Burns : journal of the International Society for Burn Injuries
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The use of tear gas in controlling riots has been an accepted practice in many countries for the past four decades. In a recent event, a large quantity of tear-gas canisters were used during a situation of unrest in a Hong Kong Refugees' Detention Centre. We report 96 cases of acute burn injury as an unpredicted side effect of o-chlorobenzylidene malononitrile (CS) tear gas. ⋯ The mechanism of burn injury was due to the flame generated from the grenade explosion, direct contact between the hot canister and the victim's skin, and the effect of the chemical powder inside the canisters when it splashed onto the victim's body. We suggest that the noxious transient effects of tear gas are underestimated, furthermore varying cutaneous effects and deep burns may result from its uncontrolled use during riots. There is a continuing need to reassess the potential toxic effects of CS tear gas as a riot control agent and to debate whether its future use can be condoned under any circumstances.
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From 1 January 1979 to 31 December 1993, 1109 patients were admitted to our burn unit located at Hacettepe University. Of the patients, 638 (57.5 per cent) were children (under the age of 16 years). The male to female ratio was 1.4:1 in children, and was approximately 2.6:1 for patients over 16 years of age. ⋯ The overall mortality rate was 34.4 per cent. The epidemiological pattern of the burns showed that emergency measures should be taken to prevent scalding accidents to children throughout the country, and for electrical burns in adults, particularly those living in the Black Sea Region. In establishing, implementing and directing prevention programmes, regional differences should be taken into consideration.
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This study determines the nature of microbial wound colonization in 28 patients with large burns admitted to the Burn Centre, Haukeland University Hospital, Bergen. Altogether, 748 swabs were taken in 141 sampling procedures. A total of 414 microbial isolates were detected and their resistance patterns to a variety of systemic antimicrobial agents determined. ⋯ The time-related changes of burn wound colonization showed that on admission and during the first week, staphylococci and alpha-haemolytic streptococci were dominant. During the next weeks, these bacteria were gradually superceded by enterococci, gram-negative opportunists (mainly Pseud. aeruginosa, Acinetobacter calcoaceticus and Escherichia coli) and Candida species. The nature of microbial wound colonization and how the flora changes with time should be taken into consideration by those treating thermally injured patients.
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Case Reports Clinical Trial
Initial experience of using GRAFTAC absorbable staples to attach split skin grafts.
The GRAFTAC skin stapler with absorbable tacs has been used to attach split-skin grafts in 28 patients, under a variety of clinical situations, and the outcomes studied. This knowledge has been reviewed in the light of our existing experience with the more familiar metal staple. ⋯ The relative costs were analysed and an attempt made to compare the cost-effectiveness of tacs and staples. A rationale for use of the more expensive GRAFTAC stapler is presented.
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This retrospective study involved analysis of the data of the inpatients discharged with a diagnosis of burns, from various hospitals in Scotland, during the period 1970-92. There were 51,350 such inpatients all over Scotland, with an average annual rate of 2233 cases. Overall burn incidence in actual numbers was 43.7 per cent in < 15 year olds, 41.2 per cent in 15-64 year olds and 15.1 per cent in > or = 65 year olds. ⋯ The total number of deaths due to burns and/or smoke inhalation has declined in all age groups and the decline has been statistically significant (chi-squared = 19.62, 1 d.f., P < 0.001). Maximum number of deaths occurred in > or = 65 year olds (44 per cent), followed closely by 16-64 year olds (43.5 per cent), and 12.5 per cent of deaths in adolescents and children. The decline was due to improved management of burns and a decrease in the number of patients having large body surface area burns.