Burns in a Suburban Teaching Hospital: A Retrospective Record Review in Kanchipuram, India

Background: Burn injuries rank among the most severe type of injury with high morbidity and mortality worldwide. Burn injuries not only affect patients physical health but also affects their social and psychological well being along with severe economic loss to the individual, their family and to the society. About 90% burn injuries are preventable, but poor adherence of safety measures and awareness leads to disability and disfigurement throughout their life. Hence, the need for various demographic variables to understand the cause and pattern in our region are required. Objectives: To describe the demographic and socio-cultural aspects of burn patients and to learn the cause of burn victims in our region. Materials and Methods: A record based retrospective study was conducted at Saveetha Medical College and Hospital, Thandalam, Kanchipuram district. The medical records of all patients over a period of 4 years (January 2017 to December 2020) were reviewed. Data were recorded on a pre-structured and pretested questionnaire. Chi-square test was done to study association between socio-demographic variables and burn injury and (p<0.05) was considered statistically significant. Results: A total of 208 burn cases were involved in this study out of which 56.7% were females and 43.3% were males. Most of the burn patients were 31-45 years and lived in rural areas. The majority of burn injuries were accidental; thermal burns was the most common cause of deep burns. Conclusion: Socio-demographic factors are important in raising educational programs and awareness in rural areas for improving quality of life.

Download Full-text

53 Frailty is Not Only a Phenomenon of Elderly Burn Patients

Journal of Burn Care & Research ◽

10.1093/jbcr/irab032.057 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

pp. S38-S39

Author(s):

Kathleen S Romanowski ◽

Melissa J Grigsby ◽

Soman Sen ◽

Tina L Palmieri ◽

David G Greenhalgh

Keyword(s):

Chart Review ◽

Burn Injury ◽

Frailty Index ◽

Age Groups ◽

Retrospective Chart Review ◽

Burn Injuries ◽

Burn Patients ◽

Chi Square ◽

Frail Patients ◽

Modified Frailty Index

Abstract Introduction Recent evidence indicates that increased frailty is associated with increased mortality in patients with burn injuries over the age of 50 years old. This work found that 35.7% of burn patients over 65 years old were frail at the time of their burn admission while 19.2% of burn patients 50 to 64 years old were frail. While frailty is associated with increased age the two are separate entities suggesting that frailty may be present in much younger patients who present with burn injuries. We hypothesize that frailty exists in all age groups of patients presenting with burn injury and the prevalence increases with age. Methods Following IRB approval, a 5-year (2014–2019) retrospective chart review was conducted of all burn patients admitted to the burn center. Data collected includes age, gender, and burn size (% TBSA). Frailty was determined using the Modified Frailty Index 11 (MFI 11) from co-morbidities included in the burn registry. Patients were considered frail if they have an MFI ³ 2 and pre-frail for an MFI³1 and < 2. Patients were assessed by decades for age. Statistical analysis included descriptive statistics, chi-square, and t-tests. Results A total of 2173 patients (mean age 46.1±17.3 years, 1584 males (72.8%), mean % TBSA 12.5±16.3%) were analyzed. All age groups included patients who were pre-frail (Table 1). In the under 20-year-old group, 8.5% were pre-frail. This increases with each age group to the 71-80-year-old group in which 41.7% of patients are pre-frail. The over 80-year-old group had slightly fewer pre-frail patients (35.9%). There were no frail patients in the under 20-year-old group. In the 21–30 there were 3 patients (0.7%) that had an MFI of 2 or more placing them in the frail group. Frailty was significantly different across the age groups (p< 0.001). As patients age, the proportion of female patients increases (from 17.6% to 37.5%. p< 0.0001). Frailty was also associated with gender with women having a higher percentage of frailty (p=0.0006). With respect to burn size, age category was not associated with burn size (p=0.12), but frail patients had smaller burns than non-frail or pre-frail patients (9.5% vs. 13.3% vs. 12.2%, p=0.0002). Conclusions Pre-frail patients were identified in all age groups. Frailty was present in all age groups except for those who are under 20 years of age. Frailty was associated with female sex and smaller burns. By not specifically looking for frailty in all burn patients admitted to the hospital we are potentially missing frail patients who may benefit from interventions to improve their outcomes.

Download Full-text

ANALYSIS OF INCIDENCE, ETIOLOGY AND RISK FACTORS ASSOCIATED IN ACUTE BURN INJURY IN ADULTS AT ANMMCH, GAYA, BIHAR

10.36106/ijsr/6132929 ◽

2020 ◽

pp. 1-3

Author(s):

Kishore Kumar Sinha ◽

Abhai Kumar Jha Suman ◽

Alok Kumar ◽

Debarshi Jana

Keyword(s):

Burn Injury ◽

Point Of View ◽

Burn Injuries ◽

Unknown Etiology ◽

High Morbidity ◽

Burn Patients ◽

Age Group ◽

Major Health Problem ◽

Number Of Patients ◽

Study Results

Introduction: Burn injuries have major health problem because of its high, morbidity, disability andmortality in young and middle-aged people. Burn injuries also have social problems associated with it. It may be associated with accidental, suicidal or homicidal causes. Despite of such importance of burn injuries from clinical and social point of view, there is scarcity of research on burn injuries in India. Thus we tried to highlight our observations in this study which had been undertaken to find out the causes of burn and it's clinical profile and treatment outcome of burn patients in the our Institute. Material methods: This observational study was conducted from August 2016 to March 2020 in patients ofburn injury who were admitted in surgery wardsand burn ICU of Anugrah Narayan Magadh Medical College & Hospital, Gaya, Bihar. We have studied 226 burn patients who admitted in our general surgical units and burn icu of our Institute. Burns patients who are above 18 years and both sexes were including in the study. Results: A total of 226 patients had burns injuries. 162 were male and 64 female in the ratio of M: F-2.53:1.Males were mostly affected (71.68%) in comparison to females. Most of the burn patients were in the age group of 21-30 years in this studied.i.e.42.02%. Lesser patients were seen in age group 50 -75 . As regard the causes,duringthe house hold activities has maximum number of patients as shown and electricity is causing second highest cases (26.99%), less number of patients are suicidal (3.53) and unknown etiology is seen in seven cases. Conclusion: Burn injury prevention is very difficult task, but to avoid the significant morbidity andmortality following the burn injury. We have to take every measures to control its incidence. A coordinated and dedicated approach by social workers, medical and paramedical personnel and administrators can only minimize the incidence of burn injury in India.

Download Full-text

Epidemiology and Characteristics of Burn Patients in Dr. Soedarso General Hospital during 2017 – 2020: Retrospective Study

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.6544 ◽

2021 ◽

Vol 9 (B) ◽

pp. 711-714

Author(s):

Doni Setiawan ◽

Winsen Haryono

Keyword(s):

Retrospective Study ◽

Medical Records ◽

Burn Injury ◽

Total Body Surface Area ◽

Well Being ◽

Epidemiological Studies ◽

Burn Injuries ◽

Burn Patients ◽

Total Body

Background: Burns are devastating injuries, often resulting in significant morbidity, impairment of emotional well-being, and experienced quality of life. The etiological factors of burn injuries is vary considerably in different communities and regions, hence the need for detailed epidemiological studies to understand the problem status in different regions. Methods: A retrospective study of non-random consecutive sampling of medical records of Dr. Soedarso Regional Hospital in the period August 2017 – December 2020 Results: A total 108 samples were included in this study. There were 88 (81,5%) male and 20 (18,5%) female; mostly adult (>18 years) 57 (52,8%). The etiology of burn injury was flame (35,2%), electrical (34,3%) and scald (30,6%). The most total body surface area (TBSA) of burns from 1-10%. The mortality rate was obtained by 8 (7.4%) respondents. Conclusion: : Based on the results of this study, that the major proportion of burn patients were male and in the age group of > 18 years old. Flame was the most leading cause of burn. Considering the size of the burn, it was revealed that the most TBSA of burns was 1-10%.

Download Full-text

Follow up after burn injury is disturbingly low and linked with social factors

Journal of Burn Care & Research ◽

10.1093/jbcr/irab065 ◽

2021 ◽

Author(s):

Irina P Karashchuk ◽

Eve A Solomon ◽

David G Greenhalgh ◽

Soman Sen ◽

Tina L Palmieri ◽

...

Keyword(s):

Social History ◽

Drug Dependence ◽

Burn Injury ◽

Retrospective Chart Review ◽

Burn Patients ◽

Chi Square ◽

Factors Associated ◽

Ed Visits ◽

Zip Code

Abstract For medical and social reasons, it is important that burn patients attend follow up appointments (FUAs). Our goal was to examine the factors leading to missed FUAs in burn patients. A retrospective chart review was conducted of adult patients admitted to the burn center from 2016-2018. Data collected included burn characteristics, social history, and zip code. Data analysis was conducted using chi-square, Wilcox Rank Sum tests, and multivariate regression models. A total of 878 patients were analyzed, with 224 (25.5%) failing to attend any FUAs and 492 (56.0%) missing at least one appointment (MA). Patients who did not attend any FUAs had smaller burns (4.5 (8)% vs. 6.5 (11)% median (inter quartile range)), traveled farther (70.2 (111.8) vs. 52.5 (76.7) miles), and were more likely to be homeless (22.8% vs. 6.9%) and have drug dependence (47.3% vs. 27.2%). Patients who had at least one MA were younger (42 (26) vs. 46 (28) years) and more likely to be homeless (17.5% vs. 2.6%) and have drug dependence (42.5% vs. 19.4%). On multivariate analysis, factors associated with never attending a FUA were: distance from hospital (odds ratio (OR) 1.004), burn size (OR 0.96), and homelessness (OR 0.33). Factors associated with missing at least one FUA : age (OR 0.99), drug dependence (OR 0.46), homelessness (OR 0.22), and ED visits (OR 0.56). A high percentage of patients fail to make any appointment following their injury and/or have at least one MA. Both FUAs and MAs are influenced by social determinants of health.

Download Full-text

Epidemiological study of burn injury with special reference to its prevention- A Nine-year retrospective study from a tertiary care hospital of West Bengal, India

Asian Journal of Medical Sciences ◽

10.3126/ajms.v7i1.13044 ◽

2015 ◽

Vol 7 (1) ◽

pp. 70-75 ◽

Cited By ~ 1

Author(s):

Shib Shankar Kuiri ◽

Bikash Chandra Ghosh ◽

Nilay Mandal ◽

Mintu Mohan Nandi ◽

Tusar Kanti Saradar ◽

...

Keyword(s):

Retrospective Study ◽

Injury Risk ◽

West Bengal ◽

Burn Injury ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Burn Injuries ◽

Care Hospital ◽

Burn Patients ◽

Age Group

Aims and Objectives: We conducted a retrospective analysis among 1984 burn patients to study the incidence, prevalence of burn injury, its various types and modes (actual event behind the burn injury), risk factors and to find out the preventive measures.Materials and Methods: The retrospective study was carried out among 1984 patients having burn injuries, admitted in a tertiary care hospital of West Bengal, India over a period of nine years. The sources of information were the admission registers and the patients' folders from the medical records department. The Ethical clearance was taken from the Institutional Ethical Committee. The information obtained included age, sex, whether accidental or suicidal, etiology of burn injury and particularly the mechanism of injury. Results: Females were mostly affected (83%) in comparison to males. Among the study population, most of the burn patients were in the age group of 21-30yrs i.e. 35.3%. The number of burn patients were less in number in the age group of 11-20yrs i.e. 7.3%. Most of the burn injuries (87%) were accidental. Suicidal burns occurred in 10% cases. Of which about 1/3rd of the cases were due to dowry related issues. A significant number of teenagers also attempted suicides due to trivial reasons (e.g. failure in examination, quarrelling with parents). Gas oven related injuries occurred in 2.7% cases. Oil lamps (‘kupi’), candles and hurricane-lanterns, diyas were also responsible to some extent in rural India for flame burns(5%). Smoking related burn injuries occurred in 1.7% cases. Scald injuries occurred in 14% cases. Chemical injuries (0.3%) were due to spillage of unlabelled bottles of acid/alkali. Electrical burn injury occurred in 4.9% cases. Conclusion: Burn injury prevention is not easy, but to avoid the significant morbidity and mortality following injury we have to prevent it by any means. A coordinated and dedicated approach among social workers , medical and paramedical personnel, administrators can only minimize the incidence of burn.Asian Journal of Medical Sciences Vol.7(1) 2015 70-75

Download Full-text

Considerations for pediatric burn sedation and analgesia

Burns & Trauma ◽

10.1186/s41038-017-0094-8 ◽

2017 ◽

Vol 5 ◽

Cited By ~ 8

Author(s):

Alice Fagin ◽

Tina L. Palmieri

Keyword(s):

Pain Management ◽

Burn Injury ◽

Burn Injuries ◽

Burn Patients ◽

Injury Treatment ◽

Sedation And Analgesia ◽

Patients Experience ◽

Medication Response

Abstract Burn patients experience anxiety and pain in the course of their injury, treatment, and recovery. Hence, treatment of anxiety and pain is paramount after burn injury. Children, in particular, pose challenges in anxiety and pain management due to their unique physiologic, psychologic, and anatomic status. Burn injuries further complicate pain management and sedation as such injuries can have effects on medication response and elimination. Burn injuries further complicate pain management and sedation as such injuries can have effects on medication response and elimination. The purpose of this review is to describe the challenges associated with management of anxiety, pain, and sedation in burned children and to describe the different options for treatment of anxiety and pain in burned children.

Download Full-text

Neuronal Plasticity Associated with Burn Injury and Its Relevance for Perception and Management of Pain in Burn Patients

Pain Research and Management ◽

10.1155/2000/541502 ◽

2000 ◽

Vol 5 (3) ◽

pp. 205-213

Author(s):

Terence J Coderre ◽

Manon Choinière

Keyword(s):

Neuronal Plasticity ◽

Pain Perception ◽

Burn Injury ◽

Clinical Care ◽

Strong Support ◽

Burn Injuries ◽

Burn Patients ◽

Pain Mechanisms ◽

Gate Control Theory

Through the introduction of the gate control theory and various subsequent works, Ronald Melzack has inspired many investigators worldwide to realize two important facts about pain. First, incoming pain messages are subject to both negative and positive modulation, which significantly affect its perception. Second, the progression of knowledge about the basic mechanisms underlying persistent and chronic pain is critically dependent on the increased understanding of the complexity of the symptoms experienced by pain patients. The present paper examines these two very important issues in an effort to understand better the mechanisms that underlie the pain suffered by burn patients. The physiological responses to burn injury involve many different mediators and mechanisms, all of which contribute to pain perception and development of neuronal plasticity underlying short and long term changes in pain sensitivity. While experimental burn injuries in humans and animals are typically well controlled and mild, in burn victims, the severity is much more variable, and clinical care involves repeated traumas and manipulations of the injured sites. Recurrent inputs from damaged and redamaged tissue impinge on a nervous system that becomes an active participant in the initiation of changes in sensory perception and maintenance of long term sensory disturbances. Recently acquired experimental evidence on postburn hyperalgesia, central hyperexcitability and changes in opioid sensitivity provides strong support that burn patients need an analgesic approach aimed at preventing or reducing the 'neural' memory of pain, including the use of more than one treatment modality. Burn injuries offer a unique opportunity to combine experimental and clinical research to understand pain mechanisms better. Over the years, Ronald Melzack has insisted that one of the most laudable enterprises in research is to span the gap between these two often separate worlds.

Download Full-text

A rare Fusarium equiseti infection in a 53-year-old male with burn injury: A case report

Current Medical Mycology ◽

10.18502/cmm.7.1.6245 ◽

2021 ◽

Author(s):

Tang Xuan Hai ◽

Nguyen Thai Ngoc Minh ◽

Do Ngoc Anh ◽

Tran Ngoc Dung ◽

Ngo Thi Minh Chau ◽

...

Keyword(s):

Case Report ◽

Susceptibility Testing ◽

Burn Injury ◽

Large Subunit ◽

Antifungal Susceptibility ◽

Herbal Product ◽

Burn Injuries ◽

Burn Patients ◽

Fusarium Equiseti

Background and Purpose: Burn injuries are prone to infection caused by bacteria, fungi, or other pathogens. Fungal wound infection usually has non-specific clinical symptoms.Nevertheless, in some cases, the fungal burden is so substantial that can easily be seen by the naked eyes, but this phenomenon has rarely been reported with Fusarium. Case report: A 53-year-old patient with severe burn injury was admitted to the intensive care unit of the National Hospital of Burn, Ha Noi, Vietnam. His wound was dressed with a traditional herbal product before the hospital admission. On the 5th day after the admission, some white patches suspected of fungal colonies appeared on burn lesions where the herbal medicine was placed. Histological examination (Periodic acidSchiff) and culture of biopsy samples taken from those lesions revealed fungus that was identified as Fusarium equiseti after analysis of the internal transcribed spacer and D1/D2 region of the large subunit of the 28S rDNA. The isolated strain showed susceptibility to voriconazole but resistance to fluconazole, itraconazole, caspofungin,and amphotericin B in vitro. The patient received aggressive treatment, including IV voriconazole (400 mg daily from day five); however, he could not recover. Conclusion: Fusarium should be suspected in burn patients with white patches on lesions. Antifungal susceptibility testing is important since multidrug resistance is common among Fusarium strains.

Download Full-text

Ecotourism as a Catalyst of Poverty Alleviation in Rural Economy in Cebu, Philippines

Asian Review of Social Sciences ◽

10.51983/arss-2019.8.3.1605 ◽

2019 ◽

Vol 8 (3) ◽

pp. 1-7

Author(s):

Van Mari Buslon-Sia ◽

Judy Ann Ferrater-Gimena ◽

Jonathan O. Etcuban ◽

Annie U. Tan

Keyword(s):

Rural Areas ◽

Poverty Alleviation ◽

Rural Economy ◽

Data Gathering ◽

Sampling Technique ◽

Well Being ◽

Chi Square ◽

Survey Tool ◽

Significant Difference ◽

Social Overhead Capital

Inclusive economic growth encompasses alleviating the people in the rural area from massive poverty and vulnerability. The study aims to determine the indication of ecotourism’s contribution to alleviating poverty in the rural economy as a basis in formulating a tourism development plan. It applied the descriptive research design, utilizing a researcher-made survey tool as a primary instrument of data gathering. The research sites were in Olango Island Wildlife Sanctuary, Aguinid Falls, and Bojo River. Using a random sampling technique, 70 respondents were residents and earning income from the ecotourism activities. The gathered data were treated using simple percentage, weighted mean, Chi-square test of independence and ANOVA. The findings revealed that meager income for selling locally-made products, as tour guides, providing transportation services, and through fixed salaries per month. The ecotourism sites in Cebu, Philippines had a significant contribution towards alleviating poverty in terms of uplifting the standard of living, providing a means of subsistence, development of social well-being, and improvement of social overhead capital. There is a significant relationship between the respondents’ educational attainment and source of livelihood and their perceptions on the contribution of ecotourism in terms of uplifting the standards of living and improvement of social overhead capital. Lastly, there is a significant difference in the respondents’ viewpoint on the three well-known ecotourism sites in the aspect of the development of social well-being. The popular community-based ecotourism sites in Cebu holds great potential in making significant contributions to poverty alleviation since it supported the local people to escape from hunger that is prevalent in the rural areas in the developing countries.

Download Full-text

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

Jurnal Plastik Rekonstruksi ◽

10.14228/jprjournal.v8i1.309 ◽

2021 ◽

Vol 8 (1) ◽

pp. 15-20

Author(s):

Gammaditya Adhibarata Winarno ◽

Aditya Wardhana ◽

Sanjaya Faisal Tanjunga ◽

A. S Augiani ◽

An’umillah Arini Zidna

Keyword(s):

Length Of Stay ◽

Skin Graft ◽

Burn Injury ◽

Study Groups ◽

Cross Sectional Study ◽

Burn Injuries ◽

Split Thickness Skin Graft ◽

Burn Patients ◽

Cross Sectional ◽

Thickness Skin

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.

Download Full-text