scholarly journals Paediatric injuries due to home treadmill use: an emerging problem

2012 ◽  
Vol 94 (2) ◽  
pp. 121-123 ◽  
Author(s):  
P Lohana ◽  
S Hemington-Gorse ◽  
C Thomas ◽  
T Potokar ◽  
YT Wilson
Keyword(s):  
Surgical Intervention ◽  
Public Awareness ◽  
Total Body Surface Area ◽  
Home Exercise ◽  
Patient Demographics ◽  
Burn Units ◽  
Total Body ◽  
The Uk ◽  
Type Of Injury ◽  
Exercise Equipment

INTRODUCTION The use of home exercise equipment is increasing and treadmills are becoming more popular. This has brought with it an emerging but preventable problem. We present our experience, highlight the importance and promote public awareness of this type of injury. To our knowledge this has not been reported previously in the UK. METHODS A retrospective review was conducted of the medical records at two regional burn units of children who sustained treadmill-related injuries between July 2003 and July 2009. Data on patient demographics, mechanism of injury, management, surgical intervention and outcome were recorded. RESULTS Twenty-nine children (15 boys, 14 girls) sustained treadmill-related injuries. The mean age was 3.8 years (range: 1–13 years). All injuries occurred at home and the majority of children trapped their hand under the running belt when an adult was using the machine. Most of the injuries were to the upper limb (97%) with less than 1% of the total body surface area burnt. More than two-thirds of patients had deep burns and 17 (58%) required surgical intervention. Five patients developed hypertrophic scars. All patients achieved a good functional outcome. CONCLUSIONS Treadmills can pose a significant danger to children. These injuries are preventable. Regulatory authorities, manufacturers and parents should take steps to prevent this emerging health problem.

524 Effectiveness of Burns Wound Cleansing by Comparison of Prewash and Post Wash Swab Reports

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
M A Sayed ◽  
S Jabeen ◽  
A Soueid
Keyword(s):  
Bacterial Load ◽  
Total Body Surface Area ◽  
Wound Management ◽  
Burn Patients ◽  
Burn Wound ◽  
Staph Aureus ◽  
Sex Type ◽  
Total Body ◽  
Burns Unit ◽  
Type Of Injury

Abstract Aim The main aim and objective were to optimise wound healing through infection prevention. This clinical audit aimed to investigate the effectiveness of burn wound cleansing in decreasing bacterial load by comparing pre-wash and post-wash swab results against local burn wound management and aseptic non touch technique (ANTT) guidelines. Method The audit was conducted retrospectively on children admitted to Burns Unit during August 2019, excluding resuscitation burn patients. Pre- and post-wash swabs taken on admission were included and the results obtained from Chameleon database. Data were collected on excel spread sheets including demographic variables such as age, sex, type of injury, percentage total body surface area (TBSA) and mechanism of injury. Data were analysed and results compiled. Results Fifty patients were admitted over a month period; amongst those 60% were male and 40% female of ages ranging from 5 months to 14 years. Scald (50%) was found to be the most common mode of injury followed by contact burn (36%) involving 0.30 to 9% TBSA. Among 50 patients, 30 (60%) showed no growth in pre-wash and 36 (72%) in post-wash swabs. However, 6% post-wash swabs that were initially negative later showed bacillus cereus, staph aureus, Enterobacter, and Acinetobacter. Similarly, another 4% post-wash swabs developed new microorganisms as compared to pre-wash swabs. Conclusions The most common bacteria colonising both pre- and post-wash swabs was staph aureus. Overall, cleansing had reduced the bacterial load significantly around 82% very effective. It is imperative to stick to local guidelines to reduce morbidity and mortality in burn patients.

scholarly journals Firecracker injuries during Diwali festival: The epidemiology and impact of legislation in Delhi

2012 ◽  
Vol 45 (01) ◽  
pp. 097-101 ◽  
Author(s):  
R. Tandon ◽  
K. Agrawal ◽  
R.P. Narayan ◽  
V.K. Tiwari ◽  
V. Prakash ◽  
...  
Keyword(s):  
Public Awareness ◽  
Total Body Surface Area ◽  
Family Welfare ◽  
National Capital Region ◽  
Burn Care ◽  
Number Of Patients ◽  
Management Protocol ◽  
National Capital ◽  
Diwali Festival ◽  
Total Body

ABSTRACT Setting and Design: A hospital-based retrospective study of firecracker-related injuries was carried out at a government sponsored hospital in Delhi. Materials and Methods: 1373 patients attended the emergency burn care out-patients clinic during 2002-2010 pre-Diwali, Diwali and post-Diwali days. Every year, a disaster management protocol is revoked during these 3 days under the direct supervision of the Ministry of Health and Family Welfare, Government of India. Results: There was an increase in the number of patients of firecracker-related injuries in Delhi national capital region from the year 2002 to 2010, based on the hospital statistics. During the study period, the hospital received approximately one patient with firecracker-related injury per 100,000 population of the city. 73.02% of the victims were 5-30 years old. Majority (90.87%) of them sustained <5% total body surface area burn. Conclusions: In spite of legislations and court orders, the number of patients is on the rise. The implementation agencies have to analyse the situation to find a way to control this preventable manmade accident. Websites, emails, SMS, social sites, etc. should be used for public education, apart from conventional methods of public awareness.

Optimising management of self-inflicted burns: a retrospective review

2019 ◽  
Vol 28 (6) ◽  
pp. 317-322
Author(s):  
Khosrow S. Houschyar ◽  
Christian Tapking ◽  
Dominik Duscher ◽  
Zeshaan N. Maan ◽  
Clifford C. Sheckter ◽  
...  
Keyword(s):  
Retrospective Review ◽  
Psychiatric Treatment ◽  
Total Body Surface Area ◽  
Length Of Hospital Stay ◽  
Operative Management ◽  
The Self ◽  
Control Group ◽  
Patient Admissions ◽  
Burn Units ◽  
Total Body

Objective: Self-inflicted burns typically result in extensive injuries requiring intensive care and attention in a specialised burn unit. Burn units should be familiar with the optimal management of self-inflicted burns, including the psychological and psychiatric treatment. This paper describes the experiences of managing these challenging injuries in a German burn centre. Methods: A retrospective review of patients with self-inflicted burns admitted to the burn centre between 2000 and 2017. Demographics, details of injury, presence of psychiatric disorder, clinical course, operative management and patient outcomes were recorded and compared with a control group without self-inflicted burns. Outcome measures included graft take rate, complications and need for further surgery. Results: There were a total of 2055 burn patient admissions, with 17 cases (0.8%) of self-inflicted burns. The mean age was 36±11 years with an mean percentage total body surface area (%TBSA) burned of 43.5±22.5% which was not significantly different from the control group (p=0.184). Schizophrenia and personality disorder were the most common diagnoses in the self-inflicted burns patients (n=11; 65%). Of these, four had sustained previous self-inflicted burns. Length of hospital stay was significantly longer in the self-inflicted burn group than in the control group (49.0±16.7 days, respectively, p=0.002). Conclusion: Attempted suicide by self-inflicted burns represents <1% of burn admissions. This population demonstrates a high incidence of prior psychiatric disorders. Successful treatment includes multidisciplinary management of acute medical, surgical, and psychiatric care.

scholarly journals A rare case of failed healing in previously burned skin after a secondary burns

2017 ◽  
Vol 5 ◽  
Author(s):  
Stephen J. Goldie ◽  
Shaun Parsons ◽  
Hana Menezes ◽  
Andrew Ives ◽  
Heather Cleland
Keyword(s):  
Surface Area ◽  
Rare Case ◽  
Unusual Case ◽  
Surgical Intervention ◽  
Early Stage ◽  
Total Body Surface Area ◽  
Case Presentation ◽  
Burned Skin ◽  
Aggressive Management ◽  
Total Body

Abstract Background Patients presenting with large surface area burns are common in our practice; however, patients with a secondary large burn on pre-existing burn scars and grafts are rare and not reported. Case presentation We report on an unusual case of a patient sustaining a secondary large burn to areas previously injured by a burn from a different mechanism. We discuss the potential implications when managing a case like this and suggest potential biological reasons why the skin may behave differently. Our patient was a 33-year-old man who presented with a 5% TBSA burn on skin scarred by a previous 40% total body surface area (TBSA) burn and skin grafts. Initially assessed as superficial partial thickness in depth, the wounds were treated conservatively with dressings; however, they failed to heal and became infected requiring surgical management. Conclusions Burns sustained in areas of previous burn scars and grafts may behave differently to normal patterns of healing, requiring more aggressive management and surgical intervention at an early stage.

scholarly journals The impact of COVID-19 on adult burn management in the UK: a regional centre experience

2021 ◽  
Author(s):  
Parvathi Varma ◽  
Diana Kazzazi ◽  
Mohammad Umair Anwar ◽  
Preetha Muthayya
Keyword(s):  
Surface Area ◽  
Body Surface Area ◽  
Healthcare System ◽  
Body Surface ◽  
Total Body Surface Area ◽  
Inpatient Stay ◽  
The Mean ◽  
Total Body ◽  
The Uk ◽  
The Impact

Abstract In this study, the authors aim to quantify the impact of COVID-19 on burns provision at an adult regional burn centre. Two cohorts of patients were identified for comparison: one during the beginning of the COVID-19 lockdown in April 2020 and a comparator cohort in April 2019. There was a 30% decrease in the incidence of adult burns in 2020. The mean total body surface area (TBSA) was 1.8% and 4.3% in 2019 and 2020, respectively. Scald injuries were the commonest mechanism of burns in both cohorts. Depth of burns were deeper in 2019, with 17.6% of patients presenting with deep burns, compared with 9.6% in 2020. 8% of patients in 2019 required theatre compared with zero patients in 2020. A similar percentage of patients were admitted in both cohorts. In 2019, admitted patients had an average inpatient stay of 0.57 days per TBSA. In 2020, the average stay per TBSA in all patients was 0.6 days and 1.5 days in survivors. In the lockdown period, 54% of patients were followed up by telemedicine. This difficult period has taught us how important a functioning healthcare system is and how we can be better prepared in the future.

scholarly journals Retrospective review of a tertiary adult burn centre’s experience with modified Meek grafting

2016 ◽  
Vol 4 ◽  
pp. 1-7 ◽  
Author(s):  
Namal Munasinghe ◽  
Jason Wasiak ◽  
Andrew Ives ◽  
Heather Cleland ◽  
Cheng Hean Lo
Keyword(s):  
Total Body Surface Area ◽  
Skin Grafting ◽  
Patient Records ◽  
Tertiary Referral ◽  
Patient Demographics ◽  
Grafting Technique ◽  
Split Skin Grafting ◽  
Total Body ◽  
Split Skin ◽  
Rate Requirement

Abstract Background Autologous split skin grafting is the gold standard in treating patients with massive burns. However, the limited availability of donor sites remains a problem. The aim of this study is to present our experience with the modified Meek technique of grafting, outcomes achieved and recommendations for optimized outcomes. Methods We retrospectively reviewed patient records from our tertiary referral burn centre and the Bi-National Burns Registry to identify all patients who had modified Meek grafting between 2010 and 2013. Patient records were reviewed individually and information regarding patient demographics, mechanism of injury and surgical management was recorded. Outcome measures including graft take rate, requirement for further surgery and complications were also recorded. Results Eleven patients had modified Meek grafting procedures. The average age of patients was 46 years old (range 23 – 64). The average total body surface area (TBSA) burnt was 56.75 % (range 20–80 %). On average, 87 % of the grafted areas healed well and did not require regrafting. In the regrafted areas, infection was the leading cause of graft failure. Conclusions Modified Meek grafting is a useful method of skin expansion. Similar to any other grafting technique, infection needs to be sought and treated promptly. It is recommended for larger burns where donor sites are not adequate or where it is desirable to limit their extent.

The Epidemiology of Burn Injuries in Saudi Arabia: A Systematic Review

2020 ◽  
Vol 41 (5) ◽  
pp. 1122-1127
Author(s):  
Mohammed A Almarghoub ◽  
Ahmed S Alotaibi ◽  
Anas Alyamani ◽  
Faisal A Alfaqeeh ◽  
Faisal F Almehaid ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Public Awareness ◽  
Total Body Surface Area ◽  
Burn Injuries ◽  
Cochrane Library ◽  
Eligibility Criteria ◽  
Thermal Burn ◽  
Overall Ratio ◽  
Total Body ◽  
And Gender

Abstract Burns are potentially catastrophic injuries that disproportionately affect non-Western countries. We summarize results on the epidemiology of burn injuries in Saudi Arabia of all eligible papers through 2019, specifically evaluating the age and gender of patients, the location and mechanism of injury, burn size and severity, and outcomes. Between July 5 and July 10, 2019, a comprehensive literature review was performed on MEDLINE, EMBASE, Google Scholar, and the Cochrane Library. For this search, “Saudi Arabia,” coupled with the search terms “burn,” “thermal burn,” “flame burn,” “chemical burn,” “electrical burn,” and “contact burn” to identify all abstracts potentially relating to the topic of interest. Eleven studies, encompassing 3308 patients, met eligibility criteria. Younger children (variably defined as ≤10–12) accounted for 52% of all burns. Males outnumbered females by an overall ratio of 1.42:1. About 83% of burns occurred at homes. Scald injuries accounted for 62.4% of injuries, followed by flame-induced burns (28.7%), electrical burns (3.3%), and chemical burns (2.8%). Pertaining to burn extent and severity, 80% to 100% of the burns were limited to &lt;40% total body surface area, while roughly 60% were second-degree burns. Most patients remain in the hospital for 1 to 4 weeks. The overall mortality across studies including patients of all ages was 6.9%, while just 0.76% in the two studies restricted to pediatric patients. Scald injuries involving young children comprise the lion’s share of burn injuries in Saudi Arabia. Increased public awareness is necessary to reduce the incidence and severity of these potentially catastrophic injuries.

scholarly journals Interrater Agreement and Reliability of Burn Size Estimations between Emergency Physicians and Burn Unit

2020 ◽  
Author(s):  
Michael J Yoo ◽  
Alec J Pawlukiewicz ◽  
Jesse P Wray ◽  
Brit J Long ◽  
Curtis J Hunter
Keyword(s):  
Primary Endpoint ◽  
Intraclass Correlation ◽  
Total Body Surface Area ◽  
Burn Injuries ◽  
Secondary Endpoint ◽  
Interrater Agreement ◽  
Emergency Physicians ◽  
Burn Unit ◽  
Burn Units ◽  
Total Body

Abstract Objective The initial approach to burn injuries has remained essentially unchanged over the past several decades and revolves around trauma assessment and fluid resuscitation, frequently occurring in the emergency department (ED). While previous research suggests that emergency physicians (EP) are poor estimators at total body surface area (TBSA) affected, we believe that estimation differences are improving drastically. This study investigated the interrater agreement and reliability of burn size estimations at an academic ED and its cohabiting burn unit. Methods This single center, retrospective study was conducted at a trauma center with a cohabited burn unit. The study included adult patients admitted to the burn unit after receiving paired burn size estimations from EPs and the burn unit. The primary endpoint was the interrater agreement, measured by kappa (k), of 10% TBSA estimation intervals. The secondary endpoint was the intraclass correlation coefficient (ICC), evaluating the reliability of absolute TBSA estimations. Results A chart review was performed for patients evaluated from November 1, 2016 to July 31, 2019. 1,184 patients were admitted to the burn unit, 1,176 of which met inclusion criteria for the primary endpoint. The interrater agreement of TBSA between EPs and the burn unit was 0.586, while the weighted k was 0.775. These values correlate to moderate and substantial agreements, respectively. Additionally, 971 patients had specific TBSA estimations from paired EPs and the burn unit which were used for the secondary endpoint. The ICC between EPs and the burn unit was 0.966, demonstrating an excellent agreement. Further sub-analysis was performed, revealing absolute mean overestimation and underestimation differences of 3.93% and 2.93%, respectively. Conclusion EPs at academic institutions with cohabited burn units are accurate estimators of TBSA in the assessment of burn injuries.

scholarly journals Population screening for glaucoma in UK: current recommendations and future directions

Eye ◽  
2021 ◽  
Author(s):  
Sana Hamid ◽  
Parul Desai ◽  
Pirro Hysi ◽  
Jennifer M. Burr ◽  
Anthony P. Khawaja
Keyword(s):  
Screening Test ◽  
Vision Loss ◽  
Open Angle Glaucoma ◽  
Public Awareness ◽  
Population Based ◽  
Population Screening ◽  
Effective Population ◽  
Future Directions ◽  
The Future ◽  
The Uk

AbstractEffective population screening for glaucoma would enable earlier diagnosis and prevention of irreversible vision loss. The UK National Screening Committee (NSC) recently published a review that examined the viability, effectiveness and appropriateness of a population-based screening programme for primary open-angle glaucoma (POAG). In our article, we summarise the results of the review and discuss some future directions that may enable effective population screening for glaucoma in the future. Two key questions were addressed by the UK NSC review; is there a valid, accurate screening test for POAG, and does evidence exist that screening reduces morbidity from POAG compared with standard care. Six new studies were identified since the previous 2015 review. The review concluded that screening for glaucoma in adults is not recommended because there is no clear evidence for a sufficiently accurate screening test or for better outcomes with screening compared to current care. The next UK NSC review is due to be conducted in 2023. One challenge for POAG screening is that the relatively low disease prevalence results in too many false-positive referrals, even with an accurate test. In the future, targeted screening of a population subset with a higher prevalence of glaucoma may be effective. Recent developments in POAG polygenic risk prediction and deep learning image analysis offer potential avenues to identifying glaucoma-enriched sub-populations. Until such time, opportunistic case finding through General Ophthalmic Services remains the primary route for identification of glaucoma in the UK and greater public awareness of the service would be of benefit.

scholarly journals Treatment of Anaemia in Patients with Acute Burn Injury: A Study of Blood Transfusion Practices

2021 ◽  
Vol 10 (3) ◽  
pp. 476
Author(s):  
Ioana Tichil ◽  
Samara Rosenblum ◽  
Eldho Paul ◽  
Heather Cleland
Keyword(s):  
Blood Transfusion ◽  
Surgical Management ◽  
Burn Injury ◽  
Total Body Surface Area ◽  
Perioperative Period ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Burn Care ◽  
Transfusion Requirements ◽  
Total Body

Objective: To determine blood transfusion practices, risk factors, and outcomes associated with the use of blood products in the setting of the acute management of burn patients at the Victorian Adult Burn Service. Background: Patients with burn injuries have variable transfusion requirements, based on a multitude of factors. We reviewed all acute admissions to the Victorian Adult Burns Service (VABS) between 2011 and 2017: 1636 patients in total, of whom 948 had surgery and were the focus of our analysis. Method and results: Patient demographics, surgical management, transfusion details, and outcome parameters were collected and analyzed. A total of 175 patients out of the 948 who had surgery also had a blood transfusion, while 52% of transfusions occurred in the perioperative period. The median trigger haemoglobin in perioperative was 80mg/dL (IQR = 76–84.9 mg/dL), and in the non-perioperative setting was 77 mg/dL (IQR = 71.61–80.84 mg/dL). Age, gender, % total body surface area (TBSA) burn, number of surgeries, and intensive care unit and hospital length of stay were associated with transfusion. Conclusions: The use of blood transfusions is an essential component of the surgical management of major burns. As observed in our study, half of these transfusions are related to surgical procedures and may be influenced by the employment of blood conserving strategies. Furthermore, transfusion trigger levels in stable patients may be amenable to review and reduction. Risk adjusted analysis can support the implementation of blood transfusion as a useful quality indicator in burn care.

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