scholarly journals Factors associated with mortality, amputation, pneumonia, and skin graft loss among electrical burn patients admitted in a Philippine tertiary hospital burn center from 2013 to 2019

Burns Open ◽  
2021 ◽  
Vol 5 (4) ◽  
pp. 46-51
Author(s):  
Mar Aristeo G. Poncio ◽  
Jose Joven V. Cruz
Keyword(s):  
Skin Graft ◽  
Graft Loss ◽  
Tertiary Hospital ◽  
Burn Patients ◽  
Factors Associated ◽  
Burn Center

662 Single Surgeon Experience Using a Polyactide-based Copolymer Dressing to Over and Secure Split Thickness Skin Grafts in Burn Patients.

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S186-S187
Author(s):  
Eduardo Navarro ◽  
Tera Thigpin ◽  
Joshua S Carson
Keyword(s):  
Skin Graft ◽  
Outer Layer ◽  
Healing Process ◽  
Graft Loss ◽  
Total Body Surface Area ◽  
Surgeon Experience ◽  
Pain Outcomes ◽  
Total Body ◽  
Operative Notes

Abstract Introduction In both partial thickness burns and skin graft donor sites, coverage with Polylactide-based copolymer dressing (PLBC dressing) has been shown to result in expedited healing and improved pain outcomes when compared to more traditional techniques. These advantages are generally attributed to the way in which PLBC remains as an intact coating over the wound bed throughout the healing process, protecting wounds from the contamination and microtraumas associated with changes more conventional dressings. At our institution, we began selectively utilizing PLBC as a means of securing and protecting fresh skin graft, in hopes that we would find similar benefits in this application. Methods Clinical Protocol-- The PLBC dressing was used at the attending surgeon’s discretion. In these cases, meshed STSG was placed over prepared wound beds. Staples were not utilized. PLBC dressing was then placed over the entirety of the graft surface, securing graft in place by adhering to wound bed through intercises. (Staples were not used.) The graft and PLBC complex was further dressed with a layer of non-adherent cellulose based liner with petroleum based lubricant, and an outer layer of cotton gauze placed as a wrap or bolster. Post operatively, the outer layer (“wrap”) of gauze was replaced as needed for saturation. The PLBC and adherent “inner” liner were left in place until falling off naturally over the course of outpatient follow-up. Retrospective Review-- With IRB approval, patients treated PLBC over STSG between April 2018 to March 2019 were identified via surgeon’s log and pulled for review. Documentation gathered from operative notes, progress notes (inpatient and outpatient) and clinical photography was used to identify demographics, mechanism of injury, depth, total body surface area percentage (TBSA%), size of area treated with PLBC dressing, graft loss, need for re-grafting, signs of wound infection, antibiotic treatment, and length of stay. Results Twenty-two patients had STSG secured and dressed with PLBC. Median patient age was 36.5 years. Median TBSA was 5.1%, and median treated area 375 cm2. Follow up ranged from 21 to 232 days post-operatively, with two patients lost to follow up. All patients seen in outpatient follow up were noted to have “complete graft take” or “minimal” graft. None of the areas treated with PLBC dressing required re-grafting. There were no unplanned readmissions, and no wound infections were diagnosed or treated. Practitioners in in-patient setting and in follow up clinic reported satisfaction with the PLBC dressing. Conclusions The PLBC dressing was a feasible solution for securing and dressings STSGs. Future work is needed to determine whether its use is associated with an improvement in patient outcomes.

scholarly journals Management of peno-scrotal wound defects in a tertiary hospital in North-Western Nigeria: a 20-year retrospective review

2021 ◽  
Vol 27 (1) ◽  
Author(s):  
Abubakar Sadiq Muhammad ◽  
Ngwobia Peter Agwu ◽  
Abdullahi Abduwahab-Ahmed ◽  
Ahmed Mohammed Umar ◽  
Muhammad Ujudud Musa ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Graft Loss ◽  
External Genitalia ◽  
Tertiary Hospital ◽  
Advancement Flap ◽  
Fournier’S Gangrene ◽  
Fournier's Gangrene ◽  
Direct Closure ◽  
Secondary Intention ◽  
North Western

Abstract Background Fournier’s gangrene and trauma to the external genitalia are the commonest causes of peno-scrotal wound defects in our environment. The management of these patients includes initial resuscitation and subsequent wound care with or without wound cover. The aim of this study is to document our experience in the management of peno-scrotal defects in a tertiary hospital of North-Western Nigeria. Methods This is a 20-year retrospective study of patients managed for peno-scrotal wound defects by the Urology Unit in the Department of Surgery of our hospital from January 2001 to December 2019. Data were collected from the patients’ case notes and entered into a proforma. Data were analysed using SPSS version 25.0. Results A total number of 54 patients with peno-scrotal wound defects were managed within the study period with the mean age of 46.27 ± 22.09 years and a range of six weeks to 107 years. The wound defects were sequelae of Fournier’s gangrene in 42 patients (77.8%) and traumatic in 12 patients (22.2%). Healing by secondary intention was achieved in 20 patients (37.0%). Direct closure was done in 17 patients (31.5%), skin graft in nine patients (16.7%), and advancement flap in eight patients (14.8%) depending on the location and size of the defects. Fourteen patients (26.0%) developed surgical site infection ± wound dehiscence and partial graft loss. The complication rate was higher in post-Fournier’s gangrene wound defects, but without statistical significance (p = 0.018). Conclusion Fournier’s gangrene and trauma to the external genitalia are the commonest causes of peno-scrotal wound defects in our environment. Smaller wound defects were healed by secondary intention, while larger defects required either direct closure or the use of advancement flap or skin grafting depending on the location and size of the wound. The study reported a higher post-repair complication in patients that had Fournier’s gangrene.

Follow up after burn injury is disturbingly low and linked with social factors

2021 ◽  
Author(s):  
Irina P Karashchuk ◽  
Eve A Solomon ◽  
David G Greenhalgh ◽  
Soman Sen ◽  
Tina L Palmieri ◽  
...  
Keyword(s):  
Social History ◽  
Drug Dependence ◽  
Burn Injury ◽  
Retrospective Chart Review ◽  
Burn Patients ◽  
Chi Square ◽  
Factors Associated ◽  
Ed Visits ◽  
Zip Code

Abstract For medical and social reasons, it is important that burn patients attend follow up appointments (FUAs). Our goal was to examine the factors leading to missed FUAs in burn patients. A retrospective chart review was conducted of adult patients admitted to the burn center from 2016-2018. Data collected included burn characteristics, social history, and zip code. Data analysis was conducted using chi-square, Wilcox Rank Sum tests, and multivariate regression models. A total of 878 patients were analyzed, with 224 (25.5%) failing to attend any FUAs and 492 (56.0%) missing at least one appointment (MA). Patients who did not attend any FUAs had smaller burns (4.5 (8)% vs. 6.5 (11)% median (inter quartile range)), traveled farther (70.2 (111.8) vs. 52.5 (76.7) miles), and were more likely to be homeless (22.8% vs. 6.9%) and have drug dependence (47.3% vs. 27.2%). Patients who had at least one MA were younger (42 (26) vs. 46 (28) years) and more likely to be homeless (17.5% vs. 2.6%) and have drug dependence (42.5% vs. 19.4%). On multivariate analysis, factors associated with never attending a FUA were: distance from hospital (odds ratio (OR) 1.004), burn size (OR 0.96), and homelessness (OR 0.33). Factors associated with missing at least one FUA : age (OR 0.99), drug dependence (OR 0.46), homelessness (OR 0.22), and ED visits (OR 0.56). A high percentage of patients fail to make any appointment following their injury and/or have at least one MA. Both FUAs and MAs are influenced by social determinants of health.

scholarly journals Key donor factors associated with graft loss among liver transplant recipients with human immunodeficiency virus

2016 ◽  
Vol 30 (9) ◽  
pp. 1140-1145 ◽  
Author(s):  
Isabel Campos-Varela ◽  
Jennifer L. Dodge ◽  
Peter G. Stock ◽  
Norah A. Terrault
Keyword(s):  
Human Immunodeficiency Virus ◽  
Liver Transplant ◽  
Graft Loss ◽  
Transplant Recipients ◽  
Factors Associated ◽  
Immunodeficiency Virus ◽  
Donor Factors ◽  
Liver Transplant Recipients

Association of Ventilator Type with Hospital Mortality in Critically Ill Patients with SARS-CoV2 Infection: A Retrospective Study.

2021 ◽  
Author(s):  
Alexis FERRE ◽  
Fabien Marquion ◽  
Marc Delord ◽  
Jean-Pierre Bédos ◽  
Hugo Bellut ◽  
...  
Keyword(s):  
Hospital Mortality ◽  
Multivariate Regression ◽  
Distress Syndrome ◽  
Invasive Mechanical Ventilation ◽  
Patient Characteristics ◽  
Tertiary Hospital ◽  
Prospective Data ◽  
Factors Associated ◽  
Kaplan Meier ◽  
Patient Groups

Abstract Background: To evaluate the association between ventilator type and hospital mortality in patients with acute respiratory distress syndrome (ARDS) related to COVID-19 (SARS-CoV2 infection) during the first wave of the disease in France.Methods: We retrospectively included consecutive adults admitted to the intensive care unit (ICU) of a university-affiliated tertiary hospital for ARDS related to proven COVID-19, between March and May 2020. All patients were intubated. We compared two patient groups defined by whether an ICU ventilator or a less sophisticated ventilator such as a transport ventilator was used. Kaplan-Meier survival curves were plotted. Cox multivariate regression was performed to identify associations between patient characteristics and hospital mortality.Results: We included 82 patients (61 [74.4%] men) with a median age of 64 years [55–74], of whom 23 (28.1%) died before hospital discharge. By multivariate analysis, factors associated with in-hospital mortality were older age (HR, 1.06/year; 95%CI, 1.00–1.11; P=0.05) and diabetes mellitus (HR, 3.32; 95%CI, 1.13–9.76; P=0.03) but not ventilator type. Using non-ICU ventilator was associated neither with a longer duration of invasive mechanical ventilation (20 [12-36] vs. 25 [15-31] days; P=0.87) nor with a longer ICU stay (24 [14-40] vs. 27 [15-37] days; P=0.64).Conclusions: In patients with ARDS due to COVID-19, the use of non-ICU ventilators, such as transport ventilators, was not associated with worse outcomes. Although prospective data are needed to confirm our findings, this study suggests that transport ventilators may be valuable during COVID-19 surges that overwhelm ICU resources.

scholarly journals Alcohol use and smoking in burn patients at the Helsinki Burn Center

Burns ◽  
2018 ◽  
Vol 44 (1) ◽  
pp. 158-167 ◽  
Author(s):  
Raimo Palmu ◽  
Timo Partonen ◽  
Kirsi Suominen ◽  
Jyrki Vuola ◽  
Erkki Isometsä
Keyword(s):  
Alcohol Use ◽  
Burn Patients ◽  
Burn Center

Careful attention to graft loss areas can prevent forgotten staples in burn patients

Burns ◽  
2009 ◽  
Vol 35 (8) ◽  
pp. 1188-1189 ◽  
Author(s):  
Ali Akbar Mohammadi ◽  
Hamed Ghoddusi Johari
Keyword(s):  
Graft Loss ◽  
Burn Patients ◽  
Careful Attention

scholarly journals Factors Associated with the Survival Outcome of Hepatocellular Carcinoma Patients on Supportive Care in a Tertiary Hospital in South-West Nigeria

2019 ◽  
Vol 15 (24) ◽  
Author(s):  
Olusegun Adekanle ◽  
Oluwasegun Ijarotimi ◽  
Akinwumu Oluwole Komolafe ◽  
Samuel Anu Olowookere ◽  
Comfort Olusola Famurewa ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Supportive Care ◽  
Tertiary Hospital ◽  
Survival Outcome ◽  
Factors Associated ◽  
South West

scholarly journals Clinical Risk Factors Associated with Mortality Among Burn Patients Admitted to Jinnah Burn and Reconstructive Surgery Center, Lahore

2020 ◽  
Vol 34 (3) ◽  
pp. 46-50
Author(s):  
Fatima Sakhawat
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Reconstructive Surgery ◽  
Low Income ◽  
Burn Injuries ◽  
Clinical Risk Factors ◽  
Burn Patients ◽  
Factors Associated ◽  
Clinical Risk ◽  
Surgery Center

Introduction: Burn injuries being highly devastating in nature, are associated with extensive morbidity and mortality. Although the incidence of burn injuries is less in developed countries but it is increasing in developing and low income countries. Aims & Objectives: The aim of this study was to determine clinical risk factors associated with mortality among burn patients. Place and duration of study: Jinnah Burn and Reconstructive Surgery Center, Lahore from August 2018 till January 2019. Material & Methods: Data was collected by researchers themselves by studying files of patients. Data analysis was done by using SPSS and Pearson Chi Square test was used to determine association of clinical risk factors with mortality among burn patients. Results: Out of 200 patients, 137 were males. The Mortality rate was 12.50 %. Cardiopulmonary arrest was the most common cause of death. Sepsis was the most common complication among burn patients. Higher mortality rates were observed among patients with arterial/venous and urinary catheterization done. Higher survival rates were seen in those patients who were treated with debridement, grafting surgeries, Colistin Use and aided by mechanical ventilation. Conclusion: Aid through mechanical ventilation, grafting surgeries, wound debridement, use of colistin are associated with improved survival outcomes among burn patients. Whereas inhalational injury, arterial/venous catheterization, urinary catheter and sepsis are seen as major predictors of mortality among burn patients

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