scholarly journals The Effect of Early Tangential Excision and Split Thickness Skin Graft in Reducing Length of Stay in Burns Patients in Jakarta Islamic Hospital Cempaka Putih

2021 ◽  
Vol 8 (1) ◽  
pp. 15-20
Author(s):  
Gammaditya Adhibarata Winarno ◽  
Aditya Wardhana ◽  
Sanjaya Faisal Tanjunga ◽  
A. S Augiani ◽  
An’umillah Arini Zidna

Introduction: Early tangential excision (TE) and split-thickness skin graft (STSG) have increased the outcome in burn patients treated at specialized burn centers. This study was conducted to compare the length of stay (LOS) in burn patients undergoing early TE & STSG and delayed TE & STSG. Method: This is a retrospective cross-sectional study including 42 patients with varied burn degrees, and TBSA admitted to Jakarta Islamic Hospital Cempaka Putih (JIHCP) Burn Unit. Patients were assigned to two study groups, the early TE & STSG group including 32 patients and the delayed TE & STSG group including 10 patients. All data were collected from the medical record and compared between two study groups. Result: The mean of LOS in a group with early TE & STSG was shorter (9.81±6.41 days) than LOS in the delayed TE & STSG group (15.80±5.67 days). The data of LOS between these groups were compared using an independent T-test. The LOS in the early TE & STSG group was significantly shorter than the delayed TE & STSG group (p=0.012). Conclusion: In patients with burn injuries, early TE & STSG is associated with a shorter length of stay than the delayed TE & STSG. Our study indicates that early excision within five days after burn injury is optimal to reduce the length of stay in burn patients.

2021 ◽  
Vol 57 (2) ◽  
pp. 166
Author(s):  
Lynda Hariani ◽  
Agus Santoso Budi ◽  
Ephora Christina Wulandari

The rate of failed skin graft in Dr. Soetomo General Academic Hospital Surabaya was around 26% of the cases, and it became a concern because skin graft was the main procedure to close large burn wounds. Many problems might affect this event; one of them was electrolyte imbalance. Hypernatremia was found in major burn patients. This condition disrupted the wound healing process of skin graft. This cross-sectional study evaluated patients with burns admitted to the Burn Centre of Dr. Soetomo Hospital between January 2014 and December 2018. 143 subjects participated in this study. Hypernatremia was found in 16% of all subjects (23 subjects), 19% with hypernatremia (28 subjects), and the majority of it, 65% with normonatremia (92 subjects). This study found that the risk of failed skin graft was higher on hypernatremia than normonatremia subjects. This risk was higher if the skin graft procedure took more than 10%.


2011 ◽  
Vol 32 (1) ◽  
pp. 129-134 ◽  
Author(s):  
Ryan T.M. Mitchell ◽  
Duane Funk ◽  
Rae Spiwak ◽  
Sarvesh Logsetty

2015 ◽  
Vol 3 ◽  
pp. 1-7 ◽  
Author(s):  
Mary Adjepong ◽  
Pius Agbenorku ◽  
Patricia Brown ◽  
Ibok Oduro

Abstract Background Burn injury results in emotional stress affecting dietary intake and antioxidant micronutrient intake, which is known to have effects on recovery outcomes. The study aimed to assess dietary intake of antioxidant micronutrients and recovery outcomes of burn patients. Methods Questionnaires were administered to 40 burn patients at Komfo Anokye Teaching Hospital (Ghana) from January 1, 2014 to May 30, 2014. The data taken include anthropometric measurements and dietary assessment. Their nutrient intakes were assessed with the Nutrient Analysis Template. The average intakes were compared to the recommended daily allowance. Assessment of recovery was based on records of wound healing assessments and infection rates from the health practitioners. Results A cross-sectional study of 40 patients revealed an average total burn surface area (TBSA) of 31.4 %, where 70.0, 35.0, 75.0, 52.5, 12.5 and 32.5 % patients were deficient in vitamins A, C and E, zinc, copper and selenium, respectively and adequate amounts of vitamin C intake were related with significantly better wound healing progress. Positive wound healing outcomes were observed for patients with adequate vitamins A and E and zinc intake. Less infection presented among patients with adequate amount of vitamins A and C and zinc, but this was not observed for patients with adequate vitamin E, copper and selenium. Conclusions Most burn patients did not meet their dietary requirements for antioxidant micronutrients and this was due to meals not tailored to suit individual requirements. Adequacy of the antioxidants especially vitamin C resulted in positive wound healing outcomes. Hence, there is need for planned well-balanced meals of high vitamin C.


2019 ◽  
Vol 40 (6) ◽  
pp. 763-768
Author(s):  
Xuekang Yang ◽  
Zhuoqun Fang ◽  
Mengdong Liu ◽  
Yue Zhang ◽  
Qiaohua Chen ◽  
...  

Abstract We aimed to introduce a technique by combining free fascia flaps transfer with split-thickness skin graft for the reconstruction of deep burn wounds at the ankle. Fifteen patients from 2009 to 2016 were enrolled in this study. Patients in this series suffered from a deep burn injury around the ankle, which was accompanied with exposure of tendon and medial or lateral malleolus exposure due to severe soft-tissue defects (N = 15). All the 15 wounds were repaired combining free fascia flaps with split-thickness skin graft operations, including nine anterolateral thigh fascia lata flaps (ATFL flaps) and six superficial temporal fascia flaps (STF flaps). All the fascia flaps completely survived. Two patients showed partial grafting skin necrosis due to either wound infection or subcutaneous hematoma infection, and this was eventually healed satisfactorily after conventional dressing change. All patients achieved esthetic outcome and acceptable functionality without further revisions needed. Our present study reports a useful method that involves using free fascia flaps in combination with split-thickness skin graft to repair deep burn wounds around the ankle. This method provided reliable and durable soft-tissue coverage with good outcomes.


Author(s):  
Mina Senada ◽  
Sameh Abd El Rahman ◽  
Mohamed Saleh ◽  
Ghada Hamam ◽  
Niveen Al - Mahmoudy

2020 ◽  
Vol 6 (1) ◽  
pp. 234-242
Author(s):  
Aditya Wardhana ◽  
Gammaditya Adhibarata Winarno

Background : Burns is a significant cause of morbidity and mortality worldwide. Particularly in low- and middle-income countries (LMICs), burns account for an estimated 180.000 deaths every year. Burn-related mortality rates are exceptionally high in South-East Asia (11.6 deaths per 100 000 population per year) compare with much lower rates of 1.0 deaths per 100.000 people per year in high-income countries. This study aims to investigate the demographic data, etiology, and outcome of the patients treated in burn unit Ciptomangunkusumo Hospital, Jakarta, Indonesia. Method: This is a retrospective cross-sectional study, collecting epidemiologic data from the medical record through Electronic Health Record. A total of 709 patients admitted to burn unit between 2013-2017 were reviewed based on age, sex, total burn surface area (TBSA), burn grade, inhalation injury, etiology, length of stay, outcome, and payment method. Inclusion criteria are patients that were admitted to burn unit of Ciptomangunkusumo Hospital between 2013-2017, while there are no exclusion criteria in this study. Result : Admission of patients between 2013-2017 has inclined throughout the year, from 97 in 2013 to 166 in 2017. Average patient admission per year, reaching 141,8±26,761. Jakarta, and its suburb Bogor, Depok, Tangerang, and Bekasi, has dominated the proportion of referring hospital with 538(75.9%) The most amount of payment method is NHI (JKN/BPJS) with 534(75.3%) population. A total of 465 were male, and 244 were female, with a ratio of 1.9:1. The highest incidence in terms of age group is 16-35 years old (269, with the average age of patients, is 29±19. The highest incidence of burn injury is caused by a stove gas explosion with 253(35.7%), followed by flame 189(26.7%). There are 63 out of 709 patients with inhalation injury, where the incidence rate is 8.9%. Patients admitted to the Ciptomangunkusumo burn unit has an average length of stay of 15 days hospitalization. The most frequent population of extent, staying >14 days is 21-30% TBSA (88). The mortality rate in the Ciptomangunkusumo burn unit is 25.8% (183), with the highest number of death came from TBSA >40% (136). Conclusion: A total of 709 patients were admitted to the Ciptomangunkusumo burn unit in Jakarta, Indonesia, over 5 years, with an average of 141 patients per year and an increase of 171% from 2013 to 2017. Most patients were diagnosed with >40% TBSA and 2nd-3rd grade burn injury. An average of 15 days of hospitalization for patients leading up to 25.8% mortality rate, they are with septic shock as the most common condition causing death in the burn unit.


2017 ◽  
Vol 3 (2) ◽  
pp. 40-44
Author(s):  
Setiagung Ambari Bowo ◽  
Hardisiswo Soedjana

Background: Sepsis is an important cause of mortality in patients with burn, although many factors influence it. Early excision debridement as source control treatment has been done routinely in our center. It was intended to prevent sepsis and decrease mortality rate. Methods: We performed a retrospective, cross sectional study over 4 years (2012-2014) among patients with flame burns in Burn Unit Dr. Hasan Sadikin Hospital who underwent early excisional debridement. The criteria of patients were adult, with full thickness burn, without inhalation injury and co morbid disease. The mortality, length of stay, and incidence of sepsis were analyzed by simple regression linier statistics using SPSS 16.0 for Windows. Results: Mortality rate of all patients was 43.3%, and 42.3% was directly caused by sepsis. Thirty-nine patients matched the criteria, 20 patients had early excision (< 3 days) and 19 patients had late excision (> 3 days). In early excision group, 75% got sepsis and 55% died. Mortality and incidence of sepsis wasn’t significantly different in both groups (p=0.252 and p=0.855). Both groups have same length of stay (mean : 13.1 and p=0.236).  Sex as confounding factor wasn’t significantly different (p=0.774). The extent of TBSA and age were significant factors causing mortality rate (p < 0.05). Conclusion: There are many factors that contribute to the success of treating burn patient. Excision debridement was proven by this study not a major factor and ineffective to decrease sepsis and mortality in burned patients.


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