Adequate cool running water first aid decreases burn depth and skin grafting requirements in paediatric thermal burns

2020 ◽  
pp. edpract-2020-319381
Author(s):  
Rachael Fleming ◽  
Natalie Bee
Keyword(s):  
Skin Grafting ◽  
First Aid ◽  
Running Water ◽  
Thermal Burns ◽  
Burn Depth

57 Cool Running Water First Aid Decreases Skin Grafting Requirements in Pediatric Burns: A Cohort Study of 2495 Children

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S38-S38
Author(s):  
Bronwyn R Griffin ◽  
Cody Frear ◽  
Ed Oakley ◽  
Roy M Kimble
Keyword(s):  
Cohort Study ◽  
Length Of Stay ◽  
Hospital Admission ◽  
Clinical Outcomes ◽  
Skin Grafting ◽  
First Aid ◽  
Hospital Length Of Stay ◽  
Early Management ◽  
Running Water ◽  
Pediatric Burns

Abstract Introduction First-aid guidelines recommend the administration of cool running water in the early management of thermal injury. Our objective was to analyze the associations between first aid and skin grafting requirements in children with burns. Methods This cohort study utilized a prospectively collected registry of patients managed at a tertiary children’s hospital. Multivariate logistic regression models were used to evaluate the relation ship between first aid and the requirement for skin grafting. Secondary outcomes included time to re-epithelialization, wound depth, hospital admission and length of stay, and theater interventions. Adequate first aid was defined as 20 minutes of cool running water within three hours of injury. Results In our cohort of 2495 children, 2259 (90.6%) received first aid involving running water, but only 1780 (71.3%) were given the adequate duration. A total of 236 (9.5%) children required grafting. The odds of grafting were decreased in the adequate first aid group (OR 0.6, 95% CI 0.4 to 0.8). The provision of adequate running water was further associated with reductions in the full-thickness depth (OR 0.4, 95% CI 0.2 to 0.6), hospital admission (OR 0.7, 95% CI 0.5 to 0.9) and theater operations (OR 0.7, 95% CI 0.5 to 0.9), but not hospital length of stay (HR=0.9, 95% CI 0.7 to 1.2, p=0.48). Conclusions Burn severity and clinical outcomes improved with the administration of cool running water. Adequate first aid must be prioritized by pre-hospital and emergency services in the preliminary management of pediatric burns. Applicability of Research to Practice Although children are at particularly high risk of burn injuries there was a paucity of literature addressing the relationship between burn first aid and clinical outcomes in pediatric populations. Due to differences in volume, surface area and skin thickness it was unknown whether benefits in adults applied to children. This study supports the prioritization of the administration of cool running water for 20 minutes to be adhered to immediately after a pediatric burn to decrease the severity and improve patient outcomes.

scholarly journals Cool Running Water First Aid Decreases Skin Grafting Requirements in Pediatric Burns: A Cohort Study of Two Thousand Four Hundred Ninety-five Children

2020 ◽  
Vol 75 (1) ◽  
pp. 75-85 ◽  
Author(s):  
Bronwyn R. Griffin ◽  
Cody C. Frear ◽  
Franz Babl ◽  
Ed Oakley ◽  
Roy M. Kimble
Keyword(s):  
Cohort Study ◽  
Skin Grafting ◽  
First Aid ◽  
Running Water ◽  
Pediatric Burns

Cryogenic Refrigerant Burns: A Rare Occupational Hazard

2020 ◽  
pp. 216507992096553
Author(s):  
Suvashis Dash ◽  
Vamseedharan Muthukumar ◽  
Rajkumar R ◽  
Durga Karki
Keyword(s):  
Exposure Time ◽  
Treatment Plan ◽  
Hand Function ◽  
Skin Grafting ◽  
Burn Injuries ◽  
Air Conditioners ◽  
Burn Center ◽  
Adequate Knowledge ◽  
Treatment Measures ◽  
Burn Depth

Background Cryogenic burns induced by coolant gases used in refrigerators and air conditioners are rarely encountered, despite the wide use of these gases. To date, only a few cases have been reported in the literature. This study examined the occupational circumstances leading to such injuries, relevant injury sites, types of chemicals involved, and treatment measures. Methods This study was conducted in a tertiary burn center in India between March 2015 and March 2019. The demographic details, chemicals involved, and burn regions and characteristics were analyzed. Findings There were 15 burn cases all involving injury to the hand. All injuries were managed initially with dressings and nonoperative management. One patient required anti-edema therapy with limb elevation and fingertip debridement, while another patient required skin grafting. All patients had satisfactory hand function after treatment. Conclusions/Application to Practice Cryogenic burn injuries caused by refrigerants are rare, and their etiology varies considerably. Exposure time is the primary factor that determines burn depth and severity; hence, reducing exposure time is important in first aid. Our findings suggest that after exposure, the patient should be treated in a specialized burn center. Adequate knowledge regarding the pathophysiology of these types of burn injuries and their management is necessary; otherwise, misjudgments in the treatment plan can lead to adverse consequences.

Effect of Cool Running Water for 20 Minutes After Thermal Burns

2020 ◽  
Vol 43 (6) ◽  
pp. 63-63
Keyword(s):  
Running Water ◽  
Thermal Burns

Excision and Skin Grafting of Thermal Burns

2009 ◽  
Vol 360 (9) ◽  
pp. 893-901 ◽  
Author(s):  
Dennis P. Orgill
Keyword(s):  
Skin Grafting ◽  
Thermal Burns

scholarly journals 702 Prehospital paediatric burn care: a re-audit. The adequacy of cool running water first aid

2021 ◽  
Author(s):  
Kathryn Mullan ◽  
Susie Lenfesty ◽  
Tudor Oman ◽  
Elizabeth Dalzell ◽  
Stephen Mullen
Keyword(s):  
First Aid ◽  
Running Water ◽  
Burn Care

Management of the Burn Wound

2019 ◽  
Author(s):  
Nicole S. Gibran ◽  
Jose P. Sterling ◽  
David M. Heimbach
Keyword(s):  
Wound Care ◽  
Donor Site ◽  
Skin Grafting ◽  
Wound Management ◽  
Skin Substitutes ◽  
Burn Wound ◽  
Burn Wounds ◽  
Initial Care ◽  
Wound Excision ◽  
Burn Depth

Current approaches to burn management are based on an understanding of the biology and physiology of human skin and the pathophysiology of the burn wound. The clinical evaluation and initial care of a burn wound is described and includes an assessment of burn depth, determining the need for escharatomy and daily burn wound care. Burns can be topical or surgical. Topical burn wounds require choice in the use of antibiotics. Considerations and techniques for surgical burn wound management are described and include early excision and grafting, wound excision, skin grafting, graft and donor-site dressings, postoperative wound care, biologic dressings and skin substitutes, allograft and xenograft skin, cultured epidermal autografts, and skin substitutes. Figures show the two distinct layers of the skin, various types of burns, and both fascial and tangential excision of burn wounds.  This review contains 12 figures, 11 tables, and 61 references. Keywords: Burn wound, graft, partial-thickness, full-thickness, dermis, epidermis,  sloughing, dressing

Management of the Burn Wound

2019 ◽  
Author(s):  
Nicole S. Gibran ◽  
Jose P. Sterling ◽  
David M. Heimbach
Keyword(s):  
Wound Care ◽  
Donor Site ◽  
Skin Grafting ◽  
Wound Management ◽  
Skin Substitutes ◽  
Burn Wound ◽  
Burn Wounds ◽  
Initial Care ◽  
Wound Excision ◽  
Burn Depth

Current approaches to burn management are based on an understanding of the biology and physiology of human skin and the pathophysiology of the burn wound. The clinical evaluation and initial care of a burn wound is described and includes an assessment of burn depth, determining the need for escharatomy and daily burn wound care. Burns can be topical or surgical. Topical burn wounds require choice in the use of antibiotics. Considerations and techniques for surgical burn wound management are described and include early excision and grafting, wound excision, skin grafting, graft and donor-site dressings, postoperative wound care, biologic dressings and skin substitutes, allograft and xenograft skin, cultured epidermal autografts, and skin substitutes. Figures show the two distinct layers of the skin, various types of burns, and both fascial and tangential excision of burn wounds.  This review contains 12 figures, 11 tables, and 61 references. Keywords: Burn wound, graft, partial-thickness, full-thickness, dermis, epidermis,  sloughing, dressing

scholarly journals Burns Depth Assessment Using Deep Learning Features

2020 ◽  
Vol 40 (6) ◽  
pp. 923-933
Author(s):  
Aliyu Abubakar ◽  
Hassan Ugail ◽  
Kirsty M. Smith ◽  
Ali Maina Bukar ◽  
Ali Elmahmudi
Keyword(s):  
Prediction Accuracy ◽  
Skin Grafting ◽  
Visual Assessment ◽  
Healing Time ◽  
Doppler Imaging ◽  
Support Vector ◽  
Class Prediction ◽  
Standard Guideline ◽  
High Level ◽  
Burn Depth

Abstract Purpose Burns depth evaluation is a lifesaving task and very challenging that requires objective techniques to accomplish. While the visual assessment is the most commonly used by surgeons, its accuracy reliability ranges between 60 and 80% and subjective that lacks any standard guideline. Currently, the only standard adjunct to clinical evaluation of burn depth is Laser Doppler Imaging (LDI) which measures microcirculation within the dermal tissue, providing the burns potential healing time which correspond to the depth of the injury achieving up to 100% accuracy. However, the use of LDI is limited due to many factors including high affordability and diagnostic costs, its accuracy is affected by movement which makes it difficult to assess paediatric patients, high level of human expertise is required to operate the device, and 100% accuracy possible after 72 h. These shortfalls necessitate the need for objective and affordable technique. Method In this study, we leverage the use of deep transfer learning technique using two pretrained models ResNet50 and VGG16 for the extraction of image patterns (ResFeat50 and VggFeat16) from a a burn dataset of 2080 RGB images which composed of healthy skin, first degree, second degree and third-degree burns evenly distributed. We then use One-versus-One Support Vector Machines (SVM) for multi-class prediction and was trained using 10-folds cross validation to achieve optimum trade-off between bias and variance. Results The proposed approach yields maximum prediction accuracy of 95.43% using ResFeat50 and 85.67% using VggFeat16. The average recall, precision and F1-score are 95.50%, 95.50%, 95.50% and 85.75%, 86.25%, 85.75% for both ResFeat50 and VggFeat16 respectively. Conclusion The proposed pipeline achieved a state-of-the-art prediction accuracy and interestingly indicates that decision can be made in less than a minute whether the injury requires surgical intervention such as skin grafting or not.

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