burn depth
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2021 ◽  
Vol 26 (6) ◽  
pp. 3040-3046
Author(s):  
VASYL NAGAICHUK ◽  
ROMAN CHORNOPYSHCHUK ◽  
OLEKSANDR NAZARCHUK ◽  
LUDMILA SIDORENKO ◽  
MYKOLA ZHELIBA ◽  
...  

Objective: morphological substantiation of efficiency of prompt neutralization of traumatic action of exogenous and endogenous damage factors in burn injuries in experimental conditions. After simulating the burns on 60 rats, the traumatic hyperthermic damage factors in the main group were immediately neutralized by a gauze napkin soaked in water. Depending on its duration, the animals were divided into subgroups. Such applications were not performed on the control group. The study involved histological examination of tissues. Animals of the main groups had the presence of histologically confirmed skin appendages with a formed scar of connective tissue without signs of inflammation. In animals of the control group there were no skin appendages, which indicates a deeper thermal damage to tissues and the impossibility of self-epithelialization of wounds. These results confirm the importance and necessity of prompt neutralization of the traumatic effect of damage factors as the main elements of burn depth formation.


Author(s):  
Paul Baker ◽  
Michelle Locke ◽  
Amber Moazzam ◽  
Matthew Taylor ◽  
Francois Stapelberg ◽  
...  

Abstract New Zealand's most active volcano, Whakaari White Island was a common tourist attraction prior to its eruption on 9 th December 2019. At the time of the eruption, there were 47 people on the island from three tour groups. 39 people survived the initial eruption and were extracted. 31 entered into the New Zealand National Burn Service across four hospitals. The median age of the patients treated at the National Burn Centre was 45.5 years (range: 14 − 67 years) and median total body surface area burn was 49.5% (range: 9% - 90%). The three month survival of this eruptive event was 55%, which subsequently fell to an overall rate of 53% following one late death of an early survivor after repatriation home. Of the patients who survived the initial eruption for long enough to be admitted to the National Burn Service, the overall survival rate was 71% at three months. We describe 12 lessons we have learnt from our management of the survivors. The key surgical lessons among these are: The injuring mechanism combined ballistic trauma, thermal and acidic burn components, with the acid component being the most problematic and urgent for management. Volcanic ash burns result in on-going burn depth progression, deep underlying tissue damage and significant metabolic instability. Early skin grafting was not successful in many cases. Reconstructive strategy needed adjusting to cope with the high operative demand and limited donor sites in all patients. Protect yourself from potential dangers with additional personal protective equipment (PPE) in an unfamiliar setting.


Author(s):  
Matan Segalovich ◽  
Ariel Berl ◽  
Uri Aviv ◽  
Eli Jaffe ◽  
Ran Shelef ◽  
...  

Abstract Electric powered bicycles and scooters that use rechargeable lithium batteries are an urban transportation alternative and have become increasingly popular. However, in recent years, there has been an increase in patient admissions to the Israeli National Burn Center with burns associated with their use. In this case series of all patients (n=9) referred to the Emergency Department (February 2016 - October 2020) with lithium related battery burns from electric powered bicycles and scooters, we present burn depth, size, treatment, inhalation injuries and hospitalization. All patients were admitted to in the Israeli National Burn Center for treatment. The average total burn surface area was 27.5% (range 3-57%). All but one patient had a combination of partial to full-thickness burns affecting the upper and lower limbs. Three patients sustained inhalation injuries and a total of four patients required intubation. Seven patients required surgery that included debridement and, in most cases, skin grafting. The availability and increase in the use of battery powered bicycles and scooters may lead to an increase in injuries and death if consumers are not aware of the potential dangers related to the safe use of lithium batteries.


Author(s):  
Stefan Morarasu ◽  
Bianca-Codrina Morarasu ◽  
Nicolae Ghețu ◽  
Mihail-Gabriel Dimofte ◽  
Radu Iliescu ◽  
...  

Abstract AIM Despite a wide variety of models found in literature, choosing the right one can be difficult as many of them are lacking precise methodology. This study aims to analyze and compare original burn models in terms of burn device and technique, parameters, and wound depth assessment. METHODS A systematic search was performed according to PRISMA guidelines on studies describing original experimental burn models in rats. The adapted PICO formula and ARRIVE checklist were followed for inclusion and assessment of quality of studies. Characteristics of animals, burn technique, burn parameters and method of histological confirmation of burn depth were recorded. RESULTS Twenty-seven studies were included in the final analysis. Most studies used direct contact with skin for burn infliction (n=20). The rat’s dorsum was the most common site (n=18). Ten studies used manually controlled burn devices, while ten designed automatic burn devices with control over temperature (n=10), exposure time (n=5), and pressure (n=5). Most studies (n=7) used a single biopsy taken from the center of the wound to confirm burn depth immediately after burn infliction. CONCLUSION From the wide variety of burn models in current literature, our study provides an overview of the most relevant experimental burn models in rats aiding researchers to understand what needs to be addressed when designing their burn protocol. Models cannot be compared as burn parameters variate significantly. Assessment of burn depth should be done in a standardized, sequential fashion in future burn studies to increase reproducibility.


Author(s):  
Sangrock Lee ◽  
Rahul ◽  
James Lukan ◽  
Tatiana Boyko ◽  
Kateryna Zelenova ◽  
...  

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
S Shahid

Abstract Aim To establish a method of quantifiably determining burn depth from Laser Doppler (LD) images of burns. Method NICE advises for LD scanning to be utilised for the assessment of intermediate depth burns, where there is doubt about burn depth following experienced clinician examination. However, these scan images do not provide a quantifiable measure of burn depth. LD determines burn perfusion, with deeper burns appear blue, and superficial burns appearing red. We retrospectively studied LD images from 110 patients over the course of 2019. Using Adobe Photoshop, Histogram software, we highlighted the burns using the selection tool, and determined the proportion of the burn that was deep/poorly perfused. We then correlated these results with time till recovery. Results Burns with a poorly perfused region of larger than 20%, had a proportional increase in time till full recovery. This proportional increase was also reflected in burns with a 30% and 40% poor perfusion. Burns with less than 20% of poor perfusion were found to recover at the same rate as superficial burns. This novel method for the measurement of burn depth will allow for the examining plastic surgeon to make a decision on treatment based on concrete and quantifiable burn depth data. Conclusions We have demonstrated the initial validity of a novel method for the quantifiable measurement of burn depth. Further study is required, to establish the validity of this novel approach to the quantifiable detection of burn depth.


Burns ◽  
2021 ◽  
Author(s):  
Torsten Schulz ◽  
Jörg Marotz ◽  
Sebastian Seider ◽  
Stefan Langer ◽  
Sebastian Leuschner ◽  
...  

Author(s):  
Herb A Phelan ◽  
James H Holmes IV ◽  
William L Hickerson ◽  
Clay J Cockerell ◽  
Jeffrey W Shupp ◽  
...  

Abstract Introduction Burn experts are only 77% accurate when subjectively assessing burn depth, leaving almost a quarter of patients to undergo unnecessary surgery or conversely suffer a delay in treatment. To aid clinicians in burn depth assessment (BDA), new technologies are being studied with machine learning algorithms calibrated to histologic standards. Our group has iteratively created a theoretical burn biopsy algorithm (BBA) based on histologic analysis, and subsequently informed it with the largest burn wound biopsy repository in the literature. Here, we sought to report that process. Methods The was an IRB-approved, prospective, multicenter study. A BBA was created a priori and refined in an iterative manner. Patients with burn wounds assessed by burn experts as requiring excision and autograft underwent 4mm biopsies procured every 25cm 2. Serial still photos were obtained at enrollment and at excision intraoperatively. Burn biopsies were histologically assessed for presence/absence of epidermis, papillary dermis, reticular dermis, and proportion of necrotic adnexal structures by a dermatopathologist using H&E with whole slide scanning. First degree and superficial 2 nd degree were considered to be burn wounds likely to have healed without surgery, while deep 2 nd and 3 rd degree burns were considered unlikely to heal by 21 days. Biopsy pathology results were correlated with still photos by five burn experts for consensus of final burn depth diagnosis. Results Sixty-six subjects were enrolled with 117 wounds and 816 biopsies. The BBA was used to categorize subjects’ wounds into 4 categories: 7% of burns were categorized as 1 st degree, 13% as superficial 2 nd degree, 43% as deep 2 nd degree, and 37% as 3 rd degree. Therefore 20% of burn wounds were incorrectly judged as needing excision and grafting by the clinical team as per the BBA. As H&E is unable to assess the viability of papillary and reticular dermis, with time our team came to appreciate the greater importance of adnexal structure necrosis over dermal appearance in assessing healing potential. Conclusions Our study demonstrates that a BBA with objective histologic criteria can be used to categorize BDA with clinical misclassification rates consistent with past literature. This study serves as the largest analysis of burn biopsies by modern day burn experts and the first to define histologic parameters for BDA.


Burns Open ◽  
2021 ◽  
Author(s):  
Ilaria Mataro ◽  
Giuseppe Giudice ◽  
Rossella Elia ◽  
Roberto D'Alessio ◽  
Giulio Maggio ◽  
...  

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