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1.
Tidsskr Nor Laegeforen ; 142(7)2022 05 03.
Artigo em Norueguês | MEDLINE | ID: mdl-35510451

RESUMO

BACKGROUND: Breast reconstruction using free flaps based on the lower abdominal tissue is a common procedure. Postoperatively, the blood supply and innervation of the flap will be altered due to denervation. The case presented here illustrates the resulting increased sensitivity to heat exposure. CASE PRESENTATION: A woman in her sixties was treated for right-sided breast cancer with mastectomy and autologous reconstruction using a deep inferior epigastric perforator (DIEP) flap. Fourteen years later she experienced a dermal and subcutaneous burn in the flap after sunbathing for three hours wearing a black bikini. The burn injury required surgical treatment including debridement and skin transplantation. INTERPRETATION: Postoperative denervation resulting in altered thermoregulatory mechanisms and reduced sensation of a free flap can increase the risk of thermal damage long after surgery. Lifelong preventive measures might therefore be necessary. Patients and medical professionals need to be aware of this hazard after reconstructive surgery using free flaps.


Assuntos
Neoplasias da Mama , Queimaduras , Mamoplastia , Retalho Perfurante , Neoplasias da Mama/cirurgia , Queimaduras/etiologia , Queimaduras/cirurgia , Artérias Epigástricas/cirurgia , Feminino , Humanos , Mamoplastia/efeitos adversos , Mamoplastia/métodos , Mastectomia/efeitos adversos , Retalho Perfurante/irrigação sanguínea , Retalho Perfurante/cirurgia , Estudos Retrospectivos
2.
Emerg Med J ; 39(3): 185-205, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35190389

RESUMO

Clinical introductionA healthy 17-year-old girl presents with a wound on her left medial thigh (figure 1). Two days earlier while applying acrylic nail tips, she spilled nail glue on her jeans in the area of concern. Despite noticing an immediate irritable sensation, she did not perform any first aid nor did she remove her clothing to check the underlying skin.emermed;39/3/185/F1F1F1Figure 1Wound left medial thigh. QUESTION: What is the pathological process of this wound?De-epithelialisation due to removal of clothing glued to skin.Chemical burn.Partial thickness thermal burn.Allergic reaction to nail glue. For answer see page 02.


Assuntos
Queimaduras Químicas , Queimaduras , Lesões dos Tecidos Moles , Adolescente , Queimaduras/etiologia , Queimaduras Químicas/complicações , Feminino , Humanos , Unhas , Prevalência
3.
BMJ ; 376: e066102, 2022 02 14.
Artigo em Inglês | MEDLINE | ID: mdl-35165089
4.
Int J Mol Sci ; 23(2)2022 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-35054900

RESUMO

In the literature, burns are understood as traumatic events accompanied by increased morbidity and mortality among affected patients. Their characteristic feature is the formation of swelling and redness at the site of the burn, which indicates the development of inflammation. This reaction is not only important in the healing process of wounds but is also responsible for stimulating the patient's innate immune system. As a result of the loss of the protective ability of the epidermis, microbes which include bacteria, fungi, and viruses have easier access to the system, which can result in infections. However, the patient is still able to overcome the infections that occur through a cascade of cytokines and growth factors stimulated by inflammation. Long-term inflammation also has negative consequences for the body, which may result in multi-organ failure or lead to fibrosis and scarring of the skin. The innate immune response to burns is not only immediate, but also severe and prolonged, and some people with burn shock may also experience immunosuppression accompanied by an increased susceptibility to fatal infections. This immunosuppression includes apoptosis-induced lymphopenia, decreased interleukin 2 (IL-2) secretion, neutrophil storm, impaired phagocytosis, and decreased monocyte human leukocyte antigen-DR. This is why it is important to understand how the immune system works in people with burns and during infections of wounds by microorganisms. The aim of this study was to characterize the molecular pathways of cell signaling of the immune system of people affected by burns, taking into account the role of microbial infections.


Assuntos
Queimaduras/etiologia , Queimaduras/metabolismo , Citocinas/metabolismo , Imunidade Inata , Animais , Antioxidantes/metabolismo , Biomarcadores , Queimaduras/complicações , Queimaduras/patologia , Células Dendríticas/imunologia , Células Dendríticas/metabolismo , Suscetibilidade a Doenças , Humanos , Sistema Imunitário/citologia , Sistema Imunitário/imunologia , Sistema Imunitário/metabolismo , Infecções/etiologia , Mediadores da Inflamação/metabolismo , Mastócitos/imunologia , Mastócitos/metabolismo , Neutrófilos/imunologia , Neutrófilos/metabolismo , Estresse Oxidativo , Espécies Reativas de Oxigênio/metabolismo
5.
Br J Radiol ; 95(1130): 20210708, 2022 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-34705565

RESUMO

It is around 20 years since the first commercial 3 T MRI systems became available. The theoretical promise of twice the signal-to-noise ratio of a 1.5 T system together with a greater sensitivity to magnetic susceptibility-related contrast mechanisms, such as the blood oxygen level dependent effect that is the basis for functional MRI, drove the initial market in neuroradiology. However, the limitations of the increased field strength soon became apparent, including the increased radiofrequency power deposition, tissue-dependent changes in relaxation times, increased artifacts, and greater safety concerns. Many of these issues are dependent upon MR physics and workarounds have had to be developed to try and mitigate their effects. This article reviews the underlying principles of the good, the bad and the ugly aspects of 3 T, discusses some of the methods used to improve image quality and explains the remaining challenges and concerns.


Assuntos
Imageamento por Ressonância Magnética/métodos , Imãs , Razão Sinal-Ruído , Tecido Adiposo/diagnóstico por imagem , Artefatos , Água Corporal/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Encéfalo/metabolismo , Queimaduras/etiologia , Temperatura Alta , Humanos , Campos Magnéticos , Imageamento por Ressonância Magnética/efeitos adversos , Imageamento por Ressonância Magnética/instrumentação , Imageamento por Ressonância Magnética/estatística & dados numéricos , Espectroscopia de Ressonância Magnética , Ondas de Rádio , Supercondutividade , Fatores de Tempo , Torque
6.
J Burn Care Res ; 43(2): 496-498, 2022 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-34695205

RESUMO

High-voltage burn injuries are rare in the pediatric age group, but can lead to devastating, severe sequelae. We present the cases of two young girls who suffered high-voltage burn injuries due to direct contact with overhead power lines. Both patients came from difficult psychosocial backgrounds. The injuries resulted in severe long-term consequences and functional deficits.


Assuntos
Queimaduras , Queimaduras/etiologia , Queimaduras/terapia , Criança , Feminino , Humanos
7.
Burns ; 48(2): 420-431, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34670711

RESUMO

BACKGROUND: No epidemiological information is available of the number of burns treated in the past 30 years in Romania. The aim of the present study is to investigate the extent of burn injuries in Romania, as well as to detect and analyze the essential epidemiological characteristics. METHODS: A comprehensive retrospective study was conducted over a period of 10 years (1.01.2006 to 31.12.2015). Patient-related data were obtained from the Diagnosis-related group (DRG) Center of National School of Public Health, Management and Professional Development, which is the only official national structure that collects and manages data concerning all the hospitalized patients in Romania. RESULTS: Included in this study were all 92,333 patients with burn injury as the main International Classification of Diseases (ICD-10) code of discharge from Romanian hospitals. The data was analyzed using SPSS V.24, IBM Statistics Package. The annual number of burns decreased gradually from 10,547 in 2006 to 7313 in 2015, reaching statistical significance (p = 0.001). The incidence decreased from 47 cases per 100,000 in 2006 to 36.93 per 100,000 in 2015. The seasonal evolution showed that the number of burns increases in July-August (8.8% and 9.1% of annual burns). The mean length of stay (LoS) was 10.59 days, with the highest value in 2012 (11.00) and the lowest in 2014 (10.30). The median LoS and the mean LoS values during the 10 years period have a plateau-type evolution, with no tendency for improvement. We found a significant correlation (r = 0.708, p = 0.0118) between increased mortality and the year of study. CONCLUSIONS: This is the first nationwide epidemiological study concerning hospitalized burns in Romania. It provides insight in demographical characteristics but also uncovers a worrying trend of increasing mortality rates, which requires further investigation. This study cannot make any reference to the severity of burns (surface and depth) or towards major burns events which unfolded during the studied period, due to lack of data. Consequently, it should raise awareness towards policymakers and caregivers that for a durable burns management strategy in Romania, it would be extremely useful to implement a national burn registry.


Assuntos
Queimaduras , Unidades de Queimados , Queimaduras/epidemiologia , Queimaduras/etiologia , Queimaduras/terapia , Hospitalização , Humanos , Tempo de Internação , Estudos Retrospectivos , Romênia/epidemiologia
8.
J Burn Care Res ; 43(1): 269-276, 2022 01 05.
Artigo em Inglês | MEDLINE | ID: mdl-34015124

RESUMO

The incidence of pediatric treadmill hand friction burns has been increasing every year. The injuries are deeper than thermal hand burns, the optimal treatment remains unclear. This was a retrospective study of children who received surgery for treadmill hand friction burns from January 1, 2015, to December 31, 2019, in a single burn center. A total of 22 children were surveyed. The patients were naturally divided into two groups: the wound repair group (13 patients), which was admitted early to the hospital after injury and received debridement and vacuum sealing drainage initially, and a full-thickness skin graft later; and the scar repair group (nine patients), in which a scar contracture developed as a result of wound healing and received scar release and skin grafting later. The Modified Michigan Hand Questionnaire score in the wound repair group was 116.31 ± 10.55, and the corresponding score in the scar repair group was 117.56 ± 8.85 (p > .05), no statistically significant difference. The Vancouver Scar Scale score in the wound repair group was 4.15 ± 1.21, and the corresponding score in the scar repair group was 7.22 ± 1.09 (p < .05). Parents were satisfied with the postoperative appearance and function of the hand. None in the two groups required secondary surgery. If the burns are deep second degree, third degree, or infected, early debridement, vacuum sealing drainage initially, and a full-thickness skin graft can obviously relieve pediatric pain, shorten the course of the disease, and restore the function of the hand as soon as possible.


Assuntos
Queimaduras/etiologia , Queimaduras/terapia , Cicatriz/terapia , Traumatismos da Mão/etiologia , Traumatismos da Mão/terapia , Equipamentos Esportivos , Unidades de Queimados , Criança , Pré-Escolar , Cicatriz/etiologia , Desbridamento , Drenagem , Feminino , Fricção , Humanos , Masculino , Estudos Retrospectivos , Transplante de Pele , Inquéritos e Questionários , Cicatrização
9.
Burns ; 48(2): 381-389, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34092419

RESUMO

The majority of pediatric burns in Mongolia occur within the home, particularly in the spaces dedicated to cooking. This makes home environment modification a priority for injury prevention. Many of these injuries are caused by electric appliances used in traditional tent-like dwellings (called a ger). In the present study, we designed and provided a context appropriate kitchen rack to 50 households with children aged 0-3 years living in gers and investigated parental views on the acceptability of the rack and willingness-to-pay (WTP) through face-to-face structured individual and group interviews and the contingent valuation method. We used the DCchoice package of R to estimate the median WTP and its 95% confidence interval by the household income, previous experience of childhood burn injury, and the number of children in the household. There was a total of 89 children aged <5 years in the 50 households, with a total of 59 burn experiences since birth including 29 treated at inpatient facilities. The median WTP was MNT 106,000 (about USD 37). The WTP appeared to be higher for the households with a higher income, more severe child burn experiences, and a greater number of children in the household. In the group interviews conducted after 4-6 weeks of routine use, the participants indicated that the use of the rack had resulted in a less stressful cooking environment, and the kitchen rack was described as a positive contribution to the reduction of risk to their young children. Whilst there were some suggestions for minor modifications, the rack was well accepted as a means of child burn prevention by the parents of infants and toddlers in Mongolia.


Assuntos
Queimaduras , Queimaduras/etiologia , Queimaduras/prevenção & controle , Criança , Pré-Escolar , Culinária , Humanos , Renda , Lactente , Pais
10.
Burns ; 48(2): 432-439, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34001387

RESUMO

Burn injuries contribute significantly to childhood morbidity and mortality. This study was designed to document the pattern of presentation and outcome of pediatric burn injury in Enugu. METHODS: All children with burn injuries over a 7-year period (June 2011 to May 2018) and were managed at three tertiary health institutions, were studied. Information including their socio-demographics, clinical features and treatment outcome were obtained and analyzed using the Statistical Package for Social Sciences (SPSS) version 17.0. RESULTS: 198 out of 201 records were available for analysis. Most (186; 93.9%) burn injuries occurred at home. Hot liquid (112; 56.7%) was the commonest cause of burn injury. A lot of substances were used topically for first aid, raw eggs (52; 31%) being the commonest. The outcome had significant association with cause of injury, depth of injury, total burn surface area (TBSA), and inhalation injury. Most were safely discharged home while a total of thirteen (6.6%) children died. LA50 was 54.87%, while the maximum TBSA salvaged was 65%. CONCLUSION: Burn injuries in children in this environment remain a serious challenge in the face of widespread lack of awareness regarding safe practices in handling hot and flammable items at home.


Assuntos
Queimaduras , Queimaduras/epidemiologia , Queimaduras/etiologia , Queimaduras/terapia , Criança , Primeiros Socorros , Humanos , Nigéria/epidemiologia , Estudos Retrospectivos
11.
J Interv Card Electrophysiol ; 63(1): 197-205, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33620619

RESUMO

BACKGROUND: Severe endoscopically detected esophageal thermal lesions (EDELs) have been associated with higher risk of progression to atrio-esophageal fistula (AEF) following radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF). We sought to evaluate safety and feasibility of active esophageal cooling using the Attune Medical Esophageal Heat Transfer Device (EnsoETM) to limit frequency or severity of EDELs. OBJECTIVE: We sought To evaluate safety and feasibility of active esophageal cooling using the Attune Medical Esophageal Heat Transfer Device (EnsoETM) to limit frequency or severity of EDELs METHODS: Consecutive patients undergoing first-time RFCA were randomized in a 1:1 fashion to esophageal cooling (device group) or standard temperature monitoring (control group). Ablation on the posterior wall was performed with a maximum power of 30W for up to 20s. All patients underwent EGD within 48 h. Endoscopy findings were classified as 1, erythema-mild injury; 2, superficial ulceration-moderate injury; 3, deep ulceration-significant injury; and 4, fistula/perforation. Severe EDELs were defined as grade 3 or 4 lesions. RESULTS: Forty-four patients completed the study (22 device group, 22 control group). Adjunctive posterior wall isolation was performed more frequently in the device group (11/22, 50% vs. 4/22, 18%). EDELs were detected in 5/22 (23%) control group patients, with mild or moderate injury in 2/5 patients (40%) and severe thermal injury in 3/5 patients (60%). In the device group, EDELs were detected in 8/22 (36%) patients, with mild or moderate injury in 7/8 (87%) patients and severe thermal injury in 1/8 (12%) patients. There was no acute perforation or AEF during follow-up. CONCLUSIONS: Active esophageal cooling may reduce the occurrence of severe EDELs. A larger randomized study is warranted to further evaluate the benefit of this strategy.


Assuntos
Fibrilação Atrial , Queimaduras , Ablação por Cateter , Fibrilação Atrial/cirurgia , Queimaduras/etiologia , Queimaduras/prevenção & controle , Ablação por Cateter/efeitos adversos , Esôfago/diagnóstico por imagem , Humanos , Projetos Piloto
12.
Int Wound J ; 19(4): 845-852, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-34448552

RESUMO

This was the first study to analyse patients who sustained severe self-induced burns from this common Asian practice. There is a need to raise public awareness and physician attention about the consequences of preventable burn injuries and the importance of first aid in patients with diabetic neuropathy. Retrospective data on 16 consecutive patients who had diabetes and neuropathy admitted to the plastic surgery ward at the Tri-Service General Hospital from January 1, 2015, to February 2, 2021 with burn injuries because of heat applications were collected and analysed for this study. Age, gender, season, first aid adequacy, comorbidity, interventions, total body surface area (TBSA), degree of burn, aetiology, length of stay (LOS), and status at discharge were reviewed. The mean age of the 16 patients was 65.13 years. The most common burn aetiology was contact (50%), followed by scald (37.5%) and radiation burns (12.5%). TBSA burn averaged ± standard deviation 1.54 ± 1.22. Seven patients (44%) had wound infections, and three patients underwent amputations. The average LOS was 28.2 days. Asian practice of heat application is the common aetiology of severe and preventable burn injuries. Education about neuropathy and the consequences of a burn injury should be provided to patients with diabetes.


Assuntos
Queimaduras , Diabetes Mellitus , Neuropatias Diabéticas , Idoso , Superfície Corporal , Unidades de Queimados , Queimaduras/etiologia , Queimaduras/terapia , Neuropatias Diabéticas/complicações , Temperatura Alta , Humanos , Tempo de Internação , Estudos Retrospectivos
13.
J Burn Care Res ; 43(1): 202-206, 2022 01 05.
Artigo em Inglês | MEDLINE | ID: mdl-34363657

RESUMO

This study examines firework-associated head and neck injuries in the United States from 2008 to 2017 obtained from a single epidemiology source. The National Electronic Injury Surveillance System (NEISS) was used to collect epidemiologic data and retrospectively analyze firework-associated injuries from 2008 to 2017. Injury types included burns, concussions, contusions, foreign bodies, hematomas, internal organ injury, lacerations, and puncture wounds. Four hundred and thirty-one individuals were originally included; however, 14 participants were excluded due to inadequate injury information. Chi-squared analyses were performed between the following categorical variables: gender vs body part injured, patient age vs injury type, and patient age vs body part injured. About 417 injuries to the head and neck (67.4% male, 32.6% female) were treated in NEISS-reporting emergency departments during the 10-year period. Sixty-nine percent of the injuries occurred in July. Body parts injured included the ear (10.6%), face (61.6%), head (13.0%), mouth (4.8%), and neck (10.0%). Chi-squared analysis demonstrated an association between gender and body part injured (P = .0001). Patient age (P = .066) was independent of injury type. Children aged 0 to 12 years had the highest probability of being injured (40.2%), then adults 22 and older (33.1%) and adolescents 13 to 21 years (26.9%). Given that the preponderance of injuries caused by fireworks occurred primarily in minors, pediatricians should screen for any household firework use during the anticipatory guidance portion of well-child checks, which we believe would improve patient safety and decrease injury rates.


Assuntos
Traumatismos por Explosões/etiologia , Queimaduras/etiologia , Traumatismos Craniocerebrais/etiologia , Lesões do Pescoço/etiologia , Adolescente , Adulto , Traumatismos por Explosões/epidemiologia , Queimaduras/epidemiologia , Criança , Traumatismos Craniocerebrais/epidemiologia , Feminino , Férias e Feriados , Humanos , Masculino , Lesões do Pescoço/epidemiologia , Estudos Retrospectivos , Estados Unidos/epidemiologia
14.
J Burn Care Res ; 43(1): 281-286, 2022 01 05.
Artigo em Inglês | MEDLINE | ID: mdl-34358305

RESUMO

This study focused on patients treated at the University of New Mexico Burn Center who sustained burn injuries from contact with environmentally heated pavement. We report on our patient demographics and outcomes as well as describe our institutional staged surgical approach to treatment. We provide a comparison of our results with other case reports as well as other findings. A retrospective review of patients admitted to the University of New Mexico Burn Center with injuries suffered from contact with hot pavement was performed. Patients were stratified on the presence or absence of altered mental status (AMS) and additional inciting factors. A total of six patients were reviewed from 2018 to 2019. We looked at patient demographics and comorbidities, time of contact with hot pavement, inciting factors, total body surface area (TBSA) burned, location of areas burned, depth of burn injury at the time of presentation and at the time of initial operative debridement, percentage of autograft take, complications, length of stay (LOS), and final disposition. The patients in our study had a mean TBSA of 9.82% corresponding to pressure points of the body. All patients had nearly 100% conversion to full-thickness burns at the time of initial operative debridement. With staged excision and split-thickness autografting, our patients had nearly 100% take of their skin grafts with minimal graft loss or related complications. At the time of presentation, 100% of patients had AMS and 66% (4/6) had a drug- or alcohol-related inciting event. Finally, the average LOS was 19.5 days in comparison to 7 to 9 days for uncomplicated burns of equivalent size at our burn center. Despite an initial appearance of a partial-thickness burn, pavement burns had a high propensity to convert to full-thickness burns. Patients with AMS contributed to our patient population being found with pavement burns. Patients with pavement burns had a distinct anatomic pattern corresponding to pressure points of the body which were often areas at high risk for skin and wound breakdown and complications. Staged excision and split-thickness autografting in the treatment of pavement burns yielded excellent results. Finally, our data showed that providers must be prepared for an extended LOS for patients with pavement burns.


Assuntos
Queimaduras/etiologia , Queimaduras/terapia , Materiais de Construção/efeitos adversos , Superfície Corporal , Queimaduras/epidemiologia , Exposição Ambiental/efeitos adversos , Feminino , Temperatura Alta , Humanos , Masculino , Pessoa de Meia-Idade , New Mexico/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Luz Solar
15.
Burns ; 48(2): 328-336, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-34955293

RESUMO

BACKGROUND: Burns are one of the most important childhood injuries that can be controlled and prevented. Mothers play an important role in preventing child burns. Health education and promotional theories facilitate a precise recognition of the behavioral factors in mothers that help preventing burn injury in their children. Burns in children under five years old and the factors in prevention of burn by their mothers were examined using PRECEDE Model. The study environment was rural and urban areas of Kermanshah, Iran. METHODS: This cross-sectional study was conducted on 330 mothers in urban and rural areas of Kermanshah County in the west of Iran. The participants were randomly selected among mothers who had at least one child younger than five years old. Data was collected through interviewing the mothers using a valid and reliable questionnaire. The questionnaire included questions on demographic characteristics, PRECEDE Model, and history of burn. The data were analyzed using SPSS-16. RESULTS: The mean age of the mothers in urban areas (29.33 ± 5.987) was higher than that of those in rural areas (28.77 ± 6.236). More than 90% of the mothers were housewives, both in urban and rural areas. The rate of a history of burn in rural children under the age of five (8.3%) was greater than that in urban children (5.2%). Most of the burn cases in urban areas were mild whereas those in rural areas were moderate. The majority of burn cases had happened at home in children 1-3 years' age range; this rate was higher in boys. The majority of burns cases had happened when the child was playing (urban: 64.3%, rural: 100%). In addition, liquids and hot objects were the main causes of the burns (urban: 78.5%, rural: 100%). Among the constructs of PRECEDE models in the urban areas, knowledge (P < 0.001), attitudes (P = 0.027), and environmental factors (P = 0.03) had a significant relationship with burn-preventive behaviors in mothers. In addition, in the rural areas, attitudes (P = 0.038) had a significant relationship with burn-preventive behaviors in mothers. CONCLUSION: Burn was an important injury in the study population, especially in the rural areas. The PRECEDE model can help us to identify the factors in burn injuries in children and the preventive behaviors in mothers. The findings can be used to develop preventive interventional programs to better protect this vulnerable group in society.


Assuntos
Queimaduras , População Rural , Queimaduras/epidemiologia , Queimaduras/etiologia , Queimaduras/prevenção & controle , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , Mães , Inquéritos e Questionários
17.
J Burn Care Res ; 43(2): 504-507, 2022 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-34902027

RESUMO

Electric-powered bicycles and scooters that use rechargeable lithium batteries are an urban transportation alternative and have become increasingly popular. However, in recent years, there has been an increase in patient admissions to the Israeli National Burn Center with burns associated with their use. In this case series of all patients (n = 9) referred to the Emergency Department (February 2016-October 2020) with lithium-related battery burns from electric-powered bicycles and scooters, we present burn depth, size, treatment, inhalation injuries, and hospitalization. All patients were admitted to the Israeli National Burn Center for treatment. The average TBSA was 27.5% (range 3%-57%). All but one patient had a combination of partial to full-thickness burns affecting the upper and lower limbs. Three patients sustained inhalation injuries and a total of four patients required intubation. Seven patients required surgery that included debridement and, in most cases, skin grafting. The availability and increase in the use of battery-powered bicycles and scooters may lead to an increase in injuries and death if consumers are not aware of the potential dangers related to the safe use of lithium batteries.


Assuntos
Queimaduras , Lítio , Unidades de Queimados , Queimaduras/etiologia , Queimaduras/terapia , Fontes de Energia Elétrica/efeitos adversos , Humanos , Israel , Lítio/efeitos adversos , Estudos Retrospectivos
18.
Ulus Travma Acil Cerrahi Derg ; 28(1): 84-89, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34967422

RESUMO

BACKGROUND: Majority of the pediatric burns happen when an adult is nearby the child. This suggests the role of adult carelessness or neglect as a cause of burns. The aim of this study is to provide clinical data on pediatric hand burns and to draw attention to the role of neglect in pediatric burn injuries. METHODS: Children admitted to a tertiary burn center between September 2017 and October 2018 were included in the study. Epidemiological data including age, sex, etiology and place of injury, presence of caregiver nearby, physical signs of neglect or abuse, clinical outcomes including burned total body surface area, length of admittance, and complications were recorded. RESULTS: A total of 335 pediatric burns were admitted to the burn center. Among them 89 patients with hand involvement were included in the study. Most of the patients were under the age of 6 (79.8%) and 88.8% of the burn accidents occurred indoors. Scalding was the main mechanism for hand burns. There was an adult nearby in 71.9% of the patients. Among patients with hand involvement, 19 (21.35%) were considered as neglect. All the neglect cases were under the age of 6. CONCLUSION: Pediatric burn accidents occurred mainly at home, mostly with an adult around. Habits of drinking hot beverages, dangerous cooking practices and lack of awareness are some important issues leading to burn accident. Neglect is found in 21.35% of hand burns as the etiology. In addition to general preventive measures special attention should be paid to the signs of neglect in the evaluation of patients. These burns should also be reported to official services, as they may reflect inadequate supervision or neglect by the caregiver.


Assuntos
Queimaduras , Traumatismos da Mão , Adulto , Unidades de Queimados , Queimaduras/epidemiologia , Queimaduras/etiologia , Criança , Traumatismos da Mão/epidemiologia , Traumatismos da Mão/etiologia , Hospitalização , Humanos , Lactente , Tempo de Internação , Estudos Retrospectivos
19.
Sci Rep ; 11(1): 23753, 2021 12 09.
Artigo em Inglês | MEDLINE | ID: mdl-34887486

RESUMO

Reported advantages of early excision for larger burn injuries include reduced morbidity, mortality, and hospital length of stay for adult burn patients. However, a paucity of evidence supports the best option for paediatric burns and the advantages of non-excisional (mechanical) debridement. Procedural sedation and analgesia in the emergency department is a popular alternative to debridement in operating theatres under general anaesthesia. This study aims to evaluate the association between early (< 24 h post-injury) non-excisional debridement under general anaesthesia with burn wound re-epithelialisation time and skin graft requirements. Cohort study of children younger than 17 years who presented with burns of five percent total body surface area or greater. Data from January 2013 to December 2019 were extracted from a prospectively collected state-wide paediatric burns' registry. Time to re-epithelialisation was tested using survival analysis, and binary logistic regression for odds of skin graft requirementto analyse effects of early non-excisional debridement in the operating theatre. Overall, 292 children met eligibility (males 55.5%). Early non-excisional debridement under general anaesthesia in the operating theatre, significantly reduced the time to re-epithelialisation (14 days versus 21 days, p = 0.029)) and the odds of requiring a skin graft in comparison to paediatric patients debrided in the emergency department under Ketamine sedation (OR: 6.97 (2.14-22.67), p < 0.001. This study is the first to demonstrate that early non-excisional debridement under general anaesthesia in the operating theatre significantly reduces wound re-epithelialisation time and subsequent need for a skin graft in paediatric burn patients. Analysis suggests that ketamine procedural sedation and analgesia in the emergency department used for burn wound debridement is not an effective substitute for debridement in the operating theatre.


Assuntos
Anestesia Geral , Queimaduras/terapia , Desbridamento , Reepitelização , Transplante de Pele , Fatores Etários , Queimaduras/etiologia , Criança , Pré-Escolar , Desbridamento/métodos , Gerenciamento Clínico , Humanos , Lactente , Pediatria , Fatores de Tempo
20.
BMJ Case Rep ; 14(12)2021 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-34853051

RESUMO

We present the case of a female teenager who sustained nitrous oxide burns to the medial aspect of both thighs from contact with a nitrous oxide canister being used to fill balloons. There was a delay in presentation as the injury was not initially recognised. These burns were initially assessed as being superficial partial-thickness burns but took a prolonged time to heal despite regular wound care. This was complicated by a lack of adherence to recommended treatment for much of the patient care as well as the patient testing positive for COVID-19 during their management, which prevented surgery and significantly extended time to healing. While small numbers of similar cases have been previously described this is the first reported case outside of the Netherlands and in a child. Being aware of such cases ensures early referral to specialist burn care for appropriate management to give patients the best possible outcome.


Assuntos
Queimaduras , COVID-19 , Adolescente , Bandagens , Queimaduras/etiologia , Queimaduras/terapia , Criança , Feminino , Humanos , Óxido Nitroso/efeitos adversos , SARS-CoV-2
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