Burns

2018 ◽  
Author(s):  
Sanjay Bhananker ◽  
Paul Bhalla
Keyword(s):  
Burn Injury ◽  
Carbon Monoxide Poisoning ◽  
Fluid Management ◽  
Skin Grafting ◽  
The Body ◽  
Smoke Inhalation ◽  
Accurate Estimation ◽  
Burn Victims ◽  
Anesthesia Providers ◽  
Catabolic State

Burns injuries are a leading cause of morbidity and mortality in children. A significant burn injury affects every major organ system of the body. Initial management focuses on resuscitation along the ABCDE approach, with particular vigilance for the possibility of airway burn causing progressive edema and narrowing. Smoke inhalation is associated with carbon monoxide poisoning and possible cyanide toxicity. Fluid management depends on accurate estimation on the extent of the burn and use of a formula to calculate infusion rate, with careful monitoring of end-organ perfusion. Significant burn injuries are associated with hypermetabolic changes and a catabolic state, and burn victims are at high risk of developing sepsis. Treatment of a burn injury with debridement and skin grafting can involve multiple visits to the operating room with frequent need for sedation and anesthesia. Providers need a thorough understanding of potential anesthetic issues in burn-injured pediatric patients.

Features response and course of typical pathological processes in burn disease in puberty

2015 ◽  
Vol 6 (4) ◽  
pp. 69-74
Author(s):  
Anastasia Grigorievna Vasilyeva ◽  
Evgeny Vladimirovich Zinoviev ◽  
Denis Valerievich Kostyakov
Keyword(s):  
Burn Injury ◽  
Endocrine System ◽  
Qualitative Change ◽  
The Body ◽  
External Shocks ◽  
Metabolic Processes ◽  
Burn Victims ◽  
Adaptive Capabilities ◽  
Burn Disease ◽  
Almost All

In response to burn injury in the body of the child in puberty naturally develop typical pathological processes, which include almost all organs and systems, leads to severe disruption of homeostasis failure of adaptive mechanisms. Burn is the most powerful stress factor that causes changes in the body that are typical of the general adaptation syndrome. The main pathogenesis and peculiarities of typical pathological processes in burn disease significantly affected are determined by the endocrine system. Produce hormones are involved not only in the starting mechanism, but also in the development of compensatory-adaptive reactions, mobilizing the body's protective properties. Thus, a feature of adolescence is that at this age the body undergoes a qualitative change to the restructuring of all systems. There are significant morphological and functional restructuring of important metabolic processes in the body organs like the pituitary gland, adrenal glands, thyroid and pancreas, characterized by high activity of metabolic processes, strengthening of cell and tissue differentiation, intensification of regenerative processes. The consequence is excessive functional activity of organs and systems at rest, associated with low and often paradoxical reactivity to external shocks, including a burn injury, which leads to a decrease in functional and adaptive capabilities of the organism adolescents. All these features to consider when choosing the strategy of surgical treatment of persons puberty, burn victims.

76 The Effect of Splinting of Metacarpophalangeal Joints After Skin Grafting: A Review of the ACT Database

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S49-S50
Author(s):  
Ashley M Welsh ◽  
William S Dewey ◽  
James C Casey ◽  
Kyle B Cunningham
Keyword(s):  
Burn Injury ◽  
Treatment Time ◽  
Healing Process ◽  
Skin Grafting ◽  
The Body ◽  
Patient Acuity ◽  
Burn Scar ◽  
Dorsal Aspect ◽  
Dorsal Hand ◽  
Significant Difference

Abstract Introduction Hands are the most common area of the body to sustain a burn injury. Maintaining motion and function throughout the healing process of a burn injury is one of the most important goals of the rehabilitation process. After a deep burn to the dorsal aspect of the hand requiring skin grafting, the adjacent metacarpophalangeal (MCP) joints are at risk for developing a burn scar contracture (BSC), limiting the joints’ ability to fully flex towards a fist position. Post-operative positioning protocols state that patient’s hand should be temporarily immobilized for graft protection. A resting hand splint is used to maintain the wrist in approximately 20–30 degrees of extension, MCP joints at approximately 50–70 degrees of flexion and the interphalangeal joints in full extension. The purpose of this study was to assess the benefit of splinting as a treatment intervention to prevent MCP joint extension contractures following dorsal hand skin grafting. Methods This was a retrospective review of prospectively collected observational data from the “Burn Patient Acuity Demographics, Scar Contractures and Rehabilitation Treatment Time Related to Patient Outcomes” (ACT) study. Patients were included with grafted dorsal hand burns occurring within 1 of the 4 established cutaneous functional units (CFU) along the dorsal aspect of the second through fifth metacarpals. Since most subjects had more than one dorsal hand CFU involved, the number of CFUs were analyzed as opposed to the number of subjects. Isolated MCP joint flexion measurements were utilized to determine incidence of contracture. Included causes of contracture were scar tissue or other soft tissue limitations. Data were then analyzed by two groups: contracted and non-contracted. Results A total of 221 dorsal hand CFUs were included in this study; 119 contracted and 102 non-contracted. There was no statistical significant difference between the average splint wear time between the 2 groups. The average percent of affected CFUs grafted within the contracted group was 92.4% compared to 76.8% in the non-contracted group. In burns to the dorsal hand with less than 99% of the CFU grafted, splinting was effective in preventing 60% of MCP joint extension contractures. When greater than 99% of affected CFU was grafted, splinting was effective in prevention only 36% of contractures. Conclusions Splinting can be an effective intervention option in preventing MCP extension contractures when less than 75% of the affected CFU has been grafted; however, its effectiveness decreases as the percentage of CFU involvement increases to greater than or equal to 99%. Applicability of Research to Practice Determine most effective post-operative rehabilitations plan following dorsal hand skin grafts.

EPIDEMIOLOGY AND OUTCOMES OF ELECTRIC BURN INJURY AT TERTIARY CARE CENTER IN JODHPUR, RAJASTHAN

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Bharti Saraswat ◽  
Ashok Yadav ◽  
Krishna Kumar Maheshwari
Keyword(s):  
Burn Injury ◽  
Low Voltage ◽  
Care Center ◽  
Tertiary Care ◽  
The Body ◽  
Electrical Injury ◽  
Age Group ◽  
Electric Circuits ◽  
Medical College ◽  
Social Burden

Background- Electric burns and injuries are the result of electric current passing through the body. Temporary or permanent damage can occur to the skin, tissues, and major organs. Methods- This prospective study was carried out on patients admitted in burn unit of department of surgery M.G. Hospital associated with Dr. S.N. Medical College Jodhpur. Records of the patients admitted from January 2018 to December 2018 were studied. Bed head tickets of the patients evaluated in detail. Results- In our study out of 113 patients maximum no. of patients were in age group of 21-30 years 44 (38.94%) followed by age group <11 years in 21 (18.58%) patients and age group of > 60 years in only 3 (2.65%).39 (34.51%) patients were farmer and 15 (13.27%) were electrician in out of 113 total patients, while 37 (32.74%) were without any occupation. 65 (57.52%) cases of high voltage (HV) electrical injury and 48 (42.48%) cases were of low voltage (LV) electrical injury. Conclusion- Morbidity leading to permanent disabilities make the person physically dependent on others. It can be prevented by educating the people about the proper handling to electric circuits & devices. Proper communication among the electricians may help in lowering such accidents. Proper rehabilitation of the handicapped person & employment to the member of the affected family may reduce the social burden caused by such electricity concerned accidents.

Clinical Utility of an Exoskeleton Robot Using 3-Dimensional Scanner Modeling in Burn Patient: A Case Report

2021 ◽  
Author(s):  
So Young Joo ◽  
Seung Yeol Lee ◽  
Yoon Soo Cho ◽  
Sangho Yi ◽  
Cheong Hoon Seo
Keyword(s):  
Burn Injury ◽  
Hand Function ◽  
Three Dimensional ◽  
The Body ◽  
3D Technology ◽  
Early Management ◽  
3 Dimensional ◽  
Exoskeleton Robot ◽  
Physical Abilities ◽  
Upper Limb Dysfunction

Abstract Hands are the part of the body that are most commonly involved in burns, and the main complications are finger joint contractures and nerve injuries. Hypertrophic scarring cannot be avoided despite early management of acute hand burn injuries, and some patients may need application of an exoskeleton robot to restore hand function. To do this, it is essential to individualize the customization of the robot for each patient. Three-dimensional (3D) technology, which is widely used in the field of implants, anatomical models, and tissue fabrication, makes this goal achievable. Therefore, this report is a study on the usefulness of an exoskeleton robot using 3D technology for patients who lost bilateral hand function due to burn injury. Our subject was a 45-year-old man with upper limb dysfunction of 560 days after a flame and chemical burn injury, with resultant impairment of manual physical abilities. After wearing an exoskeleton robot made using 3D printing technology, he could handle objects effectively and satisfactorily. This innovative approach provided considerable advantages in terms of customization of size and reduction in manufacturing time and costs, thereby showing great potential for use in patients with hand dysfunction after burn injury.

scholarly journals Plasma radio-metabolite analysis of PET tracers for dynamic PET imaging: TLC and autoradiography

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Fiona Li ◽  
Justin W. Hicks ◽  
Lihai Yu ◽  
Lise Desjardin ◽  
Laura Morrison ◽  
...  
Keyword(s):  
High Performance Liquid Chromatography ◽  
Liquid Chromatography ◽  
Blood Plasma ◽  
Kinetic Parameters ◽  
High Performance ◽  
The Body ◽  
Accurate Estimation ◽  
Dynamic Pet ◽  
Arterial Concentration ◽  
In Blood Plasma

Abstract Background In molecular imaging with dynamic PET, the binding and dissociation of a targeted tracer is characterized by kinetics modeling which requires the arterial concentration of the tracer to be measured accurately. Once in the body the radiolabeled parent tracer may be subjected to hydrolysis, demethylation/dealkylation and other biochemical processes, resulting in the production and accumulation of different metabolites in blood which can be labeled with the same PET radionuclide as the parent. Since these radio-metabolites cannot be distinguished by PET scanning from the parent tracer, their contribution to the arterial concentration curve has to be removed for the accurate estimation of kinetic parameters from kinetic analysis of dynamic PET. High-performance liquid chromatography has been used to separate and measure radio-metabolites in blood plasma; however, the method is labor intensive and remains a challenge to implement for each individual patient. The purpose of this study is to develop an alternate technique based on thin layer chromatography (TLC) and a sensitive commercial autoradiography system (Beaver, Ai4R, Nantes, France) to measure radio-metabolites in blood plasma of two targeted tracers—[18F]FAZA and [18F]FEPPA, for imaging hypoxia and inflammation, respectively. Results Radioactivity as low as 17 Bq in 2 µL of pig’s plasma can be detected on the TLC plate using autoradiography. Peaks corresponding to the parent tracer and radio-metabolites could be distinguished in the line profile through each sample (n = 8) in the autoradiographic image. Significant intersubject and intra-subject variability in radio-metabolites production could be observed with both tracers. For [18F]FEPPA, 50% of plasma activity was from radio-metabolites as early as 5-min post injection, while for [18F]FAZA, significant metabolites did not appear until 50-min post. Simulation study investigating the effect of radio-metabolite in the estimation of kinetic parameters indicated that 32–400% parameter error can result without radio-metabolites correction. Conclusion TLC coupled with autoradiography is a good alternative to high-performance liquid chromatography for radio-metabolite correction. The advantages of requiring only small blood samples (~ 100 μL) and of analyzing multiple samples simultaneously, make the method suitable for individual dynamic PET studies.

scholarly journals Development of a Deep Neural Network Model for Estimating Joint Location of Occupant Indoor Activities for Providing Thermal Comfort

Energies ◽  
2021 ◽  
Vol 14 (3) ◽  
pp. 696
Author(s):  
Eun Ji Choi ◽  
Jin Woo Moon ◽  
Ji-hoon Han ◽  
Yongseok Yoo
Keyword(s):  
Neural Network ◽  
Thermal Comfort ◽  
Deep Neural Network ◽  
Mean Squared Error ◽  
Thermal Environment ◽  
The Body ◽  
Estimation Accuracy ◽  
Accurate Estimation ◽  
Body Parts ◽  
Joint Location

The type of occupant activities is a significantly important factor to determine indoor thermal comfort; thus, an accurate method to estimate occupant activity needs to be developed. The purpose of this study was to develop a deep neural network (DNN) model for estimating the joint location of diverse human activities, which will be used to provide a comfortable thermal environment. The DNN model was trained with images to estimate 14 joints of a person performing 10 common indoor activities. The DNN contained numerous shortcut connections for efficient training and had two stages of sequential and parallel layers for accurate joint localization. Estimation accuracy was quantified using the mean squared error (MSE) for the estimated joints and the percentage of correct parts (PCP) for the body parts. The results show that the joint MSEs for the head and neck were lowest, and the PCP was highest for the torso. The PCP for individual activities ranged from 0.71 to 0.92, while typing and standing in a relaxed manner were the activities with the highest PCP. Estimation accuracy was higher for relatively still activities and lower for activities involving wide-ranging arm or leg motion. This study thus highlights the potential for the accurate estimation of occupant indoor activities by proposing a novel DNN model. This approach holds significant promise for finding the actual type of occupant activities and for use in target indoor applications related to thermal comfort in buildings.

scholarly journals Biochemical approaches for nutritional support of skeletal muscle protein metabolism during sepsis

2004 ◽  
Vol 17 (1) ◽  
pp. 77-88 ◽  
Author(s):  
Thomas C. Vary ◽  
Christopher J. Lynch
Keyword(s):  
Skeletal Muscle ◽  
Amino Acids ◽  
Metabolic Response ◽  
Muscle Protein ◽  
The Body ◽  
Integrated Analysis ◽  
Skeletal Muscle Protein ◽  
Catabolic State ◽  
N Metabolism ◽  
Induced Defects

Sepsis initiates a unique series of modifications in the homeostasis of N metabolism and profoundly alters the integration of inter-organ cooperatively in the overall N and energy economy of the host. The net effect of these alterations is an overall N catabolic state, which seriously compromises recovery and is semi-refractory to treatment with current therapies. These alterations lead to a functional redistribution of N (amino acids and proteins) and substrate metabolism among injured tissues and major body organs. The redistribution of amino acids and proteins results in a quantitative reordering of the usual pathways of C and N flow within and among regions of the body with a resultant depletion of the required substrates and cofactors in important organs. The metabolic response to sepsis is a highly integrated, complex series of reactions. To understand the regulation of the response to sepsis, a comprehensive, integrated analysis of the fundamental physiological relationships of key metabolic pathways and mechanisms in sepsis is essential. The catabolism of skeletal muscles, which is manifested by an increase in protein degradation and a decrease in synthesis, persists despite state-of-the-art nutritional care. Much effort has focused on the modulation of the overall amount of nutrients given to septic patients in a hope to improve efficiencies in utilisation and N economies, rather than the support of specific end-organ targets. The present review examines current understanding of the processes affected by sepsis and testable means to circumvent the sepsis-induced defects in protein synthesis in skeletal muscle through increasing provision of amino acids (leucine, glutamine, or arginine) that in turn act as nutrient signals to regulate a number of cellular processes.

scholarly journals The Accuracy of Broselow Tape Weight Estimate among Pediatric Population

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Turki M. AlHarbi ◽  
Abdullaziz AlGarni ◽  
Fasial AlGamdi ◽  
Mona Jawish ◽  
Tariq Ahmad Wani ◽  
...  
Keyword(s):  
Body Weight ◽  
Pediatric Population ◽  
Body Height ◽  
Age Groups ◽  
Cross Sectional Study ◽  
The Body ◽  
Accurate Estimation ◽  
Cross Sectional ◽  
Actual Weight ◽  
Medical City

Objective.To determine the accuracy of the Broselow Tape (BT) versions 2007 and 2011 in estimating weight among pediatric population.Methods.A cross-sectional study was conducted at King Fahad Medical City and six schools across Riyadh province on 1–143-month-old children. BT 2007 and 2011 estimated weights were recorded. Both tapes via the child’s height produce an estimated weight, which was compared with the actual weight.Results.A total of 3537 children were recruited. The height (cm) of the subjects was97.7±24.1and the actual weight (kg) was16.07±8.9, whereas the estimated weight determined by BT 2007 was15.87±7.56and by BT 2011 was16.38±7.95. Across all the five age groups, correlation between actual weight and BT 2007 ranged between 0.702 and 0.788, while correlation between actual weight and BT 2011 ranged between 0.698 and 0.788. Correlation between BT 2007 and BT 2011 across all the five age groups ranged from 0.979 to 0.989. Accuracy of both the tape versions was adversely affected when age was >95 months and body weight was >26 kilograms.Conclusions.Our study showed that BT 2007 and 2011 provided accurate estimation of the body weight based on measured body height. However, 2011 version provided more precise estimate for weight.

scholarly journals Minimally Invasive Technologies for Treatment of HTS and Keloids: Fractional Laser

2020 ◽  
pp. 279-285
Author(s):  
M. Tretti Clementoni ◽  
E. Azzopardi
Keyword(s):  
Minimally Invasive ◽  
Burn Injury ◽  
State Of The Art ◽  
Skin Grafting ◽  
Complex Problem ◽  
Fractional Laser ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Insight Into

AbstractThis chapter presents a state-of-the-art insight into the use of fractional laser for the management of this complex problem. In particular, we focus on the management of complex scars such as those occurring post-burn injury and split-thickness skin grafting.

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