[Predictive factors of mortality of the burnt persons: study on 221 adults hospitalized between 2004 and 2009]. / Facteurs prédictifs de mortalité des brûlés : étude sur 221 adultes hospitalisés entre 2004 et 2009.

The objective of the present study is the evaluation of the predictive factors of mortality to a troop of Moroccan grown-up serious burnt persons. Variables analyzed in the study are: the age, the sex, the localization of the burn, the degree of burn, indicates Total Body Surface Area (TBSA), indicate Unit of Standard Burn (UBS) and the indication of leases, sepsis and the medical histories (tobacco, diabetes). Factors associated significantly to a mortality raised at the burned patients were the female genital organ, the localization of the burn at the level of the head, the sepsis, one TBSA greater or equal to 20%, an UBS greater or equal to 200 and an indication of leases greater or equal to 75. Other factors such as the age, the degree of burn and the histories did not show a significant difference. An evaluation and a good knowledge of factors associated to a high risk of death allow an adequate coverage of this category of patients.

[Rail plastic surgery technique in the treatment of popliteal contractures]. / La plastie en rail dans le traitement des brides rétractiles du creux poplite.

The case is presented of a patient aged 45 years suffering from thermal burns due to flame following the deflagration of a gas cylinder. The initial lesions involved the four limbs, in particular the knee, and the trunk. The initial taking in charge consisted in an early excision-graft of the limbs. The evolution of the burn was marked by the development of hypertrophic scars at the level of the non-transplanted zones and at the edge of the graft as also by the onset of contractures. Because of the functional problem caused by the contracture as a result of the considerably reduced extension, the patient was admitted for surgical treatment. Thanks to the rail technique described, the patient recovered normal knee function. Post-surgical treatment was straightforward with a hospitalization period of one month. The aesthetic results were satisfactory. The rail technique is part of the therapeutic arsenal for treating knee contractures. Its simplicity, easy technique, and satisfactory results, plus its easy follow-up, make it a highly appreciated technique in the treatment of this type of contracture.

Epidemiological analysis of burn patients in the military hospital, Rabat, Morocco.

A retrospective study was conducted of burn patients admitted to the military hospital in Rabat, Morocco, in the 6-yr period from 2004 to 2009. This is the first multivariate study to be performed in Morocco. The epidemiological data from the 291 patients hospitalized were collected and studied. The type of burn was indicated in 284 of the patients: 94% of the injuries were thermal burns, 4% were electrical burns, and 1.5% chemical burns. In 261 cases the exact aetiology was noted: 56% of accidents were caused by flames, 38% by hot liquids, 4% by electric current, and 2% by chemicals. The distribution of the Moroccan population is as follows: 0-4 yr, 7%; 5-l4 yr, 8%; 15-19 yr, 8%; 20-59 yr, 70%; over 60 yr, 7%. The male/female sex ratio was 1.63. The mean duration of hospitalization stay was 42 ± 62 days. The mean body surface area burned was 21 ± 18%. Total mortality was 5%; 57% of deaths were due to septic shock. Our results were similar to data from other studies in the literature, with certain characteristics in our series, especially the age bracket most affected, the body surface area burned, and the mechanisms of injury.

[Tissue expanders in the treatment of burn injuries]. / Les Protheses d'Expansion dans le Traitement des Sequelles de Brulures.

Les Auteurs présentent leur protocole pour l'expansion cutanée et rapportent quatre cas colligés au service des brûlures de leur hôpital au Maroc. Ils décrivent leur technique opératoire et les résultats obtenus. L'expansion cutanée reste la méthode de choix pour la couverture des pertes de substance étendues et la correction des séquelles de brûlure, et l'expérience rapportée par les Auteurs confirme les bons résultats que l'on peut obtenir avec cette technique, y compris les résultats esthétiques.

[Utility of the hypogastric flap in the treatment of burns to the dorsum of the hand]. / Interet du Lambeau Hypogastrique Dans le Traitement des Sequelles de Brulure de la Face Dorsale de la Main.

Hypogastric flaps are axial cutaneous flaps vascularized by the superficial inferior epigastric pedicle. They are an effective way of covering the posterior face of the hand and wrist. Four patients benefited from this manner of substance loss after excision of the scar tissue required a hypogastric flap severed on day 21. The aesthetical and functional results were quite satisfactory. This type of flap is the technique of choice in the treatment of hand burn sequelae with exposure of the noble elements - with its ease of dissection, it presents few complications and requires only a little eventual touching-up to provide optimal results.

[Münchausen syndrome by proxy. A case report]. / Le syndrome de Münchausen par procuration. A propos d'un cas.

The plastic surgeon rarely encounters patients with factitious disorders. The syndrome of Münchausen by proxy is a part of it. We put the point on this syndrome through a clinical observation of an eight-year-old girl victim of parental abuse.

[Not Available]. / Brulures par Bouillottes Chez les Diabetiques.

Diabetic neuropathy is a frequent complication of diabetes. The most frequent clinical form is known as "sock polyneuritis", with loss of sensitivity to pain in the feet. Hot water bottle burns are the prerogative of diabetic patients suffering from a form of sensitive polyneuropathy. Such burns are deep. It is difficult to take therapeutic responsibility and decisions must be multidisciplinary. We underline the importance of the education of diabetic patients and of arousing their awareness to the possible risks involved in the use of hot water bottles.

[Squamous Cell Carcinoma on burn scar: Summary of five cases]. / Epithelioma Spinocellulaire sur Cicatrice de Brulure (a Propos de Cinq Cas).

In order to study Marjolin's ulcer, all the case histories of patients admitted over a 5-yr period to a Service of Plastic Surgery and Burn Patients in Morocco presenting a histopathologically confirmed burn scar cancer were included in a data file with information regarding the medical background of the five patients concerned, their treatment, and the evolution of the case.After this data presentation, the problems set by spinocellular epithelioma, which is a serious and rare affection, are considered.The degeneration of burn scars is a dramatic development, caused by negligence. Preventive treatment, with systematic exeresis of any suspicious lesion, is strongly recommended as it guarantees almost certain recovery.

[Solitary fibrous tumor of the scalp: a case report]. / Tumeur fibreuse solitaire du cuir chevelu : a propos d'un cas.

The solitary fibrous tumor is a rare tumor, ubiquitous, mesenchymatous essentially affecting serosal surfaces. The location in the scalp is exceptional. We report a case of tumor in left occipital scalp discovered after recurrence of a tumor initially taken for a lipoma. The motive for consultation was mainly aesthetic. The pathological examination is the main element of diagnosis. The assumption is based on a large lumpectomy and an extended and regular clinical monitoring. The forecast is favourable with a decline of one year. However, relapses may occur in the long-term and there are malignant forms.

[Not Available]. / L'Attitude Chirurgicale dans les Brulures Electriques Graves par Haut Voltage: À Propos de Deux Cas.

Devant une brûlure électrique grave, deux attitudes chirurgicales se distinguent: 1. une attitude conservatrice; 2. une attitude d'amputation. A la lumière de deux observations, les Auteurs discutent les avantages et les difficultés de la mise en oeuvre de chaque attitude.

[Not Available]. / Brulures Profondes des Membres Apres Intoxication au Co Par Usage du Barbecue Traditionnel en Salle de Bain.

En l'absence des moyens de chauffage moderne à domicile chez une proportion non négligeable des Marocains, le recours au moyen traditionnel est fréquent. A travers six observations de brûlures profondes des membres, particulières par leur mode de survenue et par leur gravité, les Auteurs attirent l'attention sur le danger de l'utilisation du barbecue traditionnel «majmer¼ pour réchauffement en milieu clos.