scholarly journals Burns Management In Tertiary Health Care Centre

2021 ◽  
Vol 12 (1) ◽  
pp. 544-550
Author(s):  
Ajitsingh .P. Chadha ◽  
Nehadeepkaur A Chadha ◽  
Kshirsagar A Y
Keyword(s):  
Health Care ◽  
Skin Grafting ◽  
Cost Effective ◽  
Surgical Excision ◽  
Burn Wound ◽  
Health Care Centre ◽  
Burn Scar ◽  
Wound Excision ◽  
Contracture Formation ◽  
Rural Places

In rural places of our country, burns have become frequent accidents due to the use of floor-based stoves & kerosene lamps. Suicides due to burns are also quite usual in our country. The objective of this study is to evaluate the necessity of early excision of the burn wound and skin grafting to decrease the morbidity, mortality, complications of burns and stay at the hospital. Calculate pressure garment efficacy in preventing burn scar and contracture formation. To lay out cost-effective management for patients at rural hospitals. 50 patients were included in this study presenting with burn injuries, admitted in the department of plastic surgery from June 2019 to December 2020. In a recent study, Females (52%) suffered more as compared to males. Scalds were the prime root cause of the burns constituting the 52% of the cases. Infections of Burn wound was seen in 20 patients (40%). Pseudomonas was prime organism isolated. Wound excision was required in 19 patients (38%). Around 6 to 12 days, elapsed between the injury to the surgical excision. 19 patients required (38%) covering of wound permanently with STSG. The mean admission period in hospital for burns of 41-60% was 62 days, 33.4 days for 21-40% burns and 19.6 days for <20%. Amongst 50 patients, 3 died accounting to 6% of overall cases. This study concluded that initiation of resuscitation with untimely wound excision and permanent coverage with grafting can bring significant fall in mortality, painful debridements, limiting complications, decreasing the duration of stay at a hospital, curtailing the cost of health care and time apart from work.

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 Pattern of admission and clinical outcome of patients admitted in pediatric intensive care unit of a rural tertiary health care centre

2021 ◽  
Vol 8 (5) ◽  
pp. 849
Author(s):  
Vivek Parasher ◽  
Sachin Shaha ◽  
Rahul Khatri ◽  
Samarth Yadav ◽  
Sayan Das ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Clinical Outcome ◽  
Critically Ill ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Cost Effective ◽  
Critically Ill Children ◽  
Health Care Centre

Background: In the treatment of critically ill children needing specialized airway, respiratory, and hemodynamic assistance, intensive care has become very necessary and is typically admitted into the pediatric intensive care unit (PICU) in order to ensure a better result than if the patients were admitted to other sections of the hospital. To audit admissions and their findings are significant, which may help to change procedures after extensive introspection if appropriate, leading to improved patient outcomes. Objective were to examine pattern of admission and clinical outcome of patients admitted in the pediatric intensive care unit of a rural tertiary health care centre.Methods: Information retrieved included age, sex, diagnosis, outcome, morbidity and mortality profile of patients admitted in PICU in the last five years.Results: A total of 2810 patients were admitted into PICU. (1444) 51.3% were infants, and (1366) 48.6% patients aged 1-18 years. Their ages ranged from one month to 18 years, with the mean age being 40.01 ± 45.79 months. There were 1948 (69.3%) male and 862 (30.3%) female patients giving an M: F ratio of 2.27:1. The overall mortality rate was 2.4%.Conclusions: In our PICU, mortality is low. We believe that the treatment of critically ill patients with desirable results is significantly facilitated by a well-equipped intensive care unit with advanced and creative intensive care in order to improve cost-effective patient care and prevent needless stretching of the PICU services, an extension of the pediatric wards is advocated.

scholarly journals Prevalence of the aerobic infections among cases of skin grafting in a tertiary health care centre

2019 ◽  
Vol 6 (2) ◽  
pp. 101-105
Author(s):  
Vedavati B.I ◽  
◽  
Mallikarjun Koppad ◽  
Halesh LH ◽  
Vijay A ◽  
...  
Keyword(s):  
Health Care ◽  
Skin Grafting ◽  
Care Centre ◽  
Health Care Centre

scholarly journals A study of collagen dressing versus conventional dressings in burns at tertiary health care centre

2020 ◽  
Vol 7 (4) ◽  
pp. 1061
Author(s):  
Paritoshsingh B. Thakur ◽  
T. Ramachandrudu ◽  
Anant Arunrao Takalkar
Keyword(s):  
Health Care ◽  
Wound Healing ◽  
Treatment Group ◽  
Burn Injury ◽  
Cross Sectional Study ◽  
Complete Healing ◽  
Burn Wound ◽  
Health Care Centre ◽  
Cross Sectional ◽  
Time Required

Background: Worldwide, burn injury is a problem and cause intense pain, biological dressings like collagen as it forms physiological interface prevents infection effective for burn wound healing. The objective of the study was to study of collagen dressing versus conventional dressings in burns at tertiary health care centre.Methods: This was a cross sectional study carried out in the Department of Surgery during September 2018 to September 2019. Out of 50 patients, 25 were enrolled to collagen treatment group (group A) and remaining into conventional treatment group i.e. (group B). The statistical analysis was done by unpaired t-test and chi-square test.Results: Average less time required for granulation tissue to appear p<0.001, df=48, t=4.56); average less time requires for sterile wound swab culture (weeks) (p<0.05, df=48, t=3.45); less discomfort score (0-10) (p<0.001, df=48, t=6.78); less dressing removal pain score (0-10) (p<0.0001, df=48, t=9.87); less average time required for complete healing (days ) (p<0.001, df=48, t=7.79).Conclusions: It can be concluded that collagen dressings were superior to conventional dressing in wound healing of burns.

Biodegradable Temporizing Matrix reconstruction of complex perineal burn wound: A Case Report

2021 ◽  
Author(s):  
Elizabeth Concannon ◽  
Patrick Coghlan ◽  
Lindsay DamKat Thomas ◽  
Nicholas S Solanki ◽  
John E Greenwood
Keyword(s):  
Case Report ◽  
Burn Wound ◽  
Complex Anatomy ◽  
Matrix Reconstruction ◽  
Thickness Skin ◽  
Wound Excision ◽  
Microbial Environment ◽  
Contracture Formation ◽  
Perineal Wounds ◽  
And Function

Abstract This case report details our experience using two-stage Biodegradable Temporizing Matrix (NovoSorb® PolyNovo Ltd) and autograft for acute reconstruction of a complex perineal burn wound in an elderly co-morbid patient. A 77-year old man sustained 42% full thickness burns extending circumferentially from bilateral thighs and buttocks, across the entire perineal and genital regions up to his mid-trunk, following self-immolation using an accelerant. Early total burn wound excision was carried out with acute application of Biodegradable Temporizing Matrix to all affected sites. Excellent integration and vascularisation of Biodegradable Temporizing Matrix took place despite the challenge of intermittent faecal contamination affecting the perineal and buttock burn sites and matrix colonisation with multi-drug resistant organisms. Delamination and serial split thickness skin autografting was carried out 42 days after first matrix application with complete and robust graft take. Perineal burns present a reconstructive challenge due to the proximity of specialised structures such as the genitalia, urethral and anal orifices. Restoration of complex anatomy and function may be required after debridement with increased risks of infection, contracture formation and mortality compared with burns affecting other anatomical sites.Two-stage Biodegradable Temporizing Matrix represents a reliable reconstruction option for complex extensive perineal wounds in frail elderly patients, despite an unfavourable local microbial environment.

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