Study of Association of Demographic Variables with Types of Burns Presenting in a Tertiary Care Medicolegal Clinic

Background: In day to day life every human whether young or the old happens to deal or face the fire sources or any relevant entity. Great research is available in all the regions of the world and generous emphasis had been delivered widely. Though the advantages of the energy sources outweighs its disadvantages if dealt with proper care but accidents do happen in this process. The study focuses on the association of the demographic variables like age, gender, marital status and level of education. Aim: To observe the association of demographic variables with types of the burns. Methods: A total of 250 victims of burns presenting in the Medicolegal Clinic of King Edward Medical University Lahore/ Emergency of Mayo Hospital Lahore expanded over a period of several months from December 2017 to August 2018. Results: A grossly significant association of the age, gender, occupation and level of education of the victims of burns with types of different burns i.e. scalds, dry flame burns, chemical burns and electrical burns was observed with a 0.000 p value. A little lower significance of marital status of with a p value of 0.036 was observed when compared to different types of burns. Keywords: Scalds, Dry flame, Chemical, Electrical, Burns, Age, Gender, Marital Status, Occupation

Study of soft tissue reconstruction in postburn flexion contracture of the hand

Background: Burn contracture of the hand can leave patients with severe functional and psychological limitations. This study evaluates the severity of the deformity and various reconstructive options in post-burn hand injuries.Methods: This work includes the study of 50 patients who underwent reconstruction for post-burn flexion contracture of the hand, including fingers, in the department of plastic surgery. The patients were treated between April 2007 to April 2009.Results: Males were more commonly affected by burn injuries and thermal burns were more common than electrical burns. The little finger showed higher involvement and contracture release followed by grafting was the commonly done reconstructive procedure.Conclusions: Split thickness skin graft (SSG) were more effective in reconstruction in thermal injuries, while cross finger flaps (CFF) showed more promise in electrical injuries of the hand.

A case of burn evisceration with full-thickness injury to abdominal wall, bowel, bladder, and three extremities

Background Severe electrical burns are a rare cause of admission to major burn centers. Incidence of electrical injury causing full-thickness injury to viscera is an increasingly scarce, but severe presentation requiring rapid intervention. We report one of few cases of a patient with full-thickness electrical injury to the abdominal wall, bowel, and bladder. Case report The patient, a 22-year-old male, was transferred to our institution from his local hospital after sustaining a suspected electrical burn. On arrival the patient was noted to have severe burn injuries to the lower abdominal wall with evisceration of multiple loops of burned small bowel as well as burns to the groin, left upper, and bilateral lower extremities. In the trauma bay, primary and secondary surveys were completed, and the patient was taken for CT imaging and then emergently to the operating room. On exploration, the patient had massive full-thickness burns to the lower abdominal wall, five full-thickness burns to small bowel, and intraperitoneal bladder rupture secondary to full-thickness burn. The patient underwent damage-control laparotomy including enterectomies, debridement of bladder coagulative necrosis, and layered closure of bladder injury followed by temporary abdominal closure with vacuum dressing. The patient also underwent right leg escharotomy and partial right foot fasciotomies. The patient was subsequently transferred to the nearest burn center for continued resuscitation and comprehensive burn care. Conclusion Severe electrical burns can be associated with devastating visceral injuries in rare cases. Though uncommon, these injuries are associated with very high mortality rates. The authors assert that rapid evaluation and initial stabilization following ATLS guidelines, damage-control laparotomy, and goal-directed resuscitation in concert with transfer to a major burn center are essential in effecting a successful outcome in these challenging cases.

WAYS FOR IMPROVING THE RESULTS OF TREATMENT OF VICTIMS WITH DEEP ELECTRICAL BURNS

Aim. improving the results of treatment of victims with electrical injury, through early diagnosis of the depth and extent of the lesion and the introduction of methods of active surgical tactics.Material and methods. We examined 674 patients with electrical injuries admitted to the RSCEMP in the period from 2001 to 2017. the patients used the methods of bilateral comparative dermal thermometry and X-ray densitometry. To assess the severity of burn shock, the indicators of central and peripheral hemodynamics, blood oxygenation, Frank’s index, thermometry and neutrophil-lymphocyte index were assessed. The calculation of statistical indicators was carried out using the Microsoft Excel 2010 software package, including built-in statistical processing functions. The significance of differences between the groups in the quantitative values of the parameters was determined by the Student’s test. Statistical indicators were considered reliable, with p <0.05. Results. It was found that the temperature difference in the armpit and the first interdigital space of the foot by 0.5-1.5 ° C corresponds to a mild degree of burn shock, and in severe and extremely severe burn shock, the temperature difference in these zones was 1.6 -4 ° С and above 4 ° С. It is noted that active surgical tactics by early fasciotomy on the first day of injury and early necrectomy contributes to a significant decrease in the frequency of amputation and disarticulation of the extremities from 55.8 to 9.8%, makes it possible to perform early autodermoplasty, improves the survival rate of autografts and shortens the period of inpatient treatment. Active surgical tactics contributed to an improvement in the engraftability of autografts (95.2% versus 87.4%), a 2.6-fold decrease in the frequency of repeated autodermoplasty at sites of non-engraftment, a significant decrease in the frequency of mutilation operations (amputation and disarticulation of the extremities) and a reduction in the duration of inpatient treatment with 41.1 ± 12.3 to 37.7 ± 10.4 days. Conclusions. Early fasciotomy on the first day of injury and early necrectomy contribute to a significant decrease in the frequency of amputation and disarticulation of the extremities from 55.8 to 9.8%, make it possible to perform autodermoplasty in the shortest possible time and reduce the time of inpatient treatment. The process of osteonecrosis is completed within 2 weeks after the injury, and by this time it is possible to start osteonecrectomy, including one-stage radical osteonecrectomy over the entire surface of osteonecrosis.

Epidemiology and Outcome in Electrical Burn Injury: Retrospective Study of 282 Patients in a Tertiary Care Hospital of Western Uttar Pradesh, India

Electrical burns account for a small percentage of all burn injuries. However, in burn patients, they are a major source of disability. They put socioeconomic burden on the society. This is a retrospective epidemiological study of 282 electrical burn patients admitted in burn unit of a tertiary care hospital of North India. Majority of the electrical burn was due to accidental touching of uncovered wires and occupation-related burns in laborers and industrial workers who were mainly young males in the age group 20 to 40 years. Most of the cases were of high-voltage (≥1000 V) electrical burns. More severe burns, longer hospital stays, and more problems and operations were all linked to high-voltage burns. Amputation rates for high-voltage burns were significantly higher (37.3%) as compared to low-voltage burns (13.6%). Electrical burn injuries can be prevented by awareness programs, proper training, and safety measures both by public and government.

A five-year overview of fatal thermal and electrical burns in Johannesburg, South Africa

Burn injuries affect millions of people globally each year. South Africa is a developing country where fatal fires are common. Despite the pervasiveness of fatal burns in South Africa, there is a paucity of information regarding the frequency of fatal burns in the city of Johannesburg. This study aimed to describe the demographics and frequency of fatal burn cases received at the Johannesburg Forensic Pathology Services Medico-legal Laboratory for medico-legal death investigations. This study was a five-year (2010-2014) retrospective review of 185 forensic medico-legal case files of the Johannesburg Forensic Pathology Services Medico-legal Laboratory. The demographic at the greatest risk of fatal burns in Johannesburg, South Africa are black males between the ages of 20-39 years. The most common type of fatal burns is thermal in nature, as a result of flames. Burns are prevalent in the winter months, most notably July and August. Burn wounds are most common on the head, chest, upper back, abdomen, arms, and legs. This study is the first to report of fatal burns in Johannesburg, South Africa and may be used as a source to improve public services for the prevention of fatal burns.

Trends in Catastrophic Occupational Incidents among Electrical Contractors, 2007–2013

This study used methodologies of descriptive and quantitative statistics to identify the contributing factors most affecting occupational accident outcomes among electrical contracting enterprises, given an accident occurred. Accident reports were collected from the Occupational Safety and Health Administration’s fatality and catastrophe database. To ensure the reliability of the data, the team manually codified more than 600 incidents through a comprehensive content analysis using injury-classification standards. Inclusive of both fatal and non-fatal injuries, the results showed that most accidents happened in nonresidential buildings, new construction, and small projects (i.e., $50,000 or less). The main source of injuries manifested in parts and materials (46%), followed by tools, instruments, and equipment (19%), and structure and surfaces (16%). The most frequent types of injuries were fractures (31%), electrocutions (27%), and electrical burns (14%); the main injured body parts were upper extremities (25%), head (23%), and body system (18%). Among non-fatal cases, falls (37%), exposure to electricity (36%), and contact with objects (19%) caused most injuries; among fatal cases, exposure to electricity was the leading cause of death (50%), followed by falls (28%) and contact with objects (19%). The analysis also investigated the impact of several accident factors on the degree of injuries and found significant effects from such factors such as project type, source of injury, cause of injury, injured part of body, nature of injury, and event type. In other words, the statistical probability of a fatal accident—given an accident occurrence—changes significantly based on the degree of these factors. The results of this study, as depicted in the proposed decision tree model, revealed that the most important factor for predicting the nature of injury (electrical or non-electrical) is: whether the source of injury is parts and materials; followed by whether the source of injury is tools, instruments, and equipment. In other words, in predicting (with a 94.31% accuracy) the nature of injury as electrical or non-electrical, whether the source of injury is parts and materials and whether the source of injury is tools, instruments, and equipment are very important. Seven decision rules were derived from the proposed decision tree model. Beyond these outcomes, the described methodology contributes to the accident-analysis body of knowledge by providing a framework for codifying data from accident reports to facilitate future analysis and modeling attempts to subsequently mitigate more injuries in other fields.