Application of Critical Care Scores in Severely Burned Patients

2021 ◽  
Author(s):  
Khaled Dastagir ◽  
Nicco Krezdorn ◽  
Alperen Sabri Bingoel ◽  
Tobias R Mett ◽  
Christine Radtke ◽  
...  
Keyword(s):  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Total Body Surface Area ◽  
The Body ◽  
Burn Injuries ◽  
Intensive Care Treatment ◽  
Severe Burn ◽  
S3 Guidelines ◽  
Severe Burn Injuries

Abstract Early detection of sepsis is of crucial importance in patients with severe burn injuries. However, according to the S1-guideline, based on systemic inflammatory response syndrome (SIRS) criteria, the early diagnosis of sepsis in severely burned patients is difficult. The value of the new definition of sepsis based on sequential organ failure assessment (SOFA) according to S3-guidelines for patients with severe burn injuries is not described in detail in the literature. We analyzed retrospectively all data during the period 2014 to 2018 from the electronic patient information system. Using the receiver operating characteristic curve, the area under the curve was calculated for the diagnostic value of procalcitonin, SIRS, and SOFA score according to the burned total body surface area. Six hundred fifty-one patients with burn injuries were admitted to our burn unit, 315 of them had burn injuries affecting more than 10% body surface area with partial- to full-thickness burns (grade 2–4). In this group, 59 patients showed one or more septic events in the course of the intensive care treatment, defined by positive bloodstream infection. Both S1- and S3-guidelines were inappropriate to diagnose sepsis in patients with severe burn injuries. Due to pathophysiological changes of the body function in severely burned patients, which show features of both SIRS and pathological SOFA scores (>2 points) at the outset of burn injury, the diagnosis of sepsis associated with burns is intricate in this patient group. Assessing data for potential hallmarks of sepsis in burn patients we found procalcitonin to show a significant correlation with sepsis.

Management of severe burn injuries with novel treatment techniques including maggot debridement and applications of acellular fish skin grafts and autologous skin cell suspension in a dog

2022 ◽  
pp. 1-8
Author(s):  
Katherine A. Dawson ◽  
Megan A. Mickelson ◽  
April E. Blong ◽  
Rebecca A. L. Walton
Keyword(s):  
Cell Suspension ◽  
Surface Area ◽  
Body Surface ◽  
Total Body Surface Area ◽  
Multimodal Analgesia ◽  
Burn Injuries ◽  
Severe Burn ◽  
Skin Cell ◽  
Severe Burn Injuries ◽  
Total Body

Abstract CASE DESCRIPTION A 3-year-old 27-kg female spayed American Bulldog with severe burn injuries caused by a gasoline can explosion was evaluated. CLINICAL FINDINGS The dog had extensive partial- and full-thickness burns with 50% of total body surface area affected. The burns involved the dorsum extending from the tail to approximately the 10th thoracic vertebra, left pelvic limb (involving 360° burns from the hip region to the tarsus), inguinal area bilaterally, right medial aspect of the thigh, and entire perineal region. Additional burns affected the margins of the pinnae and periocular regions, with severe corneal involvement bilaterally. TREATMENT AND OUTCOME The dog was hospitalized in the hospital’s intensive care unit for 78 days. Case management involved provision of aggressive multimodal analgesia, systemic support, and a combination of novel debridement and reconstructive techniques. Debridement was facilitated by traditional surgical techniques in combination with maggot treatment. Reconstructive surgeries involved 6 staged procedures along with the use of novel treatments including applications of widespread acellular fish (cod) skin graft and autologous skin cell suspension. CLINICAL RELEVANCE The outcome for the dog of the present report highlighted the successful use of maggot treatment and applications of acellular cod skin and autologous skin cell suspension along with aggressive systemic management and long-term multimodal analgesia with debridement and wound reconstruction for management of severe burn injuries encompassing 50% of an animal’s total body surface area.

Prevalence of Psychiatric Disorders in Burn Patients in a Tertiary Care Hospital

2021 ◽  
Vol 15 (11) ◽  
pp. 3389-3391
Author(s):  
Imran Khan ◽  
Taimur Khan ◽  
Shakil Asif ◽  
Syed Azhar Ali Kazmi ◽  
Subhan Ullah ◽  
...  
Keyword(s):  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Total Body Surface Area ◽  
Burn Injuries ◽  
Care Hospital ◽  
Burn Patients ◽  
Total Body

Background and Aim: Burn injuries patients generally suffer from various psychological and mental disorders especially in lower socio-economic groups. It can adversely affect their wellbeing and health. Proper consultation and clinical diagnosis need to be carried out on burns injuries patients from the early critical phase to rehabilitation phase recovery. The current study's aim was to determine the prevalence of psychiatric disorders in burn patients in a tertiary care hospital. Materials and Methods: This cross-sectional study was conducted on 82 attempted burn suicides, adult patients in Khattak Medical Center Peshawar, Khyber Teaching Hospital Peshawar and Divisional Headquarter hospital, Mirpur AJK for duration of six months from June 2020 to December 2020. All the patients admitted with suicides burns were of either gender and had ages above 15 years. The convenience technique was used for sampling. The patients’ demographic details such as psychiatric illness, self-immolation act motivation, burn injury depth, burn total body surface area, inhalation injury, hospitalization duration, and mortality was recorded on pre-designed proforma. Data analysis was carried out with SPSS version 20. Results: The mean age of all 82 patients was 28.9±5.2 with an age range of 14 to 55 years. Of the total, 66 (80.5%) were female while 16 (19.5%) were male. In this study, the most frequent suicidal attempt was made by the marital conflicted patients 50 (61%) followed by love affair failure 8 (9.7%). An overall mean of 53.6±19.6 was observed for total body surface area affected with a range of 15-100%. The hospital duration mean was 8.2±5.9 with a range of 1-38 days. Young, married, and rural area illiterate housewives were the most common self-inflicted/suicide burn injuries. The prime cause of such injuries was getting married. The mortality rate was found at 82.3%. Conclusion: Our study concluded that patient’s well-being and mental health could be severely affected by burn injuries. Prevalent depression was noted among severe burn injuries patients. Depression related to deformity could be prevented with early grafting, wound management, proper splinting, coping ability, intense physiotherapy, and long-term rehabilitation. Keywords: Burn; Depressed mood, Psychiatric morbidity, Posttraumatic stress disorder

Estimation of body surface area of extremely obese human subjects

1960 ◽  
Vol 15 (5) ◽  
pp. 781-784 ◽  
Author(s):  
Garrett R. Tucker ◽  
James K. Alexander
Keyword(s):  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Human Subjects ◽  
Total Body Surface Area ◽  
The Body ◽  
Du Bois ◽  
Linear Formula ◽  
Total Body ◽  
Obese Human

The body surface areas of one normal and four extremely obese human subjects have been estimated by three methods: a) direct measurement by a method similar to that which Du Bois described; b) calculation from the Du Bois height-weight formula; and c) calculation from the Du Bois linear formula. The values for the total body surface area of the obese subjects calculated from the height-weight formula varied up to 11% below those that were directly measured. The values for the total body surface area obtained with the linear formula ranged between 13% and 20% above the direct measurements, this being almost entirely due to discrepancies in the trunk and in the thigh estimations. It has been concluded that estimation of the body surface area oxf extremely obese subjects by the Du Bois height-weight formula is satisfactory when considered in relation to the accuracy of the physiologic measurements with which it is generally used. Because of the unusual body form the Du Bois linear formula has been found unsatisfactory for this group. Submitted on March 1, 1960

NON-ACCIDENTAL BURN INJURIES IN ADULTS ADMITTED AT MANKWENG BURNS UNIT

2020 ◽  
Vol 3 (9) ◽  
Author(s):  
Salathiel Zhou Mzezewa ◽  
Livhuwani Makhuvha
Keyword(s):  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Total Body Surface Area ◽  
Public Health Problem ◽  
Intimate Partner ◽  
Burn Injuries ◽  
Traditional Beliefs ◽  
Causative Agents ◽  
Total Body

Abstract IntroductionBurns are a serious public health problem responsible for mortality and morbidity such as infection, contractures, and psycho-social disability.Aims and ObjectivesTo obtain information on non-accidental burn injuries admitted to our burns unit.To record the outcome.MethodsAll patients with a history of non-accidental burn injuries from January 2019 to August 2020 were prospectively included in this study. A data collection tool was created which consisted of data on age, gender, causative agents of burns, mechanism/circumstances that led to injury, total body surface area (TBSA) involved, and the patient’s outcome. ResultsWe admitted 38 patients. 22 males and 16 females. The mechanisms were intimate partner related violence 21, religious and traditional beliefs 5, self-inflicted 3, mob assault 1, robbery 2, alcohol-related conflicts 3, unclear mechanisms 3. The causative agents were scald 20, open flame 15 and chemical burns 3. The median age was 35,63(19-64) years. The median total body surface area was 24,4 (3-80) %. Mortality was 11(29%). ConclusionBurn injuries as a result of intimate partner-related violence were the leading reason for admission at 55,26%. Mortality was highest among those admitted following religious and traditional beliefs burns. The mortality was 29%.

scholarly journals Vasodilator function is impaired in burn injury survivors

2018 ◽  
Vol 315 (5) ◽  
pp. R1054-R1060 ◽  
Author(s):  
Steven A. Romero ◽  
Gilbert Moralez ◽  
Manall F. Jaffery ◽  
Mu Huang ◽  
Craig G. Crandall
Keyword(s):  
Pulse Wave Velocity ◽  
Surface Area ◽  
Body Surface Area ◽  
Wave Velocity ◽  
Body Surface ◽  
Pulse Wave ◽  
Burn Injury ◽  
Burn Injuries ◽  
Severe Burn ◽  
Injury Group

The effect of severe burn injury on vascular health is unknown. We tested the hypothesis that, compared with nonburn control subjects, vasodilator function would be reduced and that pulse-wave velocity (a measure of arterial stiffness) would be increased in individuals with prior burn injuries, the extent of which would be associated with the magnitude of body surface area having sustained a severe burn. Pulse-wave velocity and macrovascular (flow-mediated dilation) and microvascular (reactive hyperemia) dilator functions were assessed in 14 nonburned control subjects and 32 age-matched subjects with well-healed burn injuries. Fifteen subjects with burn injuries covering 17–40% of body surface area were assigned to a moderate burn injury group, and 17 subjects with burn injuries covering >40% of body surface area were assigned to a high burn injury group. Pulse-wave velocity [ P = 0.3 (central) and P = 0.3 (peripheral)] did not differ between the three groups. Macrovascular dilator function was reduced in the moderate ( P = 0.07) and high ( P < 0.05) burn injury groups compared with the control group. Likewise, peak vascular conductance during postocclusive reactive hyperemia differed from the moderate burn injury group ( P = 0.08 vs. control) and the high burn injury group ( P < 0.05 vs. control). These data suggest that vasodilator function is impaired in well-healed burn injury survivors, with the extent of impairment not dependent on the magnitude of body surface area having sustained a severe burn injury.

97 Burns in the Military Setting- analyzing 12,799 Routine & Combat Cases

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S63-S64
Author(s):  
Dafna (Shilo) Yaacobi ◽  
Alex Lvovsky ◽  
Nitay Ad-El ◽  
Diana Levi ◽  
Yuval Glick ◽  
...  
Keyword(s):  
Health Education ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Medical Records ◽  
Total Body Surface Area ◽  
Burn Injuries ◽  
Total Body ◽  
The Military

Abstract Introduction Burns are an important part of military trauma injuries. Studying the epidemiology, due to large morbidity related issues, is important for decision makers. The aim of the study is to review and characterize the burn injuries that occurred in the Israel Defense Forces (IDF) during the years 2008–2016 in training, routine and war. The burn area, degree, setting, unit, etc. will help us characterize the etiology, severity and consequences which is crucial in developing and directing resources to prevention and treatment programs. Methods All burn injuries in 2008–2016 were retrieved (ICD-Z 940–949). Data was collected from the IDF military medical records and included 3 months of follow-up. We retrieved 65,536 medical records, which included follow up of 12,799 soldiers. Special algorithms were specifically designed to retrieve and analyze variables included. Distribution analysis was performed, Parametric Kruskal–Wallis test was used and Chi Square test was used for comparing categorical variables. Results During the years 2008–2016, 65,536 burn related visits were retrieved and 12,799 burn injuries were identified. Gender distribution in figure 1. Gradual decrease in burn injuries was identified (figure 2). Distribution by Setting (figure 3), Commands (figure 4), Etiologies (figure 5), and etiologies within commands (figure 6). Average Total Body Surface Area (TBSA) was 7.524% (figure 7) and also declined over the years (7.7% in 2008 to 7.1% in 2016). Conclusions The decrease in burn rate could be attributed to the increased awareness of soldiers due to the emphasis given to health education and preventive medicine, as well as to improved protection. Scald and flame replaced by chemicals as the leading etiology, It is hypothesized that a small part of chemical burns is a result of self-infliction, which is more prevalent at non-combat units. Average Total Body Surface Area (TBSA) was similar but lower than other studies. The nature and operation mode of the IDF must be kept in mind- a relatively small army composed mainly with obligatory servicemen, there are no dedicated military hospitals, major trauma can be transported directly to the civilian medical system and not appear in the military medical charts. Applicability of Research to Practice This extensive report shows the trends and characteristics of burn injuries in the IDF, allowing for better understanding of these important injuries, and concluding for target health education based on common etiologies and at-risk populations and commands. IDF Commanders should preserve the current burn prevention educational programs, and protection instruments such as uniforms, special gloves and eye protection appliances, since they seem to work, and improvement was observed. Education should also focus on proper handling of various chemicals, and if self-inflicted suspected- psychological intervention should be considered.

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