Burns : journal of the International Society for Burn Injuries
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Case Reports
An unusual case of lightning injury: a melted silver necklace causing a full thickness linear burn.
An unusual case of lightning injury is shown. Flash-over current caused the fusion of a silver necklace producing a linear full thickness burn in the neck and chest with the silver welded throughout the wound.
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Two examples of resuscitation of a scalded child by intraosseous infusion, following failed peripheral venous cannulation, are presented. The technique of intraosseous infusion is reviewed and it is concluded that this technique provides a valuable second-line technique for establishing emergency venous access in children. It is quick, reliable and enables the rapid infusion of intravenous fluids and drugs into the systemic venous system. Complications are rare but can be serious and close observation of the infusion site is advisable.
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Case Reports
Use of an acellular allograft dermal matrix (AlloDerm) in the management of full-thickness burns.
Scarring and contracture are major long-term sequelae of meshed split-thickness autografting for full-thickness skin injury. In the absence of dermis, mature fibroblasts secrete collagen in the altered pattern of scar. This case report illustrates the use of an acellular dermal matrix processed from human allograft skin (AlloDerm) in the treatment of a full-thickness burn injury. ⋯ No specific immune response was detected, either by histology or by lymphocyte proliferation assay. By providing a dermal replacement, the grafted dermal matrix permitted the use of a thin, widely meshed autograft from the donor site, without the undesirable scarring and contracture at the wound site that commonly results from this technique. If effective, this approach would markedly reduce the amount of donor skin required for split-thickness autografts in full-thickness burn injuries.
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Contractures are frequent sequelae of burn injuries. Progressive worsening of contractures with limitation of joint movement is common in children. The results of release procedures in 10 male Chinese children using their own preputial skin obtained from circumcision were reviewed. This technique yields reliable results and is well accepted by the parents.