[Burns in adolescents]. / Quemaduras en adolescentes.

INTRODUCTION: The aim of this study was to know the epidemiology of burns in teenagers. PATIENTS AND METHODS: Burn patients over 11 years old admitted in our Institution in the last 10 years were included. Etiology, burn size, hospital stay, quirurgical interventions and long term sequelae were registered. RESULTS: One thousand and eight patients were admitted, 89 were over 11 years (8.8%), 70.7% were boys and 29.3% girls. Fire was the principal agent in 58 cases (65.1%), due to fireworks in 13 (22.4%), alcohol in 7 (12%), explosion of flammable containers (spray) in 4 (6.8%) and gasoline in 3 (5.2%). Fireworks injuries and spray explosions affected face and hand in 88% cases. The median hospital stay was 8 days after admission (1 to 90). 83.1% required surgical treatment with mean of 1.8 +/- 1.4 interventions and 21.3% had long-term sequelaes that required at least one surgical intervention. CONCLUSION: Fire is the main cause of burns in adolescents. Fireworks injuries represented a quarter of that lesions, and highlights paint spray explosions as new causative agents. Considering the high morbidity in this age group, with permanent functional and aesthetic sequelae, prevention campaigns are needed to reduce such accidents.

Quemaduras en adolescentes / Burns in adolescents

Objetivos. El objetivo de este estudio es valorar la epidemiología y etiopatogenia de las quemaduras en adolescentes. Pacientes y métodos. Estudio descriptivo retrospectivo de los pacientes mayores de 11 años ingresados en nuestro servicio por quemaduras en los últimos 10 años. Se registraron la etiología, superficie corporal quemada, estancia hospitalaria, intervenciones quirúrgicas y secuelas. Resultados. De un total de 1.008 pacientes ingresados por quemaduras, se incluyeron 89 con edad superior a 11 años (8,8%), siendo el 70,7% niños y el 29,3% niñas. El agente principal fue el fuego en 58 casos (65,1%), resultando secundario a explosión pirotécnica en 13 (22,4%), alcohol como combustible en 7 (12%), explosión de envases inflamables (spray) en 4 (6,8%) y gasolina en 3 (5,2%). La cara y las manos se vieron afectadas en las explosiones pirotécnicas y por spray de pintura en el 88% de los casos. La mediana de estancia hospitalaria fue de 8 días de ingreso (1 a 90). El 83,1% precisó de tratamiento quirúrgico con una media de 1,8 ± 1,4 intervenciones y el 21,3% presentaron secuelas que necesitaron al menos una intervención quirúrgica posterior. Conclusión. El fuego es la principal causa de quemadura en adolescentes, representando las explosiones pirotécnicas una cuarta parte y destacando la aparición de nuevos agentes causales, como la deflagración de botes de pintura (graffiti).Dada la alta morbilidad en este grupo de edad, con secuelas estéticas y funcionales permanentes, creemos conveniente la necesidad de campañas preventivas que contribuyan a disminuir este tipo de accidente (AU)

Introduction. The aim of this study was to know the epidemiology of burns in teenagers. Patients and methods. Burn patients over 11 years old admitted in our Institution in the last 10 years were included. Etiology, burn size, hospital stay, quirurgical interventions and long term sequelae were registered. Results. One thousand and eight patients were admitted, 89 were over 11 years (8.8%), 70.7% were boys and 29.3% girls. Fire was the principal agent in 58 cases (65.1%), due to fi reworks in 13 (22.4%), alcohol in 7 (12%), explosion of flammable containers (spray) in 4 (6.8%) and gasoline in 3 (5.2%). Fireworks injuries and spray explosions affected face and hand in 88% cases. The median hospital stay was 8 days after admission (1 to 90). 83.1% required surgical treatment with mean of 1.8 +1.4 interventions and 21.3% had long term sequelaes that required at least one surgical intervention .Conclusion. Fire is the main cause of burns in adolescents. Fireworks injuries represented a quarter of that lesions, and highlights paint spray explosions as new causative agents. Considering the high morbidity in this age group, with permanent functional and aesthetic sequelae, prevention campaigns are needed to reduce such accidents (AU)

[Heterogenicity of Gorham-Stout syndrome: association with lymphatic and venous malformations]. / Heterogenicidad del síndrome de Gorham-Stout: asociación a malformaciones linfáticas y venosas.

INTRODUCTION: Gorham-Stout syndrome is a rare disorder of unknown etiology characterized by osteolysis and microscopic proliferation of abnormal vessels. We report two cases of this syndrome associated with lymphatic and venous malformations. CASE REPORTS: The first case is a 5-year-old boy with disseminated lymphangiomatosis of poor prognosis, with significant pleural involvement and osteolytic lesions. The second case is a 5-year-old girl with a diagnosis of Klippel-Trenaunay syndrome with significant skeletal involvement of the lower extremities and secondary pathological fracture. CONCLUSIONS: Gorham-Stout syndrome may occasionally be associated with various lymphatic and venous malformations. Osteolysis and bone resorption may be induced by lymphatic bone involvement.

Heterogenicidad del síndrome de Gorham-Stout: asociación a malformaciones linfáticas y venosas / Heterogenicity of gorham-stout syndrome: association with lymphatic andvenous malformations

Introducción. El síndrome de Gorham-Stout constituye una rara enfermedad de etiología desconocida que se caracteriza por osteólisis rápidamente progresiva y proliferación microscópica de vasos anormales. Presentamos 2 casos clínicos asociados a malformaciones linfaticovenosas. Casos clínicos. El primer caso es un varón de 5 años afecto de linfangiomatosis generalizada de evolución desfavorable, con importante afectación pleural y lesiones osteolíticas. El segundo caso se trata de una niña de 5 años diagnosticada de síndrome de Klippel-Trénaunay con importante afectación ósea en miembros inferiores y fractura patológica secundaria. Conclusiones. El síndrome de Gorham-Stout puede presentarse ocasionalmente asociado a distintas malformaciones linfaticovenosas. La afectación linfática del hueso puede provocar osteólisis y resorción ósea (AU)

Tratamiento médico de las quemaduras en la infancia. Protocolo hospitalario / Medical treatment of burns in childhood. Hospital guidelines

Presentamos en este trabajo el protocolo clínico utilizado en nuestra Unidad para el tratamiento médico de los niños que ingresan por quemaduras graves. Hemos realizado una búsqueda bibliográfica de los últimos 5 años para actualizar el tratamiento hospitalario de estos pacientes, en base a las últimas publicaciones y a la experiencia clínica de la Unidad. Para realizar el tratamiento adecuado necesitamos previamente tener un correcto diagnóstico de la extensión y profundidad de las lesiones y un conocimiento fisiopatológico básico de las lesiones por quemadura. Resaltamos la necesidad de una correcta administración de líquidos desde las primeras horas del accidente basado en fórmulas descritas en la literatura y de amplia experiencia clínica, de un soporte nutricional adecuado que disminuya el hipermetabolismo y mejore el estado nutricional e inmunológico del paciente, y del tratamiento del dolor desde su ingreso en el hospital lo que disminuirá la hiperalgesia tan frecuente en estos niños, el estres y por consiguiente el hipermetabolismo. Un correcto tratamiento médico con un tratamiento quirúrgico precoz y efectivo van a contribuir a la curación de estos pacientes disminuyendo las complicaciones infecciosas y la morbimortalidad (AU)

[The usage of thermo-vac facial masks for the treatment of hypertrophic scars in children]. / Aplicación de Thermo-Vac en secuelas de quemaduras faciales en niños.

We present the results obtained in the treatment of facial hypertrophic scars in children admitted in the Pediatric Burn Unit of the Hospital Infantil La Paz (Madrid). During the last 30 months 13 patients, with ages ranging from 3 months to 5 years, have been treated. Compared to the elastic pressure masks, rigid masks have yielded better results both on the short and the long term. Rigid masks of Thermo-Vac material turn out to be more comfortable and easier to wear and tolerate than the classical elastic appliances.

[Torsion of the spleen]. / Torsión del pedículo del bazo.

Twisting of the spleen on its pedicle, due to the lack of the normal fixation elements, is a rare pathological condition in childhood. The revised literature reports 11 cases under the age of 10 years. We present three new cases treated at the Clínica Infantil "La Paz" (Madrid) during a period of 15 years. Ages of the three patients were 18 months, 15 months and a newborn, operated upon at 10 days. It is important to point out that only two cases of the 11 reported in the literature were younger than 12 months of age. This article also presents the embriological study of this malformation and discusses its clinic, diagnostic and treatment.

[Treatment of intestinal obstruction after surgery (author's transl)]. / Tratamiento de las obstrucciones intestinales recidivantes.

A revision of the children which during the last five years have undergone abdominal surgery is presented. 2% showed postoperative intestinal obstruction due to adhesions. Intestinal plication has been performed in children with a great amount of adhesions. A comparison is made of the Childs-Phillips and the Noble plication operation. Results in both cases showed to be good. The greater facility and the shorter duration of the surgery in the Childs-Phillips plication operation make this last technic more advisable.

Apple peel small bowel. A review of twelve cases.

This is a review of 12 cases with apple peel small bowel with agenesis of the dorsal mesentery and intestinal atresia, 11 of them jejunal and 1 duodenal in type who were treated at the Clinica Infantil "La Paz" Madrid over a period of ten years (1969--1979). The associated anomalies, the surgical treatment and the cause of death as well as the etiology and pathogenesis of this malformation are discussed.