scholarly journals Management of facial burns

2020 ◽  
Vol 8 ◽  
Author(s):  
David G Greenhalgh
Keyword(s):  
Skin Grafting ◽  
Healing Time ◽  
The Body ◽  
Full Thickness ◽  
Partial Thickness ◽  
Facial Burns ◽  
The Face ◽  
Partial Thickness Burns

Abstract Burns to the face affect a part of the body that cannot be hidden and thus exposes potentially major changes in appearance to society. Therefore, it is incumbent upon the caregiver to optimize healing and minimize scarring. The goal for partial-thickness burns is to have them heal within 2–3 weeks to minimize healing time. For full-thickness burns there needs to be strategies to optimize the outcomes for skin grafting and minimize scarring. The goal of this review is to discuss the best way to improve the outcomes of these devastating injuries.

scholarly journals The Introduction of a Protocol for the Use of Biobrane for Facial Burns in Children

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
A. D. Rogers ◽  
S. Adams ◽  
H. Rode
Keyword(s):  
Standard Of Care ◽  
Healing Time ◽  
Partial Thickness ◽  
Facial Burns ◽  
Aesthetic Results ◽  
Cadaver Skin ◽  
The Face ◽  
One Year ◽  
Partial Thickness Burns ◽  
Historical Controls

Biobrane has become an indispensible dressing with three established indications in acute burns care at our institution: (1) as the definitive dressing of superficial partial thickness facial burns, (2) after tangential excision of deep burns when autograft or cadaver skin is unavailable, and (3) for graft reduction. This paper details our initial experience of Biobrane for the management of superficial partial thickness facial burns in children and the protocol that was compiled for its optimal use. A retrospective analysis of theatre records, case notes and photographs was performed to evaluate our experience with Biobrane over a one-year period. Endpoints included length of stay, analgesic requirements, time to application of Biobrane, healing times, and aesthetic results. Historical controls were used to compare the results with our previous standard of care. 87 patients with superficial partial thickness burns of the face had Biobrane applied during this period. By adhering to the protocol we were able to demonstrate significant reductions in hospital stay, healing time, analgesic requirements, nursing care, with excellent cosmetic results. The protocol is widely accepted by all involved in the optimal management of these patients, including parents, anaesthetists, and nursing staff.

scholarly journals Evaluation of EpiProtect® microbial cellulose burns dressings in young children

2020 ◽  
Vol 6 ◽  
pp. 205951312094050
Author(s):  
Lindsay A Shanks ◽  
Andrea Cronshaw ◽  
K Skaria Alexander ◽  
Jonathan A Davies ◽  
Ciaran P O’Boyle
Keyword(s):  
Young Children ◽  
Total Body Surface Area ◽  
Case Series ◽  
Skin Grafting ◽  
Healing Time ◽  
Full Thickness ◽  
Burn Wound ◽  
Partial Thickness ◽  
Split Skin Grafting ◽  
Effective Analgesia

Introduction: EpiProtect® is a biosynthetic cellulose dressing indicated for the treatment of superficial burns and the dressing of deep burns. Prior to this study the youngest reported patient treated with EpiProtect® was aged 13 years. Method: Data were collected prospectively for patients aged < 5 years, presenting to the Children’s Burns Unit with ⩾ 2% total body surface area (TBSA) burns sustained by any mechanism. Results: Thirty children were treated (median age = 17 months, age range = 1–61 months). Thirty-six burn depths were documented: superficial partial thickness (SPT) in 53% (n=19); mid-partial thickness (MPT) in 33% (n=12); deep partial thickness (DPT) in 11% (n=4); and full thickness (FT) in 3% (n=1). Median burn size was 4.5% TBSA (range = 2%–12%). EpiProtect® was applied under general anaesthesia in all cases. The median length of stay (LOS) was two days (range = 0–6 days). EpiProtect® was tolerated well and provided effective analgesia for subsequent dressing changes. Median healing time was 13 days (SPT burns), 14 days (MPT) and 24 days (DPT burns). Three patients required split skin grafting. Hypertrophic scarring arose in one patient. Discussion: This case series represents the youngest published patient group to have been treated with EpiProtect®. Authors conclude that EpiProtect® provides a safe, reliable and well-tolerated dressing option for all burn depths in young children. Importantly, EpiProtect® is culturally neutral and may be used in situations which, for cultural reasons, may preclude the use of animal-derived products. Further studies are warranted to evaluate pain scores, burn depth, size and LOS correlation, and comparative analysis between dressing types. Lay Summary Burn injuries in the paediatric population are common and often require multiple dressing changes. Dressing changes can be painful and distressing to both children and their care givers. This article describes the experience of using a synthetically derived burns dressing, called EpiProtect®, in children aged ⩽ 5 years. Thirty patients were recruited with varying depths of scald burns and all underwent application of EpiProtect® dressing. The results suggested that EpiProtect® was a user-friendly dressing that can be used to treat partial-thickness burns and to dress full-thickness (FT) burns. It was well-tolerated and provided effective analgesia at the time of dressing changes. There was no incidence of increased burn wound infection rates and all wounds healed. In addition, as EpiProtect® is a synthetic product, it has the benefit of being culturally neutral, which is advantageous in a culturally diverse population. Further studies are warranted to evaluate the effectiveness of this dressing and to compare it to similar dressings that are available.

Outcomes of the glove-gauze regimen for managing burn injuries of the hand

2020 ◽  
Vol 45 (7) ◽  
pp. 737-741
Author(s):  
Oleksandra Vyrva ◽  
Elliott Smock ◽  
Joel Pessa ◽  
Sunil M. Thirkannad
Keyword(s):  
Physical Therapy ◽  
Range Of Motion ◽  
Full Range ◽  
Effective Means ◽  
Healing Time ◽  
Full Thickness ◽  
Level Of Evidence ◽  
Partial Thickness ◽  
And Function ◽  
Hand Burns

We studied the efficacy of the glove-gauze regimen in treating superficial, partial-thickness and small full-thickness hand burns. Outcome measures included healing time, need for surgical intervention, need for formal physical therapy, restoration of range of motion, return to function and incidence of infection. All patients ( n = 123) successfully completed the regimen with an average healing time of 3.7 weeks. None required surgical debridement and seven (6%) required formal physical therapy. One hundred and eighteen patients (96%) regained full range of motion and 122 (99%) returned to their previous level of work. We believe that the glove-gauze regimen provides a simplified and effective means of managing hand burns. We conclude from our patients that the glove-gauze regimen is an effective treatment that can ensure uneventful healing of superficial, partial-thickness and small full-thickness burns. A majority of our patients healed with full range of motion and function without formal physical therapy. Level of evidence: IV

scholarly journals Hyperpigmentation after surgery for a deep dermal burn of the dorsum of the hand: partial-thickness debridement followed by medium split-thickness skin grafting vs full-thickness debridement followed by thick split-thickness skin grafting

2016 ◽  
Vol 4 ◽  
pp. 1-11 ◽  
Author(s):  
Yoshitaka Kubota ◽  
Nobuyuki Mitsukawa ◽  
Kumiko Chuma ◽  
Shinsuke Akita ◽  
Yoshitaro Sasahara ◽  
...  
Keyword(s):  
Skin Graft ◽  
Skin Grafting ◽  
Japanese Patients ◽  
Interquartile Range ◽  
Split Thickness Skin Graft ◽  
Full Thickness ◽  
Color Spaces ◽  
Partial Thickness ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting

Abstract Background Early excision and skin grafting are commonly used to treat deep dermal burns (DDBs) of the dorsum of the hand. Partial-thickness debridement (PTD) is one of the most commonly used procedures for the excision of burned tissue of the dorsum of the hand. In contrast, full-thickness debridement (FTD) has also been reported. However, it is unclear whether PTD or FTD is better. Methods In this hospital-based retrospective study, we compared the outcomes of PTD followed by a medium split-thickness skin graft (STSG) with FTD followed by a thick STSG to treat a DDB of the dorsum of the hand in Japanese patients. To evaluate postoperative pigmentation of the skin graft, quantitative analyses were performed using the red, green, and blue (RGB) and the hue, saturation, and brightness (HSB) color spaces. We have organized the manuscript in a manner compliant with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. Results Data from 11 patients were analyzed. Six hands (five patients) received grafts in the PTD group and eight hands (six patients) received grafts in the FTD group. Graft take was significantly better in the FTD group (median 98 %, interquartile range 95–99) than in the PTD group (median 90 %, interquartile range 85–90) (P &lt; 0.01). Quantitative skin color analyses in both the RGB and HSB color spaces showed that postoperative grafted skin was significantly darker than the adjacent control area in the PTD group, but not in the FTD group. Conclusions There is a possibility that FTD followed by a thick STSG is an option that can reduce the risk of hyperpigmentation after surgery for DDB of the dorsum of the hand in Japanese patients. Further investigation is needed to clarify whether the FTD or the thick STSG or both are the factor for the control of hyperpigmentation.

scholarly journals Ultrasonographic findings of re-epithelialized skin after partial-thickness burns

2018 ◽  
Vol 6 ◽  
Author(s):  
Jong Dae Kim ◽  
Suk Joon Oh ◽  
Sun Gyu Kim ◽  
Song Vogue Ahn ◽  
Yu Jin Jang ◽  
...  
Keyword(s):  
Medical Records ◽  
Normal Skin ◽  
Healing Time ◽  
Ultrasound Images ◽  
Strongly Correlated ◽  
Varying Thickness ◽  
Partial Thickness ◽  
The Difference ◽  
Partial Thickness Burns ◽  
The Relationship

Abstract Background This study aimed to investigate the difference between ultrasonographic findings of normal skin and those of re-epithelialized skin after partial-thickness burns and to evaluate the relationship between these findings and clinical outcomes. Methods This study retrospectively analysed the ultrasound images of re-epithelialized skin after partial-thickness burns and contralateral normal skin from January 2016 to December 2016. A total of 155 lesions from 148 patients were analysed with ultrasound images, and healing time was documented. The scar status of each lesion was evaluated through medical records and photographs. We analysed the difference in ultrasonographic findings between normal skin and re-epithelialized skin after partial-thickness burns and statistically analysed the relationship between healing time, scar status and ultrasonographic findings. Results The re-epithelialized skin after partial-thickness burns was significantly thicker than the contralateral normal skin, and the echogenicity was significantly lower. The ultrasound images of the re-epithelialized skin after partial-thickness burns showed the characteristic findings of low-echogenic bands (LEB), and the proportion of LEB thickness is strongly correlated with healing time. In the multivariate analysis of scar status, only the proportion of LEB thickness was statistically significant. Conclusion In this study, we found that there were ultrasonographic differences between re-epithelialized skin after partial-thickness burns and normal skin and that an LEB of varying thickness was formed after re-epithelialization. The thickness of the LEB in re-epithelialized skin after partial-thickness burns increased with healing time and was related to scar status.

532 Early Debridement and Cultured Allogenic Keratinocyte Dressing Prevent Hypertrophic Scarring in Infants with Deep Dermal Burns

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S103-S104
Author(s):  
SeungJe Lee
Keyword(s):  
Functional Disability ◽  
Skin Grafting ◽  
Healing Time ◽  
The Body ◽  
Hypertrophic Scarring ◽  
Burn Scar ◽  
The Mean ◽  
Patients Experience ◽  
Early Debridement

Abstract Introduction Deep dermal burns are frequently treated with excision and skin grafting. Otherwise, wound healing may take up to 4 to 6 weeks, with serious scarring. Especially in pediatric patients, post-burn scarring could result in psychologic trauma and functional disability. We aimed to investigate the efficacy of early debridement and dressing using cultured allogenic keratinocytes in infants with deep dermal burns to prevent hypertrophic scarring. Methods From April 2016 to April 2018, 18 infants were treated for deep dermal burns. Except for 5 infants who underwent skin grafting or excision, 13 infants were included in this study. We performed early debridement in these patients using Hydrosurgery device and serial dressings using cultured allogenic keratinocytes. Results The average operative date was 8.3 days after the accident. The mean healing time was 18.3 days after the accident. The patients did not experience any contraction, but 3 patients had hyperpigmentation, 2 patients had mild hypertrophic scarring, and 1 patient had mixed pigmentation (hyperpigmentation and hypopigmentation). Conclusions Our prophylactic scar therapy, using early debridement with VersajetTM and dressings with Kaloderm®, may be beneficial for infants with dermal burns. This method was able to shorten the healing time, resulting in better scar outcomes. Our follow-up findings revealed that the scars had an aesthetically pleasing appearance and patients were able to perform normal activities without restrictions. Applicability of Research to Practice Burn scars are painful regardless of their seriousness. They restrict the function of the body, are aesthetically unappealing, and may feel unpleasant. Patients with a post-burn scar may have aesthetic, functional, and psychological problems. In particular, infant patients experience difficulties due to scarring as they grow up.

Evaluation of tendoAchilles Lesions by (MRI)

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Maha Mohamed Abd Elraouf ◽  
Mennatallah Hatem Shalaby ◽  
Mohamed AbdElaziz Yehia Rabeai
Keyword(s):  
The Body ◽  
Radiology Department ◽  
Full Thickness ◽  
University Hospitals ◽  
Partial Thickness ◽  
Careful Clinical Examination ◽  
Important Diagnostic Tool ◽  
Study Population ◽  
Mri Study

Abstract Background: The AT is the largest tendon in the body; it plays an important role in the biomechanics of the lower extremity; despite its strength, the AT is also vulnerable to injury, due to its limited blood supply from musculotendinousa, also it withstands great forces, especially during sporting exercises and it's located superficially. Aim of the Work: To evaluate the role of (MRI) in the diagnosis of AT disorders. Patients and Methods: Type of Study: retrospective and prospective studies. Study Setting The study was conducted in Radiology Department at Ain Shams University Hospitals. Study Period from march 2018 to march 2020. Study Population This study included 40 patients. The patients were referred from either the orthopedic, rheumatology outpatient clinics of Ain Shams hospitals or private clinics to radiology department in Ain Shams University. Results Full thickness tear (30.0%) and Tendenosis (30.0%) were the most frequently detected pathologies followed by partial thickness tear (27.5%) and bursitis ( 22.5%) with significant more risk in male gender and middle age ( &gt;46 years). More than one pathology were found in the same MRI study and this led to development of degenerative theory, that consider almost ruptured AT develop on top of pathological one. Conclusion MRI is a gold standard and important diagnostic tool in the evaluation of AT lesions especially in chronic and complex cases, and who do not respond to conservative measures and provides precious information for surgical intervention in parallel with careful clinical examination. Full thickness tear and partial thickness tear may develop on top of pathological tendon.

A Case Series of Candle Wax Burns during the Lantern Festival in Hong Kong

2002 ◽  
Vol 9 (4) ◽  
pp. 221-225
Author(s):  
PC Lee ◽  
WM Ching ◽  
CW Kam ◽  
HH Yau
Keyword(s):  
Hong Kong ◽  
Children And Adolescents ◽  
Water Vapour ◽  
Cold Water ◽  
Case Series ◽  
Burn Injuries ◽  
Partial Thickness ◽  
The Face ◽  
Partial Thickness Burns

Every year there was significant number of burn cases during the Lantern (Mid-Autumn) Festival in Hong Kong because children liked to play with fire on that day. They would either burn the lantern or boil the wax from candles in a pot over a fire. When the wax has melted, they poured cold water into it, causing a small explosion with water vapour and wax droplets. Children and adolescents were more common than adults to be burnt by the hot vapour, fire or hot wax. The majority sustained partial thickness burns involving the face. Such burn injuries should be preventable by education and legislation.

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