Pediatric Craniofacial and Neck Burns.

This study aimed to determine the epidemiological features, risk factors, current management trends and prognosis associated with injury severity in paediatric craniofacial and neck burn injuries. In the study conducted between January 2016 and January 2022, the data of 204 paediatric patients with head and neck burns hospitalised in Gazi Yasargil Training and Research Hospital Burn Centre were scanned from medical records in a hospital computer. Of the total 204 patients, 114 (55.9%) were boys and 90 (44.1%) were girls. The age group most affected by burn trauma was the 1-4 age group at 55.4%. Scald burns were the most common cause in all age groups. Electrical, chemical and sunburns were rare causes. Among the patients, 97 (47.5%) developed acute conjunctivitis due to burns. Among the patients, 91 (44.6%) lived in rural areas and 113 (55.4%) in urban areas. The wound culture results of the patients were 24% positive, and the most common bacteria were Staphylococcus hominis (5.4%) and Staphylococcus aureus (4.9%). During follow-up, neck contracture developed in six (2.94%) patients with neck burns. Four (1.96%) patients died because of sepsis. The mean hospital stay was 5.49 ± 4.14 days. Craniofacial and neck burns in the paediatric population are complex and leave sequelae after burns, often requiring advanced care. Children are at risk for injury by liquid, kitchen and chemical products, which serve as common caustic injury mechanisms.

Analysis of traumatic acute diaphragmatic injuries.

Introduction: Diaphragm rupture (DR) is a rare pathological event usually caused by trauma. We aimed to analyse the characteristics of acute diaphragmatic injuries due to trauma and the treatment of such injuries. Methods: This study included the data of 15 patients who sustained diaphragmatic injuries due to trauma and underwent surgery at the Diyarbakir Gazi Yasargil Training and Research Hospital General Surgery Service between January 2016 and December 2019. Results: There were 240 patients who presented with abdominal trauma during the study period, and DR was detected in 15 (6.25%) of these patients. The male to female ratio was 14 to 1, and the average age of the patients was 29.66 ± 10.56 (15-46) years. The most common cause of diaphragmatic injury was penetrating abdominal injuries (86.7%). Blunt abdominal trauma accounted for 13.3% of the DR cases. Preoperative shock was present in four (26.7%) patients. Preoperative diagnosis was made in only one (6.7%) of 15 patients with DR. Other patients were diagnosed during operation. Thirteen (86.7%) patients had additional organ injuries, and two patients had isolated diaphragmatic injuries. The most frequently injured organ was the lung (n = 7, 46.6%). Complications developed in six patients (morbidity rate 40%), and pulmonary complications were most frequently encountered (n = 5, 33.3%). The mortality rate was 6.7%. Conclusion: As traumatic DRs are uncommon and often associated with additional organ injuries, a careful general assessment of the patient should be made.

Profile of patients with burns according to seasonal changes.

OBJECTIVE: In this study, the aim was to discuss the effects of seasonal changes on the patient profile and number of patients hospitalised at our burn centre. METHOD: All cases of burns that occurred between 1 January 2014 and 1 January 2020 at our hospital were investigated. RESULTS: In total, 1417 patients were investigated, 799 of whom were male (56.4%) and 618 (43.6%) were female. The number of patients with burns in the 1-4 years age group was the highest of all the age groups. Scald burns and electrical burns were mostly observed in the spring; flame burns were mostly observed in the winter, and hot object contact and chemical burns were mostly observed in the summer. When considered in total, burn cases were mostly observed in spring and autumn. CONCLUSION: Understanding seasonal epidemiology of burn injuries can facilitate seasonal injury prevention campaigns and education efforts. Burn centres can also allocate resources appropriately, according to the patient volume and possible burn outcomes for each season.

Laser Hemorrhoidoplasty Versus Ligasure Hemorrhoidectomy: A Comparative Analysis.

Background and objective Minimally invasive techniques in the surgical treatment of hemorrhoids have been gaining in popularity. Laser hemorrhoidoplasty (LHP) and LigaSure™ (LigH; Medtronic, Dublin, Ireland) hemorrhoidectomy methods are the most recent innovative methods that are increasingly used. In this study, we aimed to compare the effectiveness of these two innovative techniques. Methods The data of patients who underwent LHP or LigH for grade III hemorrhoidal disease at our clinic between January 2022 and June 2023 were retrospectively analyzed. Postoperative pain levels, time to return to work or daily activities, complication rates, and recurrence rates of the treated patients were recorded. Results A total of 100 patients were included in the study. Of these, 48 patients had LHP surgery and 52 had LigH surgery. The demographic characteristics of both groups were similar. The mean operation time was statistically significantly shorter in the LHP group (p<0.001). The visual analog scale (VAS) scores on postoperative days one and seven were lower in favor of the LHP (2.4 ± 0.7 and 1.2 ± 0.9 vs. 6.2 ± 1.5 and 3.8 ± 1.3, respectively; p< 0.001). The median time to return to daily activity was 2.3 (range: one to three) days in the LHP group and 4.6 (range: 3-11) days in the LigH group (p<0.001). Recurrence was observed in 11 (22%) patients in the LHP group and in three (6%) patients in the LigH group (p<0.001). Conclusion Based on our findings, LHP is an effective procedure for the surgical treatment of hemorrhoidal disease as it is associated with less morbidity, less pain, early return to work, and acceptable recurrence rates.

Why is milk so dangerous in rural areas?

OBJECTIVE: In this study, hot milk burns observed in paediatric patients were examined, and the results were compared with those obtained from other types of scalding burns. METHOD: A 10-year retrospective study was conducted with paediatric patients hospitalised for hot milk burns at the Gazi Yasargil Training and Research Hospital Burn Center, Turkey. RESULTS: Of the 87 patients included in the study, 49 (56.3%) were male and 38 (43.7%) were female, with a male/female ratio of 1.29:1. Patients were aged two months to 18 years, with a mean age of 3.62±2.82 years. The highest rate of burn injury was observed in patients aged 0-4 years (n=67, 77.0%). The upper (n=56, 64.4%) and lower extremities (n=75, 86.2%) were the most frequently affected areas. Of the total number of patients examined, 25 (28.7%) exhibited second-degree burns, while 62 (71.3%) exhibited third-degree major burns. The mean hospitalisation time was 6.28±5.04 days. None of the patients died or underwent amputation. CONCLUSION: Scalding is the most common cause of burns in the paediatric population in Turkey. Hot milk burns attract attention due to their higher infection rates and length of hospital stay.

Our experience of emergency colorectal injury as a result of abdominal trauma

Objective: In the present study, we aimed to examine the treatments and their outcomes in cases with colon injuries after blunt and penetrating abdominal traumas. Materials and Methods: Twenty-six patients who underwent a laparotomy and were found to have a colon injury due to blunt abdominal trauma, penetrating stab injury, gunshot injury, and traffic accident were included. All patients were admitted into the emergency outpatient clinic of Gazi Yasargil Training and Research Hospital General Surgery Clinic between 2016 and 2020. The records of the cases were analyzed retrospectively. Results: Colon injuries were detected in 26 cases. All 26 (100%) cases were males with an average age of 29.80 ± 11.4 (range: 17-60) years old. Colon injuries observed during emergency operations included 18 (69.23%) patients with a GSI (gunshot injuries), 3 (11.53%) with penetrating stab injuries, 4 (15.38%) who were a part of traffic accidents and 1 (3.85%) patient with a blunt abdominal trauma. A primary colon repair was performed in 10 patients. Five patients underwent a colon resection and there were end colostomies. Four patients underwent a loop ileostomy after a colon resection and anastomosis. Colon resections with anastomoses were performed in seven patients. The mean hospitalization period was 26 ± 29.28 days. Conclusion: Patients should be classified intraoperatively with findings, such as peritoneal contamination, degree of colon injury, duration of the injury, and any accompanying injuries. (AU)

A rare type of burn : Nylon burns.

Objectives: In this study, it was aimed to examine nylon burns in paediatric patients and compare the results with other causes of hot object contact burns. Material and Methods: A 10-year retrospective study was conducted on 77 paediatric patients hospitalized for hot body burns at Gazi Yasargil Training and Research Hospital Burn Center. Results: Of those patients with hot body burns, 72.7% (n= 56) were males and 27.3% (n= 21) were females. Male-to-female ratio was 2.67:1. Mean age of the patients was 4.79 (min= 1, max= 16) years. There were 42 patients who applied to our hospital on the day of their burn, while four patients applied one day after the burn, one patient applied two days after the burn, 13 patients applied three days after the burn and 17 patients applied five days after the burn. Most burns (79.3%) were third-degree burns, whereas 19.5% were seconddegree and 1.2% were fourth-degree burns. The most common causes of hot body burns were hot nylon and hot stoves, followed by hot ash and hot irons. The number of nylon burns was the highest in the summer and the highest number of hot stove burns occurred in the winter. Nylon burns were most common in the three to eight age group and then gradually decreased. The highest burn rate was observed in nylon burns. Conclusion: The most common cause of all burns in the Turkish paediatric population is scalding. Although nylon burns are rare, they draw attention due to their higher burn degrees.

Review of our 10 years experience in cold burns at the burn center in the Southeast Anatolia region of Turkey.

BACKGROUND: Frostbite injuries remain to be one of the most complex and current problems of emergency medicine. Although cold burns are less frequent in hot climatic regions, it is a trauma, especially for men in our region. Also, most of the patients have difficulties in gaining early access to health and burn centers. METHODS: We performed a retrospective analysis on sixteen patients aged between 13 and 82, who were presented to Gazi Yasargil Training and Research Hospital Burn Center due to frostbite injuries. Data of each patient, including age, gender, injury time, extremity injuries, bacteriological observations, and general warming, were obtained from patients' files and computer records. RESULTS: After providing the first intervention to all the patients with trauma, a circulatory disorder of the injury area was deter-mined, and the treatment was provided accordingly. The treatment of these patients required very long and expensive operations, which often resulted in making them disabled. CONCLUSION: Deep frostbites in the cold winter months are frequently observed due to the unconscious use of ice and illegal crossings from the mountains at the Turkey border.

Evaluation of the Epidemiological Characteristics of the Patients Admitted to Our Clinic as a Result of Electric Shock.

Electric shocks (ESs) are common traumas in burn units that require treatment by specialists due to high mortality and morbidity. This study aimed to investigate the demographic and clinical characteristics of patients of ES, complications, and injury-related mortality and morbidity rates. The authors retrospectively analyzed data of 432 ES patients treated at the Gazi Yasargil Training and Research Hospital Burn Center, Turkey, between January 2010 and December 2020. Of the 432 patients, 92 (21.3%) and 340 (78.7%) sustained high- and low-voltage injuries, respectively. While high-voltage burns were common in January and December, low-voltage burns peaked in September and July. Burn patients were mostly males and were between the ages of 19 and 59 years. The majority of the ES events occurred at home. All four patients who died had suffered high-voltage burns, with two of high-voltage burns (2.17%) requiring amputation. None of the patients with low-voltage burns underwent amputation. High-voltage injuries manifested with larger burn surfaces, longer hospitalization, and more complications. Electrical injuries are largely preventable with simple safety precautions in daily life as well as serious consideration of workplace safety.

Diagnostic importance of serum C-reactive protein and procalcitonin in sepsis after burn.

INTRODUCTION: In this study, we investigated the usefulness of blood white blood cell (WBC), C-reactive protein (CRP) and Procalcitonin (PCT) levels with a clinical diagnosis of infection in patients with severe burns, with a bacterial culture (+) wound site, in patients with SIRS and sepsis. MATERIALS AND METHODS: In the study, 23 patients with (+) burn wound culture hospitalized in the intensive care unit of Gazi Yasargil Training and Research Hospital Burn Center burn between January 2016 and January 2021 were analyzed. While five of these patients were showing symptoms of SIRS. Sepsis was observed in five patients. RESULTS: From 23 patients, 18 (78.3%) were male, and 5 (21.7%) were female. The majority of our patients were lived in rural areas. The average age of patients was 1,061±17,273 years. The wound culture results of the 23 patients were (+), mostly due to Staphylococcus aureus in 21.7% (n=5) and Staphylococcus epidermidis in 21.7% (n=5). PCT and CRP results did not statistically differ in patients with sepsis, SIRS and (+) wound culture. CONCLUSION: The laboratory biomarkers WBC, CRP and PCT do not have a superior value in determining and monitoring infection processes in patients with serious burns.

Cases of Lower Extremity and Perianal Burns at the Burn Center in the Southeast Anatolia of Turkey.

Introduction: In this study, the aim is to discuss the cases of lower extremity and perianal burns at the burn center in the southeast Anatolia of Turkey. Material and methods: A 4-year retrospective study was conducted on 775 patients who had been admitted to Gazi Yasargil Training and Research Hospital Burn Centre with lower extremity and perianal burn injuries between January 2016 and January 2020. Results: Of the patients, 427 were male and 348 were female. Scald burns are most commonly affect the perianal and lower extremities. The right lower extremity was affected in 602 (77.7%) patients, the left lower extremity was affected in 574 (74.1%) patients and the perineum was affected in 70 (9.0%) patients. Most burn injuries occur in individuals between 0 to 4 years old, and the rate of burn injuries gradually decreases in individuals outside of this age range. No patient underwent colostomy for perianal burns. Conclusion: Early, aggressive and extensive debridement, in addition to adequate antimicrobial therapy, should be performed as the basis of treatment.

Flame burns.

Flame burns lead to significant long-term morbidity and functional consequences. This study analyzed the mortality-related factors in patients with flame burns to compare with the existing literature. This retrospective descriptive study was carried out at the General Surgery Clinic, Gazi Yasargil Training and Research Hospital, Turkey, to include 131 patients admitted and treated with emergency surgery for flame burns between January 2016 and December 2019. Of the patients hospitalized for flame burn, 103 (78.6%) were male and 28 (21.4%) were female (M:F = 3.6) with a mean age of 25.3 ± 20.78 years. The 15-34 years age group was the most affected by flame burns. The most frequently affected body areas were the upper extremities and face (n = 68, 51.9%); conjunctivitis developed in 49 (37.4%) patients. The wound infection rate was 34.3%, and Staphylococcus epidermidis had the highest growth rate in wound culture results (24.4%). Flame burns were most common in winter and autumn. The majority of patients (n = 95, 72.5%) were treated with escharectomy and dressing, while grafting was performed in 36 (27.5%) patients. A total of 3 (2.2%) patients died-one died in a suicide attempt, one due to inhalation burn after flame burn, and another died due to sepsis. The average length of hospital stay was 8.0 ± 3.9 days. Flame burns are much more common in young men, causing deeper and wider burns and requiring greater surgical intervention. This leads to frequent wound infections and longer hospital stays.

Bochdalek hernia: A rare case report of adult age.

INTRODUCTION: Bochdalek hernia is the most common type of congenital diaphragmatic hernia and constitutes 85% of cases. Bochdalek hernia (BH) in adults is extremely rare. We present a BH case in an adult patient and discuss the literature. PRESENTATION: 22-year-old female patient with abdominal pain, occasional cramps, dysphagic problems, constipation, shortness of breath and choking for about 2 years applied to our clinic. DIAGNOSIS: A defect about 5 cm in the left hemidiaphragm posterior area and herniation of intra-abdominal fat plan in the left hemithorax was seen in intravenous and oral whole abdominal CT. TREATMENT: Patient was operated laparoscopically. Transverse colon and a large portion of the omentum entering into hemidiaphragm were pulled in to intraperitoneal area carefully. Approximately 10 × 8 cm intraabdominal mesh was fixed to the defect area with the help of laparoscopic tacker. CONCLUSION: Adult BH is very rare and when confronted laparoscopic treatment with mesh fixation can be performed safely.

Solid cystic pseudopapillary tumor of pancreas with splenic metastasis: Case report and review of literature.

INTRODUCTION: Solid-cystic pseudopapillary tumor of the pancreas is rare and most commonly seen in young women. We present a young women with solid-cystic pseudopapillary tumor of the pancreas and discuss the literature. PRESENTATION OF CASE: Thirty nine years old female patient with a mass about 12cm in the pancreas with splenic invasion seen in our clinic. After having CT and PET-CT view, patient underwent surgery. Distal pancreatectomy with mass excision and splenectomy was performed. Microscopic examination result was solid cystic pseudopapillary tumor with spleen invasion. DISCUSSION: Solid-cystic pseudopapillary tumor of the pancreas has cystic solid pseudopapillary structures. Prognosis of tumor is better than other pancreatic tumor. Complete resection of tumor with splenic inclusion is surgical treatment. CONCLUSION: In case of large slow growing pancreatic tumor with splenic metastasis, solid-cystic pseudopapillary tumor of the pancreas should be considered in the diagnosis. Complete surgical resection is associated with long-term survival even in the presence of metastatic disease. Close follow-up is necessary after surgery.