Severe scalds sustained during steam inhalation therapy in an adult population: Analysis of patient outcomes and the financial burden to healthcare services.

BACKGROUND: Steam inhalation therapy (SIT) is a common home remedy for the treatment of upper respiratory tract infections. Literature reports are increasingly discouraging this practice in the paediatric population due to the risk of scalds, however, this is yet to be echoed for adults. METHODS: A retrospective review of patients admitted to a tertiary burns centre from 2015 to 2020 was undertaken identifying all adult patients requiring in-patient specialist treatment for scald injuries sustained during steam inhalation. Cost analysis and long-term patient outcomes were reviewed. RESULTS: Twelve adult patients required inpatient management with a mean length of admission of 8 nights. One patient required operative intervention, long-term sequelae included scarring, skin sensitivity, pain, or psychological morbidity. The estimated mean cost per patient was £5402 giving a mean cost per year of £12 964. CONCLUSION: SIT can be associated with severe scald injuries in adults and incur considerable costs for healthcare providers.

Head and neck research in plastic surgery-Ahead of the rest? An analysis of abstracts presented at British association of plastic reconstructive and aesthetic surgeons meetings.

INTRODUCTION & AIMS: Historically, the head and neck (H&N) discipline has been integral to the service a plastic surgeon provides. Recently, it has been postulated that its popularity is declining. The output of scientific meetings may indicate the popularity of each sub-speciality interest, also allowing comparison with other H&N conferences. AIM: To analyse the proportion of H&N themed, podium and poster presentations from British Association of Plastic Reconstructive and Aesthetic Surgeons' (BAPRAS) scientific meetings and the resulting contribution to published literature. MATERIAL AND METHODS: H&N-themed abstracts were identified from finalised programmes of the biannual BAPRAS meetings between 2008 and 2015. PubMed and Google Scholar databases were searched using keywords and author names from each abstract to identify subsequent publication in a peer-reviewed journal. RESULTS: Overall, 19.3% (350/1815) of BAPRAS abstracts were H&N themed. The publication rate of H&N abstracts was 40.3% (141/350), comprising 43.0% (114/265) of podium and 31.8% (27/85) of poster presentations. H&N reconstruction and cleft and craniofacial were the most frequent topics, with facial palsy having the lowest conversion rate at 15.4%. The mean time to publication was 17.8 months. Research was published in 39 journals, with a mean impact factor of 2.151 (range = 0.772-11.541). The most popular journal was Journal of Plastic, Reconstructive & Aesthetic Surgery (JPRAS; 31.7%; 45/141). Published abstracts originated from 17 different countries. The senior author was a plastic surgeon in 77.3% of abstracts. CONCLUSIONS: From the multiple potential sub-specialties, H&N-themed abstracts consistently contributed 20% of all research presented at BAPRAS. The 40.3% publication rate exceeds the international average of scientific meetings. H&N remains a prominent field in the armamentarium of a plastic surgeon.

In patients undergoing video-assisted thoracic surgery for pleurodesis in primary spontaneous pneumothorax, how long should chest drains remain in place prior to safe removal and subsequent discharge from hospital?

A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was how long chest drains should be left in place following video-assisted thoracic surgery (VATS) pleurodesis for primary spontaneous pneumothorax. Altogether, a total of 730 papers were found using the reported search, of which eight represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. We report that the main determining factor for the length of hospital stay following VATS pleurodesis is chest-drain duration. Providing no postoperative complications occur, and chest X-ray appearances of lung inflation are satisfactory, there is no documented contraindication to removing chest drains as early as 2 days postoperatively, with discharge the following day. Furthermore, leaving chest drains on water seal after a brief period of suction has been shown to benefit in reducing postoperative chest-drain duration and subsequent hospital stay. There is a paucity of literature directly addressing early vs late chest-drain removal protocols in this patient group. Hence, we conclude that, in clinical practice, the decision of when to remove chest drains postoperatively should remain guided empirically towards the individual patient.