scholarly journals Epidemiology of Cracker (Fire Works) Injuries in a Tertiary Burn Care Centre

2016 ◽  
Vol 4 (1) ◽  
Author(s):  
B. Rajeswari ◽  
B. Shankari ◽  
Angeline Selvaraj
Keyword(s):  
Hand Function ◽  
Burn Injuries ◽  
Tissue Loss ◽  
Vulnerable Groups ◽  
Multiple Fractures ◽  
Burn Wounds ◽  
Burn Care ◽  
Number Of Patients ◽  
Function Loss ◽  
The Face

<div><p><em>Fireworks related burns are one of the causes of recurring incidences of burn injuries every year during festivals. Sporadic events are reported in family and communal celebrations / temple festivals and in funerals. These burns are different from other burns as the burn percentage is not the major burden,  but the increasing number of patients with cracker burn injuries with loss of hand function, loss of vision and at times blast injury of the face with major tissue loss and multiple fractures (shattered tissues), which are challenging for the reconstructive surgeon, are major concern. The vulnerable groups are innocent children who sustain injuries due to ignorance, negligence and lack of supervision. These fire cracker burn wounds are to be classified separately as the wounds are more like traumatic wounds than burn wounds. They are also associated with more morbidity than mortality.<sup>(1,2,3)</sup></em></p><p><em> The management of these wound is multidisciplinary, with involvement of various specialists like paediatricians, ophthalmologists, psychiatrists, orthopaedic surgeons and specialists in rehabilitative medicine along with plastic and reconstructive surgeons.Reconstruction of blast hand and face needs multiple surgeries and prolonged period of physiotherapy and rehabilitation. The effective and appropriate decision made in the acute phase is important to reduce their morbidity.<sup>(4)</sup></em></p></div>

CHALLENGES IN THE MANAGEMENT OF FIRE CRACKER BURNS OF HANDS IN A TERTIARY BURN CARE CENTER

2021 ◽  
pp. 67-69
Author(s):  
Dharmil Doshi ◽  
Angeline Selvaraj ◽  
S. Suja ◽  
K. Panchapakesan
Keyword(s):  
Care Center ◽  
Hand Function ◽  
Blast Injury ◽  
Burn Injuries ◽  
Tissue Loss ◽  
Multiple Fractures ◽  
Burn Wounds ◽  
Burn Care ◽  
Number Of Patients ◽  
The Face

Fireworks related burns are one of the causes of recurring incidences of burn injuries every year during festivals. Sporadic events are reported in family and communal celebrations / temple festivals and in funerals. These burns are different from other burns as the burn percentage is not the major burden, but the increasing number of patients with cracker burn injuries with loss of hand function, loss of vision and at times blast injury of the face with major tissue loss and multiple fractures (shattered tissues), which are challenging for the reconstructive surgeon, are major concern. These re cracker burn wounds are to be classied separately as the wounds are more like traumatic wounds than burn wounds. They are also associated with more morbidity than mortality. Upper limbs, mainly the hands are the most common site of injury in case of cracker burns. Blast injury while lighting crackers causes severe damage to the tissues, and along with the added contamination of the wound, makes repair and reconstruction of such limbs a herculean task. (1,2,3)

556 The Use of a Concentrated Surfactant Based Gel to Promote Burn Wound Healing

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S126-S127
Author(s):  
Rebecca Coffey ◽  
Rachel Penny
Keyword(s):  
Wound Healing ◽  
New Product ◽  
Ease Of Use ◽  
Burn Injuries ◽  
Full Thickness ◽  
Burn Wound ◽  
Burn Wounds ◽  
Burn Care ◽  
Product Trial ◽  
Burn Wound Healing

Abstract Introduction Strategies to remove necrotic tissue from burn wounds include excisional and non-excisional debridement. Alternative treatments could promote burn wound healing while minimizing patient discomfort and the need for surgery. We evaluated the usage of a concentrated surfactant gel (CSG) to promote burn wound healing in those with indeterminate depth and full thickness burn injuries. Methods An IRB approved retrospective study was conducted during a 10-patient new product trial period with enrollment between September and October 2019. Patients included in this study had indeterminate or full thickness burn wounds and were treated with a concentrated surfactant-based gel. Patients with non-burn diagnoses were excluded. Data collected included demographic information, injury descriptors, and additional burn wound characteristics. Results A total of 10 patients were included in this study as part of a new product trial. The subjects were 80% male with an average TBSA of 7.5%. 40% had indeterminate and 60% had full thickness burn wounds. Prior to initiation of the CSG, the burn wounds had been open for an average of 41 days. There were no infections or complications with usage of the CSG. 90% of patients reported less pain than the standard of care topical agents for burns. Average duration of treatment with the CSG until healing was 28 days. After usage of the CSG, no patients required surgery. Conclusions Our findings support the usage of a concentrated surfactant-based gel in patients with burn wounds. Patients reported decreased pain during dressing changes and ease of use compared to the standard topical agent in burn care. It also prevented surgical debridement in those with indeterminate and full thickness burn injuries.

scholarly journals Post-Traumatic Defects And Face Deformations: Features Of Diagnostics And Treatment

2021 ◽  
Vol 03 (01) ◽  
pp. 55-66
Author(s):  
Iftikhor Obidjonovich Nigmatov ◽  
◽  
Shukhrat Abdujalilovich Boymuradov ◽  
Jamolbek Abdukakhkhorovich Djuraev ◽  
Yusupov Shokhrukh Shukhratovich ◽  
...  
Keyword(s):  
Traffic Accidents ◽  
Soft Tissues ◽  
Road Traffic ◽  
Craniocerebral Trauma ◽  
High Growth ◽  
Facial Skeleton ◽  
Multiple Fractures ◽  
Number Of Patients ◽  
The Face ◽  
Post Traumatic

The high growth of injuries, the absence in the country of a unified approach to the treatment of victims with pathology of the bones of the face and skull leads to a sharp increase in the number of patients with post-traumatic deformities, defects, often to their disability and death. This problem has recently acquired the greatest importance in connection with the increase in the number of victims in areas of natural disasters and road traffic accidents. Severe multiple fractures of the bones of the middle zone of the facial skeleton, accompanied by craniocerebral trauma of varying degrees, bleeding and liquorrhea, are often outwardly unnoticeable, since they are hidden by pronounced edema, hemorrhages in soft tissues, and can only be determined with a targeted specialized examination. These types of examinations and the provision of specialized medical care are possible only in multidisciplinary centers. Therefore, these types of injuries are not always diagnosed in a timely manner, especially in severely injured with the presence of pronounced injuries of other localizations.

811 Comparison of an Enzymatic Debrider with Antibiotic Ointment in the Outpatient Care of Minor Partial Thickness Burns

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S244-S245
Author(s):  
Suzanne Mitchell ◽  
Dhaval Bhavsar ◽  
Jessica Reynolds ◽  
Jessica Jones ◽  
Julia M Pena
Keyword(s):  
Wound Closure ◽  
Statistical Significance ◽  
Burn Injuries ◽  
Topical Antibiotic ◽  
Burn Wounds ◽  
Burn Care ◽  
Partial Thickness ◽  
Partial Thickness Burn ◽  
Partial Thickness Burns ◽  
Antibiotic Ointment

Abstract Introduction In the U.S. about 450,000 people per year receive medical burn care through hospital emergency departments, hospital outpatient clinics, free-standing urgent care centers and private physician offices. Burns are generally classified in terms of depth and severity. Outpatient management of partial thickness burns normally involves the application of an ointment, which may contain an antibiotic and is widely used in burn care. This clinical study has been designed to prospectively evaluate potential benefits of an enzymatic debrider in partial thickness burn wounds compared to antibiotic only treatment. The primary purpose of this study is to compare an enzymatic debrider with a topical antibiotic ointment in the proportion healed at 3 weeks after initiation of treatment, and time to healing (in weeks). Methods A convenience sample of 20 subjects, aged 19–56, with an acute thermal burn injury less than 72 hours old, and less than 10% TBSA were randomly assigned to outpatient treatment with an enzymatic debrider or a topical antibiotic. The proportion of subjects healed after 3 weeks of treatment was analyzed using ANOVA. In addition, a t-test comparison between the enzymatic debrider and the topical antibiotic was performed. Results For partial thickness burns, the mean time to heal using an enzymatic debrider was 18 days compared to 28 days for the topical antibiotic. However, there was no statistical significance in burn wound closure between subjects receiving an enzymatic debrider compared to a topical antibiotic, t (13) = .677; p = .510. An analysis of variance comparing an enzymatic debrider and a topical antibiotic also showed no statistical significance in time to heal (F=.849, p=374). Conclusions Due to the small sample size, the results from this study do not support the use of an enzymatic debrider versus a topical antibiotic in treating partial thickness burn injuries to advance wound closure or shorten time to heal. The results of this study show clinical significance, with burn wounds healed in 18 days when an enzymatic debrider was used compared to 28 days when a topical antibiotic was used. The lack of statistical significance was due to an under-powered study. Furthermore, partial thickness burns should spontaneously heal within 7–14 days, regardless of the topical treatment, excluding concomitant co-morbidities. Applicability of Research to Practice Continued research is necessary, employing larger sample sizes to adequately compare the use of an enzymatic debrider compared to topical antibiotics in deep partial thickness burn wounds. In addition, outpatient management of deep thickness and full-thickness burn injuries, utilizing sharp debridement in conjunction with enzymatic debridement, in patients who decline surgical treatment of burn wounds should be explored, analyzing time to heal, scar evaluation, and cost analysis,

Integration of CAD/CAE/RP Environment for Developing a New Product in Medical Field

2020 ◽  
Vol 38 (9A) ◽  
pp. 1276-1282
Author(s):  
Nabeel I. Allawy ◽  
Amjad B. Abdulghafour
Keyword(s):  
Maxillofacial Surgery ◽  
Essential Element ◽  
Severe Trauma ◽  
Simulation Software ◽  
Oral And Maxillofacial Surgery ◽  
Virtual Surgery ◽  
Multiple Fractures ◽  
Engineering Programs ◽  
Mesh Model ◽  
The Face

Reconstruction of the mandible after severe trauma is one of the most difficult challenges facing oral and maxillofacial surgery. The mandible is an essential element in the appearance of the human face that gives the distinctive shape of the face, holds. This paper aims to propose a methodology that allows the surgeon to perform virtual surgery by investing engineering programs to place the implant by default and with high accuracy within the mandible based on the patient's medical data. The current study involved a 35-year-old man suffering from a traffic accident in the mandible with multiple fractures of the facial bones. Basically, an identification of the steps required to perform virtual surgery and modeling images from the CBCT technology has been done by using the software proposed in the research. The implant model is designed as a mesh model, allowing the patient to return to a normal position. Moreover, an application of FEA procedures using the Solidworks simulation software to test and verify the mechanical properties of the final transplant.

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.

82 The Significant Burden of Burn Injuries in the Middle East: An Epidemiological Study of Nineteen Countries over 27 Years

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S56-S57
Author(s):  
Zachary J Collier ◽  
Yasmina Samaha ◽  
Priyanka Naidu ◽  
Katherine J Choi ◽  
Christopher H Pham ◽  
...  
Keyword(s):  
Middle East ◽  
Age Groups ◽  
Mortality Rates ◽  
Burn Injuries ◽  
Burn Care ◽  
Life Years ◽  
Significant Burden ◽  
Mortality Ratio ◽  
Incident Cases ◽  
Age And Sex

Abstract Introduction Despite ongoing improvements in burn care around the world, the burden of burn morbidity and mortality has remined a significant challenge in the Middle East due to ongoing conflicts, economic crises, social disparities, and dangerous living conditions. Here, we examine the epidemiology of burn injuries in the Middle East (ME) relative to socio-demographic index (SDI), age, and sex in order to better define regional hotspots that may benefit most from sustainability and capacity building initiatives. Methods Computational modeling from the 2017 Global Burden of Disease (GBD17) database was used to extrapolate burn data about the nineteen countries that define the ME. Using the GBD17, the yearly incidence, deaths, and Disability-Adjusted Life Years (DALYs) from 1990 to 2017 were defined with respect to age and sex as rates of cases, deaths, and years per 100,000 persons, respectively. Mortality ratio represents the percentage of deaths relative to incident cases. Data from 2017 was spatially mapped using heat-mapping for the region. Results Over 27 years in the ME, an estimated 18,289,496 burns and 308,361 deaths occurred causing 24.5 million DALYs. Burn incidence decreased by 5% globally but only 1% in the ME. Although global incidence continued to decline, most ME countries exhibit steady increases since 2004. Compared to global averages, higher mortality rates (2.8% vs 2.0%) and DALYs (205 vs 152 years) were observed in the Middle East during this time although the respective disparities narrowed by 95% and 42% by 2017. Yemen had the worst death and DALY rates all 27 years with 2 and 2.2 times the ME average, respectively. Sudan had the highest morality ratio (3.7%) for most of the study, twice the ME average (1.8%), followed by Yemen at 3.6%. Sex-specific incidence, deaths, and DALYs in the ME were higher compared to the global cohorts. ME women had the worst rates in all categories. With respect to age, all rates were worse in the ME age groups except in those under 5 years. Conclusions For almost three decades, ME burn incidence, deaths, DALYs, and mortality rates were consistently worse than global average. Despite the already significant differences for burn frequency and severity, especially in women and children, underreporting from countries who lack sufficient registry capabilities likely means that the rates are even worse than predicted.

scholarly journals Are telephone consultations here to stay in rheumatology?

2020 ◽  
Author(s):  
Sabrina R Raizada ◽  
Natasha Cleaton ◽  
James Bateman ◽  
Diarmuid M Mulherin ◽  
Nick Barkham
Keyword(s):  
Older Patients ◽  
Online Survey ◽  
Vulnerable Groups ◽  
Age Group ◽  
Telephone Consultation ◽  
Survey Tool ◽  
Face To Face ◽  
Vulnerable Patients ◽  
Number Of Patients

Abstract Objectives During the COVID-19 pandemic, face-to-face rheumatology follow-up appointments were mostly replaced with telephone or virtual consultations in order to protect vulnerable patients. We aimed to investigate the perspectives of rheumatology patients on the use of telephone consultations compared with the traditional face-to-face consultation. Methods We carried out a retrospective survey of all rheumatology follow-up patients at the Royal Wolverhampton Trust who had received a telephone consultation from a rheumatology consultant during a 4-week period via an online survey tool. Results Surveys were distributed to 1213 patients, of whom 336 (27.7%) responded, and 306 (91.1%) patients completed all components of the survey. Overall, an equal number of patients would prefer telephone clinics or face-to-face consultations for their next routine appointment. When divided by age group, the majority who preferred the telephone clinics were &lt;50 years old [χ2 (d.f. = 3) = 10.075, P = 0.018]. Prevalence of a smartphone was higher among younger patients (&lt;50 years old: 46 of 47, 97.9%) than among older patients (≥50 years old: 209 of 259, 80.7%) [χ2 (d.f. = 3) = 20.919, P &lt; 0.001]. More patients reported that they would prefer a telephone call for urgent advice (168, 54.9%). Conclusion Most patients interviewed were happy with their routine face-to-face appointment being switched to a telephone consultation. Of those interviewed, patients &gt;50 years old were less likely than their younger counterparts to want telephone consultations in place of face-to-face appointments. Most patients in our study would prefer a telephone consultation for urgent advice. We must ensure that older patients and those in vulnerable groups who value in-person contact are not excluded. Telephone clinics in some form are here to stay in rheumatology for the foreseeable future.

HYPERPIGMENTED BURN INJURIES OF THE FACE: TREATMENT WITH THE Q-SWITCHED RUBY LASER

1997 ◽  
Vol 99 (1) ◽  
pp. 265-266 ◽  
Author(s):  
Christian Raulin ◽  
Stefanie Hellwig ◽  
Matthias P. Schönermark
Keyword(s):  
Ruby Laser ◽  
Burn Injuries ◽  
The Face

scholarly journals 47 COVID-19 Impact on Burn Care- A Summary of Weekly Bed Counts and Surge Capacity

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S35-S35
Author(s):  
Jeffrey E Carter ◽  
Herbert Phelan ◽  
Colleen M Ryan ◽  
James C Jeng ◽  
Kathryn Mai ◽  
...  
Keyword(s):  
Substantial Reduction ◽  
Surge Capacity ◽  
Burn Centers ◽  
Resource Limitations ◽  
Burn Care ◽  
Regional Trends ◽  
Number Of Patients ◽  
Bed Capacity ◽  
Initial Survey ◽  
The Impact

Abstract Introduction The COVID-19 pandemic has raised global awareness of healthcare resource limitations. Specifically, the pandemic has demonstrated that burn disaster planning should involve non-burn disasters that threaten staff, supplies, or space. The ABA facilitated bed counts with the assistance of regional disaster coordinators from April through August of 2020. Our analysis examines the impact of the pandemic on burn surge and bed capacity in the U.S. Methods Bed availability was obtained by the ABA regional disaster coordinators through an initiative by the Organization and Delivery of Burn Care Committee. Bed availability was defined as immediately available burn beds and categorized as adult, pediatric, or flexible. Surge capacity was defined as the maximum number of patients that a burn center could admit in a surge situation. Data was deidentified by the central office with descriptive statistics to determine bed availability and surge capacity trends regionally and nationally. Results Bed counts were performed 6 times from 04/17/2020 through 08/14/2020. Response rates from the 137 North American burn centers varied from 86–96%. At least 6 burn centers (5%) were either closed or converted for COVID patients during the initial two bed counts. The total number of adult or pediatric burn beds was 2,082. Total bed availability decreased from 845 at the first survey down to 572 beds at the last survey. Surge capacity baseline was 1,668 beds and decreased from 1,132 beds in the initial survey down to 833 beds in the final survey. Conclusions Our study demonstrates a significant impact on burn bed availability due to the COVID-19 pandemic with a 37% reduction in available burn beds from April to August and a 26% reduction in surge capacity. This study demonstrates a substantial reduction in bed availability during the pandemic with additional analysis in process to examine regional trends.

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