对照组仅进行常规治疗、护理及功能锻炼,干预组在此基础上实施心理干预。比较两组患者干预前后焦虑状态及生活质量变化情况。结果:1个月后,干预组SDS、SAS评分明显低于干预前(P<0.05),生活质量总分明显高于对照组(P<0.05)。结论:心理干预能有效缓解重度烧伤患者的焦虑、悲观情绪,提高患者生活质量。

  15. Clinical significance of continuous thrombocytopenia in predicting sepsis after severe burn%持续血小板减少症预测严重烧伤并发脓毒症的临床意义

    Institute of Scientific and Technical Information of China (English)

    郭峰; 梁勋; 郇京宁

    2014-01-01

    Objective To explore the relationship between continuous thrombocytopenia and sepsis in patients with severe burns.Methods Clinical data of 148 severely burned patients admitted to our two burn centers from January 2007 to December 2011 and conforming to the study criteria were retrospectively analyzed.All patients were divided into sepsis group (n =44) and non-sepsis group (n =104) according to the presence or absence of sepsis within post burn day (PBD) 30.The data of age,gender,total burn area,full-thickness burn area,fluid infusion volume within post burn hour (PBH) 24,plasma concentration of calcium ion on PBD 1,plasma concentration of albumin on PBD 1,platelet count on PBD 1,acute physiology and chronic health evaluation (APACHE) Ⅱ score on admission,the presence or absence of hypovolemic shock or inhalation injury on admission,the presence or absence of disseminated intravascular coagulation (DIC) within PBH 48,operation or no operation within PBD 3,thrombocytopenia duration within PBD 10,and mortality were statistically compared between two groups to screen the independent risk factors of sepsis.Data were processed with t test,chi-square test,single factor Logistic regression analysis,and multi-factor Logistic regression analysis.Results Between two groups,there were statistically significant differences in total burn area,full-thickness burn area,plasma concentration of calcium ion on PBD 1,plasma concentration of albumin on PBD I,APACHE Ⅱ score on admission,presence or absence of hypovolemic shock on admission,presence or absence of inhalation injury on admission,presence or absence of DIC within PBH 48,and mortality (with t values from 2.433 to 4.082,x2 values from 8.818 to 31.528,P <0.05 or P < 0.01).Furthermore,the duration of thrombocytopenia within PBD 10 in sepsis group was (5.2 ±2.4) d,which was significantly longer than that in non-sepsis group [(2.9±1.9) d,t =6.189,P <0.01].There were no statistically significant differences in the

  16. Fluid management in major burn injuries

    Directory of Open Access Journals (Sweden)

    Haberal Mehmet

    2010-10-01

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

  17. Effects of Xuebijing on intestinal function and inflammatory responses in patients with severe burn%血必净对严重烧伤患者肠道功能及炎症反应的影响

    Institute of Scientific and Technical Information of China (English)

    蔡晨; 徐庆连; 胡宏; 唐益忠; 戚伟伟

    2010-01-01

    Objective To investigate the effects of Xuebijing injectio (Chinese herb preparation) on intestinal function and inflammatory responses in severe burn patients. Method Thirty-two patients with comparable severity in burn injury were randomly divided into Xuebijing injectio treatment group (n = 16) and control group (n = 16). Patients in both groups received routine burn therapy, while those in Xuebijing treatment group additionally received Xuebijing injectio 100mL in intravenous drip twice a day for 7 days. Before the treatment and on the 3rd and the 7th day after the treatment, blood concentrations of diamine oxidase (DAO), lipopolysaccharide (LPS) ,tumor necrosis factor-α(TNF-α) and interleukin-6 (IL-6) were determined in both groups. Analysis was made by SPSS 12.0 software. Results The plasma levels of DAO, LPS, TNF-α and IL-6 were decreased in both groups after the treatment. However, the plasma levels of DAO, LPS, TNF-α and IL-6 in the Xuebijing treatment group were significantly lower than those in control group on the 3rd and 7th day after the treatment (P< 0.05).Conclusions Xuebijing injectio could protect intestinal function, decrease the plasma level of endotoxin and lessen zhe inflammatory responses in severe burn patients.%目的 探讨血必净注射液对严重烧伤患者肠道功能及炎症反应的影响.方法 将同期严重程度相当的32例严重烧伤患者随机(随机数字法)分为血必净治疗组(n=16)和对照组(n=16).对照组按烧伤常规治疗;治疗组在常规治疗基础上给予血必净注射液,每次100 mL,静脉滴注,2次/d,连续使用7 d.检测两组患者治疗前与治疗后3 d和7 d血浆二胺氧化酶(DAO)、内毒素(LPS)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平变化.采用SPSS 12.0统计软件进行统计分析.结果 两组烧伤患者治疗后,血浆DAO,LPS,TNF-α及IL-6水平均较治疗前下降(P<0.05);血必净治疗组在治疗后3 d和7 d,血浆DAO,LPS,TNF-α及IL-6

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

    Science.gov (United States)

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

    2006-06-01

    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.

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

    Science.gov (United States)

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

    2010-01-01

    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

  20. Nosocomial fungal infections in 18 severely burn patients: an retrospective clinical analysis%18例危重烧伤患者医院感染真菌回顾性分析

    Institute of Scientific and Technical Information of China (English)

    吴祖煌; 宋斌; 卓燕舞; 陈国养

    2011-01-01

    目的 分析烧伤后真菌性感染的相关因素,进一步探讨真菌性医院感染的防治措施.方法 回顾性分析2004年1月-2008年12月18例危重烧伤(烧伤面积≥30%体表总面积)后真菌性感染的病例资料.结果 白色假丝酵母菌是危重烧伤真菌性医院感染的主要病原菌,占75.8%;长期使用广谱抗菌药物是最常见的诱因,烧伤程度重、住院时间长、低白蛋白血症、侵入性操作、高龄、大剂量激素的应用等也是该病重要的危险因素;临床表现无特异性,临床症状不典型.结论积极控制感染相关危险因素,合理使用抗菌药物,减少侵入性操作,提高患者机体免疫力和尽早切削痂治疗等是预防真菌性医院感染的主要措施.%OBJECTIVE To analyze the predisposing factors and investigate the preventive measures for nosocomial fungal infection. METHODS The clinical features, therapy and outcome of 18 patients with in nosocomial fungal infection burn patients which happened from Jan 2004 to Dec 2008 were retrospectively reviewed. RESULTS Candida albican was the main pathogens causing nosocomial fungal infection. The rate of nosocomial fungal infection was higher in burn patients with long-term use of broad-spectrum antibiotic> severity of burn, long bed-days, hypoalbuminemia, invasive operation, long aging, abuse application of hormone. CONCLUSIONS We must take some measures to control the risk factors, reasonably use antibiotics, reduce the invasive procedure, improve physical immunity of the patients and perform crust treatment in early stage, which are key to prevention of nosocomial fungal infection.

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

    National Research Council Canada - National Science Library

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

    2012-01-01

    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...

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

    National Research Council Canada - National Science Library

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

    2012-01-01

    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...

  3. Analysis of drug resistance of Staphylococcus aureus infection at severely burned wounds surface%重度烧伤创面金黄色葡萄球菌感染的耐药性分析

    Institute of Scientific and Technical Information of China (English)

    孟朝晖; 钱小毛; 王亚玲

    2014-01-01

    目的:了解重度烧伤患者创面金黄色葡萄球菌(SAU )感染的耐药性,为临床预防和治疗用药提供科学依据。方法共207株S A U均为2009年1月-2011年12月重度烧伤患者创面分离株;药敏试验采用 K-B法;MRSA检测采用头孢西丁纸片法;克林霉素诱导性耐药采用D试验。结果 SAU对万古霉素、利奈唑胺、替加环素和呋喃妥因全部敏感,其他药物的耐药率:替考拉宁为1.4%,磺胺甲噁唑/甲氧苄啶为36.2%;对红霉素耐药而对克林霉素敏感的36株进行D试验,结果有19株阳性,阳性率52.8%;207株S A U共检出M RS A 134株,检出率64.7%;MRSA的耐药率明显高于MSSA。结论 SAU创面感染株的耐药性很高,临床应及时做病原菌检测,充分利用实验室所提供的细菌耐药趋势和有关耐药机制的信息,合理使用抗菌药物,积极处理烧伤创面,严格执行消毒隔离制度,有助于减少SAU感染,降低感染菌的耐药性。%OBJECTIVE To investigate the status of drug resistance of a Staphylococcus aureus (SAU ) isolated from a severe burn wound ,thereby providing the scientific evidence for the clinical prevention and treatment of pharmacy .METHODS From Jan .2009 to Dec .2011 ,samples of 207 strains of SAU were acquired from severe burn wounds and then their drug sensitivity tests were carried out by K-B .Cefoxitin disk was used to detect MRSA .D-test was used to detect the inducible resistance of clindamycin .RESULTS All bacterial strains were sensitive to vancomycin ,linezolid ,tigecycline and nitrofurantoin .The rate of drug resistance of other drugs were 1 .4% against teicoplanin , 36 .2% against sulfamethoxazole/trimethoprim ; The 36 strains resistant to erythromycin but sensitive to clindamycin were given D-test ,19 strains were positive ,accounting for 52 .8% ;Among 207 strains of SAU ,134 strains of MRSA were detected ,accounting for 64 .7% ;the resistant rate of

  4. [Cell apoptosis and expression of hypoxia-inducible transcription factor-1 alpha in kidney tissue after severe burn with delayed fluid resuscitation in rats in areas of different altitude].

    Science.gov (United States)

    Jiang, Jiang; Liu, Yi; Zhang, Shi-fan; Cai, Qian; Zhang, Xian-ying; Zhang, Bin; Xiao, Bin

    2008-07-01

    To explore the relationship of cell apoptosis and expression regularity of hypoxia-inducible transcription factor (HIF)-1 alpha after severe burn with delayed fluid resuscitation in areas of different altitude. A total of 240 male Wistar rats, which were raised in areas of different altitude (1,517 and 3,840 meters), were employed as the experimental models [They received a 30% total body surface area (TBSA)III degree scald injury], and then they were randomly divided into 3 groups: delayed fluid resuscitation group (DFR, n=50), immediate fluid resuscitation group (IFR, n=60) and control group (CG, n=10). Renal tissue samples were harvested at 1, 6, 12, 24, 72 and 168 hours after burn, respectively. Cell apoptosis was detected by tissue chip technology and terminal deoxynucleotidyl transferase-mediated dUTP biotin nick end labeling (TUNEL). The expression of HIF-1 alpha was assessed by immunohistochemistry and image analysis. With increase in altitude, cellular edema, degeneration, necrosis and disintegration of renal tissue were gradually worsening, the capillaries of renal glomeruli became dilated and engorged, with degeneration and necrosis of endothelial cells, engorgement and edema of renal interstitium, and infiltration of inflammatory cells. Pathological changes in DFR group were more serious than that of IFR group. Cell apoptosis and the expression of HIF-1 alpha were both enhanced, the latter mainly appeared in nuclei of renal cells, and they were more marked at 3,840 meters compared with those at 1,517 meters. They were more marked in experimental groups than in control group, especially so in DFR group (Pkidney cell apoptosis.

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

    Institute of Scientific and Technical Information of China (English)

    翟建霞; 蒋红; 吴菁; 刘晓虹

    2011-01-01

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

  6. Acute pain management in burn patients

    DEFF Research Database (Denmark)

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

    2014-01-01

    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...

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

    Directory of Open Access Journals (Sweden)

    Kemalettin Koltka

    2011-07-01

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

  8. Emergency in Burn; Burn in Emergency

    Directory of Open Access Journals (Sweden)

    Yalcin Bayram

    2012-06-01

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

  9. Severe burn patients of central venous catheter colonization and control measures%重度烧伤患者中心静脉导管细菌定植分析及防治措施

    Institute of Scientific and Technical Information of China (English)

    刘强; 徐庆连

    2011-01-01

    Objective To severe burn patients with central venous catheter colonization factors, compare their resistance mecha nisms and explore the prevention and treatment methods. Methods First Affiliated Hospital of Anhui Medical University, January 2005 - December2009's severe bum patients with the clinical data of central venous catheters, intravenous contrast the incidence of catheter coloniza tion. Results Of severe burn patients of central venous catheter colonization rate of 35.4%, higher than the reported incidence of other criti cally ill patients 26.3%; by vein puncture wound by wound infection rate is higher than the incidence of puncture; venous catheters for more than 7 days, venous catheter significantiy increased risk of infection, more than 14 days, the infection rate further increased. Conclusion Prevent deep venous catheter, catheter shortened time, the wound is not as much as possible can significantly reduce the tube due to deep ve nous catheter infection and British Gas.%目的 探讨重症烧伤患者中心静脉导管细菌定植的影响因素,并对比其耐药机制,探讨其防治方法.方法 收集安徽医科大学第一附属医院烧伤科2005年1月至2009年12月重症烧伤患者行中心静脉导管的临床资料,对比静脉导管细菌定植的发生率.结果 重症烧伤患者的中心静脉导管细菌定植发生率35.4%,高于文献报道的其他重症患者的发生率26.3%;经创面静脉穿刺感染发生率高于经创面穿刺的发生率;静脉导管留置时间超过7 d,静脉导管感染发生几率明显升高,超过14 d,则感染发生率进一步升高.结论 避免深静脉置管、缩短置管时间、尽可能不在创面置管可以明显降低因深静脉置管而引起的感染.

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

    Science.gov (United States)

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

    2015-11-01

    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.

  11. 严重烧伤后不同时机实施肠内营养的对比研究%A Comparative Study on Enteral Nutrition in Different Times for Patients with Severe Burns

    Institute of Scientific and Technical Information of China (English)

    徐风瑞; 乔亮; 姚忠军; 杨帆; 何明武

    2016-01-01

    目的:通过观察严重烧伤患者不同时机实施肠内营养的临床效果,探讨严重烧伤后实施肠内营养的最佳时机。方法收集2012年6月-2015年10月烧伤面积≥30%的烧伤患者合计86例,根据实施肠道复苏时机不同分为A组(29例,伤后6 h内实施)、B组(27例,伤后24~48 h实施)及C组(30例,伤后48 h后实施)。肠道复苏应用肠内营养乳剂瑞高。对比观察3组胃肠动力状况,入院第1、3、7、14天营养状况指标,以及血清降钙素原( PCT),血浆革兰阴性菌脂多糖( LPS),C-反应蛋白( CRP)变化。结果 A组便秘发生率少于B、C组,首次排便时间早于B、C组(P<0.05);A组住院第3、7天白蛋白、前白蛋白水平均优于B、C组,同时B组优于C组(P<0.05);A组住院第3、7、14天CRP水平和第3、7天PCT及LPS水平均低于B、C组(P<0.05)。结论以6 h以内起始的早期肠内营养是可行的,与24及48 h后延期肠内营养比较,具有更好的改善营养及降低机体炎性反应的效果。%Objective To observe the clinical effect of enteral nutrition at different times on patients with severe burn in order to study the best time for the implementation of enteral nutrition after severe burns. Methods A total of 86 severely burnt patients with burn area equal or greater than 30% of total body surface area ( TBSA) during June 2012 and October 2015 were divided into group A (treated with enteral nutrition within 6 h after injury, n=29), group B (treated with enteral nutrition within 24-48 h after injury, n=27) and group C ( treated with enteral nutrition 48 h after injury, n=30 ) . The conditions of gastrointestinal motility and the changes of nutritional status indexes, serum procalcitonin (PCT), plasma gram negative bacterial lipopolysaccharide (LPS) and C-reactive protein (CRP) the1st, 3rd, 7th and 14th d after admission were compared and observed in the three groups. Results Compared with those in group B and C, in group A, the

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

    Institute of Scientific and Technical Information of China (English)

    孙勇; 王良喜; 周宜芳; 孙曙光; 毛学飞; 邓向东; 张盼

    2013-01-01

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

  13. [Recognizing prevention and treatment of burn sepsis with the concept of holistic integrative medicine].

    Science.gov (United States)

    Huan, J N

    2017-04-20

    Sepsis remains a major cause of death in severe burns. The effect of sepsis management is influenced by its complicated pathophysiologic changes. In order to improve the outcome of burn sepsis, the predisposing factor of sepsis after burn analyzed by advanced technology, the early prevention, antibiotics therapy, and combined treatment in severe burns with sepsis are discussed using the concept of holistic integrative medicine.

  14. High burn rate solid composite propellants

    Science.gov (United States)

    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

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

    Science.gov (United States)

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

    2011-05-01

    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

  16. Epidermal-dermal crosstalk during burn wound scar maturation

    NARCIS (Netherlands)

    T.E. Hakvoort (Eveline)

    1999-01-01

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

  17. Epidermal-dermal crosstalk during burn wound scar maturation

    NARCIS (Netherlands)

    T.E. Hakvoort (Eveline)

    1999-01-01

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

  18. Burn healing plants in Iranian Traditional Medicine

    Directory of Open Access Journals (Sweden)

    Sh. Fahimi

    2015-11-01

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

  19. Hospital costs associated with pediatric burn injury.

    Science.gov (United States)

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

    2008-01-01

    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.

  20. 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

    Directory of Open Access Journals (Sweden)

    Kamran Aghakhani M.D.

    2011-06-01

    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

  1. Crude oil burning mechanisms

    DEFF Research Database (Denmark)

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

    2015-01-01

    In order to improve predictions for the burning efficiency and the residue composition of in-situ burning of crude oil, the burning mechanism of crude oil was studied in relation to the composition of its hydrocarbon mixture, before, during and after the burning. The surface temperature, flame...... 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...

  2. Pathophysiologic Response to Burns in the Elderly.

    Science.gov (United States)

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

    2015-10-01

    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.

  3. STUDY ON PRETHROMBOTIC STATE IN BURNED PATIENTS

    Institute of Scientific and Technical Information of China (English)

    王鸿利; 邵慧珍; 支立民; 肖玉瑞; 杨丽英; 史济湘

    1992-01-01

    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.

  4. Pathophysiologic Response to Burns in the Elderly

    Directory of Open Access Journals (Sweden)

    Marc G. Jeschke

    2015-10-01

    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.

  5. 严重烧伤后早期营养支持途径对肝功能的影响%Effects of nutrition route on liver function at the initial stage of severe burn patients

    Institute of Scientific and Technical Information of China (English)

    陈忠勇; 谷才之; 叶祥柏; 王锡华; 余斌; 汪仕良

    2001-01-01

    目的考察严重烧伤早期营养支持途径对机体肝功能的影响。方法 37例烧伤病人随机分为早期肠道营养组和肠外营养组,观察不同途径的营养支持两周后肝功指标的变化情况。结果严重烧伤后血清血清谷草转氨酶、碱性磷酸酶、乳酸脱氢酶均明显高于正常值,不同途径的营养支持两周,血清谷草转氨酶及血清碱性磷酶活性在伤后14d肠外营养组均明显高于肠道营养组(P<0.05)。结论严重烧伤后病人出现不同程度的肝脏功能受损,肠外营养与肝脏功能的受损有关。%Objective This prospective study attempts to appraise effects of nutrition route on liver function at the initial stage of severe bum patients. Methods 37cases were collected and divided randomly into early enteral nutrition group(EN)and parenteral nutrition group (PN), liver function tests were investigated after two weeks. Result Serum glutmic-oxaloacetic transaminase, alkaline phosphatase and lactate dehydrogenase were significantly higher than normal after burn injury, on the 14th day postburn the level of serum glutamic-oxaloacetic transaminase, alkaline phosphatase and lactate dehydrogenase in PN group were significantly higher than that of EN group(P<0.05). Conclusion It is indicated that the liver function tests abnormalities were common at early stage of burn injury. There is obviously correlation between patenteral nutrition and liver function abnormalities.

  6. Learn Not To Burn.

    Science.gov (United States)

    English, Nancy; Hendricks, Charlotte M.

    1997-01-01

    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…

  7. Economics of pediatric burns.

    Science.gov (United States)

    Bass, Michael J; Phillips, Linda G

    2008-07-01

    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.

  8. Minor burns - aftercare

    Science.gov (United States)

    ... 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 ...

  9. Epidemiology of burns

    NARCIS (Netherlands)

    Dokter, Jan

    2016-01-01

    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

  10. Treatment of extra large area severe burne patient complicated with superior mesenteric artery syndrome%特大面积重度烧伤合并肠系膜上动脉综合征患者救治体会

    Institute of Scientific and Technical Information of China (English)

    曹贵军; 李冬严; 孙丽莉; 李继华; 刘志军

    2012-01-01

    [Objective] To summarize the treatment of extra large area severe patient complicated by superior mesenteric artery syndrome. [Methods] After aggressive anti-infection, improvement of renal dysfunction, microskin and allograft skin grafting were performed to one patient with extensive burns of 95TBSA% (Ⅲ° 85%TBSA). SMAS was diagnosed by color Doppler flow imaging, including vomiting, abdominal distension occurred on 20 days postburns. After fasting and gastrointestinal decompression, the intravenous and enteral nutrient support was applied via duodenal tube by endoscopy. [Results] Symptoms of vomiting and abdominal distension of SMAS were disappeared on 21 days postburns. The wounds healed on 38 days post burns. [Conclusions] The color Doppler flow imaging is the optimal method to diagnosis on SMAS. A systemic treatment of strategy is needed to the successful treatment of major burns complicated by SMAS, such as aggressive wound management, sound allogenic or heterogenic skin grafting, the intravenous and enteral nutrient support by duodenal tube put by endoscopy.%[目的]总结成功救治特大面积烧伤患者合并肠系膜上动脉综合征(superior mesenteric artery syndrome,SMAS)的临床经验.[方法]治疗1例95%总体表面积(Ⅲ°85%总体表面积)烧伤患者,在积极补液复苏、抗感染、纠正肾功能不全及维护机体水电解质酸碱平衡的基础上,于伤后5d行四肢Ⅲ°创面切痂自体微粒皮大张异体皮移植术,伤后3周再行背、臀、四肢部残余创面清创,分期自体邮票皮+异种(猪)皮相间移植术.患者因反复呕吐、腹胀3d,于伤后20d经彩色多普勒超声检查确诊为肠系膜上动脉综合征,立即给予禁食、胃肠减压等措施,纤维胃镜下放置鼻肠管置入空肠,行肠内营养支持及静脉高营养维持.[结果]患者于伤后21d呕吐、腹胀消失,肠系膜上动脉综合征明显好转.伤后38d创面已基本愈合.[结论]彩色多普勒超声检查是

  11. Corneoscleral burn during phacoemulsification surgery.

    Science.gov (United States)

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

    1998-10-01

    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.

  12. Partial Burn Laws in Propellant Erosive Burning

    Directory of Open Access Journals (Sweden)

    S.V. Finjakov

    1999-04-01

    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.

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

    Science.gov (United States)

    Koljonen, Virve

    2008-01-01

    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.

  14. Sexual Function Following Burn Injuries: Literature Review.

    Science.gov (United States)

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

    2015-01-01

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

  15. Moderate systemic hypothermia decreases burn depth progression.

    Science.gov (United States)

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

    2013-05-01

    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.

  16. Epidemiology of hospitalized burns patients in Taiwan.

    Science.gov (United States)

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

    2003-09-01

    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.

  17. Increased admissions for diabetes mellitus after burn.

    Science.gov (United States)

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

    2016-12-01

    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.

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

    Science.gov (United States)

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

    2010-01-01

    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

  19. In-Situ Burning of Crude Oil on Water

    DEFF Research Database (Denmark)

    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...

  20. Infections in critically ill burn patients.

    Science.gov (United States)

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

    2016-04-01

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

  1. Clinical study of Xuebijing on the management of early inflammatory response after severe burns%血必净治疗重度烧伤早期炎性反应的临床研究

    Institute of Scientific and Technical Information of China (English)

    晁生武; 李毅; 王献珍; 崔强; 张毅平; 祁永章; 王洪瑾

    2013-01-01

    目的 探讨血必净对重度烧伤患者早期重要脏器功能的作用,并观察其对早期炎性反应的相关炎性因子C-反应蛋白(CRP)、前降钙素(PCT)水平的影响.方法 将40例重度烧伤患者随机分为实验组和对照组,每组20例,对照组按常规补液、创面处理、合理应用抗生素等治疗,实验组在常规治疗的基础上静脉滴注血必净注射液100 mL,2次/d,7d一个疗程.测定两组用药前、用药后第3天、用药后第7天静脉血谷丙转氨酶(ALT)、谷草转氨酶(AST)、肌酸激酶(CK)、尿素氮(BUN)、肌酐(Cr)、CRP及PCT浓度.结果 患者用药前提取血清标本,测定CRP、PCT浓度,两组比较差异无统计学意义(P>0.05);测定血ALT、AST、CK、BUN、Cr浓度,两组比较差异无统计学意义(P>0.05).实验组应用血必净第7天血CRP(32.76±5.0)、PCT(1.4 ±0.3)浓度较第3天CRP(46.52±15.00)、PCT(3.1±0.3)明显下降,与对照组比较差异有统计学意义(P<0.05);实验组应用血必净第7天ALT (45.1±8.0)、AST(37.9±7.3)、CK(150.9±25.2)、BUN(5.1±1.3)、Cr(41.5±8.2)明显下降,与对照组比较差异有统计学意义(P<0.05).结论 血必净能减轻由细胞炎性因子介导的炎性反应,有效保护重度烧伤患者早期各脏器功能.%Objective To explore the effects of Xuebijing on major organ functions at the early stage of severe burn and its effects on the levels of C reactive protein (CRP) and procalcitonin (PCT).Methods Forty severe burn patients were randomly divided into the treatment group (n =20) and the control group (n =20).Patients in the control group received the primary treatment included immediate and optimal fluid resuscitation supporting the systematic defense power and dealing with the wounds correctly.Antibiotics were employed reasonably.While those in the treatment group received intravenous dripping of Xuebijing on the basis of routine therapy.Blood samples were taken for the determination of serum alanine

  2. Effect of the activation and secretion function of macrophage Notch1 after the stimulation of severe ;burn rat serum%重度烧伤大鼠血清对巨噬细胞 Notch1的激活及分泌功能的影响

    Institute of Scientific and Technical Information of China (English)

    王姝月; 樊磊; 白晓智; 杨龙龙; 蔡维霞; 赵彬; 苏琳琳; 石继红; 胡大海

    2015-01-01

    目的:研究重度烧伤大鼠血清刺激后巨噬细胞 Notch1蛋白表达变化,及其细胞分泌因子白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)的水平变化。方法选取成年雄性 SD 大鼠24只,随机分为假伤组、烧伤24 h 组和烧伤7 d 组,每组8只。烧伤组 SD 大鼠造成约30%总体表面积(TBSA)Ⅲ度烧伤,分别于伤后24 h、7 d 收集血清;假伤组大鼠用37℃水浴,水浴后24 h 取其血清作为对照。用上述各组血清制成20%培养液,刺激小鼠源巨噬细胞系 RAW264.7,分别于加入血清刺激后即刻和刺激4、8、12、24、48 h 后收取细胞及其上清液。另外用含20%假伤血清+脂多糖(100 ng/mL)培养液刺激巨噬细胞,于相同时间点收样。Western Blot 检测各时间点巨噬细胞中Notch1蛋白表达变化,酶联免疫吸咐试验检测刺激24 h 后培养上清液中 IL-6及 TNF-α的含量变化。结果(1)假伤组血清刺激后即刻和刺激4、8、12、24、48 h 后,Notch1蛋白表达无明显变化;(2)烧伤24 h 组血清刺激后,Notch1蛋白表达明显升高,并随时间延长而达高峰;(3)烧伤7 d 组血清刺激后, Notch1蛋白表达无明显变化,与假伤组血清刺激结果类似;(4)假伤组血清+脂多糖混合刺激后, Notch1蛋白表达明显增加;(5)烧伤24 h 组血清及假伤组血清+脂多糖,上清液中 IL-6和 TNF-α含量均明显高于假伤组血清及烧伤7 d 组血清。结论烧伤血清刺激下的巨噬细胞 Notch1信号被激活,IL-6及 TNF-α分泌能力增强,且这种激活可被脂多糖刺激所模拟。%Objective To investigate the dynamic expression of Notch1 signaling and the secretion of interleukin-6 (IL-6)and tumor necrosis factor alpha(TNF-α)from macrophage RAW264.7 cells induced by severe burn rat serum.Methods Twenty-four male Sprague-Dawley rats were divided into sham burn group and burn at 24 h and 7

  3. Application of safety objectives management in severe burns patients complicated with reactive mental disorder%安全目标管理在重度烧伤并反应性精神障碍病人中的应用

    Institute of Scientific and Technical Information of China (English)

    郭建军; 袁淑兰; 朱文娟; 范敏; 游贵方

    2012-01-01

    Objective:To probe into the applied effect of safe objective management in severe burns patients complicated with mental disorders, so as to provide a series of scientific and systematic safe care for patients. Methods: A total of 85 severe burns patients complicated with mental disorders were randomly divided into intervention group and control group, 45 cases in each,safe object management was carried out for intervention group cases, including making the target of nursing safety, evaluating paitents correctly and making safety precautions plan; strengthening ward and patient safety management, paying attention to drug safety, preventing accidents, cognitive - behavioral intervention for patients to promote psychiatric rehabilitation. Routine nursing was given to control group cases. Results: Since the implementation of safety objective management, the incidence of nursing unsafe event in intervention group was much lower than that of control group (P

  4. 音乐疗法对改善重度烧伤患者焦虑情绪的效果观察%Influence of music therapy on relieving the anxiety and depression of severely-burned patients

    Institute of Scientific and Technical Information of China (English)

    周桃

    2014-01-01

    Objective To discuss the inf1uence of music therapY on re1ieving the anXietY and depression of severe1Y - burned pa_tients. Methods 42 severe1Y-burned patients were divided into the Observed Group and the Contro1 Group random1Y. Norma1 therapY was given to two groups whi1e the Observed Group were given music therapY specia11Y. Performance of two groups were a11 marKed and eva1ua_ted. Then the before-after performance of two groups were compared under the SAS and the SDS. Results The SAS scores and SDS scores of both groups a11 dec1ined significant1Y after their treatments,the difference was statistica11Y significant( P﹤0. 05),and the SAS and SDS scores of the Observed Group( with music therapY)were both 1ower than those of the Contro1 Group( without music therapY),the difference was statistica11Y significant(P﹤0. 05). conclusion Music therapY can p1aY an effective ro1e in re1ieving the anXietY and depression and e1_evating the performance of nursing,which to a certain eXtent wi11 do good to the recoverY of patients.%目的:探讨音乐疗法在改善重度烧伤患者的焦虑及抑郁情绪中的临床护理效果。方法:随机将42例重度烧伤患者分为对照组和观察组,两组各21例。对照组实施常规护理,观察组给予常规护理的同时采用音乐疗法。观察两组患者在接受治疗前后的焦虑及抑郁情绪,并做好记录和评价。采用焦虑自测量表( SAS)和抑郁自测量表( SDS)对两组患者治疗前后焦虑和抑郁水平进行比较。结果:考察组和对照组在接受治疗后,SAS及SDS评分均明显下降,差异有统计学意义( P﹤0.05);且观察组在接受音乐疗法后,SAS和SDS分数均低于对照组,差异有统计学意义( P﹤0.05)。结论:音乐疗法可减轻患者的焦虑、抑郁情绪,提高护理质量,对烧伤患者的康复有一定的帮助。

  5. [Enteral nutrition in burn patients].

    Science.gov (United States)

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

    1992-01-01

    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

  6. Early diagnostics and treatment with acute burn sepsis

    Institute of Scientific and Technical Information of China (English)

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

    2015-01-01

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

  7. Disseminated intravascular coagulation in burn injury.

    Science.gov (United States)

    Lippi, Giuseppe; Ippolito, Luigi; Cervellin, Gianfranco

    2010-06-01

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

  8. Burns and epilepsy.

    Science.gov (United States)

    Berrocal, M

    1997-01-01

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

  9. 42 years′experience on the prevention and treatment of systemic infection after severe burn%42年严重烧伤全身性感染的防治经验

    Institute of Scientific and Technical Information of China (English)

    彭毅志; 肖光夏

    2001-01-01

    目的通过对严重烧伤(>50%TBSA)全身性感染患者329例进行分析和总结,旨在进一步提高严重烧伤感染的救治水平。方法利用1958年至2000年8月我所共收治烧伤面积>50%TBSA患者1 127例临床资料,分析不同时期严重烧伤后全身性感染发生率及死亡率降低的主要原因。结果本组1 127例烧伤患者中,发生全身性感染共329例,总发生率29.4%,第二阶段感染发生率为29.3%,显著低于第一阶段的48.5%(P<0.01~0.05);第三阶段(13.1%)与前两个阶段相比又显著下降(P<0.01~0.05)。总治愈率和不同烧伤面积治愈率均逐步提高,尤以烧伤面积>70%TBSA明显。结论防治严重烧伤全身性感染的主要经验是加强了早期处理,包括及时液体复苏、早期肠道喂养、有效抗生素的短程使用与早期切痂等。%Objective To summarize the experience of the management of 329 patients with major burn accompanied by severe systemic infection during the past 42 years, so as to help improve the treatment standard. Methods One thousand and one hundred twenty seven cases with major burns( TBSA > 50% ) were admitted to our hospital during the past 42 years. The incidence of postburn systemic infection and change in the mortality were analyzed in terms of 3 periods, i. e. 1958 to 1980,1981 to 1990 and 1991 to 2000. Results Postburn systemic infection developed in 329 out of 1127 cases with the morbidity of 29.4%. The incidences of the infection were 48.5% ,29.3% and 13. 1% in the 3 periods, consectively, with significant differences between them( P <0.01 ~ 0. 05 ). During the 3 periods of past 42 years, the overall cure rate and cure rates in patients with different TBSA increased gradually,especially in those with TBSA Larger than 70%. Conclusion The management of pastburn systemic infection was satisfactorily achieved by early comprehensive clinical measures such as immediate fluid resuscitation

  10. 严重烧伤患者外周血高迁移率族蛋白B-1水平的检测及其临床意义%Detection of plasma high mobility group box-1 protein in severely burned patients and its clinical significance

    Institute of Scientific and Technical Information of China (English)

    肖锦华; 王亚萍; 朱华燕; 潘宇红; 黄璇

    2012-01-01

    目的 检测严重烧伤后患者血浆高迁移率族蛋白B-1 (HMGB1)水平的变化并探讨其临床意义.方法 用酶联免疫吸附试验法检测77例严重烧伤患者血浆HMGB1水平,同步检测肿瘤坏死因子-α(TNF-α)含量,并与30名健康对照组进行比较.结果 77例严重烧伤患者按烧伤面积分为3组,A组31例,烧伤总面积30%~49%,B组25例,烧伤总面积50%~69%,C组21例,烧伤总面积70%~95%;烧伤患者血浆HMGB1及TNF-α水平在A组为(22.15±6.34) ng/ml、(89.26±21.41)pg/ml,B组为(26.24±9.71)ng/ml、( 132.45±76.32)pg/ml,C组为(36.45±11.63)ng/ml、(213.61±87.45) pg/ml,对照组为(2.17±1.13)ng/ml、(45.32±13.84)pg/m1,烧伤各组HMGB1及TNF-α水平明显高于对照组(P<0.01);24例特大面积烧伤患者根据预后情况分为生存组和死亡组进行动态观察,两组患者血浆HMGB1水平在伤后第1天即显著升高(P<0.01),在伤后3~21 d,死亡组明显高于生存组(P<0.05),而TNF-α含量在伤后第3~7 d达高峰,以后逐渐下降,到21d时生存组与死亡组相比已差异无统计学意义.结论 严重烧伤后HMGB1的表达异常升高,HMGB1作为重要的晚期炎症介质和TNF-α相互诱生相互作用,参与严重烧伤后全身炎症反应综合征的病理生理过程,动态观察其水平变化有助于烧伤患者病程监测及预后判断.%OBJECTIVE To investigate the changes of plasma high mobility group box-1 protein ( HMGB1) in severely burned patients and its clinical significance. METHODS The plasma HMGB1 and TNF-α levels were measured by enzyme linked immunosorbent assay(ELISA) simultaneously in all patients and were compared with 30 healthy control subjects. RESULTS Totally 77 burned patients were involved in this study, and they were divided into three burn size groups: 30%-49% total body surface area(TBSA) burn(group A, n = 31), 50% - 69% TBSA burn (group B, n = 25) and 70%-95% TBSA burn(group C, n = 21). The levels of HMGB2 and TNF

  11. The Burning Saints

    DEFF Research Database (Denmark)

    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....

  12. Management of Hand Burns

    Directory of Open Access Journals (Sweden)

    Fatih Irmak

    2017-09-01

    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.

  13. American Burn Association Consensus Statements

    Science.gov (United States)

    2013-08-01

    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

  14. Burns in pregnancy.

    Science.gov (United States)

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

    2006-03-01

    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.

  15. Burns and military clothing.

    Science.gov (United States)

    McLean, A D

    2001-02-01

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

  16. 钙通道阻滞剂在危重烧伤脓毒症防治中的应用%Study of calcium channel blockers on prevention and treatment of patients with severe burn sepsis

    Institute of Scientific and Technical Information of China (English)

    吴祖煌; 宋斌; 陈国养; 王光毅

    2010-01-01

    Objective To analyze the effect of nimodipine on prevention and treatment of patients with severe burn sepsis. Methods Twenty-eight cases were randomized into nimodipine treatment group (n = 14) and routine group (n = 14). Besides general chnical therapy scheme treatment,the treatment group was administrated with saline plus nimodipine (15 μg/(kg · h)), while the routine group was given saline only. The Plasma concentration levels of total calcium (Ca2 +), free calcium (iCa2 +), C-reactive protein (CRP), procalcitonin (PCT), tunmor necrosis factor α (TNF-α), brain natriuretic petide (BNP) and interleukin-6 (IL-6) were measured. The hemodynamic indices of patients with severely burn sepsis were determined by transesophageal echo-Doppler device,hemodynamic indices including aortic blood flow (ABF), left ventricle ejection time (LVET), max acceleration (ACC), total systemic vascular resistance (TSVR). Mean artery pressure (MAP) and heart rate (HR) were measured. Results ABF, ACC, LVET and TSVR were improved after therapy in the routine group(t = 3.93,3. 37,3.75,7.02) (P < 0.01 or 0.05). ABF, ACC, LVET and TSVR were mproved after therapy in the treatment group (t =6.46,4.98,6.29,4.60) (P <0.01 or 0.05). ABF, ACC and LVET were increased after general clinical therapy scheme and was markedly increased in the treatment group (t = 2.29,2.07,2.23)(P<0.01~0.05).TSVR was decreased after general clinical therapy scheme and was markedly decreased in the treatment group (t =2.14) (P<0.05). Plasma TNF-α, IL-6 and CRP levels were decreased after therapy in the routine group (t =2.38,2.29,2.45)(P<0.01 or 0.05). Plasma TNF-α, IL-6 and CRP levels were decreased after therapy in the treatment group (t =4.04,4.04,2.56)(P <0.01or 0.05). Plasma PCT and BNP levels were decreased in the treatment group (t =5.45,2. 44) (P < 0.01 or 0.05). TNF-α, IL-6, CRP, PCT and BNP were decreased after generalclinical therapy scheme and was markedly decreased in the treatment group

  17. Critical issues in burn care.

    Science.gov (United States)

    Holmes, James H

    2008-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Gaoxing Luo

    2014-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Adaira Landry

    2013-03-01

    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.

  20. Nutrition of burned patients.

    Science.gov (United States)

    Gudaviciene, Daiva; Rimdeika, Rytis; Adamonis, Kestutis

    2004-01-01

    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.

  1. Burning mouth syndrome

    Directory of Open Access Journals (Sweden)

    K A Kamala

    2016-01-01

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

  2. [Chickenpox, burns and grafts].

    Science.gov (United States)

    Rojas Zegers, J; Fidel Avendaño, L

    1979-01-01

    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.

  3. Crude oil burning mechanisms

    DEFF Research Database (Denmark)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2012-06-01

    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.

  5. Nutritional and metabolic consequences in the pediatric burn patient.

    Science.gov (United States)

    Schulman, Carl I; Ivascu, Felicia A

    2008-07-01

    Nutritional support is one of the many important considerations when treating severe burn injury in children. The type, route, timing, amount, and monitoring of nutritional support have been widely investigated, yet many questions remain. This review will highlight the current state of knowledge and the important aspects of nutritional support in severe burn injury in children.

  6. Fluconazole Pharmacokinetics in Burn Patients

    Science.gov (United States)

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

    1998-01-01

    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

  7. Southeast U.S. burns

    Science.gov (United States)

    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.

  8. The influence of ulinastatin on body inflammatory factor levels in patients with severe burns%乌司他丁对重度烧伤患者炎症因子水平的影响

    Institute of Scientific and Technical Information of China (English)

    陈粹; 范友芬; 樊理华; 张淳; 吴天斌

    2014-01-01

    Objective To research the influence of ulinastatin on body inflammatory factor levels in patients with severe burns, and provide the basis treatment of patients with severe burns. Methods A total of 94 patients from Jan 2010 to June 2013 were studied in this test. The control group was treated with basic therapy including fluid infusion, antishock, cutting scab surgery and early nutrition support while the treatment group was received ulinastatin on the basic of control. Routine blood, body inflammatory factors level change and APACHE II score were compared between the two groups, Results The number of WBC and neutrophil in treatment group was higher than control 1group (P <0.05), while the PLT was lower than control group (P<0.05). The APACHE II score was in the same level between the two groups before treatment, while the score of treatment group was obvious lower than control control group after 72hr (P<0.05). The TNF-α and IL-6 in treatment group was lower than control wihle the IL-2 and IL-10 was higher than control(P<0.05). Conclusion Ulinastatin played an important role in improving the patient's body state of inflammation, the patient's symptom and preventing complications.%目的:研究乌司他丁对重症烧伤患者体内炎症因子水平的影响,为临床重症烧伤患者的治疗提供依据。方法对2010年1月~2013年6月我院入院治疗的94例重度烧伤患者进行了研究,分为两组,对照组给予常规治疗,包括补液、抗休克、早期切削痂手术以及营养支持等,治疗组患者在上述治疗方案基础上,加用乌司他丁,连续治疗7d,比较治疗前后两组患者血常规、体内炎症因素水平变化以及APACHE II评分(acute physiology and chronic health evaluation,急性生理与慢性健康评分)。结果与治疗前比较,两组患者白细胞(white blood cells,WBC)、中性粒细胞数量明显降低,血小板(blood platelet,)数量明显升高,且治疗组患者改善更明

  9. On burning a lump of coal

    Science.gov (United States)

    Alonso-Serrano, Ana; Visser, Matt

    2016-06-01

    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.

  10. On burning a lump of coal

    CERN Document Server

    Alonso-Serrano, Ana

    2015-01-01

    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.

  11. 大面积烧伤患者预防中心静脉置管感染的护理体会%Nursing Experience of Central Venous Catheter Infection Prevention of Severe Burn Patients

    Institute of Scientific and Technical Information of China (English)

    罗红

    2013-01-01

    目的:总结大面积烧伤患者预防中心静脉置管感染的护理体会。方法对138例大面积烧伤患者中心静脉置管的预防感染护理进行总结、分析。结果82例置管患者其中4例发生脓毒血症,2例置管尖端培养细菌阳性,经抗感染治疗均痊愈出院。结论中心静脉置管护理是预防大面积烧伤患者导管相关性感染的重要环节。%Objective: To summarize the experience in nursing of patients with burn prevention of central venous catheter infection in large area. Method: 138 cases of large area burn patients center vein catheter infection prevention nursing summary, analysis. Results: 82 cases of patients with sepsis occurred in 4 cases, 2 cases of catheter tip culture positive for the bacteria, the anti infection treatment were cured. Conclusion: the central venous catheter care is an important part of catheter-related infection in burn patients with large area prevention.

  12. Predictors of PTSD symptoms in caregivers of pediatric burn survivors

    Directory of Open Access Journals (Sweden)

    Lucía Del Carmen Quezada Berumen

    2015-11-01

    Full Text Available Facing a severe injury in the children is one of the most devastating experiences that parents may face. The aim of this study was to explore the role of resilience showed by fathers and mothers of children with burns, the TBSA burned, age at the time of the burn and time since the burn in PTSD symptoms in caregivers. It was a cross-sectional study where fathers, mothers and guardians of 51 burn patients were evaluated. Results showed that the higher strength and confidence in caregivers, less severity in PTSD symptoms. The post-burn reactions of parents and guardians can affect the responses and welfare of their children. Therefore, a better understanding of factors related to the adaptation in caregivers, better attention by health services.

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

    Data.gov (United States)

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

  14. Influence of intensive insulin therapy on insulin resistance of patients with severe burn or trauma%胰岛素强化治疗对严重烧创伤患者胰岛素抵抗的影响

    Institute of Scientific and Technical Information of China (English)

    闫柏刚; 任小宝; 赵晓东; 李华; 刘薇; 赵文凤

    2013-01-01

    Objective To discuss the influence of intensive insulin therapy on insulin resistance of patients with severe burn or trauma.Methods Sixty patients with severe burn or trauma hospitalized in the Third People's Hospital of Chongqing or Southwest Hospital of the Third Military Medical University from January 2010 to December 2011 were randomly divided into intensive insulin therapy group (IT,treated with intensive insulin therapy to control the blood glucose to the level of 6.0-8.0 mmol/L) and control group (C,treated with routine therapy) according to the paired grouping method,with 30 patients in each group.Before treatment and on post treatment day (PTD) 1,3,7,10,14,the levels of fasting blood glucose and fasting plasma insulin were determined.Insulin resistance index and β-cell function index were calculated using homeostasis model assessment.Data were processed with t test,analysis of variance,and LSD test.Results OnPTD 1,3,7,10,levels of fasting blood glucose in group IT [(6.8 ±1.4),(6.7±1.3),(5.8 ± 1.9),(5.4 ± 1.6) mmol/L] were significantly lower than those of group C [(14.8 ± 4.9),(12.7 ±3.7),(7.7±1.9),(6.6±1.3) mmol/L,with t values respectively 12.453,11.386,5.563,4.731,P <0.05 orP <0.01].OnPTD3,7,levels of fasting insulin in group IT [(14±5),(10±3) mU/L]were significantly lower than those of group C [(16 ±4),(13 ±4) mU/L,with t values respectively 4.212,4.364,P values below 0.05].Levels of fasting blood glucose and fasting insulin in the two groups at each time point were statistically significantly different from those before treatment (with P values below 0.01),except for the level of fasting blood glucose on PTD 3.On PTD 1,3,7,10,levels of insulin resistance index in group IT (1.60±0.80,1.46 ±0.70,0.96 ±0.21,0.90 ±0.23) were significantly lower than those in group C (2.15 ± 1.35,2.21 ± 1.21,1.50 ± 0.95,1.17 ± 0.66,with t values respectively 8.316,10.607,7.825,5.217,P < 0.05 or P < 0.01).Levels of insulin resistance index of

  15. Stem Cell Therapy to Improve Burn Wound Healing

    Science.gov (United States)

    2017-03-01

    Award Number: W81XWH-13-2-0024 TITLE: Stem Cell Therapy to Improve Burn Wound Healing PRINCIPAL INVESTIGATOR: Carl Schulman, MD, PhD, MSPH...NUMBER Stem Cell Therapy to Improve Burn Wound Healing 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Carl Schulman, MD, PhD, MSPH...chronic wounds with significant improvement in healing and scarring. Application of mesenchymal stem cell (MSC) therapy to severe burn wounds

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

    Science.gov (United States)

    2009-01-01

    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

  17. A Preliminary Study of the Relationship between Plasma Endothelin Level and Myocardial Damage at the Early Stage of Severe Burn%严重烧伤病人早期血浆内皮素变化与心肌损害关系的初步探讨

    Institute of Scientific and Technical Information of China (English)

    钟克勤; 马恩庆

    2001-01-01

    Objective: To study the effect of plasma endothelin (ET) level on myocardial injury of severely burned patients. Method: Plasma ET level was determined by radio- immunoassay and plasma levels of CK-MB by automatic serum biochemical assay. Result: Plasma ET level increased significantly 12 hr post burn as compared with normal persons (P<0.01), plasma CK MB increased significantly within first 24 hr post burn. Plasma ET level was positive correlated to CK MB level. Conclusion: The results suggested that elevated plasma ET level may be involved in the damage of myocardium in the early stage of severe burn.%目的:探讨血浆内皮素(ET)变化与烧伤早期心肌损害的关系。方法:采用放免法检测5例严重烧伤病人烧伤早期血浆ET和ASCA仪测定血浆肌酸激酶同工酶(CK-MB)。结果:伤后12h血浆ET(106.0±1.6pg/ml,n=5)较正常人组(47.6±3.4pg/ml,n=8)明显升高。血浆CK-MB在伤后明显升高。相关分析显示,ET升高与CK-MB呈高度正相关。结论:血浆ET升高可能参与了烧伤早期的心肌损害。

  18. [Treatment of burns in infants].

    Science.gov (United States)

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

    1995-10-01

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

  19. 早期肠内免疫营养对烫伤小鼠肠道免疫功能的影响%Effect of early enteral immune nutrition on immune function of intestine in mice with severe burn

    Institute of Scientific and Technical Information of China (English)

    范骏; 孟庆延; 郭光华; 谢勇; 李悦; 胡复荪; 修一平; 李泰然; 马靓

    2009-01-01

    function in mice with severe burn. Methods Twenty-four BALB/c mice were inflicted with 20% TBSA full-thickness scald, then they were randomly divided into EN( with oral administration of common enteral nutrition after 2 hours) and EIN( with oral administration of common enter-al nutrition and glutamine, arginine after 2 hours)groups. Another 10 mice were used as the normal control (NC) group. The supplied energy ratio( carbohydrate: fat: protein)in former 2 groups was 82:3 : 15, and the ratio of energy to nitrogen was 150: 1. The energy requirement of each mouse was calculated according to 732.2jJ·kg-1·d-1,one third of the requirenment was administrated on 1st day,and one half of it on 2nd day, and full energy requirement was started on the 3rd day,and the requirement was divided into 4-6 por-tions every day. The feed was isoealoric, isonitrogenous, and isovolumic for the 2 experimental groups. All mice were sacrificed and entire small intestine was harvested for determination of intestinal IgA level by ELISA, total Peyer's patches (PP) lymphocytes and their apoptosis ratio, and changes in PP lymphocytes ( CD3 + ,CD4+ ,CD19 + ) on 7th day of the experiment. Results Compared with those in NC group[ (4.5± 0.6) x 106, (42 ± 7 )μg/em , respectively ], total PP lymphocytes and intestinal IgA levels in EN and EIN groups obviously decreased[(2.3 ±0.4) ×106, (35±6)μg/cm,(3.8±0.5) × 106, (38±6)μg/cm, re-spcctively, P <0.05], among which the values in EIN group were higher than EN group( P <0.05). The changes in PP lymphocytes were similar to that of total PP lymphocytes. Compared with that in NC group [ (4.8 ±2.1 ) % ] , the apoptosis ratio of PP lymphoeytes in EN and E1N groups significantly increased [ ( 12.7 ± 2.4 ) % , ( 8.0 ± 1. 7 ) %, respectively, P < 0.05 ], however the ratio in EIN group was lower than that of EN group( P < 0.05). Conclusions Early enteral nutrition supplemented with immune nutrient can improve intestinal immune function in mice with severe

  20. Candidemia in major burns patients.

    Science.gov (United States)

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

    2016-06-01

    Major burn patients have characteristics that make them especially susceptible to candidemia, but few studies focused on this have been published. The objectives were to evaluate the epidemiological, microbiological and clinical aspects of candidemia in major burn patients, determining factors associated with a poorer prognosis and mortality. We conducted a retrospective observational study of candidemia between 1996 and 2012 in major burn patients admitted to the La Fe University Hospital, Valencia, Spain. The study included 36 episodes of candidemia in the same number of patients, 55.6% men, mean age 37.33 years and low associated comorbidity. The incidence of candidemia varied between 0.26 and 6.09 episodes/1000 days stay in the different years studied. Candida albicans was the most common species (61.1%) followed by Candida parapsilosis (27.8%). Candidemia by C. krusei, C. glabrata or C. tropicalis were all identified after 2004. Central vascular catheter (CVC) was established as a potential source of candidemia in 36.1%, followed by skin and soft tissues of thermal injury (22.2%) and urinary tract (8.3%). Fluconazole was used in 19 patients (52.7%) and its in vitro resistance rate was 13.9%. The overall mortality was 47.2%, and mortality related to candidemia was 30.6%. Factors associated with increased mortality were those related to severe infection and shock. CVC was the most usual focus of candidemia. Fluconazole was the most common antifungal drug administered. The management of candidemia in major burn patients is still a challenge. © 2016 Blackwell Verlag GmbH.

  1. PBXN-110 Burn Rate Estimate

    Energy Technology Data Exchange (ETDEWEB)

    Glascoe, E

    2008-08-11

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

  2. Burn Wise Awareness Kit

    Science.gov (United States)

    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

  3. Molten Metal Burns

    OpenAIRE

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

    1981-01-01

    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.

  4. New Fashioned Book Burning.

    Science.gov (United States)

    Gardner, Robert

    1997-01-01

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

  5. Accidental burns during surgery.

    Science.gov (United States)

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

    2006-01-01

    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.

  6. Smartphone applications in burns.

    Science.gov (United States)

    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

    2015-08-01

    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.

  7. Self-Inflicted Burns in Patients with Chronic Combat-Related Post-Traumatic Stress Disorder

    OpenAIRE

    Braš, Marijana; Lončar, Zoran; Boban, Maja; Gregurek, Rudolf; Brajković, Lovorka; Tomičić, Hrvoje; Muljačić, Ante; Mičković, Vlatko; Kalenić, Barbara

    2007-01-01

    This study examined self-inflicted burns in case series of four patients with chronic combat-related post-traumatic stress disorder (PTSD). Those patients were hospitalized in the Burn Unit of the University Hospital of Traumatology in Zagreb because of severe burns and had a premorbid psychiatric history of PTSD. Demographic data and information regarding the circumstances surrounding the incident, burn severity, treatment and outcomes of these patients were collected. The author...

  8. Burns Caused by Medical Therapy

    Science.gov (United States)

    2016-06-07

    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

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

    Science.gov (United States)

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

    2008-02-01

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

  10. [THERMOMETRY APPLICATION FOR ESTIMATION OF THE SKIN BURNS DEPTH].

    Science.gov (United States)

    Kovalenko, A O

    2015-04-01

    Determination of the burn wound depth, using noncontact infrared thermometry, permits to predict the burn affection severity, basing on the revealed difference between local, perifocal temperature and temperature in certain nonaffected areas of the body surface. The temperature difference (ΔT) over 1 °C constitutes a strict criterion of the skin burn presence. The temperature 34 °C have been considered a border one for the skin burns. If the burn wound temperature in 24 h after trauma was lower 34 °C and ΔT 2 °C and more, it have witnessed the presence of deep burn of the skin. High sensitivity (87%) and specificity (96%) of thermometric test in 24 h after trauma were established. In epidermal burns the temperature of the burn wounds have constituted (35.9 ± 0.3) °C at average, in superficial burns of the skin--(35.1 ± 0.6) °C, and in the deep burns--(33.6 ± 0.8) °C.

  11. [Changes in mesenteric microcirculation in rats following repeated skin burns].

    Science.gov (United States)

    Shtykhno, Iu M

    1976-07-01

    Acute experiments were conducted on rats; repeated extensive burn of a convalescent who formerly sustained the burn disease was better tolerated, led tono fatal outcome and was accompanied by moderate microcirculatory disturbances. The smae burn was accompanied in intact rats by a severe shock followed by death, intravascular aggregation of erythrocytes and significant microcirculatory disturbances leading to disturbance of tissue nutrition. It is supposed that the results obtained could serve as an indirect proof that toxemia played an important role in the genesis of intravascular aggregation of erythrocytes in burn shock.

  12. Accidental Chemical Burns of Oral Mucosa by Herbicide

    Directory of Open Access Journals (Sweden)

    S P Deo

    2012-03-01

    Full Text Available Glyphosate (GlySH is a broad spectrum, nonselective herbicide, widely used in agriculture. This case report describes a 25-year-old man presenting with extensive chemical burns and ulceration of the oral cavity as a result of accidental exposure to GlySH. This paper aims to illustrate the typical appearance of GlySH related chemical mucosal burn and to demonstrate the severity of the corrosive effect of GlySH which need team approach to prevent unfavorable sequelae such as microstomia. Keywords: Chemical burns, corrosive injury, glyphosate poisoning, herbicide, microstomia, oral mucosal burn.

  13. Post-burn duct carcinoma breast: An unusual case report

    Directory of Open Access Journals (Sweden)

    Neha Singh

    2013-01-01

    Full Text Available Malignancies arising from burn scars though rare are well documented in the literature; squamous cell carcinoma is the most common burn scar neoplasm, and adenocarcinoma is an extremely uncommon and rarely reported tumor in these scars. We hereby report a case of a young woman who presented with a rapidly growing lump in a scar in the mammary region that sustained severe burns 20 years back. It was diagnosed as duct carcinoma breast on cytology and later confirmed on histopathology and immunohistochemistry. The case mandates regular follow-up of patients with post-burn scars, and any lump arising in that region should be promptly investigated.

  14. [Risk factors for development of hypomagnesemia in the burned patient].

    Science.gov (United States)

    Durán-Vega, Héctor César; Romero-Aviña, Francisco Javier; Gutiérrez-Salgado, Jorge Eduardo; Silva-Díaz, Teresita; Ramos-Durón, Luis Ernesto; Carrera-Gómez, Francisco Javier

    2004-01-01

    Electrolyte abnormalities are common in the severely burned patient. There is little information with regard to the frequency and magnitude of hypomagnesemia, as well as on risk factors for this condition. We performed an observational, retrospective analysis of 35 burned patients treated at the Plastic and Reconstructive Surgery Service at the Hospital Central Sur PEMEX, Mexico City. We determined serum magnesium behavior and divided patients into two groups: the first included 11 patients with burns and hypomagnesemia, and the second, 24 patients with burns but without hypomagnesemia. Risk factor identification was performed. We found patient at risk was the one with more than 40% of 2nd or 3rd degree total burned body area, in day 4 or 10 after the burn, and with hypokalemia, hypocalcemia, or both, and without intravenous (i.v.) supplementation of magnesium. The best way to prevent or avoid major complications is to identify the high-risk patient, or to diagnose earlier.

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

    Directory of Open Access Journals (Sweden)

    Kamran Aghakhani

    2013-10-01

    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

  16. Characterization of facial burns from maxillofacial surgery. Cienfuegos 2005 - 2007

    Directory of Open Access Journals (Sweden)

    Eduardo Duarte Marrero

    2010-08-01

    Full Text Available Background: A descriptive study and retrospective study with 87 patients for facial burns, were treated at the Burn Service of the Hospital General Universitario "Dr. Gustavo Lima Aldereguía "Cienfuegos between January 2005 and September 2007. Objective: To characterize the care of patients with facial burns to help develop knowledge, attitudes and skills medical - surgery in the maxillofacial surgeon. Method: the source of information used were the records of patient care in the emergency department Burned Service and these data were selected that identified the patients as well as other related directly with facial burns. For each patient, more severe burning classified according to their size and depth. Results: In this study facial burns were more frequent in females aged 16 to 34 years, the most common cause of these lesions was in contact with boiling liquids as the predominant type skin burns, with extensions between 2 and 4% of the face area. In 44 patients affected centers facial structures, so predominant involvement of the ears. The priest most used in the facial region was the stop with silver sulfadiazine. Approximately 50% of patients were affected in the organs of sense, particularly in the ears. Conclusion: The traumatic facial burns are more severe conditions than any other location for the possible commitment to the airways.

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

    Science.gov (United States)

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

    2012-03-01

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

  18. 严重烧伤患者康复期生活质量调查及其影响因素分析%Investigation of life quality of severe burn patients at rehabilitation stage and analysis of the related influential factors

    Institute of Scientific and Technical Information of China (English)

    岳丽青; 蒋冬梅; 黄晓元

    2008-01-01

    Objeetive To investigate the life quality in severe burn patients at rehabilitation stage and analysis of related influential factors. Methods Social support rating scale,general quality of life inventory and retrospective investigation were used to evaluate the life quality of 96 severe burn patients(E group,age:over 16 years)at rehabilitation stage,and 96 healthy people were enrolled into our study as control(C group).The relationship between the life quality and sex,age,education background,occupation,post burn time,burn causes,burn depth,total burn surface area,length of hospitalization,medical cost,return to work was respectively analyzed. Results There was obvious difference in total score of the life quality be-tween two groups(53±12 in E group.vs.63±10 in C group,P<0.01).There were no obvious difference in life quality among patients with different sex,age,education,burn causes,length of hospitalization and medical expenditure(P>0.05).The score of social function dimension and material function dimension in married patients were higher than that in singles.The life quality had positive correlation with social support score,return to work,post burn time,and occupation.There were negative correlation between deep burn ar-ea and life quality. Conclusion The life quality level of severe burn patients at rehabilitation stage is low.Social support,return to work,duration after burn,occupation and deep burn area are correlating factors affecting life quality.%目的 调查严重烧伤患者康复期的生活质量及相关影响因素.方法 采用社会支持评定量表、生活质量综合评定问卷和回顾性调查方法,对96例(病例组)16岁以上严重烧伤患者康复期的生活质量进行评估.分析生活质量与伤者一般情况及烧伤原因、烧伤面积、烧伤深度、住院时间、医疗费用支付情况和重返岗位之间的关系,与96名健康人(对照组)进行比较.结果 病例组患者生活质量总分为(53±12)

  19. Increased mortality in hypernatremic burned patients

    Directory of Open Access Journals (Sweden)

    Lange, Thomas

    2010-01-01

    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.

  20. 早期肠内营养对严重烧伤后炎症反应综合征患者炎症细胞因子的影响%Inlfuence of Early Enteral Nutrition on Inlfammatory Cytokines in Severely Burned Patients with Systemic Inlfammatory Response Syndrome

    Institute of Scientific and Technical Information of China (English)

    杨萍; 刘小伟; 张赛圣; 杨志宏

    2013-01-01

    Objective:To investigate early enteral nutrition influence inflammatory factor in severely burned patients with SIRS. Methods:38 patients in severely burned with SIRS were divided into early enteral nutrition (EEN) groups and contrast group.The levels of TNF-α,CRP,IL-1 and IL-6 in the peripheral plasma were measured in the first, the fouth, the eighth, the twelfth day. Results:The levels of TNF-α,CRP,IL-1 and IL-6 in the peripheral plasma in EEN group were less than those contrast group at the the fouth, the eighth and the twelfth day respectively.Conclusion:Early enteral nutrition can decrease inflammatory factor and has a protective effect on intestinal mucosal barrier of severe burn patients with SIRS .%目的:探讨早期肠内营养(EEN)对严重烧伤后炎症反应综合征(SIRS)患者炎症因子的影响。方法:将38例严重烧伤后SIRS患者随机分成2组,对照组和EEN组。在第(1、4、8、12)d分别检测炎症介质TNF-α、CRP、IL-1和IL-6。结果:第4d、8d和第12d EEN组的TNF-α、CRP、IL-1和IL-6水平低于对照组。结论:EEN能减少炎症因子生成,对严重烧伤后SIRS患者肠黏膜屏障有保护作用。

  1. Efecto de la severidad de quemado sobre la concentración de carbono orgánico en montículos e intermontículos en el monte austral Effect of burn severity on the soil organic carbon concentration mounds and intermounds in the monte austral

    Directory of Open Access Journals (Sweden)

    Juan José Gaitán

    2007-12-01

    Full Text Available El efecto de la severidad de quemado sobre la concentración de carbono orgánico (COS en los montículos vegetados y en los intermontículos de suelo desnudo fue evaluado 4 años luego de la ocurrencia de un incendio natural en un área del Monte Austral (provincia de Río Negro. Los montículos actúan como "islas de fertilidad" dado que la concentración de COS fue mayor que en los intermontículos. La concentración de COS en los intermontículos no fue afectada por el incendio. En cambio en los montículos se halló una disminución en la concentración de COS al incrementarse la severidad de quemado. La pérdida de COS podría inducir una degradación de los pastizales, por lo tanto las prácticas de manejo del fuego deberían tender a la realización de quemas de baja severidad.The effect of burn severity on soil organic carbon concentration (COS in vegetated mounds and in bare soil intermounds was evaluated 4 years after the occurrence of a natural fire in an area of the Monte Austral (Río Negro province. The mounds act as "fertility islands" since COS concentration was higher than in the intermounds. The COS concentration in the intermounds was not affected by fire. On the other hand, in the mounds a decrease in the COS concentration was found when the burn severity increased. The COS loss could induce rangelands degradation, therefore fire management practices should tend to the realization of low severity burns.

  2. [Advances in the research of pressure therapy for pediatric burn patients with facial scar].

    Science.gov (United States)

    Wei, Y T; Fu, J F; Li-Tsang, Z H P

    2017-05-20

    Facial scar and deformation caused by burn injury severely affect physical and psychological well-being of pediatric burn patients, which needs medical workers and pediatric burn patients' family members to pay much attention to and to perform early rehabilitation treatment. Pressure therapy is an important rehabilitative strategy for pediatric burn patients with facial scar, mainly including wearing headgears and transparent pressure facemasks, which have their own features. To achieve better treatment results, pressure therapy should be chosen according to specific condition of pediatric burn patients and combined with other assistant therapies. Successful rehabilitation for pediatric burn patients relies on cooperation of both family members of pediatric burn patients and society. Rehabilitation knowledge should be provided to parents of pediatric burn patients to acquire their full support and cooperation in order to achieve best therapeutic effects and ultimately to rebuild physical and psychological well-being of pediatric burn patients.

  3. Surgical wound debridement sequentially characterized in a porcine burn model with multispectral imaging.

    Science.gov (United States)

    King, Darlene R; Li, Weizhi; Squiers, John J; Mohan, Rachit; Sellke, Eric; Mo, Weirong; Zhang, Xu; Fan, Wensheng; DiMaio, J Michael; Thatcher, Jeffrey E

    2015-11-01

    Multispectral imaging (MSI) is an optical technique that measures specific wavelengths of light reflected from wound site tissue to determine the severity of burn wounds. A rapid MSI device to measure burn depth and guide debridement will improve clinical decision making and diagnoses. We used a porcine burn model to study partial thickness burns of varying severity. We made eight 4 × 4 cm burns on the dorsum of one minipig. Four burns were studied intact, and four burns underwent serial tangential excision. We imaged the burn sites with 400-1000 nm wavelengths. Histology confirmed that we achieved various partial thickness burns. Analysis of spectral images show that MSI detects significant variations in the spectral profiles of healthy tissue, superficial partial thickness burns, and deep partial thickness burns. The absorbance spectra of 515, 542, 629, and 669 nm were the most accurate in distinguishing superficial from deep partial thickness burns, while the absorbance spectra of 972 nm was the most accurate in guiding the debridement process. The ability to distinguish between partial thickness burns of varying severity to assess whether a patient requires surgery could be improved with an MSI device in a clinical setting. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  4. Investigating the depth of thermal burns in elephants

    Directory of Open Access Journals (Sweden)

    A. Shakespeare

    2006-06-01

    Full Text Available Histological examination of burn injuries in elephants revealed that the depth was not as severe as expected from clinical observation. Although the actual burn depth was deep, the thickness of elephant skin, especially the dermis, resulted in the lesions being classified as less severe than expected. Examination of skin samples from selected areas showed that most lesions were either superficial (1st degree or superficial partial-thickness (superficial 2nd degree burns with the occasional deep partial thickness (deep 2nd degree wound. These lesions however, resulted in severe complications that eventually led to the death of a number of the elephants.

  5. Psychiatric aspects of burn

    Directory of Open Access Journals (Sweden)

    Dalal P

    2010-10-01

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

  6. Prehospital Care of Burn Patients and Trajectories on Survival.

    Science.gov (United States)

    Kallinen, Outi; Koljonen, Virve; Tukiainen, Erkki; Randell, Tarja; Kirves, Hetti

    2016-01-01

    We sought to identify factors associated with the prognosis and survival of burn patients by analyzing data related to the prehospital treatment of burn patients transferred directly to the burn unit from the accident site. We also aimed to assess the role of prehospital physicians and paramedics providing care to major burn patients. This study included adult burn patients with severe burns treated between 2006 and 2010. Prehospital patient records and clinical data collected during treatment were analyzed, and the Injury Severity Scale (ISS) was calculated. Patients were grouped into two cohorts based on the presence or absence of a physician during the prehospital phase. Data were analyzed with reference to survival by multivariable regression model. Specific inclusion criteria resulted in a sample of 67 patients. The groups were comparable with regard to age, gender, and injury etiology. Patients treated by prehospital physicians (group 1, n = 49) were more severely injured than patients treated by paramedics (group 2, n = 18) in terms of total burn surface area (%TBSA) (32% vs. 17%, p = 0.033), ISS (25 vs. 8, p prehospital prognostic factors affecting patient outcomes. Based on the results from this study, our current EMS system is capable of identifying seriously injured burn patients who may benefit from physician attendance at the injury scene.

  7. Long standing intra oral acid burn

    NARCIS (Netherlands)

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

    2015-01-01

    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

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

    African Journals Online (AJOL)

    admin

    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.

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

    Science.gov (United States)

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

    2015-03-01

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

  10. On medications for burns in classical antiquity.

    Science.gov (United States)

    Scarborough, J

    1983-10-01

    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.

  11. Field validation of Burned Area Reflectance Classification (BARC) products for post fire assessment

    Science.gov (United States)

    Andrew T. Hudak; Peter R. Robichaud; Jeffery B. Evans; Jess Clark; Keith Lannom; Penelope Morgan; Carter Stone

    2004-01-01

    The USFS Remote Sensing Applications Center (RSAC) and the USGS EROS Data Center (EDC) produce Burned Area Reflectance Classification (BARC) maps for use by Burned Area Emergency Rehabilitation (BAER) teams in rapid response to wildfires. BAER teams desire maps indicative of soil burn severity, but photosynthetic and nonphotosynthetic vegetation also influences the...

  12. Initial evaluation and management of the critical burn patient.

    Science.gov (United States)

    Vivó, C; Galeiras, R; del Caz, Ma D P

    2016-01-01

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

  13. Epidemiology of burns in Taiwan: a nationwide report including inpatients and outpatients.

    Science.gov (United States)

    Chen, Shih-Han; Chen, Yi-Chun; Chen, Tzeng-Ji; Ma, Hsu

    2014-11-01

    The aim of the study is to understand the incidence of burns among outpatients and inpatients of Taiwan in 2010. Characteristics of the burned patients were also studied in terms of gender, age, burn sites, burn degree, reconstructive surgical treatment, as well as which specialty and medical facility they are treated in. Burned patients were identified from the 1,000,000-person cohort dataset sampled from the Taiwan National Health Insurance database. Ones who had been hospitalized with discharge diagnoses related to burns were categorized as inpatients and others who had only ambulatory visits and emergency room visits were classified as outpatients. 7630 burn-injury patients were found, presenting an annual incidence of burns as 670.8/10(5) in males (n=3303) and 852.5/10(5) in females (n=4327). Only 3.4% (156 males and 107 females) of them were hospitalized. Higher incidence of burns were found in females and young children, while males and the elderly tended to have more severe burns, based on high-degree burns, admission rate, and incidence of hospitalizations for burns. This is a population-based study demonstrating the epidemiology of burns among outpatients and inpatients in Taiwan, leading us closer to the reality of burns treated in different settings of medical facilities. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  14. [Ischemic cholangiopathy induced by extended burns].

    Science.gov (United States)

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

    2013-04-01

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

  15. Burning plasmas in ITER for energy source

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-10-01

    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. Back Bay Wilderness burning support

    Data.gov (United States)

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

  17. Phoenix Society for Burn Survivors

    Science.gov (United States)

    ... 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 ...

  18. Hair bleaching and skin burning

    National Research Council Canada - National Science Library

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

    2012-01-01

    .... 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...

  19. Neuroendocrine system response modulates oxidative cellular damage in burn patients.

    Science.gov (United States)

    Xie, Xiao-Qi; Shinozawa, Yotaro; Sasaki, Junichi; Takuma, Kiyotsugu; Akaishi, Satoshi; Yamanouchi, Satoshi; Endo, Tomoyuki; Nomura, Ryosuke; Kobayashi, Michio; Kudo, Daisuke; Hojo, Nobuko

    2007-02-01

    Oxygen-derived free radicals play important roles in pathophysiological processes in critically ill patients, but the data characterizing relationships between radicals and neuroendocrine system response are sparse. To search the cue to reduce the oxidative cellular damage from the point of view of neuroendocrine system response, we studied the indicators of neuroendocrine and inflammatory responses excreted in urine in 14 burn patients (42.3 +/- 31.4 years old, and 32.3 +/- 27.6% burn of total body surface area [%TBSA]) during the first seven days post burn. The daily mean amounts of urinary excretion of 8-hydroxy-2'-deoxy-guanosine (8-OHdG), a marker of oxidative cellular damage, were above the upper limit of the standard value during the studied period. The total amount of urinary excretion of 8-OHdG in the first day post burn correlated with burn severity indices: %TBSA (r = 0.63, p = 0.021) and burn index (r = 0.70, p = 0.008). The daily urinary excretion of 8-OHdG correlated with the daily urinary excretion of norepinephrine and nitrite plus nitrate (NOx) during the studied period except day 2 post burn, and correlated with the daily urinary excretion of 17-hydroxycorticosteriod (17-OHCS) in days 2, 3, and 7 post burn. These data suggest that oxidative cellular damage correlates with burn severity and neuroendocrine system response modulates inflammation and oxidative cellular damage. Modulation of neuroendocrine system response and inflammation in the treatment in the early phase of burn may be useful to reduce the oxidative cellular damage and to prevent multiple organ failures in patients with extensive burn.

  20. Epidemiology of burns in Lithuania during 1991-2004.

    Science.gov (United States)

    Rimdeika, Rytis; Kazanavicius, Mindaugas; Kubilius, Darius

    2008-01-01

    The objective of this article is to overview and present the burn incidence and burn care in Lithuania. In this study, data from the period of 1991-2004 were collected from the Lithuanian Department of Statistics, Department of Fire and Rescue, Lithuanian Health Information Center, State Patient Fund, health care institutions, burn care facilities. In the 14-year period, 9459 persons per year (2.6/1000 population) in average sustained burn injuries. The majority of burned patients (74.8%) were adults and 25.2% were children; 21.5% of all burned patients were hospitalized (2013 inpatients per year). The number of hospitalizations per 100 000 individuals has decreased from 65.6 to 39.5, but it is still very high and worrying. Among all the patients admitted to hospitals, 67% were males and 33% females, with a male-to-female ratio of 2:1. The length of hospitalization decreased from 16.2 to 12.7 days. The number of fire-related deaths for the 14-year period was 289 deaths per year (8 per 100 000 persons). The number of deaths among inpatients was 63.6 deaths per year, the age being an important factor in mortality rates. Although the mortality of inpatients has increased in recent years, the mortality in the age group up to 14 years has decreased to 0. Children made up 24.6% of burn patients; among those admitted to hospital, they accounted for 41.1%. Mortality rates for males and females were almost the same. The number of burns is decreasing. The hospitalization rate and hospitalization time are becoming shorter. In the last few years, patients suffer from more severe burns, while children sustain more severe burns requiring hospitalization. Children and working-age persons make up 91.9% of hospitalized burn patients. Number of deaths in fire accidents is increasing.

  1. In vivo burn diagnosis by camera-phone diffuse reflectance laser speckle detection

    OpenAIRE

    Ragol, S.; Remer, I.; Shoham, Y.; Hazan, S.; Willenz, U.; Sinelnikov, I.; Dronov, V.; Rosenberg, L.; Bilenca, A.

    2015-01-01

    Burn diagnosis using laser speckle light typically employs widefield illumination of the burn region to produce two-dimensional speckle patterns from light backscattered from the entire irradiated tissue volume. Analysis of speckle contrast in these time-integrated patterns can then provide information on burn severity. Here, by contrast, we use point illumination to generate diffuse reflectance laser speckle patterns of the burn. By examining spatiotemporal fluctuations in these time-integra...

  2. The year in burns 2008.

    Science.gov (United States)

    Wolf, Steven E

    2009-12-01

    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.

  3. TIRES, OPEN BURNING

    Science.gov (United States)

    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...

  4. Chemical burn or reaction

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000059.htm 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. ...

  5. PLASTIC SURGERY AND BURNS

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    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

  6. Do Large Fire Runs Result in More Severe Fires?

    Science.gov (United States)

    Morgan, P.; Birch, D.; Kolden, C.; Smith, A. M.

    2013-12-01

    Do large fire runs consistently result in high severity fires, and how do climate, weather topography and fuels influence where they burn severely? We analyzed burn severity on 11,938 polygons representing daily area growth (0.09 - 5559 ha, median 0.75 ha) from 410 days of fire progression totaling more than 141,363 ha from 43 large forest fires from Idaho and Montana that burned 2007-2011. We used burn severity classes interpreted using differenced Normalized Burn Ratio from 30-m Landsat satellite imagery by the Monitoring Trends in Burn Severity project, along with infrared perimeter maps provided by the USDA Forest Service National Infrared Operations. Proportion burned with high severity, likely indicating tree mortality >70%, was not correlated with the daily area growth (Kendall Tau=0.288, p=Forest Machine Learning algorithm to analyze burn severity relative to 31 fuel, topography, and weather factors, with weather factors such as temperature and relative humidity based on the 24-hour burn period, all at randomly located points within polygons. Results support our hypothesis that local, bottom-up fuels and topography influences where fires burn severely, while top-down climate and weather more strongly influence area burned, even when large areas burn within a single 24-hour period.

  7. Modern management of paediatric burns

    African Journals Online (AJOL)

    2010-03-01

    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 ...

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

    Directory of Open Access Journals (Sweden)

    Kumar P

    1997-01-01

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

  9. Parker River National Wildlife Refuge : FY 1989 Prescribed Burning Plan

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The area to be burned is the Stage Island Pool, a freshwater impoundment of approximately 100 acres. The area has a large amount of edge interspersed with several...

  10. 早期应用小剂量地塞米松对中重度烧伤全身炎症反应的影响%Effects of Moderate and Severe Burns Systemic Inflammatory Response by Early Intravenous Infusion of Low Dose Dexamethasone

    Institute of Scientific and Technical Information of China (English)

    李维珊; 柯昌能; 邓雪峰

    2014-01-01

    Objective:To investigate effects of moderate and severe burns systemic inflammatory response by early intravenous infusion of low dose dexamethasone.Method:25 adult burn patients were selected as the treatment group, and treatment by early application of low-dose dexamethasone in addition to conventional anti shock. Usage was the dose of 20 mg, intravenous drip, 1 times a day, a total of 3 days. 25 adult burn patients were selected as the control group, and given conventional anti shock treatment. The TNF-α, IL-1, IL-6 concentration differences of two groups were compared after first day, second days, third days, fourth days, fifth days, sixth days and seventh day.Result:TNF-α, IL-1, IL-6 plasma concentrations in the treatment group were significantly lower than those in the control group, the differences were statistically significant (P<0.05).Conclusion:There are the obvious inhibitory actions for systemic inflammatory response used by early application of low-dose dexamethasone on moderate and severe burns.%目的:探讨早期应用小剂量地塞米松对中重度烧伤患者全身炎症反应的影响。方法:选取25例成年中重烧伤患者作为治疗组,常规抗休克治疗外,早期应用小剂量地塞米松20 mg,静滴,1次/d,共3 d;另选取25例成年中重烧伤患者作为对照组,采用常规抗休克治疗。比较烧伤后第1、2、3、4、5、6、7天两组血浆中TNF-α、IL-1、IL-6浓度的差异。结果:治疗组血浆TNF-α、IL-1、IL-6浓度均显著低于对照组,差异均有统计学意义(P<0.05)。结论:早期应用小剂量地塞米松对中重度烧伤所致的全身反应综合征有明显的抑制作用,可在烧伤早期短期应用。

  11. Noncontact imaging of burn depth and extent in a porcine model using spatial frequency domain imaging.

    Science.gov (United States)

    Mazhar, Amaan; Saggese, Steve; Pollins, Alonda C; Cardwell, Nancy L; Nanney, Lillian; Cuccia, David J

    2014-08-01

    The standard of care for clinical assessment of burn severity and extent lacks a quantitative measurement. In this work, spatial frequency domain imaging (SFDI) was used to measure 48 thermal burns of graded severity (superficial partial, deep partial, and full thickness) in a porcine model. Functional (total hemoglobin and tissue oxygen saturation) and structural parameters (tissue scattering) derived from the SFDI measurements were monitored over 72 h for each burn type and compared to gold standard histological measurements of burn depth. Tissue oxygen saturation (stO₂) and total hemoglobin (ctHbT) differentiated superficial partial thickness burns from more severe burn types after 2 and 72 h, respectively (p burns from all burn types immediately after injury (p burn types from each other after 24 h (p burn depth as measured by vimentin immunostain (r² > 0.89). These results show promise for the use of SFDI-derived tissue scattering as a correlation to burn depth and the potential to assess burn depth via a combination of SFDI functional and structural parameters.

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

    Science.gov (United States)

    Koç, Zeliha; Sağlam, Zeynep

    2012-09-01

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

  13. Burn Wound Healing and Treatment: Review and Advancements

    Science.gov (United States)

    2015-06-12

    outside the scope of this review, but several key points are noteworthy. Most burns among older people occur at home , especially in the kitchen and...plasma and Rowan et al. Critical Care (2015) 19:243 Page 11 of 12 wound exudate from children with severe burns . Bull Exp Biol Med. 2009;148:771–5. 163...REVIEW Open Access Burn wound healing and treatment: review and advancements Matthew P. Rowan1*, Leopoldo C. Cancio1, Eric A. Elster2, David M

  14. Revelation of Natural Healing about a Patient with Severe Burn Wounds%1例特重度烧伤创面自然愈合的启示

    Institute of Scientific and Technical Information of China (English)

    高步营

    2011-01-01

    A youth male was injured by explosion of gunpowder, with deep degree burn wounds 40%,deep second 10% , III °30 % , patient accompanied by the saphenous vein necrosis and the tibia and fibula explosion. It was treated with the therapy of Weinong Shengji within 32 days after injury. The wounds naturally healed after 15 months. The change of wounds environment during treatment process and the skin quality of natural healing were recorded by digital camera .which reappeared the potential and the mechanism of tissue regeneration . It reveals unique idea,special effect and humanistic spirit of the therapy of Weinong Shcngjin.%火药爆炸致1例男性青年烧伤面积40%TBSA,深Ⅱ度10%,Ⅲ度30%,伴有左小腿大隐静脉坏死、胫腓骨暴露.伤后32天采用煨脓生肌疗法治疗,15个月创面自然愈合,照片记录治疗过程中创面环境的动态变化和愈后皮肤质量,再现组织的再生潜能和机制,彰显煨脓生肌疗法治疗烧伤独特的理念、疗效和人文精神.

  15. [Sociodemographic/clinical characteristics and outcomes of patients admitted to the National Burn Center of Chile].

    Science.gov (United States)

    Albornoz, Claudia R; Villegas, Jorge; Peña, Verónica; Whittle, Sandra

    2013-02-01

    Approximately 150 subjects per year suffer severe burns in Chile. To analyze sociodemographic/clinical features and outcomes of severely burned patients. Retrospective cohort study of 936 patients aged 47 ± 20 years (66% males), admitted to the National Burn Center of Chile between 2006 and 2010. Sociodemographic/clinical and burn variables and outcomes were studied. Mean total percentage of body surface area burned was 27 + 20%. A quarter of the patients had social features that could jeopardize rehabilitation. Fire was the burning agent in 73%, which along with electricity presented greater lethality (p Chile are mainly males at working age. Fire is the main agent and 28% had impaired consciousness, which was associated with an increase in the severity of burns. Knowledge of the characteristics and outcomes of the patients is important to implement prevention and treatment strategies adjusted to the national reality.

  16. The year in burns 2011.

    Science.gov (United States)

    Wolf, Steven E; Arnoldo, Brett D

    2012-12-01

    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.

  17. Fungal infections in burns: Diagnosis and management

    Directory of Open Access Journals (Sweden)

    Capoor Malini

    2010-10-01

    , improvement in topical antifungal therapy with mould activity and implementation of appropriate systemic antifungal therapy guided by antifungal susceptibility may improve the outcome for severely injured burn victims.

  18. Soil heating and impact of prescribed burning

    Science.gov (United States)

    Stoof, Cathelijne

    2016-04-01

    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.

  19. Fire walking in Singapore-a study of the distribution of burns.

    Science.gov (United States)

    Sayampanathan, Andrew A

    2011-05-01

    Fire walking is a religious ritual practiced by predominantly Indians and some Chinese living in Singapore. Eighteen new cases of burns, directly related to a firewalking ceremony on 05 October 09, were studied as to the pattern of burns. Burns on the soles of the feet occurred in 17 patients. All these injuries were superficial or partial thickness burns. There were no deep dermal burns. The extent of burns ranged from 0.25% to 1.5% of body surface area. Burns due to falls accounted for one casualty. He sustained a mixture of deep dermal and partial thickness burns, and the extent of burns was 20% of body surface area. A new classification for the distribution of burns related to fire walking was developed based on the mechanism of injury. It was predictive of the anatomical distribution of burns, the extent of burns (in terms of body surface area), the depth of burns and the general severity of the injury: Copyright © 2010 Elsevier Ltd and ISBI. All rights reserved.

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

    Science.gov (United States)

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

    2016-09-30

    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.

  1. 重度火烧对大兴安岭天然林土壤有机碳和黑碳的影响1)%Impact of Severe Burning on Soil Organic Carbon and Black Carbon Content in Natural Forest of Daxing’ an Mountains

    Institute of Scientific and Technical Information of China (English)

    雷雨雨; 辛颖; 赵雨森; 陈璐; 王丽红

    2014-01-01

    In the severe burned area of Daxing’ an Mountains, we studied the impact of severe burning on the soil organic carbon and black carbon content of natural forest.Both soil organic carbon and black carbon content decreased with deeper soil ho-rizon in unburned natural forest and severe burned area.Compared with unburned natural forest, the soil organic carbon content at 0-5 cm increased by 41.56%in severe burned area.Soil organic carbon content at 5-10 cm and 10-20 cm hori-zon had little change.Soil black carbon content at 0-5 cm increased by 21.37 g/kg ( p<0.05) , which at 5-10 cm and 10-20 cm increased by 1.25 g/kg and 1.15 g/kg, respectively.However, the increase of soil black carbon in 5-10 cm and 10-20 cm didn’ t reach significant levels.The proportion of soil black carbon to organic carbon was in 14.0%-18.1%in unburned natural forest, and rose first then fell with soil horizon deepening.While the proportion of soil black carbon to organic car-bon in severe burned area was in 17.3%-28.0%and decreased with deeper soil horizon.The proportion of soil black car-bon to organic carbon in severe burned area was higher than that in unburned natural forest.The soil organic carbon content displayed a significant linear correlation with the soil black carbon content in both severe burned and unburned forest ( p<0.01) , which meant soil black carbon played an important role in the immobilization of soil organic carbon in Daxing’ an Mountains forests.%以大兴安岭重度火烧迹地土壤为研究对象,通过对比研究,探讨重度火烧对大兴安岭天然林土壤有机碳和黑碳的影响。结果表明:对照样地和重度火烧迹地的土壤有机碳和黑碳质量分数都随土层深入而降低。与对照样地相比,重度火烧迹地0~5 cm土层土壤有机碳质量分数增加了41.56%,>5~10 cm和>10~20 cm土层有机碳质量分数变化不大。0~5 cm土层黑碳质量分数增加了21.37 g/kg ( p<0.05

  2. Burn wound healing: present concepts, treatment strategies and future directions.

    Science.gov (United States)

    Oryan, A; Alemzadeh, E; Moshiri, A

    2017-01-02

    Burns are the most extensive forms of soft tissue injuries occasionally resulting in extensive and deep wounds and death. Burns can lead to severe mental and emotional distress, because of excessive scarring and skin contractures. Treatment of burns has always been a difficult medical problem and many different methods have been used to treat such injuries, locally. Biofilms are a collection of microorganisms that delay wound healing. One of the new methods of prevention and treatment of burn wound infections is application of antimicrobials, which act on biofilms and prevent the wound infection. Biofilm initiates a persistent, low-grade, inflammatory response, impairing both the epithelialisation and granulation tissue formation. Skin grafts have been shown to dramatically reduce deaths from infection. However, grafting has considerable limitations. Such injuries are long-lasting and many patients suffer from chronic pain for a long time. Tissue engineering is a new approach in reducing the limitations of conventional treatments and producing a supply of immunologically tolerant artificial tissue, leading to a permanent solution for damaged tissues; such criteria make it a cost-effective and reliable treatment modality. To overcome the present limitations of burn wound healing, knowledge about the latest findings regarding healing mechanisms is important. Here the authors discuss the most important events regarding burn wound healing and review the latest treatment strategies that have been used for burn wounds from in vitro to clinical levels. Finally, we discuss the role of tissue engineering and regenerative medicine in the future of burn wound healing, modelling and remodelling.

  3. Jewelry Ring-Associated Electrothermal Burn Injuries: A Nine-Patient Case Series.

    Science.gov (United States)

    Mushin, Oren P; Bogue, Jarrod T; Pencek, Megan E; Bell, Derek E

    Ring-associated burns are infrequent, comprising only a small fraction of burn consults and admissions. However, because of the location of these burns and the propensity for circumferential wounds, small burn size may belie the severity of resultant injuries. Herein, the authors present their experience with this potentially severe type of burn. Records from a regional burn center were retrospectively analyzed during a 36-month period. All patients who sustained ring burns were included. Data points included demographics, burn location, need for surgical intervention, grafted area, hospital days (length of stay), percent graft take, complications, and time to re-epithelialization. Nine patients sustained ring-associated burns during the study period, accounting for 1.4% of all patients with burns seen during the same period. Average age was 41 years (range: 29-52 years). Seven (77%) ring-associated burns involved contact with a battery. All injuries were circumferential. Average burn TBSA was 0.07%. Two patients (22%) had third-degree injuries, both of which received split-thickness skin grafts. Grafted area was 4 and 5 cm, respectively. Average length of stay was 2.8 days. Mean graft take was 99.5 ± 1.5%. Average time to complete re-epithelialization was 12 days. One patient suffered temporary disability. No patients suffered from compartment syndrome. Ring-associated burns are an uncommon source of injury in the burn population. Despite small burn TBSA, these patients are more likely to require split-thickness skin grafts and suffer dysfunction compared with similarly-sized burns in other body regions. Expedient treatment and coordination with occupational therapy should be undertaken to achieve optimal outcomes.

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

    Institute of Scientific and Technical Information of China (English)

    孙天宝; 郭钦; 黄伟艺; 方璐; 饶伶娟

    2013-01-01

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

  5. A ten-year review of lower extremity burns in diabetics: small burns that lead to major problems.

    Science.gov (United States)

    Barsun, Alura; Sen, Soman; Palmieri, Tina L; Greenhalgh, David G

    2013-01-01

    amputations) with several needing revisions or higher amputations. Patients with diabetes have an increased risk for lower extremity complications, but the risk of burns is not well known. The majority of lower extremity burns result from intentional exposure to sources of heat without recognition for the risk of burns. Once a burn occurs, morbidity and cost to the patient and society are severe. Prevention programs should be initiated to make diabetic patients and their doctors aware of the significant risk for burns.

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

    Science.gov (United States)

    Peters, W

    2000-01-01

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

  7. Assessment of burn depth and burn wound healing potential.

    Science.gov (United States)

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

    2008-09-01

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

    Science.gov (United States)

    Song, Colin; Chua, Alvin

    2005-01-01

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

  9. [The organization of burn care].

    Science.gov (United States)

    Latarjet, Jacques

    2002-12-15

    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.

  10. Acute Kidney Injury and Renal Replacement Therapy in Burns

    Directory of Open Access Journals (Sweden)

    Burak Canver

    2011-07-01

    Full Text Available Acute kidney injury (AKI is a common complication in patients with severe burn injury and one of the major causes of death. It has a negative prognostic value and almost always develops in the context of multiple organ dysfunction syndrome (MODS induced by sepsis. Over the last 20 years, according to data avaliable, the mortality rate has been reported to reach about 75%. Several definitions of AKI have been used , but nowadays the RIFLE classification is considered the gold standard, enabling a more objective comparison of populations. There are several ways to treat AKI in burn patients, including peritoneal dialysis (PD, intermittent hemodialysis, and continuous renal replacement therapy (CRRT. CRRT is generally used in patients in whom intermittent hemodialysis has failed to control hypovolemia, as well as in patients who cannot tolerate intermittent hemodialysis. Additionally, PD is not suitable for patients with burns within the abdominal area. For these reasons, most patients with unstable hemodynamic conditions receive CRRT. In burn patients with acute renal failure the dialytic treatment with continuous renal replacement therapies permitted us to achieve a survival and dialytic adequacy; however, mortality rate is high and related to septic shock and MODS. Despite the wide variation of the analysed burn populations and definitions of AKI, this review clearly showed that AKI remains prevalent and is associated with increased mortality in patients with severe burn injury. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 46-50

  11. Mechanisms of motor vehicle crashes related to burns--an analysis of the German In depth Accident Study (GIDAS) database.

    Science.gov (United States)

    Brand, S; Otte, D; Stübig, T; Petri, M; Ettinger, M; Mueller, C W; Krettek, C; Haasper, C; Probst, C

    2013-12-01

    Patients of motor vehicle crashes (MVCs) suffering burns are challenging for the rescue team and the admitting hospital. These patients often face worse outcomes than crash patients with trauma only. Our analysis of the German In-depth Accident Study (GIDAS) database researches the detailed crash mechanisms to identify potential prevention measures. We analyzed the 2011 GIDAS database comprising 14,072 MVC patients and compared individuals with (Burns) and without (NoBurns) burns. Only complete data sets were included. Patients with burns obviously resulting of air bag deployment only were not included in the Burns group. Data acquisition by an on call team of medical and technical researchers starts at the crash scene immediately after the crash and comprises technical data as well as medical information until discharge from the hospital. Statistical analysis was done by Mann-Whitney-U-test. Level of significance was p burns (0.7%; group "Burns"). Demographic data and injury severity showed no statistical significant difference between the two groups of Burns and NoBurns. Injury severity was measured using the Injury Severity Score (ISS). Direct frontal impact (Burns: 48.5% vs. NoBurns: 33%; p Burns: 33.5 ± 21.4 vs. NoBurns: 25.2 ± 15.9; p Burns: 12.5% vs. NoBurns: 2.1%; p burns. This may serve automobile construction companies to improve the burn safety to prevent flames spreading from the motor compartment to the passenger compartment. Communities may impose speed limits in local crash hot spots. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  12. 烧伤外科切痂植皮疗法新复苏方案在儿童严重烧伤治疗中的应用%Application of New Resuscitation Scheme of the Escharectomy and Skin Grafting Therapy in the Treatment of Pediatric Severe Burns

    Institute of Scientific and Technical Information of China (English)

    张宏; 林国安

    2015-01-01

    目的:探讨烧伤外科切痂植皮疗法新复苏方案在儿童严重烧伤治疗中的临床效果。方法采用新复苏方案对39例严重烧伤儿童进行液体复苏,并对比分析其与中国烧伤儿童复苏公式的复苏效果。结果本组患儿中除1例死于多器官功能衰竭外,其余38例均平稳度过休克期,其平均补液量为1953 mL,治愈率为97.44%。结论基于控制每小时补液量进行复苏的烧伤外科切痂植皮疗法新复苏方案,能够有效避免补液过程中水负荷对机体内环境和渗透压造成的不利影响,对提高复苏质量和复苏成功率具有重要意义。%Objective Investigate the clinical effects of new resuscitation scheme of the escharectomy and skin grafting therapy on children with severe burns. Methods The new resuscitation scheme was used in treatment of 39 chil⁃dren with severe burns for fluid resuscitation, compared with China pediatric burn resuscitation formula in efficacy. Results Except one patient died from multiple organ failure, the other 38 went through the shock period smoothly, the average vol⁃ume of fluid resuscitation was 1,953 ml, the cure rate was 97. 44%. Conclusion The new resuscitation scheme of the es⁃charectomy and skin grafting therapy which resuscitates based on the control of hourly volume of fluid load can avoid effec⁃tively the adverse effects caused by water load on the osmotic pressure and the body's internal environment, being of great significance to improve the resuscitation quality and the success rate of resuscitation.

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

    Science.gov (United States)

    2015-10-01

    seven joints of interest with a predilection to develop burn scar contracture. Specific Aim 2: To statistically associate the severity of burn scar...measurements in a burn population across  six (6) joints of interest in  eleven  (11) single directions. • Specific Aim 2: To compare the average reduction in...the six (6) joints of interest in  eleven  (11) single directions. •Specific Aim 3: To examine the association between the reduction in the joint range

  14. [Epidemiology of burns in France].

    Science.gov (United States)

    Latarjet, Jacques; Ravat, François

    2012-01-01

    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.

  15. Genital burns and vaginal delivery.

    Science.gov (United States)

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

    1995-07-01

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

  16. [Tactics of treatment for extended burns of various affection depth].

    Science.gov (United States)

    Kovalenko, O M

    2012-02-01

    Investigation was based on analysis of the treatment results of 75 children, suffering extended superficial and deep skin burns squared 15-30% of body surface. There was proved, that sequence of excision of superficial and deep necrotic scab influences the burn disease course. There was elaborated algorithm of sequence of the operative treatment stages in patients, suffering extended superficial skin burns, coexisting with deep burns, the superficial necrotic scab definitely, was excised after trauma and a deep one--in the second stage. The superficial and deep necrotic scab excision before 7-9th day after trauma have promoted significant reduction of the intoxication syndrome severity, the middle molecular mass peptides, indices of peroxidal oxidization of lipids, oxidizing modification of proteins, clinical signs of SIRS, rate of septic complications in 1.75 times, the stationary treatment time of severely ill patients by (7.2 +/- 1.5) days.

  17. Ice & Fire: the Burning Question

    DEFF Research Database (Denmark)

    van Gelderen, Laurens; Jomaas, Grunde

    2017-01-01

    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...

  18. Marginally Stable Nuclear Burning

    Science.gov (United States)

    Strohmayer, Tod E.; Altamirano, D.

    2012-01-01

    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.

  19. Exercise following burn injury.

    Science.gov (United States)

    de Lateur, Barbara J; Shore, Wendy S

    2011-05-01

    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.

  20. Proposing "the burns suite" as a novel simulation tool for advancing the delivery of burns education.

    Science.gov (United States)

    Sadideen, Hazim; Wilson, David; Moiemen, Naiem; Kneebone, Roger

    2014-01-01

    Educational theory highlights the importance of contextualized simulation for effective learning. We explored this concept in a burns scenario in a novel, low-cost, high-fidelity, portable, immersive simulation environment (referred to as distributed simulation). This contextualized simulation/distributed simulation combination was named "The Burns Suite" (TBS). A pediatric burn resuscitation scenario was selected after high trainee demand. It was designed on Advanced Trauma and Life Support and Emergency Management of Severe Burns principles and refined using expert opinion through cognitive task analysis. TBS contained "realism" props, briefed nurses, and a simulated patient. Novices and experts were recruited. Five-point Likert-type questionnaires were developed for face and content validity. Cronbach's α was calculated for scale reliability. Semistructured interviews captured responses for qualitative thematic analysis allowing for data triangulation. Twelve participants completed TBS scenario. Mean face and content validity ratings were high (4.6 and 4.5, respectively; range, 4-5). The internal consistency of questions was high. Qualitative data analysis revealed that participants felt 1) the experience was "real" and they were "able to behave as if in a real resuscitation environment," and 2) TBS "addressed what Advanced Trauma and Life Support and Emergency Management of Severe Burns didn't" (including the efficacy of incorporating nontechnical skills). TBS provides a novel, effective simulation tool to significantly advance the delivery of burns education. Recreating clinical challenge is crucial to optimize simulation training. This low-cost approach also has major implications for surgical education, particularly during increasing financial austerity. Alternative scenarios and/or procedures can be recreated within TBS, providing a diverse educational immersive simulation experience.

  1. [Heat stroke and burns resulting from use of sauna

    DEFF Research Database (Denmark)

    Runitz, K.; Jensen, T.H.

    2009-01-01

    We describe a case of severe heat stroke resulting from exposure to extreme heat in a sauna for an unknown period of time. The patient sustained 20% 2nd degree burns. On arrival at the emergency department, the patient's temperature was 40.5 degrees C. At the critical care unit, the patient...... developed severe multi-organ failure and critical polyneuropathy. Severe heat stroke is a rare diagnosis in Denmark. The treatment is symptomatic and the prognosis is grave, especially in combination with severe burns Udgivelsesdato: 2009/1/26...

  2. Oral Rehydration Therapy in Burn Patients

    Science.gov (United States)

    2014-04-24

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

  3. How to manage burns in primary care.

    OpenAIRE

    Waitzman, A. A.; Neligan, P C

    1993-01-01

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

  4. [Clinical and immunological criteria of burn sepsis].

    Science.gov (United States)

    Shlyk, I V; Pivovarova, L P; Krylov, K M; Filippova, O V; Il'ina, V A; Krylov, P K

    2005-01-01

    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.

  5. [Investigation and analysis of the self-esteem level and social adaptation ability of hospitalized burn patients].

    Science.gov (United States)

    He, Mei; Feng, Zheng-zhi; Zhang, Da-jun; Yang, Zong-cheng

    2006-08-01

    To investigate the self-esteem level and social adaptation ability of hospitalized burn patients in our burn ward. One hundred and twenty hospitalized burn patients in our burn ward were enrolled in the study and evaluated according to their sex, severity of burn injury and education level. Their self-esteem level and social adaptation ability were scored with the Felling of Inadequacy Scale and Abbreviated Burn Specific Health Scale. The general score of self-esteem of the patients with mild burns( 183+/-23) was obviously lower than that with moderate and severe burns (167+/-21 and 154 +/-24) , ( P burn patients was different in different sex and education level. Among the self-esteem scores, male burn patients presented evidently higher scores of self evaluation, social ability, appearance, as well as the general score than those in the female ( P patients with mild burns than that in patients with moderate and severe burns ( P patients than those in female patients, but the former were weaker than the latter in regard to the body function. The psychological function, social relationship and general condition of the patients with lower education were better than those with higher education ( P burn patients during different periods.

  6. Checklist and Decision Support in Nutritional Care for Burned Patients

    Science.gov (United States)

    2014-10-01

    attenuates the hypermetabolic state , improves wound healing, decreases catabolism, and increases the chance of survival. 7,8,25,26 Since nutrition plays...severely injured patient. Contemporary Surgery. 1978;13:15-20. 2. Lee JO, Herndon DN. Modulation of the post-burn hypermetabolic state . Nestle Nutrition ...in Nutritional Care for Burned Patients PRINCIPAL INVESTIGATOR: Steven E. Wolf, MD CONTRACTING ORGANIZATION: REPORT DATE

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

    Science.gov (United States)

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

    2001-01-01

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

  8. High-tension Electrical Burns: Report of Two Cases

    OpenAIRE

    Abbas, A.D.; Dabkana, T.M.; Tahir, C.; Naaya, H.U.

    2009-01-01

    High-tension electrical burns are a rare but devastating form of injury. The objective of this case report is to bring to the fore the severity of this rare form of injury and highlight the benefits of active surgical management of such a condition. We report the cases of two patients who were managed for high-tension electrical burns and highlight the main features of their presentation and management. Both patients needed urgent resuscitation and subsequent multiple amputations and disartic...

  9. Curcumin: a novel therapeutic for burn pain and wound healing

    Science.gov (United States)

    2013-08-01

    for controlling pain and wound healing. Several reports clearly demonstrate that cur- cumin can directly act on nociceptive neurons and inhibit...bioavailability 5. Curcumin delivery vehicles 6. Conclusion 7. Expert opinion Review Curcumin: a novel therapeutic for burn pain and wound healing Bopaiah...Surgical Research, Battlefield Pain Management Research Task Area, Fort Sam Houston, TX, USA Introduction: Managing burn injury-associated pain and wounds

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

    Science.gov (United States)

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

    1990-01-01

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

  11. White phosphorus burns and arsenic inhalation: a toxic combination.

    Science.gov (United States)

    Berndtson, Allison E; Fagin, Alice; Sen, Soman; Greenhalgh, David G; Palmieri, Tina L

    2014-01-01

    White phosphorus is a common industrial and military compound, which can cause severe thermal and chemical burns beyond what would be predicted from body surface area alone. The authors present a rare case of a 45-year-old male patient who suffered white phosphorus burns combined with arsenic inhalation because of an industrial accident. The presented case is used to review the history and the toxicities of these chemicals as well as current methods of treatment. A literature review was performed to summarize the current knowledge of white phosphorus burns, as well as arsenic poisoning, and no similar case reports of the two combined were found. The patient ultimately recovered and was discharged, though with significant chronic complications. This case highlights the risk of burns and inhalation injury present in industrial manufacturing jobs, as well as the potential severity of these conditions. The systemic effects of chemicals absorbed across burned skin and via inhalation were the main contributors to our patient's severe illness, and required more intensive treatment than the burns themselves. Arsenic toxicity is rare and could easily have been missed without the appropriate patient history.

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

    Directory of Open Access Journals (Sweden)

    Iyamu Christopher E

    2007-10-01

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

  13. Human herpes viruses in burn patients: A systematic review.

    Science.gov (United States)

    Wurzer, Paul; Guillory, Ashley; Parvizi, Daryousch; Clayton, Robert P; Branski, Ludwik K; Kamolz, Lars-P; Finnerty, Celeste C; Herndon, David N; Lee, Jong O

    2017-02-01

    The contribution of human herpes viruses, including herpes simplex virus (HSV), cytomegalovirus (CMV), and varicella zoster virus (VZV) to morbidity and mortality after burns remains controversial. This systematic review was undertaken to assess evidence of herpes virus-related morbidity and mortality in burns. PubMed, Ovid, and Web of Science were searched to identify studies of HSV, CMV, or VZV infections in burn patients. Exclusion criteria included: A level of evidence (LoE) of IV or V; nonhuman in vivo studies; and non-English articles. There was no limitation by publication date. Fifty articles were subjected to full-text analysis. Of these, 18 had LoE between I-III and were included in the final review (2 LoE I, 16 LoE II-III). Eight had a prospective study design, 9 had a retrospective study design, and 1 included both. No direct evidence linked CMV and HSV infection with increased morbidity and mortality in burns. Following burn, CMV reactivation was more common than a primary CMV infection. Active HSV infection impaired wound healing but was not directly correlated to mortality. Infections with VZV are rare after burns but when they occur, VZV infections were associated with severe complications including mortality. The therapeutic effect of antiviral agents administered after burns warrants investigation via prospective randomized controlled trials. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  14. Time from accident to admission to a burn intensive care unit: how long does it actually take? A 25-year retrospective data analysis from a german burn center.

    Science.gov (United States)

    Schiefer, J L; Alischahi, A; Perbix, W; Grigutsch, D; Graeff, I; Zinser, M; Demir, E; Fuchs, P C; Schulz, A

    2016-03-31

    Severe burn injuries often require specialized treatment at a burn center. It is known that prompt admission to an intensive care unit is essential for achieving good outcome. Nevertheless, very little is known about the duration of time before a patient is admitted to a specialized center after a burn injury in Germany, and whether the situation has improved over time. We retrospectively analyzed time from burn injury to admission to the burn intensive care unit in the Cologne-Merheim Medical Center - one of Germany's specialized burn centers - over the last 25 years. Moreover, we analyzed the data based on differences according to time of injury and day of the week, as well as severity of the burn injury. There was no weekend effect with regard to transfer time; instead transfer time was particularly short on a Monday or on Sundays. Furthermore, patients with severe burn injuries of 40-89% total body surface area (TBSA) showed the least differences in transfer time. Interestingly, the youngest and the oldest patients arrived at the burn intensive care unit (BICU) the fastest. This study should help elucidate published knowledge regarding transfer time from the scene of the accident to admission to a BICU in Germany.

  15. Analysis of pediatric burns in Nagasaki University from 1983 to 2002.

    Science.gov (United States)

    Akita, Sadanori; Nakagawa, Hiroshi; Tanaka, Katsumi; Hirano, Akiyoshi

    2005-12-01

    Pediatric burns are frequently observed: twenty-year burn analysis was performed in a single department, and 354 cases, aged 0-6 years old. The major cause of pediatric burns was scalding (68%) and hot water comprised over half of the scald burns. At 1 year old and younger, the total burn surface area (TBSA) was significantly smaller than from 1 to 6 years old (4.8+/-9.56 versus 10.5+/-18.86%, respectively, pburns was significantly greater than contact burns (8.9+/-15.76 versus 0.9+/-2.0%, respectively, ppatients (18%) and 126 patients were hospitalized (34%). Compared to the first decade of analysis, the second decade had fewer patients (222 versus 142 cases) and lower severity (7.4+/-14.6% versus 6.6+/-13.26%, TBSA). Pediatric burns in younger children should be studied closely as to their causes and with further follow-up.

  16. BURN INJURY: GENERAL CONCEPTS AND INVESTIGATION BASED ON ANTEMORTEM AND POSTMORTEM OF CLINICAL INJURY

    Directory of Open Access Journals (Sweden)

    Yulia Ratna Sintia Dewi

    2013-03-01

    Full Text Available Burn injury is a condition which catastrophic consequences can affect the suffererphysically, socially, as well as financially. Medicolegal aspect of a burn requiresphysicians to be able to examine burn injuries on both the living and the dead.Burn injury is defined as tissue damage due to contact with dry heat (fire, humidheat (vapor or hot liquid, chemicals (corrosive agents, electrical devices (lamp orelectrical current, friction, as well as electromagnetic energy. Burn can beclassified according to its breadth and degree. Death by burn injuries can beclassified into 2 categories which are slow death and the fast one. The differencebetween antemortem and postmortem burn injury is that antemortem injury willshow several intravital signs in the bullae and vesicles while postmortem injurywill have none.Three main points exist in identifying antemortem and postmortemburn injuries, namely redness lines, vesication, and reparative processes.

  17. Epidemiology and treatment of paediatric burns in a large children’s hospital in Morocco: Analysis of 394 cases

    Directory of Open Access Journals (Sweden)

    H. Droussi

    2013-09-01

    Discussion: This large case series highlights the current epidemiology, management and outcome of paediatric burn victims in Morocco. Current burn management in low resources settings can be challenging and several additional measures should be taken to reduce morbidity among paediatric burn victims.

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

    Science.gov (United States)

    ... 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 ...

  19. Nutritional management of the burn patient

    African Journals Online (AJOL)

    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.

  20. Fires and Burns Involving Home Medical Oxygen

    Science.gov (United States)

    ... nfpa.org 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 ...

  1. Wanted: Clean Coal Burning Technology

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Ashley N. Guillory

    2016-01-01

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

  3. The year in burns 2013.

    Science.gov (United States)

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

    2014-12-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Hongjun Zhai

    2014-07-01

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

  5. Instant hot noodles: do they need to burn?

    Science.gov (United States)

    Wu, C; Tan, A L; Maze, D A E; Holland, A J A

    2013-03-01

    Scalds and contact burns in children may occur as the result of spillage of hot food and drinks, including instant hot noodles. This study sought to determine the frequency of noodle burns in children and investigate the thermal properties of instant hot noodles. Data on instant hot noodle burns in children were retrieved from the New South Wales Severe Burn Injury Database between 2005 and 2010. Five widely available brands of instant hot noodles, including three cup and two packet varieties, were prepared following the manufacturer's instructions. For each preparation the initial temperature after cooking was recorded, together with the time to cool to 50°C. 291 children sustained instant hot noodle burns over the 6 year study period, representing 5.4% of all children referred to our burns unit. Over a third received inadequate first aid. Cup noodles cooked with boiling water reached the highest temperature of over 80°C and took the longest time to cool to 50°C: on average 52.3 min. Cup noodles in smaller, narrower containers achieved higher post-cooking temperatures compared to noodles in wider, bowel shaped containers. Packet noodles cooked in a Microwave oven attained lower peak temperatures and shorter cooling times compared to cup noodles. Although relatively uncommon in children, instant hot noodle burns often received inadequate first aid. When cooked according to manufacturer's instructions, noodles generally exceeded temperatures sufficient to cause a burn. Consumers and parents need to be aware of the risks of burn when preparing these foods. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

    Yang, Zong-cheng

    2007-10-01

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

  7. Seasonal characteristics of biomass burning contribution to Beijing aerosol

    Institute of Scientific and Technical Information of China (English)

    ZHENG; Xiaoyan; LIU; Xiande; ZHAO; Fenghua; DUAN; Fengkui

    2005-01-01

    110 atmospheric aerosol samples collected from November 1997 to October 1998 at two monitoring sites (Ming Tomb and Temple Heaven) in Beijing were analyzed for the concentration of organic carbon (OC) and water-soluble potassium (K+). Four biomass burning episodes, namely spring farming, summer harvesting, autumn harvesting and leaf falling were identified using the tracer of K+. Biomass burning contribution to the urban aerosol OC concentration in Beijing was estimated by regression analysis of OC and K+ concentration data. The slopes of regression analysis are similar at the two monitoring sites, presenting regional characteristics. Severe air pollution event occurred during autumn harvesting period in 1998 with substantial secondary OC formed, in which biomass burning was one of the major emission sources. Biomass burning is a prominent source of aerosol OC in Beijing and is featured by its seasonality and periodicity. It may contribute as much as 30 to 60 percent of the total OC in typical cases.

  8. Acute concentrated phenol dermal burns: Complications and management

    Directory of Open Access Journals (Sweden)

    Tapan Jayantilal Parikh

    2015-01-01

    Full Text Available Phenol burns can result in multiple organ failure. This is a case report of acute severe phenol dermal burn after accidental splash of 94% phenol on 35-year-old patient′s body who was brought to hospital after 90 min of exposure. Decontamination was done with high-density water and glycerol. Early complications in form of metabolic acidosis and acute renal failure required hemodialysis. Extensive protein denaturation was managed with IV albumin and high protein diet. Patient also developed pleural effusion and acute respiratory distress syndrome, but these were successfully managed by intercostal drain tube insertion and noninvasive ventilation. The patient survived after multiple organ failures and widespread burns despite the fact that it has been observed that outcome of phenol burns with >60 2 inches of skin affected or two or more organs failure involving renal system is nearly fatal.

  9. Ghrelin improves burn-induced delayed gastrointestinal transit in rats.

    Science.gov (United States)

    Sallam, H S; Oliveira, H M; Gan, H T; Herndon, D N; Chen, J D Z

    2007-01-01

    Delayed gastrointestinal transit is common in patients with severe burn. Ghrelin is a potent prokinetic peptide. We aimed at testing the effect of ghrelin on burn-induced delayed gastrointestinal transit in rats. Gastric emptying (GE), intestinal transit (IT), and colonic transit (CT) studies were performed in male Sprague-Dawley rats. Rats were randomized into two main groups as follows: sham injury and ghrelin-treated burn injury with doses of 0, 2, 5, and 10 nmol/rat ip 6 h after burn. Sham/burn injury was induced under anesthesia. Rats received a phenol red meal 20 min following ghrelin injection. Based on the most effective ghrelin dose, 1 mg/kg sc atropine was given 30 min before the ghrelin in one group of rats for each study. The rats in each group were killed 30-90 min later; their stomachs, intestines, and colons were harvested immediately, and the amount of phenol red recovered was measured. Percentage of gastric emptying (GE%) and geometric center for IT and CT were calculated. We found 1) severe cutaneous burn injury significantly delayed GE, IT, and CT compared with sham injury (P CT; 3) the most effective dose of ghrelin was 2 nmol/rat; and 4) atropine blocked the prokinetic effects of ghrelin on GE% and IT. In conclusion, ghrelin normalizes burn-induced delayed GE and IT but has no effect on CT in rats. The prokinetic effects of ghrelin are exerted via the cholinergic pathway. Ghrelin may have a therapeutic potential for burn patients with delayed upper gastrointestinal transit.

  10. Mapping burned areas using dense time-series of Landsat data

    Science.gov (United States)

    Hawbaker, Todd J.; Vanderhoof, Melanie; Beal, Yen-Ju G.; Takacs, Joshua; Schmidt, Gail L.; Falgout, Jeff T.; Williams, Brad; Brunner, Nicole M.; Caldwell, Megan K.; Picotte, Joshua J.; Howard, Stephen M.; Stitt, Susan; Dwyer, John L.

    2017-01-01

    Complete and accurate burned area data are needed to document patterns of fires, to quantify relationships between the patterns and drivers of fire occurrence, and to assess the impacts of fires on human and natural systems. Unfortunately, in many areas existing fire occurrence datasets are known to be incomplete. Consequently, the need to systematically collect burned area information has been recognized by the United Nations Framework Convention on Climate Change and the Intergovernmental Panel on Climate Change, which have both called for the production of essential climate variables (ECVs), including information about burned area. In this paper, we present an algorithm that identifies burned areas in dense time-series of Landsat data to produce the Landsat Burned Area Essential Climate Variable (BAECV) products. The algorithm uses gradient boosted regression models to generate burn probability surfaces using band values and spectral indices from individual Landsat scenes, lagged reference conditions, and change metrics between the scene and reference predictors. Burn classifications are generated from the burn probability surfaces using pixel-level thresholding in combination with a region growing process. The algorithm can be applied anywhere Landsat and training data are available. For this study, BAECV products were generated for the conterminous United States from 1984 through 2015. These products consist of pixel-level burn probabilities for each Landsat scene, in addition to, annual composites including: the maximum burn probability and a burn classification. We compared the BAECV burn classification products to the existing Global Fire Emissions Database (GFED; 1997–2015) and Monitoring Trends in Burn Severity (MTBS; 1984–2013) data. We found that the BAECV products mapped 36% more burned area than the GFED and 116% more burned area than MTBS. Differences between the BAECV products and the GFED were especially high in the West and East where the

  11. Functional Outcomes Following Burn Injury.

    Science.gov (United States)

    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.

  12. Topical agents in burn care

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    Momčilović Dragan

    2002-01-01

    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.

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

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Jamila Chahed

    2014-01-01

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

  15. Forward-looking infrared imaging predicts ultimate burn depth in a porcine vertical injury progression model.

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    Miccio, Joseph; Parikh, Shruti; Marinaro, Xavier; Prasad, Atulya; McClain, Steven; Singer, Adam J; Clark, Richard A F

    2016-03-01

    relevant criterion standard, temperature minima at 2 days after burn was found to be the most sensitive and specific test. FLIR imaging is a fast and simple tool that has been shown to predict burn wound outcome in a porcine vertical injury progression model. Data showed that more severe burn wounds get cooler between 1 and 2 days after burn. We found four analytic methods of FLIR images that were predictive of burn progression at 1 and 2 days after burn; however, temperature minima 2 days after burn appeared to be the best predictive test for injury progression to a full-thickness burn. Although these results must be validated in clinical studies, FLIR imaging has the potential to aid clinicians in assessing burn severity and thereby assisting in burn woun