RESUMO
Electrical injuries and especially those of high voltage still remain a source of high morbidity. Over the past few years, a change in the epidemiologic profile of these lesions was noticed at the Vall d'Hebron University Hospital Burn Unit, corresponding to an increase in cases out of the legal framework. It is our aim to describe this particular subset, to determine the extent of their injuries and to understand the reason for their increased incidence. We think this was favoured by the rise in the unemployment rate, along with higher copper prices.
Assuntos
Acidentes Domésticos/estatística & dados numéricos , Queimaduras por Corrente Elétrica/epidemiologia , Recessão Econômica , Traumatismos Ocupacionais/epidemiologia , Roubo/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Amputação Cirúrgica , Queimaduras por Corrente Elétrica/complicações , Queimaduras por Corrente Elétrica/cirurgia , Criança , Pré-Escolar , Síndromes Compartimentais/etiologia , Síndromes Compartimentais/cirurgia , Cobre , Desbridamento , Fasciotomia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Distribuição por Sexo , Transplante de Pele , Espanha/epidemiologia , Desemprego/estatística & dados numéricos , Adulto JovemRESUMO
OBJECTIVE: To assess the efficacy of cultured epidermal autografts (CEA) for closure of burn wounds in pediatric burn patients with full-thickness burns of more than 90% total body surface area. SUMMARY BACKGROUND DATA: Paucity of donor sites in massive burns makes the use of expanded skin of paramount importance. CEA techniques have been used in burned patients with differing and controversial results. The true impact and the efficacy of such techniques in massive burns remain uncertain. METHODS: Patients with full-thickness burns of more than 90% body surface area treated between May 1988 and May 1998 were studied. Patients grafted with CEA were compared with patients grafted with conventional meshed autografts. Rates of death and complications, length of hospital stay (LOS), hospital cost, acute readmissions for reconstruction, and quality of scars were studied as outcome measures. RESULTS: Patients treated with CEA had a better quality of burn scars but incurred a longer LOS and higher hospital costs. Both groups had comparable readmissions for open wounds, but patients treated with CEA required more reconstructive procedures during the first 2 years after the injury. The incidence of sepsis and pneumonia in both groups was comparable. CONCLUSIONS: Conventional meshed autografts are superior to CEA for containing hospital cost, diminishing LOS, and decreasing the number of readmissions for reconstruction of contractures. However, the use of CEA provides better scar quality such that perhaps future research should focus on bioengineered dermal templates to promote take and diminish long-term fragility.