Single-Stage Composite Reconstruction Of Complex Electrical Burn Defects By Microvascular Techniques - A Prospective Study.

Electrical burn constitutes a major proportion of patients admitted to the burn ward with life- as well as limb-threatening complications. Due to the severity of an electric current passing through the body, local tissues are greatly damaged. These patients require multiple debridements and surgeries to cover the composite defect resulting from a high voltage electrical contact burn. In our study, we intend to evaluate the application of microvascular reconstruction by doing a free tissue transfer on an electrical burn defect, and determine how doing a composite reconstruction of a complex defect in a single stage helps in decreasing morbidity.

Les brûlures électriques représentent une forte proportion des causes d'admission en CTB et entraînent des risques vitaux et fonctionnels en raison des dégâts tissulaires majeurs qu'elles génèrent. En cas d'atteinte par haut voltage, des interventions chirurgicales multiples, d'excision puis de reconstruction, sont souvent nécessaires. Cette étude évalue la reconstruction par lambeau microanastomosé dans ces situations, et la possibilité de la réaliser en un seul temps par transfert composite afin de diminuer la morbidité.

The kerosene tragedy of 1994, an unusual epidemic of burns: epidemiological aspects and management of patients.

An unusual and perhaps the first epidemic of burns occurred between 15 February 1994 and mid April 1994 in four districts of the State of Rajasthan in India. The cause of this epidemic was the accidental mixing of petrol in kerosene oil which was inadvertently overlooked. This mixture of kerosene and petrol was used mainly by people of low-income groups for lighting lamps. Most of the accidents occurred while pouring this highly inflammable petrol-kerosene mixture into ignited lamps. A total of 303 cases were reported: 118 of these patients sustained severe burns of whom 37 died. Small numbers of fresh cases kept occurring over a period of 2 months in spite of all efforts by the administration, because poor people kept using the fatal mixture due to ignorance and illiteracy. Most of the patients were managed at district hospitals with the help of plastic surgeons called for the purpose from Jaipur, the capital city of the affected State. A total of 40 out of 303 patients were transferred to SMS Hospital where a medical ward was vacated to manage these patients, as the 10-bed burn unit already had 300 per cent best occupancy. Most of these patients were not willing to be sent to a burn unit situated far away from their homes, but they had to be transferred because the general surgeons working at district hospitals were hesitant to manage them, not so much due to lack of training in the management of burns, but more due to lack of willingness to manage burns. This indicates the need for renewed emphasis not only of the necessity of training general surgeons, nursing and paramedical staff at district level in the management of burns, but also of the need to manage these cases at district level. This idea needs serious consideration and sincere efforts to implement it at the national level. The paper has been split into two parts: epidemiological aspects and management of patients.

An unusual case of acute renal failure in burns.

Nowadays acute renal failure in burns is not a common occurrence, at least not when most of the wounds have already healed. We report a case of a 6-year-old child with 45 per cent flame burns, who suffered acute renal shutdown 43 days after burns when all except 1 per cent of the raw areas had already been grafted with autologous skin. There was no identifiable focus of infection and no evidence of septicemia. The patient was not receiving any nephrotoxic drugs. The child responded well to peritoneal dialysis and recovered fully.

Paediatric burns in Jaipur, India: an epidemiological study.

This retrospective review contains 127 paediatric burns up to 14 years of age admitted to the Burn Unit of the Department of Burns and Plastic Surgery, SMS. Medical College, Jaipur over a period of 1 year from January 1990. Epidemiological data include age, sex, seasonal variation, place of burn, family size, economic status, period of time between the accident and admission to hospital. The cause and mode of burn, the relationships between mortality and age, cause of burn and extent of burn are discussed. Most of the burn injuries occurred in the winter months between December and March. Males were affected predominantly. The majority of the burns occurred at home. Most of the patients belonged to the low socioeconomic strata and were members of medium or large size families. The commonest causes of injury were scalds in children under 5 years of age and flames in the older children. The overall mortality was 19.68 per cent.