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.

scholarly journals 58 Rate and Predictors of Outpatient Follow-Up Compliance of Pediatric Burn Patients During the COVID-19 Pandemic

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S41-S42
Author(s):  
Alejandro O Chara ◽  
Erica Hodgman ◽  
Susan Ziegfeld ◽  
Carisa Parrish ◽  
Daniel Rhee ◽  
...  
Keyword(s):  
Race And Ethnicity ◽  
Time Frame ◽  
Burn Injuries ◽  
Post Injury ◽  
Burn Center ◽  
Chi Squared ◽  
Level 1 ◽  
Demographic Patterns ◽  
Burn Depth

Abstract Introduction The effect of the COVID-19 pandemic has led to increased isolation of families at home and potentially decreased access to the healthcare system. We therefore evaluated the effect of COVID-19 on rates of compliance with recommended post-injury follow-up. We hypothesized that this isolation may lead to detrimental effects on adherence to proper follow-up for children with burn injuries. Methods We queried the registry at an ABA-verified Level 1 pediatric burn center for patients aged 0–14 years who were treated and released from March 30 to July 31, 2020, which represents the height of the pandemic. As a control, we searched the registry for patients treated during the same time frame from 2016 to 2019. Patient and clinical factors were compared between the COVID and pre-COVID cohorts. Predictors of follow-up were compared using chi-squared and Kruskal-Wallis tests. Multivariable logistic regression was used to evaluate for predictors of compliance with follow-up. Results A total of 401 patients were seen and discharged from the pediatric ED for burn injuries. The COVID cohort consisted of 58 (14.5%) of these patients. Burn characteristics and demographic patterns did not differ between the COVID and pre-COVID cohorts. Demographics, including age, gender, race, and ethnicity did not differ between patients with 2-week follow-up and those without. The rate of compliance with 2-week follow-up was also not affected (62.4% prior to COVID vs. 55.2% during, p=0.29). As expected, burn size, burn depth, and mechanism of injury all significantly predicted compliance with 2-week follow up (table 1). After adjusting for these variables, there was still no difference in the odds of appropriate follow up (OR 0.6, 95% CI 0.3 – 1.1; p=0.12). Conclusions Despite concerns about decreased access to healthcare during the pandemic, the experience at our Level 1 pediatric burn center, including rates of follow-up for those managed as outpatients, appears unchanged.

scholarly journals Five Years Experience With Meek Grafting in the Management of Extensive Burns in an Adult Burn Center

2018 ◽  
Vol 27 (1) ◽  
pp. 44-48 ◽  
Author(s):  
Khosrow Siamak Houschyar ◽  
Christian Tapking ◽  
Ina Nietzschmann ◽  
Susanne Rein ◽  
Kristian Weissenberg ◽  
...  
Keyword(s):  
Total Body Surface Area ◽  
Skin Grafting ◽  
Operative Management ◽  
Burn Injuries ◽  
Burn Center ◽  
Total Body ◽  
Operative Notes ◽  
Extensive Burns ◽  
Skin Coverage ◽  
Extensive Burn

Background: In extensive burn injuries with lack of donor sites for skin grafting, the Meek technique of skin expansion can be an efficient and effective method in covering extensive wounds. The aim of this retrospective study was to present our experience with the Meek technique of grafting. Methods: We performed a retrospective analysis of patients from our burn center who underwent Meek grafting between 2012 and 2016. Demographics, burn details, clinical course, operative management, and outcomes were collected and analyzed from patient records and operative notes. Outcome measures, including graft take rate, complications and need for further surgery, were recorded. Results: Twelve patients had Meek grafting. The average age was 38 years (range: 15-66). The average percent total body surface area burned was 54.3% (range: 31%-77%). Eighty-three percent of grafted areas healed well, and no regrafting was necessary. In the remaining 17%, infection and hematoma were the leading cause of graft failure. Conclusions: Meek grafting constitutes a rapid and efficient surgical approach for the skin coverage of extensive full-thickness burn injuries with limited autograft donor sites.

The hidden danger of lithium battery powered electric bicycles and scooters: A case series of the Israeli National Burn Center experience

2021 ◽  
Author(s):  
Matan Segalovich ◽  
Ariel Berl ◽  
Uri Aviv ◽  
Eli Jaffe ◽  
Ran Shelef ◽  
...  
Keyword(s):  
Lithium Batteries ◽  
Lithium Battery ◽  
Urban Transportation ◽  
Case Series ◽  
Skin Grafting ◽  
Lower Limbs ◽  
Rechargeable Lithium Batteries ◽  
Burn Center ◽  
Patient Admissions ◽  
Burn Depth

Abstract Electric powered bicycles and scooters that use rechargeable lithium batteries are an urban transportation alternative and have become increasingly popular. However, in recent years, there has been an increase in patient admissions to the Israeli National Burn Center with burns associated with their use. In this case series of all patients (n=9) referred to the Emergency Department (February 2016 - October 2020) with lithium related battery burns from electric powered bicycles and scooters, we present burn depth, size, treatment, inhalation injuries and hospitalization. All patients were admitted to in the Israeli National Burn Center for treatment. The average total burn surface area was 27.5% (range 3-57%). All but one patient had a combination of partial to full-thickness burns affecting the upper and lower limbs. Three patients sustained inhalation injuries and a total of four patients required intubation. Seven patients required surgery that included debridement and, in most cases, skin grafting. The availability and increase in the use of battery powered bicycles and scooters may lead to an increase in injuries and death if consumers are not aware of the potential dangers related to the safe use of lithium batteries.

scholarly journals Predictors of Follow-Up Compliance in Pediatric Burn Patients During the Time of COVID

2021 ◽  
Author(s):  
Alejandro Chara ◽  
Erica Hodgman ◽  
Susan Ziegfeld ◽  
Carisa Parrish ◽  
Daniel Rhee ◽  
...  
Keyword(s):  
Time Frame ◽  
Access To Healthcare ◽  
Burn Injuries ◽  
Burn Patients ◽  
Post Injury ◽  
Burn Center ◽  
Chi Squared ◽  
Demographic Patterns ◽  
Burn Depth

Abstract The effect of the COVID-19 pandemic has led to increased isolation and potentially decreased access to healthcare. We therefore evaluated the effect of COVID-19 on rates of compliance with recommended post-injury follow-up. We hypothesized that this isolation may lead to detrimental effects on adherence to proper follow-up for children with burn injuries. We queried the registry at an ABA-verified Level 1 pediatric burn center for patients aged 0-18 years who were treated and released from March 30 to July 31, 2020. As a control, we included patients treated during the same time frame from 2016 to 2019. Patient and clinical factors were compared between the COVID and pre-COVID cohorts. Predictors of follow-up were compared using chi-squared and Kruskal-Wallis tests. Multivariable logistic regression was used to evaluate for predictors of compliance with follow-up. A total of 401 patients were seen and discharged from the pediatric ED for burns. Fifty-eight (14.5%) of these patients were seen during the pandemic. Burn characteristics and demographic patterns did not differ between the COVID and pre-COVID cohorts. Likewise, demographics did not differ between patients with follow-up and those without. The rate of compliance with 2-week follow-up was also not affected. Burn size, burn depth, and mechanism of injury all were associated with higher compliance to follow up. After adjusting for these variables, there was still no difference in the odds of appropriate follow up. Despite concerns about decreased access to healthcare during COVID, follow-up rates for pediatric burn patients remained unchanged at our pediatric burn center.

Serious Occupational Burn Injuries Treated at a Regional Burn Center

2002 ◽  
Vol 23 (4) ◽  
pp. 244-248 ◽  
Author(s):  
Allison J. Taylor ◽  
Gerald McGwin ◽  
James M. Cross ◽  
Donald R. Smith ◽  
Barbara R. Birmingham ◽  
...  
Keyword(s):  
Burn Injuries ◽  
Burn Center

Experimental models for controlled burn injuries in rats: a systematic analysis of original methods and burn devices

2021 ◽  
Author(s):  
Stefan Morarasu ◽  
Bianca-Codrina Morarasu ◽  
Nicolae Ghețu ◽  
Mihail-Gabriel Dimofte ◽  
Radu Iliescu ◽  
...  
Keyword(s):  
Final Analysis ◽  
Experimental Models ◽  
Burn Injuries ◽  
Systematic Analysis ◽  
Experimental Burn ◽  
Controlled Burn ◽  
Histological Confirmation ◽  
The Right ◽  
Burn Depth

Abstract AIM Despite a wide variety of models found in literature, choosing the right one can be difficult as many of them are lacking precise methodology. This study aims to analyze and compare original burn models in terms of burn device and technique, parameters, and wound depth assessment. METHODS A systematic search was performed according to PRISMA guidelines on studies describing original experimental burn models in rats. The adapted PICO formula and ARRIVE checklist were followed for inclusion and assessment of quality of studies. Characteristics of animals, burn technique, burn parameters and method of histological confirmation of burn depth were recorded. RESULTS Twenty-seven studies were included in the final analysis. Most studies used direct contact with skin for burn infliction (n=20). The rat’s dorsum was the most common site (n=18). Ten studies used manually controlled burn devices, while ten designed automatic burn devices with control over temperature (n=10), exposure time (n=5), and pressure (n=5). Most studies (n=7) used a single biopsy taken from the center of the wound to confirm burn depth immediately after burn infliction. CONCLUSION From the wide variety of burn models in current literature, our study provides an overview of the most relevant experimental burn models in rats aiding researchers to understand what needs to be addressed when designing their burn protocol. Models cannot be compared as burn parameters variate significantly. Assessment of burn depth should be done in a standardized, sequential fashion in future burn studies to increase reproducibility.

Expansion potential of skin grafts with novel I-shaped auxetic incisions

2021 ◽  
Author(s):  
Vivek Gupta ◽  
Arnab Chanda
Keyword(s):  
Skin Grafting ◽  
Burn Injuries ◽  
Skin Grafts ◽  
Severe Burn ◽  
Thickness Skin ◽  
Split Thickness Skin Grafting ◽  
Shape Pattern ◽  
Severe Burn Injuries ◽  
Poisson's Ratios ◽  
Poisson’S Ratios

Abstract Severe burn injures lead to millions of fatalities every year due to lack of skin replacements. While skin is a very limited and expensive entity, split thickness skin grafting, which involves the projection of a parallel incision pattern on a small section of healthy excised skin, is typically employed to increase the expansion and cover a larger burn site. To date, the real expansion capacity of such grafts are low (<3 times) and insufficient for treatment of severe burn injuries. In this study, novel I-shaped auxetic incision patterns, which are known to exhibit high negative Poisson’s ratios, have been tested on the skin to investigate their expansion potential. Fourteen two-layer skin graft models with varying incision pattern parameters (i.e., length, spacing, and orientation) were developed using finite element modelling and tested under uniaxial and biaxial tensile loads. The Poisson’s ratio, meshing ratios, and induced stresses were quantified across all models. Graft models tested uniaxially along the orthogonal directions indicated opposite trends in generated Poisson’s ratios, as the length of the I-shape incisions were increased. Biaxially, with a symmetric and closely spaced I-shape pattern, graft meshing ratios up to 15.65 were achieved without overstressing the skin. Overall, the findings from the study indicated that expansion potentials much higher than that of traditional skin grafts can be achieved with novel I-shaped auxetic skin grafts, which would be indispensable for covering large wounds in severe burn injuries.

Cyanoacrylate Nail Glue and the Pajama Catalyst

2020 ◽  
Vol 41 (6) ◽  
pp. 1306-1308
Author(s):  
Harvey Rich ◽  
Jonathan J Cubitt
Keyword(s):  
Healthcare Workers ◽  
Burn Injury ◽  
Exothermic Reaction ◽  
Natural Fibers ◽  
Skin Grafting ◽  
Young Lady ◽  
Burn Injuries ◽  
Surgical Team ◽  
The Public ◽  
Online Retailers

Abstract Nail glues are routinely used for the application of false nails and are readily available for unrestricted purchase from highstreet and online retailers. We present the case of a young lady who accidentally spilled her nail glue on to her cotton pajama trouser leg setting off a violent exothermic reaction that resulted in a full-thickness burn injury to her foot. She ultimately went on to require surgical debridement and skin grafting. We intend to remind both healthcare workers and members of the public that while nail glue alone in contact with the skin is relatively harmless, contact together with natural fibers such as cotton clothing produces a dangerous chemical reaction, which is too often underestimated and can lead to serious burn injuries. Our patient and the surgical team agree that more must be done to raise awareness of the risks these products pose, and retailers must ensure consumers are responsibly informed.

Inpatient Data of Occupational Burn Injuries Treated at a Tertiary Burn Center

2019 ◽  
Vol 41 (2) ◽  
pp. 398-401
Author(s):  
Abdulkadir Basaran ◽  
Ozer Ozlu
Keyword(s):  
Hospital Stay ◽  
Burn Injury ◽  
Health And Safety ◽  
Length Of Hospital Stay ◽  
Burn Injuries ◽  
Occupational Accidents ◽  
Cross Sectional ◽  
Work Related ◽  
Burn Center ◽  
Electrical Burns

Abstract Occupational burns are among the important causes of work-related injuries. We aimed to investigate the epidemiology and reasons of occupational burns and thereby to emphasize preventive measures. Between January 2017 and December 2018, the data of major occupational burn injury patients admitted to our burn center were evaluated in this cross-sectional retrospective study. During the study period 342 patients older than 16 years were admitted to the burn center. Among them 80 patients with occupational burns (23.4%) were identified. The mean age of the patients was 34.73 ± 12.3 years. Seventy-eight patients (97.5%) were male. Electrical burns and flame burns were the two leading type of occupational burns. The most common occupation of our patients was construction work. Dangerous behavior, carelessness, lack of protective equipment, and failure to follow instructions were causes of injury. Only 14 patients (17.5%) experienced unavoidable accident. Thirty-seven patients (46.3%) worked on temporary basis. Occupational experience was under 5 years in majority of the cases (62.5%). For the occupational burns the percentage of burned TBSA was 17.08 ± 14.5 (1–60) and the length of hospital stay was 23.94 ± 21.9 days (2–106). There were no significant differences between occupational and nonoccupational burn injuries considering TBSA, total length of hospital stay, and complications (P &gt; .05). Occupational burn injuries are common in less experienced and younger workers. Therefore, recognition of the problem and maintaining awareness is important. In order to prevent occupational accidents and burns, occupational health and safety rules must be obeyed.

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