Burns : journal of the International Society for Burn Injuries
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This report is a review of the literature and the clinical experience of electrical burns of the mouth in the West Midlands Regional Burns Unit at the Birmingham Accident Hospital, UK, over the past 10 years. There were five patients, four were children, 9 months to 5 years of age, and one adult. All patients had electrical conduction injuries involving the lips and perioral structures with involvement of the oral commissure. ⋯ Early intraoral splinting has been suggested in the literature. It was not used in any of the patients in this series and, though it may be beneficial, the patient compliance of a paediatric population may be questionable. The incidence of electrical burns has been on the decline, but those affecting the mouth still continue to be a major problem in management.
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Thirty-two patients were admitted to the South-East Scotland Burn Unit over a 4-year period (1990-94), with burns sustained as a consequence of chip-pan fires. This represented 7 per cent of all admissions to the unit. Fourteen patients came from the Edinburgh city area, and 18 from surrounding countries. ⋯ Fourteen patients were managed conservatively, and 18 needed operative intervention. The patients spent an average of 19.4 days in hospital, and they required 46.3 days for complete healing to take place. Prevention by increased community awareness and widespread education is necessary to minimize the incidence, morbidity and cost of this relatively common and preventable type of burn.
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Facial burns are a frequent component of the presentation of victims who have sustained thermal trauma, reportedly occurring in 20 per cent of burn patients. Even apparently 'f2p4r' facial injuries might well be associated with significant ocular trauma. A retrospective review of 865 patients admitted to our burn centre showed 22 per cent (192) with facial burns. ⋯ The aetiology and spectrum of ocular injuries is reviewed with lid burns and subsequent lid contractures, accounting for over 50 per cent of ocular complications. Serious ocular pathology necessitating enucleation occurred in only two patients. The difficulties encountered in performing a complete ophthalmological examination in the presence of facial burns are presented in conjunction with a recommended therapeutic plan.
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The case history of a 20-year-old male patient who sustained an 85 per cent total body surface area alkali burn to his skin, after falling into a caustic lime pit, is reported. Considerable problems regarding the correct estimate of burn wound depth, predominant location of the deepest burn on the posterior half of the body, appropriate wound coverage, and lack of sufficient skin graft donor sites required a complex treatment plan. ⋯ Human allografts and Biobrane were used extensively to achieve temporary wound closure, to provide mechanical protection of freshly autografted wounds, and to prevent desiccation following application of cultured epidermal autografts on to debrided wounds and split thickness skin grafted donor sites. The case illustrates a number of problems associated with the evaluation and treatment of patients suffering severe alkali burns, and demonstrates the implementation of both established and evolving technologies in the management of these injuries.
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Three hundred and ninety-four children were admitted to the burn centre in Brno over a 3-year period. The overall incidence was 31 children per 100,000 children aged 0-14 years. The majority of patients were aged 1-3 years and almost 80 per cent of them were scalded. ⋯ Sixty-six per cent of the children had minor burns. Four children died of the consequences of burns during the period studied. Social and economic factors had a significant influence on the incidence of childhood burns.