Tizanidine for the management of acute postoperative pain after inguinal hernia repair: A placebo-controlled double-blind trial.

BACKGROUND: α2-Agonists are used postoperatively as a component of multimodal analgesia. Tizanidine is a centrally acting α2-agonist with muscle relaxant properties. OBJECTIVE: The aim of this study was to compare the efficacy of tizanidine with placebo in terms of postoperative pain scores, analgesic consumption, return to daily activity and health-related quality of life. DESIGN: A randomised double-blind study. SETTING: Diskapi Yildirim Beyazit Training and Research Hospital. INTERVENTIONS: After obtaining ethical approval and informed patient consent, 60 patients undergoing inguinal hernia repair under general anaesthesia were randomly allocated into one of the two groups. The patients in Group T received tizanidine 4 mg orally 1 h before surgery and twice daily during the first postoperative week. The patients in Group P received the same treatment with a placebo pill. Both the groups received a standard analgesic treatment regimen comprising intravenous dexketoprofen 25 mg prior to induction of anaesthesia, dexketoprofen 25 mg orally three times daily for 1 week and intravenous paracetamol 1 g at the end of surgery. Supplemental analgesia was provided with paracetamol if the visual numerical rating scale (NRS) was at least 4 cm. MAIN OUTCOME MEASURES: Postoperative pain was assessed using the NRS. Total analgesic consumption was determined. Return to normal daily activity was evaluated using a five-point daily activity score after the first postoperative week, and health-related quality of life was evaluated using the short form-36 one month after surgery. RESULTS: The patients in Group T had significantly lower NRS pain scores than those in Group P 6, 12 and 24 h postoperatively both at rest and during movement (P < 0.001), and on postoperative days 1, 2, 3 and 4. The analgesic consumption was also lower in patients who received tizanidine. Ten patients (33%) in Group T and 23 patients (77%) in Group P consumed supplemental paracetamol (P < 0.001) after discharge. The daily activity score was lower in Group T than in Group P (P < 0.001), and the short form-36 scores were significantly different in the pain dimension [74 (74 to 100) in Group T and 74 (31 to 80) in Group P, (P < 0.001)] and in the physical component summary score. CONCLUSION: The addition of tizanidine to the postoperative pain therapy after herniorrhaphy decreased postoperative pain and analgesic consumption and improved return to normal activity and quality of life. TRIAL REGISTRATION: ClinicalTrials.gov NCT02016443 (10 October 2013, Principal investigator D. Yazicioglu).

An evaluation of treatment results of emergency versus elective surgery in colorectal cancer patients.

OBJECTIVE: Colorectal cancer is still one of the most common causes of cancer related deaths in the world despite improvements in diagnosis and treatment modalities, and application of community-based screening methods. Symptoms of colorectal cancer are non-specific and usually manifest following local progression. A number of patients with advanced stage colorectal cancer present to emergency departments with obstruction as the first sign of disease without any previous symptoms. This presentation is an indication for emergency surgery that has a high rate of morbidity and mortality. In this study, we aimed to determine the factors associated with early diagnosis and survival by comparing postoperative results of colorectal cancer patients who underwent surgery under emergency or elective situation. MATERIAL AND METHODS: Files of colorectal patients treated between 2009-2013 were retrospectively analyzed. Data on patient age, gender, operation type, intraoperative results, length of hospital stay, co-morbidities, postoperative complications and pathological results were evaluated and compared. RESULTS: There was no statistical difference between groups in terms of age, gender, and pathology results (p>0.05). The difference between groups in terms of postoperative length of hospital stay, presence of co-morbid diseases, pathological stage, and postoperative complications was statistically significant (p<0.05). Length of hospital stay, advanced stage on admission, complications such as surgical site infection, evisceration, and anastomosis leakage rates were higher in patients in the emergency surgery group. CONCLUSION: Risk groups should be determined in order to diagnose colorectal cancer patients at an early stage while they are still asymptomatic, and this information should be incorporated into effective screening programs. This approach will be beneficial to treatment outcomes, complication rates, length of hospital stay, and survival and treatment results.

Current options in umbilical hernia repair in adult patients.

Umbilical hernia is a rather common surgical problem. Elective repair after diagnosis is advised. Suture repairs have high recurrence rates; therefore, mesh reinforcement is recommended. Mesh can be placed through either an open or laparoscopic approach with good clinical results. Standard polypropylene mesh is suitable for the open onlay technique; however, composite meshes are required for laparoscopic repairs. Large seromas and surgical site infection are rather common complications that may result in recurrence. Obesity, ascites, and excessive weight gain following repair are obviously potential risk factors. Moreover, smoking may create a risk for recurrence.

Factors affecting the safety of drains and catheters in surgical patients.

OBJECTIVE: Drains and catheters are used for both prophylactic and therapeutic reasons in clinical practice. This study aimed to investigate the factors that affect safety of drains, catheters, nasogastric tube and central venous line in patients who underwent surgery. MATERIAL AND METHODS: Two hundred and four consecutive patients who were operated at the general surgery clinics under general anesthesia were included in the study. Factors that affect the safety of drains and catheter were followed and recorded prospectively. RESULTS: During follow-up period, 12 (5.8%) patients have experienced problems regarding safety of drains/catheters. The mean age of patients who were followed-up in terms of security problems was 63.1 (39-86) years. Eight (66.7%) patients had been operated emergently, and four (33.3%) patients electively. Three (25%) patients had psychiatric/neurological co-morbidities and 3 (25%) patients were confused due to anesthesia/intensive care unit treatment when the drain safety was broken. Eight (66.7%) patients withdrew the drains or catheters by themselves, in 2 (16.7%) patients the drains spontaneously came out and in 2 (16.7%) patients the wrong drain was withdrawn. One patient had dementia, one patient had Alzheimer's disease and one patient was being followed-up with a diagnosis of schizophrenia. In three (25%) patients the abdominal drain, in four (33.3%) patients nasogastric tube, in one (8.3%) patient intubation tube, in one (8.3%) patient central venous catheter, and in three (25%) patients multiple drains were removed. CONCLUSION: The inaccurate use of drains or re-intervention for an unintentionally removed drain causes problems regarding patient safety. Close monitoring of surgical patients in terms of security, and submission of additional measures for patients with confusion and neurological/psychiatric disorders are of great importance.

A rare but distinctive cause of acute abdomen: appendiceal diverticulitis.

BACKGROUND: Diverticulosis and diverticulitis of appendix vermiformis is a rare diagnosis. Clinical and laboratory examinations do not show a difference between a progressing diverticulitis and simplex appendicitis. But this entity has a higher mortality rate than common appendicitis. OBJECTIVE: This case is presented to illustrate the point that preoperative simple diagnosis of acute appendicitis according to the clinical signs and physical examination may not only be insufficient, but could be fatal in certain circumstances, like appendiceal diverticulitis, if surgical intervention is delayed. CASE REPORT: Here we present a female patient with a history of right lower abdominal pain and fever of 3 days duration. She was diagnosed with acute appendicitis according to the preoperative physical, laboratory, and imaging examinations. The appendiceal diverticulitis accompanying acute appendicitis was an intraoperative finding, which was proven by histopathologic examination. CONCLUSION: It is not easy to document this entity preoperatively. When diagnosed either preoperatively by imaging studies or intraoperatively, the only choice is appendectomy to prevent its serious complications.

The faith of ilioinguinal nerve after preserving, cutting, or ligating it: an experimental study of mesh placement on inguinal floor.

BACKGROUND: Postherniorrhaphy chronic pain may be related to the trauma to the regional nerves or prosthetic mesh. This study was aimed to search the objective findings of prosthetic mesh placement on the ilioinguinal nerve in three different nerve treatment patterns with two different mesh types. MATERIALS AND METHODS: Thirty New Zealand rabbits were used. Bilateral ilioinguinal nerves were identified. A 2×1 cm standard polypropylene mesh was laid on the nerve on right side, whereas a same sized lightweight polypropylene was applied on the left after three different nerve treatments were carried out. The nerve was completely preserved in the first group [G1], cut by scissors without a further process in the second [G2], and proximal cut end was ligated with 5/0 polyglactin. Three months after the surgery, bilateral nerve samples were taken from the contiguous nerve segment for light microscopy and electron microscopy. RESULTS: Nerve protection could not prevent microscopic changes entirely. Prosthetic mesh itself seemed to cause histopathologic changes. Overall incidence of histopathologic changes in light microscopy, without taking the nerve treatment pattern into account, was somewhat lower at standard mesh side than that of lightweight mesh side. However this difference did not reach the level of significance (P=0.39). When three groups were evaluated in respect to overall nerve damage without paying attention to mesh type, the highest damage rate was observed in G3 (cut and ligate). When each group was compared separately within itself for histopathologic changes, no differences were observed between heavy and light mesh sides in any group. When the microscopic changes were compared in respect to the different nerve treatment patterns on heavyweight mesh side, the rates were 12.5%, 12.5%, and 33.3%, respectively. On lightweight mesh side, all three groups exhibited similar microscopic finding rates, 37.5%, 25.0%, and 33.3%, respectively. Protection of the nerve resulted in virtually zero neuroma formation after two types of mesh use. Surgical trauma to the nerve was observed to have an obvious potential for neuroma formation. Mesh type did not affect the overall neuroma rate within the whole subject pool; both groups displayed same 40% overall neuroma development rate. The neuroma incidence was in 43.8% G2 and 72.2% in G3, however the difference did not attain level of significance (P=0.09). The highest rate was observed when a lightweight mesh was used after dividing and ligating the nerve. CONCLUSIONS: Light mesh could not provide a protection in subjects whose nerves were injured during surgery. Ligation of the cut end of the nerve also could not be helpful. Nerve protection still seems to be the best way for a nerve-related complaint-free postoperative period. The merit of nerve end implantation into the muscle should also be reconsidered.

Long-term complications of mesh repairs for abdominal-wall hernias.

The use of prosthetic materials in repair of abdominal-wall hernias can lower the risk of hernia recurrence. Therefore, large numbers of meshes are used worldwide every year. All types of meshes on the market have the potential to cause certain complications, such as fistula formation, migration, infection, and rejection. These long-term, clinical complications, although rare, can be serious. For this reason, we aim to provide a systematic review on these adverse effects. A PubMed search covering the last 20 years was done to obtain articles reporting these long-term effects. After searches with selected keywords, and careful evaluation of the resulting articles, 64 articles reporting specific long-term complications were selected and set aside for analysis. Most of the articles were case reports and retrospective analyses (61/64). No evidence-based data exist regarding prevention of these late complications.

Central venous catheter-associated thrombosis in the perioperative period: a frequent complication in cancer patients that can be detected early with doppler examination.

AIMS AND BACKGROUND: The aim of the study was to determine the incidence of venous thrombosis in cancer patients with central venous catheters inserted perioperatively. METHODS AND STUDY DESIGN: A prospective analysis was performed with 68 patients in whom central venous catheters were placed perioperatively. Cancer patients with planned central venous catheters had prophylaxis with low-molecular-weight heparin. Patient characteristics, procedure-related complications and venous thrombosis related to central venous catheters were recorded. In order to detect the venous thrombosis, color Doppler sonography was used after removal of the central venous catheter. RESULTS: The median age of the 68 patients was 55 years (range, 24-83). The median duration of catheter placement in patients was 9 days (range, 1-24). Venous thrombosis was detected in 45 (66.2%) patients: at the superficial veins (jugular and subclavian veins) in 27 patients, stretching from superficial veins into the vena cava in 8 cases, in the vena cava in 2 cases, in the right atrium in 2 cases, and at more then one place in 6 patients. Total thrombosis was detected only in 3 patients. CONCLUSIONS: Cancer patients have a high central venous catheter-related thrombosis risk perioperatively despite prophylactic anticoagulation. Color Doppler sonography is a rapid and noninvasive technique and it is accurate in the diagnosis of venous thrombosis. Early detection of venous thrombosis is important to prevent the systemic and fatal complication of the thrombosis.

Most cited 100 articles from Turkey on abdominal wall hernias: a bibliometric study.

OBJECTIVES: The aim of the present study was to search the most-cited articles from Turkey on abdominal wall hernias and analyze their characteristics with several parameters. MATERIAL AND METHODS: In March 2019, a search was conducted through all databases in the Web of Science (WoS) to determine the most-cited articles on abdominal wall hernias. Each article was evaluated in regard to host journal, year of publication, the complete list of authors, the type of article, main subject of the study, institution of the study group. Citation counts in Google Scholar (GSch) were also obtained. RESULTS: Mean number of citations of the top 100 articles in herniology was 30.50. Articles were published in 38 journals; Hernia is the leading host. No correlation was observed between the journal impact factors and the number of the citations. Two thirds of the articles were clinical studies. Article types had no significant effect on the citation counts. Inguinal hernia was the most frequent topic by taking place in 58 papers. Articles related to incisional hernias had a higher mean number of citations in comparison with other topics. Ankara University School of Medicine had most cited articles, the highest number of total citations, and the highest citation per articles. Ankara Numune Training and Research Hospital and Istanbul University School of Medicine had the highest number of the articles in the list. CONCLUSION: Citation counts of hernia related articles from Turkey are relatively low. Hernia is the leading journal for Turkish studies. Inguinal hernia is the most frequent topic whereas papers about incisional hernias receive more citations than others.

A questionnaire study on the surgeons' preferences for inguinal hernia repair after a decade.

During the 20th century, hernia repair trend changed several times. A very interesting competition has been going on between the opponents of Lichtenstein and laparoscopic repairs. We recently questioned the same issue by the same method to see if laparoscopic hernia repair found more opponents and preference rate in surgeons and physicians in Ankara, Turkey. In general 88.9% of the respondents preferred open repair, while only 11.1% chose laparoscopy. The majority of the participants who preferred an open repair stated that it was a better known technique to choice. Almost half considered local anaesthesia an advantage. Laparoscopic repair was mainly preferred for its advantages of less pain and early return to work. When three consecutive surveys among the same population in Ankara in 1997, 2001 and 2007 were compared the laparoscopic repair preference rates did not show a statistical difference (9.1%, 16.1% and 11.1% respectively).

Tissue oxidative stress level and remote organ injury in two-hit trauma model of sequential burn injury and peritoneal sepsis are attenuated with N-acetylcysteine treatment in rats.

BACKGROUND: The second hit in trauma leads to an exaggerated inflammatory response and multiple organ failure. Infection following burn injury is a useful model for two-hit trauma studies. The aim of this study was to investigate the effect of N-acetylcysteine (NAC) treatment as an antioxidant in a two-hit trauma model. METHODS: 30% scalding burn injury was performed in 45 rats and cecal ligation-puncture (CLP) was performed 72 hours later. Groups were allocated as follows: Group I: No treatment was performed; Group II: Rats were treated with 150 mg/kg/day i.p. NAC for 72 h following CLP; Group III: Rats were treated with 150 mg/kg/day i.p. NAC for 6 days following thermal injury. Tissue samples were collected to study the tissue malonyldialdehyde (MDA) and glutathione (GSH) levels, and for histopathological examination on day 7. RESULTS: No difference in mortality between groups was detected. Tissue MDA levels significantly decreased in the liver (p=0.01, p=0.02) and ileum (p=0.01, p=0.02) in the treatment groups. Lung tissue GSH levels were found to be significantly increased in Group II (p=0.02). Lung injury scores were decreased in Group II (p=0.005) compared to the control group. CONCLUSION: NAC attenuated tissue oxidative stress level and remote organ injury in two-hit trauma. Further experimental and clinical studies on this subject are necessary.

Hernia and Cancer: The Points Where the Roads Intersect.

Introduction: This review aimed to present common points, intersections, and potential interactions or mutual effects for hernia and cancer. Besides direct relationships, indirect connections, and possible involvements were searched. Materials and Methods: A literature search of PubMed database was performed in July 2018 as well as a search of relevant journals and reference lists. The total number of screened articles was 1,422. Some articles were found in multiple different searches. A last PubMed search was performed during manuscript writing in December 2018 to update the knowledge. Eventually 427 articles with full text were evaluated, and 264 included, in this review. Results: There is no real evidence for a possible common etiology for abdominal wall hernias and any cancer type. The two different diseases had been found to have some common points in the studies on genes, integrins, and biomarkers, however, to date no meaningful relationship has been identified between these points. There is also some, albeit rather conflicting, evidence for inguinal hernia being a possible risk factor for testicular cancer. Neoadjuvant or adjuvant therapeutic modalities like chemotherapy and radiotherapy may cause postoperative herniation with their adverse effects on tissue repair. Certain specific substances like bevacizumab may cause more serious complications and interfere with hernia repair. There are only two articles in PubMed directly related to the topic of "hernia and cancer." In one of these the authors claimed that there was no association between cancer development and hernia repair with mesh. The other article reported two cases of squamous-cell carcinoma developed secondary to longstanding mesh infections. Conclusion: As expected, the relationship between abdominal wall hernias and cancer is weak. Hernia repair with mesh does not cause cancer, there is only one case report on cancer development following a longstanding prosthetic material infections. However, there are some intersection points between these two disease groups which are worthy of research in the future.

Umbilical Hernia Repair and Pregnancy: Before, during, after .

Umbilical hernias are most common in women than men. Pregnancy may cause herniation or render a preexisting one apparent, because of progressively raised intra-abdominal pressure. The incidence of umbilical hernia among pregnancies is 0.08%. Surgical algorithm for a pregnant woman with a hernia is not thoroughly clear. There is no consensus about the timing of surgery for an umbilical hernia in a woman either who is already pregnant or planning a pregnancy. If the hernia is incarcerated or strangulated at the time of diagnosis, an emergency repair is inevitable. If the hernia is not complicated, but symptomatic an elective repair should be proposed. When the patient has a small and asymptomatic hernia it may be better to postpone the repair until she gives birth. If the hernia is repaired by suture alone, a high risk of recurrence exists during pregnancy. Umbilical hernia repair during pregnancy can be performed with minimal morbidity to the mother and baby. Second trimester is a proper timing for surgery. Asymptomatic hernias can be repaired, following childbirth or at the time of cesarean section (C-section). Elective repair after childbirth is possible as early as postpartum of eighth week. A 1-year interval can give the patient a very smooth convalescence, including hormonal stabilization and return to normal body weight. Moreover, surgery can be postponed for a longer time even after another pregnancy, if the patients would like to have more children. Diastasis recti are very frequent in pregnancy. It may persist in postpartum period. A high recurrence risk is expected in patients with rectus diastasis. This risk is especially high after suture repairs. Mesh repairs should be considered in this situation.

Comments on the new groin hernia guidelines: What has changed? What has remained unanswered?

Guidelines are meant to evaluate the options available in the current circumstances and suggest the proper solutions for particular problems. The duty of a guideline is to present a basis for decision-making. Surgical options for the treatment of groin hernias are numerous. Recently, a joint guideline called "International Guidelines for Groin Hernia Management" was developed by five continental hernia societies, the International Endo hernia Society, and the European Association for Endoscopic Surgery. This article aimed to review the methodology, statements, and recommendations of the new guidelines and emphasized the importance of the tailored surgery for groin hernias. Spreading the guidelines may provide surgeons with an up-to-date knowledge and be useful for better outcomes in groin hernia surgery.

Diagnostic value of blood D-dimer level in acute mesenteric ischaemia in the rat: an experimental study.

OBJECTIVE: The high mortality rate of mesenteric ischaemia is mainly due to delay in diagnosis. For this reason, it is of great importance to find a specific and rapidly elevating marker. The present study investigated the diagnostic value of blood D-dimer level as a potential marker for acute mesenteric ischaemia in a rat model. METHODS: Thirty male Wistar albino rats were divided into three groups. Basal D-dimer and L-lactate levels were determined in the non-operative control group (I). In the operated control group (II), the superior mesenteric artery was simply manipulated, while the artery was ligated in Group III. Blood samples were drawn in all groups for D-dimer and L-lactate assays. RESULTS: Both Group II (p=0.016) and Group III (p=0.001) had significantly higher mean D-dimer levels in the first postoperative hour compared with the basal level in Group I. However, there was no difference between the levels in Groups II and III. The mean level in Group II in the sixth hour had dropped to a statistically insignificant level compared with the basal value, while the mean value in Group III kept rising during this period (p=0.001). Nevertheless, there was no significant difference between Groups II and III. On the other hand, the mean L-lactate level in the first postoperative hour in Group III was significantly higher than the basal level in Group I (p=0.003). No significant rises were recorded in Group II in the first and sixth postoperative hours. The difference between Groups II and III in the first hour was significant (p=0.005). Group III also had significantly higher mean serum L-lactate value in the sixth hour compared with both the basal value in Group I (p=0.001) and the sixth-hour value in Group II (p=0.003). CONCLUSION: These results do not adequately support the use of blood D-dimer level as an independent parameter in the diagnosis of mesenteric ischaemia due to arterial thrombosis. However, this parameter can be used together with other tests in eliminating the possibility of a thromboembolic event.

Current Status of Hernia Centres Around the Globe.

Institutions specifically dedicated to treatment of abdominal wall hernias have gained popularity over the last years. This study aimed to determine the current situation of hernia centres worldwide. A web-based search was conducted using the common search engines Google and PubMed. The details recorded were as follows: name of the centre, country, establishment year, administrative structure (hospital affiliated, private practice group, or independent solo practice), whether or not the centre has its own operation room, the number of employed surgeons, preferred anaesthesia type, preferred repair type, laparoscopic technique option, case volume per year, and the number of scientific publications. A total of 182 centres were found in 30 different countries. Eighty-one (44.5 %) centres provide services as part of an affiliation within a general hospital (18 in university hospitals). Only 28 (15.5 %) of the centres have published a paper on abdominal wall hernias indexed by PubMed. The total number of papers in PubMed by 182 centres is 354. We observed that clinical outcomes in hernia centres are not shared globally by publishing them in scientific journals, and whether specific hernia surgeons and centres provide better outcomes in treating abdominal wall hernias, compared to general surgeons who deal with all kinds of surgical procedures, remains unclear.

[The effect of clinical, laboratory and radiologic results on treatment decision and surgical results in patients admitted to the emergency department with blunt abdominal trauma due to traffic accident]. / Acil servise trafik kazasina bagli künt abdominal travma ile basvuran hastalarda klinik degerlendirme, laboratuvar parametreleri ve radyolojik sonuçlarin tedavi kararina ve cerrahi sonuçlarina etkisi.

BACKGROUND: The purpose of this study was to evaluate the effect of clinical, laboratory and radiological results on treatment decision and surgical results in patients with blunt abdominal trauma, who were admitted to the emergency department due to traffic accident. METHODS: Two hundred and twenty-two patients with blunt abdominal trauma were included into this retrospective study. Pearson chi square, Mann-Whitney U test and logistic regression methods were used for statistical analysis. RESULTS: All patients were analyzed by complete blood count and biochemistry and abdominal sonography. Eighty-two patients were also evaluated by CT. Twenty-three patients underwent surgery. Positive findings on physical examination, sonography and CT, increased white blood cell count and liver function tests, decreased hemoglobin were associated with the need for surgery. DISCUSSION: For the surgical evaluation of patients with blunt abdominal trauma, a reliable physical examination is not possible when the patients have concomitant injuries causing disturbing pain, or when the patients are unconscious. Laboratory tests should be interpreted with the clinical and radiologic analysis. Radiologic procedures play an important role in the management of patients with blunt abdominal trauma, especially for intubated patients.

The effects of verapamil vs. allopurinol on intestinal ischemia/reperfusion injury in rats. "An experimental study".

BACKGROUND/AIMS: Although studies have reported that xanthine oxidase inhibitors or calcium channel blockers attenuate the ischemia-reperfusion injury in several organ systems, no comparative study exists on the significance of each of these pathways. To study this, in anesthetized Wistar Albino rats, a surgical model for intestinal ischemia-reperfusion injury was employed. METHODOLOGY: In experimental animals, after laparotomy, the superior mesenteric artery was occluded for 30 min, followed by a 2-h period of reperfusion; control rats underwent only a sham laparotomy procedure. One group of experimental animals was pretreated intraperitoneally with the calcium channel blocker verapamil (0.3 mg/kg), another group with the xanthine oxidase inhibitor allopurinol (100 mg/kg), the third group received no pretreatment. Plasma lactate, malondialdehyde and glutathione levels as well as intestinal tissue malondialdehyde and glutathione levels were measured to assess for possible protective effects. Histologic evaluation of the extent of injury was also performed. RESULTS: Irreversible tissue damage was depicted in the untreated group, and partially in the allopurinol pretreatment group by histologic examination. Ischemia-reperfusion injury was reversible in the verapamil group. The laboratory results also supported these findings. CONCLUSIONS: Protective effects of verapamil on ischemia-reperfusion injury have been found to be significantly (p<0.0001) more effective compared to allopurinol.

The evaluation of the patients admitted to a burn center in Turkey.

BACKGROUND: Burns constitute an important part of the accident-related deaths due to high morbidity and mortality. METHODS: The medical records of 778 (279 female) patients who were treated during last three years period were retrospectively analyzed concerning age, gender, the cause of the burn, the month when the burn occurred, admission date, duration of the hospital stay, area of the burn. The relationship between these parameters and the mortality was analyzed. RESULTS: The average age of the patients was 20 years. The burns were related to accidents in 87% patients, abuse in 8%, co-morbid diseases in 3% and suicidal attempts in 2%. In 48% of the cases there were hot fluid burns and in 37% (284) fire-flames. The burns were due to electrical burns in 13% patients and to other reasons in the remaining 2%. One hundred and seventy - two patients had fatal courses. The mortality rate was 75% in 12 patients who were above 60 years. Average burn area was 24% (10-100) and average hospital stay was 13 days. CONCLUSION: As most of the burns were due to accidents, the number of burns might be reduced by prioritizing preventive measures and better results could be obtained when the quality and the number of the burn centers is increased.